Evidence map›Paper›PMID 41425663›Full record

ArticleDepression and anxiety2025

Interrelationships of Anxiety, Burnout, Depression, and Insomnia Among Chinese Healthcare Workers Exposed to Workplace Violence: A Network Analysis.

Huixue Xu, Zejun Li, Xin Wang, Min Wu, Tieqiao Liu, Qiuxia Wu

Abstract read
In one paragraph

Article in Depression and anxiety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Huixue XuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China, csu.edu.cn.ORCID 0009-0002-6442-2950
Zejun LiDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China, csu.edu.cn.ORCID 0009-0001-1394-5818
Xin WangDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China, csu.edu.cn.ORCID 0009-0000-9643-1638
Min WuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China, csu.edu.cn.ORCID 0009-0002-9861-0204
Tieqiao LiuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China, csu.edu.cn.ORCID 0000-0002-7730-2248
Qiuxia WuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China, csu.edu.cn.ORCID 0000-0003-3043-5841

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Workplace violence (WPV) against healthcare workers (HCWs) is a global public health concern. In China, HCWs face similar challenges; however, the impacts of WPV exposure on their mental health and occupational functioning remain unclear. This study aims to investigate the symptom network of anxiety, burnout, depression, and insomnia (ABDI) and adverse outcomes in Chinese HCWs exposed to WPV. From November 2023 to June 2024, 3361 HCWs with confirmed experiences of WPV were recruited across China through snowball sampling. WPV and ABDI were assessed using the Workplace Violence Scale, Generalized Anxiety Disorder Scale-7 (GAD-7), Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI), respectively. Data on adverse personal outcomes (low quality of life [QOL] and suicidal ideation [SI]) and occupational outcomes (turnover intention [TI]) were collected. We constructed and visualized networks, calculating strength and bridge strength (BS) indices to identify central and bridge symptoms. In the ABDI network of WPV-exposed HCWs, exhaustion (EX) emerged as the most central and bridge symptom. Uncontrollable worry (GAD2) and difficulty staying asleep (ISI2) were also central symptoms, while fatigue (PHQ4) and restlessness (GAD5) were identified as secondary bridge symptoms. Disengagement (DEM) strongly predicted TI; EX and sleep dissatisfaction (ISI4) predicted low QOL; and SI was most strongly linked to worthless (PHQ6), motor disturbance (PHQ8), and feeling afraid (GAD7). This study highlights that EX may serve as a priority target for preventing and intervening in psychological distress among WPV-exposed HCWs, as well as for improving their QOL. Burnout extends beyond workplace-related issues and is broadly associated with mental health problems and adverse outcomes. Implementing early detection and intervention measures is crucial for preventing and alleviating adverse effects in HCWs exposed to WPV.

Indexed as

AnxietyBurnout, ProfessionalDepressionHealth PersonnelSleep Initiation and Maintenance DisordersWorkplace ViolenceAdultChinaFemaleHumansMaleMiddle AgedQuality of LifeSuicidal Ideationadverse outcomesburnoutmental distressnetwork analysisworkplace violence

Identifiers

PMID41425663
PMCPMC12714119

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.