Liao Liwen, Guo Ningyuan, Han Qing, Qian Yiping, Xi Huiqin, Wang Lin
School of Nursing, Shanghai Jiaotong University, Shanghai, China.
Nursing Department, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Int Nurs Rev. 2025 Jun;72(2):e70037. doi: 10.1111/inr.70037.
The mental health of emergency nurses exposed to workplace violence must be prioritized. Current resilience interventions require further investigation regarding the long-term effects. Additionally, it remains unclear whether the level of violence influences the intervention effect.
To investigate the long-term effect of the CARE program on resilience, and to assess differences in the effectiveness of the CARE program with various workplace violence levels.
This two-armed quasi-experimental study was conducted from March 2023 to October 2023, following the TREND checklist. Emergency nurses exposed to workplace violence (n = 71) were recruited in a tertiary hospital in Shanghai, China. The intervention group received the CARE program. The control group received routine violence training provided by the hospital. Data were collected at baseline, after the intervention, 4-week, and 12-week follow-up.
The scores of nurse resilience were significantly improved at the 4-week follow-up and the 12-week follow-up, as compared with the control group. Resilience, anxiety, perceived organizational support, and nurses' intent to stay scores showed a significant effect in the group-time interaction effect. Subgroup analysis indicated that emergency nurses with high exposure to workplace violence demonstrate better resilience change scores than low-risk emergency nurses.
The CARE program was effective in enhancing resilience, decreasing anxiety, and promoting perceived organizational support and nurses' intent to stay among emergency nurses exposed to workplace violence. The effectiveness of the nurse resilience intervention was dependent on the level of workplace violence experienced at the beginning of the study.
This study provides an effective method to enhance the resilience of emergency nurses. The CARE program can be replicated and integrated into systematic education programs for all nurses. More efforts should be made to reduce the incidence of workplace violence in hospitals, such as establishing policies and implementing early warning systems to protect nurses' physical and mental health.
必须优先关注遭受工作场所暴力的急诊护士的心理健康。目前的复原力干预措施在长期效果方面需要进一步研究。此外，暴力程度是否会影响干预效果仍不清楚。
调查CARE项目对复原力的长期影响，并评估CARE项目在不同工作场所暴力程度下的效果差异。
本双臂准实验研究于2023年3月至2023年10月进行，遵循TREND清单。在中国上海的一家三级医院招募了遭受工作场所暴力的急诊护士（n = 71）。干预组接受CARE项目。对照组接受医院提供的常规暴力培训。在基线、干预后、4周和12周随访时收集数据。
与对照组相比，在4周随访和12周随访时，护士复原力得分显著提高。复原力、焦虑、感知到的组织支持和护士留任意向得分在组-时间交互效应中显示出显著影响。亚组分析表明，高暴露于工作场所暴力的急诊护士比低风险急诊护士表现出更好的复原力变化得分。
CARE项目在增强遭受工作场所暴力的急诊护士的复原力、降低焦虑、促进感知到的组织支持和护士留任意向方面是有效的。护士复原力干预的效果取决于研究开始时所经历的工作场所暴力程度。
本研究提供了一种增强急诊护士复原力的有效方法。CARE项目可以被复制并纳入所有护士的系统教育项目中。应做出更多努力来降低医院工作场所暴力的发生率，例如制定政策和实施预警系统以保护护士的身心健康。
