Date of Award

Spring 5-1-2021

Degree Type


Degree Name

PhD Nursing




Judith Lothian, Ph.D

Committee Member

Bonnie Sturm, Ed.D

Committee Member

Pamela Foley, Ph.D.


workplace violence, reporting, altruism, self-concept


Incidents of workplace violence (WPV) are pervasive in healthcare settings. WPV in the US occurs four times more frequently in the healthcare sector than in the private sector. However, the true incidence of WPV in healthcare settings is thought to be much higher secondary to significant under-reporting. The American Nurses Association (2019) reports, while one in four nurses are assaulted, only 20-60% of the incidents are reported. This extensive range is due to the lack of an accepted definition of what constitutes WPV, variable reporting mechanisms, and an overall perception by healthcare workers that WPV is “part of the job”. The factors contributing to WPV have been identified in previous studies predominantly within adult ED and psychiatric clinical settings. However, nurses working in the pediatric intensive care unit also treat patients and family members who possess similar risks factors towards perpetrating violence. This study utilized the Careful Nursing model to examine the relationship of altruism and nurses’ self-concept in order to better understand the relationship of these variables on PICU nurses’ reporting incidents of WPV. No known previous research had been performed in the PICU setting that evaluated the relationship of altruism and nurses’ self-concept on reporting incidents of WPV among PICU nurses. An online survey evaluating altruism, nurses’ self-concept, the incidence of WPV and reporting of incidents of WPV was distributed to PICU nurses working the US. Two instruments were included in the survey, the Self-Report of Altruism Scale (SRA) (Rushton, Chrisjohn, & Fekken, 1981) and the Nurses’ Self-Concept Questionnaire (Cowin, 2002). A total of 119 participants completed the study. The results demonstrated 60% of the participants experienced an incident of WPV in the past five years. A total of 55.6 % of participants stated they did not report the incident of WPV. These results indicate PICU nurses both experience incidents of v WPV and report those incidents at a similar rate to those of previously published studies within adult settings. Logistic regressions were performed to assess for a relationship of altruism or nurses’ self-concept on reporting incidents of WPV. There was no significant relationship present between altruism (p= 0.61) or nurses’ self-concept (p=0.1) and PICU nurses’ decisions to report incidents of WPV. This study demonstrated that neither altruism nor NSC had a relationship on PICU nurses’ reporting incidents of WPV. However, this study elucidated that PICU nurses are equally vulnerable to WPV and report incidents similarly to other nurses. The implications of these findings are important for further research on barriers to reporting WPV, policy development to enhance reporting, and methods to improve the overall safety of healthcare workers in all settings.