The role of human resource management in managing and mitigating the effects of workplace violence: an examination of nurses and personal care assistants working in aged care
Creators: name: PARIONA CABRERA, Patricia Dina
Publisher: name: RMIT University
Year: 2024
Subjects: classificationCode: 350503
subject: Human resources management

description: Workplace violence is a critical challenge across healthcare services and aged care facilities in Australia and internationally. It has been argued that violence at work represents the highest recorded reason for clinician submission of formal complaints to management across Australian healthcare services. The purpose of this study is to provide a better understanding of the role of human resource management (HRM) practices in managing and mitigating the effects of workplace violence on nurses' and personal care assistants' (PCAs) mental health. This mixed methods study is about nurse and PCA members of the Australian Nursing Midwifery Federation (ANMF) employed in aged care facilities across the state of Victoria, Australia, the incidences of workplace violence perpetrated on them by residents, relatives and visitors and the impact this has on their mental health. A mixed methods approach is employed by integrating qualitative semi-structured interviews and an online quantitative survey. This methodology ensures a complete picture of the role of wellbeing-oriented HRM in managing and mitigating the effects of workplace violence on nurses and PCAs' mental health. 

The qualitative component involved conducting semi-structured interviews with 60 participants, comprising 10 managers and 50 nurses and PCAs across Victorian aged care facilities. For this study, they are collectively named 'nurses and PCAs'. Within this study, registered nurses, enrolled endorsed nurses and enrolled nurses are collectively named 'nurses'. The terms 'mental health' and 'wellbeing' are used interchangeably because participants used both terms during interviews to describe the impact on their health. Themes were identified in the data using NVivo with a thematic content analysis approach that categorised themes. The themes are divided into job resources and job demands in accordance with the main theoretical framework of job demands-resources (JD-R). The qualitative findings demonstrated ineffective HRM support, inadequate management support such as a lack of two-way communication, meaningful rewards and flexible work arrangements, and management's focus on financial outcomes. The qualitative findings also exposed issues around effective training and development, performance management and supportive feedback, skills utilisation and a blaming culture. The findings ultimately revealed the negative consequences of workplace violence, factors impacting the quality of resident care, and factors impacting the intention to leave.

The quantitative component involved data collected from 795 nurse and PCA members of the ANMF-Victorian branch, which were employed to test moderation and mediation hypotheses. JD-R theory, together with other complementary theories, were used to develop six hypotheses: H1 - wellbeing-oriented HRM practices moderate the relationship between workplace violence and mental health; H2 - stress mediates the relationship between workplace violence and burnout; H3 - depression mediates the relationship between workplace violence and burnout; H4 - anxiety mediates the relationship between workplace violence and burnout; H5 - burnout mediates the relationship between mental health issues and quality of resident care; and H6 - burnout mediates the relationship between mental health issues and intention to leave. These six hypotheses were tested using ordinary least squares regression via moderated and mediated regression analysis to examine the mediating and moderating relationship between variables. The quantitative findings indicated support for each of the six hypotheses: wellbeing-oriented HRM practices significantly moderates the relationship between workplace violence and mental health (H1); stress mediates the relationship between workplace violence and burnout (H2); depression mediates the relationship between workplace violence and burnout (H3); anxiety mediates the relationship between workplace violence and burnout (H4); burnout mediates the relationship between mental health issues and quality of resident care (H5); and burnout mediates the relationship between mental health issues and intention to leave (H6). 

This research contributes to HRM, workplace violence and burnout literature by addressing five under-researched areas. First, it has responded to the call for greater research on how HRM practices may promote the mental health of employees in mitigating the consequences of violence at work. Second, it has shown how JD-R theory can be used to understand the role of wellbeing-oriented HRM practices such as job design to provide autonomy and challenge, health and safety, and extensive two-way communication practices that act as job resources to manage and mitigate the effects of violence (job demands). Third, this study has contributed to the research on conservation of resources theory by examining the process through which training and development, rewards systems, and participative and supportive management (wellbeing HRM practices) act as conditional resources to accumulate and integrate key resources leading to resource gains that may contribute to the management of threats and potentially curtail the negative impact of violence. Fourth, this study has sought to unpack the process through which workplace violence can impact on burnout through mental health issues, including stress, depression and anxiety. Fifth, it contributes to research on areas of worklife theory by unpacking how mental health challenges may impact on the quality of resident care and intention to leave (performance outcomes) through burnout manifestations. 

Findings from this study have a number of practical implications for key stakeholders in aged care facilities within and beyond the aged care sector. First, the study provides a comprehensive approach to and practical recommendations from the HRM perspective for aged care management in managing and mitigating the effects of violence on the mental health of nurses and PCAs by implementing wellbeing-oriented HRM practices. Second, aged care leadership needs to develop appropriate HRM structures and promote effective communications between managers and HRM departments. HRM departments in aged care facilities should be more involved in the role of managers and their strategic function through the use of HRM practices and policies that may enhance nurses and PCAs' wellbeing and consequently drive positive in-role performance. Third, the findings draw particular attention to the importance of implementing greater training and development for managers around soft management skills and supportive leadership skills, effective communications and HRM. Finally, there needs to be training, development and interventions created to support nurses and PCAs. Training and development should contribute towards protecting nurses and PCAs from workplace violence and help them cope with the effects of aggression and violence.