Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Cheol Jeong; Eun Nam Lee

doi:10.7475/KJAN.2018.30.1.41

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Jeong and Lee: Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Original Research

Korean J Adult Nurs 2018;30(1):41-48.

Published online: 18 February 2018

DOI: https://doi.org/10.7475/KJAN.2018.30.1.41

Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Cheol Jeong¹, Eun Nam Lee^2,

^¹Dong-A University Hospital, Busan, Korea

^¹Department of Nursing, Dong-A University, Busan, Korea

Corresponding author: Lee, Eun Nam https://orcid.org/0000-0002-9421-0118 Department of Nursing, Dong-A University, 32 Daesingongwon-ro, Seo-gu, Busan 49201, Korea. Tel: +82-51-240-2864, Fax: +82-51-240-2920, E-mail: enlee@dau.ac.kr

- This article is a revision of the first author's master's thesis from Dong-A University.

Received 28 September 201730 November 2017 Accepted 16 February 2018

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate resiliency and its mediating effect on the association between violence experience and violence response among nurses in intensive care units (ICU) and emergency departments (ED).

Methods

Nurses working in ICU and ED were recruited from five hospitals in Busan city. Data were collected from 1st July to 31st August 2016 using structured questionnaires about violence experiences of nurses in the last three months and nurses’ resilience including Korean Version of the Assault Response Questionnaire (ARQ-K). Data from 195 nurses were analyzed using the SPSS/WIN 21.0 program. Baron & Kenny's 3-step hierarchical regression analysis was used to test the mediating effect of resilience on the relationship between violence experience and violence response.

Results

A positive correlational relationship between nurses’ violence experience and violence response was significant (r=.37, p<.001). Negative correlational relationships were found between nurses’ violence experience and resilience (r=-.19, p=.008) and between resil-ence and violence response (r=-.38, p<.001). This study found a partial mediating effect of resilience on the association between violence experience and violence response (z=2.49, p=.013).

Conclusion

There is a need to develop a variety of intervention programs that can improve resilience in reducing violence response of nurses.

Keywords: Violence, Mediating, Nurses

REFERENCES

1.Gates DM., Gillespie GL., Succop P. Violence against nurses and its impact on stress and productivity. Nursing Economics. 2011. 29(2):59–66.

2.Taylor JL., Rew L. A systematic review of the literature: workplace violence in the emergency department. Journal of Clinical Nursing. 2011. 20(7-8):1072–85. https://doi.org/10.1111/j.1365-2702.2010.03342.x.

3.Hong MJ. A study on nurses' experiences of violence [master's thesis]. Daejeon: Eulji University;. 2009.

4.Hahn S., Müller M., Needham I., Dassen T., Kok G. Factors asso-ciated with patient and visitor violence experienced by nurses in general hospitals in Switzerland: a cross-sectional survey. Journal of Clinical Nursing. 2010. 19(23-24):3535–46. https://doi.org/10.1111/j.1365-2702.2010.03361.x.

5.Early MR., Williams RA. Emergency nurses' experience with violence: does it affect nursing care of battered women? Journal of Emergency Nursing. 2002. 28(3):199–204. https://doi.org/10.1067/men.2002.124991.

6.Hwang YY., Park YR., Park SH. Experience of workplace violence among intensive care unit nurses. Korean Journal of Adult Nursing. 2015. 27(5):548–58. https://doi.org/10.7475/kjan.2015.27.5.548.

7.Park EY., Lee EN. Predictors of violent behavior by patient or caregiver of patient in the emergency department. Korean Journal of Adult Nursing. 2014. 26(5):500–11. https://doi.org/10.7475/kjan.2014.26.5.500.

8.Lenssen MM., McCreery S. Workplace violence in the health-care setting. Nursing Publications. 2012. 225:1–15.

9.Polk LV. Toward a middle-range theory of resilience. Advances in Nursing Science. 1997. 19(3):1–13.

10.Tusaie K., Dyer J. Resilience: a historical review of the construct. Holistic Nursing Practice. 2004. 18(1):3–10.

11.Hsieh HF., Hung YT., Wang HH., Ma SC., Chang SC. Factor of resilience in emergency department nurses who have experienced workplace violence in Taiwan. Journal of Nursing Scholar-ship. 2016. 48(1):23–30. https://doi.org/10.1111/jnu.12177.

12.Zou G., Shen X., Tian X., Liu C., Li G., Kong L, et al. Correlates of psychological distress, burnout, and resilience among Chinese female nurses. Industrial Health. 2016. 54(5):389–95. https://doi.org/10.2486/indhealth.2015-0103.

13.Yun JS. A study of violence experience from patients and their families and job satisfaction of emergency department nurses [master's thesis]. Ulsan: University of Ulsan;. 2004.

14.Shin MY. Violence, burnout and turnover intention of the nurses' in a general hospital. [master's thesis]. Seoul: Hanyang University;. 2011.

15.Lanza ML. Assault response questionnaire. Issues in Mental Health Nursing. 1988. 9(1):17–29. https://doi.org/10.3109/01612848809140907.

16.Jang MJ., Lee EN. Validity and reliability of ARQ-K(Korean Version of the Assault Response Questionnaire) for emergency department nurses in Korea. Journal of Korean Academy of Nursing. 2015. 45(4):544–53. https://doi.org/10.4040/jkan.2015.45.4.544.

17.Park MM., Park JW. Development of resilience scale for nurses. Journal of Korean Academy of Fundamentals of Nursing. 2016. 23(1):32–41. https://doi.org/10.7739/jkafn.2016.23.1.32.

18.Baron RM., Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986. 51(6):1173–82.

19.Chapman R., Perry L., Styles I., Combs S. Consequences of work-place violence directed at nurses. British Journal of Nursing. 2009. 17(20):1256–61. https://doi.org/10.12968/bjon.2008.17.20.45121.

20.Inoue M., Tsukano K., Muraoka M., Kaneko F., Okamura H. Psychological impact of verbal abuse and violence by patients on nurses working in psychiatric departments. Psychiatry and Clinical Neurosciences. 2006. 60(1):29–36. https://doi.org/10.1111/j.1440-1819.2006.01457.x.

21.Park HJ., Kang HS., Kim KH., Kwon HJ. Exposure to workplace violence and coping in intensive care unit nurses. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2011. 20(3):291–301. https://doi.org/10.12934/jkpmhn.2011.20.3.291.

22.Sung MH. Relationship of the experience of violence to burnout and job satisfaction in emergency department nurses. Journal of Korean Clinical Nursing Research. 2008. 14(2):83–92.

23.Son YJ., Gong HH., You MA., Kong SS. Relationships between workplace violence experience and posttraumatic stress symptoms, resilience in clinical nurses. Journal of the Korean Data Analysis Society. 2015. 17(1):515–30.

24.Mealer M., Jones J., Moss M. A qualitative study of resilience and posttraumatic stress disorder in United States ICU nurses. Intensive Care Medicine. 2012. 38(9):1445–51.

25.McDonald G., Jackson D., Wilkes L., Vickers MH. A work-based educational intervention to support the development of per-sonal resilience in nurses and midwives. Nurse Education Today. 2012. 32(4):378–84. https://doi.org/10.1016/j.nedt.2011.04.012.

26.Choi M., Kim M. Development and effects of a resilience training program for nurses. Journal of Korean Academy of Nursing Administration. 2016. 22(4):373–83. https://doi.org/10.11111/jkana.2016.22.4.373.

27.Kamchuchat C., Chongsuvivatwong V., Oncheunjit S., Yip TW., Sangthong R. Workplace violence directed at nursing staff at a general hospital in southern Thailand. Journal of Occupatio-nal Health. 2008. 50(2):201–7. https://doi.org/10.1539/joh.O7001.

28.Choi WJ., Cho SH., Cho NS., Kim GS. Effect of an education program on violence in the emergency department. Journal of the Korean Society of Emergency Medicine. 2005. 16(2):221–8. .S.

Table 1.

Violence Experience, Resilience, and Violence Response according to the Characteristics of Participants (N=195)

Variables	Categories	n (%)	Violence experience		Resilience		Violence response
Variables	Categories	n (%)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)
Gender	Male	7 (3.6)	38.43±9.07	0.25	110.86±18.33	0.86	72.29±14.21	-0.12
Gender	Female	188 (96.4)	37.19±13.16	(.805)	105.93±14.76	(.290)	73.16±19.74	(.907)
Age (year)	20~24 ^a	37 (19.0)	37.49±12.09	0.58	103.84±17.06	1.29	63.46±17.64	4.21
	25~29 ^b	70 (35.9)	38.69±13.76	(.629)	104.44±14.20	(.279)	73.89±17.03	(.007)
	30~34 ^c	39 (20.0)	36.23±11.97		107.92±12.56		75.90±17.29	c, d＞ a^‡
	≥35 ^d	49 (25.1)	35.76±13.54		108.74±15.59		77.16±23.69
Marital status	Single	137 (70.3)	37.71±12.72	0.63	104.97±15.40	-1.60	70.75±17.67	-2.36
Marital status	Married	57 (29.2)	36.42±13.64	(.531)	108.70±13.39	(.112)	78.72±22.76	(.020)
Years of clinical experience	＜5	92 (47.2)	37.23±12.48	-0.01	103.27±15.80	-2.55	68.65±17.91	-3.09
Years of clinical experience	≥5	103 (52.8)	37.23±13.53	(.998)	108.63±13.58	(.012)	77.14±20.14	(.002)
Experience of damage from violence	Yes	60 (30.8)	42.65±12.90	4.03	103.68±15.81	-1.52	79.88±18.47	3.30
Experience of damage from violence	No^†	135 (69.2)	34.82±12.37	(＜.001)	107.18±14.36	(.130)	70.13±19.32	(.001)
Disposition of security guard	Yes	68 (34.9)	44.43±13.53	5.79	104.68±15.10	-0.98	81.53±19.58	4.61
Disposition of security guard	No	127 (65.1)	33.38±10.98	(＜.001)	106.87±14.75	(.328)	68.64±18.05	(＜.001)
Experience of education for violence prevention	Yes	102 (52.3)	35.27±11.80	-2.20	106.75±14.55	0.64	74.28±21.28	0.87
Experience of education for violence prevention	No	93 (47.7)	39.38±13.98	(.029)	105.39±15.26	(.523)	71.87±17.47	(.386)
Necessity of education for violence prevention	Yes	171 (87.7)	37.11±12.83	-0.36	106.55±15.10	1.12	73.39±19.10	0.49
Necessity of education for violence prevention	No	24 (12.3)	38.13±14.53	(.720)	102.92±12.97	(.263)	71.29±22.84	(.623)
Protocol for incidence of violence	Yes ^a	70 (35.9)	34.47±12.68	4.43	110.53±13.77	5.04	71.80±21.00	1.07
	No ^b	24 (12.3)	43.33±14.95	(.013)	103.50±14.32	(.007)	78.46±20.28	(.345)
	Don't know ^c	101 (51.8)	37.69±12.32	b＞ a^‡	103.66±15.15	a＞ b^‡	72.79±18.27

^† Inclusion of a nurse without violence experience;

^‡ Scheffé test.

Table 2.

Violence Experience, Resilience, and Violence Response of Nurses (N=195)

Variables	Categories	n	M± SD	Range	M± SD
Variables	Categories	n	(Summed score)	Range	SD (Item score)
Violence experience	Verbal abuse	7	18.56±7.21	7~35	2.65±1.05
	Physical threat	6	12.02±4.92	6~30	2.02±0.84
	Physical assault	5	6.65±2.71	5~20	1.32±0.53
	Total	18	37.23±13.02	18~90	2.07±0.74
Resilience	Dispositional pattern	5	16.87±2.95	5~25	3.38±0.59
	Relational pattern	4	14.51±2.09	4~20	3.62±0.53
	Situational pattern	10	36.13±5.46	10~50	3.61±0.55
	Philosophical pattern	6	21.10±3.79	6~30	3.51±0.64
	Professional pattern	5	17.50±2.92	5~25	3.50±0.59
	Total	30	106.10±14.87	30~150	3.53±0.53
Violence response	Emotional response	13	42.57±10.99	13~65	3.27±0.86
	Physiological response	10	24.03±8.56	10~50	2.40±0.87
	Social response	3	6.53±2.53	3~15	2.17±0.85
	Total	26	73.13±19.54	26~130	2.81±0.77

Table 3.

Correlations among Violence Experience, Resilience, and Violence Response (N=195)

Variables	Violence experience	Resilience	Violence response
Variables	r (p)	r (p)	r (p)
Violence experience	1
Resilience	-.19 (.008)	1
Violence response	.37 (＜.001)	-.38 (＜.001)	1

Table 4.

Mediating Effects of Resilience on the Association between Violence Experience and Violence Response (N=195)

Step	Independent variables	Dependent variables	B	SE	β	t	p	F (p)
1	Violence experience	Violence response	.43	.11	.29	3.98	＜.001	12.49 (＜.001)
2	Violence experience	Resilience	-.02	.08	-.19	-2.67	.008	7.12 (.008)
3	Violence experience	Violence response	.35	.10	.23	3.47	.001	18.42 (＜.001)
3	Resilience	Violence response	-.47	.08	-.36	-6.03	＜.001	18.42 (＜.001)

Sobel test (Z=2.49, p=.013).

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