The impact of work environment on workplace violence, burnout, and work attitudes for hospital nurses: A structural equation modeling analysis

AIM: We aimed to test a model examining the direct and indirect effects of the work environment on workplace violence, nurse burnout and work attitudes of Chinese hospital nurses. BACKGROUND: Work environment is a key factor related to nurses' work attitudes. There has been limited information about how the work environment influences nurses' work attitudes. METHOD: This was a cross-sectional study that included 1,517 hospital nurses in 111 medical/surgical units in 23 hospitals from Guangdong province, China. Structural equation modelling was used to test a hypothesized model that supposed work environment has both direct and indirect effects on work attitudes (e.g. job satisfaction and intention to leave) through workplace violence and nurse burnout. RESULTS: Better work environment was related to higher job satisfaction and lower intention to leave both directly and indirectly through two mediators: workplace violence and burnout. Burnout mediated the association of workplace violence with job satisfaction and intention to leave. CONCLUSIONS: Improving work environment would promote nurse safety and subsequently contribute to stabilize the nurse workforce. IMPLICATIONS FOR NURSING MANAGEMENT: To help nurses achieve safety and improved work attitudes, nurse managers should build a positive work environment and help nurses who have experienced workplace violence relieve their burnout.