• Workplace violence in the home visiting workplace: Development of measures

      McPhaul, Kathleen Marie; Lipscomb, Jane (2005)
      Background. Workplace violence is recognized as a significant hazard in the healthcare sector but has not been studied extensively in visiting health care workers. These workers are potentially exposed to violence from clients, household members, and communities without the safety services of a "fixed" workplace. The limited data suggest that they experience risk factors including client characteristics, location, working alone, and work schedule. The prevalence of verbal violence may be as high as 37% and physical violence 19.9%. (Schulte, 1995; Barling, 2001). Purpose. Develop new measures for the study of workplace violence in the home visiting healthcare workplace using the NIOSH Organization of Work framework and the Job Demand Model. Methodology. The study was a mixed method cross-sectional design using focus groups, expert content reviewers, cognitive interviews, and a self-administered survey of home visiting health workers at four home health programs (n = 130). Three new scales were evaluated for evidence of reliability and validity using Cronbach's alpha, item analysis, CFA, and hypothesis testing. Results. Cronbach's alpha for the Home Visit Risk Scale was .77, Employer Violence Prevention Scale .87 and the Personal Safety Decision Scale .57. CFA demonstrated support for two factor solutions as follows: HVRS fit indices were chi2 = 26.08, p = .16, df = 20, GFI = .90. EVPS indices were chi2 = 36.02, p = .03, df = 22, GFI = .94. Six hypotheses were supported. The HVRS was significantly and positively associated with violence and psychological job demands and different for those who made a safety decision in the past 12 months; the EVPS was significantly associated with social support and staff perception of the OSHA Violence Prevention elements, and negatively correlated to violence. Logistic regression controlling for job type, caseload and for-profit status further supported the significance of the HVRS and EVPS with violence. Conclusions and implications. The HVRS and EVPS demonstrated preliminary evidence for reliability and validity. These scales should be utilized in a representative sample of home visiting health providers. The findings also support conceptualizing home visit risk as a psychological job demand and employer violence prevention as a social support thus demonstrating that the Job Demand model holds theoretical promise for future workplace violence research.