Verbal Workplace Violence and Burnout Among Italian Nurses: The Role of Self-Efficacy and Coping

Verbal workplace violence (WPV) is the most frequent form of aggression experienced by nurses and represents a significant psychosocial risk for professional well-being and workforce sustainability. Although individual resources such as self-efficacy and coping strategies may influence nurses' responses to verbal WPV, their role should be interpreted within the context of chronic occupational stress.

This study aimed to examine the prevalence and characteristics of verbal WPV among Italian nurses and to investigate its associations with burnout, psychological distress, perceived self-efficacy, and coping strategies, comparing nurses exposed and not exposed to verbal WPV.

A cross-sectional quantitative study was conducted using an online self-administered questionnaire. A convenience sample of 384 Italian nurses completed validated measures assessing exposure to verbal WPV, burnout (Oldenburg Burnout Inventory), psychological distress (GHQ-12), perceived self-efficacy at work, and coping strategies (Brief COPE). Descriptive analyses, group comparisons, correlation analyses, and multiple linear regression models were performed, stratified by exposure to verbal WPV.

Overall, 34.4% of participants reported experiencing verbal WPV, most frequently in high-pressure clinical settings. Nurses exposed to verbal WPV reported lower levels of emotional exhaustion but slightly higher psychological distress compared with non-exposed nurses. They also reported higher perceived self-efficacy and greater use of problem-focused and cognitive coping strategies. Among exposed nurses, self-efficacy and coping strategies explained a substantial proportion of variance in exhaustion and disengagement, indicating complex and non-linear psychological adaptation processes. More linear occupational stress patterns emerged among non-exposed nurses.

Verbal WPV is a pervasive occupational hazard in nursing and is associated with differentiated psychological adaptation processes rather than uniformly protective or detrimental outcomes. These findings indicate that organisations cannot rely solely on individual interventions and must take responsibility for preventing violence.