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Background <p>Psychiatric nurses face elevated workplace violence (WPV) risk and high occupational stress globally. This structural equation modeling study examined relationships among work pressure, communication skills, empathy, professional identity, and WPV.</p> Methods <p>Between January and July 2024, 634 nurses from six Grade-A tertiary psychiatric hospitals in Shandong Province, China, completed validated instruments assessing work pressure, communication skills, empathy, professional identity, and WPV. Structural equation modeling with path analysis was used to examine direct and mediating effects.</p> Results <p>WPV was positively associated with work pressure and negatively associated with communication skills, empathy, and professional identity. Work pressure showed direct effects on WPV (β = 0.357, <i>P</i> &lt; 0.001) and indirect effects through empathy (β = 0.091, <i>P</i> &lt; 0.05). Communication skills (β=-0.206, <i>P</i> = 0.010), empathy (β=-0.219, <i>P</i> &lt; 0.001), and professional identity (β=-0.390, <i>P</i> &lt; 0.001) demonstrated significant negative direct effects on WPV. Multiple mediation pathways were identified, including sequential mediation through empathy and professional identity. The structural model demonstrated good fit to the data.</p> Conclusions <p>Work pressure, empathy, communication skills, and professional identity are associated with WPV among psychiatric nurses through both direct and indirect pathways. Healthcare administrators should implement targeted interventions including workplace improvements, psychological support services, stress management programs, and professional identity enhancement to reduce WPV risk and support nursing staff well-being.</p> Clinical trial number <p>Not applicable.</p>

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Work pressure, communication skills, empathy, professional identity, and workplace violence in psychiatric nurses: a structural equation model analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月13日

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  • Zhijiao Zhao,
  • Xiaoning Xu,
  • Li Pang,
  • Jiaqi Min,
  • Lan Wang,
  • Yongfang Wang,
  • Xiumei Hou,
  • Pengfei Liu,
  • Qun Ma,
  • Ruihong Guo,
  • Zhongli Shi

摘要

Background

Psychiatric nurses face elevated workplace violence (WPV) risk and high occupational stress globally. This structural equation modeling study examined relationships among work pressure, communication skills, empathy, professional identity, and WPV.

Methods

Between January and July 2024, 634 nurses from six Grade-A tertiary psychiatric hospitals in Shandong Province, China, completed validated instruments assessing work pressure, communication skills, empathy, professional identity, and WPV. Structural equation modeling with path analysis was used to examine direct and mediating effects.

Results

WPV was positively associated with work pressure and negatively associated with communication skills, empathy, and professional identity. Work pressure showed direct effects on WPV (β = 0.357, P < 0.001) and indirect effects through empathy (β = 0.091, P < 0.05). Communication skills (β=-0.206, P = 0.010), empathy (β=-0.219, P < 0.001), and professional identity (β=-0.390, P < 0.001) demonstrated significant negative direct effects on WPV. Multiple mediation pathways were identified, including sequential mediation through empathy and professional identity. The structural model demonstrated good fit to the data.

Conclusions

Work pressure, empathy, communication skills, and professional identity are associated with WPV among psychiatric nurses through both direct and indirect pathways. Healthcare administrators should implement targeted interventions including workplace improvements, psychological support services, stress management programs, and professional identity enhancement to reduce WPV risk and support nursing staff well-being.

Clinical trial number

Not applicable.