{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:28:39Z","timestamp":1792070919078,"version":"4.4.0"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: People employed in emergency medical services represent a professional group which encounters events beyond ordinary human experience, great work demands, the risk of professional disputes, and stressful situations. The goal of this study is to examine the presence of mobbing and violence at work, as well as their influence on work ability of emergency medical doctors. Materials and Methods: The survey is conducted in Emergency Medical Service (EMS) in Ni\u0161 in the period between December 2017 and January 2018. Using standardized questionnaires on psychosocial conditions in work environment (COPSOQ II) and work ability index (WAI) this study encompasses 79 doctors. For estimation of the examined factors\u2019 influence on WAI linear regression analysis was used. Results: EMS doctors were exposed to abuse in 30.4% of the cases. The decline in WAI is significantly related with exposure to violence by patients (\u03b2 = 0.727), exposure to physical violence (\u03b2 = 0.896), exposure to abuse several times (\u03b2 = 0.691) and exposure to ill-treatment by patients (\u03b2 = 0.750). Conclusion: The results indicate that in the examined doctors mobbing and workplace violence are very much present and have a negative impact on their work, and therefore on the quality of health care.<\/jats:p>","DOI":"10.3390\/medicina56010031","type":"journal-article","created":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T03:20:22Z","timestamp":1579058422000},"page":"31","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Mobbing and Violence at Work as Hidden Stressors and Work Ability among Emergency Medical Doctors in Serbia"],"prefix":"10.3390","volume":"56","author":[{"given":"Dragan","family":"Nikoli\u0107","sequence":"first","affiliation":[{"name":"Center for Healthcare Analysis, Planning and Organization, Institute of Public Health of Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6463-9706","authenticated-orcid":false,"given":"Aleksandar","family":"Vi\u0161nji\u0107","sequence":"additional","affiliation":[{"name":"Center for Healthcare Analysis, Planning and Organization, Institute of Public Health of Ni\u0161, 18000 Ni\u0161, Serbia"},{"name":"Department of Social Medicine and Public Health, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,13]]},"reference":[{"key":"ref_1","first-page":"17","article-title":"Mobbing (bullying at work) in Italy: Characteristics of successful court cases","volume":"10","author":"Bernardelli","year":"2018","journal-title":"J. Inj. Violence Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e017182","DOI":"10.1136\/bmjopen-2017-017182","article-title":"Workplace violence, psychological stress, sleep quality and subjective health in Chinese doctors: A large cross-sectional study","volume":"7","author":"Sun","year":"2017","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/inm.12232","article-title":"Workplace Violence in Mental Health: A Victorian Mental Health Workforce Survey","volume":"25","author":"Tonso","year":"2016","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.1177\/0886260515591976","article-title":"Workplace Violence in the Health Sector in Turkey: A National Study","volume":"32","author":"Pinar","year":"2017","journal-title":"J. Interpers. Violence"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ijnurstu.2016.12.005","article-title":"Mobbing among care workers in nursing homes: A cross-sectional secondary analysis of the Swiss Nursing Homes Human Resources Project","volume":"66","author":"Tong","year":"2017","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_6","first-page":"411","article-title":"Psychosocial risks in healthcare","volume":"157","author":"Vevoda","year":"2018","journal-title":"Cas. Lek. Cesk."},{"key":"ref_7","unstructured":"United States Department of Labor (2019, March 22). Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers, Available online: https:\/\/www.osha.gov\/Publications\/osha3148.pdf."},{"key":"ref_8","unstructured":"(2010). Abuse Prevention Act at Work, (In Serbian)."},{"key":"ref_9","unstructured":"EU-OSHA-European Agency for Safety and Health at Work (2019, March 22). E-facts 18: Risk Assessment in Health Care. Available online: https:\/\/osha.europa.eu\/en\/tools-and-publications\/publications\/e-facts\/efact18."},{"key":"ref_10","first-page":"137","article-title":"An examination of mobbing and burnout of residents","volume":"22","author":"Dikmetas","year":"2011","journal-title":"Turk. J. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.5271\/sjweh.588","article-title":"Consequences of workplace bullying with respect to the well-being of its targets and the observers of bullying","volume":"27","author":"Vartia","year":"2001","journal-title":"Scand. J. Work Environ. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1080\/01488370903578082","article-title":"The Effect of the Mobbing on Organizational Commitment in the Hospital Setting: A Field Study","volume":"36","author":"Mansur","year":"2010","journal-title":"J. Soc. Serv. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.3906\/sag-1405-65","article-title":"Workplace physical violence, verbal violence, and mobbing experienced by nurses at a university hospital","volume":"45","author":"Aksakal","year":"2015","journal-title":"Turk. J. Med Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"438","DOI":"10.5271\/sjweh.948","article-title":"The Copenhagen Psychosocial Questionnaire\u2014A tool for the assessment and improvement of the psychosocial work environment","volume":"31","author":"Kristensen","year":"2005","journal-title":"Scand. J. Work Environ. Health"},{"key":"ref_15","first-page":"128","article-title":"Measuring psychological stress and strain at work-Evaluation of the COPSOQ Questionnaire in Germany","volume":"3","author":"Nubling","year":"2006","journal-title":"Psycho-Soc. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1177\/1403494809346873","article-title":"Do psychosocial work environment factors measured with scales from the Copenhagen Psychosocial Questionnaire predict register-based sickness absence of 3 weeks or more in Denmark?","volume":"38","author":"Rugulies","year":"2010","journal-title":"Scand. J. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3233\/WOR-192860","article-title":"Using the Work Ability Index to identify workplace hazards","volume":"62","author":"Rothmore","year":"2019","journal-title":"Work"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1177\/1403494809349858","article-title":"The second version of the Copenhagen Psychosocial Questionnaire","volume":"38","author":"Pejtersen","year":"2010","journal-title":"Scand. J. Public Health"},{"key":"ref_19","first-page":"89","article-title":"Exposure the doctors to aggression in the workplace","volume":"52","author":"Jankowiak","year":"2007","journal-title":"Adv. Med Sci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ruotsalainen, J.H., Verbeek, J.H., Marine, A., and Serra, C. (2015). Preventing occupational stress in healthcare workers. Cochrane Database Syst. Rev., CD002892.","DOI":"10.1002\/14651858.CD002892.pub5"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1136\/emj.2003.005645","article-title":"Levels of mental health problems among UK emergency ambulance workers","volume":"21","author":"Bennett","year":"2004","journal-title":"Emerg. Med. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1037\/1076-8998.11.4.328","article-title":"Overload, autonomy, and burnout as predictors of physicians\u2019 quality of care","volume":"11","author":"Shirom","year":"2006","journal-title":"J. Occup. Health Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1037\/h0087165","article-title":"When a happy worker is a productive worker: A preliminary examination of three models","volume":"34","author":"Wright","year":"2002","journal-title":"Can. J. Behav. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1037\/0021-9010.88.2.276","article-title":"High-quality work, job satisfaction, and occupational injuries","volume":"88","author":"Barling","year":"2003","journal-title":"J. Appl. Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"705","DOI":"10.2298\/VSP1009705A","article-title":"Burnout and the quality of life of workers in food industry\u2014A pilot study in Serbia","volume":"67","author":"Arandjelovic","year":"2010","journal-title":"Vojnosanit. Pregl."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Sterud, T., Ekeberg, O., and Hem, E. (2006). Health status in the ambulance services: A systematic review. BMC Health Serv. Res., 6.","DOI":"10.1186\/1472-6963-6-82"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1136\/emj.2005.025908","article-title":"Critical incident exposure in South African emergency services personnel: Prevalence and associated mental health issues","volume":"23","author":"Ward","year":"2006","journal-title":"Emerg. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1136\/emj.20.1.79","article-title":"Post-traumatic stress among Swedish ambulance personnel","volume":"20","author":"Jonsson","year":"2003","journal-title":"Emerg. Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"529","DOI":"10.2298\/MPNS0912529M","article-title":"Mobbing: Special reference to the nursing profession","volume":"62","year":"2009","journal-title":"Med. Pregl."},{"key":"ref_30","unstructured":"Pedersen, K. (2007). Violence at the workplace. Danish Experiences with the Prevention of Violence in the Social and Health Care Sector, Social Development Centre SUS."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2478\/sjph-2019-0023","article-title":"Perceived Work Ability Index of public service employees in relation to ageing and gender: A comparison in three European countries","volume":"58","author":"Pranjic","year":"2019","journal-title":"Slov. J. Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/14034940510032275","article-title":"Burnout among employees in human service work: Design and baseline findings of the PUMA study","volume":"34","author":"Borritz","year":"2006","journal-title":"Scand. J. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"493","DOI":"10.5271\/sjweh.1054","article-title":"Psychosocial stress and impaired sleep","volume":"32","author":"Akerstedt","year":"2006","journal-title":"Scand. J. WorkEnviron. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1002\/ajim.20373","article-title":"Long working hours, safety, and health: Toward a National Research Agenda","volume":"49","author":"Caruso","year":"2006","journal-title":"Am. J. Ind. Med."},{"key":"ref_35","first-page":"790","article-title":"Subjective surrogates of performance during night work","volume":"26","author":"Rogers","year":"2003","journal-title":"Sleep"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1093\/sleep\/28.6.728","article-title":"Relationships of occupational stress to insomnia and short sleep in Japanese workers","volume":"28","author":"Utsugi","year":"2005","journal-title":"Sleep"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.physbeh.2006.09.007","article-title":"Altered sleep\/wake patterns and mental performance","volume":"90","author":"Akerstedt","year":"2007","journal-title":"Physiol. Behav."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/sleep\/26.2.117","article-title":"The cumulative cost of additional wakefulness: Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation","volume":"26","author":"Maislin","year":"2003","journal-title":"Sleep"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"184","DOI":"10.5271\/sjweh.663","article-title":"Physical and psychosocial prerequisites of functioning in relation to work ability and general subjective well-being among office workers","volume":"28","author":"Ojanen","year":"2002","journal-title":"Scand. J. Work Environ. Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1093\/occmed\/51.5.318","article-title":"Promotion of work ability, the quality of work and retirement","volume":"51","author":"Tuomi","year":"2001","journal-title":"Occup. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/1\/31\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:19:41Z","timestamp":1760361581000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/1\/31"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,13]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1]]}},"alternative-id":["medicina56010031"],"URL":"https:\/\/doi.org\/10.3390\/medicina56010031","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,13]]}}}