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Geiderman JM, Moskop JC, Marco CA, Schears RM, Derse AR. Civility in Health Care: A Moral Imperative. HEC Forum 2024; 36:245-257. [PMID: 36547791 PMCID: PMC11070391 DOI: 10.1007/s10730-022-09501-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 12/24/2022]
Abstract
Civility is an essential feature of health care, as it is in so many other areas of human interaction. The article examines the meaning of civility, reviews its origins, and provides reasons for its moral significance in health care. It describes common types of uncivil behavior by health care professionals, patients, and visitors in hospitals and other health care settings, and it suggests strategies to prevent and respond to uncivil behavior, including institutional codes of conduct and disciplinary procedures. The article concludes that uncivil behavior toward health care professionals, patients, and others subverts the moral goals of health care and is therefore unacceptable. Civility is a basic professional duty that health care professionals should embrace, model, and teach.
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Affiliation(s)
- Joel M Geiderman
- Ruth and Harry Roman Emergency Department, Department of Emergency Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
| | - John C Moskop
- Department of Internal Medicine, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
- General Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157, USA.
| | - Catherine A Marco
- Department of Emergency Medicine, Penn State Health - Milton S. Hershey Medical Center,, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Raquel M Schears
- Department of Emergency Medicine, College of Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Arthur R Derse
- Department of Emergency Medicine, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Kern Institute for the Transformation of Medical Education, M1100, 8701 Watertown Plank Road, Milwaukee, WI, 53226-3548, USA
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2
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Lamont T, Chatfield C, Walshe K. Developing the future research agenda for the health and social care workforce in the United Kingdom: Findings from a national forum for policymakers and researchers. Int J Health Plann Manage 2024; 39:917-925. [PMID: 38326287 DOI: 10.1002/hpm.3775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
There is a gap between healthcare workforce research and decision-making in policy and practice. This matters more than ever given the urgent staffing crisis. As a national research network, we held the first ever United Kingdom (UK) forum on healthcare workforce evidence in March 2023. This paper summarises outputs of the event including an emerging UK healthcare workforce agenda and actions to build research capacity and bridge the gap between academics and decisionmakers. The forum brought together over 80 clinical and system leaders, policymakers and regulators with workforce researchers. Fifteen sessions convened by leading experts combined knowledge exchange with deliberative dialogue over 2 days. Topics ranged from workforce analytics, forecasting, international migration to interprofessional working. In the small groups that were convened, important gaps were identified in both the existing research body and uptake of evidence already available. There had not been enough high quality evaluations of recent workforce initiatives implemented at pace, from virtual wards to e-rostering. The pandemic had accelerated many changes in skillmix and professional roles with little learning from other countries and systems. Existing research was often small-scale or focused on individual, rather than organisational solutions in areas such as staff wellbeing. In terms of existing research, managers were often unaware of accepted high quality evidence in areas like the relationship between registered nurse staffing levels and patient outcomes. More work is needed to engage new disciplines from labour economics and occupational health to academic human resources and to strengthen the emerging diverse community of healthcare workforce researchers.
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Affiliation(s)
- Tara Lamont
- The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK
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Magnavita N, Larese Filon F, Giorgi G, Meraglia I, Chirico F. Assessing Workplace Violence: Methodological Considerations. LA MEDICINA DEL LAVORO 2024; 115:e2024003. [PMID: 38411977 PMCID: PMC10915676 DOI: 10.23749/mdl.v115i1.15186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/21/2023] [Indexed: 02/28/2024]
Abstract
The risk of violence is present in all workplaces. It must be accurately assessed to establish prevention and protection measures tailored to the features of each situation. The risk management process requires compliance in a sequential order: 1) risk identification, 2) quantitative risk assessment, and 3) impact assessment. Gathering workers' experiences using lists, focus groups, or participatory ergonomics groups is necessary to identify the phenomenon. For risk assessment, spontaneous reporting of events is often insufficient. It may be complemented with two methods: systematic recording of violent events that occurred in the past year during periodic medical examinations of workers and targeted surveys. The epidemiological analysis of data from individual interviews and surveys provides the phenomenon's prevalence, incidence, and evolution. Moreover, reporting the harm suffered by victims of violence allows constructing impact matrices to allocate resources where they are most needed.
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Affiliation(s)
- Nicola Magnavita
- Department of Life Sciences and Public Health, Univeristà Cattolica del Sacro Cuore, Rome, Italy
- Occupational Health Unit, Department of Woman, Child and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Gabriele Giorgi
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Igor Meraglia
- Department of Life Sciences and Public Health, Univeristà Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Chirico
- Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy
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4
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Ismail H, Dawam D, Muhd Aris NA, Yew SQ, Ahmad H, David CCH, Baharudin MH, Huam ZS, Jamaludin HH. Personality traits and workplace bullying among contract trainee doctors in Malaysia. Heliyon 2024; 10:e23625. [PMID: 38173473 PMCID: PMC10761799 DOI: 10.1016/j.heliyon.2023.e23625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Workplace bullying (WPB) among trainee doctors is a concerning problem in Malaysia. However, there is still limited understanding regarding the influence of trainee doctors' personality traits on WPB. Furthermore, the impact of contract employment status on WPB among trainee doctors is not yet well-defined. To address these gaps, this study was aimed to determine the prevalence of WPB among trainee doctors and to examine the association of sociodemographic characteristics, job characteristics, and personality traits with WPB among trainee doctors in Malaysia. Methods A multi-center cross-sectional study was conducted with 264 trainee doctors in Selangor, Malaysia. Eligible participants were provided with sociodemographic characteristics questionnaire, job characteristics questionnaire, WPB questionnaire, and the Big Five Inventory-10 (BFI-10). Chi-square tests were used to examine the association between: (i) sociodemographic characteristics and WPB, (ii) job characteristics and WPB; and (iii) personality traits and WPB. Multivariate logistic regression was performed to evaluate the association between the significant independent variables (as determined from Chi-square tests) and WPB. Results The prevalence of WPB was 45.1 %, with verbal abuse being the most common form of bullying (46.2 %). Chi-square test showed that only marital status and low agreeableness were significantly associated with WPB. Subsequently, multiple logistic regression demonstrated that being married (OR: 1.866; 95 % CI: 1.077-3.234) and low agreeableness (OR: 2.287; 95 % CI: 1.169-4.473) were significant predictors of WPB. Conclusion The high prevalence of WPB among trainee doctors could be attributed by marriage and low agreeableness personality traits in this population. In order to minimise WPB and maximise workforce potential, it is essential for healthcare institutions and medical training programmes to recognise this vulnerabilities and take steps to protect and support trainee doctors who are married and/or with low agreeableness personality trait.
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Affiliation(s)
- Halim Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Dzualkamal Dawam
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Nor Azila Muhd Aris
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Sheng Qian Yew
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Hanis Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Chan Chee Hoong David
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Mohd Hafiz Baharudin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Zhe Shen Huam
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Hibatul Hakimi Jamaludin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Madden MA. Defeating Nurse Workplace Bullying Through Political Activism. J Christ Nurs 2024; 41:E5-E9. [PMID: 38044528 DOI: 10.1097/cnj.0000000000001139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
ABSTRACT Workplace bullying is a social injustice with a detrimental impact on nurse retention, job satisfaction, self-esteem, and patient care. Nurses can engage in individual-, unit-, and policy-level activities aimed at promoting a healthier work environment. In the public sphere, political activism by nurses to promote the anti-bullying Healthy Workplace Bill can help improve the safety of healthcare work settings. Christian nurses' political advocacy enhances social justice as reflected in the Bible and can be seen as another avenue for godly service.
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Affiliation(s)
- Melissa A Madden
- Melissa A. Madden, PhD, MSN, RN, is an assistant professor at Louisiana Tech University in Ruston, LA. Melissa's 30+ years of nursing experience ranges from medical/surgical and critical care to nursing education and development
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Colaprico C, Grima D, Shaholli D, Imperiale I, La Torre G. Workplace Bullying in Italy: A Systematic Review and Meta-Analysis. LA MEDICINA DEL LAVORO 2023; 114:e2023049. [PMID: 38060211 PMCID: PMC10731570 DOI: 10.23749/mdl.v114i6.14673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/12/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Within any work environment, employees may be affected by "workplace bullying", a form of violent and repeated social behavior towards subordinates and colleagues. This review aimed to investigate the prevalence of bullied workers in Italy, the causes of the phenomenon, and the consequences at physical, psychological, and organizational levels. METHODS We included observational studies and systematic reviews examining the prevalence of bullied workers and the causes and consequences in Italian workplaces. Data extraction and analysis were performed on all included studies. The research strategy included three electronic databases (PubMed, Scopus, and Web of Science). A comprehensive search was done to retrieve articles based on a PRISMA-compliant protocol registered in PROSPERO: CRD 42023394635. RESULTS One hundred eighty-four articles were retrieved, and once duplicates and irrelevant articles were removed, 42 useful articles were reviewed. The mean pooled prevalence, calculated based on workers complaining of mistreatment, was 6.7% (SD: 4,09) and increased significantly to 17.0% (SD: 12.88) when considering only healthcare workplaces. Causes include how impaired mental health and high workload reinforce the possibility of being bullied in the workplace, resulting in a worsening of the worker's quality of life (physical and psychological) and the work organization with increased absenteeism and job changes. CONCLUSIONS Workplace bullying is a very present phenomenon within workplaces in Italy. In light of this, it is necessary to put prevention plans in place and find solutions to maintain optimal organizational well-being in the work environment.
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Affiliation(s)
- Corrado Colaprico
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - Daniela Grima
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - David Shaholli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - Ilaria Imperiale
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
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7
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Peng X. Advancing Workplace Civility: a systematic review and meta-analysis of definitions, measurements, and associated factors. Front Psychol 2023; 14:1277188. [PMID: 38023015 PMCID: PMC10666190 DOI: 10.3389/fpsyg.2023.1277188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
This research article focuses on the significance of Workplace Civility, defined as the respectful and courteous behavior exhibited by individuals toward their colleagues in the workplace. The primary objective of this study is to conduct a systematic review and a meta-analysis that synthesizes existing research by: (1) identifying operational definitions of the construct, (2) underlying the strongest correlations with other variables, (3) summarizing the effective strategies for promoting Workplace Civility, and (4) highlighting gaps in the literature, using the theory-characteristics-context-methodology (TCCM) framework. Multiple databases were meticulously searched, yielding 691 results, and ultimately 51 documents were included in the systematic review final sample following the application of predefined exclusion criteria. Then, a meta-analysis has been conducted including those studies with sufficient statistical data (k = 24) which allowed us to calculate 45 Effect Sizes. The review findings expose a notable dearth of research on Workplace Civility when compared to studies on incivility. This dearth highlights the pressing need for additional research endeavors to precisely define Workplace Civility, establish a robust theoretical framework, and develop reliable scales for its measurement. Related to the desirable correlates, organizational commitment, job satisfaction and mental health showed a high ES value, and for undesirable correlates, intention to quit showed a high ES value, while Emotional exhaustion only reached a medium ES value and physical symptoms showed a low ES value. Importantly, this study emphasizes that fostering civility in the workplace can yield significant benefits such as improved physical and mental well-being for workers, reduced burnout, and absenteeism rates. Thus, the promotion of civility in the workplace not only leads to healthier organizations but also enhances cost-efficiency, effectively averting the loss of both human and economic capital.
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Affiliation(s)
- Xue Peng
- School of Marxism, Shandong Normal University, Jinan, China
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Maben J, Aunger JA, Abrams R, Wright JM, Pearson M, Westbrook JI, Jones A, Mannion R. Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review. BMC Med 2023; 21:403. [PMID: 37904186 PMCID: PMC10617100 DOI: 10.1186/s12916-023-03102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/04/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Unprofessional behaviour (UB) between staff encompasses various behaviours, including incivility, microaggressions, harassment, and bullying. UB is pervasive in acute healthcare settings and disproportionately impacts minoritised staff. UB has detrimental effects on staff wellbeing, patient safety and organisational resources. While interventions have been implemented to mitigate UB, there is limited understanding of how and why they may work and for whom. METHODS This study utilised a realist review methodology with stakeholder input to improve understanding of these complex context-dependent interventions. Initial programme theories were formulated drawing upon scoping searches and reports known to the study team. Purposive systematic searches were conducted to gather grey and published global literature from databases. Documents were selected if relevant to UB in acute care settings while considering rigour and relevance. Data were extracted from these reports, synthesised, and initial theories tested, to produce refined programme theories. RESULTS Of 2977 deduplicated records, 148 full text reports were included with 42 reports describing interventions to address UB in acute healthcare settings. Interventions drew on 13 types of behaviour change strategies and were categorised into five types of intervention (1) single session (i.e. one off); (2) multiple session; (3) single or multiple sessions combined with other actions (e.g. training sessions plus a code of conduct); (4) professional accountability and reporting programmes and; (5) structured culture change interventions. We formulated 55 context-mechanism-outcome configurations to explain how, why, and when these interventions work. We identified twelve key dynamics to consider in intervention design, including importance of addressing systemic contributors, rebuilding trust in managers, and promoting a psychologically safe culture; fifteen implementation principles were identified to address these dynamics. CONCLUSIONS Interventions to address UB are still at an early stage of development, and their effectiveness to reduce UB and improve patient safety is unclear. Future interventions should incorporate knowledge from behavioural and implementation science to affect behaviour change; draw on multiple concurrent strategies to address systemic contributors to UB; and consider the undue burden of UB on minoritised groups. STUDY REGISTRATION This study was registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO): https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490 .
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Affiliation(s)
- Jill Maben
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Justin Avery Aunger
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
- NIHR Midlands Patient Safety Research Collaboration, University of Birmingham, Birmingham, UK.
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Ruth Abrams
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Judy M Wright
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Mark Pearson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Johanna I Westbrook
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Aled Jones
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Russell Mannion
- Health Services Management Centre, University of Birmingham, Birmingham, UK
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9
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Bagot KL, McInnes E, Mannion R, McMullan RD, Urwin R, Churruca K, Hibbert P, Westbrook JI. Middle manager responses to hospital co-workers' unprofessional behaviours within the context of a professional accountability culture change program: a qualitative analysis. BMC Health Serv Res 2023; 23:1012. [PMID: 37726731 PMCID: PMC10510259 DOI: 10.1186/s12913-023-09968-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The critical role that middle managers play in enacting organisational culture change designed to address unprofessional co-worker behaviours has gone largely unexplored. We aimed to explore middle managers' perspectives on i) whether they speak up when they or their team members experience unprofessional behaviours (UBs); ii) how concerns are handled; iii) the outcomes; and iv) the role of a professional accountability culture change program (known as Ethos) in driving change. METHODS Qualitative, constructivist approach. Five metropolitan hospitals in Australia which had implemented Ethos. Purposive sampling was used to invite middle-level managers from medicine, nursing, and non-clinical support services. Semi-structured interviews conducted remotely. Inductive, reflexive thematic and descriptive thematic analyses undertaken using NVivo. RESULTS Thirty interviews (approximately 60 min; August 2020 to May 2021): Nursing (n = 12), Support Services (n = 10), and Medical (n = 8) staff, working in public (n = 18) and private (n = 12) hospitals. One-third (n = 10) had a formal role in Ethos. All middle managers (hearers) had experienced the raising of UBs by their team (speakers). Themes representing reasons for ongoing UBs were: staying silent but active; history and hierarchy; and double-edged swords. The Ethos program was valued as a confidential, informal, non-punitive system but required improvements in profile and effectiveness. Participants described four response stages: i) determining if reports were genuine; ii) taking action depending on the speaker's preference, behaviour factors (type, frequency, impact), if the person was known/unknown; iii) exploring for additional information; and iv) addressing either indirectly (e.g., change rosters) or directly (e.g., become a speaker). CONCLUSIONS Addressing UBs requires an organisational-level approach beyond supporting staff to speak up, to include those hearing and addressing UBs. We propose a new hearer's model that details middle managers' processes after a concern is raised, identifying where action can be taken to minimise avoidant behaviours to improve hospital culture, staff and patient safety.
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Affiliation(s)
- K L Bagot
- Nursing Research Institute -St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Fitzroy, VIC, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, VIC, Australia
| | - E McInnes
- Nursing Research Institute -St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Fitzroy, VIC, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, VIC, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Australia
| | - R Mannion
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - R D McMullan
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - R Urwin
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - K Churruca
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - P Hibbert
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - J I Westbrook
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
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Zhang Y, Ma J, Xu Q, Rong Y, Lu S, Wang Z. Effects of sleep duration, perceived organisational support and personal resilience on anxiety in non-hospitalised residents during the COVID-19 pandemic: a survey study in Ningbo, China. BMJ Open 2023; 13:e073648. [PMID: 37607791 PMCID: PMC10445373 DOI: 10.1136/bmjopen-2023-073648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE This study assessed the association between sleep duration, perceived organisational support (POS), personal resilience and anxiety among non-hospitalised residents during the COVID-19 pandemic in Ningbo, China. METHODS In this cross-sectional study, an online survey was conducted from 27 January 2023 to 5 February 2023, involving non-hospitalised residents over 14 years old in Ningbo. We received 1938 valid responses. The study used the General Demographic Characteristics Scale, the Generalised Anxiety Disorder Scale, Brief Resilient Coping Scale and the POS questionnaire. RESULTS Among the 1938 valid questionnaires, 1068 (55.1%) participants reported anxiety. Multivariate logistic regression analysis revealed that high organisational support (β=-0.34, adjusted OR (aOR) 0.71, 95% CI 0.51 to 0.98, p=0.038), moderate resilience (β=-0.26, aOR 0.77, 95% CI 0.63 to 0.95, p=0.013), high resilience (β=-0.67, aOR 0.51, 95% CI 0.36 to 0.73, p<0.001) and sleep duration of ≥7 hours (β=-1.00, aOR 0.37, 95% CI 0.28 to 0.49, p<0.001) were significantly associated with anxiety. Participant characteristics were not associated with anxiety. CONCLUSIONS During the COVID-19 pandemic, organisational support, personal resilience and adequate sleep duration were associated with anxiety among non-hospitalised residents. These findings highlight the importance of increasing organisational support, implementing interventions that promote resilience and stress management, ensuring sufficient rest and sleep duration, and helping residents better manage anxiety.
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Affiliation(s)
- Yiqing Zhang
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Jingjing Ma
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Qihang Xu
- Department of Pharmacy, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Yuezheng Rong
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Shunshun Lu
- Department of Infection, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Zhengzheng Wang
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
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11
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Lamont T, Chatfield C, Walshe K. What we know and don't know about the health and social care workforce. BMJ 2023; 382:p1569. [PMID: 37414418 DOI: 10.1136/bmj.p1569] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Affiliation(s)
- Tara Lamont
- Health Services Research UK
- THIS Institute, University of Cambridge, UK
| | | | - Kieran Walshe
- Health Services Research UK
- University of Manchester, UK
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12
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Hu Z, Li J. Associations of Workplace Violence With Cardiovascular Disease Among United States Workers: Findings From a National Survey. J Prev Med Public Health 2023; 56:368-376. [PMID: 37551075 PMCID: PMC10415653 DOI: 10.3961/jpmph.23.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/27/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES Recent research indicates a potential association between workplace violence and an increased risk of cardiovascular disease (CVD) in the working-age population. However, the relevant evidence in the United States is sparse. Thus, this study was conducted to explore the possible relationship between workplace violence and CVD among United States workers. METHODS We utilized cross-sectional data from the 2015 National Health Interview Survey, which included a representative sample of 18 380 workers, to investigate the associations between workplace violence and the prevalence of CVD using logistic regression. Workplace violence was determined based on self-reported threats, bullying, or harassment at work over the past 12 months, supplemented with additional information regarding frequency. CVD included all forms of heart disease and stroke. RESULTS A total of 1334 workers reported experiences of workplace violence, and 1336 workers were diagnosed with CVD. After adjustment for covariates, participants who reported any instance of workplace violence had significantly higher odds of having CVD (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.35 to 2.30) than those who reported no such violence. Furthermore, the highest odds of CVD (OR, 1.80; 95% CI, 1.23 to 2.63) were observed among those frequently exposed to workplace violence. Even occasional exposure to workplace violence was associated with 74% excess odds of CVD. CONCLUSIONS Our study indicates an association between workplace violence and CVD in United States workers, exhibiting a dose-response pattern.
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Affiliation(s)
- Zheyu Hu
- Conestoga High School, Berwyn, PA,
USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, CA,
USA
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13
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Campbell-Sills L, Sun X, Kessler RC, Ursano RJ, Jain S, Stein MB. Exposure to Bullying or Hazing During Deployment and Mental Health Outcomes Among US Army Soldiers. JAMA Netw Open 2023; 6:e2252109. [PMID: 36692883 PMCID: PMC10408263 DOI: 10.1001/jamanetworkopen.2022.52109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/01/2022] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Workplace bullying is associated with mental disorders and suicidality in civilians, but few studies have examined associations of bullying with these outcomes among military personnel. OBJECTIVE To evaluate associations of being bullied or hazed during deployment with major depressive disorder (MDD), intermittent explosive disorder, posttraumatic stress disorder (PTSD), suicidal ideation, and substance use disorder (SUD). DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) New Soldier Study (NSS; April 1, 2011, to November 30, 2012) and wave 1 of the STARRS Longitudinal Study (STARRS-LS1; September 1, 2016, to April 30, 2018). A computerized survey administered at 3 US Army installations (NSS) and a web/telephone survey (STARRS-LS1) were used to collect data. Data were analyzed from October 11, 2021, to October 28, 2022. The STARRS-LS1 recruited a probability sample of active-duty soldiers and veterans who had participated in Army STARRS baseline surveys while on active duty (weighted response rate, 35.6%). Respondents whose baseline was the NSS and who had deployed to a combat theater at least once were eligible for this study. EXPOSURES Being bullied or hazed during a combat deployment. MAIN OUTCOMES AND MEASURES The primary outcomes were MDD, intermittent explosive disorder, PTSD, and suicidal ideation in the 12 months before STARRS-LS1 and SUD in the 30 days before STARRS-LS1, assessed with items from the Composite International Diagnostic Interview Screening Scales, PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Columbia-Suicide Severity Rating Scale. Logistic regression was used to estimate associations of bullying or hazing exposure with the outcomes. RESULTS The 1463 participants were predominantly male (weighted percentage [SE], 90.4% [0.9%]) and had a mean (SE) age of 21.1 (0.1) years at baseline. At STARRS-LS1, 188 respondents (weighted percentage [SE], 12.2% [1.1%]) reported bullying or hazing during deployment. Weighted outcome prevalences were 18.7% (1.3%) for MDD, 5.2% (0.9%) for intermittent explosive disorder, 21.8% (1.5%) for PTSD, 14.2% (1.2%) for suicidal ideation, and 8.7% (1.0%) for SUD. In models that adjusted for baseline sociodemographic and clinical characteristics and other potential traumas, exposure to bullying or hazing was significantly associated with MDD (adjusted odds ratio [aOR], 2.92; 95% CI, 1.74-4.88), intermittent explosive disorder (aOR, 2.59; 95% CI, 1.20-5.59), PTSD (aOR, 1.86; 95% CI, 1.23-2.83), suicidal ideation (aOR, 1.91; 95% CI, 1.17-3.13), and SUD (aOR, 2.06; 95% CI, 1.15-3.70). CONCLUSIONS AND RELEVANCE In this cohort study of combat-deployed soldiers, reports of being bullied or hazed during deployment were associated with mental disorders and suicidal thoughts. Recognition of these associations may inform efforts to prevent and address mental health problems among service members.
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Affiliation(s)
| | - Xiaoying Sun
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Sonia Jain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Murray B. Stein
- Department of Psychiatry, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Veterans Affairs San Diego Healthcare System, San Diego, California
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Pilgaard F, Agardh A, Östergren PO, Priebe G. Association between Experiences of Different Types of Harassment or Derogatory Treatment and Sexual Harassment among Employees at a Large Swedish University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:11. [PMID: 36612332 PMCID: PMC9819109 DOI: 10.3390/ijerph20010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Sexual harassment (SH) and other forms of mistreatment continue to be a significant problem at workplaces, leading to negative health and work-related outcomes. Previous studies have mainly examined SH and other types of workplace harassment separately. In this study we investigated whether harassment related to any of the seven Swedish legal grounds for discrimination (sex, transgender identity or expression, ethnicity, religion or other belief, disability, sexual orientation, or age) and derogatory treatment were associated with SH at a large Swedish university. Using cross-sectional survey data obtained from 33% of all staff, multivariable logistic regression analysis was performed to investigate associations between harassment, derogatory treatment, and SH. We found a sixfold increased risk of SH among women with experience of other forms of harassment and a three-times-higher risk among women with experience of derogatory treatment, indicating that SH co-occurs with other forms of mistreatment. This pattern was similar among men, although men reported lower prevalence of mistreatment. Our findings have implications for preventive strategies at academic workplaces indicating that issues related to the defence of power and various types of abusive behaviours, including SH, both need to be addressed to create more equal opportunities for all employees.
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Chenevert M, Vignoli M, Conway PM, Balducci C. Workplace Bullying and Post-Traumatic Stress Disorder Symptomology: The Influence of Role Conflict and the Moderating Effects of Neuroticism and Managerial Competencies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10646. [PMID: 36078361 PMCID: PMC9518343 DOI: 10.3390/ijerph191710646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Research has explored numerous consequences of workplace bullying, including a recent link to the exhibition of post-traumatic stress disorder (PTSD) symptomology. Role conflict as a workplace stressor may contribute to instances of bullying from a passive perspective, which may lead to PTSD symptomology in victims. What remains less explored is if role conflict has a direct relationship to PTSD symptomology and how personality traits such as neuroticism and workplace factors such as managerial competencies may moderate the stress brought on by role conflict. Hence the present study seeks to examine this gap in the literature. This study utilizes a between-subjects, cross-sectional design with 159 participants, 39.6% male and 60.4% female. Most participants (60%) were Italian workers of a large social cooperative organization. Confirmatory factor analysis indicated that the measurement model was valid and had an adequate model fit. Results from two separate moderated mediation analyses found a positive, full mediation between the independent variable of role conflict, the mediator of exposure to bullying, and the dependent variable of PTSD symptomology. Furthermore, in this study, neuroticism strengthened the indirect effect while managerial competencies weakened it. The results highlight the importance of training competent managers and providing resources for more vulnerable employees to moderate employee work stress and its negative outcomes.
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Affiliation(s)
- Miren Chenevert
- Department of Psychology, Alma Mater Studiorum–Università di Bologna, 40127 Bologna, Italy
| | - Michela Vignoli
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Paul M. Conway
- Department of Psychology, University of Copenaghen, 1353 Copenaghen, Denmark
| | - Cristian Balducci
- Department of Psychology, Alma Mater Studiorum–Università di Bologna, 40127 Bologna, Italy
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16
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Beitz JM, Beckmann CA. Psychometric Development of an Instrument Measuring Academic Social Bullying in Nursing Higher Education: Continuing Content and Construct Validation. J Nurs Meas 2022. [DOI: 10.1891/jnm-d-d21-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundA de novo 108-item instrument measuring academic social bullying was developed from literature, research findings, and extant instruments. Using content validity index processes, the instrument was reduced to 40 items.PurposeThe purpose of this study was to continue with psychometric development and instrument construct validation.MethodsA purposive, representative sample of nursing school faculty was surveyed. Over 2,000 nurse educators in baccalaureate and higher degree programs were contacted via email and invited to a Qualtrics site. Respondents completed a brief demographics section, rated agreement with item appropriateness using a 5-point Likert scale. Participants responded to open-ended questions about individual items.ResultsSummary aggregate data were analyzed. Over 250 respondents represented various faculty ranks. Over 75% had experienced or witnessed academic social bullying. Factor analysis ascertained construct validity. Three factors were identified explaining 67% of variance. Qualitative comments supported item appropriateness.ConclusionsThe new instrument will permit assessment of academic social bullying in future research.
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17
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Nwaogu JM, Chan APC, Akinyemi TA. Conceptualizing the dynamics of mental health among construction supervisors. INTERNATIONAL JOURNAL OF CONSTRUCTION MANAGEMENT 2022. [DOI: 10.1080/15623599.2022.2080932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Janet M. Nwaogu
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Albert P. C. Chan
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Tobi A. Akinyemi
- Department of Building, The Federal University of Technology, Akure, Ondo State, Nigeria
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18
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Forresi B, Michelini G, Sapuppo W, Costa G, Castellini G, Livellara S, Gregori Grgič R. Anger, personality traits and psychopathological symptoms in subjects exposed to negative interpersonal actions in workplaces: an observational study in a large sample attending a Center for Occupational Stress. Int Arch Occup Environ Health 2022; 95:1763-1773. [PMID: 35511292 DOI: 10.1007/s00420-022-01868-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The association between adverse working conditions and mental disorders is well established. In addition to psychopathological symptoms, this study aimed at investigating anger and personality traits in a clinical sample of subjects referring negative interpersonal experiences in workplaces. METHODS 1676 workers attending a Centre for Occupational Stress in Milan (from 2014 to 2016) were administered an assessment protocol including SCL-90 for general psychopathology, STAXI for anger intensity and expression, and MMPI-2 for personality traits. A qualitative checklist was used to collect negative experiences in workplaces. RESULTS Patients reported they were exposed to "threats to the task or the professional career" more than to "attacks to the person". Over 80% scored above the cutoff in all the subscales of the SCL-90, with highest scores in Depression, Obsessive-Compulsive Disorder, Anxiety, Somatization and Paranoia. 60% scored above the 90th percentile in the AX/in subscale, showing intense anger feelings that they mostly suppress. Abnormal elevations at the MMPI scales of Hypochondria, Depression, Hysteria, and Paranoia were found in over 50% of the sample. Women reported higher psychological difficulties and internalized anger than men. Anger towards objects and people, instead, was more common in males. No differences were observed by work sector or employment status. CONCLUSIONS In addition to severe psychological difficulties, individuals reporting negative interpersonal experiences in workplaces have high levels of internalized anger and a distinctive profile of personality traits. While a deeper investigation is needed, anger expression should be considered in future treatment programs.
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Affiliation(s)
- Barbara Forresi
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20139, Milan, Italy.
| | - G Michelini
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20139, Milan, Italy
| | - W Sapuppo
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20139, Milan, Italy.,London South Bank University, London, UK
| | - G Costa
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - G Castellini
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Livellara
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20139, Milan, Italy
| | - R Gregori Grgič
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20139, Milan, Italy
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19
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Looi JC, Allison S, Bastiampillai T. Reflections on, and responses to, managerial adverse reactions to healthcare advocacy by psychiatrists and trainees. Australas Psychiatry 2022; 30:158-161. [PMID: 34814761 DOI: 10.1177/10398562211040463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE For psychiatrists and trainees, to reflect upon adverse managerial reactions to healthcare advocacy about patient care and safety, drawing upon examples from general healthcare settings, and to share approaches to addressing these reactions. CONCLUSIONS Psychiatrists and trainees engaging in healthcare advocacy may face adverse responses from healthcare management, with personal and professional consequences. Advocates need to consider counterstrategies to negative actions by management that may include workplace incivility, bullying and harassment. Health advocacy is more effective within a network of peers, patients and the broader community, including medico-political professional organisations, such as the Australian Medical Association, Royal Australian and New Zealand College of Psychiatrists, and Unions. These organisations should advocate openness to doctors highlighting healthcare safety and quality, as well as prevention of workplace bullying.
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Affiliation(s)
- Jeffrey Cl Looi
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia.,Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Stephen Allison
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Tarun Bastiampillai
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Department of Psychiatry, Monash University, Wellington Road, Clayton, VIC, Australia
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20
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Ervasti J, Seppälä P, Olin N, Kalavainen S, Heikkilä H, Aalto V, Kivimäki M. Effectiveness of a workplace intervention to reduce workplace bullying and violence at work: study protocol for a two-wave quasi-experimental intervention study. BMJ Open 2022; 12:e053664. [PMID: 35264345 PMCID: PMC8915301 DOI: 10.1136/bmjopen-2021-053664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Uusimaa, Finland
| | | | - Nina Olin
- Finnish Institute of Occupational Health, Helsinki, Uusimaa, Finland
| | | | - Heli Heikkilä
- Finnish Institute of Occupational Health, Helsinki, Uusimaa, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Helsinki, Uusimaa, Finland
| | - Mika Kivimäki
- University of Helsinki, Faculty of Medicine, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
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21
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Sex-Specific Mediation Effects of Workplace Bullying on Associations between Employees' Weight Status and Psychological Health Impairments. Nutrients 2021; 13:nu13113867. [PMID: 34836122 PMCID: PMC8625383 DOI: 10.3390/nu13113867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Individuals with obesity face weight-related discrimination in many life domains, including workplace bullying, especially in female employees with obesity. However, associations between experiences of workplace bullying and psychological health impairments considering weight status and sex remain unclear. Methods: Within a representative population-based sample of N = 1290 employees, self-reported experiences of workplace bullying were examined for variations by weight status and sex. Using path analyses, sex-specific mediation effects of workplace bullying on associations between weight status and work-related psychological health impairments (burnout symptoms, quality of life) were tested. Results: Employees with obesity experienced more workplace bullying than those with normal weight. Workplace bullying was positively associated with psychological health impairments and partially mediated the associations between higher weight status and elevated burnout symptoms and lower quality of life in women, but not in men. Conclusions: The result that more experiences of workplace bullying were, compared with weight status, more strongly associated with work-related psychological health impairments in women, but not in men, uniquely extends evidence on sex-specific effects within weight-related discrimination. Continued efforts by researchers, employers, and policy makers are needed to reduce weight-related discrimination in work settings, eventually increasing employees’ health and job productivity.
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Abstract
Exposure to major trauma can have significant consequences for workers’ mental health, but common trauma may also result in poor mental health outcomes. This cross-sectional study retrospectively investigated the occurrence of common physical or psychological workplace trauma in 901 health, social service, and trading company workers and studied these experiences in relation to occupational stress, anxiety, and depression. Stress was measured with the effort/reward imbalance (ERI) model while anxiety and depression were evaluated with the Goldberg Anxiety and Depression Scale (GADS). Healthcare workers reported a high frequency of trauma and significantly higher levels of stress, anxiety, and depression than other workers. Even in the entire population of workers of the various professional categories, verbal violence (harassment and threats), traffic accidents, home injuries, and family bereavement were significantly associated with high levels of stress, anxiety, and depression. Major trauma survivors are known to be at increased risk of mental disorders and require support in the workplace, however, even minor repeated emotional trauma and injuries can affect mental health. During mandatory health surveillance, the occupational physician should systematically collect information on minor trauma and mental health outcomes when assessing the occupational fitness of the workers assigned to him.
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Iida M, Sasaki N, Kuroda R, Tsuno K, Kawakami N. Increased COVID-19-related workplace bullying during its outbreak: a 2-month prospective cohort study of full-time employees in Japan. ENVIRONMENTAL AND OCCUPATIONAL HEALTH PRACTICE 2021. [DOI: 10.1539/eohp.2021-0006-oa] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mako Iida
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo
| | - Reiko Kuroda
- Division for Environment, Health and Safety, The University of Tokyo
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo
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Evaluation of the Effects of a Bullying at Work Intervention for Middle Managers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207566. [PMID: 33080951 PMCID: PMC7589764 DOI: 10.3390/ijerph17207566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022]
Abstract
The aim of the study is to evaluate the effects of a workplace bullying intervention based on the training of middle managers regarding bullying awareness, the consequences of bullying, strategies in conflict resolution and mediation/negotiation abilities. Overall, 142 randomly selected middle managers participated in the study. First, participants completed an information record and two scales assessing bullying strategies, role conflict and role ambiguity. The last two scales were completed again in a second phase three months after the intervention had finished. The intervention produced a decrease in the following bullying strategies: effects on self-expression and communication, effects on personal reputation and effects on occupational situation and quality of life, with all of the mentioned bullying strategies being suffered by part of the sample. In addition, the conflict role decreased in the group which received the intervention. Moreover, the decrease in the effects of the bullying strategy effects on occupational situation and quality of life was especially important in managers with higher responsibilities within the workplace. Results are discussed in the framework that (1) leadership practices and, more specifically, conflict resolution skills are strongly responsible for bullying at work; and (2) the importance of intervening in the early stages of the bullying process as a key element in the correction, but also as a potential prevention element, of bullying in the workplace.
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Italia M, Forastieri C, Longaretti A, Battaglioli E, Rusconi F. Rationale, Relevance, and Limits of Stress-Induced Psychopathology in Rodents as Models for Psychiatry Research: An Introductory Overview. Int J Mol Sci 2020; 21:E7455. [PMID: 33050350 PMCID: PMC7589795 DOI: 10.3390/ijms21207455] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 12/18/2022] Open
Abstract
Emotional and cognitive information processing represent higher-order brain functions. They require coordinated interaction of specialized brain areas via a complex spatial and temporal equilibrium among neuronal cell-autonomous, circuitry, and network mechanisms. The delicate balance can be corrupted by stressful experiences, increasing the risk of developing psychopathologies in vulnerable individuals. Neuropsychiatric disorders affect twenty percent of the western world population, but therapies are still not effective for some patients. Elusive knowledge of molecular pathomechanisms and scarcity of objective biomarkers in humans present complex challenges, while the adoption of rodent models helps to improve our understanding of disease correlate and aids the search for novel pharmacological targets. Stress administration represents a strategy to induce, trace, and modify molecular and behavioral endophenotypes of mood disorders in animals. However, a mouse or rat model will only display one or a few endophenotypes of a specific human psychopathology, which cannot be in any case recapitulated as a whole. To override this issue, shared criteria have been adopted to deconstruct neuropsychiatric disorders, i.e., depression, into specific behavioral aspects, and inherent neurobiological substrates, also recognizable in lower mammals. In this work, we provide a rationale for rodent models of stress administration. In particular, comparing each rodent model with a real-life human traumatic experience, we intend to suggest an introductive guide to better comprehend and interpret these paradigms.
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Einarsen K, Nielsen MB, Hetland J, Olsen OK, Zahlquist L, Mikkelsen EG, Koløen J, Einarsen SV. Outcomes of a Proximal Workplace Intervention Against Workplace Bullying and Harassment: A Protocol for a Cluster Randomized Controlled Trial Among Norwegian Industrial Workers. Front Psychol 2020; 11:2013. [PMID: 32986046 PMCID: PMC7489146 DOI: 10.3389/fpsyg.2020.02013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Workplace bullying is an important and prevalent risk factors for health impairment, reduced workability and lowered efficiency among both targets and observers. Development and tests of effective organizational intervention strategies are therefore highly important. The present study describes the background, design, and protocol of a cluster randomized controlled trial evaluating the effectiveness of an organization-wide intervention on preventing workplace bullying with a focus on promoting active and constructive bystander behavior. The main overarching goal is to develop an easy to use and standardized organizational intervention based on theory and research in the role of bystanders in bullying situations with the potential of reducing the prevalence of workplace bullying. The theoretical framework of the study is theory of planned behavior (TPB; Ajzen, 1991). Methods/Design: Using a full randomized control trial (RCT) design, this project will empirically test the outcomes of an intervention program targeting bullying and harassment as the main distal outcomes and perceived behavioral control and helping behavior among bystanders as the main proximal outcome. A 1-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention. About 1,500 workers from two different locations of a Norwegian industrial company will be randomized into one intervention group and two control groups with at least 400 workers in each group. A survey will be conducted electronically. With a total of three assessments over 10-12 months, the time interval between the measurement times will be 4 months. Thus, the data collection will take place at baseline, completion of the intervention and at 4 months follow-up. Discussion: This study primarily aims to develop, implement, and evaluate an intervention based on the abovementioned features with the ultimate aim of reducing the prevalence of workplace bullying, by awareness raising and training of bystanders. Manager involvement and involvement of the union representative and the elected health and safety representatives is an important feature of the program. Results of the intervention study will provide important information regarding the effectiveness of preventive interventions against workplace bullying when focusing on bystanders, particularly so regarding the role of bystander awareness, bystander self-efficacy, and bystander behavioral control on the one hand and the prevalence of bullying and harassment on the other.
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Affiliation(s)
- Kari Einarsen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Leadership and Organizational Behaviour, BI Norwegian Business School, Bergen, Norway
| | - Morten Birkeland Nielsen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- National Institute of Occupational Health, Oslo, Norway
| | - Jørn Hetland
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Olav Kjellevold Olsen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Leadership and Organizational Behaviour, BI Norwegian Business School, Bergen, Norway
| | - Lena Zahlquist
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | - Justine Koløen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Kvaerner AS, Stord, Norway
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Spelten E, Thomas B, O'Meara PF, Maguire BJ, FitzGerald D, Begg SJ. Organisational interventions for preventing and minimising aggression directed towards healthcare workers by patients and patient advocates. Cochrane Database Syst Rev 2020; 4:CD012662. [PMID: 32352565 PMCID: PMC7197696 DOI: 10.1002/14651858.cd012662.pub2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Workplace aggression is becoming increasingly prevalent in health care, with serious consequences for both individuals and organisations. Research and development of organisational interventions to prevent and minimise workplace aggression has also increased. However, it is not known if interventions prevent or reduce occupational violence directed towards healthcare workers. OBJECTIVES To assess the effectiveness of organisational interventions that aim to prevent and minimise workplace aggression directed towards healthcare workers by patients and patient advocates. SEARCH METHODS We searched the following electronic databases from inception to 25 May 2019: Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley Online Library); MEDLINE (PubMed); CINAHL (EBSCO); Embase (embase.com); PsycINFO (ProQuest); NIOSHTIC (OSH-UPDATE); NIOSHTIC-2 (OSH-UPDATE); HSELINE (OSH-UPDATE); and CISDOC (OSH-UPDATE). We also searched the ClinicalTrials.gov (www.ClinicalTrials.gov) and the World Health Organization (WHO) trials portals (www.who.int/ictrp/en). SELECTION CRITERIA We included randomised controlled trials (RCTs) or controlled before-and-after studies (CBAs) of any organisational intervention to prevent and minimise verbal or physical aggression directed towards healthcare workers and their peers in their workplace by patients or their advocates. The primary outcome measure was episodes of aggression resulting in no harm, psychological, or physical harm. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods for data collection and analysis. This included independent data extraction and 'Risk of bias' assessment by at least two review authors per included study. We used the Haddon Matrix to categorise interventions aimed at the victim, the vector or the environment of the aggression and whether the intervention was applied before, during or after the event of aggression. We used the random-effects model for the meta-analysis and GRADE to assess the quality of the evidence. MAIN RESULTS We included seven studies. Four studies were conducted in nursing home settings, two studies were conducted in psychiatric wards and one study was conducted in an emergency department. Interventions in two studies focused on prevention of aggression by the vector in the pre-event phase, being 398 nursing home residents and 597 psychiatric patients. The humour therapy in one study in a nursing home setting did not have clear evidence of a reduction of overall aggression (mean difference (MD) 0.17, 95% confidence interval (CI) 0.00 to 0.34; very low-quality evidence). A short-term risk assessment in the other study showed a decreased incidence of aggression (risk ratio (RR) 0.36, 95% CI 0.16 to 0.78; very low-quality evidence) compared to practice as usual. Two studies compared interventions to minimise aggression by the vector in the event phase to practice as usual. In both studies the event was aggression during bathing of nursing home patients. In one study, involving 18 residents, music was played during the bathing period and in the other study, involving 69 residents, either a personalised shower or a towel bath was used. The studies provided low-quality evidence that the interventions may result in a medium-sized reduction of overall aggression (standardised mean difference (SMD -0.49, 95% CI -0.93 to -0.05; 2 studies), and physical aggression (SMD -0.85, 95% CI -1.46 to -0.24; 1 study; very low-quality evidence), but not in verbal aggression (SMD -0.31, 95% CI; -0.89 to 0.27; 1 study; very low-quality evidence). One intervention focused on the vector, the pre-event phase and the event phase. The study compared a two-year culture change programme in a nursing home to practice as usual and involved 101 residents. This study provided very low-quality evidence that the intervention may result in a medium-sized reduction of physical aggression (MD 0.51, 95% CI 0.11 to 0.91), but there was no clear evidence that it reduced verbal aggression (MD 0.76, 95% CI -0.02 to 1.54). Two studies evaluated a multicomponent intervention that focused on the vector (psychiatry patients and emergency department patients), the victim (nursing staff), and the environment during the pre-event and the event phase. The studies included 564 psychiatric staff and 209 emergency department staff. Both studies involved a comprehensive package of actions aimed at preventing violence, managing violence and environmental changes. There was no clear evidence that the psychiatry intervention may result in a reduction of overall aggression (odds ratio (OR) 0.85, 95% CI 0.63 to 1.15; low-quality evidence), compared to the control condition. The emergency department study did not result in a reduction of aggression (MD = 0) but provided insufficient data to test this. AUTHORS' CONCLUSIONS We found very low to low-quality evidence that interventions focused on the vector during the pre-event phase, the event phase or both, may result in a reduction of overall aggression, compared to practice as usual, and we found inconsistent low-quality evidence for multi-component interventions. None of the interventions included the post-event stage. To improve the evidence base, we need more RCT studies, that include the workers as participants and that collect information on the impact of violence on the worker in a range of healthcare settings, but especially in emergency care settings. Consensus on standardised outcomes is urgently needed.
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Affiliation(s)
- Evelien Spelten
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Brodie Thomas
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Peter F O'Meara
- Department of Emergency Health and Paramedic Practice, Monash University, McMahons Road, Australia
| | - Brian J Maguire
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | | | - Stephen J Begg
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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Myung E, Domingos-Neto J, Murta GA, Vieira A, Lima PR, Lessa L, Bernardo WM. ANAMT Technical Guideline (DT 07): epidemiological mapping and preventive interventions against workplace violence. Rev Bras Med Trab 2020; 17:268-281. [PMID: 32270130 DOI: 10.5327/z1679443520190448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 11/05/2022] Open
Abstract
Workplace violence has potentially high prevalence, in addition to positive correlation with risk of physical and mental disorders, absenteeism, high turnover rates, impaired productivity and poorer organizational climate. Workplace violence is embedded in the work routine, while its manifestations are heterogeneous and vary according to the local culture, work activities and organization. The scientific evidence for the efficacy of interventions to reduce the prevalence of violent incidents is insufficient to ground general recommendations applicable to any occupational activity. Consensus among organizational actors about notions, relevance, prevalence and risk factors associated with workplace violence, based on epidemiological mappings, is necessary, given the subjective and cultural nature of this problem, and also to enable organizational actors to jointly design pilot solutions. This approach is based on methods used in experimental studies and seeks to promote greater adherence to changes.
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Affiliation(s)
- Eduardo Myung
- Guidelines Unit, National Association of Occupational Medicine - São Paulo (SP), Brazil
| | - José Domingos-Neto
- Guidelines Unit, National Association of Occupational Medicine - São Paulo (SP), Brazil
| | | | - Anielle Vieira
- Guidelines Unit, National Association of Occupational Medicine - São Paulo (SP), Brazil
| | - Paulo Rogerio Lima
- Guidelines Unit, National Association of Occupational Medicine - São Paulo (SP), Brazil
| | - Leandro Lessa
- Guidelines Unit, National Association of Occupational Medicine - São Paulo (SP), Brazil
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Raine G, Thomas S, Rodgers M, Wright K, Eastwood A. Workplace-based interventions to promote healthy lifestyles in the NHS workforce: a rapid scoping and evidence map. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
The health and well-being of staff working in the NHS is a significant issue for UK health care. We sought to identify research relevant to the promotion of healthy lifestyles among NHS staff on behalf of NHS England.
Objectives
To map existing reviews on workplace-based interventions to promote health and well-being, and to assess the scope for further evidence synthesis work.
Design
Rapid and responsive scoping search and evidence map.
Participants
Adult employees in any occupational setting and in any role.
Interventions
Any intervention aimed at promoting or maintaining physical or mental health and well-being. Early intervention initiatives and those addressing violence against staff, workplace bullying or harassment were also included.
Main outcome measures
Any outcome related to the effectiveness, cost-effectiveness or implementation of interventions.
Data sources
A scoping search of nine databases was conducted to identify systematic reviews on health and well-being at work. Searches were limited by publication date (2000 to January/February 2019).
Review methods
The titles and abstracts of over 8241 records were screened and a total of 408 potentially relevant publications were identified. Information on key characteristics were extracted from the titles and abstracts of all potentially relevant publications. Descriptive statistics (counts and percentages) for key characteristics were generated and data from reviews and ‘reviews of reviews’ were used to produce the evidence map.
Results
Evidence related to a broad range of physical and mental health issues was identified across 12 ‘reviews of reviews’ and 312 other reviews, including 16 Cochrane reviews. There also exists National Institute for Health and Care Excellence guidance addressing multiple issues of potential relevance. A large number of reviews focused on mental health, changing lifestyle behaviour, such as physical activity, or on general workplace health/health promotion. Most of the reviews that focused only on health-care staff addressed mental health issues, and stress/burnout in particular.
Limitations
The scoping search process was extensive and clearly effective at identifying relevant publications, but the strategy used may not have identified every potentially relevant review. Owing to the large number of potentially relevant reviews identified from the scoping search, it was necessary to produce the evidence map using information from the titles and abstracts of reviews only.
Conclusions
It is doubtful that further evidence synthesis work at this stage would generate substantial new knowledge, particularly within the context of the NHS Health and Wellbeing Framework[NHS England. Workforce Health and Wellbeing Framework. 2018. URL: www.nhsemployers.org/-/media/Employers/Publications/Health-and-wellbeing/NHS-Workforce-HWB-Framework_updated-July-18.pdf (accessed 10 January 2019)] published in 2018. Additional synthesis work may be useful if it addressed an identifiable need and it was possible to identify one of the following: (1) a specific and focused research question arising from the current evidence map; it may then be appropriate to focus on a smaller number of reviews only, and provide a more thorough and critical assessment of the available evidence; and (2) a specific gap in the literature (i.e. an issue not already addressed by existing reviews or guidance); it may then be possible to undertake further literature searching and conduct a new evidence review.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 18. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Gary Raine
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sian Thomas
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Alison Eastwood
- Centre for Reviews and Dissemination, University of York, York, UK
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Johnson J, Cameron L, Mitchinson L, Parmar M, Opio-Te G, Louch G, Grange A. An investigation into the relationships between bullying, discrimination, burnout and patient safety in nurses and midwives: is burnout a mediator? J Res Nurs 2019; 24:604-619. [PMID: 34394583 DOI: 10.1177/1744987119880329] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Bullying and discrimination may be indirectly associated with patient safety via their contribution to burnout, but research has yet to establish this. Aims The aims of this study were to investigate the relationships between workplace bullying, perceived discrimination, levels of burnout and patient safety perceptions in nurses and midwives and to assess whether bullying and discrimination were more frequently experienced by Black, Asian and minority ethnic than White nurses and midwives. Methods In total, 528 nurses and midwives were recruited from four hospitals in the United Kingdom to complete a cross-sectional survey between February and March 2017. The survey included items on bullying, discrimination, burnout and individual level and ward level patient safety perceptions. Data were analysed using path analysis. Results The results were reported according to the STROBE checklist. Bullying and discrimination were significantly associated with higher burnout. Higher burnout was in turn associated with poorer individual- and ward-level patient safety perceptions. Experiences of discrimination were three times more common among Black, Asian and minority ethnic than White nurses and midwives, but there was no significant difference in experiences of bullying. Conclusions Bullying and discrimination are indirectly associated with patient safety perceptions via their influence on burnout. Healthcare organisations seeking to improve patient care should implement strategies to reduce workplace bullying and discrimination.
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Affiliation(s)
| | - Lorraine Cameron
- Bradford Institute for Health Research, Bradford Royal Infirmary, UK
| | | | | | - Gail Opio-Te
- Silsden District Nurse Team, Bradford District Care NHS Foundation Trust, UK
| | - Gemma Louch
- Bradford Institute for Health Research, Bradford Royal Infirmary, UK
| | - Angela Grange
- Bradford Institute for Health Research, Bradford Royal Infirmary, UK
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Kizuki M, Fujiwara T, Shinozaki T. Adverse childhood experiences and bullying behaviours at work among workers in Japan. Occup Environ Med 2019; 77:9-14. [PMID: 31744857 DOI: 10.1136/oemed-2019-106009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/12/2019] [Accepted: 10/30/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the relationship between adverse childhood experiences (ACEs), workplace bullying victimisation and bullying behaviours to subordinates among Japanese workers. METHODS We conducted an internet-based cross-sectional survey among workers who had enacted 0, 1 and ≥2 types of bullying behaviours that had been directed towards subordinates in the past 3 years (n=309 for each group, total N=927). We assessed ACEs with questionnaires about adverse experiences at home and bullying victimisation at school. The total and controlled direct effects of ACEs on the number of bullying behaviours to subordinates were estimated from a baseline-adjusted and a direct-effect marginal structural ordinal logistic model, respectively. RESULTS There was a positive dose-response association between the level of ACEs and the frequency of workplace bullying victimisation, as well as the number of bullying behaviours enacted at work after adjustment for sex, age and childhood socioeconomic status (both p<0.001). Workers in the highest tertile of ACEs compared with the lowest tertile had 3.15 (95% CI 2.20 to 4.50) times higher odds of having perpetrated more bullying behaviours at work. The magnitude of the effect was 2.57 (95% CI 1.70 to 3.90) via pathways not mediated by workplace bullying victimisation in a direct-effect marginal structural model. CONCLUSIONS People who had ACEs were at increased risk later in life of enacting bullying behaviours at work. Current findings may be useful to prevent bullying behaviours at work.
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Affiliation(s)
- Masashi Kizuki
- Japan Support Center for Suicide Countermeasures, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
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Dzurec L, Karpinski A, Kennison M, Rair R, Fitzgerald S. Assessing Family-Like Dynamics in the Workplace as Possible Precursors of Workplace Bullying: Psychometric Analysis of a Modified Instrument. J Nurs Meas 2019; 27:297-312. [DOI: 10.1891/1061-3749.27.2.297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and PurposeFamily-like dynamics in workplaces may serve as antecedents to workplace bullying. This study addressed the psychometric properties of an instrument modified to assess family-like dynamics in the workplace.DesignThe investigators used categorical principal components analysis (CATPCA) to investigate the psychometric properties of an instrument modified to measure coworker perceptions of family-like dynamics in the workplace.MethodsPrimarily White (95%) study participants (N= 273) completed a brief, demographic form and the modified Family Relationships Index (FRI) of the Family Assessment Scale (FES) (Moos & Moos, 1981, 1986). Demographic data were analyzed using descriptive statistics and perceptions of family-like dynamics in the workplace were analyzed using CATPCA.ResultsThe modified FRI served as a reasonable model for capturing coworker perceptions of family-like dynamics in the workplace.ConclusionsFurther research is indicated to determine the overall utility of the modified FRI and to ascertain whether family-like dynamics actually are precursors to workplace bullying victimization.
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Murray JP, Branch S, Caponecchia C. Success factors in workplace bullying interventions. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2019. [DOI: 10.1108/ijwhm-11-2018-0143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to examine the critical success factors (CSFs) required for the successful implementation of 11 workplace bullying interventions listed in a taxonomy of workplace bullying interventions.Design/methodology/approachA Delphi approach was used to gather commentary from 51 subject matter experts (SMXs) on factors that contribute to successful implementation of workplace bullying interventions.FindingsA deductive approach to thematic analysis revealed that organisational infrastructure, commitment and engagement of management and competent and resourced professionals were the most consistently raised CSFs across interventions. These are broadly consistent with suggested implementation drivers previously recommended by researchers in the workplace bullying and implementation science fields.Research limitations/implicationsTwo interventions did not receive adequate commentary meaning that key implementation drivers could not be sufficiently identified for them. While harnessing SMX commentary, the paper also develops a model of levels of evidence to guide future research.Practical implicationsThis paper can assist organisations in planning and resourcing the implementation of workplace bullying interventions, to help ensure that interventions are as effective as possible.Originality/valueThis paper has value for researchers, practitioners and organisations as it explores factors critical to successful implementation of interventions and also develops a model for the development of enhanced levels of evidence in workplace bullying intervention research.
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Risk Factors for Workplace Bullying: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111945. [PMID: 31159344 PMCID: PMC6603960 DOI: 10.3390/ijerph16111945] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022]
Abstract
Objective: The goal of this study was to systematically review risk factors for workplace bullying. Methods: The search was carried out in two databases. Studies with estimates of risk factors for workplace bullying were included in the review. We assessed the quality of the selected studies using an adapted version of the Downs and Black checklist. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines were used for reporting papers. Results: Fifty-one papers were included, and 70.6% were from European countries. Women were reported to be at higher risk of being bullied in most studies (odds ratio (OR) from 1.17 to 2.77). Authoritarian and laissez-faire leadership styles were positively associated with bullying. Several psychosocial factors, such as stress (OR from 1.37 to 4.96), and occupational risks related to work organization, such as flexible work methods, role conflict, role ambiguity, monotonous or rotating tasks, high demands, pressure of work, and unclarity of duties were strongly associated with bullying. Discussion: The findings highlight the central role of organizational factors in bullying. Policies to prevent bullying must address the culture of organizations, facing the challenge of developing a new management and leadership framework.
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Layne DM, Nemeth LS, Mueller M, Martin M. Negative Behaviors among Healthcare Professionals: Relationship with Patient Safety Culture. Healthcare (Basel) 2019; 7:E23. [PMID: 30717313 PMCID: PMC6473815 DOI: 10.3390/healthcare7010023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/21/2019] [Accepted: 01/29/2019] [Indexed: 11/16/2022] Open
Abstract
Behaviors that undermine a culture of safety within hospitals threaten overall wellbeing of healthcare workers as well as patient outcomes. Existing evidence suggests negative behaviors adversely influence patient outcomes, employee satisfaction, retention, productivity, absenteeism, and employee engagement. Our objective was to examine the presence of negative behaviors within a healthcare system and the influence of negative behaviors among healthcare workers on perceptions of patient safety culture. Using a cross-sectional design, the negative behaviors in healthcare survey (NBHC) and selected composites of the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPS) were combined within an electronic survey which was administered to physicians, clinical and managerial staff. Exposure to contributing factors of negative behaviors was moderately correlated with elements of HSOPS, including perceptions of teamwork within units, management response to error, and overall patient safety grade. Use of aggression and fear of retaliation were moderately correlated with HSOPS management response to error. Reducing healthcare worker exposure to contributing factors of negative behavior may result in increased perceptions of teamwork within a hospital unit, while addressing use of staff aggression and fear of retaliation potentially positively influences management response to error.
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Affiliation(s)
- Diana M Layne
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Lynne S Nemeth
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Mary Martin
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA.
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Keller R, Allie T, Levine R. An evaluation of the "BE NICE Champion" programme: A bullying intervention programme for registered nurses. J Nurs Manag 2019; 27:758-764. [PMID: 30615232 DOI: 10.1111/jonm.12748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/12/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022]
Abstract
AIM To explore the experiences, perceptions and attitudes of registered nurses (RNs) who completed the BE NICE Champion training programme; a home-grown programme that provides RNs tools to intervene when bullying is observed; using the "4S's": Stand by, Support, Speak up, and Sequester. BACKGROUND The growing body of literature surrounding the negative impact bullying has on individuals and organizations suggests the need to develop more effective prevention and intervention programmes. METHODS A qualitative focus group approach utilizing a purposive sample of 25 RNs who participated in the training programme. RESULTS Three consistent themes emerged from a content analysis of the transcripts: (a) awareness and understanding, (b) applying the 4S's and (c) feeling prepared, and empowered. Additional themes included impact on the work environment and additional programme recommendations tailored to nursing leadership. CONCLUSION The programme and use of the 4S's adequately provided RNs with confidence to intervene when bullying was observed. RNs felt better equipped to respond due to the techniques learned and appreciated our organizational commitment to address bullying. Furthermore, the programme may be strengthened by incorporating recommendations discussed. IMPLICATIONS FOR NURSING MANAGEMENT Leaders need to demonstrate a commitment to address bullying. Implementing this programme can positively impact their environment.
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Pattani R, Ginsburg S, Mascarenhas Johnson A, Moore JE, Jassemi S, Straus SE. Organizational Factors Contributing to Incivility at an Academic Medical Center and Systems-Based Solutions: A Qualitative Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1569-1575. [PMID: 29901655 PMCID: PMC6159691 DOI: 10.1097/acm.0000000000002310] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE A rise in incivility has been documented in medicine, with implications for patient care, organizational effectiveness, and costs. This study explored organizational factors that may contribute to incivility at one academic medical center and potential systems-level solutions to combat it. METHOD The authors completed semistructured individual interviews with full-time faculty members of the Department of Medicine (DOM) at the University of Toronto Faculty of Medicine, Toronto, Ontario, Canada, with clinical appointments at six affiliated hospitals, between June and September 2016. They asked about participants' experiences with incivility, potential contributing factors, and possible solutions. Two analysts independently coded a portion of the transcripts until a framework was developed with excellent agreement within the research team, as signified by the Kappa coefficient. A single coder completed analysis of the remaining transcripts. RESULTS Forty-nine interviews with physicians from all university ranks and academic position descriptions were completed. All participants had collegial relationships with colleagues but had observed, heard of, or been personally affected by uncivil behavior. Incivility occurred furtively, face-to-face, or online. The participants identified several organizational factors that bred incivility including physician nonemployee status in hospitals, silos within the DOM, poor leadership, a culture of silence, and the existence of power cliques. They offered many systems-level solutions to combat incivility through prevention, improved reporting, and clearer consequences. CONCLUSIONS Existing strategies to combat incivility have focused on modifying individual behavior, but opportunities may exist to reduce incivility through a greater understanding of the role of health care organizations in shaping workplace culture.
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Affiliation(s)
- Reena Pattani
- R. Pattani is staff physician, Division of General Internal Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada, and assistant professor, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shiphra Ginsburg
- S. Ginsburg is staff physician, Division of Respirology, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada; professor, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; and scientist, Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada
| | - Alekhya Mascarenhas Johnson
- A. Mascarenhas Johnson is research coordinator, Knowledge Translation (KT) Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Julia E. Moore
- J.E. Moore is program manager, Team for Implementation, Evaluation, and Sustainability (TIES), KT Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Sabrina Jassemi
- S. Jassemi is research assistant, KT Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Sharon E. Straus
- S.E. Straus is staff physician, Division of Geriatrics, St. Michael’s Hospital; physician-in-chief, Department of Medicine, St. Michael’s Hospital; division director of geriatrics, University of Toronto; professor, Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto; and director, KT Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
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Giga SI, Fletcher IJ, Sgourakis G, Mulvaney CA, Vrkljan BH. Organisational level interventions for reducing occupational stress in healthcare workers. Hippokratia 2018. [DOI: 10.1002/14651858.cd013014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sabir I Giga
- Lancaster University; Division of Health Research, Faculty of Health and Medicine; Bailrigg Lancaster UK LA1 4YG
| | - Ian J Fletcher
- Lancaster University; Clinical Psychology, Division of Health Research, Faculty of Health and Medicine; Furness College Lancaster UK LA1 4YG
| | - Georgios Sgourakis
- Furness General Hospital; General Surgery; Dalton Lane Barrow-in-Furness UK
| | | | - Brenda H Vrkljan
- McMaster University; Department of Occupational Therapy; 1400 Main street West IAHS Room 450 Hamilton Ontario Canada L8S 1C7
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Briscoe S. A review of the reporting of web searching to identify studies for Cochrane systematic reviews. Res Synth Methods 2017; 9:89-99. [PMID: 29065246 DOI: 10.1002/jrsm.1275] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 09/11/2017] [Accepted: 10/09/2017] [Indexed: 11/08/2022]
Abstract
The literature searches that are used to identify studies for inclusion in a systematic review should be comprehensively reported. This ensures that the literature searches are transparent and reproducible, which is important for assessing the strengths and weaknesses of a systematic review and re-running the literature searches when conducting an update review. Web searching using search engines and the websites of topically relevant organisations is sometimes used as a supplementary literature search method. Previous research has shown that the reporting of web searching in systematic reviews often lacks important details and is thus not transparent or reproducible. Useful details to report about web searching include the name of the search engine or website, the URL, the date searched, the search strategy, and the number of results. This study reviews the reporting of web searching to identify studies for Cochrane systematic reviews published in the 6-month period August 2016 to January 2017 (n = 423). Of these reviews, 61 reviews reported using web searching using a search engine or website as a literature search method. In the majority of reviews, the reporting of web searching was found to lack essential detail for ensuring transparency and reproducibility, such as the search terms. Recommendations are made on how to improve the reporting of web searching in Cochrane systematic reviews.
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Affiliation(s)
- Simon Briscoe
- Exeter HS&DR Evidence Synthesis Centre, Institute of Health Research, University of Exeter Medical School, Exeter, UK
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Post Sennehed C, Gard G, Holmberg S, Stigmar K, Forsbrand M, Grahn B. "Blue flags", development of a short clinical questionnaire on work-related psychosocial risk factors - a validation study in primary care. BMC Musculoskelet Disord 2017; 18:318. [PMID: 28738803 PMCID: PMC5525291 DOI: 10.1186/s12891-017-1677-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/13/2017] [Indexed: 12/30/2022] Open
Abstract
Background Working conditions substantially influence health, work ability and sick leave. Useful instruments to help clinicians pay attention to working conditions are lacking in primary care (PC). The aim of this study was to test the validity of a short “Blue flags” questionnaire, which focuses on work-related psychosocial risk factors and any potential need for contacts and/or actions at the workplace. Methods From the original“The General Nordic Questionnaire” (QPSNordic) the research group identified five content areas with a total of 51 items which were considered to be most relevant focusing on work-related psychosocial risk factors. Fourteen items were selected from the identified QPSNordic content areas and organised in a short questionnaire “Blue flags”. These 14 items were validated towards the 51 QPSNordic items. Content validity was reviewed by a professional panel and a patient panel. Structural and concurrent validity were also tested within a randomised clinical trial. Results The two panels (n = 111) considered the 14 psychosocial items to be relevant. A four-factor model was extracted with an explained variance of 25.2%, 14.9%, 10.9% and 8.3% respectively. All 14 items showed satisfactory loadings on all factors. Concerning concurrent validity the overall correlation was very strong rs = 0.87 (p < 0.001).). Correlations were moderately strong for factor one, rs = 0.62 (p < 0.001) and factor two, rs = 0.74 (p < 0.001). Factor three and factor four were weaker, bur still fair and significant at rs = 0.53 (p < 0.001) and rs = 0.41 (p < 0.001) respectively. The internal consistency of the whole “Blue flags” was good with Cronbach’s alpha of 0.76. Conclusions The content, structural and concurrent validity were satisfactory in this first step of development of the “Blue flags” questionnaire. In summary, the overall validity is considered acceptable. Testing in clinical contexts and in other patient populations is recommended to ensure predictive validity and usefulness.
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Affiliation(s)
- Charlotte Post Sennehed
- Department of Clinical Sciences Lund, Lund University, Orthopedics, Lund, Sweden. .,Epidemiology and Register Centre South, Region Skåne, Lund, Sweden. .,Department of Research and Development, Region Kronoberg, Box 1223, 35112, Växjö, Sweden.
| | - Gunvor Gard
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Sara Holmberg
- Department of Research and Development, Region Kronoberg, Box 1223, 35112, Växjö, Sweden.,Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kjerstin Stigmar
- Epidemiology and Register Centre South, Region Skåne, Lund, Sweden.,Department of Health Sciences, Lund University, Lund, Sweden
| | - Malin Forsbrand
- Department of Clinical Sciences Lund, Lund University, Orthopedics, Lund, Sweden.,Epidemiology and Register Centre South, Region Skåne, Lund, Sweden.,Blekinge Centre of Competence, Landstinget Blekinge, Karlskrona, Sweden
| | - Birgitta Grahn
- Department of Clinical Sciences Lund, Lund University, Orthopedics, Lund, Sweden.,Epidemiology and Register Centre South, Region Skåne, Lund, Sweden.,Department of Research and Development, Region Kronoberg, Box 1223, 35112, Växjö, Sweden
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Spelten E, Thomas B, O'Meara PF, Maguire BJ, FitzGerald D, Begg SJ. Organisational interventions for preventing and minimising aggression directed toward healthcare workers by patients and patient advocates. Hippokratia 2017. [DOI: 10.1002/14651858.cd012662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Evelien Spelten
- La Trobe University; La Trobe Rural Health School; PO Box 199 Bendigo Victoria Australia 3552
| | - Brodie Thomas
- Ambulance Victoria; 375 Manningham Road Doncaster Victoria Australia 3108
| | - Peter F O'Meara
- La Trobe University; La Trobe Rural Health School; PO Box 199 Bendigo Victoria Australia 3552
| | - Brian J Maguire
- Central Queensland University; School of Medical and Applied Sciences; Bruce Highway Rockhampton Queensland Australia 4702
| | | | - Stephen J Begg
- La Trobe University; La Trobe Rural Health School; PO Box 199 Bendigo Victoria Australia 3552
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Gillen PA, Sinclair M, Kernohan WG, Begley CM, Luyben AG. Interventions for prevention of bullying in the workplace. Cochrane Database Syst Rev 2017; 1:CD009778. [PMID: 28134445 PMCID: PMC6464940 DOI: 10.1002/14651858.cd009778.pub2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bullying has been identified as one of the leading workplace stressors, with adverse consequences for the individual employee, groups of employees, and whole organisations. Employees who have been bullied have lower levels of job satisfaction, higher levels of anxiety and depression, and are more likely to leave their place of work. Organisations face increased risk of skill depletion and absenteeism, leading to loss of profit, potential legal fees, and tribunal cases. It is unclear to what extent these risks can be addressed through interventions to prevent bullying. OBJECTIVES To explore the effectiveness of workplace interventions to prevent bullying in the workplace. SEARCH METHODS We searched: the Cochrane Work Group Trials Register (August 2014); Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1); PUBMED (1946 to January 2016); EMBASE (1980 to January 2016); PsycINFO (1967 to January 2016); Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus; 1937 to January 2016); International Bibliography of the Social Sciences (IBSS; 1951 to January 2016); Applied Social Sciences Index and Abstracts (ASSIA; 1987 to January 2016); ABI Global (earliest record to January 2016); Business Source Premier (BSP; earliest record to January 2016); OpenGrey (previously known as OpenSIGLE-System for Information on Grey Literature in Europe; 1980 to December 2014); and reference lists of articles. SELECTION CRITERIA Randomised and cluster-randomised controlled trials of employee-directed interventions, controlled before and after studies, and interrupted time-series studies of interventions of any type, aimed at preventing bullying in the workplace, targeted at an individual employee, a group of employees, or an organisation. DATA COLLECTION AND ANALYSIS Three authors independently screened and selected studies. We extracted data from included studies on victimisation, perpetration, and absenteeism associated with workplace bullying. We contacted study authors to gather additional data. We used the internal validity items from the Downs and Black quality assessment tool to evaluate included studies' risk of bias. MAIN RESULTS Five studies met the inclusion criteria. They had altogether 4116 participants. They were underpinned by theory and measured behaviour change in relation to bullying and related absenteeism. The included studies measured the effectiveness of interventions on the number of cases of self-reported bullying either as perpetrator or victim or both. Some studies referred to bullying using common synonyms such as mobbing and incivility and antonyms such as civility. Organisational/employer level interventionsTwo studies with 2969 participants found that the Civility, Respect, and Engagement in the Workforce (CREW) intervention produced a small increase in civility that translates to a 5% increase from baseline to follow-up, measured at 6 to 12 months (mean difference (MD) 0.17; 95% CI 0.07 to 0.28).One of the two studies reported that the CREW intervention produced a small decrease in supervisor incivility victimisation (MD -0.17; 95% CI -0.33 to -0.01) but not in co-worker incivility victimisation (MD -0.08; 95% CI -0.22 to 0.08) or in self-reported incivility perpetration (MD -0.05 95% CI -0.15 to 0.05). The study did find a decrease in the number of days absent during the previous month (MD -0.63; 95% CI -0.92 to -0.34) at 6-month follow-up. Individual/job interface level interventionsOne controlled before-after study with 49 participants compared expressive writing with a control writing exercise at two weeks follow-up. Participants in the intervention arm scored significantly lower on bullying measured as incivility perpetration (MD -3.52; 95% CI -6.24 to -0.80). There was no difference in bullying measured as incivility victimisation (MD -3.30 95% CI -6.89 to 0.29).One controlled before-after study with 60 employees who had learning disabilities compared a cognitive-behavioural intervention with no intervention. There was no significant difference in bullying victimisation after the intervention (risk ratio (RR) 0.55; 95% CI 0.24 to 1.25), or at the three-month follow-up (RR 0.49; 95% CI 0.21 to 1.15), nor was there a significant difference in bullying perpetration following the intervention (RR 0.64; 95% CI 0.27 to 1.54), or at the three-month follow-up (RR 0.69; 95% CI 0.26 to 1.81). Multilevel InterventionsA five-site cluster-RCT with 1041 participants compared the effectiveness of combinations of policy communication, stress management training, and negative behaviours awareness training. The authors reported that bullying victimisation did not change (13.6% before intervention and 14.3% following intervention). The authors reported insufficient data for us to conduct our own analysis.Due to high risk of bias and imprecision, we graded the evidence for all outcomes as very low quality. AUTHORS' CONCLUSIONS There is very low quality evidence that organisational and individual interventions may prevent bullying behaviours in the workplace. We need large well-designed controlled trials of bullying prevention interventions operating on the levels of society/policy, organisation/employer, job/task and individual/job interface. Future studies should employ validated and reliable outcome measures of bullying and a minimum of 6 months follow-up.
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Affiliation(s)
- Patricia A Gillen
- Ulster UniversityInstitute of Nursing and Health ResearchJordanstownNewtownabbeyNorthern IrelandUKBT37 0QB
- Southern Health and Social Care TrustNursing, Midwifery and Allied Health Professions Research and Development68 Lurgan RoadPortadownUKBT63 5QQ
| | - Marlene Sinclair
- Ulster UniversityInstitute of Nursing and Health ResearchJordanstownNewtownabbeyNorthern IrelandUKBT37 0QB
| | - W George Kernohan
- Ulster UniversityInstitute of Nursing and Health ResearchJordanstownNewtownabbeyNorthern IrelandUKBT37 0QB
| | - Cecily M Begley
- Trinity College DublinSchool of Nursing and Midwifery24 D'Olier StreetDublinIreland
- The Sahlgrenska Academy, University of GothenburgInstitute of Health and Care SciencesGothenburgSweden
| | - Ans G Luyben
- University of LiverpoolInstitute of Psychology, Health and Society1‐5 Brownlow StreetBlock B Waterhouse BldsLiverpoolUKL69 3GL
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Brailey S, Luyben A, van Teijlingen E, Frith L. Women, Midwives, and a Medical Model of Maternity Care in Switzerland. INTERNATIONAL JOURNAL OF CHILDBIRTH 2017. [DOI: 10.1891/2156-5287.7.3.117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article presents a case study on the organization of maternity health care in Switzerland. Switzerland has a costly health care system with high intervention rates within an obstetric-led maternity care model. Evidence has shown that midwifery care is associated with lower cost, higher satisfaction rates among women, and less intervention. However, in this model, midwives are both marginalized and underused.The article focuses on the distribution of power and knowledge between midwives, women, and the medical profession. The varying power structures that shape the maternity care system in Switzerland are examined, using a case study approach that draws on Foucault’s concepts of the gaze, surveillance, disciplinary power, and the docile body. This article critically analyzes the model of maternity care received by women in Switzerland and how it negatively impacts on both women’s personal and midwives’ professional autonomy while simultaneously driving up costs.A better understanding of the underlying power structures operating within the maternity care system may facilitate the implementation of more midwifery-led care currently being endorsed by the Swiss Midwifery Association and some government agencies. This could result in reduced cost and lower intervention rates with reduced associated morbidity.
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