Title: How psychological resources connect among psychiatric nurses exposed to workplace violence
Abstract:
Background: Workplace violence (WPV) represents a prominent occupational hazard in the global nursing field, with psychiatric nurses at higher risk due to the complexity of patient symptoms. WPV can lead to emotional exhaustion, burnout, and post-traumatic stress, compromising nurse well-being and clinical care quality. Mindfulness, resilience, and trait coping strategies constitute key psychological resources that buffer the impact of WPV, being closely related to emotion regulation, recovery from adversity, and cognitive processing of stressful events. However, these resources may interact in complex and non-linear ways that traditional linear analyses cannot fully capture.
Objective: This study aimed to systematically examine the complex network relationships among mindfulness, resilience, and trait coping strategies in psychiatric nurses exposed to WPV. It also sought to identify key nodes within the psychological resource network to inform targeted and effective interventions.
Methods: A multicenter cross-sectional survey was conducted from August to September 2024. A total of 680 psychiatric nurses in hospitals across Shanghai with WPV experiences were assessed using a demographic questionnaire, Workplace Violence Scale, the 15-item Five Facet Mindfulness Questionnaire (FFMQ-15), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the Trait Coping Style Questionnaire (TCSQ). Data were analyzed using SPSS 27.0 and R 4.5.1.
Results: A total of 635 valid questionnaires were collected. The median WPV score (P25, P75) was 5 (2, 10), with the most prevalent types being verbal violence (71.5%), threats (64.9%), physical violence (49.6%), and sexual harassment (18.9%). The mean mindfulness score was (2.70 ± 0.68), representing a moderate level, while the mean resilience score was (3.38 ± 0.81), indicating a relatively high level. The mean score for positive coping was (3.14 ± 0.72), which was significantly higher than that for negative coping (2.68 ± 0.74; t = 11.05, p < 0.001). Network analysis revealed that the “non-judging” dimension of mindfulness had the highest strength centrality, whereas the “describing” dimension exhibited the highest closeness and betweenness centrality. Moreover, resilience and positive coping showed the strongest positive correlation (r = 0.810, p < 0.001).
Conclusion: Nurse managers should prioritize enhancing mindfulness among psychiatric nurses exposed to WPV. Group-based interventions such as acceptance and commitment therapy (ACT) can be employed to strengthen non-judgmental attitudes and improve descriptive skills, thereby facilitating communication and proactive help-seeking following violent incidents. Such approaches may enhance resilience and promote positive trait coping strategies.
