Nablus University for Vocational and Technical

Education-Ibn sina colluage for health profession

Pattern of violence
against Nursing
student during Clinical
Training
June , in
2025
North West Bank
https://nu- Info @ nu- +970923104 https://
 Team Members

Sujood sirify Jomana Eid Jasmeen Zamel Hadeel

Mashaqi
The leader Litriture review Data collection Writer and editer
coordinater coordinater

Supervised
Agenda Overview
01 Background of the 05 Framework
study
02 Significant of the study 06 Methodology

03 Problem statment 07 Data Analysis & Result

04 The Purposes 08 Conclusion & Limitation

09 Recommendations
Background of
the Study
The definition of Workplace
Violence :

According Occupational Safety and Health

Administration (OSHA) any act or threat of
physical violence, harassment, intimidation, or
other threatening disruptive behavior that
occurs at work

According WHO The intentional use of power,

threatened or actual, against another person or
against a group, in work-related circumstances,
that either results in or has a high degree of
likelihood of resulting in injury, death,
Background of
the Study
The workplace violence may be physical or psychological

The Physical one :The use of physical force against another person
or group, that results in physical, sexual or psychological harm. It
includes among others, beating, kicking, slapping, stabbing,
shooting, pushing, biting and pinching.
the Psychological one Intentional use of power, including threat of
physical force, against another person or group, that can result in
harm to physical, mental, spiritual, moral or social development. It
includes verbal abuse, bullying/mobbing, harassment and
Signifi cant
Accord ing to the Bureau of Lab or
S tatistics, 20,050 workers in the
p rivate ind ustry exp erienced trauma
from nonfatal workp lace violence.

T hese incid ents req uired :

d ays away from work

392 U.S . workers d ied from

workplace homicid e in 2020
 Co
nt
Violence against nurses has been a
pandemic
According to the WHO “between 8 and 38% of nurses suffer from
health-care violence at some point of their career
the American Nurses Association reported one quarter out of
14,000 participants RNs and student nurses had been physically
assaulted at work by a patient or patient’s family member .
 Also , In Palestine
In (2013) According qualitative study conducted
among nurses students about vertical violence reveal

Cont… that All interviewed students reported experiencing or

witnessing vertical violence, such as humiliation,
shouting, neglect, or being ignored
After 7th Oct War , another study found the impact of
political violence on nurses students in palestinian
universities , the estimated prevalence of depression
was 65.9, and 60.9% for anxiety

Even when a study was conducted in Saudi Arabia to

assess occupational safety, it found that one of the most
prominent occupational hazards faced by nursing students
was verbal and physical violence (reported by 53%), and
more than 50.7% reported experiencing anxiety and anger
during clinical training
Problem
Statments Workplace violence (WPV) in nursing is a growing global
01 concern, with
student nurses being especially vulnerable. It causes
stress, academic

02 disruption, and increases the risk of students leaving the

A little Study in Palestine assess WPV against nursing
profession
students

03 Lack of resources after the 2023 war Due to ongoing conflict

and economic crisis

These factors increase students’ risk of exposure to violence in ⚬

clinical setting
Objectives
Aim to assess the prevalence of workplace violence
against nursing students during clinical practice in North
West Bank , Palestine

Objective Objective Objective

01 02
To assess nursing To evaluate the 03 the
To examine
students’ concerns usefulness of relationship between
and reporting measures and students' demographic
characteristics and their
regarding violence students’ satisfaction
exposure to different
in clinical settings with handling
forms of workplace
incidents of violence violence.
 Litriture
review
We are analyzed of 11 international
quantitative studies (2014–2024) focusing on
prevalence, type, and impacts of workplace
violence between nursing students.
Systematic search using PubMed, and
”.GoogScholar abuse
Included Peer-reviewed, quantitative studies
.focused on nursing students
Excluded Studies on licensed nurses only,
qualitative
Country & year Sample Tool Used key findings

24-question survey adapted from 77% verbal violence, 70% physical

Scottish 138 student
ILO/ICN/WHO/PSI + South African tools aggression
2021 nurses from HEI (excluding sexual/horizontal violence)

Over 50% experienced WPV: 66.1%

Australia 381 undergrad nursing Modified ILO/ICN/WHO/PSI survey
verbal, 26.5% physical, 19.4% sexual,
2024 students from 20 universities adapted for students
18.8% racial harassment

Face-to-face interviews using Workplace 60%+ experienced violence; types:

Turkya 1,216 final-year nursing
Violence Scale verbal abuse, racism, unfair treatment,
2020 students from 7 universities
assault, sexual harassment
Framework
Based on UniSAFE (2021) framework on gender-based violence

Adapted to the context of nursing students in clinical settings

The framework is based on feminist theory, which interprets violence as both a

result and a tool for maintaining unequal power relations between genders. It also
draws on intersectionality theory to understand how overlapping social identities
—such as gender, age, and academic level—can increase students’ vulnerability to
violence. Additionally, it incorporates the organisational violence perspective,
which examines how institutional culture, reporting mechanisms, and clinical
hierarchies may normalize or perpetuate violence. Finally, the framework is informed
by structural violence theory, highlighting indirect or invisible forms of harm, such
.as neglect, policy failure, or institutional tolerance of abuse
 Prevention Protection Prosecution Provision Partnership
Policies

Framework
Design
 Methodol N=2281 from three university in the
north west bank

ogy
The Design & AAU: 1200
Alnajah :720
Population
Nablus University :361
descriptive cross-sectional ‫نص‬
These universities were specifically
‫فقرتك‬
study design selected because they are the only
institutions in the northern West Bank
that offer bachelor's degree programs in
nursing
Clinical training for students from .
these universities takes place in a
variety of governmental and private
hospitals across the region, providing
relevant exposure to real-world clinical
N=2 environments where workplace violence
ample & Sampling

convenience sampling technique

was employed

n=167

This distribution was designed to

ensure a degree of proportional
representation while accounting
for logistical limitations and
participant availability.
 Study
Used a translated version from “Workplace Violence in the Health Sector” survey
Instrument
developed by WHO, ILO, ICN, and PSI (2003)
modified to suit the cultural context and academic level of undergraduate nursing students
in Palestine, as opposed to professional healthcare
The final version of the questionnaire consisted of 78 items, organized into five main
)section
A.Demographic Data 11

B.Physical violence 13

C.Psychological violence (Verbal , bullying, racial , sexual 40

D.Institutionall response 8

E.Personal Opinions & suggested strategies 6

 Validity & Reliability
In previous study using Arabic version from tool the Cronbach’s Alpha = 0.93
In our study the tool is piloted with a limited number of participants 10% of the 167
.participants in the study (n=17) were selected
The cronbachs alpha in the pilot study = 0.8 , In main study=0.801
greater than 0.7 in both the pilot and main studies suggested that the study's
instrument seemed reliable

Cronbachs Alpha

pilot study Main study

0.824 0.801
 Data
Collection
03 04 05
01 02

The The
Formal The research Students were
online approval was survey
team also shared informed about
survey Requested link was
was from the the survey link the study’s
officially
created deans of on social media purpose and
nursing sent via assured of
using to increase reach
Google faculties in email to confidentiality
the the and
Forms and anonymity
 Ethical
IRB approval was obtained from Nablus University
Consideration
Ethical Committee before starting the study

Formal permission was Requested from

participating
universities by emailing the deans of nursing
. faculties
The approval taken from AAUP & NU
another university data obtained from socialization
with their students

Approval to use the questionnaire was requested

from its authors

participants were given informed consent that

explained the study’s purpose, questionnaire
content, voluntary participation, right to withdraw
Analysis

Version 21 of SPSS was used

for the statistical analysis to
assess the pattern of violence
against nursing students during
clinical training in the North West
bank
 The
the majority of the 167
Result
participants in the study were
female. (66.5%) and single
(77.2%), and the majority were
young people (97.6%) between
the ages of 19 and 24. Studentsin
their third and fourth years
made up the largest academic
groups (35.9% and 32.3%,
respectively), indicating a focus on
more advanced pupils. An-Najah
University had the most presence
among the three universities from
which participants were recruited
(42.5%), followed by AAUP
(35.9%) and Nablus University
ive Statistics of Violence Exposure Types among Nursing Students

The data indicate that verbal

violence is the most commonly
experienced form among nursing
students, reported by 68.9% of
participants. It is followed by
bullying (60.5%), racially motivated
violence (44.3%), and physical
violence (31.1%). Sexual violence
was the least reported, with a
prevalence of 19.8%. These findings
suggest that non-physical forms
of violence are more prevalent
 Descriptive Statistics of Violence Exposure Types
among Nursing Students
The results showed that sexual
violence had the highest mean
severity score (13.1), followed by
physical violence (12.5), indicating
that although these forms were less
frequently reported, placing both in
the moderate disturbance category.
Verbal violence and bullying both
had a mean score of 11.6, which
.falls into the low disturbance range
Racially motivated violence had
the lowest mean score (10.9), Low Disturbance.=(5-11.7)
reflecting comparatively milder Moderate = )18.5– 11.8(
experiences in this category also Disturbance
Nursing Students’ Concerns and Reporting Regarding Violence in
Clinical Settings
The findings indicate varied levels of concern among
nursing students regarding violence in clinical
Procedu
training settings. While over half (54.5%) expressed re
moderate suggesting differing
.levels of perceived safety across training sites
Only 34.7% confirmed the existence of reporting
procedures for violence, and a majority (52.7%) were
unaware—highlighting a significant gap in
.communication and policy awareness
Encouragement to report violence was nearly evenly
.split, with 50.9% feeling supported and 48.5% not
Among those encouraged, the main sources were
administration (34.1%) and unions (16.8%), with
others citing colleagues, friends, family, or
.unspecified sources
This emphasizes the importance of formal structures
 Satisfaction with the way the
incident was handled
The data indicate that nursing
students generally reported
neutral satisfaction with how
incidents of violence were
managed at their training sites,
across all types of violence

Low Satisfaction →1-2.33

Neutral → 2.34-3.67
Satisfaction 5
High Satisfaction →3.68-
 Usefulness of Measures to Address Violence in the
Clinical Work Environment
nursing students viewed
most proposed measures to
reduce clinical violence as
effective, with mean scores
above 3.2. The highest-rated
strategies were improving
the environment, training,
raising awareness, rotating
schedules, and limiting
public access. Other
measures, such as
enhancing security and
reviewing patient records,
 Patterns of Violence across
Demographic Data
The ANOVA test revealed significant differences in
experiences of physical violence (p = 0.034), verbal
violence (p = 0.005), and sexual violence (p =
0.028) among students from different universities.
Students from AAUP University reported
higher mean scores for physical (M = 13.14)
and sexual violence (M = 15.08), while An-
Najah University students had the highest
mean for verbal violence (M = 12.51)
 Patterns of Violence
across
t-test results Age
P=0.0
Independent P=0.0 35
45
revealed statistically significant
gender differences in
experiences of physical violence
(p = 0.045) and sexual violence
(p = 0.035), with female
students reporting higher mean
scores (M = 12.92 and M =
13.54, respectively) compared to
male students (M = 11.47 and M
= 12.00). These findings indicate
that female nursing students are
more likely to encounter physical
Recommendation
s
1-Nursing education institutions should integrate training on
recognizing, responding to, and reporting workplace violence
within the core curriculum.
2-Hospital policies must clearly define student protection
protocols and provide easy-to-access reporting systems.

3-University–hospital coordination should include joint supervision,

student mentoring, and structured debriefing after exposure to
violence.

4.Gender-sensitive policies and culturally informed

awareness campaigns are also crucial to protect vulnerable
groups.

5.Strengthening Legal Frameworks and Enforcement:

Explicitly Include Nursing Students in Workplace Violence
Prevention Laws
 Limitation
geographic scope, as data were collected
only from the North West Bank, and the
using of convenience sampling technique
, which may restrict the generalizability
of the results
time constraints , and political
instability and military barriers

strengthen
Between a few quantitative study in Palestine
focused on workplace violence against nursing
students during clinical training.
Included a diverse sample from multiple
universities, increasing relevance and credibility
Assessed various types of violence
Conclusion
Workplace violence poses a serious threat to
nursing students in Palestine, potentially
impacting
their professional future and psychological
well-being. There is an urgent need for
,institutional policies
educational interventions, and protective
measures to address and reduce violence in
clinical training
.environments
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Thank
You