Relationship Between Anxiety, Depression and Post‐Traumatic Stress Disorder in Nurses Exposed to Horizontal Violence

AIM: To estimate the longitudinal predictive relationships between anxiety, depression and post-traumatic stress disorder symptoms in nurses exposed to horizontal violence and identify the most influential symptom using cross-lagged panel network analysis. DESIGN: A longitudinal cross-lagged panel network analysis study. METHODS: Data were obtained from a short longitudinal survey conducted at four tertiary hospitals in Shandong Province, China. Two follow-up surveys spaced 7 weeks apart were conducted on 298 nurses with horizontal violence exposure using the General Information Scale, the Negative Acts Questionnaire, the seven-item Generalised Anxiety Disorder scale, the nine-item Patient Health Questionnaire and the four-item SPAN. Unique longitudinal relationships between symptoms were estimated using cross-lagged panel network analysis. RESULTS: The results showed that the out-expected influence of A2 (Uncontrollable worry) and P2 (Physiological arousal) was highest and they were the most predictive symptoms in the network. The bridge out-expected influence of A2 (Uncontrollable worry) was also highest and it was the key bridge symptom within the network. CONCLUSIONS: A2 (Uncontrollable worry) and P2 (Physiological arousal) were the top risk factors contributing to mental health deterioration in nurses with horizontal violence exposure. IMPACT: This study precisely identified the predictive mechanisms and core symptoms among psychological symptoms in nurses exposed to horizontal violence, which is expected to play a significant role in improving the mental health of this group. The results showed that "Uncontrollable worry" and "Physiological arousal" were the core symptoms with the strongest predictive effects on other symptoms. Additionally, "Uncontrollable worry" was also the bridge symptom driving the mutual transmission and development of anxiety, depression and post-traumatic stress disorder. Nursing managers should prioritise "Uncontrollable worry" and "Physiological arousal" as intervention targets, optimising mental health interventions to effectively enhance the psychological well-being of nurses exposed to horizontal violence. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.