Workplace Violence and Its Effects on Burnout and Secondary Traumatic Stress among Mental Healthcare Nurses in Japan

Abstract

Workplace violence (WPV) in healthcare settings has drawn attention for over 20 years, yet few studies have investigated the association between WPV and psychological consequences. Here, we used a cross-sectional design to investigate (1) the 12-month prevalence of workplace violence (WPV), (2) the characteristics of WPV, and (3) the relationship between WPV and burnout/secondary traumatic stress among 599 mental healthcare nurses (including assistant nurses) from eight hospitals. Over 40% of the respondents had experienced WPV within the past 12 months. A multivariate logistic regression analysis indicated that occupation and burnout were each significantly related to WPV. Secondary traumatic stress was not related to WPV. Our results suggest that WPV may be a long-lasting and/or cumulative stressor rather than a brief, extreme horror experience and may reflect specific characteristics of psychological effects in psychiatric wards. A longitudinal study measuring the severity and frequency of WPV, work-and non-work-related stressors, risk factors, and protective factors is needed, as is the development of a program that helps reduce the psychological burden of mental healthcare nurses due to WPV. healthcare settings occurs in psychiatric departments, emergency services, polyclinics/waiting rooms, and geriatric units [8].According to a review of WPV in psychiatric wards over the past 20 years, studies of WPV have examined mainly its occurrence rate, risk assessment, and risk management; fewer investigations have assessed the physical and psychological consequences of WPV [2]. WPV may cause not only physical injuries but also psychological impacts, resulting in higher rates of fear or anxiety, anger, insecurity, depression, emotional exhaustion, suicidal thoughts, post-traumatic stress symptoms, guilt, self-blame, and shame [2,8]. The consequences of WPV include decreased job satisfaction, increased intent to leave the organization, and lowered health-related quality of life [2].WPV and its consequences among nurses in Japan have been described [10,[16][17][18][19][20]. Of respondents to previous surveys, 33-47% of the nurses had experienced WPV during the prior 12 months [16][17][18]. The proportion of nurses who experienced physical aggression and verbal abuse was significantly high in psychiatric wards [16]. Another study showed that nurses who had encountered verbal abuse or violence by patients in psychiatry departments had experienced severe psychological impacts such as secondary traumatic stress and low satisfaction with family support [10]. The characteristics of WPV itself in Japan have been evaluated, but few studies have examined the psychological effects of WPV in detail.Burnout is defined as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed [21]. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one's job or feelings of negativism or cynicism related to one's job; and reduced pro...

Prevalence of burnout among nurses working at a psychiatric hospital in the Western Cape

“…Konstantinou et al ( 2018 :453) state that male nurses experience more emotional exhaustion and depersonalisation, compared with female nurses. Male gender is a predictor of burnout (Kobayashi et al 2020 :2).…”

“…The mental health care working environment has been identified as a stressful environment to work in (Yoshizawa et al 2016 :3). Stressful working conditions may lead to burnout (Alenezi, McAndrew & Fallon 2019 :1046; Alqahtani, Al-Otaibi & Zafar 2020 :114; Ghavidel et al 2019 :3893; Kobayashi et al 2020 :2; Konstantinou et al 2018 :449; Looff et al 2018 :514). Burnout is defined as a psychological condition that leads to depletion of physical as well as mental energy; it is caused by chronic unresolved work-related stress and ineffective coping strategies (Konstantinou et al 2018 :450); and it is prevalent in occupations that work with humans under challenging situations (O’Connor, Neff & Pitman 2018 :74).…”

“…Burnout has consequences that are potentially very serious for the mental health nurses, MHCUs they care for and the hospitals where the nurses are employed (Kobayashi et al 2020 :2). Burnout could affect the well-being of the mental health nurses negatively (McTiernan & McDonald 2015 :208); it leads to alcohol consumption, impairment of the immunological system, musculoskeletal disorders and depressive disorders (Konstantinou et al 2018 :449), substance abuse (Ghavidel et al 2019 :3894) and suffering from irritability, tiredness, fatigue, headaches, gastrointestinal disorders, anger, exhaustion, insomnia, dyspnea and abnormal weight loss or gain (El-Azzab, Abdel-Aziz & Alam 2019 :737).…”

“…Globally, studies (Alenezi et al 2019 :1046; Ghavidel et al 2019 :3893; Kobayashi et al 2020 :2; Konstantinou et al 2018 :449; Looff et al 2018 :506) have alluded to the escalation of work-related stress, which may lead to burnout among mental health nurses. Mental health nursing is stressful because it is a helping profession that involves close interpersonal working relationships with, as well as providing nursing care to, MHCUs with severe mental illness and complex emotional demands (Lee et al 2015 ).…”

“…Burnout does not only have severe negative impact on mental health nurses but also on the MHCUs they serve and the mental health settings they work in (Kobayashi et al 2020 :2). Anecdotal evidence suggests that the nurses working in the research setting may be experiencing burnout; however, given that a study of this nature has not been conducted in this setting, it is unknown whether this is the case.…”