The mediating effect of moral distress on workplace violence and compassion fatigue in psychiatric nurses

Abstract

Aims

To examine the associations among compassion fatigue, workplace violence, and moral distress in psychiatric nurses.

Background

The demanding environment of psychiatric departments, characterized by frequent exposure to workplace violence, may contribute to both moral distress and compassion fatigue among nurses. This reciprocal relationship underscores the necessity of interventions targeting both issues concurrently, with the goal of enhancing psychiatric nurses' well-being and retention.

Methods

A convenience sample of 665 psychiatric nurses was recruited from two tertiary psychiatric hospitals in Beijing and Xinxiang City between July and September 2023. Participants completed the Workplace Violence Scale, the Chinese version of the Nurse Moral Distress Scale, and the Chinese version of the Compassion Fatigue Brief Scale. Data were analyzed using SPSS 25.0 for Spearman correlation analysis and Process v3.4 for mediation analysis.

Results

The incidence of workplace violence among psychiatric nurses was 91.9 %. The median (interquartile range) scores for moral distress and compassion fatigue were 45.00 (26.00, 74.00) and 31.00 (18.00, 46.00), respectively. Compassion fatigue was positively correlated with both moral distress and workplace violence (P < 0.05). The mediating effect of moral distress between workplace violence and compassion fatigue was 0.189, representing 20.32 % of the total effect.

Conclusion

Moral distress partially mediates the relationship between workplace violence and compassion fatigue in psychiatric nurses. Hospital administrators should prioritize addressing workplace violence among psychiatric nurses, regularly assess and monitor moral distress, and implement evidence-based interventions informed by positive psychology to mitigate compassion fatigue.