Oppression and exposure as differentiating predictors of types of workplace violence for nurses

Workplace violence and turnover intention among Chinese nurses: the mediating role of compassion fatigue and the moderating role of psychological resilience

BACKGROUND

Workplace violence is a global public health issue and a major occupational hazard cross borders and environments. Nurses are the primary victims of workplace violence due to their frontline roles and continuous interactions.

OBJECTIVE

The present study aimed to investigate the status of workplace violence, turnover intention, compassion fatigue, and psychological resilience among Chinese nurses, and explore the mediating role of compassion fatigue and the moderating role of psychological resilience on relationship between workplace violence and turnover intention among Chinese nurses.

METHOD

A cross-sectional study was conducted among a convenience sample of clinical registered nurses from public hospitals in Changsha, Hunan, China. Data was collected through an online questionnaire, which included a demographic information form, the Workplace Violence Scale (WVS), the Turnover Intention Questionnaire (TIQ), the Compassion Fatigue Scale (CF-CN), and the Connor-Davidson Resilience Scale (CD-RISC). Descriptive statistics and correlation analysis were employed to examine the relationships among the main variables. A moderated mediation analysis was further conducted using the PROCESS macro for SPSS (Model 4 and Model 8) to examine the mediating role of compassion fatigue and the moderating role of psychological resilience.

RESULT

The present survey recruited a convenience sample of 1,141 clinical registered nurses, who reported experiencing multiple types of workplace violence during the past year. Correlation analysis revealed significant positive correlations between workplace violence and turnover intention (r = 0.466, P < 0.01) as well as compassion fatigue (r = 0.452, P < 0.01), while negative correlation between workplace violence and psychological resilience (r=-0.414, P < 0.01). Moderated mediation analysis revealed that compassion fatigue mediated, while psychological resilience moderated, the positive relationship between workplace violence and turnover intention (all P < 0.05).

CONCLUSION

This study underscores the mediating effect of compassion fatigue and the moderating role of psychological resilience in the relationship between workplace violence and turnover intention among Chinese nurses. Future efforts should be undertaken to develop effective preventive measures and intervention strategies at individual, organizational, and national levels to mitigate workplace violence and foster supportive work environment.

CLINICAL TRIAL NUMBER

Not applicable.

Psychosocial study environment characteristics associated with exposure to sexual harassment at a large public university in southern Sweden: a cross-sectional study

BACKGROUND

Universities can be understood as work-like environments for students, with similar risks and expectations regarding psychosocial environment. Limited research has examined this study environment from a Demand-Control-Support perspective with regard to sexual harassment. Understanding this environment is key to designing protective measures. This study aimed to examine the association between individual and psychosocial study environment characteristics and exposure to sexual harassment among students at Lund University, Sweden.

METHODS

This cross-sectional study utilised data from an online survey conducted among students. Questions on background characteristics, exposure to sexual harassment while at university and psychosocial study environment as measured by a Demand-Control-Support-instrument were used. Bivariate, and multivariable logistic regressions were used, together with Population Attributable Fractions (PAF), and synergy indexes (SI).

RESULTS

High demands and low control were independently associated with higher odds of being exposed to sexual harassment among both females and males (OR 1.41, OR 1.26 and OR 1.55, OR1.34, respectively). When adjusting for background characteristics, high study strain (combination of high demands and low control) was associated with exposure to sexual harassment among both female and male respondents (aOR 1.67 and 1.98 respectively) and could account for PAF of 14% and 15% of study environment sexual harassment for females and males, respectively. Low lecturer support was associated with higher odds for sexual harassment among females (aOR 1.19) but not males. Little evidence was found for a buffering effect of student support on high strain and sexual harassment (SI 0.7).

CONCLUSION

Working to reduce situations of high strain study environments could be an effective strategy for reducing sexual harassment in university settings. Improving support from lecturers could also modify this relationship, but more research is required to identify causal pathways underlying this result.

Violence, Harassment, and Turnover Intention in Home and Community Care: The Role of Training

BACKGROUND

Violence and harassment affect healthcare workers' well-being and career decisions in the home and community care sector.

PURPOSE

The objective of this study is to assess the role of training in alleviating the relationship between violence and harassment at work and turnover intention among personal support workers (PSWs).

METHODOLOGY/APPROACH

Cross-sectional survey data from 1401 PSWs in Ontario, Canada are analyzed with structural equation modeling. Utilizing a resource perspective, the associations between job demands (i.e., violence and harassment at work), personal resources (i.e., self-esteem), job resources (i.e., workplace violence training and challenging task training), stress, and intention to stay among personal support workers (PSWs) are examined.

RESULTS

Challenging task training is positively associated with self-esteem and negatively associated with stress, whereas workplace violence training does not have a significant association with either variable. Stress has a negative relationship with intention to stay. Self-esteem is the mediator of both associations between violence and harassment at work and stress and between challenging task training and stress.

DISCUSSION

The results point to varied degrees of training effectiveness that may be shaping turnover decisions of PSWs who experience violence and harassment in home and community care organizations.

PRACTICE IMPLICATIONS

There seems to be a need to assess and redesign workplace violence training. Home and community care managers might be able to lower the impact of violence and harassment on PSWs' turnover by providing training that is not directly related to workplace violence and harassment.

A review: Developing an ecological model approach to co-worker incivility experiences of new graduate nurses

AIM

To explore how an ecological approach be used to explore relationships among workplace empowerment, authentic leadership, trust in management, areas of work life and co-worker incivility experiences of new graduate nurses.

DESIGN

Key concepts related to new graduate nurses' incivility experience informed the research question building on the findings of our first author's integrative review. Second, relevant theories and concepts were identified by conducting a literature review. Third, the themes build on prior theories and factors to propose a hypothetical model.

DATA SOURCES

(2016-2019) CINAHL, OVID, PSYCINFO, PUBMED, EBSCO, ERIC, SCOPUS, Cochrane Library; PROQUEST and Google Scholar.

REVIEW METHODS

(a) Constructs identified in an IR (Blackstock et al., 2018) guided a literature review on predictive variables linked to new graduate nurse's co-worker incivility experiences; (b) an ecological approach was explored; and (c) we demonstrate how multidimensional organizational factors related to incivility experiences of new graduate nurses can be situated in an ecological model.

RESULTS

Structural and organizational factors, and nurse leaders influencing new graduate nurses' experiences are situated in an ecological model. Placing new graduate nurses' co-worker incivility experiences in the microsystem and close to the mesosystem (nurse supervisor) and exosystem (workplace empowerment) of our ecological model provides new insights into their incivility experiences and informs future research.

CONCLUSION

The ecological approach and operational definition of incivility help to clarify incivility behaviours as not merely individual behaviours observed by others needing corrective cognitive behaviours, nor support in a graduate transition program, but rather a symptom of work environment factors contributing to multidimensional work environments of new graduate nurses' and influence incivility behaviours.

IMPACT

New graduate nurse co-worker incivility research could measure change across time and across system domains informed by this ecological approach and can shape new ways of thinking about how to prevent and mitigate incivility.

A Middle-Range Theory of Nurses' Psychological Trauma

Vicarious trauma, secondary trauma, and workplace violence are the common forms of psychological trauma associated with nurses. Additional areas of nurses' trauma have not been adequately described, defined, or conceptually organized in the literature. In this article, a new middle-range theory of nurses' psychological trauma is presented with a novel discourse of nurse-specific traumas, theoretical statements, and outcomes of psychological traumas that are unique to nurses and the professional worlds in which they live. A middle-range theory is forwarded so that future scholars may test this theory and derive implications for practice, education, policy, and research.

The Demand-Control Model and Pupils' Aggressive Behaviour towards Teachers: A Follow-Up Study

Purpose: Pupils’ aggressive behaviour towards teachers is a common phenomenon in schools across different countries. The purpose of this study is to test hypotheses that are central to the Job Demand–Control model as risk factors for pupils’ aggressive behaviour towards teachers. Method: Questionnaire data were collected in 2018 and 2019 from teachers at 94 public schools in Denmark. In total, 1198 teachers participated in both rounds. Demands and social support at work were measured in 2018, and pupils’ aggressive behaviour was measured in 2019. The analyses were performed using multivariate logistic regression analysis. Results: Teachers were often exposed to pupils’ aggressive behaviour during their work. High emotional work demands and low control were associated with increased risk of pupils’ aggressive behaviour. No mitigating effect of high control was found on the association between emotional demands and risk for pupils’ aggressive behaviour towards teachers. Conclusion: High emotional demands were strongly associated with the aggressive behaviour of pupils towards teachers. Job control over own work situation was not enough to lower the risk of aggressive behaviour under conditions in which teachers experience high emotional demands. Based on these results, we recommend that supervisors carefully balance teachers’ emotional demands to their resources.

The impacts of organizational culture and neoliberal ideology on the continued existence of incivility and bullying in healthcare institutions: A discussion paper

Countless research studies have demonstrated the detrimental effects of incivility and bullying in healthcare. Despite the abundance of proposed solutions to this issue, many healthcare leaders continue to fail in mitigating the existence of such negative behaviors in the workplace. Personality attributes of perpetrators and victims have received attention, but much less research has examined the organizational and neoliberal causations of incivility and bullying in healthcare. Being the largest occupational group in the health sector, nursing professionals have the greatest influence and are crucial in ending these behaviors. This discussion paper outlines the effects of incivility and bullying in healthcare and provides a critical analysis on how organizational culture and neoliberal ideology influence the pervasiveness and persistence of these negative behaviors. The analysis reveals that organizational cultures that misuse power, disregard equality, and facilitate oppression, foster the existence of incivility and bullying in the workplace. Such cultures permit perpetrators to misuse their authority to control resource allocation, ignorance to social inequalities, and the silence of victims. Furthermore, the neoliberal concept of deregulation, austerity, and individualism further these behaviors. The neoliberal reforms have led to underfunding of anti-bullying programs and policies, use of bullying behaviours as management strategies, and victim-blaming for profit maximization. Financial cutbacks have resulted in denial and acceptance of uncivil and bullying behaviours in healthcare institutions, which endangers the rights of healthcare providers to a safe workplace environment. To curtail these negative behaviors, robust anti-bullying policies and programs must be strictly enforced and sustained in practice. Further exploration on the association of organizational culture and neoliberal principles to incivility and bullying in healthcare is greatly warranted.

The symptoms and factors associated with post-traumatic stress disorder for burns nurses: a cross-sectional study from Guangdong province in China

BACKGROUND

The symptoms of post-traumatic stress disorder (PTSD) among medical staff has become a significant issue. Environments related to burns are highly stressful for nurses and can lead to PTSD, thus affecting their mental health. It is vital to consider that the quality of burns care, and the outcomes of such treatments, may be threatened if nurses experience PTSD. We evaluated PTSD symptoms in burns nurses and explored the correlations between demographic characteristics, work-related characteristics, professional identity, turnover intention, and PTSD symptoms.

METHODS

This was a cross-sectional study involving 273 nurses working in burns unit from Guangdong, China, between July and August 2019. Nurses were recruited from 30 hospitals and completed three validated psychological questionnaires: Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Professional Identity Scale for Nurses (PIS), and Turnover Intention Questionnaire (TIQ). We also collated information relating to socio-demographic and work-related characteristics.

RESULTS

The cut-off point for the PCL-C was defined as 38 points; 17.22% (n=47) of participants scored higher than or equal to 38. The PCL-C score was negatively correlated with professional identity level (P < 0.01) and positively correlated with turnover intention (P < 0.01). The workplace, mean monthly income, experience of workplace violence, and professional identity level, were important factors and all associated with the severity of PTSD.

CONCLUSION

PTSD symptoms were common in burns nurses. Attention should be paid to the mental wellbeing of these staff. Screening processes need to be initiated to identify individuals suffering from PTSD and take appropriate early interventional action.

Freirean Conscientization With Critical Care Nurses to Reduce Moral Distress and Increase Perceived Empowerment: A Pilot Study

Moral distress in nursing has been linked to a relative lack of power in the workplace. We designed and piloted a Freirean-based conscientization intervention to raise awareness and address disempowerment with 13 critical care nurses in the US Midwest who recently experienced moral distress. A transformative, mixed-methods, pre/post design was used with convergence of qualitative and quantitative data. Results showed improved moral distress and mixed results in perceived personal and group empowerment. Further study is warranted to test conscientization-based interventions that give nurses opportunity collectively to develop empowered responses to situations that lead to moral distress.

Which nurses are victims of bullying: the role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff

Background

Bullying among nurses is a universally recognized problem that has important consequences for nurses, patients and health institutions. This research was conducted with the aim of studying the relationship between role conflict, negative affect and core self-evaluations with bullying in nurses.

Methods

In this cross-sectional study, 329 nurses were selected by census method. Data were collected using PANAS Scale (negative affect), role conflict questionnaire, Core Self-Evaluations Scale (CSES), and the Negative Acts Questionnaire-Revised (NAQ-R). Data were analyzed using t-test, one way analysis of variance, Pearson correlation coefficient and multiple regression analysis with SPSS software (v. 22).

Results

The results showed that there is a significant difference between the mean bullying scores in according to gender and ward of affiliation. The influence of other variables (marital status, education level, years of experience, age group and work position) was not meaningful. Pearson correlation analysis results indicated that there is a significant positive relationship between role conflict (r = 0.47) and negative affect (r = 0.56) with bullying. Also there is a significant negative relationship between core self-evaluations and bullying (r = − 0.39). Moreover, regression analysis results revealed that negative affect, role conflict and gender can predict 44% of bullying variance significantly.

Conclusions

Based on these findings, core self-evaluations, negative affect and role conflict are good factors in predicting bullying among nurses. Consequently, hiring nurses with low negative affect and high core self-evaluations, improving nurses’ self-esteem and self-efficacy and changing workplace conditions in order to reducing role conflict can be useful in reducing workplace bullying.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00578-3.

Workplace violence towards emergency nurses: A cross-sectional multicenter study

BACKGROUND

Workplace violence (WPV) against nurses continues to be a challenge within healthcare systems worldwide. Quantifying the burden of WPV in emergency departments will inform the design of appropriate interventions. This study aimed to determine the prevalence, pattern and factors associated with WPV among emergency nurses working in Saudi Arabia.

METHODS

A multicenter descriptive online survey was conducted using a standardized self-administered questionnaire. Emergency nurses working in public hospitals in the country were invited to participate. Data were analyzed with descriptive statistics and multivariate logistic regression.

RESULTS

The study recruited 849 emergency nurses, most (73.7%) had experienced WPV in the past two years; 47.4% experienced physical violence and 94.3% experienced non-physical violence. Most exposures to WPV occurred during the afternoon shifts (70.8%), and mainly perpetrated by family members or relatives of the patients (88.3%).

CONCLUSION

WPV encountered by emergency nurses in Saudi Arabia is alarmingly high, and underreported by the affected nurses. Increased workload, inadequate staffing levels, poorly enforced visitor policy, unmet expectations, and a lack of clarity in reporting were the most frequent causes of WPV. There is a need to reassess the current occupational safety measures in the emergency departments in the country.

The Influence of Bullying on Nursing Practice Errors: A Systematic Review

Workplace bullying is an important nursing issue that can influence a nurse's propensity to commit practice errors. This systematic review examines the influence of bullying behaviors on nursing practice errors and includes articles from 2012 to 2017 that focus on bullying among nurses in multiple health care settings, including ORs, emergency departments, and acute inpatient and critical-care units. Analysis of 14 relevant articles revealed four themes: the influence of the work environment on nursing practice errors, individual-level connections between bullying and nursing practice errors, barriers to teamwork, and communication impairment. This review indicates that nurses perceive that bullying influences nursing practice errors and patient outcomes, although the mechanisms are unclear. Additional research is needed to elucidate the effects of bullying on nursing practice errors and patient outcomes.

A cross-sectional survey on workplace psychological violence among operating room nurses in Mainland China

AIM

To investigate the status of workplace psychological violence (WPV) from managers, coworkers, or subordinates against operating room (OR) nurses in mainland China and identify risk factors.

BACKGROUND

WPV is a serious problem for nurses. However, limited information is available regarding the prevalence and risk factors of WPV against OR nurses in mainland China.

METHODS

A multi-center, cross-sectional study was conducted. OR nurses (n = 1557) from 26 hospitals, located in 13 cities of China, participated in this study.

RESULTS

Of the participants, 92.1% experienced WPV (30.9% from surgeons and 18.1% from senior nurses). Only 30.1% of the sufferers would report WPV. A logistic regression analysis revealed that nurses who had been in service longer and with senior professional titles were more likely to experience WPV.

CONCLUSION

Nursing managers should identify and resolve issues in a timely manner. Measures that promote effective team communication and facilitate teamwork, as well as inter-disciplinary educational workshops may be effective.

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.

A critical realist exploration of the vulnerability of staff to sexual harassment in residential long-term care

Despite that sexual harassment of care staff negatively affects mental health and occupational outcomes, limited research has explored this in the context of residential long-term care homes. This ethnographic study explored how female care staff (e.g. providers, supervisors) understood and responded to sexual harassment from residents within the regulatory context of residential long-term care in Ontario, Canada. Data were collected from March 2017 to March 2018 and included observations and interviews with 26 staff, as well as legal, educational, and other regulatory documents. Management strategies were found to be ineffective, and despite staff acknowledgement of the negative impact of sexual harassment, they expressed tolerance of their persistent vulnerability. Drawing on critical realism, our analysis demonstrates a complex interrelationship between staff's reflexive deliberations about their experiences, health and safety regulations, and normative assumptions underpinning the education and training that they receive. Understanding the vulnerability of staff to sexual harassment at the intersection of regulation and reflexivity has important implications for the development of an effective multi-faceted approach to prevention.

Bullying in Nursing: Is it in the Eye of the Beholder?

The nursing profession is presented with numerous definitions of workplace bullying. This study provides an in-depth analysis of the concept of bullying in the nursing profession in Australia through a scoping review of definitions presented in literature published up until 2018. The research questions used to guide the search were as follows: How has the definition of bullying in nursing in Australia been conceptualized in the literature? How do these definitions of bullying differ? How has the definition of bullying, as used in the literature, evolved over time? The review was informed by the approach of Arksey and O'Malley, containing explicit definitions of bullying in nursing literature. The findings reveal that the literature does not reflect a shared and integrated vision of the exact nature of bullying in the nursing profession. The conceptualization of bullying in the nursing profession has become more dynamic over time. The myriad ways in which bullying in nursing is defined in Australia has important implications for research, practice, education, and policy.

An evaluation of the "BE NICE Champion" programme: A bullying intervention programme for registered nurses

AIM

To explore the experiences, perceptions and attitudes of registered nurses (RNs) who completed the BE NICE Champion training programme; a home-grown programme that provides RNs tools to intervene when bullying is observed; using the "4S's": Stand by, Support, Speak up, and Sequester.

BACKGROUND

The growing body of literature surrounding the negative impact bullying has on individuals and organizations suggests the need to develop more effective prevention and intervention programmes.

METHODS

A qualitative focus group approach utilizing a purposive sample of 25 RNs who participated in the training programme.

RESULTS

Three consistent themes emerged from a content analysis of the transcripts: (a) awareness and understanding, (b) applying the 4S's and (c) feeling prepared, and empowered. Additional themes included impact on the work environment and additional programme recommendations tailored to nursing leadership.

CONCLUSION

The programme and use of the 4S's adequately provided RNs with confidence to intervene when bullying was observed. RNs felt better equipped to respond due to the techniques learned and appreciated our organizational commitment to address bullying. Furthermore, the programme may be strengthened by incorporating recommendations discussed.

IMPLICATIONS FOR NURSING MANAGEMENT

Leaders need to demonstrate a commitment to address bullying. Implementing this programme can positively impact their environment.

The relationship between perceived competence and perceived workplace bullying among registered nurses: A cross sectional survey

BACKGROUND

Workplace bullying is one of the most prevalent work-related psychological and physical issues in health care facilities. Workplace bullying has detrimental effects not only on the bullied person/persons but also on health care facilities and care quality and patient safety.

AIMS

To examine the prevalence of workplace bullying and the relationship between workplace bullying and perceived competence among Jordanian registered nurses working in private hospitals DESIGN: A cross-sectional survey study.

SETTING

Data were collected from registered nurses working in seven private hospitals in the Capital of Amman.

PARTICIPANTS

Participants were 269 registered nurses who had a minimum of a bachelor degree, passed the hospital's competency nursing examinations, able to read and understand English, and were able and willing to complete the survey.

METHODS

The Negative Act Questionnaire-Revised, and Nurse Professional Competence scale were used for data collection. Multiple linear regression analysis was conducted to assess predictors of greater reporting of perceived workplace bullying.

FINDINGS

Almost 43% of the participants perceived themselves to be victims of severe workplace bullying while more than 31% perceived themselves to be victims of occasional workplace bullying. Person-related bullying was the most frequently reported type of workplace bullying followed by work-related bullying. Age, gender, and sum score on Nurse Professional Competence scale explained significant amount of variance in perceived workplace bullying.

CONCLUSION

The majority of Jordanian nurses working in private hospitals perceive themselves as victims of either occasional or severe workplace bullying. Amongst all related variables, perceived competence is the most significant predictor of perceived workplace bullying.

Reframing and addressing horizontal violence as a workplace quality improvement concern

AIM

To reframe horizontal violence as a quality improvement concern.

BACKGROUND

Although the number of studies exploring horizontal violence has increased, evidence supporting the effectiveness of current interventions is weak and the problem persists. Often framed as an individual or interpersonal issue, horizontal violence has been recognized as a complex phenomenon that can only be understood through an examination of social, individual and organizational factors. As such, interventions to address horizontal violence must be applied systemically and address contributions from all sources.

DESIGN

This is a discussion paper.

DATA SOURCES

This discussion is based on results of a study of nurses' perceptions of horizontal violence and review of the literature.

IMPLICATIONS FOR NURSING

Context is recognized as a contributing factor in human behavior, yet often overlooked in interventions to address horizontal violence. Moving the focus away from the individual and investigating systems contributions to horizontal violence using existing quality improvement frameworks is suggested.

CONCLUSION

To date, efforts to address horizontal violence have not been proven effective. There is a call for a wider application and investigation of interventions. This reframing provides the system level application suggested and would address a broader range of factors contributing to the perpetuation of the phenomenon.

Determinants of Workplace Injuries and Violence Among Newly Licensed RNs

Workplace injuries, such as musculoskeletal injuries, needlestick injuries, and emotional and physical violence, remain an issue in U.S. hospitals. To develop meaningful safety programs, it is important to identify workplace factors that contribute to injuries. This study explored factors that affect injuries in a sample of newly licensed registered nurses (NLRNs) in Florida. Regressions were run on models in which the dependent variable was the degree to which the respondent had experienced needlesticks, work-related musculoskeletal injuries, cuts or lacerations, contusions, verbal violence, physical violence, and other occupational injuries. A higher probability of these injuries was associated with greater length of employment, working evening or night shifts, working overtime, and reporting job difficulties and pressures. A lower probability was associated with working in a teaching hospital and working more hours. Study findings suggest that work environment issues must be addressed for safety programs to be effective.

Encouraging employees to report verbal violence in primary health care in Serbia: A cross-sectional study

Introduction

Workplace violence is a serious and multidimensional problem that adversely affects professional and personal lives of employees. The aim of this study was to assess the prevalence and characteristics of verbal violence as a part of psychological violence among employees in primary health care in Belgrade, and to identify contributing factors of verbal violence in the workplace.

Methods

In this cross-sectional study, the final analysis included 1526 employees, using multi-stage sampling. Data were collected using the questionnaire Workplace Violence in the Health Sector Country Case Studies Research, developed by ILO/ICN/WHO/PSI. Descriptive statistics and logistic regression analysis were used to analyse the data. The general response rate was 86.8% (1526/1757).

Results

It was found that 47.8% of the participants were subjected to verbal violence. The main source of verbal violence was patient/client, 55.6% of employees did not report the incident. Among those who did not report the incident, 74.9% believed that reporting violence was useless. The interaction with patients (OR, 1.45; 95% CI, 1.02-2.06) and work between 6pm and 7am (OR, 1.27; 95% CI, 1.01-1.60) were significant contributing factors of verbal violence.

Conclusion

The results are indicative of a high prevalence of verbal violence against employees in primary health centres, which could have undesirable consequences. Conducting a better organizational measure and encouraging employees to report workplace violence could reduce the prevalence of verbal violence.

Workplace violence towards nurses in Hong Kong: prevalence and correlates

BACKGROUND

Nurses are especially vulnerable to violent and other forms of aggression in the workplace. Nonetheless, few population-based studies of workplace violence have been undertaken among working-age nurse professionals in Hong Kong in the last decade.

METHODS

The study estimates the prevalence and examines the socio-economic and psychological correlates of workplace violence (WPV) among professional nurses in Hong Kong. The study uses a cross-sectional survey design. Multivariate logistic regression examines the weighted prevalence rates of WPV and its associated factors for a population of nurses.

RESULTS

A total of 850 nurses participated in the study. 44.6% had experienced WPV in the preceding year. Male nurses reported more WPV than their female counterparts. The most common forms of WPV were verbal abuse/bullying (39.2%), then physical assault (22.7%) and sexual harassment (1.1%). The most common perpetrators of WPV were patients (36.6%) and their relatives (17.5%), followed by colleagues (7.7%) and supervisors (6.3%). Clinical position, shift work, job satisfaction, recent disturbances with colleagues, deliberate self-harm (DSH) and symptoms of anxiety were significantly correlated with WPV for nurses.

CONCLUSIONS

WPV remains a significant concern for healthcare worldwide. Hong Kong's local health authority should put in place a raft of zero-tolerance measures to prevent WPV in healthcare settings.

Workplace violence against nurses in three different Greek healthcare settings

BACKGROUND

Healthcare workers are at high risk of facing workplace violence and nurses represent the most affected group.

OBJECTIVE

This study aimed to assess workplace violence encountered by nurses working in three different healthcare settings.

METHODS

This was a cross-sectional study conducted in a tertiary hospital, a non-tertiary hospital and a primary care unit. The research tool was an anonymous self-report questionnaire concerning the prevalence, characteristics, consequences, causes and preventive measures of workplace violence. The statistical analysis was performed with SPSS 17.0.

RESULTS

Eighty nurses participated in the study. The majority (76%) had experienced workplace violence. Men (OR, 0.08; 95% CI, 0.01-0.56) and more experienced nurses (OR, 0.82; 95% CI, 0.70-0.97, for each additional year of working experience) were less affected in the last year. Verbal violence was the dominant type (98%). The vast majority (80%) reported a negative psychological impact, while 65% reported that they feel sometimes, rarely or never safe in their workplace. One of the main suggested causes of workplace violence was the long waiting time (99%), while the most common suggested measure of prevention was entrance control (93%).

CONCLUSIONS

This study revealed a high prevalence of workplace violence against nurses working in different healthcare facilities. Country and unit-specific studies may be beneficial for implementing appropriate interventions for reducing work place violence.

Workplace bullying prevention: a critical discourse analysis

AIM

The aim of this study was to analyse the discourses of workplace bullying prevention of hospital nursing unit managers and in the official documents of the organizations where they worked.

BACKGROUND

Workplace bullying can be a self-perpetuating problem in nursing units. As such, efforts to prevent this behaviour may be more effective than efforts to stop ongoing bullying. There is limited research on how healthcare organizations characterize their efforts to prevent workplace bullying.

DESIGN

This was a qualitative study.

METHOD

Critical discourse analysis and Foucault's writings on governmentality and discipline were used to analyse data from interviews with hospital nursing unit managers (n = 15) and organizational documents (n = 22). Data were collected in 2012.

FINDINGS

The discourse of workplace bullying prevention centred around three themes: prevention of workplace bullying through managerial presence, normalizing behaviours and controlling behaviours. All three are individual level discourses of workplace bullying prevention.

CONCLUSION

Current research indicates that workplace bullying is a complex issue with antecedents at the individual, departmental and organizational level. However, the discourse of the participants in this study only focused on prevention of bullying by moulding the behaviours of individuals. The effective prevention of workplace bullying will require departmental and organizational initiatives. Leaders in all types of organizations can use the results of this study to examine their organizations' discourses of workplace bullying prevention to determine where change is needed.

Psychological Violence in the Health Care Settings in Iran: A Cross-Sectional Study

Background:

Psychological violence is the most common form of workplace violence that can affect professional performance and job satisfaction of health care workers. Although several studies have been conducted in Iran, but there is no consensus regarding current status of such violence.

Objectives:

This study aimed to investigate the prevalence of psychological violence among healthcare workers employed at teaching hospitals in Iran.

Patients and Methods:

In this cross-sectional study, 5874 health professionals were selected using multistage random sampling. Data were collected using a self-administered questionnaire developed by the International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. Descriptive statistics were used to analyze the data.

Results:

It was found that 74.7% of the participants were subjected to psychological violence during the past 12 months. Totally, 64.5% of psychological violence was committed by patients’ families, but 50.9% of participants had not reported the violence, and 69.9% of them believed that reporting was useless.

Conclusions:

The results are indicative of high prevalence of psychological violence against healthcare workers. Considering non-reporting of violence in more than half of participants, use of an appropriate reporting system and providing training programs for health professionals in order to prevent and manage workplace violence are essential.

Barriers to Effective Implementation of Programs for the Prevention of Workplace Violence in Hospitals

Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.

Racial and ethnic differences in factors related to workplace violence victimization

Workplace violence (WPV) is a significant public health concern affecting all racial or ethnic groups. This study examined whether different racial/ethnic groups differed in vulnerability to WPV exposure and utilization of resources at the workplace. This cross-sectional research focused on White, Black, and Asian nursing employees (N = 2,033) employed in four health care institutions in a mid-Atlantic U.S. metropolitan area. Whereas childhood physical abuse was significantly related to risk of WPV among workers from all racial/ethnic backgrounds, intimate partner abuse was a significant factor for Asians and Whites. Blacks and Asians were found to be less likely than Whites to be knowledgeable about WPV resources or use resources to address WPV. Services to address past trauma, and education and training opportunities for new workers may reduce risk of WPV and promote resource utilization among minority workers.

Hospital violence and the role of the occupational health nurse

Between 1993 and 1999, an average of 1.7 million violent workplace incidents were recorded per year. Of the nonfatal injuries and lost days due to occupational violence, 32% occur in the health care setting. The annual incidence rate for violence against nurses is 22 incidents per 1,000 nurses. When an occupational health professional analyzes an exposure, engineering controls, administrative controls, and personal protective equipment policies are drafted to ensure the future safety of employees. This literature review identifies best practice controls used to protect health care workers from violence in the workplace.