NIOSH Study Examines Violence Against Home Health Workers

The National Institute for Occupational Safety and Health hopes a new research project will shed light on the growing problem of workplace violence in the home health care industry.

Home health care is one of the largest and most rapidly growing industries in the U.S., employing more than 1.3 million workers and bringing in an estimated $40 billion per year. Baby boomers are expected to increase the need for home health care workers in the coming decade.

Health and safety officials are growing increasingly alarmed by reports of unsafe working conditions for home health care workers. In a recent Columbia University study, 48 percent of home health care workers reported three or more stressful household conditions in their current caseload, including unsanitary conditions, unsafe conditions conducive to slips/trips/falls, presence of aggressive pets, poor lighting, neighborhood violence/crime, drug use in homes, and racial/ethnic discrimination.

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About the study. In the NIOSH study, survey responses from 677 home health care aides and nurses were used to explore factors associated with violence against home health care workers by their patients. Previous research has addressed home health care violence generally without specifying perpetrators (patients themselves or others in the home) or forms of violence (physical abuse or verbal abuse). However, NIOSH officials said this is one of the first scientific studies in which researchers focused specifically on physical assaults by patients on workers.

"By pursuing this line of inquiry, we hope to generate data that will help to improve safety for workers and patients alike," said Traci L. Galinsky, lead investigator for the study. "Based on available data from earlier research, this approach addresses an issue of great concern for our stakeholders and holds promise for leveraging safety interventions that have proven successful in other health care settings."

The preliminary results, which were released last April, found that 31 (4.6 percent) of the survey respondents reported having been assaulted (hit, kicked, pinched, shoved or bitten) by a patient one or more times during the past 12 months. Researchers said certain factors were predictive of risk of physical assault by patients, including patient handling (lifting/moving/bathing/dressing), caring for patients with dementia, and feeling threatened by violence from others in and around the patients' homes. The results also noted that workers who had been assaulted by patients were generally more likely to shorten visits when they felt threatened.

Galinsky said detailed results from the NIOSH study are being prepared for peer-reviewed journal publication early this year.

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March 1, 2010

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