Workplace Violence Is Associated With Impaired Work Functioning in Nurses: An Italian Cross-Sectional Study

Objective: Workplace violence against nurses is a widespread phenomenon that has been associated with many unfavorable individual and organizational outcomes. The aim of this study was to analyze the relationship between violence and work functioning in a sample of Italian nurses. Design: Cross-sectional, with retrospective analysis of exposure. Methods: All nurses from a local hospital were invited to complete a questionnaire assessing violent experiences that occurred in the previous 12 months. The questionnaire also measured job strain (with the Demand-Control-Support questionnaire), organizational justice (with Colquitt’s Questionnaire), and work impairment (with the Nurses Work Functioning Questionnaire). The associations were examined with logistic regression analyses. Findings: Of the 302 nurses who were invited, 275 (91.1%) agreed to participate. The total work impairment score was significantly higher among the nurses exposed to violence compared with the nonexposed nurses (42.2 ± 27.8 vs. 31.9 ± 31.6, respectively; p <.001). Exposed nurses also reported significantly higher levels of job strain (0.96 ± 0.25 vs. 0.8 ± 0.21; p =.003) and lower levels of perceived organizational justice (56.6 ± 12.6 vs. 62.5 ± 14.8; p =.001) than nonexposed nurses. Nurses who had experienced violence had a significantly higher risk for impairment of work functioning than their colleagues (crude odds ratio [OR] = 2.33; 95% confidence interval [CI 95%] = 1.42–3.83). The association between violence and impairment remained significant after adjusting for demographic variables, occupational stress, and perceived organizational justice (OR = 1.83; 95% CI 95% = 1.06–3.17). Conclusions: Workplace violence is associated with impaired work function in nurses. Job strain and perceived organizational injustice are associated with impairment. Clinical Relevance: Violence prevention programs in healthcare activities should include training for violent behavior identification and de-escalation techniques, structural and administrative measures for violence control (such as alarms, surveillance, staff increase), and measures to reduce occupational stress, which can include wellness courses, spirituality, organizational improvements, and staffing methodologies.