| Objectives:To investigate the current situation of empathy fatigue,work engagement and workplace violence among emergency nurses,analyze the influencing factors of workplace violence suffered by emergency nurses,and explore the relationship among work engagement,empathy fatigue and workplace violence of emergency nurses from the perspective of ternary interaction theory.Methods:Part Ⅰ was cross-sectional study.Nurses from emergency departments of 7third-class grade A hospitals in Yunnan province from July to September,2022 were selected as research objects.Utrecht Work Engagement Scale,professional Quality of Life Scale,Workplace psychologically Violent Behaviors Instrument and General Information Questionnaire were used for investigation.Sp SS25.0 software was used to analyze the data.The enumeration data were expressed as frequency and percentage,and the measurement data were expressed as mean and standard deviation.t-test or chi-square test was used to compare the scores of social demographic related variables in workplace violence;Multiple stepwise regression was used to analyze the influence of social demographic variables,empathy fatigue and work engagement on workplace violence.Part Ⅱ was qualitative study.From July to September,2022,13 emergency nurses from the third-class grade A hospitals in Yunnan province were interviewed by semi-structure interview method.Nvivo12.0 was used for qualitative data analysis to deeply understand the influence relationship among empathy fatigue,work engagement and workplace violence of emergency nurses.Results:1.Current situation of workplace violence for emergency nurses: The violence suffered by emergency nurses in the past year from high to low was as follows: verbal violence,physical violence and sexual violence.29.0% of nurses had been abused 2-3times in a year,and 8.4% of nurses had been subjected to physical violence once.Violence mostly occurred in emergency rooms and night shifts;59.6% of the perpetrators were family members of patients.Male perpetrators accounted for78.9%;41.5% of the perpetrators were aged 31-40 years old.50.9% of the reasons for violence were that they fail to meet their unreasonable demands.After violence,more than 60% of nurses still patiently explained,and 43.3% of nurses turned to security guards.After violence,64.3% of nurses felt wronged,and 52.6% of nurses’ work enthusiasm decreased.Nurses didn’t talk to their leaders after suffering violence,and43.5% of the reasons were that they didn’t make a fuss.2.Current situation of empathy fatigue for emergency nurses: The empathy fatigue scores of 214 emergency nurses were 83.50 ± 11.50 points,the highest scores were 31.22 ± 5.34 points,and the lowest scores were 24.59 ± 5.01 points for secondary injury.2.Among the 214 emergency nurses,only 0.5% had no empathy fatigue,57.0% had moderate empathy fatigue,and 35.5% had severe empathy fatigue.3.Current situation of work engagement for emergency nurses: The score of work engagement was 28.66±14.67 points,the highest score of concentration was10.41±5.20 points,and the lowest score of vitality was 9.41±4.83 points.More than70% of nurses in the three dimensions were in a state of high vitality,high dedication and high concentration.4.Influencing factors of emergency nurses suffering from workplace violence:There were statistically significant differences in sympathy fatigue grade,age group,secondary trauma and vitality score(p < 0.05).Those with moderate and severe fatigue suffered more language violence than those with mild fatigue,and those with moderate fatigue suffered more language violence than those with mild fatigue;there were statistically significant differences in gender and job burnout among emergency nurses(p < 0.05).5.The mixed study of workplace violence suffered by emergency nurses from the perspective of ternary interaction theory shows that:5.1 There was a positive correlation between workplace violence and empathy fatigue in emergency nurses.Correlation analysis showed that there was a positive correlation between compassion fatigue and workplace violence(r=0.255,p <0.05).Through qualitative interviews,the theme was obtained: workplace violence aggravated empathy fatigue of nurses,and emergency nurses with severe empathy fatigue were vulnerable to workplace violence.5.2 There was a negative correlation between workplace violence and work engagement of emergency nurses,and there was a mutual influence between them.Cross-sectional survey showed that there was a significant difference in the scores of verbal violence(p < 0.05),and people with high scores of verbal violence suffered less than those with low scores of verbal violence.Correlation analysis showed that workplace violence was negatively correlated with activity(r=-0.156,p <0.05).Qualitative study showed that low work engagement could be considered as unprofessional,and nurses who were inactive in their work were vulnerable to workplace violence.Emergency nurses would have psychological shadow and emotional instability after suffering from workplace violence,which would result in lower work engagement.5.3 The relationship between empathy fatigue and work engagement of emergency nurses depended on the initiative and intensity of work engagement.Cross-sectional investigation showed that empathy fatigue was negatively correlated with the activity dimension of work engagement(r=-0.137,p <0.05).Qualitative research showed that the emergency department had a large workload,needs high input,and high-intensity work input easily resulted in physical fatigue,which will lead to empathy fatigue.Nurses with serious empathy fatigue paid less attention to patients and did not consider patients comprehensively.people who took the initiative to work pursue a sense of accomplishment from their work,which would not lead to empathy fatigue.Conclusions:1.Emergency nurses suffer from serious empathic fatigue,moderate level of work involvement and serious workplace violence.2.From the perspective of ternary interaction theory,workplace violence,empathic fatigue,and job engagement among emergency nurses are correlated.Human emotion,environment and behavior interact with each other and influence each other.Managers and nurses should pay attention to the chain reaction between the three.Emergency nurses should pay attention to their own empathic fatigue.They can relieve empathic fatigue by means of mindfulness-based stress reduction,yoga practice and extensive reading.Find a balance between home and work and be active enough at work to reduce your risk of workplace violence.Managers should arrange shifts reasonably,improve incentive mechanism,improve nurses’ work involvement,reduce nurses’ empathic fatigue,and thus reduce the probability of nurses suffering from workplace violence. |
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