Fear of future violence at work and job burnout: A diary study on the role of psychological violence and job control

Workplace violence and depressive symptoms: the mediating role of fear of future workplace violence and burnout among Chinese nurses

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

Daily experiences of non-psychiatric nurses in acute psychiatric wards

AIM

To explore and describe the daily experiences of non-psychiatric nurses working in selected acute psychiatric wards in South Africa.

DESIGN

A qualitative explorative and descriptive study design was used.

METHODS

Individual face-to-face semi-structured interviews were used to gather data from fifteen non-psychiatric nurses with a minimum of one month of experience working in acute psychiatric wards in Limpopo Province, South Africa. Data were analysed using eight Tech techniques. The study is reported following consolidation criteria for reporting qualitative research.

RESULTS

Findings on non-psychiatric nurses' daily experience revealed three themes: (1) Unsafe working environment, (2) Managing difficulties due to lack of skills and (3) Strategies to support non-psychiatric nurses in acute psychiatric wards. Findings suggested institutional and managerial interventions in the form of orientation, in-service training and workshops and resource provision. Future studies should be done to develop a model for supporting non-psychiatric nurses in Limpopo Province, South Africa's acute psychiatric wards.

Impact of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region: propensity score matching analysis

BACKGROUND

Owing to different social background factor in Yunnan-Myanmar Chinese border region, stressful working environment may lead to extra psychological burden among nurse staff in China. However, the prevalence of workplace violence and its effect on psychological characteristics among nurse staff are still unclear. This study aims to explore the effect of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region.

METHODS

A cross-sectional survey was conducted among 18 local governmental hospitals in Dehong districts. Participants were 1,774 nurses. Psychosocial characteristics were screened by sleep quality, the 9-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, the Connor Davidson Resilience Scale - 10 item for resilience, the multidimensional scale of perceived social support for social support, the Chinese version of Work place Violence Scale for workplace violence. Propensity score matching and multivariate linear regression were applied to analyze the data.

RESULTS

The nurse staff with workplace violence have a higher risk of bad sleep quality (b = -0.883, 95%CI = [-1.171, -0.595]), anxiety symptoms (b = 2.531, 95%CI = [2.031, 3.031]) and depressive symptoms (b = 3.227, 95%CI = [2.635, 3.819]), loneliness (b = 0.683, 95%CI = [0.503, 0.863]), perceived cognitive deficits (b = 1.629, 95%CI = [1.131, 2.127]), poor resilience (b = -2.012, 95%CI = [-2.963, -1.061]), and poor social support (b = -5.659, 95%CI = [-7.307, -4.011]).

CONCLUSIONS

Preventing workplace violence can improve mental health outcomes significantly among nurse staff, including loneliness, perceived cognitive deficits, anxiety symptoms, depressive symptoms, sleep quality, resilience and social support.

Emotional responses in archival work

Building on previous work investigating the impact of exposure to (a) records with traumatic potentialities and (b) interactions with donors and community researchers whose suffering is documented in the archives, this study sought to better understand emotional aspects of archival work. Using a diary research methodology, 15 archivists engaged in diary keeping for approximately four months. What emerged was a broad set of events and experiences that triggered a wide range of emotional responses arising from archival work. This included: pre-existing emotional states and characterological traits; emotional exchanges in the workplace with colleagues and others; emotional demands of the work (including emotion work and emotional labour); team and leader interactions arising from group tasks and leader behaviour; and organizational policies, climate, resources and demands. This broader set of interactional factors forms the foundation on which traumatic and other troubling events are encountered. Future research must consider the nature of archival organizations and interactions within them that contribute to the overall working experience. In addition, archival organizations need to take responsibility for creating a culture that demonstrates respect and appreciation for workers, acknowledges the interpersonal challenges of the work, and provides supports for archivists who are shouldering the challenges.

The association between fear of future workplace violence and depressive symptoms among nurses based on different experiences of workplace violence: a cross-sectional study

BACKGROUND

Fear of future workplace violence (FFWV) has a negative impact on individuals' health. However, no study has investigated the association between FFWV and depressive symptoms. Nurses with different experiences of workplace violence may have different levels of FFWV and differences in mental health. This study explored the association between FFWV and depressive symptoms among Chinese nurses with different experiences of workplace violence.

METHODS

A cross-sectional study was conducted involving 1888 Chinese nurses from 12 tertiary hospitals in Shandong Province. The Fear of Future Violence at Work scale was used to measure FFWV. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression scale. Multiple logistic regression analysis was used to examine the association between FFWV and depressive symptoms.

RESULTS

The prevalence of depressive symptoms was 45.9% (no aggression group: 24.3%; non-physical violence group: 46.1%; physical violence group: 63.7%), and 72.8% of nurses had high levels of fear of future workplace violence (no aggression group: 60.2%; non-physical violence group: 75.6%; physical violence group: 70.8%). Compared with low levels of FFWV, high levels of FFWV were associated with more depressive symptoms among nurses in the no aggression group (odds ratio [OR] = 3.269, 95% confidence interval [CI]: 1.102-9.695) and in the non-physical violence group (OR = 2.338, 95% CI: 1.385-3.945).

CONCLUSION

Nurses who had experienced physical violence had the most depressive symptoms and nurses with experience of non-physical violence had the greatest FFWV. Our findings suggested that there was a significant association between FFWV and depressive symptoms among Chinese nurses in the no aggression and non-physical violence groups. Hospital administrators need to address FFWV needs when developing strategies to reduce depressive symptoms among nurses.

How Daily Obstacles Affect Frontline Healthcare Professionals' Mental Health during Omicron: A Daily Diary Study of Handwashing Behavior

Based on coping theory, the current research examines how and why COVID-19 phobia affects frontline healthcare professionals' mental health, as well as their burnout and work-related stress. We focused on the mediating role of burnout and work-related stress in this study. In the current study, we also examined the moderating influence of healthcare professionals' handwashing behavior using the Hayes Process model. We employed a daily diary approach to collect data from respondents in Pakistan's frontline healthcare professionals (n = 79, 79 × 10 = 790) who were directly treating COVID-19 patients during the omicron wave. According to the findings of the study, COVID-19 phobia significantly disturbs healthcare professionals' mental health, as well as significantly strengthens burnout and work-related stress. The findings also demonstrated that burnout significantly negatively influences mental health. The mediation influence of burnout and work-related stress in the association between COVID-19 phobia and mental health has shown to be significant. The moderation analysis revealed that high handwashing behavior significantly buffers the negative impact of COVID-19 phobia, as well as the adverse effect of burnout on healthcare professionals' mental health. Moreover, our findings have theoretical and managerial implications, as well as new research directions for scholars to understand the adverse impact of daily obstacles on professionals' (nurses and doctors, etc.) mental health and work performance, as well as issues based on resource conversation philosophy.

Assessment of Non-physical User Violence and Burnout in Primary Health Care Professionals. The Modulating Role of Job Satisfaction

Introduction

Growing concern about workplace violence shows the need for an evaluation in specific contexts in order to identify the particularities of each professional group. The health sector consists of a group of professionals with high exposure to violence, specially from users. There are differences depending on the professional category or unit in which the professional works. In this regard, Primary Health Care (PHC) is characterized by a personalized and continuous patient treatment over time, which is not exempt from cases of violence. Among the commonly studied consequences of these situations are decreases in job satisfaction and burnout.

Objective

The main objective of this study is to analyze the modulating role of job satisfaction in the relationship between non-physical user violence and the onset of burnout.

Methods

Cross-sectional comparative descriptive design. The sample consisted of 574 professionals from 39 PHC centers of the Murcian Health Service. Data were collected using two-stage cluster sampling. For data analysis, descriptive analysis, correlations and stepwise hierarchical regression were used to analyze the interaction between the variables.

Results

Regression analysis draws a model where non-physical violence and low intrinsic and extrinsic job satisfaction act as modulators of non-physical violence, cynicism and emotional exhaustion.

Conclusions

This study provides evidence of the psychological consequences of the perception of user violence in the PHC staff. Furthermore, it is evident that the emergence of burnout syndrome in these professionals is related to exposure to verbal or non-physical violence together with low job satisfaction. In this sense, a circular and bidirectional relationship between the variables studied is proposed as a possible explanatory model.

Burnout syndrome and workplace violence among nursing staff: a cross-sectional study

BACKGROUND

Among healthcare professionals, nursing workers are the most prone to becoming victims of workplace violence and present the highest burnout levels.

OBJECTIVES

To investigate the association between burnout syndrome and workplace violence among nursing workers.

DESIGN AND SETTING

Cross-sectional study carried out at a teaching hospital in southern Brazil.

METHODS

This study involved 242 nursing workers. We collected data over a six-month period using a sociodemographic and occupational survey, the Survey Questionnaire Workplace Violence in the Health Sector and the Maslach Burnout Inventory - General Survey. For occupational violence, we selected the Survey Questionnaire Workplace Violence in the Health Sector. Burnout syndrome was evaluated using the Maslach Burnout Inventory - General Survey. The data were analyzed in the Statistical Package for the Social Sciences (SPSS). Categorical variables were described as absolute and relative frequencies and numerical variables in terms of central trend and dispersion measurements. For data analysis, we applied descriptive statistics and multiple logistic regression.

RESULTS

The multiple models indicated that the workers who had experienced verbal abuse, physical violence and concern about workplace violence over the past 12 months had significantly higher chances of presenting high emotional exhaustion (P < 0.05) and depersonalization (P < 0.05) and low professional accomplishment (P < 0.05).

CONCLUSION

Occurrence of violence significantly increased the chances of great emotional exhaustion and depersonalization and low professional achievement, within burnout syndrome. Therefore, workplace violence prevention strategies need to be put in place to provide workers with a safe workplace in which to conduct their activities.

The role of fear in the relationship between vicarious violence at work and work ability in nurses: a cross-sectional study

Fear is a powerful emotion that can influence future behavior. This study investigates how fear influences the relationship between vicarious violence at work and employees' work ability. This is a quantitative cross-sectional study. Self-report data were collected from 154 Portuguese nurses who completed an online survey. Statistical significance of the indirect effect was based on bias-corrected bootstrap confidence intervals. The results support the mediation model. Those who observe/hear of others being beaten or threatened experience strong affective reactions, such as fear, which in turn has a negative impact on the assessment of their work ability. We suggest that occupational safety and health programs designed to prevent violence at work take into account those who experience violence at work vicariously and include strategies and interventions focused on affective reactions to minimize the negative effects of vicarious violence at work, with benefits in employees' improved ability to work.

The association between fear of future workplace violence and burnout among nurses in China: A cross-sectional study

BACKGROUND

Fear of future workplace violence has adverse effects on nurses' health outcomes. However, the association between fear of future workplace violence and burnout among nurses in China remains unknown.

METHODS

Enrolled in the study were 1897 nurses from 12 tertiary hospitals of Shandong Province, China. Fear of future workplace violence was measured using the Fear of Future Violence at Work scale. Burnout was measured using the 15-item Maslach Burnout Service Inventory. Ordinal logistic regression analysis was used to examine the association between fear of future workplace violence and burnout.

RESULTS

The prevalence of high emotional exhaustion, high cynicism, and low personal accomplishment was 26.7%, 38.1%, and 35.6%, respectively, while 72.9% of participants had high levels of fear of future workplace violence. Among nurses, compared with high levels of fear of future workplace violence, low levels of fear were associated with a lower degree of emotional exhaustion, cynicism, and personal accomplishment; and medium levels of fear were associated with a lower degree of emotional exhaustion, cynicism, and a higher degree of personal accomplishment.

LIMITATIONS

This was a cross-sectional study, which could not establish the causal relationship between fear of future workplace violence and burnout.

CONCLUSION

There was a significant association between fear of future workplace violence and burnout among nurses. Fear of future workplace violence should be regarded as important issue for hospital administrators and healthcare policy makers when taking measures to ameliorate nurses' burnout.

Associations Between Workplace Violence, Mental Health, and Physical Health among Korean Workers: The Fifth Korean Working Conditions Survey

BACKGROUND

Workplace violence (WPV) is a global public health problem and a threat to the health of Korean workers. This study assessed the prevalence and risk factors of WPV and its association with mental and physical health among Korean workers.

METHODS

Data obtained for 50,205 respondents to the Fifth Korean Working Conditions Survey were utilized for this study. Verbal abuse, threats, physical violence, and sexual harassment were assessed individually and as a composite for "any WPV." Workers were characterized by education, income, shift work status, access to a health and safety education program, work sector and overall health. Descriptive analyses and multiple logistic regression analyses were used to estimate the prevalence of WPV and its association with mental and physical health.

FINDINGS

Overall, 5.6% of workers reported experiencing one of four forms of WPV. The prevalence of verbal abuse, threats, physical violence, and sexual harassment were 4.9%, 0.7%, 0.2%, and 1.1%, respectively. Most perpetrators were customers. Prevalence of WPV was associated with lower education level, poor health status, long working hours, shift work, and no experience of health and safety education; 9.0% of service workers experienced violence. Workers who had experienced WPV were more likely to experience anxiety, sleep-related problems, depressive symptoms, back pain, headache/eye strain, and overall fatigue.

CONCLUSIONS/APPLICATIONS TO PRACTICE

Workplace violence is a serious occupational and public health concern in Korea. These results suggest managing WPV may improve workers' well-being and that violence-prevention strategies, policies, and regulations should be implemented across most industries.

Fear of future workplace violence and its influencing factors among nurses in Shandong, China: a cross-sectional study

BACKGROUND

Fear of workplace violence has become a critical issue worldwide, which can lead to burnout, low levels of job satisfaction, and turnover. However, to date, little attention has been directed toward fear of workplace violence among nurses. Accordingly, this study investigated the level of fear of future workplace violence and its influencing factors among nurses in Shandong, China.

METHODS

A cross-sectional study was conducted from July 30 through September 30, 2020 in Shandong Province, China. A total of 1898 nurses were enrolled from 12 tertiary hospitals. Fear of future workplace violence was measured using the Fear of Future Violence at Work scale. Demographic information, employment characteristics, social support, and experience of workplace violence were assessed. Multiple linear regression analysis was used to explore the influencing factors of fear of future workplace violence.

RESULTS

The average score of fear of future violence at work was 67.43 ± 17.20 among nurses. Multiple linear regression analysis showed that higher fear of future violence at work scores were reported among nurses who were female (B = 7.10, p < 0.001), married (B = 3.50, p = 0.028), with a monthly income ≥5000 Chinese yuan (CNY) (B = 3.14, p = 0.007), working in the department of internal medicine (B = 2.90, p = 0.032), surgery (B = 5.03, p < 0.001), pediatrics (B = 5.38, p = 0.003), or emergency department (B = 4.50, p = 0.010), working as a contract employee (B = 2.41, p = 0.042), or who had experienced workplace violence (B = 7.02, p < 0.001). Lower fear of future violence at work scores were found among nurses who took vacations (1-14 days: B = - 2.52, p = 0.047; ≥15 days: B = - 3.69, p = 0.007) and had a high-level of social support (B = - 2.03, p = 0.020).

CONCLUSIONS

There was a high level of fear of future workplace violence among nurses in Shandong, China. This should be considered an important issue by hospital administrators and government officials. Effective interventions need to be enacted to address the influencing factors of fear of future workplace violence.

Within- and between-person factor structure of the Oldenburg Burnout Inventory: Analysis of a diary study using multilevel confirmatory factor analysis

The study examined the factor structure of burnout, as measured with the Oldenburg Burnout Inventory. The participants were 235 employees of a public administration agency who assessed their burnout online for 10 consecutive working days. Two models were tested with multilevel confirmatory factor analysis, assuming the same one or two-factor structure at the within- and between-person levels. Both models showed a reasonable fit to the data, but due to a strong correlation between exhaustion and disengagement and low within-person reliability for disengagement, a unidimensional model seems more valid. A cross-level invariance was not confirmed for either of the structures, showing that factor loadings for the same items differ significantly between the levels. This suggests that burnout is not the same latent variable at each level; rather, there are factors other than daily burnout that influence person-level scores and ignoring these across-level discrepancies may lead to biased conclusions.

Cross-sectional and longitudinal relationships between psychological violence and teacher burnout

OBJECTIVE

This study aimed to identify cross-sectional and longitudinal relationships between psychological violence (PV) and burnout after two years of follow-up.

METHODS

This is a longitudinal study involving 430 public school teachers from a city in southern Brazil. PV was defined as insults by students, humiliation or embarrassment by colleagues or superiors or threats by any member of the school. Burnout was measured using the emotional exhaustion (EE) and depersonalization (DP) subscales of the Maslach Burnout Inventory-Human Services Survey. Analyses were performed using structural equation models in R.

RESULTS

Younger age (β = - .167) and poor/fair relationship with students (β = .275) had a direct effect on PV. Temporary employment (β = - .111) and poor/fair perception of the number of students in the classroom (β = .124) had a direct effect on EE. Cross-sectionally, PV showed a direct effect at both T0 and T1 on EE (T0: β = .435; T1: β = .334) and on DP (T0: β = .332; T1: β = .325). Longitudinally, PV at T0 did not have a significant direct effect on burnout at T1. However, indirect effects of PV on EE (β = .459) and DP (β = .428) at T1 were observed.

CONCLUSIONS

The effect of PV on burnout occurs in a short period of time. However, the long-term effect should be considered because there is a cumulative burden of exposure to violence over time.

Doctors and Nurses: A Systematic Review of the Risk and Protective Factors in Workplace Violence and Burnout

The present study aims analyze the risk factors that lead to high levels of burnout among nurses and physicians and the protective factors that prevent them. Thus, it is also intended to explore the possible correlation between physical and verbal violence produced at work and the symptoms derived from burnout. Methods: The search was carried out on the Scopus, PubMed and Web of Science databases between 2000 and 2019 (on which date the bibliographic search ends). Descriptive studies estimating the prevalence of workplace violence and risk and protective factors and burnout were included. An adapted version of the Downs and Black quality checklist was used for article selection. 89.6 percent of the studies analysed were in the health sector. There is a significant correlation between burnout symptoms and physical violence at work. On the one hand, the risk factors that moderate this correlation were of structural/organisational type (social support, quality of the working environment, authoritarian leadership, little autonomy or long working days, etc.) and personal type (age, gender, nationality or academic degree, etc.). On the other hand, protective factors were the quality of the working environment, mutual support networks or coping strategies. The results were analysed in-depth and intervention strategies were proposed.

Daily Work-Family Conflict and Burnout to Explain the Leaving Intentions and Vitality Levels of Healthcare Workers: Interactive Effects Using an Experience-Sampling Method

There is an intensification of work in global health systems, a phenomenon that could increase work-family conflict, exhaustion, and intentions to leave among healthcare workers. The main objective of this study is to analyze if daily work-family conflict and burnout could explain the daily leaving intentions and vitality of healthcare workers. This is a diary study, which employs an experience-sampling methodology (ESM). A total of 56 physicians, nurses, and nursing aides from intensive care and nephrology units filled out various quantitative scales during 5 working days (56 × 5 = 280 observations). Multilevel hierarchical analysis showed that daily work-family conflict and burnout were significantly associated with higher daily intentions of leaving the profession, and with lower levels of daily vitality. In addition, those workers who experienced more work-family conflict and depersonalization on a daily basis were those who showed more intentions to leave and less daily vitality, showing an interactive effect. The results highlight the importance of examining the psychosocial risks experienced by healthcare workers by employing experience-sampling methodologies, which could help us to deepen our understanding of the proximal antecedents of their intentions to leave and their psychological well-being.

Psychosocial factors and Burnout Syndrome among mental health professionals

Objective:

to identify biopsychosocial factors at work associated with the Burnout Syndrome in mental health professionals.

Method:

a cross-sectional study with a quantitative approach conducted with a sample of 293 mental health service workers from the public network of a municipality in the inland of the state of São Paulo, Brazil. An instrument composed of three self-administered questionnaires was applied, namely: biosocial data form, the Job Stress Scale (JSS) and the Maslach Burnout Inventory (MBI- HSS). The data were analyzed through the application of the Chi-squared and logistic regression tests, with the adoption of a 5% significance level.

Results:

Burnout Syndrome prevalence was 7% with a predominance of nursing professionals and was associated with the work sector, the use of psychotropic drugs, low satisfaction with the manager and with the low control over the work activity. Among the professionals with Burnout Syndrome, twelve performed functions considered of high wear, six performed passive work and two were in low wear activity.

Conclusion:

low control was the main psychosocial factor at work associated with Burnout Syndrome, making it necessary to develop actions that promote worker autonomy and improve the management of stress-triggering psychosocial factors.

Burnout as a State: Random-Intercept Cross-Lagged Relationship Between Exhaustion and Disengagement in a 10-Day Study

Background

Burnout has been traditionally seen as a chronic and stable state in response to prolonged stress. However, measures of momentary burnout are not well established, even though the within-person approach suggests that the symptoms of burnout may vary from day to day for the same employee. The aim of this study is to examine the daily inter- and intra-personal variability of the symptoms of burnout and the cross-lagged relationship between two components of burnout, exhaustion and disengagement.

Methods

An online diary study over 10 consecutive workdays was conducted among 235 civil servants (75% women, average tenure of 15 years). Daily burnout was measured with the eight-item Oldenburg Burnout Inventory.

Results

The intra-class correlation coefficients indicate that, although significant between-person variability exists, most of the burnout variance is within persons. Using the random intercept cross-lagged panel (RI-CLP) model to control for these between-person differences, mainly insignificant “pure” within-person cross-lagged relationships between exhaustion and disengagement were revealed. Moreover, day-to-day autoregressive effects were weaker than same-day residual correlations.

Conclusion

This is one of the first studies to use daily diaries and the RI-CLP model to study burnout, including the separation of the more stable and more dynamic parts of each component. When stable parts were controlled for, the same-day relationships between exhaustion and disengagement were more pronounced than day-to-day effects. This might suggest stronger situational influences than carryover mechanism. Thus, conceptualizing burnout in terms of daily symptoms may shed promising insights into how it develops and add implications for pro-healthy changes in the workplace.

Cross-sectional study of aggression against Spanish nursing personnel and effects on somatisation of physical symptoms

INTRODUCTION

Violence against nursing personnel in their place of work is a severe problem generating important consequences for these workers. Even though there is a large body of research on the subject, the emotional impact of aggression against healthcare workers continues to be debated.

OBJECTIVES

The objective of this quantitative, observational cross-sectional study was to analyse the effects of aggression against nursing personnel and the mediating role of anxiety in somaticising physical symptoms.

METHOD

The sample was made up of 1357 nursing professionals who answered questionnaires evaluating their sensitivity to anxiety and the presence of somatic symptoms.

RESULTS

Of the professionals who indicated that they had been the victims of aggression by family members or patients in the previous year, 52.8% said it had happened to them on one occasion, 25.2% had experienced two episodes, while 6.9% and 15.1% said they had undergone three or more aggressions, respectively. Although 89.3% of the professionals affected by acts of indicated that they had not undergone physical or psychological consequences, there was a higher prevalence of somatic alteration among workers who had been victims of violence in the workplace. Furthermore, aggression at work had a direct effect on physical somatisation, which in turn acted as a mediator in the level of anxiety of nursing professionals. Thus, aggression increased the level of anxiety of nurses through the appearance of somatic symptoms.

CONCLUSIONS

The results are discussed based on some of the consequences that appeared after episodes of aggression in the healthcare sector and their relationship.

Burnout and Emotional Well-Being among Nephrology Fellows: A National Online Survey

BACKGROUND

Physician burnout and emotional distress are associated with work dissatisfaction and provision of suboptimal patient care. Little is known about burnout among nephrology fellows.

METHODS

Validated items on burnout, depressive symptoms, and well being were included in the American Society of Nephrology annual survey emailed to US nephrology fellows in May to June 2018. Burnout was defined as an affirmative response to two single-item questions of experiencing emotional exhaustion or depersonalization.

RESULTS

Responses from 347 of 808 eligible first- and second-year adult nephrology fellows were examined (response rate=42.9%). Most fellows were aged 30-34 years (56.8%), male (62.0%), married or partnered (72.6%), international medical graduates (62.5%), and pursuing a clinical nephrology fellowship (87.0%). Emotional exhaustion and depersonalization were reported by 28.0% and 14.4% of the fellows, respectively, with an overall burnout prevalence of 30.0%. Most fellows indicated having strong program leadership (75.2%), positive work-life balance (69.2%), presence of social support (89.3%), and career satisfaction (73.2%); 44.7% reported a disruptive work environment and 35.4% reported depressive symptoms. Multivariable logistic regression revealed a statistically significant association between female gender (odds ratio [OR], 1.90; 95% confidence interval [95% CI], 1.09 to 3.32), poor work-life balance (OR, 3.97; 95% CI, 2.22 to 7.07), or a disruptive work environment (OR, 2.63; 95% CI, 1.48 to 4.66) and burnout.

CONCLUSIONS

About one third of US nephrology fellows surveyed reported experiencing burnout and depressive symptoms. Further exploration of burnout-especially that reported by female physicians, as well as burnout associated with poor work-life balance or a disruptive work environment-is warranted to develop targeted efforts that may enhance the educational experience and emotional well being of nephrology fellows.

Effect of Workplace Violence on Turnover Intention: The Mediating Roles of Job Control, Psychological Demands, and Social Support

Exposing nursing staff to workplace violence workplace violence (WV) affects their psychological, emotional, and physical health; engenders increased workload; affects the medical reciprocity between nurses and patients; and ultimately leads to staff turnover intention. To preventing WV, development of intervention strategies and WV prevention measures are crucial. This study discusses the mediating effect of job control, psychological needs, and social support on WV and turnover intention. Through this discussion, this study aims to aid medical institutions in reducing their nursing staff turnover rate and to provide a reference for hospital management and decision making. A cross-sectional research method was adopted and conducted quantitative research to prove the complexity of the relationship between WV and turnover intention. Participants comprised clinical nurses working in 2 regional teaching hospital in central Taiwan. A total of 268 questionnaires were distributed, and 213 completed questionnaires were returned. Of the returned questionnaires, 198 contained valid responses, yielding a response rate of 73.9%. Our results demonstrated the mechanisms through which psychological demands and social support mediate the relationship between WV and turnover intention. This study determined the mediating effects of psychological demands and social support. The results expand the findings of previous research and demonstrate the complexity of the relationship between WV and turnover intention. Hospitals should formulate effective mechanisms for preventing and addressing incidents of WV, improve their ability to address and regulate violent incidents in clinics, reduce the psychological pressure exerted on employees, and establish communication channels for social support.