Workplace violence prevention strategies: perspectives of health professionals in Bulgaria

Abstract Background Workplace violence is an escalating issue in Bulgaria, affecting health workers’ safety and well-being. Contributing factors include overcrowded facilities, staff shortages, inadequate policies, and weak administrative oversight. The study aims to identify effective prevention strategies from the health professionals’ perspective. Methods A cross-sectional survey was conducted in 2024 via a poll agency, using an online self-administered questionnaire completed by 943 health professionals. Data analysis employed the Friedman test to rank preferred preventive strategies and ANOVA to examine differences across professional groups. Results A substantial proportion of respondents reported experiencing verbal abuse (32.1%; 95%CI 29.1-35.2, p<.001) or other forms of violence (6.8%; 95% CI 5.3-8.6, p<.001), with variations observed by professional groups. Three categories of prevention strategies emerged: environmental control and security measures; organisational interventions, including adequate staffing and safety culture; and national-level interventions, such as public awareness campaigns and enforcement of sanctions. Friedman ANOVA revealed significant differences in the perceived importance of these strategies (p<.001, df = 10), with institutional and awareness measures rated highest, followed by violence response procedures and reporting protocols. Kruskal-Wallis ANOVA indicated that physicians, dentists, and nursing professionals emphasised environmental security and national-level interventions. Priorities included robust reporting protocols, secure access, visitor screening, and enforcement of sanctions. Conclusions Workplace violence in the health sector has severe consequences for both staff and patient care. Addressing this issue requires a comprehensive, system-wide approach integrating policy development, environmental improvements, and a culture of safety and support. Enacting targeted programs and policies is essential for establishing a safer workplace. Key messages • Comprehensive strategies are essential to effectively prevent violence in the health sector. • Strong policies, improved security, and a supportive culture are crucial for a safer workplace environment.