# Perceptions of patients and their relatives about schadenfreude towards doctors

## TL;DR

This study explores how patients and their relatives in Turkey feel about taking pleasure in doctors' misfortunes, aiming to understand the psychological roots of healthcare violence.

## Contribution

This is the first study to examine Schadenfreude in healthcare, using all five dimensions to explore violence against doctors in Turkey.

## Key findings

- Lower empathy and sympathy towards doctors correlate with higher levels of Schadenfreude and aggression.
- Perceptions that doctors deserve violence directly increase aggression levels.
- Schadenfreude positively and significantly affects anger and aggression.

## Abstract

Violence in healthcare is a global issue that healthcare professionals experience. The concerning increase in violent incidents in Turkiye particularly makes it a significant problem to explore by examining the underlying psychological factors. In this sense, this study focuses on the concept of Schadenfreude, the malicious joy of someone else's misfortune, towards doctors, which is an under-researched topic in healthcare violence. Particularly, there is a lack of research on patients' and relatives' perceptions of doctors.

This study aims to determine the level of schadenfreude in Turkish society towards the violence experienced by doctors and to develop a model revealing the underlying causes.

Using a convenience sampling method, we recruited 402 participants, who are not first-degree relatives of healthcare professionals, for this quantitative study. For data collection, we developed a survey instrument to measure the level of schadenfreude and six different psychological factors including empathy, sympathy, anger, aggression, and deservingness. For data analysis, we used structural equation modeling.

The results showed that the lower the levels of empathy and sympathy towards doctors were, the higher the levels of both schadenfreude and aggression were. Envy had no significant effect on either schadenfreude or aggression, while deservingness directly affected aggression. The perceptions of participants regarding doctors that they deserve violence increased their aggression levels. Schadenfreude had a positive and significant effect on anger and aggression.

The examination of underlying factors of violence towards doctors points to a lack of mutual understanding between patients and doctors. The results of this study indicate a need for increasing empathy towards health professionals by creating societal awareness of their experiences. Local authorities and healthcare organizations can create environments that bring together the public and health professionals to share their experiences with each other or conduct campaigns to draw public attention to the issue. Moreover, training sessions on effective communication can be offered for health professionals to help improve patient-doctor relationships and healthcare outcomes.

•This study explores Schadenfreude for the first time in healthcare to inform policy and practice regarding violence in healthcare.•This study uniquely addresses all five dimensions of schadenfreude together to explore violence against doctors in Turkiye, unlike past research.•Violence has led many doctors to leave Turkey, resulting in a loss of qualified labor. To develop a new perspective, our research examined healthcare violence and various related concepts.•Exploration of factors related to the concept of schadenfreude through structural equation modeling after having tested the explanatory and confirmatory factor analyses.

This study explores Schadenfreude for the first time in healthcare to inform policy and practice regarding violence in healthcare.

This study uniquely addresses all five dimensions of schadenfreude together to explore violence against doctors in Turkiye, unlike past research.

Violence has led many doctors to leave Turkey, resulting in a loss of qualified labor. To develop a new perspective, our research examined healthcare violence and various related concepts.

Exploration of factors related to the concept of schadenfreude through structural equation modeling after having tested the explanatory and confirmatory factor analyses.