The relationship between workplace violence, job satisfaction and turnover intention in emergency nurses

Exploring the protective capabilities developed by hospital nurses to deflect workplace violence: a qualitative study in Taiwan

BACKGROUND

Workplace violence is a serious safety hazard in the healthcare sector and has attracted much attention worldwide, especially for nursing staff. Equipping nursing personnel with protective capabilities for workplace violence can reduce the risk they face in work settings. This study explored scenarios of common violent patient-nurse conflicts in the workplace of hospital nursing staff and their capabilities for de-escalating such conflicts.

METHODS

We used a qualitative content analysis for this study. Qualitative interviews were conducted with 21 nurses in two teaching hospitals in New Taipei City, Taiwan, until data saturation was reached. The data were transcribed, encoded, and analyzed and similar concepts were grouped under the same category.

RESULTS

Four categories of workplace violence scenarios common to hospital nursing staff were identified: unreasonable requests, caring for high-risk patients, long waiting times for medical consultation, and close contact when caring for patients. Two protective capabilities were recognized: communication and interpersonal capabilities and problem-solving skills. Each scenario may require a different combination of abilities.

CONCLUSION

Our findings suggest that a violence-prevention training program could be designed for various workplace violence scenarios to enhance nurses' abilities to de-escalate workplace violence in hospitals.

The Role of Work-Life Balance, Work Stress, and Work-Family Conflict in Creating Job Satisfaction and Their Impact on Turnover Intention in Nurses at Level I Health Facilities Hospital in Karawang

Turnover intention research with the addition of independent variables of work-life balance and work stress in nurses with health backgrounds is rarely found in type c public hospitals in Karawang city, where literature about this research needs to explain it. This research aims to ascertain how work-life balance, workplace stress, and work-family conflict affect nurses' intentions to quit their jobs by using job satisfaction as a mediator. The sampling for this study was carried out using the probability sampling method known as proportionate stratified random sampling. A total of 550 nurses from 4 schools submitted responses. Work-life balance, work-related stress, and job happiness all significantly influence the likelihood of turnover. The desire to increase or reduce hospital turnover is significantly influenced by work-life balance, stress at work, and work-family conflict. This study has limitations that can lead to imperfect conclusions because the sample used is only the nurse division, so this study can only be generalized to some other districts. The variables studied still need to be reviewed to affect turnover intention by mediating job satisfaction.

Beyond the Basics: Partnerships and Innovations for Empowerment to Address Workplace Violence, a Call to Action

Workplace violence (WPV) has become a crisis for health care workers, with a significant increase in violent events taking place in health care settings across the nation. Health care organizations should develop a comprehensive WPV program that includes recognition, management, and reporting of all types of WPV. A large health care system developed strategies and a program to address WPV. The health care system believes that a safe and respectful work environment is foundational to the goal of zero preventable harm. The "Safety in the Workplace" initiative was designed to raise awareness of concerning behaviors and to offer tools and resources for identifying, responding to, and reporting incidents of violence, aggression, or disruptive behaviors of WPV. During a 6-month pilot of a WPV bundle, there was a 44% reduction in physical violence reports and a 44% reduction in reported incidents of WPV. From June 2020 to June 2021, there was a 10% decrease in WPV overall.

The effect of multiple types of workplace violence on burnout risk, sleep quality, and leaving intention among nurses

OBJECTIVE

The aim of our study is to explore the associations between multiple types of workplace violence (WPV) and burnout risk, sleep problems, and leaving intention among nurses.

METHODS

This cross-sectional survey recruited 1,742 nurses, and data on WPV experiences were collected through self-administered questionnaires. Work conditions, burnout risk scales, sleep quality, and leaving intentions were also evaluated. Multivariate logistic regression analyses were performed to examine the associations of WPV with burnout risk, sleep quality, and leaving intentions, adjusting for demographic characteristics and work conditions.

RESULTS

The study found that 66.7% of nurses reported experience of WPV, with 26.9% experiencing both physical and nonphysical forms. Those who experienced multiple types of WPV reported worse work conditions, higher burnout risk, poorer sleep quality, and a stronger leaving intention compared to those without such experiences. Adjusting for working conditions, logistic regression analysis showed that nurses who experienced multiple types of WPV had 2.12-fold higher odds of high personal burnout risk, 2.36-fold higher odds of high client-related burnout risk, 1.95-fold higher odds of poor sleep quality, and 1.80-fold higher odds of high leaving intention, compared to those without WPV experiences.

CONCLUSIONS

Strategies by hospital managers and policymakers to monitor and reduce workplace violence are vital for sustaining nurses' mental health, well-being, and preventing early attrition from the profession.

"Working in the emergency department is not a job; it's like a war" A narrative inquiry and interpretive phenomenology of the violence experienced by emergency nurses in Turkey

AIMS

This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them.

METHODS

This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi-structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used.

RESULTS

In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub-themes.

CONCLUSIONS

This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management.

Effect, feasibility, and acceptability of a Comprehensive Active Resilience Education (CARE) program in emergency nurses exposed to workplace violence: A quasi-experimental, mixed-methods study

BACKGROUND

Workplace violence (WPV) against emergency nurses has been common but unavoidable. Promoting resilience may mitigate the subsequent health harms of workplace violence. Current interventions mainly focused on internal factors related to resilience, though the external factors can influence personal growth.

AIM

To test the effect, feasibility, and acceptability of a Comprehensive Active Resilience Education (CARE) program on promoting resilience in emergency nurses exposed to workplace violence.

DESIGN

This is a two-armed quasi-experimental using mixed methods, following the TREND checklist.

METHODS

This study was conducted from March 2023 to July 2023 in a tertiary hospital in Shanghai, China. Emergency nurses exposed to workplace violence were recruited using cluster sampling and allocated to the intervention and control groups. The intervention group received the CARE program. The control group received no intervention.

RESULTS

71participants were recruited and no participants withdrew during the intervention. The resilience and anxiety scores displayed a significant effect in the group*time interaction effect. After four months, the intervention group demonstrated a significant improvement in resilience and anxiety scores. The intervention group showed greater improvement in coping, perceived organizational support, and depression scores compared to the control group. Two themes of joyful engagement experience and effective intervention were identified from qualitative interviews with the intervention group.

CONCLUSION

The Comprehensive Active Resilience Education (CARE) program was effective, feasible, and acceptable in increasing resilience in emergency nurses exposed to workplace violence. The CARE program we developed can be replicated and integrated into systematic education programs for all nurses to help them maintain their mental health and good job performance while dealing with workplace violence.

Identifying the obstacles facing emergency nurses regarding treating CTAS1 and CTAS2 in Saudi Arabia

BACKGROUND

Emergency nurses play a pivotal role in delivering efficient emergency healthcare, yet they often encounter numerous challenges, especially while managing life-threatening cases, impacting both their well-being and patient satisfaction. This study seeks to identify the prevalent challenges faced by these nurses in Saudi hospitals when handling Canadian Triage and Acuity Scale (CTAS1 and CTAS2) cases, with the aim of mitigating or managing these issues in the future.

METHODS

This study incorporated a mixed-method approach to identify obstacles in Emergency Department (ED) nursing treatment of CTAS1 and CTAS2 cases in two major Saudi Arabian hospitals. The research began with qualitative focus group interviews with expert ED nurses, followed by a quantitative survey to measure and explore relationships among the qualitative findings. Data analysis leveraged qualitative thematic analysis and principal component analysis, ensuring rigorous examination and validation of data to drive meaningful conclusions.

FINDINGS

From expert interviews, key challenges for emergency nurses were identified, including resource management, communication, training compliance, and psychological factors. A survey of 172 nurses further distilled these into five major issues: patient care management, handling critical cases, administration support, patient care delay, and stress from patients' families.

CONCLUSION

Through a mixed-method approach, this study pinpoints five pivotal challenges confronting emergency nurses in Saudi hospitals. These encompass difficulties in patient care management, the psychological toll of handling critical cases, inadequate administrative support, delays due to extended patient stays, and the stress induced by the presence of patients' families, all of which significantly impede emergency department efficiency and compromise nurse well-being.

Factors that contribute to turnover and retention amongst emergency department nurses: A scoping review

BACKGROUND

Internationally, the emergency nursing workforce shortage is of critical concern.

AIM

To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses.

METHOD

A scoping review using the Joanna Briggs Institute approach was undertaken. Fivedatabases (Embase, MEDLINE, PsycINFO, CINAHL, and Business Source Complete) were searched for papers published in English between January 2011 and June 2023 where the population was nurses, context was the emergency department, and the concept was turnover or retention. A quality appraisal was performed on included studies.

RESULTS

A total of 31 articles met the inclusion criteria. Twenty-six studies focussed on turnover and five studies focussed on retention. Factors that contribute to ED nursing turnover included workplace violence, personal aspects (e.g., burnout or depression), organisational characteristics, and environmental/ job characteristics. Factors that contributed to ED nursing retention included mentoring programs, the advancement in nursing skills, and the transition to practice speciality (emergency) programs.

CONCLUSIONS

A large body of literature exists regarding ED nurses' reasons for leaving their area of practice, yet limited evidence exist on retention. Research exploring factors that promote retention of emergency nurses that leads to subsequent stability and growth in the emergency nursing workforce is needed.

Male nurses' adaptation experiences after turnover to community institutions in Korea: A grounded theory methodology

We aimed to develop a substantive theory according to the associations between adaptation experience-related factors identified in male nurses after turnover to community institutions. From April through August 2019, data were collected through direct observations and in-depth interviews of 22 male nurse participants who were recruited purposively and analyzed simultaneously with the method proposed by Strauss and Corbin. Furthermore, 29 subcategories were derived from 11 categories, including: (1) leaving the clinical sector and changing jobs, (2) shaking while settling, (3) characteristics of the new job, (4) personal disposition, (5) support system, (6) finding my place, (7) solidifying my place, (8) demonstrating my professional competence, (9) stable settlement in my place, (10) preparing for a better future, and (11) still confused. The core category was identified as "putting down roots in another place for myself." The verification of this theory in this study's results indicates a need for research into the evaluation and development of professional development programs and related policies to provide support to male nurses who are pursuing opportunities in community institutions to maintain their nursing identity and further their efforts for developing a nursing specialty.

Work outcomes in public safety personnel after potentially traumatic events: A systematic review

BACKGROUND

It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety.

METHODS

The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of N = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis.

RESULTS

Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across n = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. N = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. N = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization.

CONCLUSIONS

Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.

Stress and Coping in Emergency Nurses Following Trauma Patient Care: A Qualitative Grounded Theory Approach

BACKGROUND

Experiencing symptoms of traumatic stress may be the cost of caring for trauma patients. Emergency nurses caring for trauma patients are at risk for traumatic stress reactions.

OBJECTIVE

This study explored the stress and coping behaviors experienced by emergency nurses who provide trauma care.

METHODS

Focus groups were held at three urban trauma centers in the Midwestern United States: a Level I pediatric trauma center, a Level I adult trauma center, and a Level III adult trauma center. Data were collected between December 2009 and March 2010. Data analysis was guided by the principles of grounded theory. Line-by-line coding and constant comparative analysis techniques were used to identify recurring constructs.

RESULTS

A total of 48 emergency nurses participated. Recurring constructs emerged in the data analysis and coding, revealing four major themes: care of the trauma patient, professional practice, personal life, and support.

CONCLUSIONS

Nurse job engagement, burnout, and professional and personal relationships are influenced by trauma patient care. The study's resulting themes of care of the trauma patient, professional practice, personal life, and support resulted in the development of the "trauma nursing is a continual experience theory" that can be used as a framework to address these effects. Intentional support and timely interventions based on this new theory can help mitigate the effects of traumatic stress experienced by trauma nurses.

The mediation role of work-family conflict in the effect of workplace violence on job satisfaction and intention to leave: a study on health care workers in Turkey

Background

This study aims to determine how workplace violence experienced by healthcare workers in Turkey affects their job satisfaction and intention to leave. It also examines the mediating role of employees' work-family conflict between these effects.

Methods

The PROCESS method was used in the study. The research was conducted on 595 health workers in three public hospital affiliated with the Istanbul Provincial Health Directorate. The convenience sampling method was used in the selection of the participants.

Results

As a result of the analysis, it was determined that there is a positive, significant, moderate (R = 0.35, p < 0.01) relationship between workplace violence and work-family conflict, and a negative, significant and weak relationship between workplace violence and job satisfaction (R = -0.27, p < 0.01), there is a positive, significant, and weak (R = 0.26, p < 0.01) relationship between workplace violence and intention to leave. In addition, there is a negative, significant, and weak (R = -0.27, p < 0.01) relationship between work-family conflict and job satisfaction, and a positive, significant, and weak (R = 0.28, p < 0.01) relationship between work-family conflict and intention to leave. Workplace violence had significant and negative effects on the employees' job satisfaction and significant and positive effects on the intention to leave and work-family conflicts.

Discussion

As a result of the mediating variable analysis, it was determined that work-family conflict has a partial mediator role in the relationship between workplace violence, job satisfaction, and intention to leave. The results are very important, especially for managers working in the healthcare sector. Reducing workplace violence against healthcare personnel will contribute to increasing productivity in the sector and providing better quality service to the healthcare sector.

Relationship between workplace violence, job satisfaction, and burnout among healthcare workers in mobile cabin hospitals in China: Effects of perceived stress and work environment

Background

Although workplace violence is prevalent in the healthcare system, the relationship between workplace violence, job satisfaction, and burnout among healthcare workers (HCWs) in mobile cabin hospitals in China during the COVID-19 pandemic has not yet been investigated. This study analyzes the mediating effects of perceived stress and work environment in the relationship between workplace violence, job satisfaction, and burnout.

Methods

A cross-sectional study was conducted in December 2022 on 1,199 frontline HCWs working in mobile cabin hospitals in Chongqing, China, during the COVID-19 pandemic. Multiple linear regression and mediation analysis were performed.

Results

A positive correlation was observed between workplace violence and burnout (r = 0.420, P < 0.01) and perceived stress (r = 0.524, P < 0.01), and a negative correlation was observed with job satisfaction (r = -0.254, P < 0.01). The perceived stress was positively correlated with burnout (r = 0.528, P < 0.01) and negatively with job satisfaction (r = -0.397, P < 0.01). Job satisfaction was negatively correlated with burnout (r = -0.300, P < 0.01). Perceived stress plays a significant mediating role between workplace violence and job burnout and between workplace violence and job satisfaction. The work environment has a significant moderating effect between workplace violence and job burnout and between workplace violence and job satisfaction.

Conclusion

To reduce burnout among HCWs, hospital administrators should focus on reducing the incidence of workplace violence and perceived stress from work and on improving the work environment and job satisfaction.

The Development and Acceptability of a Comprehensive Crisis Prevention Program for Implementation in Health Care Settings

INTRODUCTION

Behavioral crises are increasingly prevalent in health care settings. Existing programs, however, include procedures that lack adaptability, omit critical components, and deviate from clinical best-practice recommendations. Health care employees also continue to report lacking confidence for safely managing behavioral crises.

AIMS

We described the development and acceptability of a comprehensive crisis prevention program and its modification for a large pediatric health care system to help remediate the limitations of existing programs.

METHOD

Chi-square analyses evaluated the acceptability of the crisis prevention program pre- versus post-training and at 3- and 6-month follow-up times. For insignificant outcomes, logistical regressions identify whether responses differed between emergency-department and nonemergency-department employees.

RESULTS

Chi-square analyses were significant for 10 of 15 questions suggesting that employees were more confident in managing and communicating during behavioral crises post-training, and that this confidence was maintained. Logistic regressions found that emergency-department employees differed in some responses to the acceptability questionnaire than nonemergency-department employees over time.

CONCLUSION

The present crisis prevention program is adaptable to various settings and patients, and it is well received overall by employees. The safety of patients and employees is integral to the delivery of quality care and improving patient-provider relations.

Factors influencing turnover intention among male nurses in China: A large-scale descriptive correlational study

AIM

This study examined the correlation among turnover intention, emotional intelligence and job burnout in male nurses and determined its influencing factors.

BACKGROUND

The number of male nurses has increased in China; however, the turnover rate is very high. Nurses' turnover intention is related to job burnout and emotional intelligence.

INTRODUCTION

Recent studies have shown that job burnout and emotional intelligence are related to medical and health institution employees' intention to leave their jobs. It is not clear if the same conclusions can be drawn about male nurses.

METHODS

For this cross-sectional study, 627 male nurses were recruited from across China between May and July 2018. Data were collected through an online questionnaire, and Pearson's product-moment correlation coefficient and multiple linear regression were performed to analyse the data.

RESULTS

There was a weak negative, moderate positive and moderate negative correlation between turnover intention and emotional intelligence, turnover intention and job burnout, and emotional intelligence and job burnout, respectively. Factors that significantly affected turnover intention among male nurses included job burnout, young age, lack of interest in nursing and working in the emergency department.

CONCLUSION

The study revealed the factors that affected male nurses' turnover intention and the relationships between turnover intention, emotional intelligence and job burnout.

IMPLICATIONS FOR NURSING MANAGEMENT AND SOCIAL POLICY

Hospital managers should provide necessary help and support to reduce male nurse turnover rates and incorporate emotional intelligence training. The policy should eliminate the unfair college admission practices for students choosing nursing majors, raise the nursing profession's salaries and vigorously develop specialty nursing. In addition, diversified values should be promoted, and stereotypes of male nurses in nursing should be broken.

The Relationship between Patients' Demands and Workplace Violence among Healthcare Workers: A Multilevel Look Focusing on the Moderating Role of Psychosocial Working Conditions

Workplace violence against healthcare workers is a widespread phenomenon with very severe consequences for the individuals affected and their organizations. The role played by psychosocial working conditions in healthcare workers' experiences of violence from patients and their family members has received relatively scant attention. In the present study, we investigated the idea that psychosocial working conditions (workload, job control, supervisor support, and team integration), by affecting the well-being and job performance of healthcare workers, play a critical role in the relationship between patients' demands and the escalation of workplace violence. Specifically, we tested the hypothesis that psychosocial working conditions moderate the relationship between patients' demands and workplace violence. Participants were 681 healthcare workers distributed in 55 work groups of three public healthcare facilities in Italy. Multilevel analysis showed significant interactions between patients' demands and each of the investigated psychosocial factors on workplace violence, which in all the cases were in the expected direction. The results suggest that improving the quality of the psychosocial work environment in which healthcare workers operate may be a critical aspect in the prevention of workplace violence.

Association between Organizational Support and Turnover Intention in Nurses: A Systematic Review and Meta-Analysis

Although recent studies suggest a negative relationship between organizational support and turnover intention among nurses, there has been no systematic review on this issue. The aim of this systematic review and meta-analysis was to synthesize and evaluate the association between organizational support and turnover intention in nurses. The review protocol was registered with PROSPERO (CRD42023447109). A total of eight studies with 5754 nurses were included. All studies were cross-sectional and were conducted after 2010. Quality was moderate in five studies and good in three studies. We found a moderate negative correlation between organizational support and turnover intention since the pooled correlation coefficient was -0.32 (95% confidence interval: -0.42 to -0.21). All studies found a negative correlation between organizational support and turnover intention ranging from -0.10 to -0.51. A leave-one-out sensitivity analysis showed that our results were stable when each study was excluded. Egger's test and funnel plot suggested the absence of publication bias in the eight studies. Subgroup analysis showed that the negative correlation between organizational support and turnover intention was stronger in studies in China and Australia than those in Europe. Organizational support has a moderate negative correlation with turnover intention in nurses. However, data regarding the impact of organizational support on turnover intention are limited. Moreover, our study had several limitations, and thus, we cannot generalize our results. Therefore, further studies should be conducted to assess the independent effect of organizational support on turnover intention in a more valid way. In any case, nursing managers should draw attention to organizational support by developing effective clinical practice guidelines for nurses so as to reduce turnover intention.

Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study

The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, "Whether living with relatives" and "Monthly income" had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = -0.459) and job satisfaction (r = -0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.

The intention to leave among academics in Iran: an examination of their work-life quality and satisfaction

BACKGROUND

Despite the importance of faculty retention, there is little understanding of how demographic variables, professional and institutional work-life issues, and satisfaction interact to explain faculty intentions to leave. This study aimed to investigate the intention to leave among academics and their Work-Life Quality and Satisfaction.

METHODS

This is a descriptive cross-sectional study conducted by 8 faculties affiliated to Urmia University of Medical Sciences located in Urmia, West Azarbaijan province, Iran. The participants in the study were 120 faculty members from Nursing and Midwifery, Medicine, Allied health professions, and Health management and medical information faculties. The Work-Life Quality and Satisfaction scale, and the intension to leave scale were used for data collection. Uni- and multivariable linear regression analyses were employed to determine predictors of the intention to leave (P-values < 0.05).

RESULTS

The mean scores of all dimensions of Work-Life Quality and Satisfaction scale, and intention to leave were in an average level. There is a negative correlation between Work-Life Quality and Satisfaction subscales, along with demographic factors, and the intention to leave (P < 0.05), while multivariate analysis showed that work experience and Discipline were significant independent predictors of intention to leave (P < 0.05).

CONCLUSIONS

In order to improve education in universities, it is necessary to pay attention to the conditions of creating job satisfaction in academics. Considering the high intention to leave among Nursing lecturers, without sufficient support of nursing schools in terms of human resources, it may suffer by the lack of academic staff; eventually the quality of education will reduce in undergraduate nursing in the long term.

Assessing the mediation pathways: How decent work affects turnover intention through job satisfaction and burnout in nursing

AIM

This study aimed to assess the potential mediating roles of nurses' job satisfaction and burnout in the association between decent work and turnover intention.

BACKGROUND

There is a global challenge of nursing shortages in healthcare systems worldwide. Decent work is crucial for safeguarding the rights and professional development outcomes of nurses. However, there is currently limited research on decent work among nurses, and there is a lack of studies exploring the relationships between nurses' decent work, job satisfaction, burnout, and turnover intention.

METHODS

A cross-sectional survey design was employed with a sample of 460 nurses from three hospitals: The Affiliated Hospital of Hangzhou Normal University, Hangzhou Third People's Hospital, and Hangzhou Red Cross Hospital. The STROBE checklist was used. Mediation analysis using the PROCESS Macro was used to examine the relationships between decent work, job satisfaction, burnout, and turnover intention.

RESULTS

The results showed that nurses' perception of decent work directly influences their turnover intention. Additionally, these findings strongly support the role of job satisfaction and burnout as mediating factors in the relationship between decent work and turnover intention.

CONCLUSIONS

Decent work reduces nurse burnout and turnover intention of enhancing their job satisfaction.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

This study's findings have important implications for healthcare organizations and policymakers. Recognizing the pivotal role of decent work in nurses' job satisfaction and well-being can guide the development of strategies to improve working conditions and reduce turnover rates. It is imperative for healthcare institutions to prioritize creating safe, supportive, and equitable work conditions for nurses, as this can contribute to higher job satisfaction and, subsequently, lower turnover rates.

Exploring National Trends and Organizational Predictors of Violence and Mistreatment From Patients and Visitors

GOAL

Rising incidents of violence and mistreatment of healthcare workers by patients and visitors have been reported. U.S. healthcare workers are five times more likely to experience nonfatal workplace violence (WPV) than workers in any other profession. However, less is known about the national trends in the incidence of violence and mistreatment in healthcare. The specific organizational and individual-level factors that relate to stress arising from these occurrences specifically by patients and family members are also not fully understood. The goals of this study were to examine national trends of violence toward healthcare workers, understand which populations are most vulnerable to stress from violence and mistreatment, and explore organizational factors that are related to these occurrences.

METHODS

Data were collected from three sources: (1) The Bureau of Labor Statistics Intentional Injury by Another Person data for the period 2011-2020, (2) data from a large national workers' compensation claim services provider for the period 2018-2022, and (3) results from a survey distributed at a large medical center in June and July 2022. Data were represented graphically and analyzed using multivariate regression and dominance analysis to identify specific predictors of WPV and mistreatment among healthcare workers.

PRINCIPAL FINDINGS

Of the total surveyed sample, 23.7% of participants reported mistreatment from patients or visitors as a major stressor and 14.6% reported WPV from patients or visitors as a major stressor. Stress from mistreatment and WPV was most frequently reported by nurses, employees aged 18 to 24 years other than nurses, those who identified as White, and those who identified as female or a gender minority. The emergency room (ER) showed the highest percentages of stress from mistreatment (61.8%) and violence (55.9%) from patients or visitors. The top predictors of stress from WPV and mistreatment by patients or visitors among healthcare workers ranked high to low were working in the ER, working as a nurse, a lack of necessary supplies or equipment, patient or visitor attitudes or beliefs about COVID-19, and working in a hospital-based unit.

PRACTICAL APPLICATIONS

In addition to protecting employees as a moral imperative, preventing WPV is critical for organizational performance. Employee productivity is estimated to decrease up to 50% in the 6 to 18 weeks following an incident of violence, while turnover can increase 30% to 40%. An effective WPV prevention plan and a proactive approach to supporting the physical and mental health conditions that may result from WPV can mitigate the potential costs and exposures from these incidents. Organizations must also set clear expectations of behavior with patients and visitors by refusing to tolerate violence and mistreatment of caregivers. The impact of WPV can remain present and active for up to 8 years following an incident. Policy-level interventions are also needed. Currently, there are no federal protections for healthcare workers related to violence, though some states have made it a felony to abuse healthcare workers.

Turnover intention of nurses in public hospitals and its association with quality of working life: a cross-sectional survey in six provinces in China

Objectives

High turnover intention can exacerbate the workforce shortage of nurses. This study aimed to determine the level of turnover intention of public hospital nurses in China and its associated factors.

Methods

A cross-sectional questionnaire survey of 2,863 nurses was conducted in 48 public hospitals across six provinces in mainland China, measuring the sociodemographic (gender, age, marital status, and monthly basic salary) and work characteristics (professional title, workload, night sleep deprivation, and workplace violence) of respondents, their quality of working life (QWL), and turnover intention. Multivariate logistic regression models were established to determine the association between QWL and turnover intention after adjustment for variations of the sociodemographic and work characteristics.

Results

Overall, 42.8% of respondents reported turnover intention. Higher QWL scores (AOR = 0.824 for job and career satisfaction, p < 0.001; AOR = 0.894 for professional pride, p < 0.001; AOR = 0.911 for balance between work and family, p < 0.05) were associated with lower turnover intention. Workplace violence was the strongest predictor of higher turnover intention (AOR = 3.003-4.767) amongst the sociodemographic and work characteristics, followed by an age between 30 and 40 years (AOR = 1.457 relative to <30 years), and night sleep deprivation (AOR = 1.391-1.808). Senior professional title had a protective effect (AOR = 0.417 relative to no title) on turnover intention.

Conclusion

High levels of turnover intention are evident across China in nurses employed by public hospitals, in particular in those aged between 30 and 40 years. Low QWL and poor work environment are significant predictors of turnover intention.

Evaluating the impact of an information-based education and training platform on the incidence, severity, and coping resources status of workplace violence among nurses: a quasi-experimental study

BACKGROUND

Workplace violence among nurses has emerged as a critical issue, posing a significant threat to their occupational safety. Education and training are the primary measures employed to prevent and respond to workplace violence. However, the current approaches have proven ineffective, possibly due to a lack of consideration for the specific needs of clinical nurses. Therefore, it is essential to explore the effectiveness of an informational education and training platform tailored to nurses' requirements. This study aimed to investigate the impact of such a platform on the incidence, severity, and coping resources of WPV in nurses.

METHODS

This research was a quasi-experimental study. An information-based education and training platform focused on nurse workplace violence was developed through literature reviews, expert meetings, consultations with software development companies, and a trial run. A tertiary general hospital in Suzhou was selected, in which hospital district A was the intervention group and hospital district B was the control group. A total of 276 nurses were recruited, 140 in the intervention group and 136 in the control group. The nurses' incidence, severity, coping resources status, and evaluation of the application were measured before the intervention and at 1, 3, and 6 months after the intervention.

RESULTS

The overall incidence of workplace violence, verbal aggression, and verbal threat among nurses showed statistically significant differences (P < 0.05) for the time effect, while the incidence of physical aggression demonstrated statistically significant differences (P < 0.05) for the between-group effect and the time effect. The severity of physical violence among nurses exhibited statistically significant differences (P < 0.05) for the between-group effect and time effect, and the severity of psychological violence showed statistically significant differences (P < 0.05) for the time effect. Nurses' total coping resources score and dimensions also showed statistically significant differences in terms of group, time, and interaction effects (P < 0.001). The evaluation questionnaire for the mobile application indicated usefulness scores of 2 (1, 2); ease of learning scores of 2 (1, 2); ease of use scores of 2 (1, 2); trust scores of 2 (1, 2.75); acceptance score of 1 (1, 2); and satisfaction scores of 2 (1, 2).

CONCLUSIONS

Implementing the nurse workplace violence information-based education and training platform proved beneficial in reducing the incidence and severity of workplace violence among nurses and enhancing their coping resources. This outcome suggested the platform's potential for further application and promotion in clinical settings.

Patients' opinion on violence against healthcare workers and their level of satisfaction in emergency department in Turkey: A cross-sectional study

BACKGROUND

Violence, with an increasing rate of cases in the health care system which adversely affects the quality of provision of services, has become a social health issue that also has negative impacts both on healthcare workers and patients. This study was conducted to determine the opinion of patients, who had been admitted to the emergency department, towards violence against healthcare workers, and their level of satisfaction with health services.

METHODS

The study employed a cross-sectional design and was conducted with 348 patients who had received healthcare services in the adult emergency department in Turkey. The Emergency Department Patient Satisfaction Survey and An eight-item questionnaire prepared by the researchers consisting of the patient's characteristics and their statements on violence were used to collect the data.

RESULTS

Among the patients, 26.7% stated that they had been violent toward healthcare workers. It was determined that 91.4% of the cases were verbal and 8.6% were physical. Among the patients, 82.2% had not known about the legal sanctions for violence against healthcare workers. The low level of propensity for violence in patients who were satisfied with the emergency department service was statistically significant (p < 0.05).

CONCLUSIONS

As a result of the study, it was found that one in four patients had been violent to healthcare workers, and the vast majority had a lack of information about legal sanctions. Policymakers should take deterrent measures to prevent the occurrence of violence and develop more critical sanctions.

The relationship between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic

Objectives

Workplace violence is a major issue in society, business and healthcare settings. It adversely affects both employee safety and their ability to provide healthcare services.

Aim

This study examined the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic.

Methods

We collected data from 513 nurses. We conducted 'Process Macro' analysis. Firstly, we included three mediators in the model: job satisfaction, workplace violence and emotional exhaustion. Secondly, we used work hours and anxiety as moderators of the relationship between workplace violence and turnover intention.

Results

The findings revealed statistical significance that job satisfaction and workplace violence mediated the relationship between emotional exhaustion and nurse turnover intentions. Work hours and anxiety also moderated the relationship between workplace violence and nurses' turnover intention.

Conclusion

Respondents indicated that they were most affected by verbal violence during this time. Workplace violence is a negative factor that affects nurses' work, affecting them physically and psychologically. This occupational risk should be considered when evaluating nurses exposed to violence, as it affects job satisfaction and turnover intentions. The main theoretical contribution of this research is the identification of the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic. It is clear that the research findings will be useful for healthcare professionals. The findings may have practical implications for healthcare administrators and their staff.

The effectiveness of a workplace violence prevention strategy based on situational prevention theory for nurses in managing violent situations: a quasi-experimental study

BACKGROUND

Workplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses' specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects.

METHODS

Under the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training.

RESULTS

The WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066, P < 0.001) and physical violence (Wald χ² = 9.100, P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05).

CONCLUSIONS

The described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses' WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.

The Mediating Role of Job Stress Between Organizational Climate and Work Alienation Among Nurses in Emergency Departments: A Cross-sectional Study

BACKGROUND

Nurses suffer a certain degree of work alienation (a psychological state in which employees feel separated from their jobs because the jobs do not meet the needs of employees or do not match their expectations). It is necessary to identify predictors of work alienation and find effective interventions.

OBJECTIVE

To explore the influence of organizational climate and job stress on work alienation among nurses in emergency departments.

METHODS

This was a cross-sectional study conducted from June to August 2022. A convenience sampling method was adopted to invite 342 nurses from emergency departments in 12 tertiary public hospitals in 4 cities in China. Data were collected using self-reported questionnaires on organizational climate, job stress, and work alienation. Path analysis implemented by IBM AMOS 21.0 was used to explore the associations among organizational climate, job stress, and work alienation.

RESULTS

Job stress can positively affect work alienation among nurses in emergency departments (β = 0.44, P < .01). Organizational climate can directly and negatively affect work alienation (β = -0.33, P < .01); it can also negatively and indirectly affect work alienation through job stress (β = -0.20, 95% confidence interval: -0.252 to -0.146).

CONCLUSIONS

Job stress partially mediated the effect of organizational climate on work alienation among nurses in emergency departments. The findings provided a valuable perspective on predictors of work alienation among emergency department nurses.

The impact of utilizing inclusive leadership among nurses during crises: A multisite comparative study

Nurses' psychological wellness and satisfaction are threatened by exposure to many stressors. Adopting a promising leadership style has beneficial impacts at different levels, especially during crises. This study aimed to examine the impact of inclusive leadership on nurses' satisfaction and psychological distress during crises, focusing on three Arabic countries. A cross-sectional descriptive design was utilized to meet the study goal. Data were collected electronically in the three countries using the Kessler Psychological Distress Scale (K-10), Minnesota Satisfaction Questionnaire, and Carmel's Inclusive Leadership Scale. Two hundred seventy-four participants fully responded: 90 from Egypt, 82 from Saudi Arabia, and 102 from Jordan. Descriptive statistics, Pearson R, Spearman Rho, Point biserial, and ANOVA tests were used to answer the research questions. There were statistically significant differences between countries in the mean scores of inclusive leadership and psychological distress. In addition, statistically significant relationships between inclusive leadership, psychological distress, and job satisfaction were found. The study focused on the importance of approaching inclusive leadership to increase employee satisfaction, reduce psychological distress, and achieve organizational goals.

Incidence and trends in workplace violence within emergency departments in the United Kingdom 2017-2022: an observational time series analysis

Background

Workplace violence (WPV) is a notable issue facing healthcare services and workers globally. WPV impacts upon the well-being of staff and can put healthcare provision at risk with detrimental effects on patient care. This study aims to investigate and quantify, at national and regional levels, the incidence and trends of WPV within emergency departments (EDs).

Methods

We requested data relating to WPV from all 152 trusts with an ED in the United Kingdom from January 2017-March 2022. We applied interrupted time series and trend analysis to check for significant differences in WPV across the COVID-19 pandemic.

Results

We conducted time series analysis on 58 million attendances and detected statistically significant increases in WPV in March 2020-5.06/100,000 attendances (95% CI 1.59/100,000-8.53/100,000 p < 0.01) and May 2020-20.63/100,000 attendances (95% CI 9.39-31.87 p < 0.01). Rises in incidents of 0.37/100,000 attendances per month (95% CI 0.21-0.53 p < 0.0001) were found January 2017-March 2020. We analyzed 96 million attendances for yearly trends, which revealed statistically significant increasing trends of WPV in London and North-West England (p < 0.05), and physical WPV in the North West England (p < 0.05).

Conclusion

There have been dramatic increases in incidents of WPV in United Kingdom EDs over the last 5 years with concerning rises during the COVID-19 period. Our findings highlight the potential to further demoralize a workforce already under significant strain, resulting in increased absences for physical or mental health and an exodus of staff. Therefore, trusts should ensure there are robust systems in place to protect and safeguard staff.

Factors related to turnover intention among emergency department nurses in China: A nationwide cross-sectional study

BACKGROUND

Turnover intention among nurses is high, especially in the emergency department. However, factors that are associated with Chinese emergency department nurses' turnover intention have been scarcely studied.

AIMS

The present study examined relationships between turnover intention and demographic characteristics, job-related factors, depressive symptoms, and organizational commitment among emergency department nurses.

STUDY DESIGN

A cross-sectional study of emergency department nurses was conducted in China between July and August 2018. The questionnaire included demographic characteristics (age, gender, level of education, and self-rated health status), job-related factors (qualification title, job seniority, night shifts, and workplace violence), depressive symptoms, organizational commitment, and turnover intention. A hierarchical linear regression model was used to identify factors that are associated with turnover intention among emergency department nurses.

RESULTS

A total of 17 582 emergency department nurses participated in the study. The response rate was 68.9%. The findings indicated that poor self-rated health status (β = 0.25, p < .001), working more than 11 night shifts per month (β = 0.14, p < .01), experiencing workplace violence in the past year (β = 0.08, p < .05), and higher depressive symptom scores (β = 0.07, p < .001) positively correlated with turnover intention. More years of service (β = -0.38, p < .001) and higher organizational commitment scores (β = -0.45, p < .001) negatively correlated with turnover intention.

CONCLUSIONS

Health status, job seniority, night shift frequency per month, workplace violence, depressive symptoms, and organizational commitment were significantly associated with emergency department nurses' turnover intention.

RELEVANCE TO CLINICAL PRACTICE

To reduce turnover intention in the emergency department nurses, hospital administrators and managers should implement measures to improve their physical and mental health, increase organizational commitment, develop staff acceptable shift schedules, and reduce incidences of workplace violence.

Workplace violence, occupational commitment and intention among emergency room nurses: A mixed-methods study

AIMS AND OBJECTIVES

This study aimed to determine the correlations between the violence experienced by emergency nurses in the work environment, their occupational commitment and their intention to resign.

BACKGROUND

The emergency service, when compared with other hospital departments, is the unit where violence against healthcare workers is most common.

DESIGN

A multi-method design was used.

METHODS

The research was carried out between 15 January 2020 and 15 May 2021. The sample of the study consisted of 202 emergency service nurses. The first stage of the research was reserved for the validity and reliability study of the Turkish version of the Perceptions of the Prevalence of Aggression Scale (POPAS). Quantitative data were collected using the POPAS, the Three-Component Model of Commitment Scale. A qualitative method was used to determine in-depth the causes and effects of the violence the nurses were exposed to and what they thought and felt about the factors affecting their commitment to the occupation and their intention to resign. The Consolidated criteria for Reporting Qualitative Research (COREQ) were used for this paper.

RESULTS

The fit index values of the POPAS, which were confirmed with 15 items and four subdimensions, were determined to be acceptable and highly reliable. It was determined that 96.5% of the nurses were exposed to verbal violence. Qualitative interviews with nurses revealed that the violence they were subjected to in the working environment affected the nurses physically, psychologically, socially and caused them to consider leaving their jobs.

CONCLUSIONS

The increasing incidence of exposure to violent behaviours and verbal violence was found to decrease nurses' emotional commitment to their occupation.

RELEVANCE TO CLINICAL PRACTICE

Nurses' working conditions and work environments should be improved and their workload should be reduced in order to maximise their level of occupational commitment and prevent them from thinking about resigning.

Violence against Emergency Nurses in Kermanshah-Iran: Prevalence and Associated Factors

Background

Violence against emergency nurses is a global concern with undesirable physical and psychological consequences. This study was conducted to investigate the characteristics of physical and verbal violence against emergency nurses in Iran.

Methods

In this cross-sectional study, 150 nurses working in seven hospitals affiliated to Kermanshah University of Medical Sciences were included in the study using the stratified random sampling method. The data collection tools included a personal information form and a researcher-made questionnaire. Violence-related characteristics were assessed using descriptive statistics. Logistic regression was used to identify factors related to physical and verbal violence.

Results

The frequency rates of physical and verbal violence during the past 12 months were equal to 62% (n = 93) and 94.7% (n = 142), respectively. In both types of physical violence (49.5%, n = 46) and verbal violence (40.4%, n = 57), the nursing station was the most common place of violence. In both physical (n = 40, 43.0%) and verbal violence (n = 101, 71.1%), the most common perpetrator was the patient's family. Most physical violence (57.0%, n = 53) and verbal violence (35.2%, n = 50) occurred in the night shifts. No statistically significant relationship was found between physical and verbal violence and gender, age, marital status, type of employment, and work experience. Discussion. The results indicate the seriousness of workplace violence against nurses. It is necessary to adopt a global approach along with providing sufficient manpower and psychological empowerment of nurses. Further studies with a forward-looking approach are suggested.

Retaining nurses via organizational support and pay during COVID-19 pandemic: The moderating effect between intrinsic and extrinsic incentives

AIM

There has been growing concern about the nurses' turnover intention as well as life satisfaction during COVID-19 pandemic in Iran. The past research has provided evidence on the effect of organizational support on nurses' job satisfaction and turnover intention. However, little is known about the underlying mechanism behind these associations.

DESIGN

A cross-sectional survey was undertaken.

METHODS

An online survey was conducted in Iran from May to June 2020 through Google Docs Forms. In total, 305 nurses were participated and completed the online survey. Data were analysed using structural equation modelling through (AMOS). This study was checked with the STROBE checklist.

RESULT

The results showed that nurses' perception of organizational support was positively related to their job satisfaction which in turn decreases the turnover intention. Likewise, the job satisfaction partially mediated the relationship between organizational support and nurses' life satisfaction.

Psychological Reactions of Lebanese Nurses to Workplace Violence in Critical Care Units

Introduction

Workplace violence (WPV) is a growing concern that constitutes a major threat to occupational health and safety, thereby comprising a priority issue for policymakers. Given the increasing prevalence of chronic diseases and comorbidities among the Lebanese population, nurses working in critical care settings encounter intense workloads and high-risk interactions, potentially increasing the risk of WPV.

Objectives

This study aimed to investigate the traumatic and psychological reactions of Lebanese critical nurses who have been exposed to WPV, and the risk factors for depression and anxiety.

Methods

The study utilized a cross-sectional descriptive correlational design; 112 critical care nurses from diverse departments took part in this study during the period of June to July 2021.

Results

A positive, significant correlation between WPV exposure and self-reported anxiety was observed, p = .03 with high levels of WPV, especially among patients and their families. Although verbal abuse was found to be more prevalent among critical care nurses in Lebanon compared to physical and sexual violence, the severity of the situation and its impact on the nurses' mental health and well-being cannot be ignored.

Conclusions

WPV for critical care nurses is a serious issue that needs to be considered. Policy-makers should develop the politics of regulating the nursing profession, especially for critical care nurses in Lebanon.

Emergency nurses' communication experiences with patients and their families during the COVID-19 pandemic: A qualitative study

BACKGROUND

In the emergency department, essential information is verified primarily through communication with patients and families. Thus, an in-depth understanding of emergency nurses' communication experiences with patients is required to facilitate the provision of effective therapeutic care.

OBJECTIVE

To analyze emergency nurses' communication experiences with patients and their families.

METHODS

A qualitative descriptive design was used. Interviews were conducted with 15 nurses between 2021 and 2022. Thematic analysis was carried out. This study was conducted in accordance with the consolidated criteria for reporting qualitative studies (COREQ).

RESULTS

Three themes were identified: transformation of communication approaches due to COVID-19, obstacles in therapeutic communication, and continuous endeavors for improved communication.

CONCLUSION

Emergency nurses experienced various barriers in communication with patients and their families, which were exacerbated by COVID-19. Nevertheless, nurses attempted to enhance their communication skills. Organizational support is pertinent to establish effective communication strategies.

Triggers of Workplace Violence in Emergency Departments: A Qualitative Study

Background: Workplace violence has become an alarming phenomenon facing healthcare systems worldwide. Emergency nurses were the most victimized from workplace violence incidents. There is a crucial need for conducting qualitative research addressing the unique contextual factors associated with workplace violence against emergency nurses in Jordan.Purpose: This study aimed to explore circumstances that Jordanian emergency nurses, who were victims of workplace violence from clients and/or their relatives, perceive as provocative for workplace violence events.Methods: A qualitative phenomenological method was used. Purposive sampling was utilized to recruit participants (n=15), who were victims of workplace violence, and working in eight emergency departments distributed over all regions of Jordan. Semi-structured face-to-face interviews were conducted. All interviews were recorded and transcribed into Arabic. The Interpretive Phenomenological Analysis (IPA) was used to manually analyse the gathered data. Member checking, prolonged engagement with data, stepwise replication, and personal journaling were used to enhance the rigor of the study.Results: Findings of this study resulted in four superordinate themes that represents the main individual, social, and organisational factors contributing to workplace violence in Jordanian emergency departments. These themes include aggressors’ misconceptions and misbehaviours with four subordinate themes, inappropriate Jordanian social customs with two subordinate themes, organisational circumstances of emergency department with two subordinate themes, and escalator nurses with three subordinate themes.Conclusion: This study highlighted how specific social, cultural, legal, and administrative aspects of Jordanian society were inappropriately employed so as to lead to spread of the workplace violence. This study has provided insight into the need for change at personal level of emergency nurses, social level of Jordanian public, and organizational level of hospital administration and environment in order to mitigate workplace violence incidence in emergency departments.

More exposure to medical injury news, better doctor-patient communication, but less doctors' professional identity: A moderated chain mediation model

Objectives

In recent years, news of medical malignant injury events has become common in China. However, it is unclear how exposure to this news affects medical staff.

Methods

The present study collected data from a sample of 311 medical staff in China. It explored the effect of exposure to such news on medical staff's communication and willingness to let their children be doctors, which was an attitude that reflects their professional identity well. In addition, this study also examined the mediating roles of outgroup attribution and anxiety, and the moderating role of social support.

Results

The results showed that exposure to news of medical injury could positively and directly predict the quality of doctor-patient communication, but negatively and indirectly predict medical staff's willingness to let their children become doctors. These effects existed through the mediating role of anxiety and the chain mediating role of both outgroup attribution and anxiety. In addition, social support could mitigate the negative correlation between news exposure and outgroup attribution.

Conclusions

These results suggest that news of medical malignant injury events may incentivize medical staff to improve the quality of communication in the short term, but it is not conducive to medical staff's long-term mental health. That is, exposure to news of medical injury is likely to lead to a negative influence on their professional identity, although social support can alleviate this negative influence.

Effect of Nurses’ Autonomy Levels and Problem-Solving Skills on Job Satisfaction

Objective: This study aimed to determine the effect of nurses’ autonomy levels and problem-solving skills on job satisfaction and was conducted in public, private and university hospital between July and September 2021. Methods: This descriptive and relational – screening study was conducted with 278 nurses. Data were collected through the Socio-demographic Form, the Problem-Solving Inventory, the Sociotrophy-Autonomy Scale, and the Minnesota Job Satisfaction Questionnaire (MJSQ). Data were analyzed using SPSS 26 and AMOS 24 programs using numbers, percentages, minimum/maximum values, means, and standard deviation values. Results: Modern mediation analysis findings performed using the Bootstrap method showed that the indirect effect of the autonomy score on the overall satisfaction score with the mediation of the problem-solving skills was significant (p< .05). Conclusion: Problem-solving skills were found to have a partial mediating role in the effect of nurses’ autonomy levels on their job satisfaction.

Correlation of the job turnover intention of Iranian nurses with job satisfaction and burnout in the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has led to numerous psychological consequences and a drastic increase in the workload of nurses. The present study aimed to investigate the correlation of the job turnover intention of Iranian nurses with job satisfaction and burnout in the COVID-19 pandemic.

MATERIALS AND METHODS

This cross-sectional descriptive study was conducted on 300 nurses working in the hospitals in Sabzevar, Iran from October 2020 to January 2021. Data were collected using the questionnaires of turnover intention, Spector job satisfaction, and Maslach burnout in a self-report manner. Correlation analysis was used. Then, for assessing a predictive model used a simple linear regression and multiple linear regression analyses. Data analysis was performed using SPSS version 24.

RESULTS

The results showed that the variables of burnout and job satisfaction are effective on nurses' willingness to job turnover. Furthermore, among the background variable, the findings showed that the economic status of nurses and the male gender of patients under their care can be effective on nurses "job turnover intention and can be used as predictor variables of nurses" job turnover intention.

CONCLUSION

According to the results, special attention must be paid to the job satisfaction, burnout, and the economic situation (as a mediator variable) of nurses to prevent their job turnover in the COVID-19 pandemic. Therefore, it is recommended that health managers prevent the job turnover intention of nurses in the COVID-19 pandemic by taking psycho-socio-economic support measures.

(Un)Broken: Lateral violence among hospital nurses, user violence, burnout, and general health: A structural equation modeling analysis

Introduction

Workplace violence is a social problem yet to be solved. Although it is present in virtually all work environments, its prevalence in healthcare settings stands out, being perceived as something inherent to the job. Most studies in this context have focused on user violence against professionals. However, it has been observed that violence among colleagues in these types of jobs is a risk factor for the health of workers and has rarely been studied as a whole. Among the main consequences of exposure to violence reported in the literature, burnout syndrome, depression, anxiety, or somatic problems have been among the most studied. On the one hand, some authors claim that being exposed to workplace violence can increase the associated physical and psychological pathology and lead to a picture congruent with burnout. On the other hand, it has been hypothesized that violence is associated with burnout, which can trigger physical and psychological symptoms. Taking into account this background, the aim of this study is to explore workplace violence in health personnel, symptomatology, and burnout syndrome through mediation models that allow us to know the interrelationships between the variables.

Methods

A cross-sectional design with a double descriptive-associative strategy was used. The sample was composed of 950 nursing professionals from public hospitals. The scales of physical and non-physical violence from users to professionals HABS-U, personal, social, and occupational violence among co-workers using the Health Aggressive Behavior Scale - Co-workers and Superiors (HABS-CS) scale, the burnout scale Maslach Burnout Inventory - General Survey (MBI-GS) which evaluates professional exhaustion, efficacy and cynicism, and the factors referring to depression, anxiety, somatization, and dysfunction of the GHQ-28 scale were applied. In order to calculate the models, workplace violence was used as a predictor of symptomatology, using the burnout variables as mediators. Regression coefficients with and without mediation model, direct and standardized estimates were obtained. For statistical power, Bootstrap analysis was used to calculate direct mediation effects.

Results

After controlling the mediation effects of burnout and cynicism, physical and non-physical user violence toward healthcare personnel were significant predictors of the GHQ-28 scores. These same results were obtained when assessing the relationship between social, occupational, and personal violence among co-workers and GHQ-28 scores.

Conclusion

Our results contribute to increase the evidence about the effects of violence on the health of professionals and to advance in the characterization of the possible consequent psychological damage. Regardless of the type of violence experienced, exposure to violence can lead to anxious, depressive or somatization symptoms, among others. Violence is also a predictor of burnout syndrome, which in turn accentuates the rest of the consequences studied. Despite the limitations of the proposed model, these results serve to highlight the complexity of the situation experienced by healthcare professionals. Moreover, it serves as a basis for proposing intervention/prevention programs to raise awareness and protect professionals from these risks. To this end, self-care tools should be proposed with which professionals take care of their own health through the management of violent situations and/or the improvement of occupational health.

A terrifying problem: healthcare professionals’ homicides

Background

As in all over the world, healthcare professionals in Turkey are increasingly affected by violence. The purpose of this study was to evaluate homicide, which is the most severe form of violence against health care professionals.

Methods

Information regarding characteristics of the incidents, victims, and perpetrators were gathered from the media reports subjecting murders of healthcare professionals between 2000 and 2019 were compiled and discussed with descriptive statistics.

Results

There were 60 homicides involving health professionals (35 male, 25 female) between 2000 and 2019. Homicides of health professionals were found to have increased significantly between 2015 and 2019. The most common crime scene was the victim’s workplace, whereas the most common method of homicide was the use of firearms. In female healthcare professional homicides, the murderer was a former or existing partner in most cases.

Conclusions

The assessment of cultural factors, and the performance of various studies to prevent homicide of health professionals is crucial. Policies against individual weaponry and the prevention of armed persons entering healthcare facilities could be useful. In addition, regulations prohibiting targeting health professionals as a scapegoat for system failures will help address this problem.

Exploration of potential indicators of burnout, psychological distress and post-traumatic stress disorder, among Australian female first responders

There is limited research on the psychological wellbeing of female first responders (FRs) and therefore we explore potential indicators of burnout, psychological distress and post-traumatic stress disorder among Australian female FRs. We conducted an online health survey among Australian female FRs (fire, police, paramedical, aeromedical, remote area and other e.g., State Emergency Service). Of the 422 eligible participants who submitted the online survey, 286 completed at least 80% of all survey questions and were used in the final analyses. The main outcomes of interest were moderate burnout (compared to low burnout) and high scores for combined PCL-5/K10 (compared to low scores). Using logistical regression stepwise regression models, we analysed associations between the outcomes of interest and various work-psychosocial factors. Results showed the strongest indicators of moderate burnout to be, 1) returning to work with <12-hour break, 2) exposure to gossip and slander, 3) not enough time to do things, 4) and having experienced rape/sexual assault. The strongest indicators of higher PCL-5/K10 scores were, 1) exposure to unpleasant teasing, 2) pressure at work and home, 3) having experienced physical violence (e.g., beaten/mugged), and 4) someone close to them died unexpectedly. These findings show workforce stressors have more impact on female FRs psychological wellbeing, compared to lifetime traumatic exposures.

The Effect of Organizational Trust on Turnover Intention of Rural Kindergarten Teachers: The Mediating Role of Teaching Efficacy and Job Satisfaction

Recent studies have focused on turnover among rural kindergarten teachers. However, none of these studies have shown a clear connection between turnover intention and organizational trust, although there are studies in other areas showing that organizational trust can affect turnover intention. Drawing on a sample of 330 kindergarten teachers in rural areas, this study explores the mechanism of influence between organizational trust and turnover intention with teaching efficacy and job satisfaction as mediators. We found that organizational trust negatively impacted teachers' turnover intention, and this relationship was mediated by a significant chain mediating effect of teaching efficacy and job satisfaction. The findings enrich knowledge about turnover among rural kindergarten teachers and inspire us to create a more supportive organizational environment against the backdrop of the COVID-19 pandemic to improve job satisfaction and alleviate turnover among rural kindergarten teachers.

The impact of COVID-19 pandemic on temporal trends of workplace violence against healthcare workers in the emergency department

Background

It is known that there has been an increase over the years in attacks by patients admitted to the emergency department (ED) on healthcare workers; it is unclear what effect the COVID-19 pandemic has on these attacks.

Aim

to verify through a long-term time analysis the effect of COVID-19 on ED attacks on healthcare workers.

Mothods

a quasi-experimental interrupted time-series analysis on attacks on healthcare workers was performed from January 2017 to August 2021. The main outcome was the monthly rate of attacks on healthcare workers per 1000 general accesses. The pandemic outbreak was used as an intervention point.

Results

1002 attacks on healthcare workers in the ED were recorded. The rate of monthly attacks on total accesses increased from an average of 13.5 (SD 6.6) in the pre-COVID-19 era to 27.2 (SD 9.8) in the pandemic months, p < 0.001. The pandemic outbreak led to a significant increase in attacks on healthcare workers from 0.05/1000 attacks per month (p = 0.018), to 4.3/1000 attacks per month (p = 0.005).

Conclusions

The COVID-19 pandemic has led to a significant increase in attacks on healthcare workers in the ED. Trends compared to pre-pandemic months do not seem to indicate a return to normality. Health institutions and policymakers should develop strategies to improve the safety of the working environment in hospitals and EDs.

Workplace violence and the risk of post-traumatic stress disorder and burnout among nurses: a systematic review and meta-analysis

AIM

This review examined the association between workplace violence and the risk of post-traumatic stress disorder (PTSD) and burnout among nurses.

BACKGROUND

The extent to which workplace violence is associated with an increased risk of PTSD and burnout in nurses remains unclear.

EVALUATION

We searched nine electronic databases (PubMed, Cochrane, Embase, Web of Science, CINAHL, PsycINFO, Chinese Biomedical, China National Knowledge Internet, and WANFANG).

KEY ISSUES

Overall, 114 full-text studies were identified; 43 met the inclusion criteria, of which 10 were included in the meta-analysis. Compared to their counterparts with non-exposure to workplace violence, nurses experiencing it had 2.13 and 2.25 times higher odds of reporting PTSD and burnout after adjusting the confounding factors. Additionally, the moderator and mediator factors might help reduce the risk of both in this population.

CONCLUSION

This study indicated that workplace violence increases the risk of PTSD and burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

Our review identified the magnitude of the association between exposure to workplace violence and the reported symptoms of PTSD and burnout in nurses. Furthermore, multi-targeted efforts directed at the identified social/organisational, task-related, and individual resources might help mitigate their harmful impact in the aforementioned population.

What is the impact of patient violence in the emergency department on emergency nurses' intention to leave?

AIM

To examine the impact that patient violence, experienced in the emergency department, has on emergency nurses' intention to leave their job.

BACKGROUND

Emergency departments have become known for their overcrowding, chaos, unpredictability and violence. Emergency nurses are at high risk of experiencing workplace violence, which is cited in the literature as having a direct effect on general nurses' intention to leave. A high rate of nursing turnover may lead to short staffing, jeopardize the quality of patient care and increase overcrowding and wait times.

EVALUATION

A systematic review was undertaken in CINAHL, Medline and Psych INFO databases using published data until November 2021. Six articles were included, and PRISMA guidelines were adhered it.

KEY ISSUES

Workplace violence in the emergency department had a direct impact on emergency nurses' intention to leave and decreased their job satisfaction. Verbal abuse is the most experienced form of workplace violence.

CONCLUSIONS

Workplace violence experienced by emergency nurses in the emergency department had a direct positive impact on their intention to leave and subsequently negative impact on their job satisfaction.

IMPLICATIONS FOR NURSING MANAGEMENT

This review may inform clinical decision-making and aid in the development of clinical practice guidelines for a workplace violence prevention programme, specific to the emergency department.

Violence against nurses by patients and visitors in the emergency department: A concept analysis

AIM

This analysis investigates the concept of violence against nurses by patients and visitors in the emergency department. It aims to differentiate, clarify, and clearly identify this specific concept, which will facilitate more apt measurement and reporting, ultimately to contribute violence reduction measures.

BACKGROUND

Due to contextual factors, occupational risk and patient characteristics, violence against nurses by patients and visitors in the emergency department varies from other types of violence against other health care staff.

METHODS

This study employed Walker and Avant's concept analysis technique.

RESULTS

The analysis found that violence against nurses by patients and visitors in the emergency department is primarily an occurrence of interpersonal violence based on the working relationship, whereby the patient and/or visitor becomes an assailant, and a nurse becomes a target in the absence of capable guardianship. There is also an intentional use of physical force or power, which results in or has a high chance of causing harm.

CONCLUSION

A clearer understanding of the antecedents, attributes, and consequences of violence against nurses by patients and visitors arising from this concept analysis provides a framework that will assist in the understanding, measurement, reporting, and prevention of violence and inform future research.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers are encouraged to adopt strategies that act on the factors related to attributes and antecedents that will serve to reduce the occurrence of intentional violent acts.

Verbal Violence and Turnover Intention Among New Nurses in Korea: A Time-Lagged Survey

AIM

To test a model examining the impact of verbal violence against new nurses on their turnover intention and the mediating effects of emotional reaction and burnout based on affective events theory.

BACKGROUND

In Korea, turnover rate of nurses, especially new nurses, is at a serious level. Verifying the paths is important by which nurses decide to turnover intention after experiencing verbal violence, which is the most common form of workplace violence. In particular, Research on new nurses who are vulnerable to exposure to verbal violence and have a high turnover rate is insufficient.

METHODS

Data was collected using a time-lagged online surveys from 212 Korean new nurses. Structural equation modelling was used to test the hypothesized model.

RESULTS

The level of the turnover intention of new nurses was almost 4 out of 5. Verbal violence not only has a direct effect on turnover intention, but also has an indirect effect through burnout. Emotional reactions and burnout sequentially mediated the relationship between verbal violence and turnover intention; these variables explained approximately 57% of turnover intention.

CONCLUSIONS

To decrease negative emotional reactions and burnout caused by verbal violence may benefit to reduction of turnover intention of new nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

The critical need for new nurses' violence interventions that focus on emotional reactions and burnout, and subsequently improving desirable patient-coworker-nurse relationships and quality of life for new nurses.

Prevalence and Risk Factors of Workplace Violence Against Emergency Department Nurses in China

Objectives: We aim to find out the prevalence, characteristics, and predictors of workplace violence (WPV) against current Chinese emergency department (ED) nurses.

Methods: A cross-sectional survey of 20,136 ED nurses was conducted in 31 provinces in China between July and September 2019. Descriptive analyses were used to examine the prevalence and characteristics of WPV. Chi-square analysis and Binary logistic regression analysis were used to identify the predictors of WPV.

Results: During the past 12 months, there are 79.39% of ED nurses exposed to any type of WPV, including 78.38% and 39.65% exposed to nonphysical and physical violence, respectively. Binary logistic regression analysis shows that ED nurses who were male, had bachelor’s degrees, had average monthly salary between 5,001 and 12,000, worked in central China, had higher professional titles, were more experienced, arranging shift work, and had higher work stress were more likely to experience WPV.

Conclusion: A relatively high prevalence of WPV against Chinese ED nurses has been revealed in this study. The characteristics and predictors of WPV remind us to take positive measures to reduce WPV.

The impact of the COVID-19 pandemic on the prevalence and risk factors of workplace violence among healthcare workers in China

Background

The pandemic of COVID-19 has significantly increased the burden on healthcare workers and potentially affect their risk of workplace violence (WPV). This study aimed to explore the prevalence and risk factors of WPV among healthcare workers during the peaking and the remission of the COVID-19 pandemic in China.

Methods

Using the snowball method, a repeated online questionnaire survey was conducted among Chinese healthcare workers from March 27th to April 26th in 2020 and 2021, respectively. Data included healthcare workers' socio-demographic and occupational characteristics, psychological status, and workplace violence.

Results

A total of 3006 samples in 2020 and 3465 samples in 2021 were analyzed. In 2020, the prevalence of WPV and witnessing colleagues suffering from WPV among healthcare workers were 64.2% and 79.7% respectively. Compared with 2020, the prevalence decreased by 11.0% and 14.4% in 2021, respectively. Logistic regression showed that WPV in 2020 was influenced by males, long working experience, working in the psychiatric department, direct contact with COVID-19 patients, self-discovery of medical errors, moral injury, depression, and anxiety (minimum OR = 1.22, maximum OR = 2.82). While risk factors of WPV in 2021 included males, working in psychiatric departments, self-discovery of medical errors, moral injury, depression, and anxiety (minimum OR = 1.33, maximum OR = 3.32); and protective factors were holding a master's degree (OR = 0.78) and working in other departments (OR = 0.54).

Conclusion

This study retains the common effects of WPV among healthcare workers, though after the baptism of the COVID-19 pandemic, the prevalence of WPV among healthcare workers decreased; however, part of the influencing factors changed. In addition, COVID-19 has seriously affected the mental health of healthcare workers, and the effect of mental health problems on WPV should also attract more attention.