UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Risk of violence among healthcare staff and return-to-work outcomes Choi, Kelvin


Healthcare workers are at-risk for a time-loss injury due to violence and organizational factors such as staffing ratios. There is little understanding how workers return-to-work (RTW) after violence-related injury and how staffing ratios can improve RTW outcomes. The first objective of this thesis explores RTW outcomes of healthcare workers with violence-related injuries (WVI) compared to healthcare workers with nonviolence-related injuries (WNVI). The study then seeks to examine differences in the likelihood of violence and RTW by staffing ratio, and if violence modifies the relationship between staffing ratios and RTW. The first retrospective cohort study used British Columbia (BC) workers’ compensation data from 2009 to 2014. After matching on age, gender, injury type, care setting, and occupation, 5,762 healthcare workers with at least one day off-work were included. Cox regression and piecewise models were stratified for injury types and adjusted for age, sex, wage, occupation, injury types, history of violence, care setting, and shift type. The second retrospective cohort study used BC workers’ compensation data and long-term care (LTC) staffing data in 2014. The cohort included 1,590 injured LTC workers with at least one day off-work. Negative binomial regression models were adjusted for health region, bed count, and public versus private funding. Cox regression models stratified by WVIs and WNVIs were adjusted for health region, bed count, public versus private funding, sex, age, wage, injury types and occupations. In the first study, RTW was more likely within one month, less likely from two to six months, and just as likely after six months post-injury for WVIs compared to WNVIs. WVIs with mental health injuries were less likely to RTW anytime one-year post-injury compared to WNVIs with mental health injuries. In the second study, higher staffing ratios was associated with lower risk of violence-related injuries compared to lower staffing ratios. For both WVIs and WNVIs, RTW was more likely at higher staffing ratios. However, WVIs had a higher likelihood of RTW compared to WNVIs at high staffing ratios. Findings suggest targeting interventions toward WVIs with mental health injuries and increasing staffing ratio to reduce the risk of violence and improve RTW outcomes.

Item Media

Item Citations and Data


Attribution-NonCommercial-NoDerivatives 4.0 International