Investigating the association between patient verbal aggression and emotional exhaustion among Italian health care professionals during the COVID-19 pandemic

J Nurs Manag. 2022 Sep;30(6):1713-1723. doi: 10.1111/jonm.13578. Epub 2022 Mar 16.

Abstract

Aims: To analyze whether patient verbal aggression would be related to emotional exhaustion and whether this relationship would be mediated by work-family conflict and moderated by dehumanization and resilience.

Background: Although patient verbal aggression has been identified as one of the most experienced forms of aggression, its effects on Italian health care providers during the pandemic are still poorly known.

Methods: A total of 197 Italian health care professionals completed paper-and-pencil questionnaires. Descriptive statistics and moderated mediation analyses were performed.

Results: Patient verbal aggression was positively related to health care professionals' emotional exhaustion, both directly and indirectly, as mediated by work-family conflict. Health care providers were more likely to become emotionally exhausted when they had low resilience and, simultaneously, tended to ascribe patients non-uniquely human traits.

Conclusions: Patient verbal aggression may spill over onto health care professionals' family lives. Dehumanization represents an ineffective coping strategy that exacerbates the effects of aggression on work-family conflict, whereas resilience represents a protective resource against emotional exhaustion.

Implications for nursing management: Hospital organisations could benefit from providing their staff with stress management interventions, aggression management, psychological support and psychological resilience training programmes. These programmes should incorporate coping skills on establishing work-home boundaries and balancing empathy with cognitive problem-solving abilities.

Keywords: COVID-19; dehumanization; emotional exhaustion; patient aggression; resilience.

MeSH terms

  • Aggression / psychology
  • COVID-19*
  • Emotions
  • Health Personnel / psychology
  • Humans
  • Pandemics