Workplace Violence Against Nurses and Its Association With Mental Health and Turnover Intention: A National Cross-Sectional Study

Abstract

Hospital workplace violence is a significant global public health concern, impacting nurses’ mental well-being and their likelihood of leaving their jobs. Previous research explored the associations between workplace violence, mental health, and turnover intention among nurses, which yielded inconsistent results due to smaller sample sizes, thus highlighting the need for a more comprehensive investigation with a large sample of a representative population. This study, drawing on a large dataset of 116,345 nurses from 67 tertiary hospitals across 31 provinces in China, aimed to assess the relationship between workplace violence and nurses’ mental health and turnover intentions between October and December 2023. Data were analyzed using multilevel regression models. The study assessed the varying levels of workplace violence (low, moderate, and high), mental health outcomes, and turnover intention. The study found that a substantial number of nurses, 30,987 (26.6%), experienced workplace violence in the year prior to the survey, with varying levels of severity. Specifically, 27,225 (23.4%) encountered low-level violence, 3519 (3%) moderate violence, and 243 (0.2%) high-level violence. After controlling for sociodemographic and work-related variables, workplace violence was significantly associated with depressive symptoms (p < 0.001), stress (p < 0.001), anxiety symptoms (p < 0.001), burnout (p < 0.001), and turnover intention (p < 0.001). These findings underscore the critical need for policymakers, hospital administrators, and supervisors to take proactive measures. It is essential to implement strategies that both reduce the incidence of workplace violence and provide robust psychological support and interventions for nurses who have been affected. This collaborative effort will be crucial in protecting the mental health of nursing professionals and fostering a safer, more supportive work environment. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2300072142.