Workplace Violence as an Occupational Hazard in Psychiatric Nursing: Burnout, Quality of Life, and Turnover Intentions in Saudi Arabia.

Background/Objectives: Workplace violence (WPV) is a major occupational health hazard and psychosocial safety concern in psychiatric nursing, yet evidence integrating exposure, worker well-being, and workforce stability within a single theory-informed model remains limited in Saudi Arabia. This study examined associations between WPV and proximal occupational outcomes (burnout, job satisfaction, and absenteeism) and distal outcomes (quality of life [QoL] and turnover intentions) among psychiatric nurses and tested burnout as a statistical mediator of the WPV-turnover intentions association. Methods: A multicentre cross-sectional census survey was conducted across three psychiatric facilities in northern Saudi Arabia between June and August 2025 (N = 171). Participants reported WPV exposure over the preceding 12 months using Arabic versions of standardised instruments, including validated Arabic versions where available and a forward-backward-translated WVSQ. Linear, negative binomial, and logistic regression models examined outcome associations and factors associated with WPV exposure; the PROCESS macro (Model 4, 5000 bootstrap resamples) tested statistical mediation. Results: Most nurses reported at least one WPV incident in the preceding 12 months, most commonly verbal abuse. Younger age, male sex, shorter psychiatric nursing experience, lower perceived staffing adequacy, and inadequate security were associated with higher WPV exposure. WPV exposure was associated with lower QoL across all WHOQOL-BREF domains, higher burnout, lower job satisfaction, higher absenteeism, and stronger turnover intentions. Burnout showed a partial statistical mediation pattern in the WPV-turnover intentions association. Because the study was not specifically powered for the indirect effect, the mediation result should be interpreted with caution. Conclusions: In this cross-sectional study, WPV was a pervasive occupational exposure among Saudi psychiatric nurses and was associated with poorer QoL and higher turnover intentions, with burnout showing a partial statistical mediation pattern. Multilevel prevention, safer staffing, and structured post-incident psychological support are needed to support psychiatric nurses' well-being and workforce retention.