{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T11:52:34Z","timestamp":1788004354528,"version":"build-2784847793"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Mental Health Nurs"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Psychiatric patient violence adversely affects healthcare workers' quality of life and patient quality of care. In contrast to the common adult patient emphasis, the present study was designed to examine the relationship between healthcare staff\u2010directed verbal and physical violence exhibited by children and adolescent psychiatric inpatients and post\u2010traumatic stress (PTSD) symptoms, emotional labour, and physical and mental fatigue of staff. Our cross\u2010 sectional study recruited 113 multidisciplinary staff members working in child and adolescent psychiatric wards: 33 (29.2%) educational staff, including special education schoolteachers and social guides; 53 (46.9%) nursing staff, including nurses and nurse aides; and 27 (23.9%) multidisciplinary clinical staff, including physicians, psychologists, social workers, and occupational therapists. Five questionnaires were used: Exposure to Violence Questionnaire, PCL\u20105 (PTSD), Emotional Labour Questionnaire, MFI\u201020 (physical and mental fatigue), and a sociodemographic survey. Findings indicated that nearly all personnel had experienced verbal violence, and most had experienced physical violence from hospitalised children and adolescents. Such violence caused staff a moderate level of emotional labour. Exposure to violence was significantly related to PTSD symptoms, which fully mediated the relationship between violence exposure and physical and mental fatigue. Regression analysis identified PTSD symptoms as the primary predictor of staff fatigue. The most intensely felt emotions towards patients were empathy, caring and compassion. We conclude that healthcare staff engage in emotional labour to suppress negative and promote positive emotions to maintain professional functioning and cope with challenging patient behaviours. PTSD symptoms among violence\u2010exposed healthcare teams should be addressed with targeted interventions as emotional\u2010support, emotion\u2010regulation workshops, training in conflict management and violence de\u2010escalation. Providing a safe and supportive work environment for both patients and staff is of paramount importance.<\/jats:p>","DOI":"10.1111\/inm.70207","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T12:26:32Z","timestamp":1766751992000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Violence Directed at Healthcare Staff by Children and Adolescents Treated in In\u2010Patient Psychiatric Wards: Emotional Labor,\n                    <scp>PTSD<\/scp>\n                    Symptoms, and Physical and Mental Fatigue"],"prefix":"10.1111","volume":"34","author":[{"given":"Nataly","family":"Manevich Lozovsky","sequence":"first","affiliation":[{"name":"Department of Nursing Sciences, Stanley Steyer School of Health Professions, Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Merhavim Medical for Brain and Mind Treatment  Beer Yaacov\u2010Ness Ziona Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4078-0585","authenticated-orcid":false,"given":"Irit","family":"Bluvstein","sequence":"additional","affiliation":[{"name":"Department of Nursing Sciences, Stanley Steyer School of Health Professions, Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5182-403X","authenticated-orcid":false,"given":"Michal","family":"Itzhaki","sequence":"additional","affiliation":[{"name":"Department of Nursing Sciences, Stanley Steyer School of Health Professions, Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2012.07.003"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzr022"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.14234"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2017.1361038"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1096771"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102834.2011.01305.x"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2009.01.002"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078390316687372"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12330"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3758\/bf03193146"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126\u2010022\u201010008\u20105"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3233\/WOR\u2010172540"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269758020953760"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12672"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.5465\/30040678"},{"key":"e_1_2_13_18_1","volume-title":"Report on Violence Against Medical and Administrative Staff in the Healthcare System","author":"Greenberg N.","year":"2022"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960\u2010015\u20100018\u20102"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0844562117719202"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201900226"},{"key":"e_1_2_13_22_1","volume-title":"The Managed Heart: Commercialization of Human Feelings","author":"Hochschild A.","year":"1983"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1086\/227049"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17218019"},{"key":"e_1_2_13_25_1","unstructured":"Israeli Ministry of Health.2017.Ministerial Committee on Eliminating violence against Medical and AdministrativeStaff.www.gov.il\/he\/pages\/voilence\u2010prevention\u2010committee\u2010meetings\u20102017"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12151"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/01612840.2013.824053"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.22913"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jjns.70001"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph120100652"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102023\u2010074887"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijn.12792"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20562"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010018\u20105817\u20107"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.52.1.397"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960\u2010020\u201000563\u20109"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2018.02.003"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep14010010"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000405"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022\u20103999(94)00125\u2010o"},{"key":"e_1_2_13_41_1","first-page":"741","volume-title":"Proceedings of the Fifth Annual Industrial Engineering Research Conference","author":"Soh T.","year":"1996"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16193687"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744\u2010618x.1996.tb00293.x"},{"key":"e_1_2_13_44_1","unstructured":"Weathers F. 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