Workplace Violence and Burnout Among Health Workers Two Years After the COVID-19 Outbreak in Wuhan, China: The Chain Mediation Effect of Sleep Disturbance and Work Ability

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2024 Sep 28

PMID 39337244

Authors

Fuyuan Wang

Min Zhang

Nian Xiong

Yiming Huang

Yuting Tang

Chuning He

Xinxin Fang

Xi Fang

Lan Chen

Qing Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Health workers (HWs) faced considerable psychosocial hazards during the COVID-19 pandemic, which profoundly affected their occupational health and job performance. The potential indirect relationship between workplace violence (WPV) and burnout among HWs needs to be further explored. The purpose of this study is to examine the chain mediating effects of sleep disturbance and work ability in the relationship between WPV and burnout among HWs.

Methods: A cross-sectional study was conducted in a secondary hospital two years after the COVID-19 outbreak in Wuhan, China. A sample of 571 HWs was recruited using a cluster sampling method, achieving a response rate of 80.06%. Participants completed self-report questionnaires that included demographic information and measures of WPV, burnout, sleep disturbance, and work ability.

Results: The prevalence rates of burnout and WPV among HWs two years after the COVID-19 outbreak were 37.30% and 31.52%, respectively. WPV was significantly associated with burnout (β = 0.446, < 0.001). Sleep disturbance was identified as a mediator in the relationship between WPV and burnout (β = 0.063, 95% CI: 0.027-0.105), accounting for 14.13% of the total effect. Similarly, work ability also played a mediating role in this relationship (β = 0.142, 95% CI: 0.065-0.225), accounting for 31.84%. Additionally, both sleep disturbance and work ability exhibited a chain mediation effect on the association between WPV and burnout (β = 0.020, 95% CI: 0.008-0.036), and the total indirect effect accounted for 50.67%.

Conclusions: Among Chinese HWs, WPV exerts significant direct and indirect effects on burnout symptoms, mediated by sleep disturbance and work ability. This finding provides valuable empirical insights for designing interventions to mitigate the adverse effects of psychosocial factors such as WPV and burnout among HWs. After exposure to WPV, measures focused on reducing sleep disturbance and enhancing work ability may prove effective in alleviating burnout in subsequent interventions.

Citing Articles

Work Reward Moderates the Association Between Work Effect and Workplace Violence Among Medical Staff in China.

Zhao Y, Zhang A, Zhang W, Sun L J Multidiscip Healthc. 2024; 17:5763-5774.

PMID: 39655295 PMC: 11626205. DOI: 10.2147/JMDH.S495514.

References

Sottimano I, Guidetti G, Converso D, Viotti S . We cannot be "forever young," but our children are: A multilevel intervention to sustain nursery school teachers' resources and well-being during their long work life cycle. PLoS One. 2018; 13(11):e0206627. PMC: 6211713. DOI: 10.1371/journal.pone.0206627. View

West C, Dyrbye L, Sloan J, Shanafelt T . Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009; 24(12):1318-21. PMC: 2787943. DOI: 10.1007/s11606-009-1129-z. View

Matta M, Gupta S, Alfonso J, Carrero M, Agahari I, Sabouret P . Prevalence and patterns of gender disparity in workplace violence among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Public Health. 2024; 235:76-83. DOI: 10.1016/j.puhe.2024.06.037. View

Dyrbye L, Awad K, Fiscus L, Sinsky C, Shanafelt T . Estimating the Attributable Cost of Physician Burnout in the United States. Ann Intern Med. 2019; 171(8):600-601. DOI: 10.7326/L19-0522. View

Fei Y, Yang S, Zhu Z, Lv M, Yin Y, Zuo M . Workplace violence and burnout among Chinese nurses during the COVID-19 pandemic: does the sense of coherence mediate the relationship?. BMC Psychiatry. 2023; 23(1):573. PMC: 10408152. DOI: 10.1186/s12888-023-05060-9. View

Moss M, Good V, Gozal D, Kleinpell R, Sessler C . A Critical Care Societies Collaborative Statement: Burnout Syndrome in Critical Care Health-care Professionals. A Call for Action. Am J Respir Crit Care Med. 2016; 194(1):106-13. DOI: 10.1164/rccm.201604-0708ST. View

Ferri P, Silvestri M, Artoni C, Di Lorenzo R . Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study. Psychol Res Behav Manag. 2016; 9:263-275. PMC: 5042196. DOI: 10.2147/PRBM.S114870. View

Thornton J . Violence against health workers rises during COVID-19. Lancet. 2022; 400(10349):348. PMC: 9333996. DOI: 10.1016/S0140-6736(22)01420-9. View

Nikolic D, Visnjic A . Mobbing and Violence at Work as Hidden Stressors and Work Ability Among Emergency Medical Doctors in Serbia. Medicina (Kaunas). 2020; 56(1). PMC: 7022686. DOI: 10.3390/medicina56010031. View

10.

Chowdhury S, Kabir H, Chowdhury M, Hossain A . Workplace Bullying and Violence on Burnout Among Bangladeshi Registered Nurses: A Survey Following a Year of the COVID-19 Pandemic. Int J Public Health. 2022; 67:1604769. PMC: 9618602. DOI: 10.3389/ijph.2022.1604769. View

11.

Li Q, Jing W, Wei Z, Wang Y, Sun L . Associations Between Workplace Violence and Mental Health Among Chinese Health Technicians: A Moderated Mediation Analysis of Sleep Quality and Physical Activity. Psychol Res Behav Manag. 2023; 16:2045-2057. PMC: 10252941. DOI: 10.2147/PRBM.S411098. View

12.

Zhang S, Zhao Z, Zhang H, Zhu Y, Xi Z, Xiang K . Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Environ Sci Pollut Res Int. 2023; 30(30):74838-74852. PMC: 10199297. DOI: 10.1007/s11356-023-27317-2. View

13.

Tan X, Cedernaes J, Forsberg L, Schioth H, Benedict C . Self-reported sleep disturbances and prostate cancer morbidity and mortality in Swedish men: A longitudinal study over 40 years. J Sleep Res. 2018; 27(6):e12708. DOI: 10.1111/jsr.12708. View

14.

Kabir T, Tan A, Koh F, Chew M . Burnout and professional fulfilment among surgeons during the COVID-19 pandemic. Br J Surg. 2021; 108(1):e3-e5. PMC: 7799337. DOI: 10.1093/bjs/znaa001. View

15.

Chang A, Kim A . Verbal violence and turnover intention among new nurses in Korea: A time-lagged survey. J Nurs Manag. 2022; 30(6):1823-1830. DOI: 10.1111/jonm.13756. View

16.

Devi S . COVID-19 exacerbates violence against health workers. Lancet. 2020; 396(10252):658. PMC: 7470723. DOI: 10.1016/S0140-6736(20)31858-4. View

17.

Zhou J, Yang Y, Qiu X, Yang X, Pan H, Ban B . Serial multiple mediation of organizational commitment and job burnout in the relationship between psychological capital and anxiety in Chinese female nurses: A cross-sectional questionnaire survey. Int J Nurs Stud. 2018; 83:75-82. DOI: 10.1016/j.ijnurstu.2018.03.016. View

18.

Liu Y, Zou L, Yan S, Zhang P, Zhang J, Wen J . Burnout and post-traumatic stress disorder symptoms among medical staff two years after the COVID-19 pandemic in Wuhan, China: Social support and resilience as mediators. J Affect Disord. 2022; 321:126-133. PMC: 9585849. DOI: 10.1016/j.jad.2022.10.027. View

19.

West C, Dyrbye L, Shanafelt T . Physician burnout: contributors, consequences and solutions. J Intern Med. 2018; 283(6):516-529. DOI: 10.1111/joim.12752. View

20.

Gibbs A, Jewkes R, Willan S, Mamun M, Parvin K, Yu M . Workplace violence in Bangladesh's garment industry. Soc Sci Med. 2019; 235:112383. DOI: 10.1016/j.socscimed.2019.112383. View