Cultural discourse patterns and violence against healthcare workers: a comparative social media analysis of Türkiye, Brazil, and Italy

Violence against healthcare workers has emerged as a global crisis threatening healthcare system sustainability, with digital platforms increasingly serving as spaces where such violence manifests through discourse patterns. This study examines cultural communication patterns and violence indicators in social media discourse directed toward healthcare workers across Türkiye, Brazil, and Italy. Using a mixed-methods comparative research design, we analyzed 132,694 tweets collected over twelve months from January to December 2024, employing quantitative content analysis and qualitative discourse analysis informed by cross-cultural communication theory and digital ethnography approaches. The analysis revealed significant variations in discourse patterns, with Brazil exhibiting the highest violence indicator frequency (18.0%) and emotional intensity, Italy maintaining the lowest violence indicators (8.0%) with elevated professional respect themes, and Türkiye demonstrating moderate levels (15.0%) characterized by formal respectful language combined with economic frustration narratives. Correlation analysis identified that professional respect for language and institutional trust served protective functions against violent discourse, while economic inequality themes and high emotional intensity correlated with increased violence indicators. The findings explain 47.3% of the variance in violence indicator frequencies across countries, suggesting that cultural communication norms are associated with differences in healthcare worker discourse safety, though causal interpretation requires caution given the observational design and potential structural confounders. These results offer preliminary support for developing culturally-sensitive intervention strategies that leverage potentially protective cultural factors while addressing risk-associated discourse patterns; causal claims must be tempered given the observational design and acknowledged structural, political, and platform-level confounders, contributing to both theoretical understanding of digital violence patterns and practical violence prevention policy development.