The impact of work environment on workplace violence, burnout and work attitudes for hospital nurses: A structural equation modelling analysis

Aim We aimed to test a model examining the direct and indirect effects of the work environment on workplace violence, nurse burnout and work attitudes of Chinese hospital nurses. Background Work environment is a key factor related to nurses' work attitudes. There has been limited information about how the work environment influences nurses' work attitudes. Method This was a cross-sectional study that included 1,517 hospital nurses in 111 medical/surgical units in 23 hospitals from Guangdong province, China. Structural equation modelling was used to test a hypothesized model that supposed work environment has both direct and indirect effects on work attitudes (e.g. job satisfaction and intention to leave) through workplace violence and nurse burnout. Results Better work environment was related to higher job satisfaction and lower intention to leave both directly and indirectly through two mediators: workplace violence and burnout. Burnout mediated the association of workplace violence with job satisfaction and intention to leave. Conclusions Improving work environment would promote nurse safety and subsequently contribute to stabilize the nurse workforce. Implications for nursing management To help nurses achieve safety and improved work attitudes, nurse managers should build a positive work environment and help nurses who have experienced workplace violence relieve their burnout.