Burned out and ready to leave? How workplace violence drives turnover among Chinese nurses and the role of well-being HRM.

IF 2.6 3区 医学 Q3 HEALTH POLICY & SERVICES
Health Care Management Review Pub Date : 2026-10-01 Epub Date: 2026-08-24 DOI:10.1097/HMR.0000000000000499
Timothy Bartram, Patricia Pariona-Cabrera, Qinyan Gong, Xiaoyan Liang, Di Fan, Jessica Borg, Hannah Meacham, Tse Leng Tam, Shea Fan, Jillian Cavanagh, Justine Ferrer, Peter Holland
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Abstract

Background: Workplace violence is a growing phenomenon in health care settings, which negatively impacts nurses' physical and mental well-being and intention to leave. Understanding the forces that shape nurses' intention to leave is therefore fundamental to safeguarding the quality of patient care, patient safety, and system sustainability, a critical and central concern for health care management.

Purpose: Against a backdrop of workplace violence, high workloads, and chronic nurse burnout, we test the mediating role of burnout on the relationship between workplace violence and intention to leave. We also test the buffering role of well-being human resource management (WBHRM) on the relationship between burnout and intention to leave, so that higher levels of WBHRM will mitigate the positive relationship between burnout and intention to leave.

Methodology/approach: We test these hypotheses using the conservation of resources (COR) theory and a three-wave matched sample of 179 nurses working in a large Chinese health service.

Findings: We confirm one of our two hypotheses. We report that nurse burnout positively mediates the relationship between workplace violence and intention to leave. However, interestingly, we find that WBHRM does not buffer the relationship between nurse burnout and intention to leave but actually exacerbates this relationship.

Practical implications: We discuss the health care management implications of our findings and suggest various possible explanations for WBHRM exacerbating the relationship between burnout and intention to leave. We suggest that health care managers need to understand WBHRM within its wider social context, the proactive use of HRM practices to prevent violence and burnout before significant personal resource loss, and the need for structural changes in hospital settings to tackle systemic workforce challenges such as high workloads and work intensification.

精疲力竭,准备离开?职场暴力如何驱动中国护士的离职以及幸福感人力资源管理的作用。
背景:工作场所暴力是卫生保健机构中日益严重的现象,对护士的身心健康和离职意愿产生负面影响。因此,了解影响护士离职意向的因素对于保障患者护理质量、患者安全和系统可持续性至关重要,这是医疗保健管理的关键和核心问题。目的:在工作场所暴力、高工作量和慢性护士职业倦怠的背景下,检验职业倦怠在工作场所暴力与离职意向之间的中介作用。我们还检验了幸福感人力资源管理(WBHRM)在职业倦怠和离职意向之间的缓冲作用,表明幸福感人力资源管理水平的提高会缓解职业倦怠和离职意向之间的正相关关系。方法/方法:我们使用资源保护(COR)理论和在中国一家大型卫生服务机构工作的179名护士的三波匹配样本来检验这些假设。研究结果:我们证实了两个假设中的一个。我们报告护士职业倦怠正向中介工作场所暴力与离职意图之间的关系。然而,有趣的是,我们发现WBHRM并没有缓冲护士倦怠和离职意愿之间的关系,反而加剧了这种关系。实际意义:我们讨论了我们的研究结果对医疗保健管理的意义,并提出了各种可能的解释WBHRM加剧了倦怠和离职意图之间的关系。我们建议,卫生保健管理人员需要在更广泛的社会背景下理解WBHRM,在重大个人资源损失之前主动使用人力资源管理实践以防止暴力和倦怠,以及医院环境中需要进行结构性改革以解决高工作量和工作强度等系统性劳动力挑战。
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来源期刊
Health Care Management Review
Health Care Management Review HEALTH POLICY & SERVICES-
CiteScore
4.70
自引率
8.00%
发文量
48
期刊介绍: Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.
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