Construction and validation of risk prediction model for workplace bullying among nurses based on the Chinese Nurses' Health Cohort Study(TARGET)

LIU Guanglin; WEI Na; ZHANG Xinyue; LI Li; ZHANG Huihui; CAO Yingjuan

doi:10.12102/j.issn.1009-6493.2026.05.002

Abstract：Objective:To analyze the influencing factors of workplace bullying among nurses and construct risk prediction model to assist hospital administrators in developing targeted preventive measures and reducing the incidence of workplace bullying in this population.Methods:Based on data from the Chinese Nurses' Health Cohort Study(TARGET)covering 46 790 nurses from February 2021 to February 2024,surveys were conducted using the General Information Questionnaire,the Chinese version of the Negative Acts Questionnaire,the Generalized Anxiety Disorder Questionnaire,the Patient Health Questionnaire,the Chinese version of the Ten-Item Big Five Inventory,the Trait Coping Style Questionnaire,and the Chinese version of the Perceived Stress Scale.Participants were randomly divided into a modeling group(32 752 individuals)and a validation group(14 038 individuals)at a ratio of 7∶3.Univariate and logistic regression analyses were used to screen the influencing factors of workplace bullying among nurses and establish a risk prediction model.The Bootstrap method was employed for internal validation of the prediction model,and external validation was performed using the validation group data.The calibration curve was used to evaluate the predictive performance of the model.Results:Among the 46 790 nurses,9 274 experienced workplace bullying,with an incidence rate of 19.82%.Logistic regression analysis showed that age,gender,position,years of work experience,anxiety level,depression level,perceived stress score,positive coping score,negative coping score,Big Five personality traits(extraversion,agreeableness,emotional stability,openness),education level,department,and employment type were influencing factors for workplace bullying among nurses(P<0.05).The areas under the receiver operating characteristic curve for the modeling group and validation group were 0.729[95%CI(0.723,0.736)]and 0.728[95%CI(0.718,0.738)],respectively,with specificity of 0.664 and 0.631 and sensitivity of 0.683 and 0.718.The calibration curve indicated a good fit.Conclusions:Based on the TARGET cohort data,this study screened the relevant influencing factors of workplace bullying among Chinese nurses,constructed and validated risk prediction model for bullying in this population.The model can help identify high-risk individuals early and provide a reference for targeted preventive interventions and the optimization of clinical management practices.