The impacts of patient mistreatment on healthcare workers' role behaviors: a study in Chinese Fangcang shelter hospitals

BACKGROUND

Fangcang shelter hospitals have played an important role in the battle against the COVID-19 epidemic in China. Patients' verbal and physical attacks on medical workforce are prone to occur in such hospitals. This study explored the impacts of patient mistreatment on healthcare workers' role behaviors (service performance and patient-oriented organizational citizenship behavior).

METHODS

We examined the influence of patient mistreatment on service performance and patient-oriented organizational citizenship behavior, as well as the mediating effect of emotional exhaustion and the moderating effect of displaced aggression by patients, using hierarchical linear regression and conditional process analysis.

RESULTS

Patient mistreatment was positively associated with emotional exhaustion among healthcare workers, while emotional exhaustion was negatively associated with service performance and patient-oriented organizational citizenship behavior. Mediation analysis revealed that emotional exhaustion mediated the association between patient mistreatment and both types of role behaviors. Moderated mediation analysis found that the mediation effect was weaker when the displaced aggression by patients was high.

CONCLUSIONS

The findings clarified the relationship among patient mistreatment, emotional exhaustion, service performance, and patient-oriented organizational citizenship behavior. Additional assistance should be provided to healthcare workers dealing with patient mistreatment. Displaced aggression by patients attenuates the positive effects of patient mistreatment on the emotional exhaustion of healthcare workers. Our findings reveal the mechanism and boundary conditions of patient mistreatment affecting healthcare workers' service performance and patient-oriented organizational citizenship behavior.

Employment relationships of Chinese expatriates: A multi-foci perspective of psychological contract

Introduction

Research into expatriation has made a great contribution to the understanding of issues surrounding international human resource management. However, academic discussion around the subject of expatriate management remains Western-centred, neglecting the use of expatriate staffing in multinational corporations (MNCs) from Eastern countries. By adopting a multi-foci perspective of the psychological contract, the overall objective of this research is to explore the content of Chinese expatriates' psychological contracts.

Methods

This paper draws on the findings of an organisational case study and is based on semi-structured interviews with 14 expatriates.

Results

The findings provide evidence that individuals have multiple simultaneous psychological contracts, each with a different focus. The contracts held by the Chinese expatriates in this sample contain predominately balanced contract beliefs, which contrast sharply to what the other authors find to be salient beliefs (e.g., transactional contract beliefs) for expatriates based on Western samples. Importantly, the most frequently listed exchange partners by the pre-departure expatriates were line managers and department managers in headquarters; individuals appreciate the respective role of each party in shaping their aspects of work conditions whilst acknowledging the simultaneous existence of such influences.

Discussion

This paper has implications for expatriate management in the following ways. First, managers are encouraged to appreciate the role of multiple parties in shaping expatriates' psychological contracts. This helps to enhance management's understanding on the motives and demands of those expatriates. Second, policies of support and contact would aid feelings of integration. Finally, more attention should be paid to planning expatriate career prospects.

Psychological Contract Breach and Outcomes: A Systematic Review of Reviews

A psychological contract is a set of individual beliefs that a person has about the reciprocal obligations and benefits established in an exchange relationship, such as an employment relationship in an organizational setting. A psychological contract breach is a subjective experience referred to the perception of one of the parties that the other has failed to adequately fulfill its obligations and promises. Breaches have been systematically connected to employees' attitudes and behaviors that hamper the employment relationship. Despite its apparent clarity, some relevant topics about psychological contract breach, psychological contract fulfillment and the relationships with their consequences still remain unclear. The main objective of this review of reviews is to conduct a review of reviews on psychological contract breaches, considering both systematic reviews and metanalytical papers with the purpose of synthesizing the evidence to date under the psychological contract theory. Using the SPIDER tool, our systematic review of reviews focuses on: (a) Sample; (b) Phenomenon of Interest; (c) Design; (d) Evaluation; and (e) Research type. Finally, only eight systematic reviews and meta-analyses met the inclusion criteria. Of the eight reviews included, seven were meta-analyses while the other was a systematic quantitative review. This study describes the available empirical research on psychological contract breaches and fulfillment and summarizes the meta-analytical evidence on their relationships with attitudinal and behavioral outcomes, as well as the role of potential moderator variables. Due to the methodological caveats of the reviews themselves and of the primary studies they were based on, our conclusions about the impact of psychological contract breaches on outcomes still remain tentative.