Assessment of Nurses' Knowledge and Attitudes About Workplace Harassment Laws and Reporting Mechanisms at a Tertiary Care Public Hospital in Lahore, Pakistan

Abstract

Workplace harassment in hospitals affects nurses' wellbeing and can reduce the quality of patient care. Effective prevention depends on nurses' awareness of legal protections and their confidence in using institutional reporting mechanisms. Objective: To assess nurses' knowledge and attitudes about workplace harassment laws and reporting mechanisms at a tertiary care public hospital in Lahore, and to examine the association between knowledge and reporting attitudes. Methods: A quantitative descriptive cross-sectional study was conducted among 254 registered nurses selected through simple random sampling. Data were collected using an adapted Workplace Violence in Healthcare Settings questionnaire with additional items on legal knowledge and reporting confidence. Data were analyzed in SPSS version 26 using descriptive statistics and the Chi-square test (p<0.05 considered significant). Results: Verbal abuse was the most common form of harassment (70.1%), followed by humiliation or ridicule (55.9%); physical assault was reported by 18.1% of nurses. Participants strongly agreed that harassment affected their emotional wellbeing (mean 1.82) and caused fear when interacting with certain individuals (mean 1.95). Fear of retaliation was the strongest barrier to reporting (mean 2.12). Awareness of the Protection Against Harassment Act, 2010 was present in only 40.2% of nurses, and knowledge of external mechanisms such as FOSPAH and helplines was low. Knowledge level was significantly associated with reporting attitude (χ² = 18.72, p = 0.001). Conclusion: Workplace harassment was common among nurses and was predominantly non-physical in nature. Legal knowledge and awareness of reporting mechanisms were limited, and fear of retaliation reduced nurses' readiness to report. Strengthening legal literacy, confidentiality, and institutional response is recommended to improve reporting and protection for nurses.