The Effect Of Horizontal Violence On Turnover Intention Of Nurses Based On Stress Coping Theory

ObjectiveThe purpose of this study is to investigate the current situation of horizontal violence and turnover intention among nurses,and analyze the influencing factors of turnover intention of nurses.Based on the stress coping theory,the model of the influence process of nurses’ horizontal violence on turnover intention was constructed and verified.Methods1.Through literature review,a model of horizontal violence and turnover intention of nurses was constructed based on stress coping theory.2.To understand the prevalence of horizontal violence and turnover intention among nurses through cross-sectional survey.Volunteers were recruited from The First Affiliated Hospital of Soochow University for investigation.SPSS 21.0 and AMOS 24.0 were used to analyze the data and verify the hypothesis model.Through the model fitting index,the feasibility of the hypothesis model explaining the process of turnover intention caused by horizontal violence of nurses was judged.According to the fitting index and path coefficient,the model was revised,and formed a well-fitting model finally.Results1.Current situation and related factors of horizontal violence in nursesAmong 1225 nurses,66.29%of them had suffered horizontal violence in the past six months,and 48.57%of them had suffered both external violence and internal violence.Among the manifestations of horizontal violence suffered by nurses,the top five with the highest prevalence were LV13(opinions and views were ignored),LV1(blocking news),LV5(spreading rumors and gossip),LV3(being forced to do things beyond their ability),LV2(to humiliate or ridicule).2.Current situation and influencing factors of nurses’ turnover intentionA total of 1225 nurses were investigated.The res±ults showed that the total average score of turnover intention of nurses was(2.35±0.63),and the turnover intention of nurses was generally at a high level.The comparison of each dimension showed that the score of turnover intention III was the highest,followed by turnover intention II,and the lowest score was turnover intention I.Multiple factor analysis showed that horizontal violence,employment form,perceived threat of horizontal violence,organizational atmosphere,department,weekly working hours and level of nurses were the main influencing factors of nurses’ turnover intention(P<0.05).3.Correlation between variables.Pearson correlation analysis showed that horizontal violence was positively correlated with turnover intention(r=0.347,P<0.01&r=0.296,P<0.01).The correlation analysis of each dimension of horizontal violence and horizontal violence threat perception showed that external violence and internal violence were positively correlated with threat and stakes perceived by nurses(P<0.01),and internal violence was negatively correlated with challenge(r=-0.058,P<0.05).In the correlation analysis of each dimension of horizontal violence and coping style,horizontal violence was negatively correlated with integration,concession and escape(P<0.01),and had no correlation with dominance.The correlation analysis between horizontal violence of treating and coping style showed that challenge was positively correlated with integration(r=0.121,P<0.01),not correlated with concession(r=0.012,P>0.05),negatively correlated with dominance and escape(P<0.01),and negatively correlated with threat and interest with coping style(P<0.05).Psychological resilience was negatively correlated with each dimension of turnover intention(P<0.01),and negatively correlated with each dimension of horizontal violence(P<0.01).Organizational climate was negatively correlated with each dimension of turnover intention(P<0.01),and negatively correlated with each dimension of horizontal violence(P<0.01).4.Model fitting results of nurses’ horizontal violence on turnover intention.The initial fit of the model was poor,and one path was found to be not statistically significant in the initial path,so it was eliminated.According to the correction index(MI)and the path coefficient,the structural equation statistical analysis was performed for each path change.After the model is modified,the final fitting result is as follows:Chi-square specific degrees of freedom(X2/df)=2.936,root mean square error of approximation(RMSEA)=0.049,comparative fit index(CFI)=0.977,Tucker-Lewis index(TLI)=0.970,normative fit index(NFI)=0.966.The simplified goodness of fit index(PNFI)was 0.753,and the standardized root mean square residual(SRMR)was 0.042.The result of model adjustment was reasonable.The final modified model confirmed that horizontal violence and turnover intention,horizontal violence and coping style were direct paths,organizational climate played a complete mediating role between coping style and turnover intention,and horizontal violence threat perception,psychological resilience,and organizational climate played a partial mediating role between horizontal violence and turnover intention.Conclusion1.Current situation of horizontal violence.Through cross-sectional investigation and research,the prevalence of horizontal violence in nurses is still at a high level.The main forms of horizontal violence are internal violence.2.Current situation of turnover intentionThrough cross-sectional survey and research,the nurses’ turnover intention is generally at a high level.In the comparison of the scores of each dimension,the score of turnover intention III is the highest and the score of turnover intention I is the lowest.The analysis of the influencing factors of nurses’ turnover intention showed that nurses’turnover intention was related to horizontal violence,employment form,perceived threat of horizontal violence,organizational atmosphere,department,weekly working hours and level of nurses.3.Construction of the influence model of nurses’ horizontal violence on turnover intention.The result of the influence model of nurses’ horizontal violence on turnover intention was adjusted reasonably.The horizontal violence of nurses has a direct predictive effect on turnover intention,and the perception of horizontal violence threat,coping style,psychological resilience and organizational atmosphere play an indirect role in the influence of horizontal violence of nurses on turnover intention.