Workplace violence, job stress, and the buffering role of HRM in healthcare: A cross-cultural analysis

This study investigates how workplace-based human resource management (WBHRM) practices can moderate the relationship between workplace violence and job stress among healthcare workers and examines how job stress mediates the workplace violence and perceived quality of care relationships. Two cross-sectional studies were conducted in Indian healthcare contexts: Study 1 with 260 nurses and multitasking staff in Assam neonatal facilities, and Study 2 with 140 doctors and nurses in Arunachal Pradesh hospitals. Data were collected using validated measures for workplace violence, job stress (DASS-21), perceived quality of care, and WBHRM practices (Guest’s five-domain framework). Mediation and moderation analyses used bootstrapping and hierarchical regression. Results consistently supported all hypotheses across both studies. Workplace violence was positively associated with job stress. Job stress mediated the relationship between workplace violence and the perceived quality of care in both samples. WBHRM practices moderated violence-stress relationships. The association between workplace violence and job stress was weaker at higher levels of WBHRM practices. The findings of the study contribute to the HRM literature. The study provides a WBHRM approach to support healthcare workers in coping with workplace violence-induced job stress. This research provides the first empirical evidence for moderating role of WBHRM practices in the relationship between workplace violence effects and job stress in healthcare settings. The cross-cultural validation across different healthcare contexts and worker populations demonstrates the practical value of systematic HRM approaches in supporting healthcare workers’ well-being and maintaining perceived quality of care.