Decent work threatened: A review of reviews on gender-related violence and harassment in healthcare

<ns3:p>Background Workplace violence and harassment in the healthcare sector are prevalent phenomena that undermine decent work. However, the role of gender remains unclear and lacks conceptual consensus. This review of reviews synthesised evidence on workplace violence and harassment through a gender-sensitive lens, foregrounding gender-related mechanisms in healthcare workplaces to clarify concepts, map antecedents and consequences, appraise instruments, theoretical frameworks, and interventions, and inform policy and practice. Methods The systematic search was conducted in indexing databases (EBSCO, Cochrane Library, and PsycINFO) for peer-reviewed reviews published in English within the last five years. Of the 1,439 initial records, 102 reviews were selected for inclusion. Content analysis was supported by a large language model (NotebookLM) to aid in data synthesis. Results Gender-related violence and harassment are inconsistently defined and operationalised, weakening comparability and prevalence estimation. Nurses and physicians are most frequently targeted, not only by patients/visitors but also co-workers/supervisors, evidencing both horizontal and vertical violence. Gender differences were found regarding types of violence: women are more frequently victims of verbal violence and men of physical violence. Consequences for the victims are severe, such as turnover, psychological distress, impaired care quality, and substantial organisational costs. Perpetrators suffer virtually no consequences and are not accountable. Assessment of the phenomenon is highly heterogeneous, with a heavy reliance on self-report and insufficient awareness of the influence of gender and culture. Current interventions focus on secondary outcomes, such as enhancing staff coping skills, rather than on prevention. Conclusion Violence and harassment in healthcare are common, multilevel, and gendered, but hampered by definitional ambiguity, with weak measurement, and a lack of a unifying theoretical framework. Standardised, gender and culturally informed definitions and instruments, rigorous outcome-focused evaluation of multicomponent interventions are needed and can contribute to building violence- and harassment-free healthcare workplaces.</ns3:p>