The relationship between workplace violence and turnover intention among psychiatric nurses: the mediating roles of ward atmosphere and social distance

Front Public Health. 2026 Jun 12;14:1828081. doi: 10.3389/fpubh.2026.1828081. eCollection 2026.

ABSTRACT

BACKGROUND: Psychiatric nurses face high turnover rates and increasing levels of turnover intention. Workplace violence is associated with turnover intention among psychiatric nurses. Social exchange theory suggests that ward atmosphere and social distance may play a significant role in this process. However, the mechanisms underlying this relationship remain unclear.

OBJECTIVE: To explore how workplace violence influences nurses’ turnover intention through ward atmosphere and social distance, and to provide strategies for promoting nurses’ wellbeing.

METHODS: A questionnaire survey was conducted among 1,485 psychiatric nurses recruited through the Mental and Psychological Care Alliance from September to October 2024. Variables were measured using a demographic questionnaire, a turnover intention item, the Workplace Violence Scale, the Ward Atmosphere Scale, and the Social Distance Scale. Statistical analysis and model construction and validation were performed using SPSS 29.0 software.

RESULTS: Ward atmosphere was negatively correlated with turnover intention (r = -0.423), social distance (r = -0.340), and workplace violence (r = -0.307). Turnover intention was positively correlated with both social distance (r = 0.221) and workplace violence (r = 0.214). Workplace violence was positively correlated with social distance (r = 0.159). Workplace violence directly affected turnover intention among psychiatric nurses (β = 0.181, p < 0.001). The workplace violence also indirectly affects turnover intention among psychiatric nurses through the simple mediating effect of ward atmosphere (β = 0.232, p < 0.001) and social distance (β = 0.010, p < 0.001). And the sequential mediating effect of ward atmosphere and social distance between workplace violence and turnover intention is also significant (β = 0.017, p < 0.01). Additionally, that ward atmosphere and social distance totally mediated the link between workplace violence and turnover intention (indirect effect = 0.259, 95% CI: 0.207-0.313), explaining 58.863% of the total effect.

CONCLUSION: This study suggests that we should pay attention to the influencing factors of the turnover intention and take effective measures. It is imperative to mitigate the occurrence of workplace violence within the ward. Additionally, we should cultivate a positive ward atmosphere, enhance the attitudes of psychiatric nurses toward their patients, and diminish expectations of social distance. These actions may reduce nurse turnover.

PMID:42368963 | PMC:PMC13303584 | DOI:10.3389/fpubh.2026.1828081