Objective To assess the prevalence of violence in the healthcare environment and to identify its respective origin and determinants in two university hospitals in the Central -East region of Tunisia.

Methods A bi-centric and exhaustive cross-sectional study was carried out in health professionals from two public hospitals in the Center-East of Tunisia over a period of eight months. The study was based on a self-administered and structured individual questionnaire composed of two parts: a first part for the evaluation of the socio-professional characteristics of the participants and a second part for the evaluation of violence at work (VAW) and its origins (external and internal).

Results A total of 546 healthcare professionals agreed to participate in this study, giving an overall response rate of 19%. The prevalence of VAW was 95.8%. The mean age was 34.5 ± 9.6 years with a sex ratio of 0.42. Doctors, Nurses and Senior Technicians were significantly the most exposed to VAW (p = 0.000). External violence (EV) was more frequent than internal violence (IV) (93.4% and 77.8%, respectively). EVs were moral (92.3%) and physical (73.4%) and IVs were mainly moral (76.9%). After multivariate regression, the predictive factors of VAW were the level of education (primary/secondary, OR = 12.2) and the profession (Technician (OR = 21.2), Doctor (OR = 14.5) and Nurse (OR = 12.8)). Predictors of EVs were nationality (OR = 6.2), level of education (primary/secondary, OR = 7.2) and occupation (Doctor (OR = 10.4) and Nurse (OR = 8.8)). The only predictor of IV was male gender (OR = 0.6).

Conclusion This study has identified a high prevalence of VAW among health workers dominated by external violence. Sensitization and staff training on the management and prevention of violence should be necessary to improve professional performance in public hospitals.