Iranian Nurses' Experiences with Sexual Harassment in Workplace: a Qualitative Study

Sexual Harassment at Work: Scoping Review of Reviews

Background

This article presents a scoping review of reviews on the topic of Sexual Harassment (SH) in the workplace, a subject that has garnered significant global attention. The phenomenon of SH poses a critical challenge to equal opportunity and gender equity in the workplace.

Aim

The review aims to synthesize existing research, focusing on the antecedents, consequences, and interventions related to SH.

Methods

The inclusion and exclusion criteria were established based on the research question, which was adapted from the PICO strategy. A protocol was devised following the "DS-CPC" format, which encompasses considerations related to Documents, Studies, Construct, Participants, and Contexts. The search was carried utilizing several automated databases, specifically focusing on the fields of Psychology, Behavioral Sciences, and Health. Preliminary search yielded a total of 468 articles, and the review ultimately encompassed a total of 22 articles.

Results

This review critically examines the complexity of SH, including the role of bystanders, the perpetuation of myths and misconceptions, and the exploitation of power imbalances by harassers. It also explores the manifestation of SH in male-dominated workplaces and the varying levels of organizational awareness and response to such incidents. The review highlights the importance of fostering an organizational culture that not only acknowledges and protects victims but also implements effective measures to penalize perpetrators.

Implications

It aims to elucidate the intricacies of SH and advocate for a workplace environment characterized by respect and accountability. Through this comprehensive analysis, the article seeks to inform and guide future research, policy development, and organizational practices concerning SH.

Development and validation of the nurses sexual harassment scale in Iran

INTRODUCTION

In recent years, the prevalence of sexual harassment has become a global problem, and nursing, like other professions, has not been immune to this issue. By having a valid and reliable instrument, healthcare personnel can be helped in preventing and managing this problem and reduce its negative consequences on mental health and well-being. The aim of this study was developing and psychometrically measuring the Nurses Sexual Harassment Scale.

MATERIALS AND METHODS

This study is the second phase of a mixed method study. Initially in the first phase, a qualitative approach with conventional content analysis was used to explain nurses' experiences of sexual harassment in the workplace. To design the Nurses Sexual Harassment Scale, qualitative data and literature were reviewed. In the quantitative phase (second phase), the target scale was psychometrically evaluated using content validity (14 experts), face validity (12 nurses with being sexually harassed), construct validity (316 nurses working in hospitals affiliated to Kerman University of Medical Sciences), and reliability (internal consistency and repeatability).

RESULTS

A 15-item scale with two components: "latent sexual harassment" (9 items) and "manifest sexual harassment" (6 items), which explained 68.4% of the total variance was developed. Also, due to the strong correlation between the Nurses Sexual Harassment Scale and the Impact of Event Scale-Revised (r = 0.67), convergent validity was confirmed. Also, the scale of the present study had good reliability (Cronbach's alpha coefficient = 0.94, Omega coefficient = 0.94, and ICC = 0.92).

CONCLUSION

Given the importance of sexual harassment among nurses, measuring the dimensions of this problem may allow professionals to plan interventions to prevent it. Overall, the results of the present study showed that the psychometric properties of the " Nurses Sexual Harassment Scale" with 15 items are acceptable and this scale can be used in the clinical environment. A further study within the nursing community is recommended to confirm the findings.

A Qualitative Systematic Review of Healthcare Practitioners' Experience of Workplace Violence

Healthcare practitioners face significant risks of workplace violence due to various reasons such as hospital congestion, miscommunication, and aggressive behaviours of patients and relatives. Exposure to workplace violence may disrupt the workflow process and compromise patient care in healthcare facilities, ultimately affecting job performance, reducing job satisfaction, and negatively affecting the physical and mental health of healthcare practitioners. This study aimed to review all the published studies conducted on the experiences of workplace violence among healthcare practitioners. This study is a systematic review of qualitative studies. Data were collected through online databases including ScienceDirect, PubMed, MEDLINE and JSTOR were searched from the year 2015-2021. The inclusion criteria were: qualitative methods and mixed methods of data collection and analysis; studies that were carried out among healthcare practitioners who have been experience on workplace violence; scope of the primary studies included experience of workplace violence; and published in English/Malay in academic journal between 2015 and 2021. A total of 15 papers were included in the final analysis. The overall quality of the included papers was high. Of the 15 papers, 12 studies fully met the CASP criteria. The results of the 15 included studies were organised into the thematic groups of: i) verbal violence as the common workplace violence; ii) perceived causes of workplace violence and iii) seeking help. Across different countries, verbal violence was the most common type of workplace violence reported by healthcare practitioners. This review also identified that a lack of information, failure to meet patient expectations, and delayed treatment were the main contributing factors to workplace violence.

Nursing students' experiences of sexual harassment - A qualitative study from feminist identity perspective

AIM

To explore experiences of sexual harassment among nursing students in an East Asian region and to gain knowledge of the underlying factors influencing nursing students' conceptualization of and response to sexual harassment.

BACKGROUND

Nursing students are susceptible to sexual harassment due to gender and power inequality in healthcare systems. Sexual harassment has an adverse impact on the students' physical and mental health. Studies on sexual harassment among nursing students are limited and reported significantly varied occurrence prevalence in different cultures. Feminist identity theory can provide a framework to examine social-culturally constructed perceptions of sexual harassment.

DESIGN

A qualitative descriptive study.

METHODS

The study was conducted in Macau, a Special Administrative Region of China. Purposive sampling was applied. Twenty-six nursing students and five nursing educators participated in the study. Semi-structured interviews were conducted. Thematic analysis was used to analyze the interview data. A series of measures were applied to enhance the trustworthiness of the study.

RESULTS

While most of the students had not experienced or heard of sexual harassment, a limited number claimed sexual harassment as a frequently encountered instance. The students expressed uncertainty about what constituted sexual harassment, mainly due to a lack of exposure to information on sexual harassment. They were caught in a dilemma between exerting nursing professional virtues and exposing the misconduct of the suspected perpetrators, leading to taking passive approaches of ignoring and avoiding as the primary coping strategies. In contrast, nursing educators advocated proactive approaches as coping strategies to address sexual harassment.

CONCLUSIONS

A conflict between nursing professional identity and feminist identity is observed among nursing students. Healthcare institutions and nursing schools should develop interventions to enhance nursing students' assertiveness to sexual harassment.

Influence of job demands on implicit absenteeism in Chinese nurses: mediating effects of work-family conflict and job embeddedness

Purpose

It has been widely noted that implicit absenteeism is common among nurses, with job demand influencing it. Theoretically, work-family conflict and job embeddedness may help link job demands to implicit absenteeism. However, the mediating effects of the two on the association between job demands and implicit absenteeism remain unclear. Thus, this study aims to explore the association between nurses' job demands and implicit absenteeism, and the chain mediating effect of work-family conflict and job embeddedness in this relationship.

Patients and methods

Data were collected from 1,420 nurses from five tertiary public hospitals in China. They were asked to respond to a questionnaire asking about job demands, implicit absenteeism, work-family conflict, and job embeddedness. The data were coded and analyzed using IBM SPSS version 21.0. Descriptive analysis, t-test, one-way ANOVA, hierarchical multiple regression analysis, and bootstrapping were used to analyze the extracted data.

Results

The mean score for implicit absenteeism was 17.75 ± 5.60. There was a significant correlation (p < 0.05) between nurses' job demands, work-family conflict, job embeddedness, and implicit absenteeism. Nurses' job demands directly influenced implicit absenteeism and indirectly influenced implicit absenteeism through the mediating effects of work-family conflict and job embeddedness. Furthermore, work-family conflict and job embeddedness have a chain effect on the association between job demands and implicit absenteeism.

Conclusion

The study found that nurses' job demands directly and positively influence implicit absenteeism, and indirectly influence implicit absenteeism through single and chain mediating effects of work-family conflict and job embeddedness.

Experiences of Sexual Harassment by Patients among Nurses at the Mental Hospital of West Java Province: A Qualitative Study

Sexual harassment is behavior related to forced sex without the consent of the victim. Incidents of sexual harassment on nurses can be in the form of physical behavior and verbal behavior. The factor of power relations between men and women and the patriarchal culture in Indonesia are the causes of the sexual harassment of mental health nurses, so many incidents of the sexual harassment of women occur. The forms of sexual harassment that occur include kissing, hugging from behind, and verbal abuse related to sex. The purpose of this study was to explore the experience of sexual harassment of psychiatric nurses at the Mental Hospital of West Java Province. This study implemented a qualitative descriptive approach using the NVIVO 12 software application. The sample in this study was 40 psychiatric nurses at the Mental Hospital of West Java Province. The sampling technique in this study was focus group discussions with semi-structured and in-depth interviews. The data analysis in this study used a thematic analysis. This study shows that sexual harassment behavior is carried out by patients in physical and verbal forms. Sexual harassment is mostly carried out by male patients towards female nurses. Meanwhile, sexual harassment took the form of hugging from behind, kissing, naked patients in front of nurses, and disturbing nurses with verbal abuse related to sex. Nurses feel disturbed, afraid, anxious, and shocked by the incidents of sexual harassment committed by patients. Sexual harassment by patients towards nurses causes psychological problems for nurses and causes nurses to want to leave their jobs. Gender adjustment between nurses and patients is a preventive effort to prevent the sexual harassment of nurses. Sexual harassment by patients causes a decrease in the quality of work of nurses in providing nursing care, creating a work environment that is less safe and comfortable.

Sexual harassment as experienced by nurses from selected healthcare facilities in Ghana

BACKGROUND

Workplace Sexual Harassment (WSH) remains a major occupational health hazard to many nurses globally. Despite the negative impact of WSH on health and safety of nurses, there are limited studies exploring sexual harassment experiences of nurses in the line of duty in Low- and middle-income countries (LMICs) including Ghana.

AIM

This study aimed at exploring the lived sexual harassment experiences among nurses working in healthcare facilities in the Central Region of Ghana.

METHOD

This study used a qualitative interpretive phenomenological approach (IPA). Data from 24 participants, 13 participants' written descriptive narratives of sexual harassment experiences (via online) and 11 telephone interviews were analysed concurrently using the IPA.

RESULTS

Participants experienced verbal, non-verbal and physical forms of sexual harassment, often perpetrated by physicians, colleague workers, and patients. Most victims reacted passively to the acts sexual harassment and cases are often not reported despite the negative impact on victims' health. While some participants dealt with sexual harassment by accepting the behaviour as an inevitable part of their job, others either quit or intend to quit the job to avoid the harassers. Most participants are unaware of any workplace measure such as policy that addresses sexual harassment in the health sector in Ghana.

CONCLUSION

This study highlights the problems of sexual harassment against nurses in the healthcare sector in Ghana, and calls for urgent development of measures such as a sexual harassment policy to prevent occurrence and promote effective resolution of sexual harassment within the healthcare sector in the country. Sexual harassment against nurses could be hampering quality healthcare delivery in the region.

Sexual Harassment at the Workplace is Still a Hindrance among Midwives and Nurses Working in Northwestern Ethiopia Referral Hospitals: A Multicenter Cross-Sectional Study

Introduction

Sexual harassment in the workplace is still the tip of the iceberg among front-line health workers, resulting in a high turnover of professionals, job dissatisfaction, absenteeism, and disharmonized health-care delivery. Research on the magnitude of workplace sexual harassment and factors associated with the workplace among nurses and midwives in Ethiopia is lacking. The study aimed to assess the magnitude and its associated factors among nurses and midwives working in northwestern Ethiopia referral hospitals.

Methods

This multicenter hospital-based cross-sectional study was conducted from April 11 to May 15, 2021 in northwestern Ethiopia referral hospitals. A self-administered structured questionnaire was used to collect data. Data were entered into EPI info 7.2.3.2 and analyzed using SPSS version 25. Binary logistic regression was utilized to identify factors associated with sexual harassment, and associations were deemed significant at P<0.05.

Results

As the findings show, sexual harassment prevalence in the workplace among female nurses and midwives was found to be 17.4% (95% CI 14.5%–19.5%). Many nurses and midwives who had experienced sexual harassment were harassed by patients’ families — 43.2%. Factors associated with sexual harassment in the workplace were being unmarried (AOR 4, 95% CI 2.3–12.6), work experience of less than 5 years (AOR 5, 95% CI 1.2–19), and participant age of 18–25 (AOR 7.2, 95% CI 5.9–17) years, all strongly associated with the outcome variable.

Conclusion and Recommendation

Sexual harassment among midwives and nurses employed in northwestern Ethiopia referral hospitals is not tolerable, as indicated in these findings. The government should address this by amending and reforming policies and strategies to obviate this problem.

Bitter silence allows sexual harassment to continue in workplace: A qualitative study in Iranian nurses

Background

Sexual harassment in the workplace is continuing. However, the rate of sexual harassment disclosure is low, which causes many problems. Non-disclosure of sexual harassment can cause nurses' psychological distress and physical harm, and affect their productivity and quality of care. Therefore, the present study aimed to investigate the reasons why Iranian nurses stayed silent and did not disclose sexual harassment in their workplace.

Method

This qualitative descriptive-explorative study was conducted to investigate the reasons why Iranian nurses (n = 18) stayed silent on sexual harassment. Conventional content analysis and purposeful sampling method were used in this study. Data was collected through in-depth semi-structured interviews. Maximum variance in terms of age, sex, work experience, education level, marital status, and type of hospital and ward was considered in order to obtain rich information. Guba and Lincoln criteria were used to increase the study's trustworthiness, while the Graneheim and Lundman approach was used to analyze the content.

Results

The research data indicated 112 codes, a major category, 4 subcategories, and 9 primary categories. The major category, "The missing link is bitter silence; sexual harassment is still going on," includes four subcategories: fear of social stigmas, organizational and legal barriers, family barriers, and personal barriers.

Conclusions

Nurses cannot break their silence on sexual harassment because they are afraid that disclosure of sexual harassment has negative consequences for their personal and professional lives. Policies and strategies should be developed to encourage nurses to disclose sexual harassment. This issue must be studied socially, culturally, and politically.

Strategies to prevent workplace sexual harassment among Iranian nurses: A qualitative study

Background

Sexual harassment in the workplace has many negative consequences for nurses and the delivery of patient care. Appropriate policies and strategies can help to create a safe work environment for nurses. Therefore, the present study aimed to investigate Iranian nurses’ strategies for preventing sexual harassment in the workplace.

Materials and methods

This qualitative descriptive-explorative study used conventional content analysis to investigate how Iranian nurses cope with sexual harassment (n = 22). Participants were selected using a purposeful sampling method. Data was collected through in-depth, semi-structured interviews from September 2020 to April 2021. In order to obtain rich information, maximum variation was considered (age, sex, work experience, level of education, marital status, and type of hospital and ward). The Guba and Lincoln criteria were used to increase the study’s trustworthiness, while the Graneheim and Lundman approach was used to analyze the content.

Results

One hundred and twelve codes, one main category, four categories, and 12 subcategories were extracted. The main category, strategies to prevent sexual harassment among nurses in the workplace, includes four categories: behavioral response, working conditions adjustment, informing, and performance of hospital security guards. The most common strategy used by nurses was behavioral response.

Conclusion

Basic measures are required to prevent sexual misconduct against nurses, which is an obvious part of the professional organizational culture. Managers and policymakers should develop workplace ethics, legal accountability, and safety. They should also develop training programs and prevention strategies to help nurses improve their coping skills. Further quantitative and qualitative research in other healthcare groups is required to confirm the findings of this study.

Psychological coherence, inclusive leadership and implicit absenteeism in obstetrics and gynecology nurses: a multi-site survey

BACKGROUND

Implicit absenteeism is very common among clinical nurses. We aimed to evaluate the role of psychological coherence in the inclusive leadership and implicit absenteeism among obstetrics and gynecology nurses, to provide evidence to the clinical management of nurses.

METHODS

Through the convenience sampling method, a survey of gynecology nurses in tertiary hospitals in 16 cities of Anhui Province, China was conducted using the General Information Questionnaire, the Stanford Implicit Absence Scale, the Inclusive Leadership Scale and the Sense of Coherence Scale. Statistical analysis was performed by SPSS 20.

RESULTS

A total of 1080 nurses were included with an effective response rate of 93.5%. The average score of nurses' recessive absenteeism in this study was (16.8 ± 0.15). The average of inclusive leadership score was (34.25 ± 7.23). The average score of psychological coherence score of obstetrics and gynecology nurses was (55.79 ± 8.28). Pearson correlation analysis showed that there was a relationship between implicit absenteeism behavior, inclusive leadership, and the level of psychological coherence in obstetrics and gynecology nurses (all P < 0.05). Linear regression analysis indicated that psychological coherence played a partial mediating role between inclusive leadership and obstetrics and gynecology nurses' implicit absenteeism (all P < 0.05).

CONCLUSIONS

Obstetrics and gynecology nurses have serious recessive absenteeism with low sense of psychological coherence and inclusive leadership. Nursing managers should improve the psychological coherence through effective interventions, thereby reducing the incidence of implicit absenteeism.