Association between violence from patients and caregivers and nursing work interruptions, burnout and quality of nursing care: a cross-sectional study in a South Korean tertiary hospital.

Abstract

To examine the associations between violence perpetrated by patients and caregivers and nursing work interruptions, burnout and quality of nursing care, and to explore potential mediation pathways among these variables. A descriptive, cross-sectional correlational study using path analysis. A tertiary university-affiliated hospital in South Korea. A convenience sample of 200 registered nurses providing direct patient care, recruited between September and October 2024. Patient and caregiver violence, nursing work interruptions, burnout and perceived quality of nursing care. The average level of violence perpetrated by patients and caregivers was moderate, with verbal abuse being the most frequently reported type (mean=2.58 on a 5-point scale). Violence from patients and caregivers was significantly positively correlated with work interruptions (r=0.50, p<0.001) and burnout (r=0.32, p<0.001) and negatively correlated with quality of nursing care (r = -0.18, p=0.012). Path analysis indicated that violence from patients and caregivers was significantly associated with increased work interruptions (β=0.50, p<0.001) and burnout (β=0.22, p=0.003), while burnout was negatively associated with quality of nursing care (β = -0.37, p<0.001). Mediation analysis showed that burnout had a significant indirect association with the relationship between violence and quality of care (indirect effect = -0.054, p=0.001). A sequential indirect pathway from violence through work interruptions and burnout to quality of care was also statistically significant (indirect effect = -0.024, p=0.010). Violence perpetrated by patients and caregivers is associated with reduced quality of nursing care through a sequential process involving increased work interruptions and burnout. These findings highlight the importance of addressing both workflow disruptions and nurses' psychological well-being through systemic interventions aimed at improving care quality.