Patient verbal abuse, emotional exhaustion, and affective commitment among healthcare workers: A moderated mediation model of peer support

Empirical studies
By Igor Portoghese, Maura Galletta, Ernesto D’Aloja, Gabriele Finco, Marcello Campagna

In the last decade, patient violence against hospital workers has been recognized as an emerging occupational hazard with negative effects at both individual and organizational levels. The aims of the current study were to examine the mediating role of emotional exhaustion on the relationship between patient verbal abuse (PVA) and unit affective commitment in a sample of healthcare workers (HCWs). In addition, we analyzed whether peer support was a moderator on the mediating effect. Using survey data from 870 HCWs, the results indicated that there was no significant direct effect of PVA on unit affective commitment after controlling for emotional exhaustion. The conditional indirect effect test showed that emotional exhaustion mediated the relationship between PVA and unit affective commitment at both low and high levels of peer support. Particularly, our results showed that the more peer support the stronger the relationship between PVA and emotional exhaustion. Finally, the moderation tests also showed that the less peer support the stronger the negative effect of emotional exhaustion on unit affective commitment. Several implications for future research and policy are discussed.


  • patient verbal aggression
  • emotional exhaustion
  • affective commitment
  • peer support
  • moderated mediation model
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