Authors: Amal Humed Ali , Asmaa Sobhy Soliman

Abstract

Background: Workplace violence (WPV) is a pervasive occupational hazard in healthcare, with nurses particularly vulnerable due to their frontline role. In Saudi Arabia, fragmented evidence exists regarding WPV prevalence and risk factors. This systematic review and meta-analysis aimed to provide pooled estimates of WPV among nurses and identify associated determinants.

Methods: We conducted a systematic search of PubMed, Scopus, and Web of Science up to September 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies included cross-sectional or cohort designs reporting WPV prevalence or risk factors among nurses in Saudi Arabia. Data were extracted independently by two reviewers, and study quality was assessed using the Newcastle–Ottawa Scale. Pooled prevalence estimates were calculated in RStudio using the meta package with random-effects models. Heterogeneity was quantified using I2, and publication bias was evaluated with DOI plots and Luis Furuya–Kanamori index.

Results: Nineteen studies comprising 8,754 nurses were included. The pooled prevalence of any WPV was 65% (95% confidence intervals: 55–74), with 25% reporting physical violence, 39% verbal violence, and 13% sexual violence. Only 41% of incidents were formally reported. Heterogeneity was high across outcomes (I2 > 98%). Risk factors consistently associated with WPV included Saudi nationality, rotating or night shifts, longer professional tenure, and employment in high-risk departments such as psychiatry and emergency.

Conclusion: WPV is highly prevalent among nurses in Saudi Arabia, particularly in psychiatric and emergency settings. Findings highlight the urgent need for targeted institutional policies, reporting mechanisms, and protective interventions to safeguard nurses’ wellbeing and strengthen healthcare system resilience.

Keywords: Workplace violence, abuse, harassment, nurses, Saudi Arabia.