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Health policy
Research
Impact of workplace violence and compassionate behaviour in hospitals on stress, sleep quality and subjective health status among Chinese nurses: a cross-sectional survey
  1. Shu-E Zhang1,
  2. Wenhui Liu2,
  3. Jinghui Wang2,
  4. Yu Shi2,
  5. Fengzhe Xie2,
  6. Shuang Cang3,
  7. Tao Sun2,
  8. Lihua Fan2
  1. 1 Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
  2. 2 Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
  3. 3 Department of Medical Examination Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
  1. Correspondence to Professor Tao Sun; hydsuntao{at}126.com and Professor Lihua Fan; lihuafan{at}126.com

Abstract

Objectives The aim of this study is to describe the current state of workplace violence (WPV) and compassionate behaviour towards nurses and to explain how they affect nurses’ stress, sleep quality and subjective health status.

Design A cross-sectional online survey study.

Setting The survey was conducted across eight provinces in China.

Participants A total of 1024 nurses were recruited to complete an online questionnaire survey from February to May 2016 in China.

Results Approximately 75.4% participants had experienced some form of violence. Most of the participants experienced WPV such as verbal violence (65.2%), made difficulties (54.5%), tarnished reputation (37.5%), mob behaviour (34.9%), intimidation behaviour (18.8%), physical violence (14.6%) and sexual harassment (5.9%). In this study, 92.4% participants experienced compassionate behaviour from their coworkers (84.9%), supervisors (67.3%), and from their patients (65.3%). The results show that the exposure to WPV behaviour significantly affected the psychological stress (β=0.295, p<0.01), sleep quality (β=−0.198, p<0.01) and subjective health status (β=−0.252, p<0.01) of nurses. The exposure to compassionate behaviour significantly affected the psychological stress (β=−0.229, p<0.01), sleep quality (β=0.326, p<0.01) and subjective health status (β=0.342, p<0.01) of nurses. The results of the mediation analysis showed that psychological stress is a partial mediator in the relationship between violence and sleep quality (β=−0.458, p<0.01) and between violence and subjective health (β=−0.425, p<0.01). Moreover, psychological stress also partially mediated the relationship between compassionate behaviour and sleep quality (β=−0.473, p<0.01), and between compassionate behaviour and subjective health (β=−0.405, p<0.01).

Conclusion In China, most nurses have experienced different forms of WPV from patients and/or their relatives, as well as experiencing various forms of compassionate behaviour from their coworkers, supervisors and/or patients. This study investigates the prevalence of the different types of WPV and compassionate behaviour. Several aspects of harm to nurses from exposure to violence is confirmed. We found that WPV can damage nurses’ health outcomes, while compassionate behaviours were beneficial to their health outcomes. A harmonious nursing environment should be provided to minimise threats to nurses’ health status.

  • workplace violence
  • Chinese nurses
  • sleeping quality
  • subjective health atatus
  • compassion

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2017-019373

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    Footnotes

    • S-EZ and WL contributed equally.

    • Contributors Conceived and designed the experiments: LF, TS, WL and S-EZ. Performed the experiments: S-EZ, WL, JW, YS and FX. Analysed the data: TS, WL and S-EZ. Contributed reagents/materials/analysis tools: WL, S-EZ and SC. Wrote the paper: S-EZ, WL and TS.

    • Funding This study was funded by the Innovation Science Research Foundation of Harbin Medical University (2016RWZX09) to TS and also was funded by the Natural Science Foundation of China (71473063) to LF.

    • Patient consent Parental/guardian consent obtained.

    • Ethics approval The research described in the present article meets the ethical guidelines of the ethics committee of the College of Public Health, Harbin Medical University, and the project has been approved by the Ethics Committee of the Harbin Medical University (ECHMU).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.