Workplace bullying among healthcare professionals in Sweden: a descriptive study

Bullying against Healthcare Professionals and Coping Strategies: A Scoping Review

Violence against healthcare professionals is an event that further burdens the daily lives of those who try every day to care for and assist those who need it most. In an attempt to overcome these events, there are coping strategies that can be used to reduce the stress caused. Therefore, this study aims to analyse the phenomenon of violence against healthcare professionals and the relationship between the bullying suffered by these professionals and the coping strategies they developed to overcome these moments. To this end, a scoping review was conducted in which eight articles were selected for final analysis from a total of 276 articles found in three electronic databases (EBSCO, PubMed, and Web of Science). This review concludes that the most common workplace bullying behaviours include excessive workloads, humiliation and ridicule, impossible deadlines, and verbal attacks. Professionals reported negative impacts, such as helplessness, depression, stress, insomnia, and the desire to change jobs. Victims of workplace bullying often expressed their intention to leave their current job or even abandon the profession. Problem-focused coping strategies are the most used. The studies indicated that workplace bullying negatively affects professionals in physical and mental terms, as well as in terms of quality of life at work, requiring more research and adoption of preventive measures to identify and combat the problem.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Relationship Between Personality Traits and Workplace Bullying Victims in Saudi Arabia

Background Workplace bullying is persistent aggressive behavior, including verbal or physical abuse, exhibited in a working environment. The impact of workplace bullying in any industry leads to negative outcomes in multiple dimensions, such as issues with mental health, problems with physical health, and a reduction in productivity in the workplace. This study aims to measure the relationship between personality traits and workplace bullying victims. Moreover, it explores how personality traits predict being a victim of workplace bullying. Methodology A cross-sectional study was conducted among 625 participants from various regions of Saudi Arabia. Data was collected using a self-administered survey, which included sociodemographic questions, the Negative Acts Questionnaire-Revised (NAQ-R) for bullying assessment, and the Big Five Personality Inventory (BFI-10) for personality trait assessment. The statistical analysis encompassed descriptive statistics and inferential tests such as the correlation test, Mann-Whitney U test, and Kruskal-Wallis test. These analyses were conducted using the SPSS software version 27.0.1 (IBM Corp., Armonk, NY, USA). Results Personal-related bullying was more prevalent compared to work-related bullying, particularly "facing disregard of opinion" was the most frequent type of bullying. Moreover, conscientiousness, agreeableness, and openness to experience were demonstrated as major self-perceived personality traits among participants. Some sociodemographic factors were reported to be significantly associated with both bullying and personality trait scores. Personality traits such as conscientiousness, agreeableness, and extraversion were adversely correlated while openness to experience and neuroticism were positively correlated with bullying. Conclusions Our study illustrates the current prevalence of workplace bullying in Saudi Arabia and its impact on participants' mental health and productivity. We identified a significant correlation between self-perceived personality traits and the risk of experiencing workplace bullying. These findings offer valuable insights for policymakers, enabling them to develop targeted interventions to reduce bullying within work settings in Saudi Arabia.

Magnitude and Impact of Workplace Violence Against Obstetric Healthcare Personnel: A Multicentre Cross-Sectional Study

Background

Workplace violence is defined by the World Health Organization (WHO) as incidents where staff is abused, threatened or assaulted in work settings. In emergency predominated branch like obstetrics, there is a need to study the magnitude and impact of violence against healthcare workers (HCW). Materials and Methodology: This cross-sectional study was conducted in the Department of Obstetrics at 2 centres in Lucknow district, for a period of 6 months. The study population included trainee residents, senior residents, nursing staff and consultants. Standard definitions from the WHO were used to define the types of violence. The validated questionnaire was designed in English with 25 questions to understand the incidence of workplace violence, prevention policy, reporting and follow-ups of incidents and impact of violence.

Results

With a response rate of 90%, 274 HCW participated in the study. In total, 172 HCW (62.7%) either faced physical or verbal assault. In 70% of incidents, patient, their relatives or public were perpetrators of violence, and the rest 30% incidents were by colleagues or management. Majority of the incidents were in emergency areas. Only 22% of the abused reported to the concerned authorities. At least 123 (71.5%) HCW were extremely dissatisfied with the action taken. Action was taken against only 9.8% of the perpetrators. None of the respondents received any training to handle workplace violence.

Conclusion

There is an alarming high prevalence of workplace violence by patients and colleagues. Adequate training to handle these incidents, improvement of working environment and unconditional support from management will bring a positive work experience.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13224-023-01809-0.

Association between offensive behaviors and burnout and depression risks in health workers

OBJECTIVE

to evaluate the occurrence of offensive behaviors at work, their characteristics and association with sex, stress, burnout and depression in health workers.

METHOD

a cross-sectional, descriptive and quantitative study carried out with 125 workers from the Brazilian Unified Health System. The data were collected from June 2021 to April 2022 through three self-applied questionnaires that assess personal and occupational characteristics; offensive behaviors, stress and burnout; and depressive symptoms. Descriptive statistics, the chi-square association test and logistic regression analysis were applied.

RESULTS

44% of the sample reported 83 behaviors, with threats of violence as the most frequent ones (26%). Nursing technicians/assistants, nurses and physicians were the most exposed professionals. The main aggressors were the patients, except for bullying, which was perpetrated by co-workers (48%). There was an association between offensive behaviors and burnout (OR: 4.73; 95% CI: 1.29-17.3; p=0.02) and between offensive behaviors and depression symptoms (OR: 1.05; 95% CI: 1.01-1.10; p=0.02).

CONCLUSION

the occurrence of offensive behaviors in health work is frequent and characteristic and burnout and depressive symptoms respectively increased 4.73 and 1.05 times the chances of workers suffering these offensive behaviors in the work environment.

International Cross-Sectional Survey of Bullying, Undermining, and Harassment in the Vascular Workplace

OBJECTIVE

Bullying, undermining behaviour, and harassment (BUH) may exist in healthcare settings, impacting on patient care. The aim of this international study was to evaluate the characteristics of BUH experienced by physicians treating vascular diseases at various career stages.

METHODS

This was an anonymous international structured non-validated cross-sectional survey distributed via relevant professional societies in collaboration with the Research Collaborative in Peripheral Artery Disease. The survey was disseminated through societies' newsletters, emails, and social media. Data were collected online, allowing free text entries alongside structured multiple choice questions based on previous surveys. Demographics, geographical information, and data relating to stage and training environment were collected.

RESULTS

Of 587 respondents from 28 countries, 86% were working in vascular surgery, mostly at a university hospital (56%); 81% were aged between 31 and 60 years, 57% were working as a consultant, and 23% as a resident. Respondents were mostly white (83%), male (63%), heterosexual (94%), and without disability (96%). Overall, 253 (43%) reported experiencing BUH personally, 75% had witnessed BUH toward colleagues, and 51% witnessed these in the last 12 months. Female sex and non-white ethnicity were associated with BUH (53% vs. 38% and 57% vs. 40% respectively; p < .001 in both cases). While working as a consultant, 171 (50%) reported experiencing BUH, more often among females, non-heterosexuals, those who were not working in their country of birth, and non-white people. Specialty and hospital type were not associated with BUH.

CONCLUSION

BUH remains a major problem in the vascular workplace. Female sex, non-heterosexuality, and non-white ethnicity are associated with BUH at various career stages.

The evaluation of mobbing cases in the healthcare sector based on Supreme Court case law in Turkey

PURPOSE

This study aimed to examine mobbing in the health sector based on the Supreme Court case law.

DESIGN AND METHODS

The data were accessed on the website of the Supreme Court. Searches were made using mobbing and health-related keywords and filters. As a result, 43 lawsuits were included.

CONCLUSIONS

Most of the cases occurred in private hospitals. Hospital managers were accused of mobbing in 88% of cases. In 30% of cases, nurses were plaintiffs. Also, 45% of cases involved an attack on the occupational situation of employees.

PRACTICE IMPLICATIONS

It is important to develop policies specific to mobbing behavior in the workplace at the macro level and to consider legislation and management monitoring by health managers and especially nurse managers at the micro level.

Horizontal Violence Toward Emergency Medicine Residents: Gender as a Risk Factor

Introduction: Horizontal violence (HV) is defined as “persistent exposure to interpersonal aggression and mistreatment from colleagues.” Our objective in this pilot, single-site study was to identify sources of HV toward emergency medicine (EM) residents, using the Negative Acts Questionnaire-Revised (NAQ-R). Methods: In this investigation we used a descriptive cross-sectional survey design to categorize HV. All voluntary participants were residents in an Accreditation Council for Graduate Medical Education- approved, three-year academic EM residency. Data were collected via electronic survey and occurred six months into an academic year. We collected demographic information and responses to the NAQ-R in 2020. Horizontal violence is subdivided into three categories: work-related; person-related; and physical intimidation. Emergency medicine residents answered questions as they related to their interactions with residents and support staff, which included nursing. Results: A total of 23 of 26 residents responded (89%). Participants were 56% women, 78% white, 11% Hispanic, and 89% heterosexual. Participant clinical year was 39% first-, 39% second-, and 22% third-year residents. Women reported a higher frequency of HV compared to men (1.3 vs 1.1, P =.01). By category, women indicated higher incidence of work-related violence from other residents (P = .05) and staff (P =.02). There was no difference in reported frequency of violence for interns compared to senior residents. Conclusion: Our pilot study demonstrated horizontal violence toward EM residents exists and is more prevalent in women.

Job demands, job resources, and health outcomes among nursing professionals in private and public healthcare sectors in Sweden - a prospective study

Background

Nursing professionals exhibit high prevalence of stress-related health problems. Job demands and job resources are parallel drivers of health and well-being among employees. Better job resources associate with better job satisfaction, job motivation and engagement even when job demands are high. To date, there is limited research which explores the association between job demands, job resources and health outcomes among nursing professionals in the Swedish context. The aim of this study was therefore to investigate Swedish nursing professionals’ job demands and job resources in relation to health outcomes, with comparisons between the private and public healthcare sectors. The specific research questions were as follows: (1) Are there differences between private and public healthcare regarding job demands, job resources, and health outcomes? and (2) Are there prospective associations between job demands and job resources in relation to health outcomes?

Methods

Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2016 and 2018, including 520 nurses and 544 assistant nurses working in the private and public healthcare sectors from 2016 (baseline). Data were analyzed using binary logistic regression.

Results

Nursing professionals reported higher threats, lower bullying, lower control, lower social support, and lower cohesion in the public healthcare units compared to the private healthcare units. The prospective analyses showed that job resources in terms of social support and rewards were associated with higher self-rated health and lower burnout. Cohesion was associated with higher self-rated health. Job demands in terms of psychological demands and job efforts were associated with lower self-rated health, higher burnout, and higher sickness absence, while emotional demands were associated with higher burnout.

Conclusions

Nursing professionals’ job resources are deficient in public healthcare units. Job resources are associated with positive health outcomes, whereas job demands are associated with negative health outcomes, among nursing professionals. Strengthening job resources among nursing professionals in the private and public healthcare sectors can promote and sustain their work-related health.

The Prevalence and The Relationship of Workplace Bullying and Nurses Turnover Intentions: A Cross Sectional Study

Introduction: Sustaining a healthy work environment is a major challenge for health care organizations worldwide. Nursing professionals are often exposed to workplace bullying, which imposes serious challenges to nursing retention. Objectives: To determine the prevalence of workplace bullying and turnover intention among nurses, and to investigate the relationship between workplace bullying and nurse turnover. Methods: A cross-sectional correlational design. Convenience sampling was applied, whereby 347 nurses working in a tertiary medical city in Riyadh, Saudi Arabia, were recruited. Data were collected using the Negative Acts Questionnaire and the Anticipated Turnover Scale. Results: The rate of workplace bullying was high, bullying occurred at a cumulative rate of 33.4% (n = 116). Work related bullying behaviors formed the most common bullying acts with (34.5%) followed by personal bullying with (31.1%) meanwhile physical intimidating accounted by (25.6%). Among the participants, 31.7% exhibited a high turnover intention. The demographic variable age was revealing an inverse correlation with workplace bullying. There was a positive significant correlation between workplace bullying and turnover intentions (r = .24, p < 0.01). Conclusion: The alarming prevalence of both bullying and turnover intention among participants confirms that when nurses are exposed to workplace bullying, they are more likely to demonstrate an increased intention for turnover. Managers are urged to use proper enforcement of anti-bullying policies along with education and training to create a healthy environment and mitigate workplace bullying.

Workplace bullying among operating room nurses in China: A cross-sectional survey

PURPOSE

To investigate the prevalence and level of severity of workplace bullying among operating room nurses and to identify the risk factors that contribute to workplace bullying in operating room nurses in China.

DESIGN AND METHODS

This descriptive research was conducted on 411 nurses from six medical centers in Harbin using a structured questionnaire.

FINDINGS

The prevalence of workplace bullying was 15.8%. There were significant differences in workplace bullying by sex, hospital level, and marital status. Stepwise multiple regression analysis indicated that gender and marital status were significant determinants of workplace bullying.

PRACTICE IMPLICATIONS

These findings portray a comprehensive landscape of workplace bullying among operating room nurses in China. Understanding the factors that influence workplace bullying may enhance the recognition and management of bullying behaviors.

Bullying in the Nuclear Medicine Department and During Clinical Nuclear Medicine Education

Workplace bullying (WPB) in the medical field is a significant occupational hazard and health-care safety concern, though many cases go unreported. Often regarded as a rite of passage to desensitize and toughen new employees and students, WPB causes psychologic harm and creates an unsafe working environment resulting in health complications, anxiety, depression, low self-esteem, difficulty concentrating, and self-harm. Decreased productivity, increased absenteeism, high turnover rates, and inappropriate patient care are linked to WPB, perpetrating organizational dysfunction. This research study evaluated WPB (prevalence, frequency, and behaviors; associated characteristics; effects on patient care; and awareness and enforcement of antibullying protocols) in nuclear medicine (NM) departments and clinical education. Methods: A quantitative single-group correlational analysis was used to survey certified NM technologists and students in the Nuclear Medicine Technology Certification Board e-mail database (n = 20,389). The highest response rate for any individual question was 836. Data were collected using the short version of the negative-acts questionnaire along with a researcher-created survey and analyzed using χ² testing and central tendencies. Results: WPB existed in varying degrees (46.8%) within the previous 6 mo, predominantly in the form of being ignored, excluded, and subjected to repeated reminders of errors and having information affecting performance withheld. NM professionals are more likely to witness and experience WPB than students and are more likely to be bullied by a fellow technologist. Some characteristics, such as sex, age, and occupation, were statistically significant, whereas others, such as race, height, body type, experience, and education, showed no significant correlation. Attention to patient care decreased (39.6%) when WPB was present. An 8% variation exists between enforcement and nonenforcement of antibullying policies, with 26% of professionals being unaware of whether antibullying policies exist at their workplace. Conclusion: Explanations for underreported WPB include fear of retaliation, nonenforcement and lack of awareness of antibullying policies, organizational complacency, and perceived hierarchic power. Recommendations to minimize WPB include adopting and publicizing a descriptive definition, implementing antibullying policies, using mediation procedures, and imposing noncompliance penalties. A decrease in the incidence of WPB correlates with an increase in employee satisfaction and retention, patient safety, and student success.

Prevalence of Workplace Bullying and Its Associated Factors at a Multi-Regional Saudi Arabian Hospital: A Cross-Sectional Study

Background

Workplace bullying (WPB) refers to any form of repeated and unreasonable verbal, physical or sexual harassment that an employee endures by a person or a group. In healthcare settings, practitioners are occasionally victims of WPB incidents. The aim of this study was to survey victims of WPB and determine factors associated with being a victim of WPB at a multiregional health care facility in Saudi Arabia.

Methods

This cross-sectional study was conducted in 2018, by distributing a self-administered questionnaire via a private electronic mail to all fulltime healthcare practitioners within a multi-regional hospital in Saudi Arabia. Healthcare practitioners included physicians, nurses, allied healthcare professionals and pharmacists who reported being exposed to WPB in the past year. Study outcomes were the prevalence rate ratio of WPB and its associated factors, such as victim, perpetrator and incident characteristics.

Results

WPB has been reported by 684 participants. Perpetrators were mainly patients (36.1%), their families/relatives (29.5%), and hospital staff (27.2%) or managers/supervisors (7.2%). The type of WPB incident was mostly verbal abuse (98.1%) followed by physical harassment (11.8%) and sexual connotations (5.8%). WPB was 30% more prevalent among younger nurses and 24% less prevalent among higher educated nurses compared to their counter groups, P<0.001 each. Among technicians and administrative employees, WPB was 54% more prevalent among females, 36% more prevalent among the younger group, and 25% more prevalent among expatriate workers compared to their counter groups P<0.014, P<0.001 and P=0.017, respectively. WPB was 20% less prevalent among higher educated allied health professionals, P=0.002. Among physicians, WPB was 33% more prevalent among females, P=0.041 and was 47% more prevalent among higher educated physicians compared to their counter groups, P=0.018.

Conclusion

WPB might occur any time, anywhere and by any person within health care facilities. The prevalence of WPB varies within health occupational groups. Gender, age, educational level, and nationality were significantly associated factors with WPB.