Violência no local de trabalho contra profissionais de saúde: uma scoping review de práticas de denúncia, barreiras e respostas institucionais (2020-2025)

Abstract

Background: Violence against Healthcare Workers (HCWs) is a widespread global problem that has attracted attention in recent years, with significant consequences for their well-being and quality of care provided. Despite the existence of public policies and digital platforms for reporting incidents, underreporting persists, becoming an issue of the present. Individual and organizational barriers contribute to a culture of silence. To combat this phenomenon, coordinated action is needed between national policies and institutional strategies to prevent violence and promote reporting. This study aimed to identify current practices, institutional and organization barriers, and research gaps in reporting violent incidents against HCWs. Emphasis is placed on the Portuguese context, where the main policy response and existing digital reporting platforms are described. Methods: The scoping review was structured following the methodological framework originally proposed by Arksey & O'Malley (2005). An exploratory scientific literature was conducted in PubMed, Scopus and Web of Science databases, covering the period 2020 to 2025. Results: More than 50% of violence against healthcare workers episodes goes underreported. Verbal violence is the most identified type of violence and, paradoxically, the least reported. The main individual barrier mentioned was the belief in the uselessness of reporting, "nothing will be done" like the organizational barrier was ineffectiveness of reporting systems. In Portugal, as in Italy, Sweden, California and Turkey, there is a public policy to prevent violence supported by national digital reporting platforms. In 2014, a national platform called NOTIFICA® was created in Portugal to monitor and to report this phenomenon of violence, but this situation no longer exists. Currently, incidents of violence against HCWs are only reported on institutional platforms such as SAGRIS® and HER+. The most effective strategy described in the studies to combat violence and underreporting was the combined use of training and education in prevention with awareness campaigns. Conclusion: Combating violence against healthcare workers in healthcare sector, in Portugal as in the rest of world, requires political will, institutional accountability and change in organizational culture. Future efforts should focus on integrating violence indicators into quality and safety metrics across the system.