Latent Profile Analysis Of Intra-organizational Workplace Psychological Violence Among Nurses And Their Relationship With Psychosomatic Health

ObjectivesIntra-organizational workplace psychological violence(referred to as Intraorganizational psychological violence)is common among nurses and it seriously endangers nurses’ psychosomatic health.However,the current researches on nurses suffering from Intra-organizational psychological violence were mostly analyzed based on a variable-centered method from group-level which ignored the heterogeneity of participants.Therefore,this study aimed to identify latent classes of Intraorganizational psychological violence among nurses through a person-centered statistical approach,and to explore the relationship between the different latent classes of Intra-organizational psychological violence among nurses and their anxiety symptoms,depression symptoms and somatic sub-health symptoms.MethodsWe selected eligible nurses from 4 tertiary hospitals in 4 cities of Shandong Province through a multi-stage stratified cluster random sampling method from October to December in 2020.We conducted an online questionnaire survey through the electronic questionnaire platform "Wenjuanxing",and 1954 valid questionnaires were recovered.This is a cross-sectional research.The measuring tools include general information questionnaires(sociological demographic characteristics such as gender,education level,marital status,age,etc;work-related characteristics such as job titles,monthly night shifts,etc),Generalized Anxiety Disorder 7-item scale,Patients’ Health Questionnaire Depression Scale-9 item,Somatic Complaints of Subhealth Status Questionnaire,Workplace Psychologically Violent Behaviors Instrument.Latent Profile Analysis(LPA)was used to identify the latent classes of Intra-organizational psychological violence among nurses through Mplus7.4,its model fitting indicators include Akaike information criteria,Bootstrap likelihood ratio test,Bayesian information criteria,Lo-Mendell Rubin likelihood,Entropy.Other statistical methods include descriptive analysis,variance analysis,chi-square test,Kruskal-Wallis nonparametric test,binary logistic regression,etc.Results1.The total score of Intra-organizational psychological violence among nurses was 14(41),the score of "isolated from work" dimension was 7(18),the score of "attack on professional status" dimension was 4(16),the score of "attack on personality"dimension was 0(6),and the score of "direct negative behavior" dimension was 0(4).Among the 1954 nurses,31.3%(n=611)suffered Intra-organizational psychological violence.2.Through LPA,the research subjects in terms of Intra-organizational psychological violence was divided into 4 latent classes:"suffering low violence group"accounted for 65.6%;"isolated from work/attack on professional status group"accounted for 17.0%;"suffering moderate violence group" accounted for 8.4%;"suffering severe violence group" accounted for 9.0%.3.The anxiety symptoms score among nurses was(5.22±4.64),its prevalence was 14.2%;the depression symptoms score was(6.33±5.50),its prevalence was 19.4%;the somatic sub-health symptoms score was(23.19±4.40),its prevalence was 10.59%.4.The results of variance analysis showed that nurses who suffered different latent classes of Intra-organizational psychological violence were statistically significantly different in age(F=5.841,P=0.001),fatigue score(F=73.670,P<0.001),sleep problem score(F=69.119,P<0.001),gastrointestinal discomfort score(F= 17.144,P<0.001),pain score(F=98.305,P<0.001).5.The chi-square test results showed that nurses who suffered different latent classes of Intra-organizational psychological violence were statistically significantly different in gender(χ2=14.519,P=0.002),working years(χ2=32.195,P<0.001),the number of night shifts per month(χ2=26.114,P=0.002),anxiety symptoms(χ2=200.621,P<0.001),depression symptoms(χ2=239.026,P<0.001).6.The binary logistic regression analysis results showed that after controlling for age,professional title,number of night shifts per month,and working years,taking"suffering low violence group" for reference,the risk of positive anxiety symptoms,depression symptoms and somatic sub-health symptoms was 7.945(OR=7.945,95%CI:5.049-11.671),7.667(OR=7.667,95%CI:5.386-10.914)and 10.137(OR=10.137,95%CI:6.777-15.914)times higher for "suffering severe violence group" nurses than for "suffering low violence group" nurses;the risk of positive anxiety symptoms,depression symptoms and somatic subhealth symptoms was 6.494(OR=6.494,95%CI:4.340-11.671),6.234(OR=6.234,95%CI:4.236-8.983)and 5.514(OR=5.514,95%CI:3.524-8.630)times higher for "suffering moderate violence group" nurses than for"suffering low violence group" nurses;the risk of positive anxiety symptoms,depression symptoms and somatic sub-health symptoms was 4.086(OR=4.086,95%CI:2.900-5.755),3.637(OR=3.637,95%CI:2.689-4.920)and 2.971(OR=2.971,95%CI:1.980-4.458)times higher for "isolated from work/attack on professional status group" nurses than for "suffering low violence group" nurses.Conclusionsl.The prevalence of Intra-organizational psychological violence among nurses in tertiary hospitals is high.2.The prevalence of anxiety symptoms,depression symptoms and somatic subhealth symptoms of nurses in tertiary hospitals are high.3.The nurses suffered Intra-organizational psychological violence in tertiary hospitals could be divided into 4 types:"suffering low violence group","isolated from work/attack on professional status group","suffering moderate violence group" and"suffering severe violence group".Moreover,with the highest proportion of "suffering low violence group" nurses and the lowest proportion of "suffering moderate violence group".4.Compared with "suffering low violence group","suffering severe violence group" are most likely to develop psychosomatic health symptoms(anxiety symptoms,depression symptoms,and somatic sub-health symptoms),followed by "suffering moderate violence group",and "isolated from work/attack on professional status group"are the lower.