Association Between Workplace Bullying Occurrence and Trauma Symptoms Among Healthcare Professionals in Cyprus

Risk factors and consequences of mental health problems in nurses: A scoping review of cohort studies

Mental health problems in nurses are prevalent and impairing. To date, no literature has comprehensively synthesised cohort evidence on mental health among nurses. This scoping review aimed to synthesise the existing literature on the risk factors and consequences of mental health problems in nurses. A systematic search was conducted on PubMed, EMBASE, Epistemonikos database, Web of Science, CINAHL, and PsycINFO from inception to March 2023. We identified 171 cohort studies from 16 countries, mostly (95.3%) from high-income economies. This review indicated that nurses worldwide encountered significant mental health challenges, including depression, cognitive impairment, anxiety, trauma/post-traumatic stress disorder, burnout, sleep disorder, and other negative mental health problems. These problems were closely related to various modifiable risk factors such as nurses' behaviours and lifestyles, social support, workplace bullying and violence, shift work, job demands, and job resources. Moreover, nurses' mental health problems have negative effects on their physical health, behaviour and lifestyle, occupation and organisation, and intrapersonal factors. These findings provided an enhanced understanding of mental health complexities among nurses, and shed light on policy enactment to alleviate the negative impact of mental health problems on nurses. Addressing mental health among nurses should be a top priority.

Impact of Workplace Bullying on Nursing Care Quality: A Comprehensive Review

Workplace bullying, commonly known as mobbing, persists as a significant problem across various industries, including the healthcare sector. To establish effective interventions and protocols for enhancing the well-being of healthcare workers and patients, it is vital to fully grasp the link between workplace bullying and the quality of nursing care. The analysis highlights the complex link between workplace bullying and nursing care quality, stressing the urgency of addressing this issue due to its wide-reaching impact on individuals and healthcare organizations, ultimately affecting patient safety. Emphasizing the significance of addressing workplace bullying across different professional settings is crucial for protecting the mental health and well-being of employees. The research identifies various forms of aggression and emphasizes the need to understand how these behaviors affect patient outcomes. Further investigation is needed to clarify nurses' responses to workplace violence, particularly in specialized settings like mental health facilities. The studies underscore the numerous challenges nurses encounter when trying to report incidents of workplace bullying. This insight is vital for developing effective reporting mechanisms and targeted interventions to combat bullying behaviors in medical environments. Ultimately, establishing a safer working environment for nurses is paramount. This article aims to review the associations between workplace bullying and the quality of nursing care.

Parents' knowledge and attitudes towards extracorporeal membrane oxygenation and their post-traumatic stress symptoms

This cross-sectional study, conducted between January 2020 and July 2023, aimed to assess the knowledge, attitude, and post-traumatic stress symptoms (PTSS) among parents with children undergoing extracorporeal membrane oxygenation (ECMO) treatment. Out of 201 valid questionnaires collected, the median knowledge score was 3.00, the mean attitude score was 27.00 ± 3.20, and the mean PTSS score was 3.50 ± 1.54. Logistic regression identified associations between PTSS and parents with lower education levels, particularly junior high school and high school/technical secondary school education, as well as those occupied as housewives. Structural equation modeling highlighted direct effects, such as the impact of residence on education, education on employment status, and associations between knowledge, attitude, PTSS, employment status, monthly income, and parental demographics. The findings indicated inadequate knowledge and suboptimal attitudes among parents, especially those with lower education levels, emphasizing the need for educational resources. Furthermore, addressing parental PTSS through psychosocial support and screening was deemed essential, providing valuable insights for tailored interventions in this context.

The use of religious resources in helping victims of workplace mobbing

Research shows that in providing assistance to individuals who have experienced psychological traumas, it is beneficial not only to take into account the specific religious spiritual needs but also to employ religious resources. Although the role of religious counsellors using various psychological theories in helping to cope with traumatising experiences is acknowledged, there is still a lack of a conceptualising approach to the possibilities of employing religious resources used in Christian spiritual assistance, seeking to help cope with the effects of workplace mobbing. Therefore, this study aims to conceptualise the perspective of integrating Christian spiritual assistance resources in overcoming the individual consequences of workplace mobbing. This review is based on an interdisciplinary approach and abundant literature of psychology, psychotherapy and theology sciences. The article details the main physical, psychological and social aspects of damage to the person, caused by mobbing, which provide for a corresponding triple assistance perspective. After highlighting the essential resources provided by the Christian religion for coping with traumatic experiences, the necessity to consider the religious needs of the victims of mobbing is reasoned and the possibilities of using religious spiritual resources are discussed. In the context of helping victims of mobbing, two main functions of Christian spiritual assistance are distinguished and discussed: auxiliary and main. The results of this review are a useful resource for lay and religious counsellors and encourage their collaboration. The research findings also provide a basis for further research on the use of religious resources in the context of helping victims of mobbing.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

The impact of interprofessional incivility on medical performance, service and patient care: a systematic review

The stressful nature of the medical profession is a known trigger for aggression or abuse among healthcare staff. Interprofessional incivility, defined as low-intensity negative interactions with ambiguous or unclear intent to harm, has recently become an occupational concern in healthcare. While incivility in nursing has been widely investigated, its prevalence among physicians and its impact on patient care are poorly understood. This review summarises current understanding of the effects of interprofessional incivility on medical performance, service and patient care. A structured search and screening of literature returned 13 studies of diverse origin, methodology, quality, size and population type. The consensus is that interprofessional incivility is common among physicians and nurses and has both psychological and clinical outcomes, resulting in stress, compromised patient safety and poor quality of care. Junior staff are affected more often than consultants, with higher rates in radiology, general surgery, neurosurgery and cardiology. Incivility also undermines medical team performance, particularly in perioperative settings. In patient care, incivility is associated with complications, medical errors, mortality, and compromised patient safety and quality of care. Patients whose surgeons have a record of incivility can be at higher risk of complications. The impact of incivility on medical performance, service and patient care appears systemic and must be addressed accordingly. This analysis was limited by the methodological weaknesses of the included studies, which highlights the need for more high-quality empirical research. This would benefit the NHS and other stakeholders when designing targeted interventions. In particular, establishing quantitative methods for identifying and measuring incivility will be crucial for improving our understanding of the phenomenon.

Bullying in Academic Medicine: Experiences of Women Physician Leaders

PURPOSE

Bullying is defined as offenders abusing positions of authority and intentionally targeting individuals through persistent negative behaviors to impede education or career growth. This study sought to estimate the prevalence and nature of bullying experienced by women physician leaders in academic medicine.

METHOD

In this survey-based study, 547 physician graduates of an executive women's leadership training program were invited to complete a survey that measured workplace bullying in 2021. Participants were asked whether and when they had been bullied, how it impacted their careers, and remedies for bullying. Descriptive statistics were used to profile mistreatment and bullying experienced by the respondents during their professional careers and the nature of bullying. Content analysis of open-ended comments was used to describe how bullying impacted women physicians and outline recommendations for bullying prevention and mitigation.

RESULTS

The survey response rate was 64.7% (354/547). Most women (302/354 [85.3%]) had experienced mistreatment during their careers, with more than half experiencing bullying while an attending physician (198/302 [65.6%]). Many women (187/302 [61.9%]) who screened positive for mistreatment also reported that they had been bullied at work. Of these 187 respondents, 173 (92.5%) experienced bullying from men and 121 (64.7%) reporting bullying from women (effect size = 0.34, P ≤ .001), and 115 (61.5%) reported that bullies were their immediate supervisors. Qualitative findings suggested that bullying harmed individuals' career advancement, mental health, reputation, and relationships with others. Many had to change roles or leave jobs. Participants proposed that initiatives by top-level leaders, clear definitions of bullying behavior, reporting mechanisms, and upstander training for faculty and staff could mitigate bullying.

CONCLUSIONS

Most women physician leaders have experienced bullying. These results highlight the need to address bullying in academic medicine so that women can reach their full career potential.

Workplace mobbing, group cohesion and intraindividual variables in nurses from a rural hospital in Northern Greece: A correlation study

BACKGROUND

High levels of mobbing are reported in Greek nurses, but the intraindividual and perceived group emotional correlates are little investigated.

OBJECTIVE

To determine the relationship between workplace mobbing (specifically in the nursing sector of a public rural hospital in Greece) and emotional correlates.

METHODS

Questionnaires measuring emotional aspects such as Negative Act Questionnaire - Revised (NAQ-R) for measuring perceived exposure to bullying and victimization at work, Maslach Burnout Inventory (MBI), Overall Job Satisfaction Scale (OJS), Job Affect Scale (JAS: positive and negative subscales), Perceived Cohesion Scale (PCS), Ethical Climate Questionnaire (ECQ), and Short General Health Questionnaire (GHQ-12) were administered. For the analysis of the data, descriptive and parametric tests were performed through the Pearson correlations and regression for the relationship between variables.

RESULTS

High mobbing levels were reported (M = 45.93) compared to already established cutoff scores. Statistically significant positive correlations were found for NAQ-R and MBI (Exhaustion subscale) (r = .569, p < .001), NAQ-R and JAS-negative affect (r = .610, p < .001), NAQ-R and GHQ-12 (r = .280, p = .002), and NAQ-R andeducational level (r = .196, p = .033). Statistically significant negative correlations were found for NAQ-R and ECQ (r = -.323, p < .001), NAQ-R and JAS-positive affect (r = -.556, p < .001), and NAQ-R and PCS (r = -.586, p < .001). Only burnout,negative affect, and perceived group cohesion predicted mobbing measured by NAQ- R.

CONCLUSION

As mobbing and its consequences are related to specific emotional variables, these perceived individual and group indices, could be targeted in future prevention initiatives.

Work-Related Traumatic Stress Response in Nurses Employed in COVID-19 Settings

Nurses may be at a higher risk of experiencing work-related traumatic stress response during the COVID-19 pandemic compared to other clinicians. This study aimed to investigate the correlations between work-related trauma symptoms and demographic factors, psychosocial hazards and stress response in a census sample of nurses working in COVID-19 settings in Cyprus. In this nationwide descriptive and cross-sectional study, data were collected between April and May 2020 using a questionnaire that included sociodemographic, educational and employment and work-related variables, as well as a modified version of the Secondary Traumatic Stress Scale (STSS) for the assessment of work-related trauma symptoms during the pandemic. Overall, 233 nurses participated (with a response rate of 61.3%) and 25.7% of them reported clinical work-related trauma symptoms (STSS-M > 55; actual scale range: 17-85). The mean value for emotional exhaustion was 7.3 (SD: 2.29; visual scale range: 1-10), while the value for distress that was caused by being avoided due to work in COVID-19 units was 6.98 (SD: 2.69; visual scale range: 1-10). Positive associations were noted between trauma symptoms and both emotional exhaustion and distress from being avoided by others due to work in a COVID-19 setting and a negative association was also found between trauma symptoms and satisfaction from organizational support variables (all p < 0.002). Working in COVID-19 settings during the pandemic is a stressful experience that has been linked to psychologically traumatic symptoms Thus, supportive measures are proposed for healthcare personnel, even in countries with low COVID-19 burden.

Prevalence of Aggressive Behavior Toward Fellows, Residents, and Nurses at a Tertiary Care Hospital in Riyadh, Saudi Arabia

Background Workplace bullying (WPB) is a form of mistreatment toward an individual manifested by physical, verbal, or indirect aggression. Affected victims display a wide range of signs and symptoms that impact their health. This study aimed to investigate the prevalence of aggressive behavior toward healthcare workers and its effects on job satisfaction, general health, and mental health. Methodology An online survey comprising a revised version of the Negative Acts Questionnaire-Revised (NAQ-R) was distributed to the fellows, residents, and nurses working in a tertiary care hospital. The survey collected information regarding the group's demographics and their exposure to WPB encountered in the work environment while maintaining confidentiality. Survey results were analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA). Results Among the 339 participants who filled the survey, 53% of healthcare practitioners in different services had experienced some form of WPB. Among the targeted group, it was noted that female gender (50%), age between 31 and 41 years (57.03%), nurses (51.98%), non-Saudi practitioners (41.94%), and those working in inpatient settings (49.74%) were the most commonly affected individuals in the medical facility. Furthermore, higher bullying prevalence was correlated with lower job satisfaction and mental health levels. Conclusions Age, gender, job, and nationality were factors associated with increased susceptibility to WPB. WPB in any facility is an unfortunate event, especially in a healthcare setting. It affects health practitioners by decreasing job satisfaction, jeopardizing health, and increasing the risk of harm to patients. WPB will eventually have a negative impact on the medical facility and the healthcare sector. Hence, hospital administrations should be alarmed about the rise in WPB, and adequate measures must be taken to deal with the root cause of the problem.

Compassion Fatigue and Satisfaction in Nurses and Midwives during the COVID-19 Pandemic in Turkey

Objective: To examine the levels of compassion fatigue and compassion satisfaction of nurses and midwives during the COVID-19 pandemic and the influencing factors. Methods: This descriptive study was carried out with the participation of Turkish midwives and nurses. In the study using the convenience sampling method, data were collected online using an online questionnaire. The questionnaire, created through the Google form, was shared between May and June 2021 in the midwife and nurse groups (Facebook, Instagram, WhatsApp) on electronic platforms. Compassion fatigue (CF) and compassion satisfaction (CS) consisting of the burnout (BO) and secondary traumatic stress (STS) subcomponents were assessed by the Professional Quality of Life scale. The study was completed with 402 nurses and midwives from various units. Descriptive statistics, and the Mann-Whitney U and Kruskal-Wallis tests were used in the analysis of the data. Results: Among the participants, the rate of dissatisfaction with the clinic worked was 24.6% and the turnover intention rate was 70.6%. During the pandemic period, 75.6% of the participants reported that they were exposed to verbal violence, 7.7% to physical violence, and 74.4% to mobbing behaviors. Low CS was found in 24.9% of the participants, a high level of BO in 27.1%, and high STS in 32.8%. Conclusion: Violence and mobbing against nurses and midwives should be prevented in order to increase the professional quality of life.

The COVID-19 Pandemic Increased Burnout and Bullying among Newly Graduated Nurses but Did Not Impact the Relationship between Burnout and Bullying and Self-Labelled Subjective Feeling of Being Bullied: A Cross-Sectional, Comparative Study

(1) Background: The COVID-19 pandemic posed a great challenge to health care systems worldwide. Health care personnel, including nurses, work under high pressure and are overworked and overwhelmed, which results in a higher prevalence of burnout and workplace bullying, which further increases the intention to leave the nursing profession. (2) Methods: A comparative correlational and cross-sectional study design was adopted, and an online questionnaire was used to collect data between October 2019 and October 2021. Two hundred and fifty-seven newly graduated nurses participated in this study. The studied variable was measured using the Oldenburg Burnout Inventory, the Negative Acts Questionnaire, and metrics developed by the authors. (3) Results: The prevalence of bullying and burnout is significantly higher among nurses who worked during the COVID-19 pandemic than among those who worked before the pandemic, but the pandemic has not had an impact on the level of the subjective assessment of bullying. Working as a newly graduated nurse before or during the COVID-19 pandemic is a moderator between person-related bullying and its dimensions and disengagement. (4) Conclusions: Pandemics increase bullying and burnout among newly graduated nurses; however, the current challenges have caused some of this to remain unrevealed, the repercussions of which will appear with double strength later.

Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers

The coronavirus disease 2019 (COVID-19) has a great impact on healthcare workers (HCWs) that includes negative mental health outcomes, such as post-traumatic stress, anxiety and depressive symptoms. In this cross-sectional study, we report on mental health outcomes among HCWs in Cyprus. Data were collected between 3 May and 27 May 2020, with the use of an online questionnaire that included demographics (sex, age, occupation, education, work sector, years of work experience), the 9-item Patient Health Questionnaire (PHQ-9) which assesses depressive symptoms, the Impact of Events Scale Revised (IES-R), which measures post-traumatic stress disorder (PTSD) symptoms, and the-10 item Perceived Stress Scale (PSS-10) which quantifies stress responses. Participants (42% physicians, 24% nurses, 18% physiotherapists, 16% classified as “other”) were 58% of female gender and aged 21–76. A total of 79 (18.6%) and 62 HCWs (14.6%) reported clinically significant depressive (PHQ-9 ≥ 10) and post-traumatic stress (IES-R > 33) symptoms respectively. Nurses were more likely than physicians to suffer from depression (adjusted prevalence ratio 1.7 (1.06–2.73); p = 0.035) and PTSD (adjusted prevalence ratio 2.51 (1.49–4.23); p = 0.001). Even in a country with a rather low spread of the COVID-19, such as Cyprus, HCWs reported a substantial mental health burden, with nurses reporting increased depressive and PTSD symptoms compared to other HCWs.