Influences of Experience of Violence and Cognitive-Emotion Regulation Strategies on Psychiatric Nurses’ Post-Traumatic Stress

Highlights: What are the main findings? Psychiatric nurses experiencing workplace violence showed high post-traumatic stress levels, exceeding clinical cutoff thresholds, with verbal violence being the most frequently experienced type. Maladaptive cognitive-emotion regulation strategies were the strongest predictor of post-traumatic stress, followed by violence experiences and educational level, explaining 62.6% of variance. What are the implications of the main findings? Healthcare institutions should implement comprehensive violence prevention programs and provide immediate psychological support for all types of workplace violence, including verbal abuse, which is often underreported. Interventions should focus on teaching psychiatric nurses to reduce maladaptive cognitive-emotion regulation strategies while enhancing adaptive coping mechanisms to mitigate post-traumatic stress development. Background/Objectives: Psychiatric nurses are constantly exposed to physical and verbal violence from patients with mental illnesses, which can lead to post-traumatic stress (PTS). This study investigated the correlations among psychiatric nurses’ experiences of violence, cognitive-emotion regulation strategies, and PTS and sought to identify factors associated with PTS. Although workplace violence and its psychological effects have been examined among nurses, little is known about how cognitive-emotion regulation influences PTS in psychiatric nurses who are frequently exposed to violence. Understanding these mechanisms is crucial for developing interventions to support their mental health. Methods: This was a cross-sectional, descriptive correlational study. Participants were 140 psychiatric nurses with more than one year of clinical experience working in psychiatric wards at university, general, and psychiatric hospitals in South Korea. Collected data were analyzed using SPSS/WIN 25.0. A hierarchical regression analysis was performed to identify factors influencing the nurses’ PTS. Hierarchical regression analysis was performed in three steps: demographic variables were entered first, followed by violence experience, and finally cognitive-emotion regulation strategies. All assumptions of linearity, normality, and homoscedasticity were satisfied. Results: In Model 3, after controlling for demographic and work-related variables, maladaptive emotion regulation strategies, experiences of violence, and education level emerged as significant predictors of PTS among psychiatric nurses. These variables together explained a substantial proportion of the variance in PTS. Conclusions: To reduce PTS among psychiatric nurses, it is necessary to develop and implement violence prevention and coping programs, stress and mental health management initiatives, and educational programs. Based on the findings, hospitals should strengthen organizational systems by establishing structured mechanisms for reporting and debriefing after violent incidents. In addition, hospitals should provide regular training on cognitive-emotion regulation and enhance institutional support to help nurses manage the psychological impact of workplace violence. Such interventions may not only minimize violent incidents but also reduce reliance on maladaptive cognitive-emotion regulation strategies. While the findings provide important insight, the cross-sectional design limits causal inference. Further longitudinal research is recommended to verify these relationships.