Impact of violence on emotional exhaustion risk of registered nurses in Germany: a Bayesian analysis of cross-Sectional data with multiple imputations.

backgroundMedical workers are at risk of burnout due to various stressors, affecting their health, reducing quality of care, and threatening the retention of a resilient workforce. Among these stressors, workplace violence has emerged as a contributor to an increased risk of burnout among nurses. However, evidence from the German context remains limited. This study investigates the association between the frequency of workplace violence and the risk of the primary dimension of burnout, emotional exhaustion.

methodsThis analysis is based on data from a German survey of registered nurses, measuring burnout risk and experiences of workplace violence. Multiple imputations were applied to missing data. The primary outcome, emotional exhaustion, was assessed with the Maslach Burnout Inventory. Extensive literature searches guided variable selection and prior elicitation for ordinal Bayesian regression. The main independent variables measured self-reported frequencies of physical and verbal violence from different perpetrators.

resultsA total of 4317 RNs responded to the survey. Multiple imputed estimates revealed a high prevalence of frequent verbal (21.6%) and physical (3.8%) violence by patients and their families. High frequency verbal and physical violence perpetrated by staff was reported by 7.8% and 9.7% of respondents, respectively. Bayesian regression analyses across multiple imputed datasets showed a robust association between all types of workplace violence and increased risk of emotional exhaustion.

conclusionRepeated exposure to physical and verbal violence is a major contributor to the risk of burnout in the emotional exhaustion dimension among German RNs. Given its high prevalence, there is an urgent need for reforms and policy measures to prevent violence and address its impact. Updated evidence and targeted interventions are essential to safeguard workers and maintain a resilient nursing workforce. CLINICAL TRIAL NUMBER: Not applicable.