Relationship between workplace violence and occupational health in emergency nurses: The mediating role of dyssomnia.

Background: Violence in the workplace is a common concern within the health care field, particularly in the high-intensity, high-risk and high-stress environment of the emergency and critical care department. Workplace violence poses significant risks to their physical, psychological and sleep quality. Therefore, it is essential to explore the mechanisms through which workplace violence impacts the occupational health of emergency and critical care nurses.

Aim: To explore how dyssomnia affects the relationship between workplace violence and emergency and critical care nurses' health, as well as to determine the degree of interaction between workplace violence, dyssomnia and somatic symptoms.

Study design: This cross-sectional survey study included 1540 emergency and critical care nurses from 30 tertiary hospitals across 20 provinces and autonomous regions in mainland China, conducted between 26 December 2023 and 18 January 2024. Spearman correlation analysis was employed to evaluate the relationship among workplace violence, sleep disorders and somatic symptoms. A mediated structural equation model analysis was performed utilizing the Latent Moderated Structural Equations (LMS) method. In this manuscript, we adhered to the STROBE checklist.

Results: In total, 85.0% (1309) of emergency and critical care nurses had experienced workplace violence in the preceding year, and 59.3% (913) had developed dyssomnia. Significant path coefficients were found for workplace violence on sleep (β = 0.333, 95% confidence interval = [0.276, 0.388], p < .01), sleep on somatization symptoms (β = 0.572, p < .01) and workplace violence on symptoms (β = 0.307, 95% confidence interval = [0.254, 0.359], p < .01). The mediating effect of dyssomnia between workplace violence and somatization symptoms in emergency and critical care nurses accounted for 38% of the total effect, indicating a significant mediating effect.

Conclusion: Sleep disorders were found to mediate the link between workplace violence and somatic symptoms, suggesting that measures other than sleep-specific interventions are required to reduce the risk of somatization symptoms developing in emergency and critical care nurses. In addition, the conjunction effect of workplace violence and sleep highlighted the benefits of simultaneous and integrated interventions to mitigate health risks for nurses.

Relevance to clinical practice: The study's findings stress the importance of physical and mental health and sleep quality interventions for emergency and critical care nurses, given the strong connection between sleep disorders and workplace violence. Nursing administrators are encouraged to explore interventions such as individual counselling, a reasonable shift system and adequate time off for emergency and critical care nurses to alleviate sleep disorders, ultimately enhancing their overall physical and mental health.