Date of Award
2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
Committee Chair
Jennifer Bail
Committee Member
Miranda Smith
Committee Member
Suzanne Prevost
Committee Member
Todd Smith
Committee Member
Christian N. Burchill
Subject(s)
Medical personnel--Violence against, Aggressiveness--Environmental aspects, Aggressiveness--Genetic aspects
Abstract
Patient Violence against nurses is a widespread problem resulting in both emotional and physical injury to the nurse. Emergency Department (ED) nurses are at an increased risk due to the volume and variety of the patients they serve, and the general chaotic environment of the ED; however, little research has been done examining the characteristics of patients who offend and the physical environment of the ED where the event happened. The aim of this three-article dissertation was to develop a more thorough understanding of the personal attributes (endogenous) of the individual patient and external (exogenous) factors of the emergency department (ED) setting and how they potentially influence violence against nurses in the ED. The first manuscript was a scoping literature review that aimed to gain a deeper understanding of potential precipitating factors for patient violence in the ED. The second manuscript applied Juarez’s Public Health Exposome Conceptual Model to the concept of patient violence against nurses, proposing the novel investigator developed Patient Violence Public Health Exposome (PVPHE) Conceptual Model. This model explained endogenous factors of individuals and how these factors affect the potential for violence. The third manuscript was a descriptive qualitative study guided by Florence Nightingale’s Environmental theory that sought to develop a deeper understanding of the lived experience of ED nurses in Alabama that had been the victim of or witness to patient violence against nurses and the role the physical environment potentially played in these acts. Findings showed that both endogenous and exogenous factors influence the potential for patient violence and that system and nursing interventions could potentially mitigate this risk.
Recommended Citation
Graham, Laura Baker, "Patient violence in the emergency department : the potential role of endogenous and exogenous factors" (2025). Dissertations. 441.
https://louis.uah.edu/uah-dissertations/441
