Causes and consequences of aggression and violence toward nurses by patients and their relatives: A scoping review

Anastassiya Vlassova, Feruza Saduyeva, Vilen Molotov-Luchanskiy

2026

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DOI 10.1016/j.ijans.2026.101140
Data confidence 70 medium
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Abstract

Objective To synthesize the scientific evidence regarding the causes, forms, and consequences of aggression and violence against nurses by patients, their relatives, and visitors. Materials and Methods A scoping review was conducted to map existing studies on workplace violence in nursing practice. The review included 27 publications released between 2014 and 2025. Cross-sectional studies, qualitative studies, integrative reviews, mixed-methods studies, and narrative reviews were analyzed. For each publication, data were extracted regarding the authors, country, study design, sample, type of healthcare organization, source and form of violence, causes/risk factors, consequences, and main conclusions. Results The most common form of violence was verbal and psychological aggression, including insults, threats, humiliation, and verbal pressure. Physical violence was less common but was more frequently reported in emergency departments, psychiatric wards, and intensive care units. The primary sources of violence were patients, patients' relatives, and visitors. The leading causes and risk factors included long waits for medical care, overcrowded wards, staff shortages, poor communication, anxiety and fear among relatives, patients' mental disorders, the absence of clear response protocols, and insufficient support from management. The consequences of violence included stress, anxiety, burnout, somatic symptoms, reduced job satisfaction, intention to leave the profession, underreporting of incidents, and a decline in the quality of nursing care. Conclusion Aggression and violence against nurses are multifactorial problems that affect staff safety, the quality of medical care, and organizational workforce stability. Comprehensive prevention programs, conflict de-escalation training, a clear reporting system, and a zero-tolerance policy toward violence are necessary.