Work-related factors and violence among nursing staff in the European NEXT study : a longitudinal cohort study

Background: The occurrence of workplace violence is rather frequent within the nursing profession, with well-known consequences on the psychological health of victims. Objectives: This study is aimed at assessing the relationships between relevant individual, organizational, and psychosocial factors, and the frequency of several types of workplace violence; the direct as well as the interactive impact of violence and psychosocial factors on organizational commitment and perceived health. Design: Questionnaire-based cross-sectional and longitudinal survey designs were employed for the two study objectives, respectively. Setting: Five hundred and sixty-five healthcare institutions from eight European countries participated in the Nurses' Early Exit Study. Participants: The 34,107 participants were nursing staff holding different qualifications. The response rate was 55.1% in the cross-sectional part and 40.5% in the follow-up phase. At baseline, the respondents were mostly female (89.3%), in the age group 30-44 years (52.9%), registered or specialized nurses (67.0%), working mainly in medico-surgical wards (36.3%), and employed full-time (72.8%). Methods: In the cross-sectional analysis, the relationship between the predictor variables and frequency of violence was assessed by means of a hierarchical multiple linear regression. In the longitudinal analysis, main direct and interactive effects of violence and psychosocial factors on perceived health and organizational commitment were assessed by means of hierarchical multiple linear regression analyses with interaction terms. Results: Higher levels of adverse work-related factors were significantly associated with higher frequency of the distinguished types of violence. Significant interactions were found between psychosocial factors and violence only in predicting organizational commitment, even if effect sizes were very low. No interactions were observed for perceived health. The prevalence of the distinguished types of violence varied across the participating countries according to the presence of adverse work- and non-work-related factors. Conclusions: These findings suggest the necessity of interventions both over working conditions conducive to violence and violent behaviours themselves.