The Embodiment of Insult: A Theory of Biobehavioral Response to Workplace Incivility

Explaining the negative effects of workplace incivility on family lives: a moderated mediation model of surface acting and resource-providing variables

The effects of workplace incivility have been understudied in educational settings. To expand incivility research to educational professions, the present research investigates whether, how, and when workplace incivility deriving from different sources (coworkers, supervisors, and outsiders) is related to work-to-family interference (WFI) of preschool teachers. Drawing on the conservation of resources theory, the present study proposes that workplace incivility and subsequent maladaptive emotion labor strategies (i.e., surface acting) jointly create a resource-depletion mechanism contributing to elevated WFI and two resource-providing variables (supervisor work-family support and psychological detachment after hours) function as potential mitigating factors to break the resource-depletion mechanism. This study used a female-dominated sample (i.e., preschool teachers) found that workplace incivility from insiders (supervisors and coworkers respectively) and external stakeholders (child's family members) all positively linked to WFI, and surface acting mediated these relationships. Moreover, moderated mediation analyses indicated that psychological detachment buffered the mediated effect of surface acting on WFI, whereas supervisor work-family support did not. Findings deepen the understanding of why and when workplace incivility influences employees' family lives, as well as point to future intervention strategies.

From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes

BACKGROUND

Nursing incivility, defined as disrespectful behaviour toward nurses, is increasingly recognized as a pressing issue that affects nurses' well-being and quality of care. However, research on the pathways linking incivility to outcomes is limited, especially in Saudi hospitals.

METHODS

This cross-sectional study examined relationships between perceived nursing incivility, nurse stress, patient engagement, and health outcomes in four Saudi hospitals. Using validated scales, 289 nurses and 512 patients completed surveys on exposure to incivility, stress levels, activation, and medication adherence. The outcomes included readmissions at 30 days and satisfaction.

RESULTS

More than two-thirds of nurses reported experiencing moderate to severe workplace incivility. Correlation and regression analyzes revealed that nursing incivility was positively associated with nursing stress. An inverse relationship was found between stress and patient participation. Serial mediation analysis illuminated a detrimental cascade, incivility contributing to increased nurse stress, subsequently diminishing patient engagement, ultimately worsening care quality. Conclusions The findings present robust evidence that nursing incivility has adverse ripple effects, directly impacting nurse well-being while indirectly affecting patient outcomes through reduced care involvement. Practical implications advocate for systemic interventions focused on constructive nursing cultures and patient empowerment to improve both healthcare provider conditions and quality of care. This study provides compelling information to inform policies and strategies to mitigate workplace mistreatment and encourage participation among nurses and patients to improve health outcomes.

Not all uncivil behaviours are equal: exploring responses to incivility in veterinary practice using vignettes

Workplace incivility is considered a common workplace stressor, linked to a range of adverse impacts such as reduced wellbeing. However, there is a lack of research focused on how targets of incivility respond. The current study addresses that gap by examining responses to incivility within veterinary practice. Veterinarians and veterinary nurses (n = 132) evaluated six scenarios depicting two types of incivility (direct e.g. demeaning comments/indirect, for example, ignoring someone) across three instigators (clients, co-workers, senior colleagues), reporting their perception and appraisal of the uncivil behaviour depicted along with potential responses. Direct incivility was linked to responses such as reciprocation, exit, and support seeking, whereas indirect incivility was associated with affiliative and ignoring responses. Negative appraisal of incivility predicted a higher likelihood of exit, avoidance, support seeking and reporting responses. These findings suggest that incivility targets utilise a broad range of response options and adapt their response dependent on the situation.

The prevalence of incivility in hospitals and the effects of incivility on patient safety culture and outcomes: A systematic review and meta-analysis

AIM

Workplace incivility is a barrier to safe and high-quality patient care in nursing workplaces and more broadly in tertiary hospitals. The present study aims to systematically review the existing evidence to provide a comprehensive understanding of the prevalence of co-worker incivility experienced and witnessed by nurses and other healthcare professionals, the effects of incivility on patient safety culture (PSC) and patient outcomes, and the factors which mediate the relationship between incivility and patient safety.

METHODS

A systematic review with narrative synthesis and meta-analysis was undertaken to synthesize the data from 41 studies.

DATA SOURCES

Databases searched included MEDLINE, PubMed, SCOPUS, CINAHL, PsycInfo, ProQuest, Emcare and Embase. Searches were conducted on 17 August 2021 and repeated on 15 March 2023.

RESULTS

The pooled prevalence of experienced incivility was 25.0%. The pooled prevalence of witnessed incivility was 30.1%. Workplace incivility was negatively associated with the PSC domains of teamwork, reporting patient safety events, organization learning/improvement, management support for safety, leadership, communication openness and communication about error. The composite pooled effect size of incivility on these domains of PSC was OR = 0.590, 95% CI [0.515, 0.676]. Workplace incivility was associated with a range of patient safety outcomes (PSOs) including near misses, adverse events, reduced procedural and diagnostic performance, medical error and mortality. State depletion, profession, psychological responses to incivility, information sharing, help seeking, workload and satisfaction with organizational communication were found to mediate the relationship between incivility and patient safety.

CONCLUSION

Experienced and witnessed incivility is prevalent in tertiary hospitals and has a deleterious effect on PSC and PSOs. A better understanding of the mechanisms of this relationship will support the development of interventions aimed at reducing both incivility and patient harm.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE IMPACT

This study quantifies the effect of incivility on PSC and outcomes. It provides support that interventions focusing on incivility are a valuable mechanism for improving patient care. It guides intervention design by highlighting which domains of PSC are most associated with incivility. It explores the profession-specific experiences of workplace incivility.

REPORTING METHOD

This report adheres to PRISMA reporting guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. The focus of this study is the nursing and healthcare workforce, therefore, patient or public involvement not required.

Incivility and interpersonal harm in organizational context: A qualitative exploration of values in STEM training programs

This study investigates science, technology, engineering, and math (STEM) PhD students' perceptions of organizational values and incivility. Interviews with 26 STEM PhD students elicited examples of and perceptions surrounding incivility and related harms. Productivity, prestige, expertise, objectivity, self-sufficiency, and collaboration values were identified. Each included aspects deemed useful (e.g., productivity fueling discovery; expertise facilitating learning) as well as potentially contributing to harm when weaponized (e.g., productivity appeared in incivility stories when one "looked down" on those who did not work long days; expertise appeared when people gossiped about intelligence). Some aspects of collaboration (e.g., long-lasting working relationships fueling scientific discovery) may be protective. Organizational values such as productivity appeared to supersede considerations such as well-being. Current framing of these values may bolster refusal to engage in or support social justice and mental health efforts, which some participants identified as needed. Implications across settings are discussed.

Coping with Workplace Incivility in Hospital Teams: How Does Team Mindfulness Influence Prevention- and Promotion-Focused Emotional Coping?

Incivility is a growing concern for researchers and practitioners alike, yet we know little about how the team context is related to the way that employees respond to it. In this study, we examined the role of team mindfulness and its direct and buffering effects on individual-level promotion- and prevention-focused emotional coping. We also examined how these forms of coping were related to individual work engagement. In a temporally lagged study of 73 hospital teams (involving 440 team members), multi-level analyses showed that team mindfulness was directly negatively associated with individual-level prevention-focused emotional coping (behavioral disengagement, denial, and venting); however, it was not positively related to individual-level promotion-focused forms of coping (positive reframing and acceptance). In addition, a cross-level interaction effect was identified whereby team mindfulness reduced the positive relationship between incivility and venting, meaning there was less individual-level venting following incivility in the context of higher team mindfulness. These findings may have implications for work engagement, which was shown to be negatively related to venting and behavioral disengagement. Our findings are useful for managers of teams that regularly experience customer incivility as it uncovers how they can develop a team context that discourages ineffective coping responses.

How employees leverage psychological capital and perform, even in the presence of rude co-workers: an empirical study from Pakistan

Purpose

This study aims to unpack the link between co-worker incivility and job performance, by detailing a mediating role of psychological detachment and a moderating role of psychological capital.

Design/methodology/approach

The research hypotheses are tested with three-wave, time-lagged data collected from Pakistani-based employees and their supervisors.

Findings

An important reason that disrespectful co-worker treatment curtails job performance, with respect to both in-role and extra-role work efforts, is that employees detach from their work environment. This mediating role of psychological detachment is less salient to the extent that employees possess high levels of psychological capital.

Practical implications

For organizations, this study pinpoints a key mechanism, a propensity to distance oneself from work, by which convictions that co-workers do not show respect direct employees away from productive work activities. This study also shows how this mechanism can be subdued by ensuring that employees exhibit energy-enhancing personal resources.

Originality/value

This study expands extant research on the dark side of interpersonal co-worker relationships by revealing pertinent factors that explain why and when co-worker incivility can escalate into diminished performance-enhancing activities.

Hospital nurses experiencing day-to-day workplace incivility: A diary study on the benefits of daily social support

AIM

The present study investigated the adverse effects of daily experienced incivility and the positive role of daily social support during the workday in predicting daily emotional exhaustion after work and vitality and positive affect at bedtime.

BACKGROUND

Despite the broad knowledge of the impact of experienced incivility in different occupations, little is known about day-to-day nurse incivility, much less in the hospital context.

METHOD

After completing a general questionnaire, hospital nurses (n = 96) completed a diary questionnaire twice a day for five consecutive workdays (n = 480 diary observations). The diary design had two levels: 5-day repeated measures (Level 1, day level) nested in persons (Level 2, person level) using an experience-sampling methodology.

RESULTS

Multilevel hierarchical analyses showed that incivility during the workday increased emotional exhaustion after work (t = 3.00, p = <0.05) and reduced vitality (t = -2.48, p = 0.05) and positive affect (t = -2.23, p = 0.05) at bedtime. However, daily social support during the workday was a crucial job resource that directly benefited hospital nurses' daily wellbeing (t = 5.19, p = 0.01 vitality; t = 4.89, p = 0.01 positive affect) and buffered the adverse effects of daily workplace incivility (t = -2.33, p = 0.05).

CONCLUSION

The within-person approach of our findings suggests that supportive practices can reduce day-to-day incivility spirals.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can promote a civility culture within their units using in service training programmes at work.