The impact of workplace psychological violence on clinical nurses’ turnover intention: the mediating role of perceived stress – Frontiers

Report on Workplace Psychological Violence and Nurse Turnover in Southwest China: An SDG Perspective

Introduction and Context

• The global shortage of nurses represents a significant public health challenge, directly impacting the achievement of universal health coverage as outlined in the Sustainable Development Goals (SDGs).
• This report analyzes research on the drivers of nurse turnover intention, a critical predictor of workforce instability, which undermines progress towards SDG 3 (Good Health and Well-being).
• The objective of the original study was to examine the mediating role of perceived stress in the relationship between workplace psychological violence and turnover intention among nurses in tertiary general hospitals in Southwest China.

Research Methodology

• A cross-sectional survey was conducted between October 2024 and March 2025.
• The study included a sample of 798 nurses selected via convenience sampling from 9 tertiary general hospitals in the region.
• Data was collected using four instruments: the General Information Questionnaire, the Turnover Intention Scale, the Psychological Violence in the Workplace Scale, and the Perceived Stress Scale.
• Statistical analysis, including mediation effects, was performed using SPSS and PROCESS Model 4.

Key Findings and Statistical Analysis

1. A significant positive correlation was identified between Workplace Psychological Violence and Turnover Intention (r= 0.364, P
2. A significant positive correlation was found between Perceived Stress and Turnover Intention (r= 0.423, P
3. Workplace Psychological Violence was also positively correlated with Perceived Stress (r= 0.486, P

• The central finding revealed that perceived stress acts as a partial mediator in the relationship between workplace psychological violence and turnover intention. The mediating effect accounted for 36.96% of the total effect, indicating that a substantial portion of the impact of workplace violence on turnover is channeled through increased stress levels.

Implications for Sustainable Development Goals (SDGs)

• SDG 3: Good Health and Well-being: High nurse turnover compromises the quality and continuity of patient care, threatening the stability of health systems. Addressing the mental health and well-being of the nursing workforce is essential for building resilient healthcare infrastructure.
• SDG 8: Decent Work and Economic Growth: The study highlights the prevalence of workplace psychological violence, a direct contravention of the principles of decent work. Creating safe and secure working environments is a core target of SDG 8, and reducing nurse turnover enhances the economic sustainability of healthcare institutions.
• SDG 5: Gender Equality: As nursing is a predominantly female profession, protecting nurses from workplace violence and stress is a critical issue for gender equality and the empowerment of women in the workforce.
• SDG 16: Peace, Justice and Strong Institutions: Eradicating violence in the workplace contributes to building effective, accountable, and inclusive institutions. A healthcare facility that fails to protect its staff from psychological violence cannot be considered a strong or just institution.

Conclusion and Recommendations

• The research confirms that perceived stress is a significant mediator between workplace psychological violence and nurses’ intention to leave their jobs.
• To advance the SDGs, particularly goals 3 and 8, it is recommended that nursing and hospital management implement targeted interventions.

1. Develop and enforce zero-tolerance policies against workplace psychological violence to ensure a safe working environment, aligning with SDG 8 and SDG 16.
2. Implement stress-reduction programs and mental health support systems for nursing staff to mitigate the negative effects of workplace stressors, directly supporting SDG 3.
3. By addressing these root causes, healthcare organizations can reduce nurse turnover, thereby fostering a stable, sustainable, and effective nursing workforce essential for achieving global health objectives.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article directly addresses this goal by highlighting the “global shortage of nurses” as a “significant health emergency.” The stability of the nursing workforce is crucial for functioning health systems. Furthermore, the study’s focus on the “mental health” and “perceived stress” of nurses aligns with the goal of promoting well-being for all.

• SDG 8: Decent Work and Economic Growth

  This goal is central to the article’s discussion of working conditions for nurses. The focus on “workplace psychological violence” directly contradicts the aim of providing “safe and secure working environments.” Issues like high “turnover intention” and the need to improve “job satisfaction” are key elements of the decent work agenda.

• SDG 5: Gender Equality

  While not explicitly mentioned, nursing is a profession dominated by women globally. Therefore, issues such as workplace violence, high stress, and poor job satisfaction disproportionately affect women. Addressing these challenges contributes to the economic empowerment and well-being of women, making SDG 5 highly relevant.

• SDG 16: Peace, Justice and Strong Institutions

  The article’s investigation into “workplace psychological violence” connects to this goal’s aim to reduce all forms of violence. A hospital is an institution, and ensuring it is free from violence is essential for it to be effective and just.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.c: Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries.

   The article’s entire premise is built around understanding and reducing “nurses’ turnover intention” to address the nursing shortage. The conclusion explicitly aims to promote the “stability and sustainable development of the nursing team,” which is a direct reference to the *retention* of the health workforce.

2. Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

   The study’s focus on “perceived stress” and its conclusion about the need to improve nurses’ “mental health” directly align with the promotion of mental health and well-being as stipulated in this target.

3. Target 8.8: Protect labour rights and promote safe and secure working environments for all workers.

   The investigation into “psychological violence in the workplace” is a direct examination of the failure to provide a safe and secure working environment. The article’s findings support the need for interventions to protect workers from such harm, which is the core of this target.

4. Target 16.1: Significantly reduce all forms of violence and related death rates everywhere.

   Workplace psychological violence is a specific form of violence. By studying its causes and effects, the article contributes to the knowledge base needed to reduce this form of violence within institutions, as called for by this target.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Nurse Turnover Intention/Rate

  The article uses the “Turnover Intention Scale” and identifies this as an “important predictor of actual turnover rates.” This serves as a direct, measurable indicator for Target 3.c, as it quantifies the challenge of retaining the health workforce.

• Incidence of Workplace Psychological Violence

  The study measures this using the “Psychological Violence in the Workplace Scale.” The results from this scale provide a clear indicator of the safety of the working environment, which is crucial for monitoring progress towards Target 8.8.

• Level of Perceived Stress

  The use of the “Perceived Stress Scale” provides a quantifiable measure of the mental well-being of the nursing staff. This indicator is directly relevant to tracking progress on promoting mental health as part of Target 3.4.

• Job Satisfaction

  The conclusion mentions the goal of “improving nurses’ job satisfaction.” While not measured with a specific scale in the abstract, it is identified as a key outcome and serves as an implied indicator for decent work (SDG 8) and workforce stability (SDG 3).

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article.

Source: frontiersin.org