Workplace Bullying and Medically Certified Sickness Absence: Direction of Associations and the Moderating Role of Leader Behavior

The role of familial factors and neuroticism in the association between exposure to offensive behaviors at work and long-term sickness absence due to common mental disorders - a prospective twin study

OBJECTIVES

The aim of this study was to investigate associations between exposure to work-related violence/threats and harassment, and future sickness absence (SA) due to common mental disorders (CMDs), taking familial factors (shared genetics and early-life environment) and neuroticism into account.

METHODS

The study sample included 8795 twin individuals from the Swedish Twin Project of Disability Pension and Sickness Absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE). Self-reported work-related violence and/or threats as well as work-related harassment (including bullying) and national register data on SA due to CMDs were analyzed using standard logistic regression, and conditional logistic regression among complete twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses.

RESULTS

Exposure to work-related violence/threats was associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children, education, type of living area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52-2.95). Higher odds of SA due to CMDs were also found for exposure to harassment (OR 1.52, 95% CI 1.10-2.11) and a combined indicator of exposure to violence/threats and/or harassment (OR 1.98, 95% CI 1.52-2.59), compared with the unexposed. Analyses of twins discordant on exposure, using the unexposed co-twin as reference, showed reduced ORs. These ORs were still elevated but no longer statistically significant, potentially due to a lack of statistical power. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, indicating higher odds of SA due to CMDs in the group scoring lower on neuroticism.

CONCLUSIONS

Exposure to work-related offensive behaviors was associated with SA due to CMDs. However, the results indicated that these associations may be partly confounded by familial factors. In addition, an interaction between exposure and neuroticism was suggested. Thus, when possible, future studies investigating associations and causality between offensive behaviors at work and mental health-related outcomes, should consider familial factors and neuroticism.

Bidirectional associations between workplace bullying and sickness absence due to common mental disorders - a propensity-score matched cohort study

BACKGROUND

The link between workplace bullying and poor mental health is well-known. However, little is known about the prospective and potentially reciprocal association between workplace bullying and mental health-related sickness absence. This 2-year prospective study examined bidirectional associations between exposure to workplace bullying and sickness absence due to common mental disorders (SA-CMD) while controlling for confounding factors from both work and private life.

METHODS

The study was based on propensity score-matched samples (N = 3216 and N = 552) from the Swedish Longitudinal Occupational Survey of Health, using surveys from years 2012, 2014 and 2016. Self-reported exposure to workplace bullying was linked to registry-based information regarding medically certified SA-CMD (≥ 14 consecutive days). The associations were examined by means of Cox proportional hazards regression and via conditional logistic regression analysis. Hazard ratios and odds ratios with 95% confidence intervals were estimated.

RESULTS

Exposure to workplace bullying was associated with an increased risk of incident SA-CMD (HR: 1.3, 95% CI: 1.0-1.8), after accounting for the influence of job demands, decision authority, previous SA-CMD, as well as other sociodemographic covariates. However, we found no statistically significant association between SA-CMD and subsequent workplace bullying (OR 1.2, 95% CI 0.7-1.9).

CONCLUSIONS

The results support an association between self-reported workplace bullying and SA-CMD, independent of other sociodemographic factors and workplace stressors. Preventing workplace bullying could alleviate a share of the individual and societal burden caused by SA globally.

Effectiveness of a workshop-based intervention to reduce bullying and violence at work: A 2-year quasi-experimental intervention study

INTRODUCTION

Bullying and violence at work are associated with reduced wellbeing of the victims, but few evidence-based interventions are available to prevent these offensive behaviours. We developed and examined the effectiveness of an intervention aimed at prevention of bullying and violence at work through modifications in psychosocial work environment.

METHODS

In accordance with pre-published protocol, employees and supervisors of 12 work units in 3 cities (intervention group A: n = 315; intervention group B: n = 271) received a workshop-based intervention on organizational practices to prevent bullying and violence, including supervisor support, supervisor justice, workplace social capital, and psychological safety and were compared to a reference group (n = 2310) which did not receive the intervention. Latent change score modelling (LCSM) was used to estimate between- and within-individual differences in changes of organizational practices and prevalence of bullying and violence from baseline (2020) to follow-up (2022).

RESULTS

No direct or indirect effects of intervention were observed. Of the potential mediator variables, supervisor support (B = 0.04; 95% confidence interval 0.006, 0.07) and supervisor justice (0.04; 0.01, 0.08) improved in the intervention group B between the measurements and compared to control group, but the result was not replicated in intervention group A. No changes were observed between the measurement points in bullying or violence at work.

CONCLUSIONS

No intervention effects on bullying and violence at work were observed. It may be worthwhile to develop the intervention further to focus more on supervisor and co-worker relationships and on psychosocial resources of work team.

Is there a bidirectional relationship between workplace bullying and the risk of sickness absence? Systematic review and meta-analysis of prospective studies

Exposure to workplace bullying increases the risk of sickness absence. However, the extent and direction of this relationship for different follow-up lengths are not well established. To provide evidence regarding the direction and extent of the relationship between workplace bullying and different durations of sickness absence. We searched nine databases from their inception to 29 November 2022. Multiple independent observers screened the literature, extracted the data and used the Risk Of Bias In Non-randomised Studies of Exposure to assess the methodological quality. The overall effect sizes of odds ratio, relative risk, hazard ratio and 95% confidence intervals were calculated. Our meta-analysis demonstrated a 26% increased risk of sick leave among workers exposed to workplace bullying for all follow-up lengths (95% CI 1.18 to 1.35), even after adjusting for confounding factors. Moreover, we found a significant association between long-term sickness absence and a higher likelihood of subsequent exposure to workplace bullying, with a pooled OR of 1.63 (95% CI 1.21 to 2.04). Our study established a bidirectional relationship between workplace bullying and long-term sickness absence, highlighting that it increases the risk of sickness absence at different follow-up lengths among employees who have been bullied. Hence, organisations should be mindful of workers who resume work after prolonged absences due to illness and adopt appropriate management strategies to prevent workplace bullying.

Adverse social behaviour at work and health-related employment exit: a prospective population-based four-wave survey

BACKGROUND

The level of evidence for various aspects of adverse social behaviour (ASB) at work as risk factors for exit from employment due to health problems or diseases is inconclusive.

METHODS

We obtained data from four consecutive surveys (2006/09/13/16) of the general population of Norway. Respondents who were interviewed in two consecutive surveys and employed at the first survey time point constituted the sample (n = 17 110 observations). We investigated associations of self-reported exposure to ASB (i.e. experiencing sexual harassment, bullying or violence/threats in the first survey) and health-related employment exit (i.e. individuals reporting exit from employment due to health problems or disease between two consecutive surveys) by means of mixed-effect logistic regression.

RESULTS

The prevalence of ASB and health-related employment exit was 10.8% (n = 1853) and 2.6% (n = 440), respectively. Adjusted for age, sex, level of education, occupation and weekly work hours, sexual harassment, bullying and violence/threats were associated with an increased risk of exit from employment. The odds ratios (ORs) for the association between exposure to any of the three aspects of ASB and employment exit was 1.78 [95% confidence interval (CI) 1.33-2.38]; the estimated corresponding population attributable risk was PAR% = 7.32 [95% CI 2.67-12.27]. Further adjustment of mental distress attenuated the observed association between exposure to any ASB and exit from employment (OR = 1.45 [95% CI 1.07-1.95], i.e. a reduction of 42% in the OR).

CONCLUSIONS

ASB at work increases the risk of health-related exit from employment in the Norwegian workforce.

Prediction of bullying at work: A data-driven analysis of the Finnish public sector cohort study

AIM

To determine the extent to which change in (i.e., start and end of) workplace bullying can be predicted by employee responses to standard workplace surveys.

METHODS

Responses to an 87-item survey from 48,537 Finnish public sector employees at T1 (2017-2018) and T2 (2019-2020) were analyzed with least-absolute-shrinkage-and-selection-operator (LASSO) regression. The predictors were modelled both at the individual- and the work unit level. Outcomes included both the start and the end of bullying. Predictive performance was evaluated with C-indices and density plots.

RESULTS

The model with best predictive ability predicted the start of bullying with individual-level predictors, had a C-index of 0.68 and included 25 variables, of which 6 remained in a more parsimonious model: discrimination at work unit, unreasonably high workload, threat that some work tasks will be terminated, working in a work unit where everyone did not feel they are understood and accepted, having a supervisor who was not highly trusted, and a shorter time in current position. Other models performed even worse, either from the point of view of predictive performance, or practical useability.

DISCUSSION

While many bivariate associations between socioeconomic characteristics, work characteristics, leadership, team climate, and job satisfaction were observed, reliable individualized detection of individuals at risk of becoming bullied at workplace was not successful. The predictive performance of the developed risk scores was suboptimal, and we do not recommend their use as an individual-level risk prediction tool. However, they might be useful tool to inform decision-making when planning the contents of interventions to prevent bullying at an organizational level.

Risk factors for infertility treatment-associated harassment among working women: a Japan-Female Employment and Mental health in assisted reproductive technology (J-FEMA) study

PURPOSE

This study aims to elucidate the risk factors of infertility treatment-associated harassment (I-harassment) among Japanese working women.

METHODS

The study participants were 1103 female patients who enrolled in the Japan-Female Employment and Mental Health in artificial reproductive technology (J-FEMA) study. Of the 1727 female patients, 1103 female patients were working during the initiation of infertility treatment and were still working during the survey. Risk factors for I-harassment were analyzed using a multivariable logistic regression model.

RESULTS

In this study, 82 female patients (7.4%) experienced I-harassment. The risk was significantly higher in those who had more in vitro fertilization (IVF) cycles than those who had fewer IVF cycles (OR, 1.06; 95% CI, 1.01-1.10). Similarly, those who disclosed their infertility treatment to their workplace were at significantly higher risk for I-harassment than those who did not (OR, 1.80; 95% CI, 1.03-3.15).

CONCLUSION

This study found that 7.4% of female patients experienced I-harassment after infertility treatment initiation. Those female patients who "experienced more IVF cycles," and "disclosed their infertility treatment in their workplace" should be carefully followed up by healthcare professionals to prevent I-harassment.

Effectiveness of a workplace intervention to reduce workplace bullying and violence at work: study protocol for a two-wave quasi-experimental intervention study

INTRODUCTION

Bullying and violence at work are relatively common in Finnish public sector workplaces. Previous research has demonstrated their association with increased risk of poor health and well-being, but only few intervention studies exist. The aim of this protocol paper is to describe the development and assessment of the effectiveness of a workplace intervention aimed at reducing these harmful phenomena.

METHODS AND ANALYSIS

This protocol describes a two-wave quasi-experimental intervention. Each of the three participating Finnish public sector organisations (cities) will select four work units (a total of 450-500 employees) to participate in an intervention including 2-3 workshops for the work unit, 2-3 consultative meetings with the supervisor of the work unit, a follow-up meeting for the entire work unit (a maximum of 6-month time lag) and online meetings with the supervisor to monitor achievements and discuss about difficult cases, if any. Three age-matched, sex-matched and occupation-matched controls for each participants of the intervention group will be randomly selected, a total 1350-1500 individuals in the control group. For intervention and control groups, premeasurement is based on responses to a survey that was conducted in 2020. Postintervention measurement will be based on survey responses in 2022. Data will be analysed using latent change score modelling or difference-in-difference analysis.

ETHICS AND DISSEMINATION

Ethics approvals are from the Ethics committees of the Helsinki and Uusimaa hospital district and the Finnish institute of Occupational Health. Results will be made available to participating organisations and their employees, the funder and other researchers via open access article in a peer-reviewed journal and subsequent reporting of the results via social media channels and press release to the public.

Leadership and Job Demands-Resources Theory: A Systematic Review

The purpose of this article is to provide a systematic review of leadership and Job Demands-Resources (JD-R) theory. We have analyzed 139 studies that study the relationship between leadership and Job Demands-Resources (JD-R) theory. Based on our analysis, we highlight ways forward. First, research designs can be improved by eliminating endogeneity problems. Regarding leadership concepts, proper measurements should be used. Furthermore, we point toward new theory building by highlighting three main ways in which leadership may affect employees, namely by: (1) directly influencing job demands and resources, (2) influencing the impact of job demands and resources on well-being; and (3) influencing job crafting and self-undermining. We hope this review helps researchers and practitioners analyze how leadership and JD-R theory can be connected, ultimately leading to improved employee well-being and organizational performance.

The effect of workplace bullying on burnout: the mediating role of affective well-being

Purpose

This study aims to examine the impact of workplace bullying on employees’ burnout by investigating the mediating effect of affective well-being (AWB).

Design/methodology/approach

Data of 532 employees from diverse organizations in Portugal were collected. These data were collected using anonymously completed structured questionnaires available online.

Findings

The results support the research hypotheses proposed, confirming that workplace bullying is related to both AWB and burnout. Moreover, affective workplace bullying partially mediates the relationship between workplace bullying and burnout, indicating that the victims have their AWB reduced, and, consequently, increase their burnout levels.

Practical implications

The findings suggest that organizations can foster employees’ AWB and reduce the level of burnout by encouraging organizations to develop preventive policies and practices to safeguard against bullying at work.

Originality/value

To this date, only a few studies have examined mediating and moderating variables (Nielsen and Einersen, 2018) and none include AWB as a mediator of the relationship between workplace bullying and burnout. This study answers the call for further empirical research from those who have argued that more information is needed to understand the workplace bullying phenomenon and contributes to the growing debate on this topic and its effects on employees.

Understanding the Decision-Making Process Between Presenteeism and Absenteeism

Due to their impact on various stakeholder groups, research on the global phenomena of sickness presenteeism (working despite illness) and sickness absenteeism (absence due to illness) is constantly growing. Most studies focus on identifying factors associated with the attendance behaviors. In contrast, there have been few theoretical approaches to explain the individual decision-making process for or against working while ill. Moreover, their empirical verification is still pending. In the present study, we refer to expectancy theory to theoretically explain how the decision is made. To empirically test the model predictions we applied experimental vignette methodology in an online survey with working adults. The hypotheses were confirmed in that the calculated and predicted decisions significantly matched the intentionally chosen decisions. The results contribute to a better theoretical understanding of the decision-making process and provide starting points for interventions to manage attendance behavior in organizations.

Impact of Workplace Conflicts on Self-Reported Medically Certified Sickness Absence in Latvia

Sickness absence is one of the most important working population health indicators. It is a complex phenomenon that is investigated by health care and occupational health specialists, economists, and work psychologists. Sickness absence is used as a predictor for morbidity and mortality, but besides the health status of an individual, sickness absence is influenced by demographic, socio-economic factors, and work environment factors. Conflicts at work are a common psychosocial risk factor that can affect sickness absence. The aim of the study was to investigate the association between different types of workplace conflict and self-reported medically certified sickness absence using cross-sectional survey data pooled from four periodic national surveys-Work conditions and risks in Latvia (2006-2018). The sample is representative of the working population of Latvia, as respondents were randomly drawn from different regions and industries. In total, the study sample (n = 8557) consisted of employees between 16 and 80 years old (average 42.8 +/- 12.6) of which 46.2% were males and 53.8% were females. Researchers used the computer-assisted personal interviewing (CAPI) method for collecting data. The association between workplace conflicts and sickness absence was analysed by using binomial logistic regression and calculated as odds ratios (OR) with 95% confidence intervals (CI), with adjustment for gender, age, education and survey year. The risk of sickness absence was higher among women (OR = 1.24, CI 1.13-1.35), employees aged 25-44 years old and employees with higher income. Controlling for socio-demographic factors and survey year, the odds of sickness absence increased significantly for all types of workplace conflict analysed. The strongest association with sickness absence was related to conflicts between managers and employees (OR = 1.51, CI 1.37-1.66) and conflicts between groups of employees (OR = 1.45, CI 1.31-1.61). Conflicts between employees and with customers also increased the odds of sickness absence (OR = 1.39, CI 1.27-1.52 and OR = 1.11, CI 1.01-1.23, respectively). Our findings suggest that tailored interventions at a company level for reducing workplace conflicts as risk factors of sickness absence are required. Those should focus on the improvement of managers' leadership and human resource management skills.

Gender Matters: Workplace Bullying, Gender, and Mental Health

The aim of this study was to examine the role of gender in the process of workplace bullying. In particular, we examined how gender affects reported prevalence rates and health consequences of bullying. In addition, we pay particular attention to if the measurement method – self-labelling or behavioural experience methods – affects potential gender differences. A longitudinal study, with two measurement points 18 months apart, was conducted in Sweden (n = 1854 at T1; n = 1096 at T2). It was a probability sample out of a population of all 3.3 million people in Sweden working at workplaces with ten or more employees. The results showed a slightly higher tendency for women to self-label as bullied (8% vs. 6%), while a higher proportion of men than women could be labelled as bullied based on the negative acts they had been exposed to (21% vs. 14%). Exposure to negative acts was associated with more subsequent mental health problems for both men and women, whereas self-labelling was associated with mental health problems for men only. Mental health problems at baseline also increased the risk of bullying for both men and women; however, the measurement method affected if the effect was stronger for men or women. Overall, the study advances our understanding of the role of gender in bullying, in particular highlighting the importance of the measurement method for understanding such gender differences.

Working Excessively and Burnout Among Nurses in the Context of Sick Leaves

INTRODUCTION

Nurses are particularly at risk of being affected by professional burnout because of the unique patient - caregiver relationship, which requires strong emotional involvement.

AIM

In this study, we decided to examine the mutual correlations of working excessively and burnout - two basic occurrences affecting the mental well-being of employees - and their relationship with sick leave.

MATERIALS AND METHODS

The study was conducted among 460 nurses working in 3 hospitals in Poland. The polish version of Maslach Burnout Inventory and the Working Excessively Questionnaire developed by Paluchowski were used to conduct the survey. All the demographic data and data on sick leaves were obtained from surveys in the form of respondents' self-reports.

RESULTS

The constructed regression model shows that the tendency to work excessively, as assessed by loss of control over work (LCW), perfectionist work style (PWS), and perceived oppressiveness of the organization (OOP) measures, explains 12.4% of the variation in burnout levels. This confirms that overburden with work can be a factor contributing to the increase in burnout measures. The constructed logistic regression model showed that increase in the level of occupational burnout by 1 point, the chance of nurse having at least three sick leaves per year increases 1.029 times (i.e., by about 2.9%). None of working excessively measures affected the frequency of sick leaves.

CONCLUSION

(1) Excessive workload increases burnout symptoms, which in turn encourages nurses to take sick leave more frequently. (2) The tendency for nurses to overburden themselves with work may be seen by hospital managers as a positive phenomenon, but, based on this study, it is clear that this can only be done in the short term, whereas in the long term it will be clearly detrimental to the organization of hospitals and the quality of care.

Targets' Social Relationships as Antecedents and Consequences of Workplace Bullying: A Social Network Perspective

Research on workplace bullying has largely focused on individual and organizational factors that place individuals in a vulnerable position. Although theorists have highlighted social aspects of workplace bullying and its antecedents, the role of individuals' social relations with other members of their organization has rarely been examined empirically. Drawing on insights from social network research and research on social rejection, the purpose of this study was to examine the relationship between exposure to bullying and employees' informal social relationships (here: friendships; negative relationships) with other members of their organization. Data from two waves of surveys among 249 employees in eight organizations in Finland were analyzed using stochastic actor-oriented modeling. We found that employees' centrality (i.e., the number of their relationships) had no effect on exposure to bullying. However, exposure to bullying affected targets' perceptions of their relationships with colleagues: employees who had experienced bullying subsequently reported significantly more friendship relationships, but not significantly more negative relationships, suggesting that aggressive or antisocial responses may be more muted in field settings than in experimental settings. Our study contributes to research on workplace bullying by providing a more detailed understanding of the relationship between workplace bullying and employees' social relations, and by offering insights about the consequences of workplace bullying for targets' social relations.

The Combined Effect of Poor Perceived Indoor Environmental Quality and Psychosocial Stressors on Long-Term Sickness Absence in the Workplace: A Follow-Up Study

Background: Poor perceived indoor environmental quality (IEQ) can generate conflicts and experiences of injustice in workplaces. Therefore we examined whether the combined effect of poor IEQ and self-reported psychosocial stressors (low social support from supervisors and experiences of injustice) increase the risk of employees’ long-term sickness absence (more than 10 days) in comparison to employees who report only poor perceived IEQ and no psychosocial stressors. Methods: Using negative binomial modelling, we analysed a representative sample of the working-age population in Finland (N = 16,084) from the Finnish Quality of Work Life Surveys (FQWLS) from 1997, 2003, 2008 and 2013, combined with register-based follow-up data on employees’ long-term absences covering a period of one to three years after each FQWLS was collected. Results: After background variables were included in the model, employees who reported poor IEQ and low social support had 1.18 (incidents rate ratios; 95% CI 1.05–1.33) higher rates of long-term absence than those who reported poor IEQ and high support. Similarly, employees who reported poor IEQ and experiences of injustice had 1.31(incidents rate ratios; 95% CI 1.15–1.48) higher rates of absence than those who reported poor IEQ and no injustice. Conclusions: Employees who reported poor perceived IEQ and a psychosocial stressor had higher rates of long-term sickness absence one to three years later, in comparison with those who report only poor perceived IEQ and no psychosocial stressors. These findings demonstrate the importance of taking account of psychosocial stressors as well, when resolving indoor environmental problems.