Prevalence of Workplace Violence against Nurses and Healthcare Workers in Pakistan: A Systematic Review and Meta-analysis

Abstract

Background & Aim: Workplace violence is a growing concern within healthcare systems worldwide and poses serious risks to the well-being of nurses and other healthcare workers. Although several studies address this issue in Pakistan, no comprehensive national estimate exists. This study aims to synthesize the reported prevalence of different forms of workplace violence against nurses and healthcare workers in Pakistan through a systematic review and meta-analysis.
Methods & Materials: A systematic literature search was conducted across major electronic databases from January 2000 to October 2025. Twenty-six cross-sectional studies met the inclusion criteria. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Pooled prevalence estimates were calculated using random-effects models in STATA version 17. Heterogeneity was evaluated with the I2 statistic and Cochran’s Q test, and potential small-study effects and publication bias were examined using Egger’s regression test and the trim-and-fill method.
Results: The meta-analysis shows that the pooled prevalence of physical and verbal workplace violence among healthcare workers is 20.0% (95% CI: 15.0%–25.0%) and 57.0% (95% CI: 48.0%–66.0%), respectively. Pooled rates for sexual and psychological violence are 13.0% (95% CI: 4.0%–22.0%) and 41.0% (95% CI: 18.0%–64.0%). In subgroup analyses by profession, nurses experience higher rates than other healthcare workers across categories: physical (29.3% vs. 16.1%; p = 0.003) and verbal (62.7% vs. 55.3%; p = 0.455). Meta-regression reveals no significant trend over time.
Conclusion: Workplace violence is highly prevalent among healthcare workers in Pakistan, with a particularly substantial burden observed among nurses. Although this review synthesizes prevalence rather than downstream clinical consequences, documented literature indicates that such pervasive exposure jeopardizes healthcare workers’ psychological well-being, job satisfaction, and overall quality of care. Targeted institutional policies, robust incident reporting systems, and multi-level protective interventions are urgently warranted to enhance occupational safety across healthcare settings.