The moderating effect of psychological capital on the relationship between nurses’ perceived workplace bullying and emotional exhaustion: a cross-sectional study

Workplace bullying (WPB) is widely acknowledged as a pervasive issue faced by the nursing profession [1]. It involves ongoing and recurring negative behaviors, whether real or perceived, executed by individuals or groups in positions of authority. Victims of WPB often face challenges in effectively protecting themselves over prolonged periods [2]. Bullying behaviors include but are not limited to unwarranted criticism, verbal assaults, refusal to help, persistent undermining of achievements, disregard for opinions, provocation, intimidation and the utilization of threats or biased penalties [3]. A systematic review found the global prevalence of WPB among nurses to be approximately 30.8% [4]. In a study conducted by Peng et al. [5], which surveyed over 5000 Chinese nurses, it was reported that 30.75% had encountered WPB within the preceding six months.

Previous research has shown that WPB negatively impacts the psychological and physical well-being of bullied nurses [6]. It also hinders effective teamwork and communication among nursing professionals and other team members, which ultimately threatens the quality of nursing care and compromises patient safety [6]. It is noteworthy that emotional exhaustion often emerges as the initial negative response experienced by nurses subjected to WPB, thereby triggering the aforementioned negative consequences. Emotional exhaustion is defined as the feeling of being emotionally overextended and drained by one’s work, which is regarded as the core element of job burnout [7, 8]. According to the study of Ma et al., it is suggested that emotional exhaustion may serve as a mediator in the relationship between WPB and nurses’ affective occupational commitment [9]. Likewise, Srivastava et al. [10] revealed that emotional exhaustion plays a mediating role between WPB and workers’ intention to leave. Therefore, it can be inferred that WPB contributes to emotional exhaustion among nurses.

The theory of Job Demand-Resource (JD-R) provides a heuristic way for viewing how job characteristics influence the employees’ emotional exhaustion. As per the JD-R theory, when employees face high job demands and limited job resources, their chances of experiencing emotional exhaustion are heightened [11]. Previous studies have demonstrated that WPB can be considered as a type of job demand within the JD-R framework, which contributes to employees’ emotional exhaustion and depletes the available resources that could be better used to achieve work goals [12]. Additionally, the affective event theory (AET) posits that an employee’s experience of positive or negative work events elicits individual affective responses (which refer to employees’ moods and emotions), which in turn influence their attitudes and behaviors towards work. WPB can be regarded as a negative work event or stressful situation that may cause negative affective responses, such as emotional exhaustion [13]. Numerous studies have consistently demonstrated a positive correlation between WPB and emotional exhaustion [14‐17]. Given the high prevalence of WPB in nursing profession and its serious consequences, it is imperative to explore protective factors that can help reduce the impact of WPB on nurses’ emotional exhaustion.

Psychological capital (PsyCap) is a noteworthy factor that refers to an individual’s optimistic psychological state of development, encompassing positive psychological constructs such as hope, efficacy, resilience, and optimism [18]. PsyCap has been recognized as a crucial resource that empowers individuals to effectively cope with stressors and adversities in the workplace [19]. Introducing PsyCap into the framework of WPB and its consequences, particularly emotional exhaustion, offers a promising avenue for understanding how nurses might mitigate the negative impact of bullying experiences. According to AET, personal traits moderate the effect of work events (such as WPB) on affective responses (like emotional exhaustion) [13]. Since PsyCap falls within the realm of personal traits, it implies that PsyCap could potentially moderate the relationship between WPB and emotional exhaustion. The JD-R theory also suggests that job resources have the potential to shield employees from the adverse effects of excessive job demands, implying that PsyCap might mitigate emotional exhaustion caused by WPB. However, there is currently a lack of direct empirical evidence supporting this claim. By clarifying the role of PsyCap in the relationship between nurses’ perception of WPB and emotional exhaustion, we can gain a deeper understanding of the boundary effects within this relationship. Furthermore, this insight is critical for developing strategies aimed at mitigating the negative impacts of WPB and effectively managing emotional exhaustion among nurses.

Therefore, the objective of this study was to examine how nurses’ perceived WPB affects their emotional exhaustion and whether PsyCap has a moderating effect on this association. Based on the aforementioned evidence, we postulate that: (1) nurses’ perceived WPB has a positive impact on their emotional exhaustion; and (2) PsyCap has a moderating effect on the relationship between WPB and emotional exhaustion. The hypothetical model we developed is shown in Fig. 1.

This study is the first study to explore how PsyCap moderates the relationship between nurses’ perceived WPB and emotional exhaustion, to the best of our knowledge. The findings showed that nurses’ perceived WPB has a positive impact on their emotional exhaustion, and PsyCap moderates this relationship.

This study revealed that 24.0% of nurses reported experiencing WPB within the preceding six months, underscoring the widespread prevalence of bullying in the nursing profession, consistent with prior research [4]. The moderation analysis further corroborated that nurses’ perceived WPB is a risk factor for emotional exhaustion, highlighting the detrimental impact of WPB on nurses’ emotional well-being[16^, 17]. Previous studies have already established a significant positive association between WPB and emotional exhaustion, indicating the robustness of this relationship across various cultures and work environments [14‐17]. This result confirms that negative work events can trigger negative affective responses, thereby validating the pathway proposed in the AET that work events can elicit affective responses. In light of this, it is imperative for nursing managers to acknowledge the severity and detrimental impact of WPB within the nursing profession. Necessary organizational measures should be taken to mitigate the prevalence of such behaviors, thereby preventing health issues such as emotional exhaustion among nurses. It is particularly advisable to conduct regular assessments of WPB levels within the organization and to analyze high-risk situations that may contribute to WPB due to ineffective management [31, 32]. Additionally, identifying and proactively preventing organizational-level risk factors that may contribute to WPB, cultivating a supportive work environment, and establishing a zero-tolerance policy towards WPB are recommended [31, 33].

The moderation analysis indicated that PsyCap served as a moderating factor in the relationship between WPB and emotional exhaustion, thus supporting our hypothesis. Further examination revealed that PsyCap can mitigate the impact of nurses’ perceived WPB on their emotional exhaustion. These findings validate the moderating role of PsyCap in the relationship between work events and affective responses. Moreover, the results also demonstrate that PsyCap can serve as a job resource to alleviate the adverse effects of high job demands. Consequently, these results not only affirm the robust explanatory power of AET and the JD-R theory but also extend the practical application boundaries of these theoretical frameworks. These results suggest that interventions aimed at enhancing nurses’ PsyCap could be effective strategies to alleviate the negative effects of WPB. For example, implementing micro-intervention training focused on the core components of hope, self-efficacy, resilience, and optimism, as outlined in the Psychological Capital Intervention Model is considered effective in enhancing PsyCap [34]. Additionally, employing positive psychology interventions, such as focusing on strengths, using Ellis Rational-Emotive Therapy, engaging in positive focus and constructive problem-solving activities, and practicing job crafting, has also been regarded as potentially beneficial in this regard [34, 35].

Interestingly, as the perception of WPB increases, the difference in emotional exhaustion between individuals with high and low PsyCap levels decreases. This finding, which has not been previously reported in prior research, indicates that the protective effect of PsyCap decreases as WPB increases in the organizational environment. This phenomenon may occur because perceived WPB is influenced by both individual and organizational factors [36, 37]. When an individual perceives a high level of WPB, there are likely to be more bullying promoting factors within the organization, such as normalization of bullying in nursing teams, organizational tolerance and reward of bullying behaviors [37]. However, PsyCap only serves as an individual protection resource and cannot effectively counteract the negative effects caused by persistent or high levels of WPB within the organization. This finding suggests that in organizations with low levels of WPB, nursing managers can partially rely on nurses’ individual protective resources to mitigate the negative impact on emotional exhaustion. However, in organizations where nurses perceive a higher severity of WPB, nursing managers must address this issue from an organizational and managerial perspective, rather than solely relying on nurses themselves.

This study advances the current understanding of the impact of nurses’ perceived WPB on their emotional exhaustion. Notably, it contributes to the existing body of knowledge by examining how PsyCap can moderate the relationship between WPB and emotional exhaustion among nurses. However, the study has several limitations that should be acknowledged. Firstly, the use of convenience sampling limits the generalizability of the findings and may introduce selection bias. To improve sample representativeness and minimize bias, future research should, where possible, employ random sampling techniques. Secondly, the sample was confined to nurses from tertiary hospitals, which necessitates caution when generalizing the results to nurses in secondary or primary healthcare settings. Replicating the study in these contexts is recommended to ensure broader applicability. Thirdly, the use of the NAQ-R questionnaire, which required participants to recall negative experiences over a six-month period, may have introduced recall bias. Additionally, the cross-sectional design of this study restricts the ability to infer causal relationships. Consequently, future research would benefit from employing longitudinal designs to better assess causality.

Nurses’ perceived WPB is a risk factor for emotional exhaustion. PsyCap exerts a buffering moderating effect on the relationship between WPB and emotional exhaustion; however, this effect weakens as levels of WPB increase. Thus, developing nurses’ PsyCap helps reduce the negative impact of WPB on bullied nurses. However, in organizational contexts with higher levels of WPB, individuals’ capacity to deal with WPB is limited. Therefore, it is recommended that nursing managers mitigate the detrimental impact of WPB on nurses’ emotional well-being by both strengthening nurses’ individual PsyCap and implementing comprehensive strategies to reduce WPB behaviors.