Workplace violence, legal knowledge, and support for nursing legislation among nurses in China: A multicenter...

Workplace violence is a major occupational hazard for nurses, but its association with support for legislative protection remains unclear. This study examined the associations among workplace violence, nursing-related legal knowledge, and explicit support for nursing legislation.

A multicenter cross-sectional survey was conducted among 4,391 nurses from 13 hospitals in Shanghai, China, in January 2024. Workplace violence was assessed using a weighted poly-victimization index based on eight violence types. Nursing-related legal knowledge and legislative support were assessed using 30-item and 14-item instruments, respectively. Spearman correlations and PROCESS Model 4 were used to estimate the indirect association between workplace violence and legislative support through nursing-related legal knowledge, adjusting for demographic and occupational covariates. Exploratory subgroup and sensitivity analyses examined department risk level, alternative workplace violence scores, age and work-tenure specifications, and hospital-level clustering.

Workplace violence was weakly negatively correlated with legal knowledge (r = -0.036, p = .017), whereas legal knowledge was positively correlated with legislative support (r = 0.131, p < .001). Workplace violence and legislative support were essentially uncorrelated in the unadjusted analysis (r = -0.001, p = .947). In the adjusted model, the total association was small (β = -0.046, 95% CI [-0.076, -0.016], p = .002), the direct association was not statistically significant (β = -0.025, 95% CI [-0.054, 0.004], p = .088), and the indirect association through legal knowledge was also small (β = -0.021, 95% bootstrap CI [-0.030, -0.012]). Subgroup analyses showed descriptive differences across department risk groups, and sensitivity analyses yielded similar coefficient estimates.

Nursing-related legal knowledge was associated with stronger explicit support for nursing legislation and contributed to a small indirect statistical association between workplace violence and legislative support. The small effect estimates and cross-sectional design preclude causal or strong policy conclusions. Longitudinal studies are needed to clarify temporal ordering and practical relevance.