Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Cheol Jeong; Eun Nam Lee

doi:10.7475/KJAN.2018.30.1.41

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Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Cheol Jeong¹, Eun Nam Lee²

Korean Journal of Adult Nursing 2018;30(1):41-48.
Published online: February 18, 2018

DOI: https://doi.org/10.7475/KJAN.2018.30.1.41

¹Dong-A University Hospital, Busan, Korea

¹Department of Nursing, Dong-A University, Busan, Korea

Corresponding author: Lee, Eun Nam https://orcid.org/0000-0002-9421-0118 Department of Nursing, Dong-A University, 32 Daesingongwon-ro, Seo-gu, Busan 49201, Korea. Tel: +82-51-240-2864, Fax: +82-51-240-2920, E-mail: enlee@dau.ac.kr

- This article is a revision of the first author's master's thesis from Dong-A University.

• Received: September 28, 2017 • Accepted: February 16, 2018

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
The purpose of this study was to investigate resiliency and its mediating effect on the association between violence experience and violence response among nurses in intensive care units (ICU) and emergency departments (ED).
Methods
Nurses working in ICU and ED were recruited from five hospitals in Busan city. Data were collected from 1st July to 31st August 2016 using structured questionnaires about violence experiences of nurses in the last three months and nurses’ resilience including Korean Version of the Assault Response Questionnaire (ARQ-K). Data from 195 nurses were analyzed using the SPSS/WIN 21.0 program. Baron & Kenny's 3-step hierarchical regression analysis was used to test the mediating effect of resilience on the relationship between violence experience and violence response.
Results
A positive correlational relationship between nurses’ violence experience and violence response was significant (r=.37, p<.001). Negative correlational relationships were found between nurses’ violence experience and resilience (r=-.19, p=.008) and between resil-ence and violence response (r=-.38, p<.001). This study found a partial mediating effect of resilience on the association between violence experience and violence response (z=2.49, p=.013).
Conclusion
There is a need to develop a variety of intervention programs that can improve resilience in reducing violence response of nurses.
Key Words: Violence; Mediating; Nurses

Table 1.

Violence Experience, Resilience, and Violence Response according to the Characteristics of Participants (N=195)

Variables	Categories	n (%)	Violence experience		Resilience		Violence response
Variables	Categories	n (%)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)
Gender	Male	7 (3.6)	38.43±9.07	0.25	110.86±18.33	0.86	72.29±14.21	-0.12
Gender	Female	188 (96.4)	37.19±13.16	(.805)	105.93±14.76	(.290)	73.16±19.74	(.907)
Age (year)	20~24 ^a	37 (19.0)	37.49±12.09	0.58	103.84±17.06	1.29	63.46±17.64	4.21
	25~29 ^b	70 (35.9)	38.69±13.76	(.629)	104.44±14.20	(.279)	73.89±17.03	(.007)
	30~34 ^c	39 (20.0)	36.23±11.97		107.92±12.56		75.90±17.29	c, d＞ a^‡
	≥35 ^d	49 (25.1)	35.76±13.54		108.74±15.59		77.16±23.69
Marital status	Single	137 (70.3)	37.71±12.72	0.63	104.97±15.40	-1.60	70.75±17.67	-2.36
Marital status	Married	57 (29.2)	36.42±13.64	(.531)	108.70±13.39	(.112)	78.72±22.76	(.020)
Years of clinical experience	＜5	92 (47.2)	37.23±12.48	-0.01	103.27±15.80	-2.55	68.65±17.91	-3.09
Years of clinical experience	≥5	103 (52.8)	37.23±13.53	(.998)	108.63±13.58	(.012)	77.14±20.14	(.002)
Experience of damage from violence	Yes	60 (30.8)	42.65±12.90	4.03	103.68±15.81	-1.52	79.88±18.47	3.30
Experience of damage from violence	No^†	135 (69.2)	34.82±12.37	(＜.001)	107.18±14.36	(.130)	70.13±19.32	(.001)
Disposition of security guard	Yes	68 (34.9)	44.43±13.53	5.79	104.68±15.10	-0.98	81.53±19.58	4.61
Disposition of security guard	No	127 (65.1)	33.38±10.98	(＜.001)	106.87±14.75	(.328)	68.64±18.05	(＜.001)
Experience of education for violence prevention	Yes	102 (52.3)	35.27±11.80	-2.20	106.75±14.55	0.64	74.28±21.28	0.87
Experience of education for violence prevention	No	93 (47.7)	39.38±13.98	(.029)	105.39±15.26	(.523)	71.87±17.47	(.386)
Necessity of education for violence prevention	Yes	171 (87.7)	37.11±12.83	-0.36	106.55±15.10	1.12	73.39±19.10	0.49
Necessity of education for violence prevention	No	24 (12.3)	38.13±14.53	(.720)	102.92±12.97	(.263)	71.29±22.84	(.623)
Protocol for incidence of violence	Yes ^a	70 (35.9)	34.47±12.68	4.43	110.53±13.77	5.04	71.80±21.00	1.07
	No ^b	24 (12.3)	43.33±14.95	(.013)	103.50±14.32	(.007)	78.46±20.28	(.345)
	Don't know ^c	101 (51.8)	37.69±12.32	b＞ a^‡	103.66±15.15	a＞ b^‡	72.79±18.27

^†Inclusion of a nurse without violence experience;

^‡Scheffé test.

Table 2.

Violence Experience, Resilience, and Violence Response of Nurses (N=195)

Variables	Categories	n	M± SD	Range	M± SD
Variables	Categories	n	(Summed score)	Range	SD (Item score)
Violence experience	Verbal abuse	7	18.56±7.21	7~35	2.65±1.05
	Physical threat	6	12.02±4.92	6~30	2.02±0.84
	Physical assault	5	6.65±2.71	5~20	1.32±0.53
	Total	18	37.23±13.02	18~90	2.07±0.74
Resilience	Dispositional pattern	5	16.87±2.95	5~25	3.38±0.59
	Relational pattern	4	14.51±2.09	4~20	3.62±0.53
	Situational pattern	10	36.13±5.46	10~50	3.61±0.55
	Philosophical pattern	6	21.10±3.79	6~30	3.51±0.64
	Professional pattern	5	17.50±2.92	5~25	3.50±0.59
	Total	30	106.10±14.87	30~150	3.53±0.53
Violence response	Emotional response	13	42.57±10.99	13~65	3.27±0.86
	Physiological response	10	24.03±8.56	10~50	2.40±0.87
	Social response	3	6.53±2.53	3~15	2.17±0.85
	Total	26	73.13±19.54	26~130	2.81±0.77

Table 3.

Correlations among Violence Experience, Resilience, and Violence Response (N=195)

Variables	Violence experience	Resilience	Violence response
Variables	r (p)	r (p)	r (p)
Violence experience	1
Resilience	-.19 (.008)	1
Violence response	.37 (＜.001)	-.38 (＜.001)	1

Table 4.

Mediating Effects of Resilience on the Association between Violence Experience and Violence Response (N=195)

Step	Independent variables	Dependent variables	B	SE	β	t	p	F (p)
1	Violence experience	Violence response	.43	.11	.29	3.98	＜.001	12.49 (＜.001)
2	Violence experience	Resilience	-.02	.08	-.19	-2.67	.008	7.12 (.008)
3	Violence experience	Violence response	.35	.10	.23	3.47	.001	18.42 (＜.001)
3	Resilience	Violence response	-.47	.08	-.36	-6.03	＜.001	18.42 (＜.001)

Sobel test (Z=2.49, p=.013).

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Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Korean J Adult Nurs. 2018;30(1):41-48. Published online February 28, 2018

DOI: https://doi.org/10.7475/kjan.2018.30.1.41

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Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Korean J Adult Nurs. 2018;30(1):41-48. Published online February 28, 2018

DOI: https://doi.org/10.7475/kjan.2018.30.1.41

Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses

Table 1.

Violence Experience, Resilience, and Violence Response according to the Characteristics of Participants (N=195)

Variables	Categories	n (%)	Violence experience		Resilience		Violence response
Variables	Categories	n (%)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)
Gender	Male	7 (3.6)	38.43±9.07	0.25	110.86±18.33	0.86	72.29±14.21	-0.12
Gender	Female	188 (96.4)	37.19±13.16	(.805)	105.93±14.76	(.290)	73.16±19.74	(.907)
Age (year)	20~24 ^a	37 (19.0)	37.49±12.09	0.58	103.84±17.06	1.29	63.46±17.64	4.21
	25~29 ^b	70 (35.9)	38.69±13.76	(.629)	104.44±14.20	(.279)	73.89±17.03	(.007)
	30~34 ^c	39 (20.0)	36.23±11.97		107.92±12.56		75.90±17.29	c, d＞ a^‡
	≥35 ^d	49 (25.1)	35.76±13.54		108.74±15.59		77.16±23.69
Marital status	Single	137 (70.3)	37.71±12.72	0.63	104.97±15.40	-1.60	70.75±17.67	-2.36
Marital status	Married	57 (29.2)	36.42±13.64	(.531)	108.70±13.39	(.112)	78.72±22.76	(.020)
Years of clinical experience	＜5	92 (47.2)	37.23±12.48	-0.01	103.27±15.80	-2.55	68.65±17.91	-3.09
Years of clinical experience	≥5	103 (52.8)	37.23±13.53	(.998)	108.63±13.58	(.012)	77.14±20.14	(.002)
Experience of damage from violence	Yes	60 (30.8)	42.65±12.90	4.03	103.68±15.81	-1.52	79.88±18.47	3.30
Experience of damage from violence	No^†	135 (69.2)	34.82±12.37	(＜.001)	107.18±14.36	(.130)	70.13±19.32	(.001)
Disposition of security guard	Yes	68 (34.9)	44.43±13.53	5.79	104.68±15.10	-0.98	81.53±19.58	4.61
Disposition of security guard	No	127 (65.1)	33.38±10.98	(＜.001)	106.87±14.75	(.328)	68.64±18.05	(＜.001)
Experience of education for violence prevention	Yes	102 (52.3)	35.27±11.80	-2.20	106.75±14.55	0.64	74.28±21.28	0.87
Experience of education for violence prevention	No	93 (47.7)	39.38±13.98	(.029)	105.39±15.26	(.523)	71.87±17.47	(.386)
Necessity of education for violence prevention	Yes	171 (87.7)	37.11±12.83	-0.36	106.55±15.10	1.12	73.39±19.10	0.49
Necessity of education for violence prevention	No	24 (12.3)	38.13±14.53	(.720)	102.92±12.97	(.263)	71.29±22.84	(.623)
Protocol for incidence of violence	Yes ^a	70 (35.9)	34.47±12.68	4.43	110.53±13.77	5.04	71.80±21.00	1.07
	No ^b	24 (12.3)	43.33±14.95	(.013)	103.50±14.32	(.007)	78.46±20.28	(.345)
	Don't know ^c	101 (51.8)	37.69±12.32	b＞ a^‡	103.66±15.15	a＞ b^‡	72.79±18.27

^†Inclusion of a nurse without violence experience;

^‡Scheffé test.

Table 2.

Violence Experience, Resilience, and Violence Response of Nurses (N=195)

Variables	Categories	n	M± SD	Range	M± SD
Variables	Categories	n	(Summed score)	Range	SD (Item score)
Violence experience	Verbal abuse	7	18.56±7.21	7~35	2.65±1.05
	Physical threat	6	12.02±4.92	6~30	2.02±0.84
	Physical assault	5	6.65±2.71	5~20	1.32±0.53
	Total	18	37.23±13.02	18~90	2.07±0.74
Resilience	Dispositional pattern	5	16.87±2.95	5~25	3.38±0.59
	Relational pattern	4	14.51±2.09	4~20	3.62±0.53
	Situational pattern	10	36.13±5.46	10~50	3.61±0.55
	Philosophical pattern	6	21.10±3.79	6~30	3.51±0.64
	Professional pattern	5	17.50±2.92	5~25	3.50±0.59
	Total	30	106.10±14.87	30~150	3.53±0.53
Violence response	Emotional response	13	42.57±10.99	13~65	3.27±0.86
	Physiological response	10	24.03±8.56	10~50	2.40±0.87
	Social response	3	6.53±2.53	3~15	2.17±0.85
	Total	26	73.13±19.54	26~130	2.81±0.77

Table 3.

Correlations among Violence Experience, Resilience, and Violence Response (N=195)

Variables	Violence experience	Resilience	Violence response
Variables	r (p)	r (p)	r (p)
Violence experience	1
Resilience	-.19 (.008)	1
Violence response	.37 (＜.001)	-.38 (＜.001)	1

Table 4.

Mediating Effects of Resilience on the Association between Violence Experience and Violence Response (N=195)

Step	Independent variables	Dependent variables	B	SE	β	t	p	F (p)
1	Violence experience	Violence response	.43	.11	.29	3.98	＜.001	12.49 (＜.001)
2	Violence experience	Resilience	-.02	.08	-.19	-2.67	.008	7.12 (.008)
3	Violence experience	Violence response	.35	.10	.23	3.47	.001	18.42 (＜.001)
3	Resilience	Violence response	-.47	.08	-.36	-6.03	＜.001	18.42 (＜.001)

Sobel test (Z=2.49, p=.013).

Table 1. Violence Experience, Resilience, and Violence Response according to the Characteristics of Participants (N=195)

†

Inclusion of a nurse without violence experience;

‡

Scheffé test.

Table 2. Violence Experience, Resilience, and Violence Response of Nurses (N=195)

Table 3. Correlations among Violence Experience, Resilience, and Violence Response (N=195)

Table 4. Mediating Effects of Resilience on the Association between Violence Experience and Violence Response (N=195)

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