Sexual harassment in healthcare: classification of harassers and rationalizations of sex-based harassment behavior

Understanding Australian female chiropractors' experiences of inappropriate patient sexual behaviour: a study using Interpretive Phenomenological Analysis

Introduction

Female practitioners are often subjected to inappropriate patient sexual behaviour (IPSB). Adverse consequences of such sexual harassment include for the practitioner psychological stress effects and negative work-related consequences that contributes to career dissatisfaction and burnout. Confronting the issue within the healthcare context has been shown to be problematic because practitioners feel an obligation to protect the therapeutic relationship above their own personal discomfort. There is an absence of research on this topic with respect to female chiropractors and we proposed a qualitative study aimed to explore female chiropractors lived experiences of managing incidents of IPSB.

Method

An Interpretive Phenomenological Analysis methodology was chosen for this study. In June and July of 2018 female chiropractors in Western Australian were recruited via Facebook sites and invited to participate in face-to-face interviews for an Honours degree study exploring the lived experience of IPSB.

Results

Participants were seven female chiropractors currently practicing in Western Australia, who had experienced an incident of IPSB. Four super-ordinate themes emerged from the analysis; (1) familiar but inarticulable, (2) the cost of conflict, (3) I’m used to it, and (4) the element of surprise. Overall, the participants recognised the incidents as inappropriate but chose to ignore the situation as a means to avoid conflict in the treatment room. Recommendations are made to better manage IPSB including greater patient awareness of appropriate behaviour, specific curriculum content and assertiveness training in undergraduate programs and continuing professional education, as well as the creation of ethical guidelines for patient behaviour by regulatory bodies.

Conclusion

This is the first study to give a forum for female chiropractors to discuss their experiences of IPSB. The domain of private practice is not immune to incidents IPSB and although similar to day-to-day non-clinical life is nonetheless surprising and impactful.

'It comes with the territory' - Staff experience with violation and humiliation in mental health care - A mixed method study

BACKGROUND

The aim of this study was to investigate staff's experiences with violation and humiliation during work in mental health care (MHC). A total of 1160 multi-professional MHC staff in Norway responded to an online questionnaire about their experiences with different kinds of violation and humiliation in the MHC setting. In addition, a sample of professionals (eight MHC nurses) were recruited for in-depth individual interviews.

METHOD

The study used an explorative mixed method with a convergent parallel design; this included a web-based questionnaire to MHC staff in combination with individual interviews. The sample is considered to be equivalent to staff groups in MHC in Norway.

RESULTS

Between 70 and 80% of the staff reported experiencing rejection, being treated with disrespect, condescending behaviour or verbal harassment. Male workers were significantly more often victims of serious physical violence, and women were significantly more often targets for sexual harassment. In interviews, participants said they considered being exposed to violence and humiliation to be part of the job when working in MHC, and that experience, as well as social support from colleagues, helped MHC practitioners to cope better with violent situations and feel less humiliated at work.

DISCUSSION

A high amount of MHC staff report experiences of being violated and humiliated during work. The participants' perceptions of the users and their behaviour seem to influence their experience of feeling violated and humiliated. Knowledge about the dynamics of aggression between staff and users in MHC may be used in safeguarding staff and users, prevent coercion and heighten the quality of care.

Problematizing Sexual Harassment in Residential Long-Term Care: The Need for a More Ethical Prevention Strategy

La promotion des droits sexuels dans les établissements de soins de longue durée est complexe sur le plan éthique, étant donné que ce milieu est à la fois une résidence et un lieu de travail. Bien que les données empiriques démontrent que le bien-être des soignants professionnels et des résidents sont inextricablement liés, les politiques publiques au Canada ne reconnaissent généralement pas cette relation et continuent de se concentrer isolément sur le bien-être des résidents ou des travailleurs. Les conséquences problématiques de cette situation sont particulièrement mises en évidence lorsque l'on considère les défis associés à la prévention du harcèlement sexuel envers les travailleurs, dans un contexte où l'on ne veut pas restreindre indûment la liberté d'expression sexuelle des résidents atteints de démence. Nous avons utilisé l'approche « Quel est le problème représenté ? » ("What's the Problem Represented to be?") de Carol Bacchi pour analyser de façon critique un plan d'action canadien récent visant à prévenir la violence et le harcèlement sexuels. Notre analyse suggère que cette approche de prévention du harcèlement sexuel n'est pas une politique publique prometteuse et pourrait même contribuer à augmenter le phénomène qu'elle vise à corriger. Il est donc urgent de concentrer les efforts de prévention sur les facteurs structurels de ce phénomène afin de soutenir les droits sexuels des soignants et des résidents.

Supporting sexual rights in residential long-term care is ethically complex. The well-being of care workers and residents is inextricably linked, and increasingly recognized empirically, yet public policy in Canada generally continues to exclusively focus on either the well-being of residents or workers. The consequences of this are particularly evident when we consider how to prevent sexual harassment towards workers without unjustly restricting the freedom of sexual expression for residents living with dementia. Employing Carol Bacchi’s “What’s the Problem Represented to be?” approach, we critically analysed a recent Canadian action plan to prevent sexual violence and harassment. Our analysis suggests that this policy is less than promising and may reproduce the very phenomenon it is intended to redress. The need to refocus prevention efforts on the structural factors implicated in this phenomenon is urgent if we are to support the sexual rights of both care workers and residents.

Sexual harassment--a touchy subject for nurses

PURPOSE

The purpose of this paper is to examine prevalence of sexual harassment (SH) in nursing and the environmental factors that contribute to incidents of SH.

DESIGN/METHODOLOGY/APPROACH

A mixed-method research methodology is adopted. A total of 538 questionnaires are collected from nurses working in eight different hospitals across metropolitan and rural areas in Australia. A total of 23 in-depth semi-structured interviews are conducted.

FINDINGS

Prevalence of SH in nursing is high with 60 percent of female nurses and 34 percent of male nurses reporting a SH incident in the two-year period prior to this paper. The questionnaire data suggest that patients are the most likely perpetrator, however, the interviews name physicians as typical perpetrators. A model is tested via structural equation modelling and revealed that leadership behaviors, an unbalanced job gender ratio and no prior socialization are positively associated with SH.

RESEARCH LIMITATIONS/IMPLICATIONS

This paper closes gaps in theory by introducing a new framework explaining the contextual factors that heighten a nurses' probability of being harassed. Some variables such as organizational culture and specific nursing units have not been explored and can be considered a limitation of the paper.

PRACTICAL IMPLICATIONS

The results of this paper assist health professionals to adopt proactive practices for managing SH and plan a workforce where SH is minimized.

ORIGINALITY/VALUE

This paper illustrates the prevalence of different types of SH and the causes for male and female nurses that have not been investigated previously. The results help health managers make informed decisions in regard to intervention strategies.

Work-related factors and violence among nursing staff in the European NEXT study: A longitudinal cohort study

BACKGROUND

The occurrence of workplace violence is rather frequent within the nursing profession, with well-known consequences on the psychological health of victims.

OBJECTIVES

This study is aimed at assessing the relationships between relevant individual, organizational, and psychosocial factors, and the frequency of several types of workplace violence; the direct as well as the interactive impact of violence and psychosocial factors on organizational commitment and perceived health.

DESIGN

Questionnaire-based cross-sectional and longitudinal survey designs were employed for the two study objectives, respectively.

SETTING

Five hundred and sixty-five healthcare institutions from eight European countries participated in the Nurses' Early Exit Study.

PARTICIPANTS

The 34,107 participants were nursing staff holding different qualifications. The response rate was 55.1% in the cross-sectional part and 40.5% in the follow-up phase. At baseline, the respondents were mostly female (89.3%), in the age group 30-44 years (52.9%), registered or specialized nurses (67.0%), working mainly in medico-surgical wards (36.3%), and employed full-time (72.8%).

METHODS

In the cross-sectional analysis, the relationship between the predictor variables and frequency of violence was assessed by means of a hierarchical multiple linear regression. In the longitudinal analysis, main direct and interactive effects of violence and psychosocial factors on perceived health and organizational commitment were assessed by means of hierarchical multiple linear regression analyses with interaction terms.

RESULTS

Higher levels of adverse work-related factors were significantly associated with higher frequency of the distinguished types of violence. Significant interactions were found between psychosocial factors and violence only in predicting organizational commitment, even if effect sizes were very low. No interactions were observed for perceived health. The prevalence of the distinguished types of violence varied across the participating countries according to the presence of adverse work- and non-work-related factors.

CONCLUSIONS

These findings suggest the necessity of interventions both over working conditions conducive to violence and violent behaviours themselves.

Sexual harassment of nurses in the workplace

Nurses who are sexually harassed at work face frustration and emotional and economic consequences. Historically before the 1970s, nurses had little legal recourse and tolerated sexual harassment as a necessary "evil" associated with working. The Civil Rights Act of 1964 created the option for legal remedies for sexual harassment/discrimination cases. Successful court cases established the legal criteria for sexual harassment. This article discusses the history, definition, high profile cases, research, consequences, and prevention of sexual harassment. Although research is scant and little is known of how nurses respond to harassing behavior, prevention requires coordinated activities of employers, individual employees, and the healthcare profession. Sexual harassment at work increases anxiety and undermines the nurse's ability to focus on the delivery of safe and competent care.