Prevalence and associated factors of workplace violence among Chinese nurses in tertiary hospitals: a national cross-sectional study

Prevalence and associated factors of workplace violence among Chinese nurses in tertiary hospitals: a national cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and associated factors of workplace violence among Chinese nurses in tertiary hospitals: a national cross-sectional study Jianghao Yuan, Jiaxin Yang, Yiting Liu, Meng Ning, Qiang Yu, Xuting Li, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5381741/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Background: Workplace violence (WPV) is a major issue for nurses worldwide, causing both physical and mental harm, and impairing their ability to work effectively. Several researches reported on the prevalence of WPV among nurses in China, ranging from 56.4–71%. However, little information is available about the correlates of different types of WPV among nurses across different departments in tertiary hospitals in China. Methods: A self-designed WeChat-based questionnaire was utilized, incorporating demographic and occupational factors. WPV was measured using the Chinese version Workplace Violence Scale. Two questions regarding career choices were employed to assess career satisfaction. Descriptive analyses, chi-square tests, and bivariate logistic regression analysis were conducted. Results: 122,237 participants were included in the analysis. 26.6% of them experienced at least one form of WPV in the past year. Male sex, shift work, postgraduate education, senior professional title, department, and working more than 50 hours per week were factors associated with WPV. Nurses encountered high levels of WPV were less likely to be satisfied with their nursing career. Conclusions: WPV is a special concern for Chinese nurses. Interventions to reduce WPV should be conducted by health authorities to create a zero-violence working environment for nurses, and to increase their career satisfaction. workplace violence nurses cross-sectional study Figures Figure 1 1. Introduction According to the National Institute for Occupational Safety and Health, WPV is defined as acts directed towards persons at work or on duty [ 1 ]. WPV encompasses a range of categories: emotional abuse (EA, mistreatment through words, such as disrespect, cursing, and disparagement), physical assault (PA, physical contact, such as pushing, beating, biting, and spitting), threats (T, use of verbal, written or physical force resulting in fear of negative consequences), verbal sexual harassment (VSH, unwelcome comments or remarks of a sexual nature), and sexual abuse (SA, unwanted touching or other sexual behaviours). Nurses are the largest professional group in the healthcare sector, and they are most vulnerable to WPV compare to other healthcare professions as they have the closest contact with patients and their relatives [ 2 ]. A meta-analysis of 253 studies showed that the proportion of exposure to any type of WPV (12-month prevalence) was 59.2% for nurses, 56.8% for physicians, and 44.4% for other healthcare professionals [ 3 ]. Many studies have reported the prevalence of WPV against nurses, In the United States, Laura McLaughlin and colleagues reported that the pooled rates of WPV among nurses was 43% from 2020 to 2022 [ 4 ]. A cross-sectional study involving nurses from five European countries (Poland, the Czech Republic, the Slovak Republic, Turkey, and Spain) showed that 54% nurses experienced non-physical violence and 20% reported physical violence in the past year [ 5 ]. In Africa, Emmanuel Ekpor.et al reported a WPV prevalence rate of 62.3% among 9831 nurses, with verbal abuse (51.2%) being the most common form [ 6 ]. In South-East Asian and Western Pacific Regions, Abin Varghese and colleagues reported pooled prevalence of WPV to be 58% [ 7 ]. According to a meta-analysis by Xin Liu MS, the 12-month incidence of WPV among Chinese nurses was 71%, with verbal violence (63%) being the most common type of violence [ 8 ]. Many studies have shown that WPV affects the physical and psychological health of nurses, resulting in reduced job performance and satisfaction and increased turnover intention and burnout, which leads to negative outcomes for patients [ 9 – 14 ]. In mainland China, there were a total of 5 million registered nurses according to the 2021 National Health Yearbook [ 15 ]. Many studies have explored the prevalence of WPV and the factors associated with nurses' experiences of it. Nurses being young, working shifts, having longer weekly working hours (>40h), and working in emergency, critical care, or psychiatric departments were more likely to suffer WPV [ 8 , 16 , 17 ]. However, there are also completely inconsistent conclusions regarding some associated factors. For example, some studies found that female nurses are more likely to experience WPV [ 6 , 18 ], while others indicate that male nurses are more prone to physical forms of WPV [ 3 , 19 ]. Additionally, some researches reported that unmarried nurses have a higher prevalence of WPV [ 6 ], whereas other studies reported that married nurses have a higher prevalence [ 18 ]. Meanwhile, previous studies have often been limited by small sample sizes or single-center, resulting in varied conclusions about the prevalence and associated factors of WPV. Furthermore, most studies have not analyzed the prevalence and associated factors of different types of WPV. Therefore, this study aims to investigate the prevalence of different types of WPV and their associated factors through a large-scale, multicenter survey across China. Furthermore, it seeks to examine the impact of WPV on job satisfaction. 2. Methods 2.1 Study design and settings This study utilized baseline data of the Nurses' Mental Health Study (NMHS), a prospective cohort investigation focusing on nurses working within 67 tertiary hospitals across 31 provincial-level administrative divisions (referred to hereafter as 'provinces'). Hospitals were eligible for inclusion based on the following criteria: they must be general tertiary hospitals, capable of handling a variety of diseases comparable to other tertiary hospitals within their respective provinces. 2.2 Data collection and participants Cluster sampling was used during baseline recruitment. Once a hospital was selected, all nurses working there were invited to participate. The inclusion criteria for nurses were: 1) age of 18 years or older; 2) being a registered nurse officially employed at the hospital; 3) willing to participate in the NMHS study. Exclusion criteria included: 1) nurses on sick leave, maternity leave, or retired; 2) nursing interns. Data were collected from November 2023 to January 2024 using an online questionnaire. The survey link was generated through “Wenjuanxing” ( https://www.wjx.cn/ ), one of China's largest online survey platforms. Prior to data collection, two researchers with Master’s degrees in Nursing were trained by the principal investigator and deemed qualified to assist in explaining the purpose of the NMHS study and the details of each questionnaire item. Subsequently, the survey link was distributed to participants via WeChat, a popular social application in China. Before beginning the questionnaire, nurses were presented with an informed consent page that explained the purpose of the NMHS study, assured them of their freedom to participate or withdraw at any time. 15 to 20 minutes were needed to complete the online questionnaire. If they had any questions or concerns, they could contact the researchers via email, phone, or WeChat.A total of 147,832 nurses were invited to participate in the survey, and 135,161 online questionnaires were returned. These returned questionnaires were reviewed by two researchers. After removing duplicates and low-quality responses, 132,910 nurses were ultimately included in the baseline data collection for the Nurse Mental Health Study (NMHS), resulting in an overall effective response rate of 89.91%. Low-quality data were identified based on the following criteria:1) data with obvious logical errors, such as the difference between the age and working years was smaller than 16 years old, a gestational week of zero, a duration of religious belief longer than the respondent’s age, or weekly working hours exceeding 168 hours (7 days a week, 24 hours a day); 2) outliers, defined as values outside the mean ± 3SD, or values lower than P25-3IQR and higher than P75 + 3IQR [ 20 ]. Additionally, 10,673 participants chose ‘prefer not to answer’ in the WPV were excluded from the analysis. Finally, 122,237 participants were included in this study. The specific procedure is outlined in Fig. 1 . 2.3 Measures The NMHS online questionnaire was developed by the research team based on a previous scoping review [ 21 ] and qualitative studies [ 22 ], with the variables determined by a comprehensive literature review. 2.3.1 Sociodemographic and Occupational variables The sociodemographic variables included age, gender, education level, and marital status, measured through self-designed questions. The occupational variables included working shifts, weekly working hours, years of working experience, and professional title, also measured by self-designed questions. 2.3.2 Workplace Violence Scale (WVS) The prevalence and frequency of WPV experienced in the past 12 months were measured using the Chinese version of the Workplace Violence Scale (WVS), which has demonstrated good reliability and validity among Chinese healthcare workers [ 23 ]. The scale consists of five items: Physical Assault (PA), Emotional Assault (EA), Threat (T), Verbal Social Harassment (VSH), and Sexual Assault (SA). Each item is scored from 0 to 3 (0 = none, 1 = once, 2 = two to three times, 3 = more than three times), reflecting the frequency of exposure to WPV in the past year. The total score is the sum of the scores for each item, ranging from 0 to 15. The severity of violence is categorized into four levels based on the sum score (None = 0, Low = 1–5, Medium = 6–10, High = 11–15). The survey provided specific definitions for each type of violence. 2.3.4 Career choice The respondents also answered two questions regarding career choice:" Knowing all the risks, would you still choose to become a nurse? (Yes/No) " and " Would you want your child to become a nurse? (Yes/No) " 2.4 Statistical analyses In this study, only participants who fully completed the five questions of the Chinese version of the Workplace Violence Scale without choosing "prefer not to answer" were included as valid samples (n = 122237), For details, please refer to Fig. 1 and supplementary material. Responses to whether the respondents had experienced any type of WPV were coded as binary answers (yes/no). The distribution of demographic and occupational data, along with the prevalence of five types of WPV, was reported in numbers and percentages. In subsequent binary logistic regression analyses, factors associated with each type of WPV, which were specified a priori with a p-value of 0.1 in the chi-square tests, were included to determine significant predictors of the outcome variables (the five types of WPV). The relationship between career choice and WPV levels was examined using chi-square tests. All analyses were conducted using IBM SPSS Statistics Version 27.0 for Windows. 3. Results 3.1 Characteristics of the participants A total of 147,832 nurses from 67 hospitals in mainland China participated in the survey. After removing duplicates and low-quality questionnaires, those fully and effectively responded to the Chinese version of WVS were considered valid samples for this study. Among these 122,237 individuals, 93.5% were female, 69.0% were married, 31.0% were single, 51.8% held a junior professional title, and 78.2% worked shifts. The age range of the respondents was between 18 and 65 years old, with 36.9% being under 30 years old, and the mean age was 33.5 ± 7.3 years. The distribution of participants according to demographic and occupational characteristics is shown in Table 1 . Table 1 The distribution of five types of WPV by demographic and occupational characteristics. Demographic variables PA EA T VSH SA N (%) N (%) N (%) N (%) N (%) Gender Male 866(10.8) 1629(20.4) 877(11.0) 147(1.8) 85(1.1) Female 6705(5.9) 26918(23.6) 11423(10.0) 2450(2.1) 1274(1.1) χ2 316.16 42.71 7.69 3.39 0.19 P value <.001 <.001 <.001 .066 0.665 Age group(yr) < 30 2881(7.4) 9106(23.4) 3498(9.0) 1238(3.2) 658(1.7) 30–39 3696(6.1) 14583(23.9) 6428(10.5) 1084(1.8) 568(0.9) ≥ 40 994(4.5) 4858(21.7) 2374(10.6) 275(1.2) 133(0.6) χ2 218.69 43.03 71.22 331.78 191.87 P value <.001 <.001 <.001 <.001 <.001 Marital status Married or cohabitang 4558(5.4) 19116(22.7) 8490(10.1) 1318(1.6) 701(0.8) Separated, widowed, or divorced 210(7.0) 802(26.7) 385(12.8) 88(2.9) 45(1.5) Never married 2803(8.0) 8629(24.7) 3425(9.8) 1191(3.4) 613(1.8) χ2 293.86 74.86 27.45 413.81 195.42 P value <.001 <.001 <.001 <.001 <.001 Education level Master degree or above 410(8.0) 1297(25.2) 652(12.7) 120(2.3) 55(1.1) Bachelor degree 6568(6.2) 25169(23.6) 10749(10.1) 2248(2.1) 1192(1.1) Associate degree or below 593(5.6) 2081(19.6) 899(8.5) 229(2.7) 112(1.1) χ2 35.11 99.01 69.26 1.24 .46 P value <.001 <.001 <.001 .539 .796 Occupational variables PA EA T VSH SA N(%) N(%) N(%) N(%) N(%) Professional title Senior 329(5.6) 1339(22.6) 770(13.0) 82(1.4) 35(0.6) Intermediate 3010(5.7) 12834(24.2) 5778(10.9) 883(1.7) 462(0.9) Primary 4232(6.7) 14374(22.7) 5752(9.1) 1632(2.6) 862(1.4) χ2 53.50 40.78 166.49 130.80 77.83 P value <.001 <.001 <.001 <.001 <.001 work schedule Shift 6491(6.8) 23359(24.4) 10030(10.5) 2208(2.3) 1163(1.2) Non-shift 1080(4.1) 5188(19.5) 2270(8.5) 389(1.5) 196(0.7) χ2 268.87 287.49 89.80 72.44 43.89 P value <.001 <.001 <.001 <.001 <.001 Weekly working hours ≥ 50h 1293(7.3) 4229(24.0) 1979(11.2) 447(2.5) 248(1.4) 40-49h 4482(6.1) 17817(24.1) 7412(10.0) 1565(2.1) 791(1.1) ≤ 39h 1796(5.8) 6501(21.1) 2909(9.5) 585(1.9) 320(1.0) χ2 48.75 114.16 39.57 21.91 16.65 P value <.001 <.001 <.001 <.001 <.001 PA : physical assault EA : emotional abuse T༚ threat VSH : verbal sexual assault SA༚ sexual assault 3.2 The prevalence and characteristics of WPV In this study, the prevalence of WPV among Chinese nurses was 26.6% (32,540 out of 122,237). The highest prevalence was for EA (23.3%), followed by T (10.1%), PA (6.2%), VSH (2.1%), and SA (1.1%). Significant differences in the prevalence rates of these five types of WPV were observed across demographic and occupational characteristics (Table 1 ). Male nurses had a higher prevalence of PA (10.8% vs. 5.9%, χ2 = 316.2, P < 0.01), T (11.0% vs. 10.0%, χ2 = 7.7, P < 0.01) compared to female nurses. Conversely, female nurses had a higher prevalence of EA (23.6% vs. 20.4%, χ² = 42.7, P < 0.01). There was no significant difference in the prevalence of VSH and SA between male and female nurses. Nurses aged under 30 years had the highest prevalence of PA (7.4%, χ2 = 218.7, P < 0.01), VSH(3.2%, χ2 = 331.8, P < 0.01), and SA (1.7%, χ2 = 191.9, P < 0.01) compared to other age groups. Nurses aged 30 to 39 years had the highest prevalence of EA (23.9%, χ2 = 43.0, P < 0.01), while nurses aged 40 years and over had the highest prevalence of T (10.6%, χ2 = 71.2, P < 0.01). Nurses with a master’s degree or higher were most vulnerable to all five types of violence (PA, EA, T,VSH, and SA were 8.0%, 25.2%, 12.7%, 2.3% and 1.1%, respectively), Primary nurses had the highest prevalence of PA (6.7%, χ2 = 71.2, P < 0.01), VSH (2.6%, χ2 = 71.2, P < 0.01), and SA (1.4%, χ2 = 71.2, P < 0.01) compared to other professional title groups. Intermediate nurses had the highest prevalence of EA (24.2%, χ2 = 40.8, P < 0.01), while senior nurses had the highest prevalence of T (13.0%, χ2 = 166.5, P < 0.01). Shift nurses appeared to be more vulnerable to PA (6.8% vs. 4.1%, χ2 = 268.9, P < 0.01), EA(24.4% vs. 19.5%, χ2 = 287.5, P < 0.01), T(10.5% vs. 8.5%, χ2 = 89.8, P < 0.01), VSH (2.3% vs.1.5%, χ2 = 72.4, P = 0.03) and SA (1.2% vs. 0.7%, χ2 = 43.9, P < 0.01) than non-shift nurses. Nurses working more than 50 hours per week were more vulnerable to PA (7.3% χ2 = 48.7, P < 0.01), T (11.2% χ2 = 39.6, P < 0.01) ,VSH (2.5% χ2 = 21.9, P < 0.01) and SA (1.41% χ2 = 16.6, P < 0.01). Nurses working in psychiatry department had the highest WPV prevalence rate (54.3%), followed by those in emergency department (43.4%), and outpatient department (31.3%). Nurses in operating room had the lowest WPV prevalence rate (7.1%). Psychiatric nurses also had the highest prevalence rates for all types of WPV (PA, EA, T, VSH, and SA were 27.4%, 47.6%, 31.7%, 4.5%, and 54.3%, respectively). The differences in the prevalence of different types of WPV across departments were significant (Table 2 ). Table 2 The prevalence of five types of WPV in different departments Departments PA EA T VSH SA Overall N(%) N(%) N(%) N(%) N(%) N(%) Internal Medicine 1692(5.4) 8219(26.1) 3257(10.4) 809(2.6) 443(1.4) 29.4 Surgery 1480(5.5) 6961(26.0) 2809(10.5) 642(2.4) 325(1.2) 29.2 Obstetrics and Gynecology 184(2.9) 1231(19.6) 566(9.0) 65(1.04) 29(0.5) 22.0 Otorhinolaryngology 145(3.8) 952(25.0) 397(10.4) 80(2.1) 32(0.8) 27.7 Pediatrics 150(3.6) 912(21.9) 386(9.3) 32(0.8) 11(0.3) 24.0 Psychiatry 238(27.4) 413(47.6) 275(31.7) 77(8.9) 39(4.5) 54.3 Infectious Diseases 83(4.4) 456(24.3) 178(9.5) 43(2.3) 19(1.0) 27.5 Intensive Care Unit 1780(12.4) 2798(19.5) 1217(8.5) 261(1.8) 157(1.1) 24.9 Outpatient Department 365(6.3) 1666(28.8) 815(14.1) 112(1.9) 52(0.9) 31.3 Emergency Department 886(12.3) 2836(39.4) 1502(20.9) 232(3.2) 106(1.5) 43.4 Operating Room 176(1.9) 542(5.7) 223(2.3) 69(0.7) 42(0.4) 7.1 Nursing Department 64(4.6) 226(16.1) 121(8.6) 29(2.1) 17(1.2) 19.0 Other 328(3.8) 1335(15.3) 554(6.3) 146(1.7) 87(1.0) 17.9 3.3 WPV levels and career choice The correlation between the level of WPV and occupational choice is presented in Table 3 . A total of 38.5% of respondents reported that they would still choose the nursing profession even if they were more aware of the risks, while 88.1% stated that they would not support their children becoming nurses. Nurses who experienced WPV in the past year were less likely to answer "yes" to both questions ( P < 0.01). Among nurses who experienced high levels of WPV in the previous year, only 47 (18.2%) reported that they would still choose to be a nurse, and just 8 (3.1%) would support their children in becoming nurses. Table 3 Association of career choice and the level of WPV. WPV level N(%) Would Opt for the Nursing Profession Again as a Career Choice. (%) Would support children to become a nurse. (%) Yes (38.5) No (61.5) Yes (11.9) No (88.1) High 259(0.2) 47(18.2) 212(81.9) 8(3.1) 251(96.9) Intermediate 3741(3.1) 741(19.8) 3000(80.2) 178(4.8) 3563(95.2) Low 28540(23.4) 7722(27.1) 20818(72.9) 1717(6.0) 26823(94.0) None 89697(73.4) 38536(43.0) 51161(57.0) 12667(14.1) 77030(85.9) P <.001 <.001 WPV level:none = 0, low = 1–5, intermediate = 6–10,high = 11–15 3.4 Associated factors for WPV Table 4 shows the results of the bivariate logistic regression analysis for five types of WPV-related factors. Table 4 Bivariate logistic regression for the association between demographic, occupational factors and five types of WPV. Risk factors PA EA T VSH SA OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) Male 1.73(1.60–1.87) 0.81(0.76–0.86) 1.15(1.07–1.24) Shift work 1.56(1.46–1.67) 1.31(1.27–1.36) 1.32(1.25–1.38) 1.33(1.19–1.48) 1.36(1.17–1.60) Age group(yr) < 30 1.26(1.13–1.40) 1.05(0.99–1.11) 0.86(0.79–0.93) 1.85(1.54–2.23) 2.07(1.60–2.68) 30–39 1.22(1.12–1.32) 1.07(1.03–1.12) 0.99(0.94–1.05) 1.34(1.15–1.55) 1.39(1.13–1.72) ≥ 40 Ref Ref Ref Ref Ref Marital status Married or cohabitang Ref Ref Ref Ref Ref Separated, widowed, or divorced 1.42(1.23–1.64) 1.27(1.17–1.38) 1.30(1.17–1.45) 2.09(1.68–2.61) 2.04(1.50–2.77) Never married 1.39(1.30–1.48) 1.20(1.15–1.24) 1.16(1.09–1.22) 1.71(1.54–1.90) 1.54(1.33–1.78) Education level Master degree and above 1.45(1.27–1.66) 1.27(1.17–1.38) 1.32(1.18–1.47) Bachelor’s degree 1.11(1.01–1.21) 1.19(1.13–1.25) 1.11(1.04–1.20) Associate degree and below Ref Ref Ref Professional title Senior 1.24(1.08–1.42) 1.16(1.07–1.25) 1.50(1.36–1.66) 1.12(0.86–1.45) 0.93(0.63–1.36) Intermediate 1.08(1.01–1.15) 1.17(1.13–1.21) 1.22(1.16–1.28) 1.06(0.95–1.19) 1.06(0.91–1.24) Primary Ref Ref Ref Ref Ref Working hours / week ≥ 50h 1.23(1.14–1.33) 1.17(1.12–1.22) 1.17(1.10–1.24) 1.37(1.21–1.55) 1.39(1.18–1.64) 40-50h 1.03(0.97–1.09) 1.17(1.14–1.21) 1.06(1.01–1.10) 1.11(1.01–1.23) 1.03(0.90–1.17) ≤ 39h Ref Ref Ref Ref Ref Regarding gender, male nurses had a significantly higher risk of experiencing PA and T compared to females (OR = 1.73, 95% CI: 1.60–1.87) (OR = 1.153, 95% CI: 1.07–1.241), while they had a lower risk of emotional abuse (EA; OR = 0.808, 95% CI: 0.763–0.856). Shift work was associated with increased risks across all types of WPV, including PA (OR = 1.56, 95% CI: 1.46–1.67), EA (OR = 1.32, 95% CI: 1.27–1.36), threat (T; OR = 1.32, 95% CI: 1.25–1.38), VSH ( OR = 1.33, 95% CI: 1.19–1.48), and SA ( OR = 1.37, 95% CI: 1.17–1.6). For age groups, nurses under 30 years old showed a higher likelihood of experiencing PA ( OR = 1.26, 95% CI: 1.13–1.4) and VSH ( OR = 1.85, 95% CI: 1.54–2.23) and a particularly high risk for SA ( OR = 2.07, 95% CI: 1.60–2.68) compared to those aged 40 or above, who were used as the reference group. Nurses aged 30–39 also exhibited increased risks for PA ( OR = 1.22, 95% CI: 1.12–1.32) and VSH ( OR = 1.34, 95% CI: 1.15–1.55) but to a lesser extent than the younger group. Marital status was another significant factor, separated, widowed, or divorced nurses e were at higher risk for most types of WPV, such as PA (OR = 1.49, 95% CI: 1.23–1.64), EA (OR = 1.27, 95% CI: 1.17–1.38), and notably for VSH (OR = 2.09, 95% CI: 1.68–2.61) and SA (OR = 2.04, 95% CI: 1.51–2.77) when compared to married or cohabiting individuals. Similarly, never-married nurses faced elevated risks for all types of WPV except for T. Higher education level, specifically master's degree and above, were linked with greater chances of experiencing PA ( OR = 1.45, 95% CI: 1.27–1.66), EA ( OR = 1.27, 95% CI: 1.17–1.38), and T ( OR = 1.32, 95% CI: 1.18–1.47) relative to those with an associate degree or below. A similar pattern was observed for nurses with a bachelor’s degree, though to a lesser extent. Nurses with senior professional title experienced higher risks of PA (OR = 1.24, 95% CI: 1.08–1.42), EA (OR = 1.16, 95% CI: 1.07–1.25), and especially T (OR = 1.5, 95% CI: 1.36–1.66) compared to nurses with primary professional title, Nurses with intermediate professional title also faced increased risk for most types of WPV, albeit to a lesser degree than senior-level nurses. Lastly, working hours per week were found to be a contributing factor. Nurses working 50 hours or more per week had higher risks of experiencing all types of WPV, including PA (OR = 1.23, 95% CI: 1.14–1.33), EA (OR = 1.17, 95% CI: 1.12–1.22), and VSH (OR = 1.37, 95% CI: 1.21–1.55), among others, when compared to those working 39 hours or less. 4. DISCUSSION This study explored the prevalence and associated factors of different types of WPV against Chinese nurses in tertiary hospitals, and investigated the relationship between WPV and their career choices. The reported prevalence of WPV among nurses was 26.6%, with the highest rate of EA at 23.4%. Independent factors associated with WPV include male sex, shift work, education level, professional title, department, and working more than 50 hours per week. Nurses experiencing higher level of WPV reported lower job satisfaction. 4.1 Prevalence of WPV Our findings indicate that the overall prevalence of WPV among nurses in Mainland China (26.6%) is significantly lower than the prevalence (43%) reported in a recent (2024) meta-analysis of 37 observational studies conducted among nurses in the United States [ 4 ]. It is also lower than the overall prevalence (54%) reported by a cross-sectional study conducted on 1089 nurses across five European countries [ 5 ]. Additionally, it is significantly lower than the WPV prevalence rate of 71% among Chinese nurses, as reported in a meta-analysis of 38 observational studies [ 8 ]. The lower prevalence of WPV in this study may be due to the methodological approach, particularly the use of cluster sampling, which enabled a larger sample size. Moreover, differences in the measurement tools used could also have impacted the study results. Furthermore, the relatively standardized safety measures, management practices, and treatment protocols implemented in top-tier hospitals in China may contribute to a safer work environment [ 24 ]. Additionally, the increased respect and appreciation observed for healthcare professionals post-COVID-19 may have played a role in reducing WPV [ 25 ]. 4.2 Sociodemographic and Occupational factors and WPV Our research revealed significant differences in the prevalence of various types of WPV between male and female nurses. The prevalence of PA and T is higher among male nurses compared to female nurses. Conversely, the rates of EA, VSH, and SA are higher among female nurses. Previous studies have yielded inconsistent findings on this topic. Several researches shown that males are at a higher risk for all types of WPV compared to females [ 19 ], while others indicate that men are more likely to encounter physical violence, whereas women are more prone to verbal abuse [ 26 , 27 ]. A possible explanation for the higher risk of PA and T prevalence among male nurses might be their greater prevalence in acute and critical care units, which consequently exposes them to more situations of potential conflict with patients and their relatives. A plausible explanation for the higher risk of EA among female nurses might be that women tend to be more emotionally sensitive and thus more susceptible to the impact of negative emotions [ 28 ]. Furthermore, male nurses might underreport EA events due to masculinity [ 29 ]. Female nurses have higher prevalence of VSH and SA, this may be because, in the minds of most people, sexual harassment is defined as heterosexual men harassing women [ 30 ], therefore, female nurses report more instances of VSH and SA. We found that nurses working shifts have higher prevalence rates of all five types of WPV compared to those who do not work shifts. This finding is consistent with the conclusions of previous studies [ 9 , 31 ]. Our research findings indicate that nurses under the age of 30 are more vulnerable to PA, VSH, and SA compared to those in older age brackets. Previous research findings are similar, indicating that younger nurses are more likely to experience WPV [ 32 , 33 ]. This may be due to their insufficient nursing skills and communication techniques [ 34 ], which provoke patient dissatisfaction and lead to violence. They also may lack effective coping mechanisms to deal with violent incidents [ 35 ], making them more vulnerable to PA. In addition, young nurses may be targeted for sexual harassment due to their perceived greater physical attractiveness [ 36 ]. We found that longer weekly working hours was significantly associated with all five types of WPV. This finding is consistent with the conclusions of previous studies. The longer working hours per week, the greater the amount of time spent with patients [ 19 ], thus, the likelihood of experiencing WPV also increases. Nurses with senior professional title reported higher rates of EA and T compared to those with junior titles. China is running three-tiered nursing system, a senior professional title typically implies greater responsibility and a heavier workload. Nurses with higher professional title often have to deal with more complex clinical nursing issues, which could be the reason they experience more EA and T. 4.3 Education level and WPV Our research found a significant correlation between education level and risk of WPV. Nurses with masters’ degree or above have higher prevalence for all five types of WPV compared to those with a bachelor's degree or lower, which was inconsistent with previous studies [ 19 , 37 ]. We analyze this as follows: on the one hand, based on Christensen et al. (2024), one of the key factors determining whether nurses report WPV is their perception of WPV [ 37 ], nurses with masters’ degree or above may have a stronger awareness of issues related to WPV and a better understanding of the definition and scope of WPV, leading to a higher likelihood of reporting such incidents [ 16 ]. On the other hand, nurses with masters’ degree or above often take more responsibilities, participate in more complex medical decisions, and may even manage teams. These duties increase their frequency of communication with patients and their families, which makes them more susceptible to violent behaviors from emotionally distressed patients or family members. 4.4 Department and WPV The prevalence of different types of WPV and the overall WPV rate among psychiatric nurses are significantly higher compared to nurses in other departments. The primary reason is that psychiatric patients have unstable mental health conditions, leading to a higher frequency of violent verbal and physical behaviors [ 7 , 31 , 38 – 41 ]. The severity of WPV among emergency nurses follows closely, and the possible reasons for this are that emergency nurses must continually handle urgent and critically ill patients in a fast-paced, high-pressure work environment. Such a high-stress setting may lead to heightened emotions among patients and their families, thereby increasing the likelihood of violent incidents [ 40 , 42 ]. 4.5 Career satisfaction and WPV This research indicated that as the level of experienced WPV increased, nurses were less inclined to respond "yes" to the two questions about their career choice. WPV can negatively impact the physical and mental well-being of nurses, leading to lower job satisfaction, diminished quality of life, and a higher risk of staff burnout and turnover [ 11 – 14 ]. These adverse effects may have undermined the nurses' trust in the healthcare system, making them more likely to answer "no" to the two questions. 5. Limitations The study have some limitations. Firstly, due to its cross-sectional design, we are unable to establish a causal relationship between the identified factors and WPV. This limitation will be addressed and refined in subsequent reports of this cohort study. Secondly, the participants were nurses working in tertiary public hospitals in China, and the findings may not be generalized to other types of healthcare workers in different regions or those working in primary and secondary hospitals. Thirdly, The data were collected retrospectively, relying on respondents' ability to recall events from the previous 12 months. This method may introduce recall bias, as participants might not accurately remember past occurrences. Additionally, the survey's reliance on the subjective interpretations of nurses regarding WPV resulted in a less than comprehensive delineation of the phenomenon in question. 6. Conclusions WPV remains a significant concern for nurses in China. The prevalence of WPV among clinical nurses identified in this study, along with the discovery of numerous associated factors, underscores the need for targeted attention and intervention strategies. The finding that nurses with graduate degrees are more susceptible to WPV compared to those with undergraduate or lower qualifications calls for particular attention and the development of specific intervention strategies to address this disparity. Clinical nurses who have experienced higher levels of WPV report lower job satisfaction, which can have profound implications for staff retention, quality of care, and the overall well-being of the nursing workforce. It is crucial for health authorities to implement interventions aimed at reducing WPV to foster a clinical nursing environment free from violence. Abbreviations WPV: Workplace violence PA: physical contact EA: emotional abuse T: threat VSH: verbal sexual assault SA: sexual assault NMHS: Nurses’ Mental Health Study WVS: Workplace Violence Scale Declarations Ethics approval and consent to participate: The Nurses’ Mental Health Study was approved by the Human Ethics Committee of the Second Xiangya Hospital of Central South University (Ethical approval number: LYF20230048). Written informed consent was obtained from individual. All methods were performed in accordance with the guidelines and regulations of the Declaration of Helsinki. Clinical trial number: Not applicable. Consent for publication: Not applicable. Availability of data and materials: The data supporting the findings of this study are accessible through the corresponding author upon reasonable request. Due to privacy or ethical considerations, the data are not available for public access. Competing interests: The authors declare that there are no conflicts of interests. Funding: STI2030-Major Projects (Grant Number:2021ZD0200700); Chinese Nursing Association (Grant Number: ZHKY202306); Major Scientific and Technological Projects in Hunan Province (Grant Number:2020SK2085) Authors' contributions: All authors participated in reviewing subsequent drafts and have approved the final version of the manuscript for publication. LYT, YJX, CZY, HCM, ZD, RZH, BCH and TYS assisted in the collection of data from each of the participating centers; NM, YQ, and LXT led the development of the study design; YJH analyzed and interpreted the data; YJH drafted the manuscript; TYS assisted in refining writing details; LYM and TYS were responsible for the supervision, validation, and critical revision of the manuscript. Acknowledgements: The researchers would like to express their gratitude to all the nurses in this study. 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Pang C, Li W, Zhou Y, Gao T, Han S: Are women more empathetic than men? Questionnaire and EEG estimations of sex/gender differences in empathic ability . Social Cognitive and Affective Neuroscience 2023, 18 (1). Mshana G, Peter E, Malibwa D, Aloyce D, Kapiga S, Stöckl H: Masculinity, power and structural constraints: Men's conceptualization of emotional abuse in Mwanza, Tanzania . Social Science & Medicine 2022, 292 . Clarke HM: #Metoo or #Hertoo? A Moderated Mediation Model of Gender Differences in Perceptions of Sexual Harassment . Archives of Sexual Behavior 2022, 51 (6):3105-3120. Li S, Yan H, Qiao S, Chang X: Prevalence, influencing factors and adverse consequences of workplace violence against nurses in China: A cross‐sectional study . Journal of Nursing Management 2022, 30 (6):1801-1810. Lindquist B, Feltes M, Niknam K, Koval KW, Ohn H, Newberry J, Strehlow M, Walker R: Experiences of Workplace Violence Among Healthcare Providers in Myanmar: A Cross-sectional Survey Study . Cureus 2020. Zhu H, Liu X, Yao L, Zhou L, Qin J, Zhu C, Ye Z, Pan H: Workplace violence in primary hospitals and associated risk factors: A cross‐sectional study . Nursing Open 2021, 9 (1):513-518. Jerome‐D'Emilia B, Suplee PD, Linz S: Challenges faced by new nurses during the COVID‐19 pandemic . Journal of Nursing Scholarship 2022, 54 (6):772-786. Alshawush K, Hallett N, Bradbury‐Jones C: The impact of transition programmes on workplace bullying, violence, stress and resilience for students and new graduate nurses: A scoping review . Journal of Clinical Nursing 2021, 31 (17-18):2398-2417. Bruschini MM, Hediger H, Busch A-K: Patients’ sexual harassment of nurses and nursing students: A cross-sectional study . International Journal of Nursing Studies Advances 2023, 5 . Christensen SS, Wilson BL, Cummins MR, Eaton J, Iacob E, Hansen SD: Exploring nurses' emotional reactions to and reporting of patient-on-nurse workplace violence: A mixed-methods study . International Journal of Nursing Studies 2024, 153 . Li L, Zhang Q, Yang H, Undergraduate SL: Incidence and related influencing factors of workplace violence among psychiatric nurses in China: A systematic review and Meta-analysis . Archives of Psychiatric Nursing 2022, 40 :68-76. Nøland ST, Taipale H, Mahmood JI, Tyssen R: Analysis of Career Stage, Gender, and Personality and Workplace Violence in a 20-Year Nationwide Cohort of Physicians in Norway . JAMA Network Open 2021, 4 (6). Stafford S, Avsar P, Nugent L, O'Connor T, Moore Z, Patton D, Watson C: What is the impact of patient violence in the emergency department on emergency nurses' intention to leave? Journal of Nursing Management 2022, 30 (6):1852-1860. Parodi JB, Burgos LM, Garcia-Zamora S, Liblik K, Pulido L, Gupta S, Saldarriaga C, Puente-Barragan AC, Morejón-Barragán P, Alexanderson-Rosas E et al : Gender differences in workplace violence against physicians and nurses in Latin America: a survey from the Interamerican Society of Cardiology . Public Health 2023, 225 :127-132. Kiymaz D, Koç Z: Workplace violence, occupational commitment and intention among emergency room nurses: A mixed‐methods study . Journal of Clinical Nursing 2022, 32 (5-6):764-779. Additional Declarations No competing interests reported. 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Introduction","content":"\u003cp\u003eAccording to the National Institute for Occupational Safety and Health, WPV is defined as acts directed towards persons at work or on duty [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. WPV encompasses a range of categories: emotional abuse (EA, mistreatment through words, such as disrespect, cursing, and disparagement), physical assault (PA, physical contact, such as pushing, beating, biting, and spitting), threats (T, use of verbal, written or physical force resulting in fear of negative consequences), verbal sexual harassment (VSH, unwelcome comments or remarks of a sexual nature), and sexual abuse (SA, unwanted touching or other sexual behaviours).\u003c/p\u003e \u003cp\u003eNurses are the largest professional group in the healthcare sector, and they are most vulnerable to WPV compare to other healthcare professions as they have the closest contact with patients and their relatives [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. A meta-analysis of 253 studies showed that the proportion of exposure to any type of WPV (12-month prevalence) was 59.2% for nurses, 56.8% for physicians, and 44.4% for other healthcare professionals [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMany studies have reported the prevalence of WPV against nurses, In the United States, Laura McLaughlin and colleagues reported that the pooled rates of WPV among nurses was 43% from 2020 to 2022 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. A cross-sectional study involving nurses from five European countries (Poland, the Czech Republic, the Slovak Republic, Turkey, and Spain) showed that 54% nurses experienced non-physical violence and 20% reported physical violence in the past year [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In Africa, Emmanuel Ekpor.et al reported a WPV prevalence rate of 62.3% among 9831 nurses, with verbal abuse (51.2%) being the most common form [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In South-East Asian and Western Pacific Regions, Abin Varghese and colleagues reported pooled prevalence of WPV to be 58% [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. According to a meta-analysis by Xin Liu MS, the 12-month incidence of WPV among Chinese nurses was 71%, with verbal violence (63%) being the most common type of violence [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMany studies have shown that WPV affects the physical and psychological health of nurses, resulting in reduced job performance and satisfaction and increased turnover intention and burnout, which leads to negative outcomes for patients [\u003cspan additionalcitationids=\"CR10 CR11 CR12 CR13\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn mainland China, there were a total of 5\u0026nbsp;million registered nurses according to the 2021 National Health Yearbook [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Many studies have explored the prevalence of WPV and the factors associated with nurses' experiences of it. Nurses being young, working shifts, having longer weekly working hours (\u0026gt;40h), and working in emergency, critical care, or psychiatric departments were more likely to suffer WPV [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. However, there are also completely inconsistent conclusions regarding some associated factors. For example, some studies found that female nurses are more likely to experience WPV [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], while others indicate that male nurses are more prone to physical forms of WPV [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Additionally, some researches reported that unmarried nurses have a higher prevalence of WPV [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], whereas other studies reported that married nurses have a higher prevalence [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Meanwhile, previous studies have often been limited by small sample sizes or single-center, resulting in varied conclusions about the prevalence and associated factors of WPV. Furthermore, most studies have not analyzed the prevalence and associated factors of different types of WPV. Therefore, this study aims to investigate the prevalence of different types of WPV and their associated factors through a large-scale, multicenter survey across China. Furthermore, it seeks to examine the impact of WPV on job satisfaction.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study design and settings\u003c/h2\u003e \u003cp\u003eThis study utilized baseline data of the Nurses' Mental Health Study (NMHS), a prospective cohort investigation focusing on nurses working within 67 tertiary hospitals across 31 provincial-level administrative divisions (referred to hereafter as 'provinces'). Hospitals were eligible for inclusion based on the following criteria: they must be general tertiary hospitals, capable of handling a variety of diseases comparable to other tertiary hospitals within their respective provinces.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Data collection and participants\u003c/h2\u003e \u003cp\u003eCluster sampling was used during baseline recruitment. Once a hospital was selected, all nurses working there were invited to participate. The inclusion criteria for nurses were: 1) age of 18 years or older; 2) being a registered nurse officially employed at the hospital; 3) willing to participate in the NMHS study. Exclusion criteria included: 1) nurses on sick leave, maternity leave, or retired; 2) nursing interns.\u003c/p\u003e \u003cp\u003eData were collected from November 2023 to January 2024 using an online questionnaire. The survey link was generated through \u0026ldquo;Wenjuanxing\u0026rdquo; (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.wjx.cn/\u003c/span\u003e\u003cspan address=\"https://www.wjx.cn/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), one of China's largest online survey platforms. Prior to data collection, two researchers with Master\u0026rsquo;s degrees in Nursing were trained by the principal investigator and deemed qualified to assist in explaining the purpose of the NMHS study and the details of each questionnaire item. Subsequently, the survey link was distributed to participants via WeChat, a popular social application in China.\u003c/p\u003e \u003cp\u003eBefore beginning the questionnaire, nurses were presented with an informed consent page that explained the purpose of the NMHS study, assured them of their freedom to participate or withdraw at any time. 15 to 20 minutes were needed to complete the online questionnaire. If they had any questions or concerns, they could contact the researchers via email, phone, or WeChat.A total of 147,832 nurses were invited to participate in the survey, and 135,161 online questionnaires were returned. These returned questionnaires were reviewed by two researchers. After removing duplicates and low-quality responses, 132,910 nurses were ultimately included in the baseline data collection for the Nurse Mental Health Study (NMHS), resulting in an overall effective response rate of 89.91%. Low-quality data were identified based on the following criteria:1) data with obvious logical errors, such as the difference between the age and working years was smaller than 16 years old, a gestational week of zero, a duration of religious belief longer than the respondent\u0026rsquo;s age, or weekly working hours exceeding 168 hours (7 days a week, 24 hours a day); 2) outliers, defined as values outside the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;3SD, or values lower than P25-3IQR and higher than P75\u0026thinsp;+\u0026thinsp;3IQR [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Additionally, 10,673 participants chose \u0026lsquo;prefer not to answer\u0026rsquo; in the WPV were excluded from the analysis. Finally, 122,237 participants were included in this study. The specific procedure is outlined in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Measures\u003c/h2\u003e \u003cp\u003eThe NMHS online questionnaire was developed by the research team based on a previous scoping review [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] and qualitative studies [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], with the variables determined by a comprehensive literature review.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1 Sociodemographic and Occupational variables\u003c/h2\u003e \u003cp\u003eThe sociodemographic variables included age, gender, education level, and marital status, measured through self-designed questions. The occupational variables included working shifts, weekly working hours, years of working experience, and professional title, also measured by self-designed questions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 Workplace Violence Scale (WVS)\u003c/h2\u003e \u003cp\u003eThe prevalence and frequency of WPV experienced in the past 12 months were measured using the Chinese version of the Workplace Violence Scale (WVS), which has demonstrated good reliability and validity among Chinese healthcare workers [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The scale consists of five items: Physical Assault (PA), Emotional Assault (EA), Threat (T), Verbal Social Harassment (VSH), and Sexual Assault (SA). Each item is scored from 0 to 3 (0\u0026thinsp;=\u0026thinsp;none, 1\u0026thinsp;=\u0026thinsp;once, 2\u0026thinsp;=\u0026thinsp;two to three times, 3\u0026thinsp;=\u0026thinsp;more than three times), reflecting the frequency of exposure to WPV in the past year. The total score is the sum of the scores for each item, ranging from 0 to 15. The severity of violence is categorized into four levels based on the sum score (None\u0026thinsp;=\u0026thinsp;0, Low\u0026thinsp;=\u0026thinsp;1\u0026ndash;5, Medium\u0026thinsp;=\u0026thinsp;6\u0026ndash;10, High\u0026thinsp;=\u0026thinsp;11\u0026ndash;15). The survey provided specific definitions for each type of violence.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.4 Career choice\u003c/h2\u003e \u003cp\u003eThe respondents also answered two questions regarding career choice:\" Knowing all the risks, would you still choose to become a nurse? (Yes/No) \" and \" Would you want your child to become a nurse? (Yes/No) \"\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Statistical analyses\u003c/h2\u003e \u003cp\u003eIn this study, only participants who fully completed the five questions of the Chinese version of the Workplace Violence Scale without choosing \"prefer not to answer\" were included as valid samples (n\u0026thinsp;=\u0026thinsp;122237), For details, please refer to Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and supplementary material. Responses to whether the respondents had experienced any type of WPV were coded as binary answers (yes/no). The distribution of demographic and occupational data, along with the prevalence of five types of WPV, was reported in numbers and percentages. In subsequent binary logistic regression analyses, factors associated with each type of WPV, which were specified a priori with a p-value of 0.1 in the chi-square tests, were included to determine significant predictors of the outcome variables (the five types of WPV). The relationship between career choice and WPV levels was examined using chi-square tests. All analyses were conducted using IBM SPSS Statistics Version 27.0 for Windows.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Characteristics of the participants\u003c/h2\u003e \u003cp\u003eA total of 147,832 nurses from 67 hospitals in mainland China participated in the survey. After removing duplicates and low-quality questionnaires, those fully and effectively responded to the Chinese version of WVS were considered valid samples for this study. Among these 122,237 individuals, 93.5% were female, 69.0% were married, 31.0% were single, 51.8% held a junior professional title, and 78.2% worked shifts. The age range of the respondents was between 18 and 65 years old, with 36.9% being under 30 years old, and the mean age was 33.5\u0026thinsp;\u0026plusmn;\u0026thinsp;7.3 years. The distribution of participants according to demographic and occupational characteristics is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe distribution of five types of WPV by demographic and occupational characteristics.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDemographic variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePA\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEA\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eT\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eVSH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSA\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e866(10.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1629(20.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e877(11.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e147(1.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e85(1.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6705(5.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26918(23.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11423(10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2450(2.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1274(1.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e316.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.19\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.665\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge group(yr)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2881(7.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9106(23.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3498(9.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1238(3.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e658(1.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30\u0026ndash;39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3696(6.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14583(23.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6428(10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1084(1.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e568(0.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e994(4.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4858(21.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2374(10.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e275(1.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e133(0.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e218.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e71.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e331.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e191.87\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried or cohabitang\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4558(5.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19116(22.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8490(10.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1318(1.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e701(0.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSeparated, widowed, or divorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e210(7.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e802(26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e385(12.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e88(2.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e45(1.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever married\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2803(8.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8629(24.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3425(9.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1191(3.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e613(1.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e293.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e413.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e195.42\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMaster degree or above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e410(8.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1297(25.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e652(12.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e120(2.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e55(1.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBachelor degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6568(6.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25169(23.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10749(10.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2248(2.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1192(1.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAssociate degree or below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e593(5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2081(19.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e899(8.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e229(2.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e112(1.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e99.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e69.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.46\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.539\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.796\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eOccupational variables\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003ePA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eEA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eVSH\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003eSA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eN(%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eN(%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN(%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eN(%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003eN(%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProfessional title\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSenior\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e329(5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1339(22.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e770(13.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e82(1.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e35(0.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntermediate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3010(5.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12834(24.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5778(10.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e883(1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e462(0.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4232(6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14374(22.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5752(9.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1632(2.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e862(1.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e166.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e130.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e77.83\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ework schedule\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eShift\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6491(6.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23359(24.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10030(10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2208(2.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1163(1.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon-shift\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1080(4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5188(19.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2270(8.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e389(1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e196(0.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e268.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e287.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e89.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e72.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e43.89\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeekly working hours\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;50h\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1293(7.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4229(24.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1979(11.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e447(2.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e248(1.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40-49h\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4482(6.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17817(24.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7412(10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1565(2.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e791(1.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;39h\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1796(5.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6501(21.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2909(9.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e585(1.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e320(1.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e114.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e39.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e21.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16.65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003ePA\u003c/b\u003e: physical assault \u003cb\u003eEA\u003c/b\u003e: emotional abuse \u003cb\u003eT༚\u003c/b\u003ethreat \u003cb\u003eVSH\u003c/b\u003e: verbal sexual assault \u003cb\u003eSA༚\u003c/b\u003esexual assault\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.2 The prevalence and characteristics of WPV\u003c/h2\u003e \u003cp\u003eIn this study, the prevalence of WPV among Chinese nurses was 26.6% (32,540 out of 122,237). The highest prevalence was for EA (23.3%), followed by T (10.1%), PA (6.2%), VSH (2.1%), and SA (1.1%). Significant differences in the prevalence rates of these five types of WPV were observed across demographic and occupational characteristics (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMale nurses had a higher prevalence of PA (10.8% vs. 5.9%, χ2\u0026thinsp;=\u0026thinsp;316.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), T (11.0% vs. 10.0%, χ2\u0026thinsp;=\u0026thinsp;7.7, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) compared to female nurses. Conversely, female nurses had a higher prevalence of EA (23.6% vs. 20.4%, χ\u0026sup2; = 42.7, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). There was no significant difference in the prevalence of VSH and SA between male and female nurses.\u003c/p\u003e \u003cp\u003eNurses aged under 30 years had the highest prevalence of PA (7.4%, χ2\u0026thinsp;=\u0026thinsp;218.7, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), VSH(3.2%, χ2\u0026thinsp;=\u0026thinsp;331.8, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and SA (1.7%, χ2\u0026thinsp;=\u0026thinsp;191.9, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) compared to other age groups. Nurses aged 30 to 39 years had the highest prevalence of EA (23.9%, χ2\u0026thinsp;=\u0026thinsp;43.0, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), while nurses aged 40 years and over had the highest prevalence of T (10.6%, χ2\u0026thinsp;=\u0026thinsp;71.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003eNurses with a master\u0026rsquo;s degree or higher were most vulnerable to all five types of violence (PA, EA, T,VSH, and SA were 8.0%, 25.2%, 12.7%, 2.3% and 1.1%, respectively),\u003c/p\u003e \u003cp\u003ePrimary nurses had the highest prevalence of PA (6.7%, χ2\u0026thinsp;=\u0026thinsp;71.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), VSH (2.6%, χ2\u0026thinsp;=\u0026thinsp;71.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and SA (1.4%, χ2\u0026thinsp;=\u0026thinsp;71.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) compared to other professional title groups. Intermediate nurses had the highest prevalence of EA (24.2%, χ2\u0026thinsp;=\u0026thinsp;40.8, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), while senior nurses had the highest prevalence of T (13.0%, χ2\u0026thinsp;=\u0026thinsp;166.5, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003eShift nurses appeared to be more vulnerable to PA (6.8% vs. 4.1%, χ2\u0026thinsp;=\u0026thinsp;268.9, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), EA(24.4% vs. 19.5%, χ2\u0026thinsp;=\u0026thinsp;287.5, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), T(10.5% vs. 8.5%, χ2\u0026thinsp;=\u0026thinsp;89.8, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), VSH (2.3% vs.1.5%, χ2\u0026thinsp;=\u0026thinsp;72.4, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.03) and SA (1.2% vs. 0.7%, χ2\u0026thinsp;=\u0026thinsp;43.9,\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) than non-shift nurses.\u003c/p\u003e \u003cp\u003eNurses working more than 50 hours per week were more vulnerable to PA (7.3% χ2\u0026thinsp;=\u0026thinsp;48.7, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), T (11.2% χ2\u0026thinsp;=\u0026thinsp;39.6, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) ,VSH (2.5% χ2\u0026thinsp;=\u0026thinsp;21.9, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and SA (1.41% χ2\u0026thinsp;=\u0026thinsp;16.6, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003eNurses working in psychiatry department had the highest WPV prevalence rate (54.3%), followed by those in emergency department (43.4%), and outpatient department (31.3%). Nurses in operating room had the lowest WPV prevalence rate (7.1%). Psychiatric nurses also had the highest prevalence rates for all types of WPV (PA, EA, T, VSH, and SA were 27.4%, 47.6%, 31.7%, 4.5%, and 54.3%, respectively). The differences in the prevalence of different types of WPV across departments were significant (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe prevalence of five types of WPV in different departments\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDepartments\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVSH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInternal Medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1692(5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8219(26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3257(10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e809(2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e443(1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1480(5.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6961(26.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2809(10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e642(2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e325(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e29.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObstetrics and Gynecology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e184(2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1231(19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e566(9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e65(1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e29(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e22.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOtorhinolaryngology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e145(3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e952(25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e397(10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e32(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePediatrics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e150(3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e912(21.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e386(9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e24.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychiatry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e238(27.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e413(47.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e275(31.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e77(8.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e39(4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfectious Diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83(4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e456(24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e178(9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43(2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive Care Unit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1780(12.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2798(19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1217(8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e261(1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e157(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutpatient Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e365(6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1666(28.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e815(14.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e112(1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e52(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmergency Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e886(12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2836(39.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1502(20.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e232(3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e106(1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e43.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOperating Room\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e176(1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e542(5.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e223(2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e69(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e42(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64(4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e226(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e121(8.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e328(3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1335(15.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e554(6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e146(1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e87(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e17.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.3 WPV levels and career choice\u003c/h2\u003e \u003cp\u003eThe correlation between the level of WPV and occupational choice is presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. A total of 38.5% of respondents reported that they would still choose the nursing profession even if they were more aware of the risks, while 88.1% stated that they would not support their children becoming nurses. Nurses who experienced WPV in the past year were less likely to answer \"yes\" to both questions (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Among nurses who experienced high levels of WPV in the previous year, only 47 (18.2%) reported that they would still choose to be a nurse, and just 8 (3.1%) would support their children in becoming nurses.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation of career choice and the level of WPV.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWPV level\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eWould Opt for the Nursing Profession Again as a Career Choice. (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eWould support children to become a nurse. (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (38.5)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003e(61.5)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes (11.9)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003e(88.1)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e259(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e212(81.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e251(96.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3741(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e741(19.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3000(80.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e178(4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3563(95.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28540(23.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7722(27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20818(72.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1717(6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26823(94.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89697(73.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38536(43.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51161(57.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12667(14.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e77030(85.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026lt;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eWPV level:none\u0026thinsp;=\u0026thinsp;0, low\u0026thinsp;=\u0026thinsp;1\u0026ndash;5, intermediate\u0026thinsp;=\u0026thinsp;6\u0026ndash;10,high\u0026thinsp;=\u0026thinsp;11\u0026ndash;15\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Associated factors for WPV\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the results of the bivariate logistic regression analysis for five types of WPV-related factors.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate logistic regression for the association between demographic, occupational factors and five types of WPV.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRisk factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVSH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSA\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.73(1.60\u0026ndash;1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.81(0.76\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.15(1.07\u0026ndash;1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eShift work\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.56(1.46\u0026ndash;1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.31(1.27\u0026ndash;1.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.32(1.25\u0026ndash;1.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.33(1.19\u0026ndash;1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.36(1.17\u0026ndash;1.60)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge group(yr)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.26(1.13\u0026ndash;1.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.05(0.99\u0026ndash;1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.86(0.79\u0026ndash;0.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.85(1.54\u0026ndash;2.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.07(1.60\u0026ndash;2.68)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.22(1.12\u0026ndash;1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.07(1.03\u0026ndash;1.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.99(0.94\u0026ndash;1.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.34(1.15\u0026ndash;1.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.39(1.13\u0026ndash;1.72)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried or cohabitang\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated, widowed, or divorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.42(1.23\u0026ndash;1.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.27(1.17\u0026ndash;1.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.30(1.17\u0026ndash;1.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.09(1.68\u0026ndash;2.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.04(1.50\u0026ndash;2.77)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.39(1.30\u0026ndash;1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.20(1.15\u0026ndash;1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.16(1.09\u0026ndash;1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.71(1.54\u0026ndash;1.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.54(1.33\u0026ndash;1.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaster degree and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.45(1.27\u0026ndash;1.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.27(1.17\u0026ndash;1.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.32(1.18\u0026ndash;1.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.11(1.01\u0026ndash;1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.19(1.13\u0026ndash;1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.11(1.04\u0026ndash;1.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssociate degree and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProfessional title\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.24(1.08\u0026ndash;1.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.16(1.07\u0026ndash;1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.50(1.36\u0026ndash;1.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.12(0.86\u0026ndash;1.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.93(0.63\u0026ndash;1.36)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.08(1.01\u0026ndash;1.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.17(1.13\u0026ndash;1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.22(1.16\u0026ndash;1.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.06(0.95\u0026ndash;1.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.06(0.91\u0026ndash;1.24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWorking hours / week\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;50h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.23(1.14\u0026ndash;1.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.17(1.12\u0026ndash;1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.17(1.10\u0026ndash;1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.37(1.21\u0026ndash;1.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.39(1.18\u0026ndash;1.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40-50h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.03(0.97\u0026ndash;1.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.17(1.14\u0026ndash;1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.06(1.01\u0026ndash;1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.11(1.01\u0026ndash;1.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.03(0.90\u0026ndash;1.17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;39h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding gender, male nurses had a significantly higher risk of experiencing PA and T compared to females (OR\u0026thinsp;=\u0026thinsp;1.73, 95% CI: 1.60\u0026ndash;1.87) (OR\u0026thinsp;=\u0026thinsp;1.153, 95% CI: 1.07\u0026ndash;1.241), while they had a lower risk of emotional abuse (EA; OR\u0026thinsp;=\u0026thinsp;0.808, 95% CI: 0.763\u0026ndash;0.856).\u003c/p\u003e \u003cp\u003eShift work was associated with increased risks across all types of WPV, including PA (OR\u0026thinsp;=\u0026thinsp;1.56, 95% CI: 1.46\u0026ndash;1.67), EA (OR\u0026thinsp;=\u0026thinsp;1.32, 95% CI: 1.27\u0026ndash;1.36), threat (T; OR\u0026thinsp;=\u0026thinsp;1.32, 95% CI: 1.25\u0026ndash;1.38), VSH ( OR\u0026thinsp;=\u0026thinsp;1.33, 95% CI: 1.19\u0026ndash;1.48), and SA ( OR\u0026thinsp;=\u0026thinsp;1.37, 95% CI: 1.17\u0026ndash;1.6).\u003c/p\u003e \u003cp\u003eFor age groups, nurses under 30 years old showed a higher likelihood of experiencing PA ( OR\u0026thinsp;=\u0026thinsp;1.26, 95% CI: 1.13\u0026ndash;1.4) and VSH ( OR\u0026thinsp;=\u0026thinsp;1.85, 95% CI: 1.54\u0026ndash;2.23) and a particularly high risk for SA ( OR\u0026thinsp;=\u0026thinsp;2.07, 95% CI: 1.60\u0026ndash;2.68) compared to those aged 40 or above, who were used as the reference group. Nurses aged 30\u0026ndash;39 also exhibited increased risks for PA ( OR\u0026thinsp;=\u0026thinsp;1.22, 95% CI: 1.12\u0026ndash;1.32) and VSH ( OR\u0026thinsp;=\u0026thinsp;1.34, 95% CI: 1.15\u0026ndash;1.55) but to a lesser extent than the younger group.\u003c/p\u003e \u003cp\u003eMarital status was another significant factor, separated, widowed, or divorced nurses e were at higher risk for most types of WPV, such as PA (OR\u0026thinsp;=\u0026thinsp;1.49, 95% CI: 1.23\u0026ndash;1.64), EA (OR\u0026thinsp;=\u0026thinsp;1.27, 95% CI: 1.17\u0026ndash;1.38), and notably for VSH (OR\u0026thinsp;=\u0026thinsp;2.09, 95% CI: 1.68\u0026ndash;2.61) and SA (OR\u0026thinsp;=\u0026thinsp;2.04, 95% CI: 1.51\u0026ndash;2.77) when compared to married or cohabiting individuals. Similarly, never-married nurses faced elevated risks for all types of WPV except for T.\u003c/p\u003e \u003cp\u003eHigher education level, specifically master's degree and above, were linked with greater chances of experiencing PA ( OR\u0026thinsp;=\u0026thinsp;1.45, 95% CI: 1.27\u0026ndash;1.66), EA ( OR\u0026thinsp;=\u0026thinsp;1.27, 95% CI: 1.17\u0026ndash;1.38), and T ( OR\u0026thinsp;=\u0026thinsp;1.32, 95% CI: 1.18\u0026ndash;1.47) relative to those with an associate degree or below. A similar pattern was observed for nurses with a bachelor\u0026rsquo;s degree, though to a lesser extent.\u003c/p\u003e \u003cp\u003eNurses with senior professional title experienced higher risks of PA (OR\u0026thinsp;=\u0026thinsp;1.24, 95% CI: 1.08\u0026ndash;1.42), EA (OR\u0026thinsp;=\u0026thinsp;1.16, 95% CI: 1.07\u0026ndash;1.25), and especially T (OR\u0026thinsp;=\u0026thinsp;1.5, 95% CI: 1.36\u0026ndash;1.66) compared to nurses with primary professional title, Nurses with intermediate professional title also faced increased risk for most types of WPV, albeit to a lesser degree than senior-level nurses.\u003c/p\u003e \u003cp\u003eLastly, working hours per week were found to be a contributing factor. Nurses working 50 hours or more per week had higher risks of experiencing all types of WPV, including PA (OR\u0026thinsp;=\u0026thinsp;1.23, 95% CI: 1.14\u0026ndash;1.33), EA (OR\u0026thinsp;=\u0026thinsp;1.17, 95% CI: 1.12\u0026ndash;1.22), and VSH (OR\u0026thinsp;=\u0026thinsp;1.37, 95% CI: 1.21\u0026ndash;1.55), among others, when compared to those working 39 hours or less.\u003c/p\u003e \u003c/div\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eThis study explored the prevalence and associated factors of different types of WPV against Chinese nurses in tertiary hospitals, and investigated the relationship between WPV and their career choices. The reported prevalence of WPV among nurses was 26.6%, with the highest rate of EA at 23.4%. Independent factors associated with WPV include male sex, shift work, education level, professional title, department, and working more than 50 hours per week. Nurses experiencing higher level of WPV reported lower job satisfaction.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Prevalence of WPV\u003c/h2\u003e \u003cp\u003eOur findings indicate that the overall prevalence of WPV among nurses in Mainland China (26.6%) is significantly lower than the prevalence (43%) reported in a recent (2024) meta-analysis of 37 observational studies conducted among nurses in the United States [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. It is also lower than the overall prevalence (54%) reported by a cross-sectional study conducted on 1089 nurses across five European countries [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Additionally, it is significantly lower than the WPV prevalence rate of 71% among Chinese nurses, as reported in a meta-analysis of 38 observational studies [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The lower prevalence of WPV in this study may be due to the methodological approach, particularly the use of cluster sampling, which enabled a larger sample size. Moreover, differences in the measurement tools used could also have impacted the study results. Furthermore, the relatively standardized safety measures, management practices, and treatment protocols implemented in top-tier hospitals in China may contribute to a safer work environment [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Additionally, the increased respect and appreciation observed for healthcare professionals post-COVID-19 may have played a role in reducing WPV [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Sociodemographic and Occupational factors and WPV\u003c/h2\u003e \u003cp\u003eOur research revealed significant differences in the prevalence of various types of WPV between male and female nurses. The prevalence of PA and T is higher among male nurses compared to female nurses. Conversely, the rates of EA, VSH, and SA are higher among female nurses.\u003c/p\u003e \u003cp\u003ePrevious studies have yielded inconsistent findings on this topic. Several researches shown that males are at a higher risk for all types of WPV compared to females [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], while others indicate that men are more likely to encounter physical violence, whereas women are more prone to verbal abuse [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA possible explanation for the higher risk of PA and T prevalence among male nurses might be their greater prevalence in acute and critical care units, which consequently exposes them to more situations of potential conflict with patients and their relatives. A plausible explanation for the higher risk of EA among female nurses might be that women tend to be more emotionally sensitive and thus more susceptible to the impact of negative emotions [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Furthermore, male nurses might underreport EA events due to masculinity [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Female nurses have higher prevalence of VSH and SA, this may be because, in the minds of most people, sexual harassment is defined as heterosexual men harassing women [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], therefore, female nurses report more instances of VSH and SA.\u003c/p\u003e \u003cp\u003eWe found that nurses working shifts have higher prevalence rates of all five types of WPV compared to those who do not work shifts. This finding is consistent with the conclusions of previous studies [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur research findings indicate that nurses under the age of 30 are more vulnerable to PA, VSH, and SA compared to those in older age brackets. Previous research findings are similar, indicating that younger nurses are more likely to experience WPV [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. This may be due to their insufficient nursing skills and communication techniques [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], which provoke patient dissatisfaction and lead to violence. They also may lack effective coping mechanisms to deal with violent incidents [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], making them more vulnerable to PA. In addition, young nurses may be targeted for sexual harassment due to their perceived greater physical attractiveness [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe found that longer weekly working hours was significantly associated with all five types of WPV. This finding is consistent with the conclusions of previous studies. The longer working hours per week, the greater the amount of time spent with patients [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], thus, the likelihood of experiencing WPV also increases.\u003c/p\u003e \u003cp\u003eNurses with senior professional title reported higher rates of EA and T compared to those with junior titles. China is running three-tiered nursing system, a senior professional title typically implies greater responsibility and a heavier workload. Nurses with higher professional title often have to deal with more complex clinical nursing issues, which could be the reason they experience more EA and T.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Education level and WPV\u003c/h2\u003e \u003cp\u003eOur research found a significant correlation between education level and risk of WPV. Nurses with masters\u0026rsquo; degree or above have higher prevalence for all five types of WPV compared to those with a bachelor's degree or lower, which was inconsistent with previous studies [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. We analyze this as follows: on the one hand, based on Christensen et al. (2024), one of the key factors determining whether nurses report WPV is their perception of WPV [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], nurses with masters\u0026rsquo; degree or above may have a stronger awareness of issues related to WPV and a better understanding of the definition and scope of WPV, leading to a higher likelihood of reporting such incidents [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. On the other hand, nurses with masters\u0026rsquo; degree or above often take more responsibilities, participate in more complex medical decisions, and may even manage teams. These duties increase their frequency of communication with patients and their families, which makes them more susceptible to violent behaviors from emotionally distressed patients or family members.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Department and WPV\u003c/h2\u003e \u003cp\u003eThe prevalence of different types of WPV and the overall WPV rate among psychiatric nurses are significantly higher compared to nurses in other departments. The primary reason is that psychiatric patients have unstable mental health conditions, leading to a higher frequency of violent verbal and physical behaviors [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan additionalcitationids=\"CR39 CR40\" citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. The severity of WPV among emergency nurses follows closely, and the possible reasons for this are that emergency nurses must continually handle urgent and critically ill patients in a fast-paced, high-pressure work environment. Such a high-stress setting may lead to heightened emotions among patients and their families, thereby increasing the likelihood of violent incidents [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Career satisfaction and WPV\u003c/h2\u003e \u003cp\u003eThis research indicated that as the level of experienced WPV increased, nurses were less inclined to respond \"yes\" to the two questions about their career choice. WPV can negatively impact the physical and mental well-being of nurses, leading to lower job satisfaction, diminished quality of life, and a higher risk of staff burnout and turnover [\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. These adverse effects may have undermined the nurses' trust in the healthcare system, making them more likely to answer \"no\" to the two questions.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Limitations","content":"\u003cp\u003eThe study have some limitations. Firstly, due to its cross-sectional design, we are unable to establish a causal relationship between the identified factors and WPV. This limitation will be addressed and refined in subsequent reports of this cohort study. Secondly, the participants were nurses working in tertiary public hospitals in China, and the findings may not be generalized to other types of healthcare workers in different regions or those working in primary and secondary hospitals. Thirdly, The data were collected retrospectively, relying on respondents' ability to recall events from the previous 12 months. This method may introduce recall bias, as participants might not accurately remember past occurrences. Additionally, the survey's reliance on the subjective interpretations of nurses regarding WPV resulted in a less than comprehensive delineation of the phenomenon in question.\u003c/p\u003e"},{"header":"6. Conclusions","content":"\u003cp\u003eWPV remains a significant concern for nurses in China. The prevalence of WPV among clinical nurses identified in this study, along with the discovery of numerous associated factors, underscores the need for targeted attention and intervention strategies. The finding that nurses with graduate degrees are more susceptible to WPV compared to those with undergraduate or lower qualifications calls for particular attention and the development of specific intervention strategies to address this disparity. Clinical nurses who have experienced higher levels of WPV report lower job satisfaction, which can have profound implications for staff retention, quality of care, and the overall well-being of the nursing workforce. It is crucial for health authorities to implement interventions aimed at reducing WPV to foster a clinical nursing environment free from violence.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eWPV: Workplace violence\u003c/p\u003e\n\u003cp\u003ePA: physical contact\u003c/p\u003e\n\u003cp\u003eEA: emotional abuse\u003c/p\u003e\n\u003cp\u003eT: threat\u003c/p\u003e\n\u003cp\u003eVSH: verbal sexual assault\u003c/p\u003e\n\u003cp\u003eSA: sexual assault\u003c/p\u003e\n\u003cp\u003eNMHS: Nurses\u0026rsquo; Mental Health Study\u003c/p\u003e\n\u003cp\u003eWVS: Workplace Violence Scale\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u0026nbsp;\u003c/strong\u003eThe Nurses\u0026rsquo; Mental Health Study\u003c/p\u003e\n\u003cp\u003ewas approved by the Human Ethics Committee of the Second Xiangya Hospital of Central South University (Ethical approval number: LYF20230048). Written informed consent was obtained from individual. All methods were performed in accordance with the guidelines and regulations of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eThe data supporting the findings of this study are accessible through the corresponding author upon reasonable request. Due to privacy or ethical considerations, the data are not available for public access.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that there are no conflicts of interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eSTI2030-Major Projects (Grant Number:2021ZD0200700); Chinese Nursing Association (Grant Number: ZHKY202306); Major Scientific and Technological Projects in Hunan Province (Grant Number:2020SK2085)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eAll authors participated in reviewing subsequent drafts and have approved the final version of the manuscript for publication. LYT, YJX, CZY, HCM, ZD, RZH, BCH and TYS assisted in the collection of data from each of the participating centers; NM, YQ, and LXT led the development of the study design; YJH analyzed and interpreted the data; YJH drafted the manuscript; TYS assisted in refining writing details; LYM and TYS were responsible for the supervision, validation, and critical revision of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eThe researchers would like to express their gratitude to all the nurses in this study.\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e\u003cstrong\u003eViolence Occupational Hazards in Hospitals \u003c/strong\u003e[http://www.cdc.gov/niosh/docs/2002-101/]\u003c/li\u003e\n\u003cli\u003eEscribano RB, Beneit J, Luis Garcia J: \u003cstrong\u003eViolence in the workplace: some critical issues looking at the health sector\u003c/strong\u003e. 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Several researches reported on the prevalence of WPV among nurses in China, ranging from 56.4\u0026ndash;71%. However, little information is available about the correlates of different types of WPV among nurses across different departments in tertiary hospitals in China.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA self-designed WeChat-based questionnaire was utilized, incorporating demographic and occupational factors. WPV was measured using the Chinese version Workplace Violence Scale. Two questions regarding career choices were employed to assess career satisfaction. Descriptive analyses, chi-square tests, and bivariate logistic regression analysis were conducted.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults:\u003c/b\u003e\u003c/p\u003e \u003cp\u003e122,237 participants were included in the analysis. 26.6% of them experienced at least one form of WPV in the past year. Male sex, shift work, postgraduate education, senior professional title, department, and working more than 50 hours per week were factors associated with WPV. Nurses encountered high levels of WPV were less likely to be satisfied with their nursing career.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eWPV is a special concern for Chinese nurses. Interventions to reduce WPV should be conducted by health authorities to create a zero-violence working environment for nurses, and to increase their career satisfaction.\u003c/p\u003e","manuscriptTitle":"Prevalence and associated factors of workplace violence among Chinese nurses in tertiary hospitals: a national cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-02 22:41:21","doi":"10.21203/rs.3.rs-5381741/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-06T20:10:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-11-05T08:09:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-11-05T06:39:34+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2024-11-03T11:17:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0ea570a7-2571-4c4a-a1b2-1f39f058e6ef","owner":[],"postedDate":"December 2nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-03-13T10:23:34+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-02 22:41:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5381741","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5381741","identity":"rs-5381741","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}