The impact of nurses' experiences of hospital violence on resilience: A mediated moderation model

Abstract

Aims: This study aims to investigate the impact of nurses' experiences of hospital violence on resilience, the mediating effect of trust in patients and the moderating effect of organizational trust.

Background: Despite belonging to the central part of health care worldwide and being the leading provider of medical services, nurses are often subjected to hospital violence, which affects their physical and mental well-being. Trust is a high-order mechanism that encourages positive thinking and personal and professional development. However, research into the impact of trust on resilience concerning nurses' experiences of hospital violence is limited.

Methods: The participants were 2331 nurses working in general hospitals in China. A cross-sectional survey was conducted, and data were collected via questionnaires from July to October 2022 and analysed using SPSS 25.0 and SPSS PROCESS 3.3 macros. This study was prepared and reported according to the STROBE checklist.

Results: Mean trust in patients was 48.00 ± 10.86 (12-60), mean organizational trust was 56.19 ± 8.90 (13-65) and mean resilience was 78.63 ± 19.26 (0-100). Nurses' experience of hospital violence had a direct negative effect on resilience (β = -.096, p = .871), a significant adverse effect on trust in patients (β = -3.022, p < .001) and a significant positive effect on trust in patients on resilience (β = 1.464, p < .001). Trusting patients played a mediating role. The significant moderating effect of organizational trust between experience of hospital violence and trust in patients was moderated by a mediating effect index of -0.1867 (95% CI = [-0.3408, -0.0345]).

Conclusions: Nurses' experience of hospital violence exerted a negative effect on resilience, trust in patients had a fully mediated effect and organizational trust had a significant moderating influence in the pathway from nurses' experience of hospital violence to patients' trust-mediated resilience.

Implications for nursing and health policy: This study highlights the impact of nurses' experiences of hospital violence on resilience and explores the importance of trust from the nurses' perspective. Measures taken by managers to provide nurses with a safe, trusting and positive work environment can be highly beneficial in enhancing nurse resilience.

Keywords: hospital violence; nurse; organizational trust; resilience; trust in patient.