Relationship between workplace violence and depressive symptoms among emergency department physicians in China: the mediating role of occupational burnout.

Background: Workplace violence (WPV) was a global public health issue worldwide. Given the specificity of emergency department physicians' professional roles, the incidence of WPV was significantly higher than that of practitioners in other healthcare groups. Investigating the association between exposure to WPV and psychological health can provide a scientific basis for managers to implement precise interventions on violent incidents, thereby effectively reducing the adverse impacts of WPV.

Methods: A multi-stage random sampling method was employed to conduct a questionnaire survey among 14 848 emergency department physicians across 31 provincial-level administrative regions in China from July to September 2019. This survey utilised the WPV Scale, the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the Center for Epidemiological Studies Depression Scale (CES-D) to investigate the levels of WPV, burnout, and depressive symptoms among respondents. Data analysis were performed using STATA 17.0 and Amos 26.0 software.

Results: A total of 90.40% of emergency department physicians reported experiencing at least one incident of WPV in the past year. The mean score for depressive symptoms was 16.80 ± 14.78, and the mean score for burnout was 82.94 ± 26.11. The correlation coefficients between WPV and depressive symptoms, WPV and job burnout, and depressive symptoms and job burnout were 0.444, 0.347, and 0.562, respectively (all P < 0.01). Structural equation analysis indicated that the total effect of WPV on depressive symptoms was 0.471, with a mediating effect of burnout at 0.421, accounting for 89.38% of the total effect.

Conclusions: Emergency department physicians had a severe level of depressive symptoms and burnout, with burnout playing a mediating role between WPV and depressive symptoms. Therefore, future policy efforts are warranted to build a supportive work environment for emergency department physicians and consequently enhance their well-being.