Third-Party Aggression and Emotion Work Among Nurses: Testing a Moderated Mediation Model

Client aggression is increasingly a stressor in the workplace. This study aims to analyze how and why these experiences may trigger burnout. Focusing on health care workers, we tested a moderated mediation model of the relationship between exposure to third-party (patients and/or relatives) verbal aggression and burnout with the goal of assessing the mediation effects of emotionwork and the moderating effects of personal resources (i.e., perceived self-efficacy in communication with patients) and job resources (job control, role clarity, social support by colleagues and by supervisors) on this relationship. A purposive sample of 356 nurses was recruited from four hospitals in northern Italy. A structured, self-report questionnaire was used to collect data. Mediated and moderated mediation regression models with PROCESS were used to test the hypotheses. As postulated, emotion workmediated the relationship between patient third-party aggression and nurses’ burnout. Role clarity and supervisors’ support were found to reduce the harmful effects of emotion work triggered by third-party aggression. Unexpectedly, perceived self-efficacy in communication did not have a buffering effect in the tested model. These results offer a novel approach to designing preventive actions aimed at cultivating resources to counter the impact of perceived exposure to client aggression on well-being.