PONE-D-20-30094

Working in labor and delivery unit increases the odds of work place violence in Amhara region referral hospitals: Cross-sectional study

PLOS ONE

Dear Dr. Dagnaw,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

The manuscript has been evaluated by two reviewers, and their comments are available below. You will see the reviewers have commented on the interest of your study. However, the reviewers have also raised critical concerns and the manuscript will need significant revision before it can be considered for publication – you should anticipate that the reviewers will be re-invited to assess the revised manuscript, so please ensure that your revision is thorough. I have outlined some of the key concerns noted by the reviewers below, but you should respond to all concerns mentioned by the reviewers in your response-to-reviewers document. 

The key concerns noted by the reviewers relate to updated references and details about the questionnaire. Specifically, Reviewer 2 requested additional information about adaptation, validation, and limitations of the questionnaire. These issues have limitations for the interpretation of the results and should be explored.

Reviewer 1 has recommended that you cite specific previously published works. As always, we recommend that you please review and evaluate the requested works to determine whether they are relevant and should be cited. It is not a requirement to cite these works. 

Please submit your revised manuscript by Mar 21 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

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Danielle Poole

Academic Editor

PLOS ONE

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8. Please include a copy of Table 4 which you refer to in your text on page 8.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review this article.

The authors proposed a cross-sectional study to assess the magnitude of workplace violence and its associated factors among health care providers working for the last one year at Obstetrics and gynaecology department in some Ethiopian Regional State Referral Hospitals.

The topic is very current and interesting. I am not a native English speaker, but I find that the article is presented in an intelligible fashion and is written in clear and unambiguous scientific English but, a spelling or syntactic check of the text may be useful.

I find some critical points that must be addressed and resolved before publication.

Here are my suggestions:

#1 Page 9, lies 23-25: The introductory section is well structured and supported by fairly up-to-date bibliographic references. I agree with the authors' statement "Factors that related to workplace violence more or less listed by some scholars which can be categorized into three classifications". However, recent studies show that there are many factors to consider. For example, in a recent literature review in the context of the emergency department, at least 24 theoretical models or conceptual frameworks are proposed in the literature that explains the phenomenon of violence against healthcare personnel (Ramacciati N, Ceccagnoli A, Addey B, Lumini E, Rasero L. Violence towards emergency nurses: A narrative review of theories and frameworks. Int Emerg Nurs. 2018 Jul;39:2-12. doi: 10.1016/j.ienj.2017.08.004.). Factors related to violence can be classified into at least 4 domains. In addition to the three correctly proposed by the authors, we must not forget the perpetrators of violent acts (patients, family members, companions, visitors or the health-care personnel for type 3 violence, called worker-on-worker violence). An example of categorization on 4 domains is the one proposed by Ramacciati and colleagues (see: Ramacciati N, Ceccagnoli A, Addey B, Rasero L. Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study. Int J Nurs Stud. 2018 May;81:21-29. doi: 10.1016/j.ijnurstu.2018.01.017.)

#2 Page 16, lines 4-16: The results of the study are well discussed in the Discussion section. As regards the correlation between gender and the risks of exposure to violence, the data emerging from the literature are conflicting. For this, a comparison with the recent study published by Zhu and colleagues in the gynaecological and obstetric setting could also be useful. (see: Zhu L, Li L, Lang J. Gender Differences in Workplace Violence Against Obstetrics and Gynecologists in China: A National Congress Questionnaire. PLoS One. 2018 Dec 10; 13 (12): e0208693 . doi: 10.1371 /journal.pone.0208693.).

#3 Page 17, lines 3-7: I suggest to move in Conclusion section this sentence: "This research revealed that the prevalence of workplace violence was high. Government stakeholders and hospitals may give attention to reduce the burden of the problem for better health care in obstetrics, gynecology, and neonatal health. This can be address by drafting WPV incident reporting procedures, assign security personnel, making legislations and polices to make the health care place safe and conducive places both for patient and clients."

4# The list of references is numerically adequate and fairly up-to-date, however, it could be useful to enrich it with some more recent bibliographic sources.

5# The References section is full of errors, it needs to be thoroughly checked and corrected:

Please, will you to write the correct Journal name for the reference # 3. Paola F, Cecilia A and ,Rosaria D. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study. Dovepress. 23 september 2016:1-3

Please, will you to write the starting and ending page numbers for the following references:

5.Sisawo EJ, Ouédraogo S, Huang SL. Workplace violence against nurses in the Gambia: mixed methods design. BMC Health Services Research. 2017;17.

7. Samir.N, Moustafa E. and Abou.H. Nurses’ attitudes and reactions to workplace violence in obstetrics and gynecology departments in Cairo hospitals. Eastern Mediterranean Health Journal. 2017;18(3).

8. Yenealem DG, Woldegebriel MK, Olana AT, Mekonnen TH. Violence at work: determinants & prevalence among health care workers, northwest Ethiopia: an institutional based cross sectional study.

Ann Occup Environ Med. 2019;31:8.

9. Abate. A, Abebaw. D, Birhanu. A , Zerihun. A, and Assefa. D.Prevalence and Associated Factors of Violence against HospitalStaff at Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia. Hindawi Psychiatry Journal Volume 2019

10. Fute M, Mengesha ZB, Wakgari N, Tessema GA. High prevalence of workplace violence among nurses working at public health facilities in Southern Ethiopia. BMC Nursing. 2015;14.

12.Lei Shi DZ, Chenyu Zhou,1Libin Yang, Tao Sun, Tianjun Hao, Xiangwen Peng, Lei Gao,1Wenhui Liu, Yi Mu, Yuzhen Han, Lihua Fan. A cross–sectional study on the prevalence and associated risk

factors for workplace violence against Chinese nurses. BMJ Global Health. 2017.

13. Shi L, Zhang D, Zhou C, Yang L, Sun T, Hao T, et al. A cross–sectional study on the prevalence and associated risk factors for workplace violence against Chinese nurses. BMJ Open. 2017;7(6).

16. Zhou C, Mou H, Xu W, Li Z, Liu X, Shi L, et al. Study on factors inducing workplace violence in Chinese hospitals based on the broken window theory: a cross-sectional study. BMJ Open. 2017;7(7).

17.Shafran-Tikva S, Zelker R, Stern Z, Chinitz D. Workplace violence in a tertiary care Israeli hospital - a systematic analysis of the types of violence, the perpetrators and hospital departments. Israel Journal

of Health Policy Research. 2017;6.

21. Bayram B, Çetin M, Çolak Oray N, Can İ. Workplace violence against physicians in Turkey’s emergency departments: a cross-sectional survey. BMJ Open. 2017;7(6).

22. Tiruneh BT, Bifftu BB, Tumebo AA, Kelkay MM, Anlay DZ, Dachew BA. Prevalence of workplace violence in Northwest Ethiopia: a multivariate analysis. BMC Nursing. 2016;15.

23. Abdellah RF, Salama KM. Prevalence and risk factors of workplace violence against health care workers in emergency department in Ismailia, Egypt. The Pan African Medical Journal. 2017;26.

24. Likassa.T,Gudissa.T, H/Mariam.Wand Jira. C. Assessment of Factors Associated with WorkplaceViolenceagainst Nurses among Referral Hospitals of Oromia Regional State, EthiopiaJournal of Health, Medicine and Nursing Vol.35, 2017.

26. Boafo IM. The effects of workplace respect and violence on nurses’ job satisfaction in Ghana: a cross-sectional survey. Human Resources for Health. 2018;16.

28. Cheung T, Lee PH, Yip PSF. Workplace Violence toward Physicians and Nurses: Prevalence and

Correlates in Macau. International Journal of Environmental Research and Public Health. 2017; 14(8).

This reference must be spelt out: 32. Amhara Regional State health bureau 2019

I hope these suggestions can help authors improve their article.

Reviewer #2: The authors present a cross-sectional study regarding an interesting topic. The investigation was conducted on a large sample (n=520) involving different professions, and the results have practical relevance. However, while their manuscript has some points of strength, there are several aspects that require attention before the paper can be considered for publication.

1) Throughout the manuscript there are many typos and unclear sentences; a linguistic revision is required. Some examples:

- Introduction, line 1: "define" should be "defined"; line 20, "burn out" should be "burnout"; last line: "is" should be "includes".

- Methods, line 16: "YES and NO" should be "YES or NO". Line 20: "number of staff" should be "number of staff members". Lines 23 and 27: "questioner" should be "questionnaire". Penultimate line: “a total of 08 persons”. Is this number correct, or should it be “8” or anything else?

- Results, section 3.2: "of them" should be deleted, "is" should be "was". Penultimate line: please define "OPD". Section 3.5: "sex" should be "gender" (the same applies to tables 1 and 3).

- Discussion, line 5: please rewrite "that was 20%". On the second page of the Discussion, from line 17 on: the sentences beginning with "This could be methodological similarity..." and "kinds of literature..." are not clear to me. Also, please don't say "a couple of articles" but specify their number.

- Table 3: I suggest to provide the data about monthly income in USD other than ETB, for clarity to an international audience.

2) The style of the references is inconsistent and some look incomplete: please refer to the authors guidelines of the Journal. In particular, number 3 presents names instead of surnames.

3) Statistical analysis is overall appropriate, but the authors should provide details about conditional odds ratios: since their main association index is AOR, what are the variables taken into account to adjust the raw OR?

4) A major concern regards adaptation of the questionnaire used for data collection: how exactly were the original tools modified, and why? Has any validation analysis been carried out? (e.g. Calculation of Cronbach’s alpha, exploratory factor analysis or PCA,…). As an alternative, are these data available elsewhere? The authors state that the Amharic version of the questionnaire was back-translated to English for the sake of consistency, but what information did the authors exactly obtain from this translation?

5) In table 3, please specify the years of training and differences between “diploma” and “degree”: do these educational level lead to different roles in the healthcare setting? I think that an international audience would find this information useful for comparing the results of this study to others.

6) In the discussion the authors cite papers coming from different countries, but only refer to healthcare providers as a whole. I think it should be useful to compare the findings of this study with data regarding specific professions, since a distinction between nurses, physicians and midwives has been done by the authors. Also, I suggest that if the authors wish to compare so many countries, they make sure that the role of the different professions involved is the same across all studies (e.g. in some countries midwives only attend uncomplicated vaginal delivery, and in others there are no nurses in the OBGYN units).

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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PONE-D-20-30094R1

Working in labor and delivery unit increases the odds of work place violence in Amhara region referral hospitals: Cross-sectional study

PLOS ONE

Dear Dr. Dagnaw,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jul 01 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Nicola Ramacciati

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments (if provided):

Dear Authors,

I have just received reviewers' comments on your revised article.

Your commitment to following many of the suggestions proposed is evident.

There are only a few points to improve before your interesting work is published.

Here are the suggestions of the reviewers.

Editor:

#1 I suggest removing the title in each chart because it is described by its caption.

#2 The reference list should be checked for some errors in the citation style.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thanks for the opportunity to review this article. I am not a native speaker and I am not able to evaluate the grammatical and syntactic correctness of the manuscript. The text is clear and legible.

The authors followed many of the reviewers' suggestions. However there are some points that need to be corrected:

#1 Page 10: in sub-section "3.2. Organizational and working unit information" only two organizational aspects are presented: the Presence of policy for WPV and the Presence WPV dealing team. Explain that Table 2 also shows other data regarding the OBGYN departments organization and give a brief presentation of this data.

#2 Page 13: delete the title in the figure "Subjects of attackers".

#3 Page 3: the caption in figure 2 is incorrect. I suggest "Type of attackers in OBGYN departments of Amhara regional state referral hospitals."

#4 Page 16, lines 3-4: I do not completely agree with the authors on this point, already highlighted in the previous review. The authors' response to the Reviewer #1's suggestion was incorrect because type III violence does not affect retired workers, but all workers, who exercise these forms of violence on their co-workers due to mobbing, bullying, lateral hostility, negative interactions. This article talks about both type II violence (as rightly stated) but also type III violence (the so-called worker on worker violence).

#5 Page 17,I also suggest replacing the reference supporting this classification by using the main source of this classification which is the following and not the interesting and authoritative article by Phillips JP:

- University of Iowa Injury Prevention Research Center (UIIPRC). Workplace violence – A report to the nation. Iowa City, IA: University of Iowa; 2001

#6 Page 23: The references section still contains some errors in the citation style (many page numbers are missing, some author names are not indicated or abbreviated in the correct form). According to the editorial rules of PLOS One a DOI number for the full-text article is acceptable as an alternative to or in addition to traditional volume and page numbers but I suggest you check your references list by following these examples of format indicated by the editorial rules available at the following link: https://journals.plos.org/plosone/s/submission-guidelines#loc-manuscript-organization

- Hou WR, Hou YL, Wu GF, Song Y, Su XL, Sun B, et al. cDNA, genomic sequence cloning and overexpression of ribosomal protein gene L9 (rpL9) of the giant panda (Ailuropoda melanoleuca). Genet Mol Res. 2011;10: 1576-1588.

- Devaraju P, Gulati R, Antony PT, Mithun CB, Negi VS. Susceptibility to SLE in South Indian Tamils may be influenced by genetic selection pressure on TLR2 and TLR9 genes. Mol Immunol. 2014 Nov 22. pii: S0161-5890(14)00313-7. doi: 10.1016/j.molimm.2014.11.005.

I hope the authors find these tips useful in order to improve their interesting work.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Working in labor and delivery unit increases the odds of work place violence in Amhara region referral hospitals: Cross-sectional study

PONE-D-20-30094R2

Dear Dr. Dagnaw,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Nicola Ramacciati

Guest Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: