Resilience and Mobbing Among Nurses in Emergency Departments: A Cross-Sectional Study

Abstract

Background: Moral harassment (mobbing) in healthcare, particularly among nurses, remains a persistent issue with detrimental effects on mental health, resilience, and quality of life.

Aim: We examine the relationship between the resilience of nurses working in Emergency Departments (EDs) and how these factors influence experiences of workplace mobbing.

Methods: This cross-sectional study included 90 nurses from four public hospitals in Greece's 5th Health District. Data were collected between October 2023 and March 2024 using the WHOQOL-BREF, Workplace Psychologically Violent Behaviors (WPVB) scale and the Connor-Davidson Resilience Scale (CD-RISC). The sample consisted primarily of full-time nurses (84.3% female; mean age = 43.1 years), with 21.1% reporting chronic conditions. Most participants were married (80.0%) and had children (74.4%), typically two (56.1%). Statistical analyses-conducted using SPSS version 27.0-included descriptive statistics, Pearson and Spearman correlations, multiple linear regression, and mediation analysis, with significance set at p < 0.05.

Results: Resilience was moderate (mean = 66.38%; Cronbach's α = 0.93) and positively correlated with all WHOQOL-BREF domains-physical, psychological, social, and environmental (r = 0.30-0.40)-but not with the overall WHOQOL-BREF. The mean overall WHOQOL-BREF score was 68.4%, with the lowest scores observed in the environmental domain (mean = 53.76%). Workplace mobbing levels were low to moderate (mean WPVB score = 17.87), with subscale reliabilities ranging from α = 0.78 to 0.95. Mobbing was negatively associated with social relationships and the environmental WHOQOL-BREF (ρ = -0.23 to -0.33). Regression analysis showed that cohabitation and higher resilience significantly predicted better WHOQOL-BREF outcomes, whereas mobbing was not a significant predictor. Mediation analysis (bootstrap N = 5000) indicated no significant indirect effect of resilience in the relationship between mobbing and WHOQOL-BREF.

Conclusions: Resilience was identified as a key protective factor for nurses' quality of life in emergency care settings. Although workplace mobbing was present at low-to-moderate levels, it was negatively associated with specific WHOQOL-BREF domains. Enhancing mental resilience among nurses may serve as a valuable strategy to mitigate the psychological effects of moral harassment in healthcare environments.

Keywords: emergency department; hospital; mental resilience; mobbing; nurses; prevention and treatment of ethical harassment; work environment.

Figure 1

Conceptual framework of the hypothesized mediation model. Workplace psychological violence (WPVB) affects nurses’ WHOQOL-BREF potentially through the mediating effect of resilience (CD-RISC).