Work-related violence and organizational commitment among health care workers: does supervisor's support make a difference?

INTRODUCTION

Work-related threats and violence are major occupational hazards, with potentially serious consequences for both victims and the organization that employs them. Only a few studies have prospectively examined the mitigating effect of social support from supervisors on organizational commitment following exposure to work-related violence and threats.

OBJECTIVE

This study aimed at examining the effect of immediate supervisor's support on affective commitment within 1, 3, 6 and 12 months after exposure to violence and threats.

METHODS

After exposure to work-related violence and threats, the employees received a questionnaire within the first month and after 3, 6 and 12 months. Right after the incident, 398 employees filled out the questionnaire, and 138 employees answered the questionnaire at all four time points. Prospective associations and mean differences between groups were calculated using linear mixed models.

RESULTS

Employees receiving very high levels of social support from supervisors immediately after being exposed to work-related violence or threats had a significantly higher level of organizational commitment across all four time points when compared to the group experiencing middle/low levels of support. Furthermore, at 1- and 3-month follow-up employees receiving very high levels of social support from supervisors following work-related violence and threats reported significantly higher levels of commitment than did the group with high levels of social support from supervisors.

CONCLUSION

Organizations should enhance the availability of social support from supervisors for employees experiencing work-related violence and threats. Training of supervisors to be very much concerned about employees exposed to work-related violence may be of critical importance to both the health and work outcomes of employees.

Exposure to work-related violence and/or threats of violence as a predictor of certified sickness absence due to mental disorders: a prospective cohort study of 16,339 Swedish men and women in paid work

OBJECTIVES

The aim of this prospective cohort study was to investigate if exposure to work-related violence and/or threats of violence predict certified sickness absence due to mental disorders.

METHODS

Information on work-related exposure to violence and/or threats of violence were derived from the biannual Swedish Longitudinal Occupational Survey of Health (SLOSH) study 2012-2016, including individuals in paid work across Sweden and from different occupations/sectors (n = 16,339). Certified sickness absence due to mental disorders were ascertained from register data from the Swedish Social Insurance Agency. Odds ratios of certified sickness absence due to mental disorders according to exposure to work-related violence were estimated using multiple logistic regression. Several potential confounding variables, such as demographic and socio-economic factors, age, sex, cohabitation, children living at home, socio-economic status, educational level, as well as other types of psychosocial work environmental factors, were adjusted for in the analyses.

RESULTS

In the total study sample, 9% reported exposure to violence and/or threats of violence and the prevalence of sickness absence due to mental disorders was 5%. Exposure to work-related violence and/or threats of violence was associated prospectively with certified sickness absence due to mental disorders (odds ratio 1.46, 95% confidence interval 1.17-1.82, p < 0.01). Analysis of possible interaction showed no difference in association when comparing women to men and different age groups.

CONCLUSIONS

Exposure to work-related violence and/or threats of violence appear to increase the odds of certified sickness absence due to mental disorders. Preventive measures aiming to lower the risk of exposure is thus of great importance.

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.