Unveiling Hidden Trauma: A Cross-Sectional Study of Violence Exposure and Its Impacts on Entrapment, Self-Stigma and Empathic Care Among Psychiatric Nurses.

Abstract

Background: Psychiatric nurses often work in high-stress environments where they are frequently exposed to various forms of violence and aggression from patients. While the immediate physical consequences of violence are usually recognised, the psychological impacts, such as feelings of entrapment, self-stigma and diminished empathy, are less understood but equally critical.

Aims: This study aimed to fill this gap by examining how different forms of violence exposure affect entrapment, self-stigma and empathic care among psychiatric nurses, providing insights that can inform both practice and policy.

Design: This study utilised a descriptive correlational research design.

Method: This study was conducted in two prominent psychiatric hospitals in Egypt, namely the Mental Health Hospital and Addiction in Benha City and Elmaamora for Psychiatric Medicine and Addiction in Alexandria. A convenience sample of 246 psychiatric nurses who filled out the Perception of Prevalence Aggression Scale, the Impact of Event Scale-Revised, the Empathetic Care Scale, the Scale for Assessing the Stigma of Mental Illness in Nursing and the Entrapment Scale was used for the study. Data collection spanned 3 months, from June to August 2024.

Findings: The findings reveal that perceived aggression is positively correlated with the impact of events (r = 0.513, p < 0.001) and entrapment (r = 0.160, p = 0.012) and negatively correlated with empathy (r = -0.232, p < 0.001). The regression analyses show that verbal aggression, threatening verbal aggression, aggressive splitting behaviour, severe self-directed violence and suicides are significant predictors of empathy, increasing its levels (R² = 0.509, p < 0.001). Stigma is negatively influenced by threatening verbal aggression, provocative aggressive behaviour, severe physical violence, mild violence against self and suicides but positively by passive-aggressive behaviour (R² = 0.377, p < 0.001).

Conclusion: These results underscore the importance of addressing aggression in psychiatric settings to promote the well-being and professional functioning of nurses.

Reporting method: STROBE is the relevant reporting method that has been adhered to.