Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xilu Road, Jinan, Shandong, China.
NHC Key Lab of Health Economics and Policy Research, Shandong University, No. 44 Wenhua Xilu Road, Jinan, Shandong, China.
BMC Psychiatry. 2024 May 21;24(1):379. doi: 10.1186/s12888-024-05827-8.
The mechanisms underlying the relationship between workplace violence (WPV) and depressive symptoms in nurses have been less studied. This study aims to examine the mediating role of fear of future workplace violence (FFWV) and burnout in the association between WPV and depressive symptoms.
We conducted a cross-sectional web survey at 12 tertiary hospitals in Shandong province, China, in 2020. The Center for Epidemiologic Studies Depression Scale (CESD-10), the Chinese version of the Maslach Burnout Inventory-General Survey and the Fear of Future Violence at Work Scale were used to collect data. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson's correlation coefficient, and ordinary least squares regression with bootstrap resampling were used to analyze the data.
The prevalence of depressive symptoms was 45.9% among nurses. The regression model showed that FFWV and burnout mediated the relationship between WPV and depressive symptoms. The total effects of WPV on depressive symptoms (3.109, 95% bootstrap CI:2.324 - 3.713) could be decomposed into direct (2.250, 95% bootstrap CI:1.583 - 2.917) and indirect effects (0.769, 95% bootstrap CI:0.543 - 1.012). Indirect effects mediated by FFWV and burnout were 0.203 (95% bootstrap CI:0.090 - 0.348) and 0.443 (95% bootstrap CI:0.262 - 0.642), respectively. Furthermore, serial multiple mediation analyses indicated that the indirect effect mediated by FFWV and burnout in a sequential manner was 0.123 (95% bootstrap CI:0.070 - 0.189).
The prevalence of depressive symptoms among Chinese nurses was high. The WPV was an important risk factor for depressive symptoms and its negative effect was mediated by FFWV and burnout. The importance of decreasing WPV exposure and level of FFWV and burnout was emphasized to prevent depressive symptoms among nurses. The findings implied that hospital managers and health policy makers should not only develop targeted interventions to reduce exposure to WPV in daily work among all nurses, but also provide psychological support to nurses with WPV experience to reduce FFWV and burnout.
工作场所暴力（WPV）与护士抑郁症状之间的关系的潜在机制研究较少。本研究旨在检验未来工作场所暴力恐惧（FFWV）和倦怠在 WPV 与抑郁症状之间的关联中的中介作用。
我们于 2020 年在山东省 12 家三级医院进行了一项横断面网络调查。采用流行病学研究中心抑郁量表（CESD-10）、中文版马氏职业倦怠量表和未来工作场所暴力恐惧量表收集数据。采用描述性统计、独立样本 t 检验、单因素方差分析、Pearson 相关系数和普通最小二乘回归与 bootstrap 重采样进行数据分析。
护士中抑郁症状的患病率为 45.9%。回归模型显示，FFWV 和倦怠中介了 WPV 和抑郁症状之间的关系。WPV 对抑郁症状的总效应（3.109，95%bootstrap CI：2.324-3.713）可分解为直接效应（2.250，95%bootstrap CI：1.583-2.917）和间接效应（0.769，95%bootstrap CI：0.543-1.012）。FFWV 和倦怠介导的间接效应分别为 0.203（95%bootstrap CI：0.090-0.348）和 0.443（95%bootstrap CI：0.262-0.642）。此外，序列多重中介分析表明，FFWV 和倦怠依次介导的间接效应为 0.123（95%bootstrap CI：0.070-0.189）。
中国护士的抑郁症状患病率较高。WPV 是抑郁症状的一个重要危险因素，其负效应由 FFWV 和倦怠介导。强调减少 WPV 暴露和 FFWV 和倦怠水平对于预防护士抑郁症状很重要。研究结果表明，医院管理者和卫生政策制定者不仅应制定针对所有护士的旨在减少日常工作中 WPV 暴露的目标干预措施，还应为经历 WPV 的护士提供心理支持，以降低 FFWV 和倦怠。
