Status quo and influencing factors of posttraumatic growth of nurses exposed to nurse-to-nurse horizontal violence: a cross-sectional multicenter study

Post-Traumatic Growth (PTG) relieves physical and psychological stress symptoms in nurses who exposed to nurse-to-nurse horizontal violence (HV), has great intervention potential to reverse the negative effects of HV events. Therefore, in-depth exploration of the overall characteristics of PTG in HV-exposed nurses and its influencing factors are of great practical significance to provide them with precise psychological adaptive interventions.

This study aims to describe the current state of PTG of HV-exposed nurses and its influencing factors.

The staged cluster sampling method used to recruit nurses. Nurses completed the Chinese version of the nurse-to-nurse Negative Acts Questionnaire (NAQ-R), the Posttraumatic Growth Inventory-Short Form (PTGI-SF), Colquitt’s Organizational Justice Measure (OJM), Inclusive Leadership Scale (ILS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Dysexecutive Questionnaire (DEX) and provided their sociodemographic characteristics. Data were collected between February, 2023 ~ March, 2024, and were analyzed using correlation analysis, t-test, ANOVA, and multivariate linear stepwise regression analyses.

The prevalence of HV within eight tertiary hospitals in Shandong Province amounted to 45.03%. On average, nurses scored 18.30 ± 14.33 in PTGI-SF. There were significant differences in PTGI-SF score according to departments (F = 2.589, p < 0.01), and educational background (F = 4.587, p < 0.01). The results of correlation analysis showed that there was a significant correlation between score in CD-RISC-10 (r = 0.120, p < 0.01), DEX (r=-0.069, p < 0.05), and PTGI-SF. The results of multivariate linear stepwise regression showed that resilience, dysexecutive, educational background, and type of department might be the influencing factors of PTG in HV-exposed nurses (R² = 0.045).

Exposure to HV posed a moderate risk for nurses, while PTG levels among HV-exposed nurses were low to moderate. Overall, the current study suggests that educational background, department type, resilience, and dysexecutive were the main factors influencing PTG in HV-exposed nurses. The study found that resilience had a positive effect on PTG, while dysexecutive had a slight negative effect. Consolidation of resilience and alleviation of dysexecutive, while dialectically looking at educational background and department type, is necessary to improve PTG in HV-exposed nurses.