Associations of workplace violence and psychological capital with depressive symptoms and burn-out among doctors in Liaoning, China: a cross-sectional study

Objectives The purpose of this study was to (1) Identify the prevalence of workplace violence among doctors in Liaoning, China. (2) Examine the relationships between workplace violence and psychological capital with depressive symptoms and burn-out in Chinese doctors. Design A quantitative, cross-sectional study. Setting Eight hospitals in Liaoning Province were surveyed using a self-reported questionnaire. Participants The study population comprised 1800 doctors. Ultimately 1392 doctors completed valid questionnaires with a response rate of 77.3%. Results The prevalence of workplace violence was 77.5%. Compared with other types of workplace violence, the prevalence of psychological aggression was the highest (72.7%). Workplace violence (depressive symptoms: beta[95% CI]=0.11 [0.06, 0.16]; emotional exhaustion: beta[95% CI]=0.18 [0.13, 0.23]; depersonalisation: beta[95% CI]=0.17 [0.12, 0.22]) and psychological capital (depressive symptoms: beta beta[95% CI]=-0.32 [-0.37, -0.27]; emotional exhaustion: beta[95% CI]=-0.23 [-0.28, -0.18]; depersonalisation: beta[95% CI]=-0.23 [-0.28, -0.18]) were associated with depressive symptoms and burn-out. Workplace violence increased the level of depressive symptoms and burn-out by damaging psychological capital (depressive symptoms: a*b=1.61, bias-corrected and accelerated [BCa] 95% CI 1.08 to 2.25; emotional exhaustion: a*b=1.29, BCa 95% CI 0.86 to 1.83; depersonalisation: a*b=0.70, BCa 95% CI 0.45 to 1.00). Conclusions In China, most doctors will be exposed to workplace violence, especially psychological aggression. A safer work environment and psychological capital development may be considered in prevention and treatment strategies for improving mental health.