Workplace aggression, psychological distress, and job satisfaction among Palestinian nurses: A cross-sectional study

A gender-based review of workplace violence amongst the global health workforce-A scoping review of the literature

Workplace violence (WPV) impacts all levels of the health workforce, including the individual provider, organization, and society. While there is a substantial body of literature on various aspects of WPV against the health workforce, gender-based WPV (GB-WPV) has received less attention. Violence in both the workplace and broader society is rooted in gendered socio-economic, cultural, and institutional factors. Developing a robust understanding of GB-WPV is crucial to explore the differing experiences, responses, and outcomes of GB-WPV with respect to gender. We conducted a scoping review and report on the prevalence and risk factors of GB-WPV in healthcare settings globally. The review followed the Preferred Reporting Items for Systematic and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We registered the scoping review protocol on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search was conducted of empirical literature in five health and social science databases. Of 13667, 226 studies were included in the analysis. Across the studies, more women than men experienced non-physical violence, including verbal abuse, sexual harassment, and bullying. Men experienced more physical violence compared to women. Younger age, less experience, shifting duties, specific clinical settings, lower professional status, organizational hierarchy, and minority status were found to be sensitive to gender, reflecting women's structural disadvantages in the workplace. Given the high prevalence and impact of GB-WPV on women, we provided recommendations to address systemic issues in clinical practice, academia, policy, and research.

Experiences of workplace violence among healthcare workers in home care settings: A qualitative systematic review

AIMS

The aims of this systematic review were to obtain a comprehensive understanding of healthcare workers' experiences who were subjected to workplace violence in the home care environment and identify their specific support needs.

BACKGROUND

Workplace violence toward healthcare workers has been a prevalent and ongoing issue. With the expansion of home care services, more emphasis should be placed on maintaining a safe in-home care environment for healthcare workers. Understanding healthcare workers' experience of workplace violence is crucial for developing effective interventions.

METHODS

A systematic search was conducted in 10 databases from their inception date until January 2022. Primary qualitative studies were included. Two reviewers performed screening of studies, methodological quality assessment, and data extraction and analysis independently. The two-step approach by Sandelowski and Barroso on meta-summary and meta-synthesis was used. This qualitative systematic review was reported according to the PRISMA guidelines.

RESULTS

Eight studies were included. Three themes were identified: (1) impact of workplace violence, (2) reasons behind tolerating violence, and (3) way forward to prevent violence.

CONCLUSION

Workplace violence is common among healthcare workers in home care settings, yet the support provided to healthcare workers is inadequate. The findings suggest the need for effective interventions and policies to address this grave issue in order to improve the well-being of healthcare workers as it may indirectly affect the care quality provided to patients.

IMPLICATIONS FOR NURSING

Due to the unique nature of home care services, interventions preventing workplace violence must be tailored to the specific home care settings and needs of healthcare workers. Future research should develop and evaluate different interventions to prevent workplace violence in home care settings.

Analysis of the characteristics and risk factors affecting the judgment results of medical damage liability disputes in 3172 second-instance and retrial cases in China

BACKGROUND

Medical disputes remain a global public health problem. However, an analysis of the characteristics and risk factors affecting the judgment results of medical damage liability disputes in second-instance and retrial cases in China has yet to be conducted.

METHODS

We conducted a systematic search and evaluation of second-instance and retrial cases among all medical damage liability disputes in China Judgments Online; SPSS 22.0 was used for the statistical analysis. A χ² test or likelihood ratio Chi-square test was used to compare differences between groups, and multivariate logistic regression analysis was performed to determine independent risk factors that could affect the judgment results of medical disputes.

RESULTS

We included 3172 second-instance and retrial cases among all medical damage liability disputes in the analysis. The results showed that 48.04% of cases were unilateral appeals by the patient, and medical institutions were responsible for providing compensation in 80.64% of these cases. Cases involving compensation ranged from Chinese Yuan (CNY) 100 000 to 500 000 ranked first (40.95%); 21.66% were non-compensation cases. Cases involving mental damage compensation of less than CNY 20 000 accounted for 39.03%. Violations of medical treatment and nursing routines accounted for 64.25% of all cases. In addition, re-identification in 54.59% of cases changed the initial appraisal opinion. Independent risk factors for medical personnel to lose a lawsuit in a multivariate logistic regression model included appeal originator [patient side: OR = 18.809 (95% CI 11.854-29.845); both sides: OR = 22.168 (95% CI 12.249-40.117)], change of the original verdict (OR = 5.936, 95% CI 3.875-9.095), judicial identification (OR = 6.395, 95% CI 4.818-8.487), violations of medical treatment and nursing routines (OR = 8.783, 95% CI 6.658-11.588), and non-standard medical document writing (OR = 8.500, 95% CI 4.805-15.037).

CONCLUSION

Our study clarifies the characteristics of second-instance and retrial cases among all medical damage liability disputes in China from multiple perspectives and identifies the independent risk factors for medical personnel losing a lawsuit. This study could help medical institutions prevent and reduce medical disputes, at the same time, it could be helpful for medical institutions to provide better medical treatment and nursing services for patients.

The Relationships Between Tendency to Aggression, Self-control, Mindfulness, and Happiness in Students of the Faculty of Health Sciences

Objectives: Previous studies focus on variables that reduce violence such as mindfulness, self-control, and happiness, but do not cover these relationships in a single study, creating a gap in the literature. The aim of this cross-sectional study was to investigate the relationships between aggression and these 3 variables in health science undergraduate students at a state university in Turkey. Methods: Students completed the aggression questionnaire, the Oxford happiness questionnaire short version, the brief self-control scale, and the mindful attention awareness scale. Results: In correlational analysis, only verbal aggression and happiness did not show a relationship. The result of hierarchical multiple regression analyses indicated that the most significant predictors that explained total aggression and aggression subscales were mindfulness and self-control, respectively. However, happiness did not have a significant link to either total aggression or subscales of aggression (except for hostility). Conclusions: The results emphasize that mindfulness and self-control may play important roles in reducing aggression. This study reveals the need for further analysis of the relationships between happiness and aggression and its subscales. Other implications are discussed.

Verbal and Physical Abuse Against Nurses Working in Hospitals and Health Centers in Buraidah, Saudi Arabia

Background Hospital staff, especially nurses, face violence of various forms in the workplace. This study aimed to assess the burden of verbal/physical abuse against nurses and their attitude towards such events in Buraidah, Saudi Arabia. Methods A cross-sectional study was conducted among nurses working in three public sectors and two private sector hospitals, and five primary healthcare facilities in Buraidah. Data was collected using a structured online questionnaire, disseminated among nurses through nursing departments of participating facilities. Data were analyzed using SPSS version 21.0. Results A total of 369 nurses participated in the survey, with a mean age of 34 (±6.9) years. About two-thirds, 68% (250) of respondents, had experienced at least one verbal/physical abuse incident during one year. The most common perpetrators were patients (44.4%). Sixteen percent of participants reported taking no action against the incident. Those working in private facilities were 80% less likely to experience abuse than those in public facilities, adjusted OR 0.20 (95% CI: 0.08-0.47). Conclusions There was a high burden of verbal/physical abuse against nurses, and they, therefore, suffer from disturbing memories. However, a little more than half do not officially report it to the managers, with only a small fraction seeing some action taken. Occupational health practitioners should take action to improve the policy and procedures related to workplace violence (WPV) in healthcare facilities. Further research is needed to characterize incidents to understand the patterns and develop interventions for the prevention of such events.

Predictors of events of violence or aggression against nurses in the workplace: A scoping review

AIM

To identify predictors and consequences of violence or aggression events against nurses and nursing students in different work contexts.

BACKGROUND

Workplace violence against nurses and nursing students is a very common and widespread phenomenon. Actions to manage or prevent violent events could be implemented knowing the risk factors and consequences. However, there is a lack of systematic reviews that summarize knowledge on the predictors and consequences of workplace violence.

EVALUATION

A scoping review was conducted using electronic databases including APA PsycInfo, CINAHL, Cochrane, Ovid Medline, PubMed and Scopus.

KEY ISSUES

After full text analysis, 87 papers were included in the current scoping review. Risk factors of horizontal violence were grouped into 'personal' and 'Environmental and organizational', and for violence perpetrated by patients into 'personal', 'Environmental and organizational' and 'Characteristics of the perpetrators'.

CONCLUSIONS

The results of this scoping review uncover problems that often remain unaddressed, especially where these episodes are very frequent. Workplace violence prevention and management programmes are essential to counter it.

IMPLICATIONS FOR NURSING MANAGEMENT

The predictors and the consequents identified constitute the body of knowledge necessary for nurse managers to develop and implement policy and system actions to effectively manage or prevent violent events.

Distress, support and psychological resilience of psychiatric nurses as second victims after violence: A cross-sectional study

AIM

The aim is to explore the impact of violence and psychological resilience on psychiatric nurses as second victims.

BACKGROUND

Workplace violence is a public health concern, seriously influencing medical staff's physical and mental health. However, few pieces of research have concentrated on psychiatric nurses as second victims.

METHOD

The socio-demographic data, violence-related data, psychological resilience scale, the Chinese version of the Second Victim Experience and Support Tool were applied to conduct a cross-sectional survey on nurses from psychiatric hospitals. The multiple linear regression model identified significant variables associated with violence-related injury and resilience.

RESULTS

A total of 683 nurses completed the survey, of whom 88.3% were women. The average scores of the second victims' experience and support, support and distress were 3.45 ± 0.43, 3.71 ± 0.57 and 3.19 ± 0.67, respectively. Physical violence, psychological violence, psychological influence and nursing work environment were positively correlated with the experience and support of the second victims, and innocuous violence was a negative factor, which explains 20.6% of the variation. Moreover, physical injury, nursing work environment, resilience restructuring, physical violence, psychological violence, psychological impact and disagreement about the existence of violence explained 14.8% of the distress. The innocuous violence, psychological violence and nursing work environment explained 46.2% of the support.

CONCLUSIONS

Our findings suggest that nurses who are second victims after the violence mainly suffer from severe psychological distress and receive the least support for the same.

IMPLICATION FOR NURSING MANAGEMENT

The study provides clues to help nursing managers' emphasis on the distress and support of second victims and provides targeted intervention based on the relevant factors and these results. The article is a cross-sectional study of psychiatric nurses, which has been approved by the ethics committee of the hospital before the survey. All the nurses who participated in the survey have been informed and agreed.

Psychopathological symptoms and work status of Southeastern Brazilian nursing in the context of COVID-19

Objective

to evaluate the relationship between psychopathological symptoms and the work situation of nursing professionals in the Southeast Region, Brazil, in the context of the COVID-19 pandemic.

Method

an observational and cross-sectional study with virtual and snowball data collection from April to July 2020. A questionnaire containing socio-demographic and labor data and the psychopathological symptoms assessment scale (psychoticism, obsessiveness/compulsivity, somatization, and anxiety) were applied. Descriptive and inferential statistics were used to analyze the data.

Results

among the 532 participants, there was a relationship between weekly workload and psychoticism. All domains of the scale were associated with embarrassment and/or violence in the course of work and receiving psychological/emotional support from the institution where the individual works/studies.

Conclusion

the age group, heavy workload, experienced violence and lack of psychological support during the pandemic were associated with increased psychopathological symptoms among nursing professionals. It is suggested the creation of institutional guidelines aimed at the reception and follow-up of these demands.

Incivility toward nurses: a systematic review and meta-analysis

One important part of a nurse’s job is to create and help maintain a safe work environment. Evidence shows that negative behaviors such as incivility are not uncommon in the nursing profession. This systematic review and meta-analysis aimed to examine the prevalence of incivility toward nurses. For this purpose, all observational studies that primarily investigated the rate of incivility toward nurses were selected. The electronic databases PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of studies was assessed using Hoy’s Critical Assessment Checklist. The study was undertaken using the random effects model, and data were analyzed using STATA14. Data on 60 articles, including data on 30801 individuals, published between 1997 and 2019, entered the study. The findings showed the prevalence of incivility to be 55.10% (95%, CI: 48.05, 62.06).

Due to the high prevalence of uncivil behavior, especially of the verbal type, nursing managers should identify risk factors in the workplace. Planners should develop programs to increase workplace safety, especially in centers that are most exposed to these behaviors. It is also recommended that future studies focus on implementation of effective evidence-based interventions based on organizational culture.

Predictors associated with the mental health of Japanese male registered nurses: focusing on environments with many female registered nurses and female patients' refusal to accept nursing services from male registered nurses

Objective: To study the improvement of the mental health of Japanese male registered nurses, we investigated the predictors associated with the Japanese version of the 12-item General Health Questionnaire (GHQ-12). For those predictors, we focused on environments with many female registered nurses and female patients’ refusal to accept nursing services from male registered nurses.

Materials and Methods: This study was conducted in 93 hospitals in the Aichi, Gifu, and Mie prefectures of Japan. The analyzed subjects were 1,216 full-time male registered nurses. The average age (standard deviation) was 34.5 (9.2) years. Multiple logistic regression analysis was conducted. A GHQ-12 score of ≤3 indicated good mental health, and a score of ≥4 indicated poor mental health. “Mental health” was a dependent variable. The independent variables were: “Age”, “Male registered nurses as important partners on the job”, “Female registered nurses’ good manners toward male registered nurses”, “Fairness regarding male registered nurses’ promotions”, and “Female patients’ refusal to accept nursing services from male registered nurses”.

Results: There were 728 (59.9%) full-time male registered nurses with good mental health and 488 (40.1%) with poor mental health. The mental health of the male registered nurses who had negative feelings regarding, “Male registered nurses as important partners on the job” was significantly worse, and that of those who had negative feelings regarding, “Female registered nurses’ good manners toward male registered nurses” was also significantly worse.

Conclusion: Female registered nurses must recognize that their attitudes toward male registered nurses influence the mental health of male registered nurses. Hospital managers should provide male registered nurses who cannot establish appropriate relations with female registered nurses with consultation opportunities. Such organizational action by managers is necessary.

Workplace violence on healthcare professionals and underreporting: Characterization and knowledge gaps for prevention

Work-related violence against healthcare workers inflicted by healthcare users is a rising multidimensional phenomenon, a cause of concern among those who ensure the safety and health of these professionals. Although different studies indicate high percentages of attacks against healthcare workers, statistics from reports reveal much lower data. Underreporting of occupational violence against healthcare workers is a well-known fact reported in many studies. It is presented as a major obstacle when it comes to proposing adequate preventive measures, because the data on which to base these measures do not correspond to the true incidence of all the assaults that take place. Underreporting also makes it difficult to correctly assess the usefulness of preventive measures implemented. The following article looks at the latest studies carried out on the subject, presenting an overview of the factors accompanying these assaults, as well as the main reasons for this underreporting. It also highlights the lack in the literature of instruments designed to measure underreporting that have undergone a validation process. For all these reasons, this problem requires further study with validated tools to determine the reasons and circumstances that accompany and promote the underreporting of violence against healthcare workers. Knowing these reasons is a preliminary step in the fight against workplace violence and to measure the true magnitude of the problem, to provide the occupational health services with precise data and develop and assess the preventive measures implemented.

Workplace Violence Among Healthcare Workers in a Tertiary Medical City in Riyadh: A Cross-Sectional Study

Introduction

Workplace violence is a common problem that is encountered by healthcare workers worldwide; however, it is still under-studied in Saudi Arabia. This study aims to determine the prevalence of workplace violence and to explore reasons for not reporting it among healthcare workers in a tertiary medical city in Riyadh.

Methods

This cross-sectional study was conducted among 404 healthcare workers who had direct contact with patients or their relatives in a tertiary care medical city in Riyadh, Saudi Arabia. Data were analyzed using Statistical Analysis Software Package (SPSS; IBM, Armonk, NY, USA).

Results

Most participants (81.4%) had experienced verbal, physical, academic, or sexual violence. Approximately 39.6% of those who experienced workplace violence did not report the incident, and the most common reason for not reporting was identified as “reporting would not accomplish anything” (49.4%). About 27.5% of violence victims did not know how to report the incidents. Patients or their relatives were the main sources of violence across all violence categories except academic violence, in which consultant physicians were the main source.

Conclusions

The prevalence of workplace violence in the population studied was higher than anticipated compared to similar studies both in Saudi Arabia and globally. Almost half of those who were subjected to violence did not report the incident, believing that reporting would not change anything. There is arguably an urgent need to develop strategies that reduce workplace violence and facilitate reporting it in hospitals. Moreover, awareness programs regarding the negative impacts of violence against healthcare workers on the quality of care are necessary.

Examining the utility of the Violence Prevention Climate scale: In a metropolitan Australian general hospital

AIM AND OBJECTIVES

To evaluate and examine the utility of the Violence Prevention Climate scale by generalist healthcare professionals.

BACKGROUND

Workplace violence in general hospital settings remains a challenge for healthcare organisations. High rates of violence are still being reported towards healthcare workers, despite organisational violence prevention strategies being implemented. There is a major challenge to healthcare organisation in the measurement of the effectiveness of these interventions, traditionally completed via the reporting and monitoring of workplace violent incidents. A novel approach to measuring workplace violence is by studying hospital atmosphere or climate.

DESIGN

A cross-sectional survey using the STARD guidelines was used.

METHODS

The Violence Prevention Climate scale was completed by 194 healthcare staff working in the emergency department, medical/surgical wards, respiratory/infectious disease, spinal care, renal unit, corrections health, and rehabilitation and community services of a major Australian tertiary referral hospital. The Violence Prevention Climate scale has previously been validated and used in mental health settings, but not general hospital settings. A content analysis of an open-ended question on violence prevention management strategies was also conducted.

RESULTS

Comprising of 14 items with two factors (patients and staff), the study revealed a 9-item staff factor scale that can be used in the general hospital setting, the patient factor did not show adequate reliability. The content analysis revealed seven categories of staff identified violence prevention and management strategies.

CONCLUSIONS

The use of the 9-item scale across an organisation annually, or added to existing organisational workforce surveys, could prove to be practical way of measuring the social climate of violence in a general hospital setting.

RELEVANCE TO CLINICAL PRACTICE

The results of which could guide clinical practice, workplace safety, policy and educational initiatives for the prevention and management of workplace violence.

Workplace stress and associated factors among vehicle repair workers in Hawassa City, Southern Ethiopia

INTRODUCTION

Workplace stress is a public health problem worldwide. Studies focusing on work-related stress among vehicle repair workers are scarce in African countries. The current study aimed to determine the prevalence of self-reported workplace stress and associated factors among vehicle repair workers in Hawassa City, South Ethiopia.

METHODS AND FINDINGS

A cross-sectional study design was employed among 347 vehicle repair workers from January 25 to February 22, 2019. Questionnaires were administered using interviews. Additional tools were used for weight and height measurements. The main findings were analyzed using descriptive statistics, bivariable, and multivariable logistic regression. The strength of association of variables was presented by odds ratio along with its 95% CI. The statistical assessments were considered significant at p<0.05. A total of 344 workers participated in the study. The prevalence of workplace stress among participants was 41.6% with 95% CI: (36.3-47.1). Factors associated with workplace stress were more than 10 years of work experience [AOR: 2.40; 95% CI (1.29-4.50)], work-related musculoskeletal disorder [AOR: 3.39; 95% CI (1.99-5.78)], squatting and lying work posture [AOR: 4.63; 95% CI (1.61-13.3)] and servicing large vehicles [AOR: 1.96; 95% CI (1.14-3.38)].

CONCLUSION AND RECOMMENDATIONS

This study showed that the overall prevalence of work-related stress was substantially high. The independently associated factors were workers' service years, symptoms of body pain, and the work environment. Preventive measures need to be implemented in vehicle repair workshops by focusing on work environment improvements.

Impact of Psychological Aggression at the Workplace on Employees' Health: A Systematic Review of Personal Outcomes and Prevention Strategies

Psychological aggression perpetrated by customers, coworkers, and supervisors is a behavior frequently experienced in the workplace with negative consequences for an individual's health. The aim of this systematic review was to examine the personal outcomes of overt workplace psychological aggression and summarize empirical evidence on how to prevent and reduce its effects. A search on PubMed, Scopus, ProQuest, and Web of Science electronic databases was made. Data were obtained from 30 studies (26 cross-sectional, 3 longitudinal, 1 quasi-experimental) representing 20,683 employees. Longitudinal studies indicated that workplace psychological aggression is significantly associated with musculoskeletal injury and psychological strains (anxiety, depression, anger) over time. Research also suggests that psychological aggression at work predicts fear, emotional exhaustion, depersonalization, personal accomplishment, and physical symptoms, for example. Additionally, the information collected suggested that support from coworkers, supervisors, and management; informational support; political skills; job resources; and confidence to prevent and respond to aggression moderate significantly the impact of workplace psychological aggression on personal and organizational outcomes. Perceptions of a violence-prevention climate, aggression-preventive supervisor behavior, and aggression-preventive employee effort are also significantly associated with a reduction in psychological aggression at work and strains. In conclusion, this review allows us to understand the effects of the psychological aggression by identifying the preventive strategies that could be adopted by managers, supervisors, or leaders to deal with it and promote individual's health in the workplace.

A worldwide bibliometric analysis of published literature on workplace violence in healthcare personnel

Background

Workplace violence in healthcare professionals has become a worldwide public health problem and has been the focus of numerous publications; however, currently, no macroscopic overviews of this research based on bibliometric analysis have been carried out. Therefore, the main aim of this study was to analyse the research trends focusing on workplace violence in healthcare personnel over the last 27 years.

Materials and methods

A bibliometric study was conducted from 1992 to 2019 in the field of workplace violence in healthcare personnel using the Scopus database. The author co-citation analysis was carried out using VOSviewer software. A worldwide map was created with Mapchart and word cloud image was created using Wordart. Descriptive and inferential statistics were applied.

Findings

1791 records were analysed, 1376 of which (76.83%) were articles, with “Medicine” the most frequent subject category (58.91%). English was the predominant language (93.41%). From 2004 onwards, there was an exponential rise in the number of publications (R² coefficient = 0.89; p < 0.0001) and the number of annual citations gradually increased from 1995 (R² coefficient = 0.73; p < 0.0001). The University of Cincinnati (United States) was the institution (and country) with the highest number of publications (n = 30; n = 549), with D. M. Gates leading the ranking of the most productive authors (n = 21). Journal of Nursing Management was the most active journal publishing on the topic (n = 34) and the commonest keyword was “human/s” (16.43%).

Conclusion

From 1992 to 2019, worldwide research into the published literature on workplace violence in healthcare personnel has grown steadily year by year, both in the number of documents and the number of citations. United States and their institutions and researchers dominates this research output.

Workplace verbal abuse, nurse-reported quality of care and patient safety outcomes among early-career hospital nurses

AIMS

To examine the differences in early-career nurses' verbal abuse experiences based on their sociodemographic characteristics, and to investigate the associations of verbal abuse experiences with nurse-reported care quality and patient safety outcomes.

BACKGROUND

Few studies have examined the relationships between early-career nurses' verbal abuse experiences and nurse-reported patient care quality and safety outcomes.

METHODS

Cross-sectional survey data from 799 early-career hospital nurses in the United States were analysed. Items assessed verbal abuse experiences from patients or their families, physicians and other employees. Associations between verbal abuse experiences and nurse-reported care quality and patient safety outcomes were examined using multiple logistic regression analyses.

RESULTS

There were significant differences in verbal abuse experiences by age, gender and work unit. Nurses who experienced verbal abuse, regardless of the perpetrator, were less likely to report high-quality care and a favourable safety grade. Nurses who experienced verbal abuse specifically from physicians or other employees were also less likely to feel comfortable reporting safety problems.

CONCLUSION

Managing verbal abuse may be important for improving patient care quality and safety. Future intervention study is needed to reduce verbal abuse.

IMPLICATIONS FOR NURSING MANAGEMENT

To optimize patient safety, managers should thoroughly monitor verbal abuse and organisations' need to establish clear expectations and ramifications for when verbal abuse occurs.

Workplace violence types in family health, offenders, reactions, and problems experienced

OBJECTIVE

to identify the types of violence that affect the health team in Family Health Units, their offenders, reactions and problems experienced by workers.

METHOD

a cross-sectional, concurrent mixed-type research. The Survey Questionnaire Workplace Violence in the Health Sector was applied to 106 workers from Family Health Units. Of these, 18 answered the semi-structured interview.

RESULTS

verbal aggression (65.1%), bullying (14.2%), racial discrimination (10.4%), physical assault (8.5%) and sexual harassment (4.7%) were prevalent. Patients were the main perpetrators of verbal aggression (79.4%) and bullying (46.7%). Workers responded by telling co-workers and reporting to the boss. Victims remained over-alert, vigilant and tense, relating exposure to violence to absenteeism and the desire to leave the profession.

CONCLUSION

verbal aggression is the most common violence with negative impact on workers' health and work performed.

Workplace bullying in the nursing profession: A cross-cultural scoping review

BACKGROUND

Globally, nurses are at high risk of exposure to workplace bullying, and there is a growing body of literature addressing bullying in the nursing profession. Yet, our understanding of cross-cultural variations in bullying among nurses is lacking. An analysis of what is currently known about bullying in different parts of the world is critical for our understanding of cross-cultural effects of bullying among nurses.

OBJECTIVES

We aimed to examine workplace bullying research among nurses with the focus on sources, antecedents, outcomes and coping responses from a cross-cultural perspective during the years 2001-2019.

DESIGN

This is a scoping review of published literature on workplace bullying among nurses.

DATA SOURCES

A literature search was conducted using the CINAHL, PubMed, PsychINFO and Web of Science databases. A total of 166 articles provided data from the following cultural clusters: Anglo, Latin Europe, Eastern Europe, Nordic Europe, Middle East, Latin America, Confucian Asia, Southern Asia and Sub-Saharan Africa.

PROCEDURE

Studies were identified through a database search. Relevant data were extracted using a narrative approach. Categories were thematically organized according to the study topics. Cultural differences regarding the variation in the perceptions of and responses to bullying were analysed in relation to the cultural dimensions: power distance, assertiveness, in-group collectivism and performance orientation.

RESULTS

Research was mostly conducted in the Anglo cluster. Antecedents and outcomes of bullying were the most often studied topics across all cultural clusters. Vertical bullying was most prevalent in higher power distance cultures, whereas horizontal bullying was either more or equally prevalent in lower power distance cultures. The risk of bullying decreased as nurses' length of service and age increased in most of the clusters. Individual antecedents were more frequently reported in high in-group collectivist cultures. Organizational antecedents such as lack of bullying prevention measures, unsupportive leadership and stressful work characteristics were frequently reported across different cultural clusters. Yet, an organizational culture that tolerates bullying was most commonly addressed in Anglo, a highly performance-oriented culture. Negative outcomes of bullying were very similar across the world. Nurses used emotion-focused coping strategies more frequently almost in all clusters; yet, there were reports of problem-focused coping strategies especially in relatively higher assertiveness cultures.

CONCLUSIONS

Analysis revealed both similarities and differences in the nurses' reports of bullying by world region. Cultural factors were found to be important for understanding the variation in the nurses' perceptions of and responses to bullying.

Prevalence of Workplace Physical Violence against Health Care Professionals by Patients and Visitors: A Systematic Review and Meta-Analysis

Workplace physical violence against health care professionals perpetrated by patients and visitors has been a persistent problem worldwide. Prevalence estimates varied vastly across studies and there was a lack of quantitative syntheses of prevalence studies. This review aimed to quantify pooled one-year prevalence estimates at the global and regional levels. A systematic literature search was performed in the databases of PubMed, PsycINFO, Web of Science, and Embase between 1 January 2000 and 8 October 2018. Studies providing information about one-year prevalence of self-reported workplace physical violence against health care professionals perpetrated by patients or visitors were included. Heterogeneity between studies was evaluated using Cochran's chi-squared test (Cochran's Q) and I2 values. Subgroup analysis and meta-regression were used to explore heterogeneity. A total of 65 eligible studies reported one-year prevalence estimates for 61,800 health care professionals from 30 countries. The pooled one-year prevalence of workplace physical violence against health care professionals perpetrated by patients or visitors was 19.33% (95% confidence interval (CI): 16.49%-22.53%) and the overall heterogeneity was high across studies. We noted geographic and staff categories variations for prevalence estimates through subgroup analysis. The meta-regression showed that sample size, type of health care setting, and quality score were significant moderators for heterogeneity. One in five health care professionals experienced workplace physical violence perpetrated by patients or visitors worldwide annually. Practical intervention was needed to ensure safety of health care professionals.

Influence of workplace incivility on the quality of nursing care

AIMS AND OBJECTIVES

To examine the influence of workplace incivility on the quality of nursing care.

BACKGROUND

Recent evidence describes workplace incivility as a serious concern in the healthcare setting worldwide. Exposure to workplace incivility can alter a nurse's behaviour, thought process and perspective towards the nursing profession. However, there is insufficient evidence to determine whether workplace incivility might be associated with the quality of nursing care in Saudi Arabia.

DESIGN

A quantitative and cross-sectional study.

METHOD

A survey was carried out amongst 378 nurses in two government hospitals in Saudi Arabia from February 2018-May 2018 using the Nurse Incivility and quality of nursing care scales. Multivariate multiple regression was performed to investigate the influence of the uncivil experiences of nurses from different sources on the different aspects of quality of nursing care. The study adhered to STROBE guideline (see Appendix S1).

RESULTS

The overall mean of the quality of nursing care scale was 3.14 (SD = 0.66) from a scale of 1-5, with patient satisfaction receiving the highest mean dimension (mean = 3.27, SD = 0.72) and health promotion the lowest mean dimension (mean = 3.08, SD = 0.74). Experience in the present hospital and the hospital were associated with the overall quality of nursing care. General and nurse incivility exerted a multivariate effect on overall quality of nursing care and its different dimensions.

CONCLUSION

General incivility and nurse incivility were found to negatively impact quality of nursing care and its different dimensions.

RELEVANCE TO CLINICAL PRACTICE

Stronger policies geared towards eliminating workplace incivility should be implemented as uncivil acts can lead to poor quality of nursing care. Nurse administrators and nurses should be pro-active in recognising, preventing, approaching, reporting and intervening with uncivil acts in the hospital to protect these workers from these types of behaviours and avoid their negative impacts on patient care.

Psychometric properties of the workplace psychologically violent behaviors-WPVB instrument. Translation and validation in Greek Health Professionals

Background

Mobbing exerts severe psychological and occupational effects on the victim. This study aims to validate the Yildirim & Yildirim's Workplace Psychologically Violent Behaviors (WPVB) instrument (2008) in the Greek language in Greece, as cultural variations may result in significantly different perceptions of mobbing.

Methodology

A translation process of the WPVB questionnaire scale was followed from the English to the Greek version and a review by a team of experts for its content validity took place, as well. Principal component analysis took place and the Cronbach's index was 0.95. The cross sectional, quantitative study was performed in 1536 health professionals (HPs), working in 11 public hospitals for at least one year with response rate of 76.8%.

Results

Factor analysis revealed two factors, and 31-item construct, compared to the four factors and the 33-item construct of the original version of the tool. All items were found to have a statistically significant correlation (p < 0.001). Median score was 0.48. Whereas 25% of answers score was above 1.00, thus suggesting significant mobbing in around 25% of HPs. Association of WPVBs subscales with sex and occupation are had lower values in women as compared to men. Lower scores on “Attack on personality” and “Total mobbing” score were recorded in nurses as compared to doctors. Doctors had lower scores on “Individual's isolation from work” as compared to administrative personnel, while had greater scores on “Individual's isolation from work” as compared to technicians. Nurses had significantly lower scores on “Attack on professional status”, “Individual's isolation from work”, “Direct attack” and “Total mobbing” score as compared to administrative personnel.

Conclusions

The study highlights that the phenomenon of mobbing exists in Greek HPs regardless of age, gender, level of study and negatively affects their lives. Focusing on improving this area, is expected to promote occupational health and safety of these workers.

An Investigation of Differential Relationships of Implicit and Explicit Aggression: Validation of an Arabic Version of the Conditional Reasoning Test for Aggression

Most personality research in the workplace relies on self-reports. Although self-report measures are believed to assess the explicit aspect of personality, a more recent approach for assessing implicit personality is based on conditional reasoning. The Conditional Reasoning Test for Aggression (CRT-A) was developed to assess implicit cognitions that justify aggressive behavior. The integrative model of personality proposes that both the explicit and implicit personality interact together to predict different behavioral outcomes. The results of this investigation are reported in two studies. The purpose of Study 1 was to adapt the CRT-A to the Arabic language and to examine its validity evidence using a large sample of Egyptian employees (n = 1,046). Study 2 aimed at examining the differential relationships of implicit and explicit components of aggressive personality in explaining different forms of aggressive behavior variance (n = 271). The results of Study 1 revealed that the psychometric properties of the adapted Arabic version of CRT-A were similar to those obtained for the United States. In addition, factor analysis results were consistent with the psychological theory used to build the conditional reasoning problems. The results of Study 2 provide substantial empirical support for the integrative model of assessment of aggression.

Psychosomatic symptoms among Palestinian nurses exposed to workplace aggression

BACKGROUND

The study examined associations between workplace aggression (WPA) and psychosomatic symptoms in Palestinian nurses.

METHODS

The 341 nurses, (62% females and 38% males), answered a WHO questionnaire and a psychosomatic symptoms checklist.

RESULTS

A total of 27.3% of the nurses reported exposure to WPA of any kind within the last 12 months. After adjusting for covariates, female nurses exposed to WPA of any kind and those exposed to verbal aggression reported a higher symptom score: (1.5; 95% confidence interval [CI]: 0.3, 2.7), and (1.4; 95%CI 0.2, 2.6), respectively, than unexposed females. Male nurses exposed to bullying reported a higher symptom score: (3.2; 95%CI 1.0, 5.5) than unexposed males.

CONCLUSIONS

Exposure to WPA was associated with higher occurrences of psychosomatic symptoms for both sexes. The female nurses reacted most strongly to verbal aggression or to WPA of any type, while bullying was associated with the male nurses' symptoms.