{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:48:21Z","timestamp":1787590101818,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":191,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The objective of this study is to examine the association between moral courage, psychological resilience, and the occurrence of workplace violence among emergency department nurses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Workplace violence represents a major occupational hazard in healthcare institutions worldwide. Moral courage refers to nurses\u2019 ability to make principled decisions when facing ethical conflicts, thereby avoiding moral distress. Psychological resilience is defined as an individual\u2019s positive internal capacity to cope with adversity and stress. Such violent incidents severely undermine nurses\u2019 physical and mental well\u2010being, while moral courage plays a pivotal role in enhancing nurses\u2019 psychological resilience and improving their mental health. However, the underlying mechanism through which moral courage influences nurses\u2019 experiences of workplace violence remains unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study surveyed 325 emergency nurses in Liaoning Province, China, using the Nurses\u2019 General Information Form, the Nurses\u2019 Moral Courage Scale, the Psychological Resilience Scale, and the Workplace Violence Scale. Descriptive analysis, correlation analysis, and analysis of influencing factors were conducted using SPSS 27.0, while AMOS 27.0 was employed for the verification and analysis of structural equation modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The final model explained 35.0% of the total variance in workplace violence among emergency department nurses. Moral courage had a positive impact on psychological resilience, with a path coefficient\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.710 (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u200915.347,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Psychological resilience negatively predicted workplace violence, with a path coefficient\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.210 (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u2009\u22122.466,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.014). Similarly, moral courage negatively predicted workplace violence, with a path coefficient\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.231 (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u2009\u22122.709,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.007). Psychological resilience played a partial mediating role between moral courage and workplace violence, accounting for 35.89% of the mediating effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study employed structural equation modeling and found a significant negative correlation between moral courage and workplace violence, as well as a partial mediating effect of psychological resilience in the relationship between moral courage and workplace violence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Management<\/jats:title>\n                    <jats:p>In the future, training measures can be developed from enhancing nurses\u2019 moral courage and psychological resilience, and constantly optimize and improve the existing interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/5540407","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:28:59Z","timestamp":1783765739000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Association Between Moral Courage, Psychological Resilience, and Workplace Violence Among Emergency Department Nurses in China: A Structural Equation Model"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0374-5177","authenticated-orcid":false,"given":"Kai","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5272-0890","authenticated-orcid":false,"given":"XinYue","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1855-5729","authenticated-orcid":false,"given":"XiangHong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-4089","authenticated-orcid":false,"given":"Ling","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2022.1604912"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.auec.2021.01.004"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102641"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/haschl\/qxae134"},{"key":"e_1_2_13_5_2","volume-title":"Study on the Correlation Between Workplace Violence, Empathic Fatigue and Work Engagement Among Emergency Nurses","author":"Aya L.","year":"2023"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/CNQ.0000000000000353"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/bs13070575"},{"key":"e_1_2_13_8_2","first-page":"1","article-title":"The Moderating Effect of Emotional Regulation Strategies on Coping Styles and Resilience in Emergency Nurses Exposed to Workplace Violence","volume":"38","author":"Liao L. W.","year":"2023","journal-title":"Journal of Nursing"},{"key":"e_1_2_13_9_2","first-page":"107","article-title":"Investigation on Occupational Exposure and Protective Behavior of Nurses in Emergency Department of Beijing Grade A Hospitals","volume":"55","author":"Guo J. Y.","year":"2020","journal-title":"Chinese Journal of Nursing"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000001329"},{"key":"e_1_2_13_11_2","article-title":"Workplace Violence Against Healthcare Workers in Emergency Settings During and After COVID-19: A Systematic Review","volume":"22","author":"Gheri F.","year":"2026","journal-title":"Signa Vitae"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13711"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ienj.2025.101661"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-025-01205-5"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.2163"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/nhs.12805"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01590-5"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12598"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13010-023-00141-9"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/17449871241310160"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/nin.12591"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-022-00931-0"},{"key":"e_1_2_13_23_2","doi-asserted-by":"publisher","DOI":"10.18502\/jmehm.v14i3.5436"},{"key":"e_1_2_13_24_2","first-page":"3180","article-title":"The Mediation Effect of Psychological Resilience and Social Support on Workplace Violence and Job Burnout in Emergency Medical Staff","volume":"23","author":"Ma Q.","year":"2023","journal-title":"General Nursing"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.13329\/j.cnki.zyyjk.2021.0160"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/ppc.12358"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn121094-20200518-00269"},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ienj.2024.101489"},{"key":"e_1_2_13_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12753"},{"key":"e_1_2_13_30_2","unstructured":"Cambridge Core Sample Size Requirements for Estimating Pearson Kendall and Spearman Correlations 2025 https:\/\/www.cambridge.org\/core\/journals\/psychometrika\/article\/abs\/sample-size-requirements-for-estimating-pearson-kendall-and-spearman-correlations\/840CA9F25E521DBD1C389D48638CE2F1."},{"key":"e_1_2_13_31_2","volume-title":"Investigation of Violence in Medical Places and Development of Theoretical Model","author":"Wang P. X.","year":"2007"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/da.10113"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.16719\/j.cnki.1671-6981.2007.05.035"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2010.05.010"},{"key":"e_1_2_13_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733018791325"},{"key":"e_1_2_13_36_2","first-page":"92","article-title":"Sinicization and Validity Test of Nurses\u2019 Moral Courage Scale","volume":"34","author":"Wang S. Y.","year":"2019","journal-title":"Journal of Nursing"},{"key":"e_1_2_13_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000005239"},{"key":"e_1_2_13_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2023.04.009"},{"key":"e_1_2_13_39_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9050507"},{"key":"e_1_2_13_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2022.104375"},{"key":"e_1_2_13_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2024.104724"},{"key":"e_1_2_13_42_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-01734-1"},{"key":"e_1_2_13_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16006"},{"key":"e_1_2_13_44_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-19964-y"},{"key":"e_1_2_13_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/inr.70037"},{"key":"e_1_2_13_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2024.104865"},{"key":"e_1_2_13_47_2","doi-asserted-by":"publisher","DOI":"10.2196\/43771"},{"key":"e_1_2_13_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnss.2020.11.006"},{"key":"e_1_2_13_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2024.104812"},{"key":"e_1_2_13_50_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01637-7"}],"container-title":["Journal of Nursing Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/5540407","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jonm\/5540407","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/5540407","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:29:05Z","timestamp":1783765745000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jonm\/5540407"}},"subtitle":[],"editor":[{"given":"Matthew","family":"Vandermeulen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jonm\/5540407"],"URL":"https:\/\/doi.org\/10.1155\/jonm\/5540407","archive":["Portico"],"relation":{},"ISSN":["0966-0429","1365-2834"],"issn-type":[{"value":"0966-0429","type":"print"},{"value":"1365-2834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5540407"}}