Fear of Violence and Work Alienation Among Nurses: The Mediating Role of Work Stress

Background Violence against healthcare workers has been investigated in many aspects, but the effects of the fear of violence have remained limited. This study examines the role of perceived work stress in the effect of fear of violence on work alienation among nurses. Methods The sample of the study consists of 392 nurses working in fully fledged hospitals in Istanbul, Türkiye. The data were collected by using the Fear of Violence Scale, the General Work Stress Scale, and the Work Alienation Scale. Confirmatory composite analysis was conducted for reliability and validity testing of the scales. Structural equation modeling was employed with SmartPLS 3.2.9, and multi-group analyses were carried out with SPSS 26 according to age, tenure, education level, gender, and history of exposure to violence. Results The results revealed that fear of violence has a positive and significant effect on perceived work stress and work alienation, both directly and indirectly through work stress. Work stress was found to have a strong positive effect on work alienation. Multi-group analyses showed that there were significant differences in fear of violence, work stress, and work alienation in terms of age, tenure, gender, and exposure to violence, while education level was not significant. Conclusions This study shows that fear of violence is not only an emotional response but also a systematic and enduring threat that reduces psychological resources and creates conditions for alienation. The results expand the stressor–strain–outcome framework and the Conservation of Resources Theory by revealing that the anticipation of violence functions as a primary stressor with long-term consequences.