Patients' aggressive behaviours towards nurses: development and psychometric properties of the hospital aggressive behaviour scale- users


Correspondence to K. Waschgler: e-mail:



This article is to report the development and psychometric testing of the Hospital Aggressive Behaviour Scale – Users.


Workplace violence is present in many work spheres, but in the healthcare sector, nurses in particular are at more risk due to the close contact they maintain with users and clients and the special characteristics of this relationship.


Using qualitative and quantitative methodology, an instrument was applied to a sample of 1,489 nurses from 11 public hospitals. Data collection was carried out in 2010 and 2011.


Exploratory factor analysis yielded a 10-item instrument distributed in two factors (non-physical violence and physical violence), which was validated by means of confirmatory factor analysis. Both the resulting questionnaire and the factors identified present high internal consistency and adequate external validity, analysed by means of statistically significant correlations between the Hospital Aggressive Behaviour Scale and job satisfaction, burnout components, and psychological well-being.


The results indicate that, in nursing personnel, higher exposure to user violence leads to lower job satisfaction, more emotional exhaustion and more cynicism, and to a lower level of psychological well-being.

The instrument developed in this study may be very useful in the sphere of assessment and prevention of psychosocial risks for the early detection of the problem of user violence in its two facets.