{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T09:40:58Z","timestamp":1771062058786,"version":"3.50.1"},"reference-count":54,"publisher":"BMJ","issue":"1","funder":[{"name":"New Century Excellent Talents of University from the Ministry of Education, China"},{"DOI":"10.13039\/501100002858","name":"the China Postdoctoral Science Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Heilongjiang Provincial Association of Social Sciences"},{"DOI":"10.13039\/501100001809","name":"the Natural Science Foundation of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Collaborative Innovation Centre of Social Risks Governance in Health."}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,12,18]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Workplace violence is relatively frequent among medical professionals who work in otorhinolaryngology units. This phenomenon reduces the quality of provided medical care and increases the incidence of depressive symptoms among physicians and nurses, seriously affecting their job satisfaction and work efficiency with a negative attitude towards providing treatment. Few existing studies have assessed workplace-violence-related factors associated with depressive symptoms among otorhinolaryngology physicians and nurses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study in grade A tertiary hospitals of Heilongjiang province in Northern China, to evaluate the occurrence and level of depressive symptoms among otorhinolaryngology physicians and nurses and to analyse the relationship between them and workplace-violence-related risk factors and demographic variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of all our participating professionals, (379 otorhinolaryngologists and 273 nurses), 57.2% were found to have depressive symptoms, whereas, of the respondents who had suffered from physical violence, 71.25% had depressive symptoms. Professionals with less than 1\u2009year of experience, as well as professionals who more frequently worked alone, were more likely to suffer from depressive symptoms than their colleagues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This research addresses an emerging issue of clinical practice, and its results differ from those of previous studies; specifically, it indicates that the frequency of depressive symptoms among otorhinolaryngology physicians and nurses may be influenced by physical violence, the number of coworkers they have for more than half of their working hours and other workplace-violence-related factors. To reduce the depressive symptoms caused by workplace violence and improve the quality of medical services, medical institutions should implement effective measures to prevent the occurrence of physical violence, strengthen team cooperation ability and increase peer support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019514","type":"journal-article","created":{"date-parts":[[2018,1,27]],"date-time":"2018-01-27T07:25:26Z","timestamp":1517037926000},"page":"e019514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Depressive symptoms and workplace-violence-related risk factors among otorhinolaryngology nurses and physicians in Northern China: a cross-sectional study"],"prefix":"10.1136","volume":"8","author":[{"given":"Huiying","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaowen","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Health Economy, School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haicheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peihang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kexin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7405-5571","authenticated-orcid":false,"given":"Mingli","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, China"},{"name":"Institute of Quantitative and Technical Economics, Chinese Academy of Social Science, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Qiao","sequence":"additional","affiliation":[{"name":"Endocrine and Metabolic Diseases, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qunhong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,27]]},"reference":[{"issue":"17-18","key":"2025121408333214000_8.1.e019514.1","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1111\/jocn.13309","article-title":"Association among components of resilience and workplace violence-related depression among emergency department nurses in Taiwan: a cross-sectional study","volume":"25","author":"Hsieh","year":"2016","journal-title":"J Clin Nurs"},{"key":"2025121408333214000_8.1.e019514.2","first-page":"1368","article-title":"An Analysis of the Causes of Frequent Cases of Violent Injuries","volume":"94","author":"Ma","year":"2014","journal-title":"National Medical Journal of China"},{"key":"2025121408333214000_8.1.e019514.3","unstructured":"Health care facilities. Violence - Occupational hazards in hospitals. 2002."},{"key":"2025121408333214000_8.1.e019514.4","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/NMC.0000000000000206","article-title":"Incivility, Bullying, and Workplace Violence","volume":"41","author":"Simpson","year":"2016","journal-title":"MCN Am J Matern Child Nurs"},{"key":"2025121408333214000_8.1.e019514.5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.2147\/PRBM.S114870","article-title":"Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study","volume":"9","author":"Ferri","year":"2016","journal-title":"Psychol Res Behav Manag"},{"key":"2025121408333214000_8.1.e019514.6","unstructured":"ISBN. Framework guidelines for addressing workplace violence in the health sector. Geneva Switzerland Ilo 2002."},{"key":"2025121408333214000_8.1.e019514.7","doi-asserted-by":"crossref","first-page":"96","DOI":"10.3390\/ijerph14010096","article-title":"Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey","volume":"14","author":"Sun","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"2025121408333214000_8.1.e019514.8","doi-asserted-by":"crossref","first-page":"7109","DOI":"10.1038\/srep07109","article-title":"Prevalence of depressive symptoms and work-related risk factors among nurses in public hospitals in southern China: a cross-sectional study","volume":"4","author":"Gong","year":"2014","journal-title":"Sci Rep"},{"key":"2025121408333214000_8.1.e019514.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041406"},{"key":"2025121408333214000_8.1.e019514.10","doi-asserted-by":"crossref","first-page":"1829-37","DOI":"10.1056\/NEJMoa041404","article-title":"Effect of reducing interns' weekly work hours on sleep and attentional failures","volume":"351","author":"Lockley","year":"2004","journal-title":"N Engl J Med"},{"key":"2025121408333214000_8.1.e019514.11","first-page":"1238","article-title":"Perceived Risk of Violence in Various Hospital Levels and Departments in Urban and Rural China","volume":"45","author":"Yan","year":"2016","journal-title":"Iran J Public Health"},{"key":"2025121408333214000_8.1.e019514.12","first-page":"56","article-title":"Quality of work life and its association with workplace violence of the nurses in emergency departments","volume":"20","author":"Eslamian","year":"2015","journal-title":"Iran J Nurs Midwifery Res"},{"key":"2025121408333214000_8.1.e019514.13","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.7812\/TPP\/14-187","article-title":"Workplace violence in the emergency department: giving staff the tools and support to report","volume":"19","author":"Stene","year":"2015","journal-title":"Perm J"},{"key":"2025121408333214000_8.1.e019514.14","first-page":"4","article-title":"Analysis and thoughts on trend and harm of hospital violence","volume":"3","author":"Wang","year":"2014","journal-title":"Chinese Hospitals"},{"key":"2025121408333214000_8.1.e019514.15","first-page":"45","article-title":"Difficulties and Countermeasures of Young Doctors in the Department of ENT in Primary Hospitals","volume":"8","author":"Zhang","year":"2016","journal-title":"Medicine and Law"},{"key":"2025121408333214000_8.1.e019514.16","first-page":"3026","article-title":"The effect on employees of violence climate in the workplace","volume":"41","author":"Ayta\u00e7","year":"2012","journal-title":"Work"},{"key":"2025121408333214000_8.1.e019514.17","doi-asserted-by":"publisher","DOI":"10.2478\/v10001-009-0027-2"},{"key":"2025121408333214000_8.1.e019514.18","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1007\/s00127-015-1039-9","article-title":"Violence at work and depressive symptoms in primary health care teams: a cross-sectional study in Brazil","volume":"50","author":"da Silva","year":"2015","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"2025121408333214000_8.1.e019514.19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.19.2391"},{"key":"2025121408333214000_8.1.e019514.20","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-90"},{"key":"2025121408333214000_8.1.e019514.21","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aef273"},{"key":"2025121408333214000_8.1.e019514.22","doi-asserted-by":"publisher","DOI":"10.1016\/0736-4679(94)90360-3"},{"key":"2025121408333214000_8.1.e019514.23","first-page":"66","article-title":"Depression in nurses","volume":"42","author":"Ohler","year":"2010","journal-title":"The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmi\u00e8res"},{"key":"2025121408333214000_8.1.e019514.24","doi-asserted-by":"crossref","first-page":"252","DOI":"10.2478\/s13382-014-0264-x","article-title":"Psychosocial and organizational work environment of nurse managers and self-reported depressive symptoms: cross-sectional analysis from a cohort of nurse managers","volume":"27","author":"Nourry","year":"2014","journal-title":"Int J Occup Med Environ Health"},{"key":"2025121408333214000_8.1.e019514.25","first-page":"18","article-title":"Correlation analysis about workplace violence and job burnout among the head nurses","volume":"8","author":"Jiang","year":"2008","journal-title":"Chinese Nursing Management"},{"key":"2025121408333214000_8.1.e019514.26","first-page":"22","article-title":"Survey on Mental Health Status of the Medical Staff","volume":"24","author":"Yuan","year":"2007","journal-title":"Nursing Journal of Chinese People\u2019s Liberation Army"},{"key":"2025121408333214000_8.1.e019514.27","first-page":"1428","article-title":"Analysis of Psychological Characteristics of Patients with Otorhinolaryngology and Analysis of Psychological Nursing","volume":"2","author":"Li","year":"2014","journal-title":"Modern Diagnosis & Treatment"},{"key":"2025121408333214000_8.1.e019514.28","unstructured":"Li Y . Interpretation and preparation of the evaluation standard of tertiary general hospital (2011 Edition) by the Ministry of health. Preparation of [C]\/\/ \"hospital accreditation standards and assessment management interpretation\" training paper. 2011."},{"key":"2025121408333214000_8.1.e019514.29","unstructured":"ILO\/ICN\/WHO\/PSI. Workplace Violence in the Health Sector Country Case Study-Questionnaire. 2003:1\u201314 http:\/\/www.who.int\/violence_injury_prevention\/violence\/interpersonal\/en\/WVquestionnaire.pdf"},{"key":"2025121408333214000_8.1.e019514.30","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0103242","article-title":"Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study","volume":"9","author":"Gong","year":"2014","journal-title":"PLoS One"},{"key":"2025121408333214000_8.1.e019514.31","unstructured":"Wang Z , Chi Y . Self-Rating Depression(SDS). Shanghai Archives of Psychiatry 1984."},{"key":"2025121408333214000_8.1.e019514.32","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1965.01720310065008"},{"key":"2025121408333214000_8.1.e019514.33","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0414"},{"key":"2025121408333214000_8.1.e019514.34","doi-asserted-by":"crossref","first-page":"254???263","DOI":"10.1097\/00005110-200505000-00009","article-title":"Health, work variables, and job satisfaction among nurses","volume":"35","author":"Ruggiero","year":"2005","journal-title":"J Nurs Adm"},{"key":"2025121408333214000_8.1.e019514.35","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-1"},{"key":"2025121408333214000_8.1.e019514.36","first-page":"944","article-title":"What\u2019s the role of perceived social support and coping styles in depression and anxiety?","volume":"19","author":"Roohafza","year":"2014","journal-title":"J Res Med Sci"},{"key":"2025121408333214000_8.1.e019514.37","first-page":"300","article-title":"Related Study between Social Support and Coping Style, and Anxiety and Depression of Nurse","volume":"19","author":"Yang","year":"2011","journal-title":"China Journal of Health Psychology"},{"key":"2025121408333214000_8.1.e019514.38","unstructured":"Ji Y , He L , Hao J , et al . Correlation study of occupational stress and mental health among medical staff, Occupation and Health. 2015;31:3393\u20135."},{"key":"2025121408333214000_8.1.e019514.39","unstructured":"Tian L . Occupational stress and its relationship to depressive symptoms and anxiety disotder among ophthalmologists in Shanghai.. 2013."},{"key":"2025121408333214000_8.1.e019514.40","doi-asserted-by":"publisher","DOI":"10.1111\/jora.12006"},{"key":"2025121408333214000_8.1.e019514.41","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.9-4-327"},{"issue":"17-18","key":"2025121408333214000_8.1.e019514.42","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1111\/jocn.13309","article-title":"Association among components of resilience and workplace violence-related depression among emergency department nurses in Taiwan: a cross-sectional study","volume":"25","author":"Hsieh","year":"2016","journal-title":"J Clin Nurs"},{"key":"2025121408333214000_8.1.e019514.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2010.10.002"},{"key":"2025121408333214000_8.1.e019514.44","first-page":"655","article-title":"The job demand-control-support model a review of empirical research","volume":"18","author":"Shi","year":"2010","journal-title":"Advances in Psychological Science"},{"key":"2025121408333214000_8.1.e019514.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2006.05.014"},{"key":"2025121408333214000_8.1.e019514.46","first-page":"777","article-title":"Ethical reflections on medical dispute in the department of otorhinolaryngology","volume":"29","author":"Liu","year":"2016","journal-title":"Chinese Medical Ethics"},{"key":"2025121408333214000_8.1.e019514.47","doi-asserted-by":"crossref","first-page":"193","DOI":"10.4236\/health.2013.52027","article-title":"Violence at work and its relationship with burnout, depression and anxiety in healthcare professionals of the emergency services","volume":"05","author":"Rold\u00e1n","year":"2013","journal-title":"Health"},{"key":"2025121408333214000_8.1.e019514.48","doi-asserted-by":"publisher","DOI":"10.1111\/j.1466-7657.2009.00745.x"},{"key":"2025121408333214000_8.1.e019514.49","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1539\/joh.13-0082-OA","article-title":"Work-related risk factors for workplace violence among Korean employees","volume":"56","author":"Lee","year":"2014","journal-title":"J Occup Health"},{"key":"2025121408333214000_8.1.e019514.50","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1586\/ern.12.29","article-title":"Saved by the bell: does working too much increase the likelihood of depression?","volume":"12","author":"Virtanen","year":"2012","journal-title":"Expert Rev Neurother"},{"key":"2025121408333214000_8.1.e019514.51","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3388"},{"key":"2025121408333214000_8.1.e019514.52","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1590\/1982-0194201500036","article-title":"Symptoms of depression and intervening factors among nurses of emergency hospital services","volume":"28","author":"Oliveira","year":"2015","journal-title":"Acta Paulista De Enfermagem"},{"key":"2025121408333214000_8.1.e019514.53","doi-asserted-by":"crossref","first-page":"203","DOI":"10.2147\/RMHP.S115326","article-title":"The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts","volume":"9","author":"Ferri","year":"2016","journal-title":"Risk Manag Healthc Policy"},{"key":"2025121408333214000_8.1.e019514.54","first-page":"31","article-title":"The prevalence of depression and its associated factors among resident doctors working in a training hospital in Istanbul","volume":"18","author":"Demir","year":"2007","journal-title":"Turk Psikiyatri Derg"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-019514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:33:43Z","timestamp":1765730023000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-019514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,1,27]]},"published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1136\/bmjopen-2017-019514"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-019514","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1]]}}}