{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:08:00Z","timestamp":1783433280748,"version":"3.54.6"},"reference-count":40,"publisher":"BMJ","issue":"7","funder":[{"name":"U.S. National Institute for Occupational Safety and Health (NIOSH)\/Centers for Disease Control and Prevention (CDC) x"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Violence from care recipients and family members, including both verbal and physical abuse, is a serious occupational hazard for healthcare and social assistance workers. Most workplace violence studies in this sector focus on hospitals and other institutional settings. This study examined verbal abuse in a large home care (HC) aide population and evaluated risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used questionnaire survey data collected as part of a larger mixed methods study of a range of working conditions among HC aides. This paper focuses on survey responses of HC aides (n=954) who reported on verbal abuse from non-family clients and their family members. Risk factors were identified in univariate and multivariable analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-two per cent (n=206) of aides reported at least one incident of verbal abuse in the 12 months before the survey. Three factors were found to be important in multivariable models: clients with dementia (relative risk (RR) 1.38, 95%\u2009CI 1.07 to 1.78), homes with too little space for the aide to work (RR 1.52, 95%\u2009CI 1.17 to 1.97) and predictable work hours (RR 0.74, 95%\u2009CI 0.58 to 0.94); two additional factors were associated with verbal abuse, although not as strongly: having clients with limited mobility (RR 1.35, 95%\u2009CI 0.94 to 1.93) and an unclear plan for care delivery (RR 1.27, 95%\u2009CI 0.95 to 1.69). Aides reporting verbal abuse were 11 times as likely to also report physical abuse (RR 11.53; 95%\u2009CI 6.84 to 19.45).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Verbal abuse is common among HC aides. These findings suggest specific changes in work organisation and training that may help reduce verbal abuse.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2018-105604","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T03:55:11Z","timestamp":1560311711000},"page":"448-454","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Home care aides\u2019 experiences of verbal abuse: a survey of characteristics and risk factors"],"prefix":"10.1136","volume":"76","author":[{"given":"Nicole D","family":"Karlsson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia K","family":"Markkanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kriebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J","family":"Gore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J","family":"Galligan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R","family":"Sama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0544-9996","authenticated-orcid":false,"given":"Margaret M","family":"Quinn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"2020050723133495000_76.7.448.1","doi-asserted-by":"publisher","DOI":"10.3912\/OJIN.Vol18No02Man01"},{"key":"2020050723133495000_76.7.448.2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12889-014-1340-7","article-title":"Workplace violence against homecare workers and its relationship with workers health outcomes: a cross-sectional study","volume":"15","author":"Hanson","year":"2015","journal-title":"BMC Public Health"},{"key":"2020050723133495000_76.7.448.3","doi-asserted-by":"publisher","DOI":"10.1177\/216507991306101004"},{"key":"2020050723133495000_76.7.448.4","unstructured":"Occupational Safety and Health Administration. Guidelines for preventing workplace violence for health care and social service workers. OSHA 3148-04r. Washington, DC, 2015."},{"key":"2020050723133495000_76.7.448.5","unstructured":"U.S. Government Accountability Office. Additional efforts needed to help protect health care workers from workplace violence. GAO-16-11. 2016 https:\/\/www.gao.gov\/products\/GAO-16-11 (Accessed 20 Mar 2019)."},{"key":"2020050723133495000_76.7.448.6","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/ajim.22543","article-title":"Characteristics of workplace violence prevention training and violent events among home health and hospice care providers","volume":"59","author":"Vladutiu","year":"2016","journal-title":"Am J Ind Med"},{"key":"2020050723133495000_76.7.448.7","doi-asserted-by":"publisher","DOI":"10.1002\/j.2048-7940.2010.tb00049.x"},{"key":"2020050723133495000_76.7.448.8","doi-asserted-by":"publisher","DOI":"10.1300\/J027v26n02_04"},{"key":"2020050723133495000_76.7.448.9","doi-asserted-by":"publisher","DOI":"10.1097\/NHH.0b013e3181dbc07b"},{"key":"2020050723133495000_76.7.448.10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3912\/OJIN.Vol9No03Man06","article-title":"Workplace violence in health care: recognized but not regulated","volume":"9","author":"McPhaul","year":"2004","journal-title":"Online J Issues Nurs"},{"key":"2020050723133495000_76.7.448.11","unstructured":"AFL-CIO. Death on the job: The toll of neglect. A national and state-by-state profile of worker safety and health in the united states. 2018 https:\/\/aflcio.org\/sites\/default\/files\/2018-04\/DOTJ2018nb.pdf (Accessed 20 Mar 2019)."},{"key":"2020050723133495000_76.7.448.12","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2003.007294"},{"key":"2020050723133495000_76.7.448.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2007.06.006"},{"key":"2020050723133495000_76.7.448.14","unstructured":"Bureau of Labor Statistics. Occupational outlook handbook: Home health aides and personal care aides. Washington, DC: U.S. Department of Labor, 2018."},{"key":"2020050723133495000_76.7.448.15","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2015-103031"},{"key":"2020050723133495000_76.7.448.16","unstructured":"Paraprofessional Healthcare Institute. U.S. Home care workers: Key facts. 2018 https:\/\/phinational.org\/resource\/u-s-home-care-workers-key-facts-2018\/ (Accessed 20 Mar 2019)."},{"key":"2020050723133495000_76.7.448.17","unstructured":"International Labour Office. Ending violence and harassment against women and men in the world of work, ilc.107\/v\/1. International Labour Conference: 107th session. Geneva, Switzerland, 2017."},{"key":"2020050723133495000_76.7.448.18","unstructured":"National Institute for Occupational Safety and Health. NIOSH hazard review: Occupational hazards in home healthcare (no. 2010-125). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2010 http:\/\/www.cdc.gov\/niosh\/docs\/2010-125\/ (Accessed 20 Mar 2019)."},{"key":"2020050723133495000_76.7.448.19","doi-asserted-by":"publisher","DOI":"10.1097\/01.NHH.0000356828.27090.bd"},{"key":"2020050723133495000_76.7.448.20","unstructured":"Gershon RRM , Pogorzelska M , Qureshi KA . et al Home health care patients and safety hazards in the home: Preliminary findings. In: Henriksen K , Battles JB , Keyes MA , Grady ML , . eds. Advances in patient safety: New directions and alternative approaches (vol. 1: Assessment). Rockville (MD), 2008."},{"key":"2020050723133495000_76.7.448.21","doi-asserted-by":"crossref","unstructured":"Ridenour ML , Hendricks S , Hartley D , et al . New Jersey Home Health Care Aides Survey Results. Home Health Care Manag Pract 2019.","DOI":"10.1177\/1084822319831933"},{"key":"2020050723133495000_76.7.448.22","doi-asserted-by":"publisher","DOI":"10.1037\/1076-8998.9.3.206"},{"key":"2020050723133495000_76.7.448.23","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1177\/1048291117739418","article-title":"Exploring relationships among occupational safety, job turnover, and age among home care aides in Maine","volume":"27","author":"Butler","year":"2018","journal-title":"New Solut"},{"key":"2020050723133495000_76.7.448.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2010.01112.x"},{"key":"2020050723133495000_76.7.448.25","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1177\/216507990605400903","article-title":"Non-physical violence: a risk factor for physical violence in health care settings","volume":"54","author":"Lanza","year":"2006","journal-title":"Aaohn J"},{"key":"2020050723133495000_76.7.448.26","doi-asserted-by":"publisher","DOI":"10.1891\/0886-6708.14.1.3"},{"key":"2020050723133495000_76.7.448.27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2834.2012.01416.x"},{"key":"2020050723133495000_76.7.448.28","doi-asserted-by":"crossref","unstructured":"Stacey CL . The caring self: the work experiences of home care aides. Ithaca, NY: Cornell University Press, 2011.","DOI":"10.7591\/cornell\/9780801449857.001.0001"},{"key":"2020050723133495000_76.7.448.29","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.22287"},{"key":"2020050723133495000_76.7.448.30","doi-asserted-by":"publisher","DOI":"10.1177\/0886260514535095"},{"key":"2020050723133495000_76.7.448.31","doi-asserted-by":"publisher","DOI":"10.1177\/1744987108092055"},{"key":"2020050723133495000_76.7.448.32","first-page":"1","article-title":"An overview of home health aides: United States, 2007","volume":"34","author":"Bercovitz","year":"2011","journal-title":"Natl Health Stat Report"},{"key":"2020050723133495000_76.7.448.33","unstructured":"Massachusetts Nurses Association. Workplace violence prevention materials booklet. 2008 http:\/\/www.massnurses.org\/files\/file\/Health-and-Safety\/Workplace-Violence\/Workplace_Violence_booklet.pdf (Accessed 20 Mar 2019)."},{"key":"2020050723133495000_76.7.448.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2006.12.012"},{"key":"2020050723133495000_76.7.448.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2008.02.028"},{"key":"2020050723133495000_76.7.448.36","doi-asserted-by":"publisher","DOI":"10.1067\/mgn.2002.122800"},{"key":"2020050723133495000_76.7.448.37","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1111\/j.1365-2702.2007.02196.x","article-title":"Violence in nursing homes: perceptions of female caregivers","volume":"17","author":"Isaksson","year":"2008","journal-title":"J Clin Nurs"},{"key":"2020050723133495000_76.7.448.38","unstructured":"Gleason H . Setting the agenda: Data driven advocacy to address home care aide policy. The Home Care Aide Foundation. 2018 http:\/\/commcorp.org\/wp-content\/uploads\/2018\/02\/Resource_HCAF_Setting-the-agenda-data-driven-advocacy-to-address-home-care-aide-policy_Feb-2018.pdf (Accessed 20 Mar 2019)."},{"key":"2020050723133495000_76.7.448.39","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnr133"},{"key":"2020050723133495000_76.7.448.40","unstructured":"Glomb TM , Cortina LM . The experience of victims: Using theories of traumatic and chronic stress to understand individual outcomes of workplace abuse. In: Kevin Kelloway E , ed. Handbook of workplace violence. Thousand Oaks, CA: SAGE Publications, Inc, 2006:517\u201334."}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2018-105604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T12:27:58Z","timestamp":1663676878000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2018-105604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,11]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,6,13]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/oemed-2018-105604"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2018-105604","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,11]]}}}