Lihua Fan

Bio: Lihua Fan is an academic researcher from Harbin Medical University. The author has contributed to research in topics: Workplace violence & Job satisfaction. The author has an hindex of 15, co-authored 25 publications receiving 783 citations.

Workplace violence, job satisfaction, burnout, perceived organisational support and their effects on turnover intention among Chinese nurses in tertiary hospitals: a cross-sectional study.

Abstract: Objectives Our aims were to assess the relationship between workplace violence, job satisfaction, burnout, organisational support and turnover intention, and to explore factors associated with turnover intention among nurses in Chinese tertiary hospitals. Methods The purposive sampling method was used to collect data from August 2016 through January 2017. A total of 1761 nurses from 9 public tertiary hospitals in 4 provinces (municipalities) located in eastern (Beijing), central (Heilongjiang, Anhui) and western (Shaanxi) regions of China completed the questionnaires (effective response rate=85.20%). A cross-sectional study was conducted using the Workplace Violence Scale, Chinese Maslach Burnout Inventory General Survey, Minnesota Job Satisfaction Questionnaire Revised Short Version, Perceived Organizational Support-Simplified Version Scale and Turnover Intention Scale. Results A total of 1216 of 1706 (69.1%) participants had high turnover intention. During the previous 12 months, the prevalence of physical violence and psychological violence towards nurses was 9.60% and 59.64%, respectively. As expected, the level of turnover intention was negatively correlated with participants’ scores on job satisfaction (r=−0.367, p Conclusions Perceived organisational support served as a mediator between workplace violence, job satisfaction, burnout and turnover intention, and it had a significantly negative impact on turnover intention. Therefore, nursing managers should understand the importance of the organisation’s support and establish a reasonable incentive system to decrease turnover intention.

The impact of workplace violence on job satisfaction, job burnout, and turnover intention: the mediating role of social support

Abstract: Workplace violence (WPV) is a global public health problem and has caused a serious threat to the physical and mental health of healthcare workers. Moreover, WPV also has an adverse effect on the workplace behavior of healthcare workers. This study has three purposes: (1) to identify the prevalence of workplace violence against physicians; (2) to examine the association between exposure to WPV, job satisfaction, job burnout and turnover intention of Chinese physicians and (3) to verify the mediating role of social support. A cross-sectional study adopted a purposive sampling method to collect data from March 2017 through May 2017. A total of nine tertiary hospitals in four provinces, which provide healthcare from specialists in a large hospital after referral from primary and secondary care, were selected as research sites based on their geographical locations in the eastern, central and western regions of China. Descriptive analyses, a univariate analysis, a Pearson correlation, and a mediation regression analysis were used to estimate the prevalence of WPV and impact of WPV on job satisfaction, job burnout, and turnover intention. WPV was positively correlated with turnover intention (r = 0.238, P < 0.01) and job burnout (r = 0.150, P < 0.01), and was negatively associated with job satisfaction (r = − 0.228, P < 0.01) and social support (r = − 0.077, P < 0.01). Social support was a partial mediator between WPV and job satisfaction, as well as burnout and turnover intention. The results show a high prevalence of workplace violence in Chinese tertiary hospitals, which should not be ignored. The effects of social support on workplace behaviors suggest that it has practical implications for interventions to promote the stability of physicians’ teams. (Project Identification Code: HMUIRB2014005), Registered March 1, 2014.

Workplace violence, psychological stress, sleep quality and subjective health in Chinese doctors: a large cross-sectional study.

Abstract: Background Workplace violence (WPV) against healthcare workers is known as violence in healthcare settings and referring to the violent acts that are directed towards doctors, nurses or other healthcare staff at work or on duty. Moreover, WPV can cause a large number of adverse outcomes. However, there is not enough evidence to test the link between exposure to WPV against doctors, psychological stress, sleep quality and health status in China. Objectives This study had three objectives: (1) to identify the incidence rate of WPV against doctors under a new classification, (2) to examine the association between exposure to WPV, psychological stress, sleep quality and subjective health of Chinese doctors and (3) to verify the partial mediating role of psychological stress. Design A cross-sectional online survey study. Setting The survey was conducted among 1740 doctors in tertiary hospitals, 733 in secondary hospital and 139 in primary hospital across 30 provinces of China. Participants A total of 3016 participants were invited. Ultimately, 2617 doctors completed valid questionnaires. The effective response rate was 86.8%. Results The results demonstrated that the prevalence rate of exposure to verbal abuse was the highest (76.2%), made difficulties (58.3%), smear reputation (40.8%), mobbing behaviour (40.2%), intimidation behaviour (27.6%), physical violence (24.1%) and sexual harassment (7.8%). Exposure to WPV significantly affected the psychological stress, sleep quality and self-reported health of doctors. Moreover, psychological stress partially mediated the relationship between work-related violence and health damage. Conclusion In China, most doctors have encountered various WPV from patients and their relatives. The prevalence of three new types of WPV have been investigated in our study, which have been rarely mentioned in past research. A safer work environment for Chinese healthcare workers needs to be provided to minimise health threats, which is a top priority for both government and society.

A cross-sectional study on the prevalence and associated risk factors for workplace violence against Chinese nurses.

Abstract: Objectives The purpose of the present study was to explore the characteristics of workplace violence that Chinese nurses at tertiary and county–level hospitals encountered in the 12 months from December 2014 to January 2016, to identify and analyse risk factors for workplace violence, and to establish the basis for future preventive strategies. Design A cross–sectional study. Setting A total of 44 tertiary hospitals and 90 county–level hospitals in 16 provinces (municipalities or autonomous regions) in China. Methods We used stratified random sampling to collect data from December 2014 to January 2016. We distributed 21 360 questionnaires, and 15 970 participants provided valid data (effective response rate=74.77%). We conducted binary logistic regression analyses on the risk factors for workplace violence among the nurses in our sample and analysed the reasons for aggression. Results The prevalence of workplace violence was 65.8%; of this, 64.9% was verbal violence, and physical violence and sexual harassment accounted for 11.8% and 3.9%, respectively. Frequent workplace violence occurred primarily in emergency and paediatric departments. Respondents reported that patients’ relatives were the main perpetrators in tertiary and county–level hospitals. Logistic regression analysis showed that respondents’ age, department, years of experience and direct contact with patients were common risk factors at different levels of hospitals. Conclusions Workplace violence is frequent in China’s tertiary and county–level hospitals; its occurrence is especially frequent in the emergency and paediatric departments. It is necessary to cope with workplace violence by developing effective control strategies at individual, hospital and national levels.

The impact of quality of work life on job embeddedness and affective commitment and their co-effect on turnover intention of nurses

Abstract: Aims and objectives. To verify with empirical evidence the hypothesised relation and the effect of quality of work life, job embeddedness and affective commitment on turnover intention of clinical nurses in China. Background. High turnover of the nursing workforce in healthcare organisations is a difficult and recurring problem in China as well as in many other countries in the world. It leads to great waste of resources and increases management cost. Developing and retaining the nursing workforce, which is a major challenge faced by human resources practitioners in hospitals and public health agencies, also becomes a subject of interest for management studies. Most of the literature about voluntary turnover focused on such traditional measures as job satisfaction and job alternatives in the past. The introduction of such new concepts as quality of work life, job embeddedness and affective commitment, which views the issue from a much broader and comprehensive spectrum, made a great breakthrough in the turnover study. In this study, we selected quality of work life, job embeddedness and affective commitment – three of the most important factors in employer–employee relations – and analysed the interaction between each one of them, as well as their co-effect on turnover intention of Chinese nurses. Methods. Cross-sectional survey and structural equation modelling were applied in studying the self-report questionnaires distributed to 1000 nurses employed in five large-scale government-owned hospitals in Heilongjiang Province, Northeast China. Findings. Our study confirmed the hypothesised positive relation of quality of work life with job embeddedness and affective commitment and the hypothesised negative relation of quality of work life with turnover intention, that is, high quality of work life perceived by the nurses enhances their job embeddedness and affective commitment and thus reduces their intention to leave the job. Conclusions. The effect of quality of work life is positive on job embeddedness and affection commitment and negative on turnover intention. Relevance to clinical practice. Nurse managers should pay great attention to the nurses' perception of quality of work life, and make great efforts in developing strategies and projects that can strengthen the nurses' embeddedness or connection with the job.

韧性（Resilience）的概念分析

Abstract: 韧性（resilience）是指个人面对生活逆境、创伤、悲剧、威胁及其他生活重大压力的良好适应，也是个人应激（stress）和应对（coping）的正面结果。在过去的数十年，护理学等健康相关领域的学者们一直在关注为什么一些人在逆境、压力、疾病等高危（high risk）经历下也能较好地维持健康，而一些人则被逆境打败，身心健康也随之处于不良状态。近年来，应激心理学、健康心理学、精神医学、教育学、护理学等各学科对韧性概念越来越重视，尤其是临床领域的研究，从过去强调人的缺点和脆弱性的病理模式转变为关注个人的优势和强韧性的健康模式。

Organizational Commitment, Job Satisfaction and Turnover Among Psychiatric Technicians. Technical Report No. 16.

Abstract: Abstract : A study is reported of the variations in organizational commitment and job satisfaction, as related to subsequent turnover in a sample of recently-employed psychiatric technician trainees. A longitudinal study was made across a 10 1/2 month period, with attitude measures collected at four points in time. For this sample, job satisfaction measures appeared better able to differentiate future stayers from leavers in the earliest phase of the study. With the passage of time, organizational commitment measures proved to be a better predictor of turnover, and job satisfaction failed to predict turnover. The findings are discussed in the light of other related studies, and possible explanations are examined. (Modified author abstract)

COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support.

Abstract: AIM: This study examines the relative influence of personal resilience, social support and organisational support in reducing COVID-19 anxiety in front-line nurses. BACKGROUND: Anxiety related to the COVID-19 pandemic is prevalent in the nursing workforce, potentially affecting nurses' well-being and work performance. Identifying factors that could help maintain mental health and reduce coronavirus-related anxiety among front-line nurses is imperative. Currently, no studies have been conducted examining the influence of personal resilience, social support and organisational support in reducing COVID-19 anxiety among nurses. METHODS: This cross-sectional study involved 325 registered nurses from the Philippines using four standardized scales. RESULTS: Of the 325 nurses in the study, 123 (37.8%) were found to have dysfunctional levels of anxiety. Using multiple linear regression analyses, social support (s = -0.142, p = .011), personal resilience (s = -0.151, p = .008) and organisational support (s = -0.127, p = .023) predicted COVID-19 anxiety. Nurse characteristics were not associated with COVID-19 anxiety. CONCLUSIONS: Resilient nurses and those who perceived higher organisational and social support were more likely to report lower anxiety related to COVID-19. IMPLICATION FOR NURSING MANAGEMENT: COVID-19 anxiety may be addressed through organisational interventions, including increasing social support, assuring adequate organisational support, providing psychological and mental support services and providing resilience-promoting and stress management interventions.

The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis.

Abstract: Background: Burnout is a psychological syndrome characterized by emotional exhaustion, feelings of cynicism and reduced personal accomplishment. In the past years there has been disagreement on whether burnout and depression are the same or different constructs, as they appear to share some common features (e.g., loss of interest and impaired concentration). However, the results so far are inconclusive and researchers disagree with regard to the degree to which we should expect such overlap. The aim of this systematic review and meta-analysis is to examine the relationship between burnout and depression. Additionally, given that burnout is the result of chronic stress and that working environments can often trigger anxious reactions, we also investigated the relationship between burnout and anxiety. Method: We searched the online databases SCOPUS, Web of Science, MEDLINE (PubMed), and Google Scholar for studies examining the relationship between burnout and depression and burnout and anxiety, which were published between January 2007 and August 2018. Inclusion criteria were used for all studies and included both cross-sectional and longitudinal designs, published and unpublished research articles, full-text articles, articles written in the English language, studies that present the effects sizes of their findings and that used reliable research tools. Results: Our results showed a significant association between burnout and depression (r = 0.520, SE = 0.012, 95% CI = 0.492, 0.547) and burnout and anxiety (r = 0.460, SE = 0.014, 95% CI = 0.421, 0.497). However, moderation analysis for both burnout-depression and burnout-anxiety relationships revealed that the studies in which either the MBI test was used or were rated as having better quality showed lower effect sizes. Conclusions: Our research aims to clarify the relationship between burnout-depression and burnout-anxiety relationships. Our findings revealed no conclusive overlap between burnout and depression and burnout and anxiety, indicating that they are different and robust constructs. Future studies should focus on utilizing more longitudinal designs in order to assess the causal relationships between these variables.