Psychosocial Antecedents and Consequences of Workplace Aggression for Hospital Nurses


Ms. Defne Demir, Locked Bag 4115, Fitzroy, VIC 3065, Australia. E-mail:


Purpose: To test a full model of the antecedents to and consequences of various forms of workplace aggression, considering psychosocial factors, for hospital nursing staff.

Design: Cross-sectional survey design.

Methods: Two hundred and seven nurses and midwives working across wards within a medium to large Australian hospital completed the survey. The survey response rate was 26.9%.

Findings: High frequencies of nurses reported exposure to workplace bullying and internal and external emotional abuse violence types. In terms of antecedents, bullying was linked to high negative affectivity (NA), as well as low supervisor support and coworker support. Internal emotional abuse was associated with low levels of these support variables, as well as high outside work support and low job control. External threat of assault was related to high job demands and NA. In terms of consequences, bullying and verbal sexual harassment were linked to increased psychological distress levels. Bullying and internal emotional abuse were related to lowered organizational commitment. Changes in job satisfaction were not found for any of the workplace aggression types. NA was a significant covariate for all analyses examining consequences of aggression.

Conclusions: Different combinations of work conditions (job demands-resources) and individual levels of NA predicted certain types of aggression. Further, nurse perceptions of psychological distress and organizational commitment were affected by exposure to several types of aggression, even after controlling for NA as a potential perceptual bias. This study therefore extends previous research on workplace bullying as a stressor to other types of workplace aggression for nurses.

Clinical Relevance: The findings highlight factors that are important in considering effective prevention and intervention of workplace aggression among nursing staff, particularly those working in hospital settings.