Psychological depletion in physicians and nurses exposed to workplace violence: a cross-sectional study using propensity score analysis

Abstract Background Workplace safety is a key issue in health care. However, workplace violence represents a serious threat to workplace safety and has become a global public health problem. Workplace violence may also lead to the psychological depletion of healthcare workers. Previous studies, although cross-sectional, did not use methods such as propensity score matching to assess the potential causality of workplace violence on mental health. Objectives To investigate the effects of workplace violence on depression and anxiety symptoms by propensity score matching, and to explore the prevalence of depression and anxiety symptoms in physicians and nurses. Design A cross-sectional study. Settings and participants A cross-sectional survey was conducted among 3,000 physicians and nurses in 15 public hospitals in Heilongjiang and Beijing provinces using a purposive sampling method. Methods Individual baseline characteristics and outcomes were compared across workplace violence and non-workplace violence groups using Pearson's Chi-squared tests for categorical variables and Mann-Whitney U tests for all non-parametric continuous variables. Propensity score matching was used to compare depression and anxiety symptoms in physicians and nurses who had experienced workplace violence with the symptoms of those who had not. Binary logistic regression analysis was used to analyse the associated factors of depression and anxiety symptoms. Results A total of 2,637 participants were involved in this study: 1,264 (47.9%) were assigned to the exposed group, and 1,373 (52.1%) to the non-exposed group. The prevalence of workplace violence among physicians and nurses in the past year was 47.9% (1,264/2,637). Before matching, the prevalence of depression and anxiety symptoms in physicians and nurses was 58.8% and 39.7%, respectively. Participants who experienced physical and non-physical violence were more likely to suffer from depression symptoms (odds ratios 1.999, 95% confidence interval: 1.497 to 2.670), and anxiety symptoms (odds ratios 1.999, 95% confidence interval: 1.497 to 2.670) than those who had not. Participants’ age, education levels, and occupation types were common influencing factors of depression and anxiety symptoms. The results also showed that nurses are more likely to suffer from anxiety and depression symptoms than physicians. Conclusions It is necessary to develop effective control strategies at the individual, hospital and national levels to protect health care workers from workplace violence. When healthcare workers experience workplace violence, it is important to pay attention to their emotional reactions and to provide them with support in order to avoid adverse impacts on mental health. Further practices and research initiatives to examine the longitudinal relation among workplace violence, anxiety, and depression are recommended.