In total, 216 questionnaires were returned, five of which were excluded because they were returned blank; the completion rate was 21.1 %. Of the participants, 62.1 % (n = 131) were male, and 34.7% (n = 79) were female. Participants' mean age was 48.2 years (standard deviation [SD] = 10.9). They worked in general practice for mean 38.1 hours per week (SD = 16.3), for a mean of 19.7 years (SD = 11.7); and spent a mean of 33.5 hours (SD = 13.1) in direct patient contact. The majority of participants (73.8%) worked in a metropolitan location (capital city or metropolitan centres), 22.7% worked in a rural location (rural or remote centres); 1 % worked in more than one location, and 2% did not disclose their location.
Descriptive statistics
Overall, 57% of GPs experienced at least one form of violence and aggression in the last 12 months. Verbal abuse was the most common form experienced by GPs (44%), followed by property damage or theft (23%), and intimidation (22%). Sexual harassment was experienced by 8%, physical abuse by 3%, and sexual assault was experienced by 1 % of GPs.
Because of the low response rate, and potential bias (GPs who experienced violence and aggression may have been more likely to respond than GPs who had not experienced violence and aggression), it is possible that the figures calculated above are the maximum, or upper rate, of prevalence. To account for this, prevalence figures were adjusted and calculated as a range that included the lowest possible rate of violence and aggression. The lowest possible rate was calculated by assuming that non-responders had not experienced violence and aggression, and taking into account the response rate of 21.1%. As such, the lowest possible rate is 21.1% of the upper limit. Therefore, with the adjustment, 12–57% of GPs had experienced at least one form of violence and aggression in the last 12 months. The adjusted prevalence range for each form of violence and aggression is 9–44% for verbal abuse, 5–23% for property damage or theft, 5–22% for intimidation, 2–8% for sexual harassment, 1–3% for physical abuse, and 0.2–1 % for sexual assault.
Sex differences and practice location differences are presented in Table 1. The only significant sex difference was for sexual harassment with more female than male GPs having experienced sexual harassment. There was no significant difference in the number of metropolitan and rural GPs who had experienced violence and aggression.
Table 1 Number (%) of GPs experiencing each form of violence and aggression in the last 12 months, according to sex and practice location.
Table 2 shows correlations between the variables of interest. There were several significant correlations, perhaps the most notable were the strong correlation between hours per week in direct patient contact and hours per week in practice; and the correlation between years in occupation and age. The correlations suggest that there is significant overlap between these variables. Based on these correlations, the variables age and hours per week in direct patient contact were dropped from multivariate analyses.
Table 2 Correlations between variables of interest.
In multivariate analyses one case was identified as a multivariate outlier with P<0.001 and was deleted. Evaluation of assumptions of linearity, normality, multicolinearity or singularity, and homogeneity of covariance revealed no threat to multivariate analyses.
A stepwise discriminant function analysis was conducted for each form of violence and aggression, and predictors emerged for four forms. For verbal abuse, the variables ‘mean hours per week in general practice’ and ‘practice type’ loaded on a function that significantly discriminated between the two groups (Wilks' λ [degrees of freedom {df} = 2] = 0.95, P = 0.008). GPs who had experienced verbal abuse worked longer hours (mean = 39.67 hours, SD [standard deviation] = 14.35) than GPs who had not experienced verbal abuse (mean = 35.61 hours, SD = 16.60). A larger number of GPs who had experienced verbal abuse worked in group practices rather than a single-handed practice (89% versus 79%). The function correctly classified 56% of cases overall. Prediction of experience of verbal abuse was considerably more accurate (64%) than for prediction of lack of exposure to verbal abuse (50%).
A function was also generated that significantly discriminated between the groups on intimidation (Wilks' λ [df = 1] = 0.97, P = 0.015). The variable ‘years in general practice’ loaded significantly on the function. GPs who had experienced intimidation had worked in general practice for fewer years (mean = 16.13, SD = 10.02) than GPs who had not experienced intimidation (mean = 21.02, SD = 12.00). The function correctly classified 58% of the cases overall, with 61% correct classification of GPs who had experienced intimidation and 57% correct classification GPs who had not experienced intimidation.
For physical abuse, mean hours per week in general practice best discriminated between the two groups and correctly classified 64% of the cases (Wilks' λ [df = 1] = 0.98, P = 0.031). GPs who had experienced physical abuse worked longer hours (mean = 51.0 hours, SD = 10.86) than GPs who had not experienced physical abuse (mean = 36.99 hours, SD = 15.66). This function had 71% correct classification of GPs exposed to physical abuse and 64% correct classification of GPs not exposed to physical abuse.
In terms of sexual harassment, sex was a discriminating factor between the two groups (Wilks' λ [df = 1] = 0.97, P = 0.03) and classified 65% of cases, with 71% correct classification of GPs who had experienced sexual harassment, and 64% correct classification of GPs who had not experienced sexual harassment. Female GPs were more likely to experience sexual harassment than male GPs.
