LAUSR

AIMS To analyze the prevalence of nurse-to-nurse horizontal violence in Chinese hospitals and examine the effects of head nurse's caring and nurse's group behavior on horizontal violence. BACKGROUND Horizontal violence is a serious global problem affecting the nursing profession, but little is known of the issue in Chinese hospitals. Increasing evidence has showed that leadership and group factors are important in facilitating horizontal violence. Whether the head nurse's caring and group behavior perceived by nurses have protective effects against horizontal violence remains unclear. METHODS A cross-sectional online-based questionnaire study was performed in seven general hospitals in Hubei Province, China. Data related to the demographic information, horizontal violence, head nurse's caring, and group behavior were collected. Descriptive analyses, chi-square tests and logistics regression were used for data analysis. RESULTS In total, 1942 valid questionnaires were collected, with a 92.70% effective response rate (1942/2095). Of those, 59.1% (1148/1942) of respondents had experienced horizontal violence at least once in the previous six months. Covert negative behaviors were more frequently reported. Compared with the low level, moderate and high levels of the head nurse's caring showed a lower risk of horizontal violence (OR = 0.400, p < 0.001; OR = 0.128, p < 0.001); moderate and high levels of group behavior also showed a reduced risk (OR = 0.601, p < 0.001; OR = 0.221, p < 0.001). CONCLUSION Horizontal violence is common among Chinese nurses. The head nurse's caring and maintaining a good climate of nurses' group behaviors could serve as protective factors for preventing horizontal violence. IMPLICATIONS FOR NURSING MANAGEMENT This study helps nursing managers identify which specific negative behaviors occur frequently and require special attention. It suggests nursing managers attach importance to improving their caring ability towards nurses and to creating an amicable climate of group behavior to buffer against horizontal violence.