A Study On The Mechanism Of Occurrence Of Attribution Bias Of Workplace Violence Among Nurses Based On Three-dimensional Attribution Theory

ObjectiveBased on the three-dimensional attribution theory,the covariant information(consistency information,consistency information,differentiation information)of the attribution bias of Workplace Violence(WPV)was analyzed.On this basis,a structural equation model of WPV attribution bias for nurses was constructed to explore the occurrence mechanism of WPV attribution bias for nurses,providing a basis for building targeted WPV education courses for nurses and reducing the incidence of WPV for nurses.MethodsThis research is divided into two parts:1.Qualitative study of covariate information of nurses’ WPV attribution biasUsing the three-dimensional attribution theory as a guide,we developed an interview outline and selected nurses who had experienced WPV in the past year at the First Affiliated Hospital of Soochow University as the study population;firstly,we used convenience sampling to conduct a survey on the "Intrinsic,Other,and Environmental Attribution Style Questionnaire" for this group of nurses to screen out nurses with WPV attribution bias;secondly,using purposive sampling,a total of 30 nurses who experienced WPV with attribution bias behavior in the same violent incident,witnesses to the incident,and managers who handled the incident were selected for a descriptive qualitative study to understand the nurses’ WPV attribution bias covariate information.2.Study of the mechanism of occurrence of attributional bias in nurses’ WPVBased on the literature review and the results of the first part of the study,a survey instrument for nurses’ WPV attribution bias was determined after discussion and integration by the group;Convenience sampling was used to conduct a cross-sectional survey of 857 inservice clinical nurses who had experienced WPV in the past year from June to November 2022 in various medical institutions in Suzhou.By exploring the interaction between various variables,a structural equation model was constructed to analyze the mechanism of WPV attribution bias among nurses.Results1.Covariate information of nurses’ WPV attribution biasBased on the three-dimensional attribution theory,interviews were conducted around the nurse WPV experiencer,the event witness,and the manager who handled the event.The covariate information of nurse WPV attribution bias consisted of three themes and ten subthemes,namely consistency information(years of work,educational background,personality traits),consistency information(department,shift,social support,history of violence exposure),and differentiation information(psychological resilience,burnout,empathy).2.Mechanisms of the occurrence of WPV attribution bias in nurses2.1 General information of nursesA total of 857 nurses were included,including 46 males and 811 females.38.6%of the survey respondents were aged<30 years,42.2%were aged 30-39 years,15.4%were aged 40-49 years,and 3.7%were aged ≥50 years;their working years ranged from 1-39 years,with an average of(11.49±8.28)years.2.2 Current status of nurses’ WPV attribution bias scoresThe score of WPV attribution bias among nurses was(3.04±6.42).2.3 Multiple linear regressionPsychological resilience,perceived social support,burnout personal fulfillment reduction dimension,and empathy were the influencing factors of WPV attribution bias among nurses(P<0.05).2.4 Correlation analysisThere was a negative correlation(P<0.05)between nurses’ WPV attribution bias and empathy(r=-0.577),perceived social support(r=-0.510),psychological resilience(r=-0.468),and reduced personal fulfillment(r=-0.413),and a positive correlation(P<0.05)between emotional exhaustion(r=0.312)and depersonalization(r=0.325).2.5 Structural equation modelingThe structural equation model for the occurrence mechanism of attributional bias in nurses’ WPV was constructed with perceived social support as an exogenous latent variable and psychological resilience and empathy as endogenous latent variables,and the model was revised and the final revised model fitted well with χ2=182.261,χ2/df=6.075,RMSEA=0.077,GFI=0.960,AGFI=0.927,and NFI=0.962,RFI=0.943,IFI=0.968,TLI=0.952,CFI=0.960.The mechanisms by which nurse WPV attribution bias occurred were that empathy directly and negatively influenced nurse WPV attribution bias(β=-0.679,P<0.001);perceived social support can directly negatively affect nurses’ WPV attribution bias(β=0.143,P=0.006),and can indirectly affect nurses’ WPV attribution bias through two paths.One is indirectly affect nurses’ WPV attribution bias through positive influence on empathy,and its indirect effect value is-0.227.The other is to indirectly affect nurses’ WPV attribution bias by positively affecting psychological resilience,which positively affects empathy,and its indirect effect value is-0.164,the sum of indirect effects was-0.391.ConclusionsNurses have higher levels of workplace violence attribution bias,nurses’ empathy and perceived social support can directly and negatively influence nurses’ WPV attribution bias,and perceived social support can also indirectly and negatively influence nurses’ WPV attribution bias through the variables of psychological resilience and empathy.The nurse WPV education and training curriculum should take the attribution bias phenomenon into account and construct a targeted training curriculum around its occurrence mechanism to provide a reference to help nurses make reasonable attributions and reduce the incidence of nurse WPV.