Association between Workplace Bullying, Job Stress, and Professional Quality of Life in Nurses: A Systematic Review and Meta-Analysis

Bullying experience among Nigerian physiotherapists: Prevalence and impact on workplace performance

Objectives

Bullying in physiotherapy education and practice is a significant issue that has received limited attention in the literature. This study assessed the prevalence and impact of bullying experiences on work performance among Nigerian physiotherapists, while also identifying the sociodemographic factors associated with these bullying experiences.

Methods

Ninety-seven physiotherapists from six purposively selected federal hospitals in South-West Nigeria participated in this study. An educational pamphlet was initially provided to consenting respondents to clarify the concept of bullying as a psychosocial construct. Subsequently, bullying experiences and their impact on work performance were assessed using validated self-administered questionnaires. Data on sociodemographic and work characteristics of the respondents were also collected.

Results

The study found a 40.2 % prevalence of bullying experiences. Of those affected, 51.3 % experienced vertical bullying, 12.8 % lateral bullying, and 35.9 % both forms. Vertical bullying was primarily perpetrated by chief medical directors (15.8 %), consultants (15.8 %), and medical officers (31.6 %). Bullying experiences were associated with negative work performance (40.2 %) and poor teamwork with other health professionals (61.6 %). There was a significant association between the level of bullying experience and work performance (χ2 = 84.718, p = 0.001).

Conclusions

Nigerian physiotherapists experience a high prevalence of lateral and vertical bullying, which negatively impacts their work performance and relationships with other healthcare providers. Addressing this issue is crucial for a healthier work environment and better professional interactions.

The prevalence of workplace violence toward psychiatric nurses in Saudi Arabia and its effect on their quality of life

Background

Workplace violence is a significant cause of work-related stress in nursing, affecting job performance and satisfaction and increasing burnout risk. This study aims to evaluate the prevalence of verbal and physical violence against psychiatric nurses and its impact on their quality of life.

Methods

This cross-sectional study was conducted from April to October 2024. A sample of 171 nurses was selected using a convenience sampling method. The study was carried out at Eradah Complex for Mental Health in Arar City, Eradah Hospital for Mental Health in Al Jouf City, and Mental Health Hospital in Al Qurayyat City. The authors evaluated workplace violence and quality of life among nurses using a questionnaire-based interview and a 36-item quality of life assessment tool. Statistical analysis was performed using SPSS version 25.

Results

The participants' mean age was 34.85 ± 4.74 years, 67.8% were male, and 52.7% had over 10 years of experience. The overall prevalence of workplace violence was found to be 100%, with 62% exposed to verbal violence and 38% to physical violence. Regarding quality of life, 66% had an average quality of life, 12.9% had a good quality of life, and 21.1% had a poor quality of life. Statistically significant associations were found between the type of violence and quality of life (P-value < 0.05).

Conclusion

The study found significant levels of verbal and physical workplace violence among psychiatric nurses, with a significant correlation between violence and their quality of life. These results highlight the need for targeted interventions, including training programs, improved workplace safety policies, and continuous monitoring to support nurse well-being and job satisfaction.

Strategies to support the mental health and well-being of health and care workforce: a rapid review of reviews

Background

Countries globally face challenges in educating, employing and retaining their health and care workforce, largely due to underinvestment in health systems. Health and care workforce report significantly greater levels of job-related burnout and mental health problems, which in turn are associated with poorer patient outcomes, increased medical errors, diminished quality and safety, decreased patient satisfaction, and reduced healthcare efficiency.

Objective

We conducted a rapid review of systematic reviews to evaluate the mental health and well-being of health and care workers since the onset of the COVID-19 pandemic and to identify interventions available at organizational and individual levels.

Methods

PubMed and Epistemonikos were searched for systematic reviews published between May 2022 and February 2024. The inclusion criteria were systematic reviews written in English with quantitative design, with or without meta-analysis.

Results

Fifty articles met the criteria for inclusion in the analysis. Overall, there has not been a significant change in the prevalence of depression and anxiety among health and care workforce since 2022, suggesting the impact of the COVID-19 pandemic on workers' mental health and well-being was not specific to their experience working during the pandemic. Sixteen studies reported two types of mental health and well-being interventions: individual-level interventions and organizational-level interventions with specific impact on mental health and work environment variables. No specific policy interventions were found. However, some studies suggested policy interventions to improve the mental health and well-being of the health and care workforce.

Discussion

Our analysis highlighted the need for systemic changes to protect the mental health and well-being of the health and care workforce in the post-COVID-19 era. Despite the wealth of evidence on mental health problems and on effective interventions, there remains a notable gap in systemic implementation and organizational accountability. The call to action for a paradigm shift must be embraced and we must strive to build resilient healthcare systems and invest in active support and sustain them, incorporating structural, non-structural and functional aspects of organizational resilience.

Resilience and Social Support Protect Nurses from Anxiety and Depressive Symptoms: Evidence from a Cross-Sectional Study in the Post-COVID-19 Era

Background: Nurses experience high levels of anxiety and depression since they work in a highly stressful environment. Thus, the identification of preventive factors against nurses' anxiety and depression is essential to improve their quality of life. In this context, our aim was to examine the impact of resilience and social support on nurses' anxiety and depressive symptoms. Methods: A cross-sectional online study was implemented in Greece in September 2024. We used the Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, and Patient Health Questionnaire-4 to measure resilience, social support, anxiety, and depressive symptoms, respectively. Results: Our sample included 677 nurses with a mean age of 37.73 years (standard deviation: 9.38). Our multivariable linear regression models identified a negative relationship between resilience and anxiety (adjusted standardized beta coefficient =-0.38; p < 0.001) and depressive symptoms (adjusted standardized beta coefficient = -0.36; p < 0.001). Similarly, we found that significant others' support was associated with reduced anxiety (adjusted standardized beta coefficient = -0.27; p < 0.001) and depressive symptoms (adjusted standardized beta coefficient = -0.23; p < 0.001). The standardized beta coefficient indicated that resilience has a greater impact on anxiety and depressive symptoms than significant others' support. Conclusions: Our findings suggest resilience and social support have a protective function against nurses' anxiety and depressive symptoms. Managers and policymakers should adopt appropriate interventions to improve nurses' resilience and social support and, thus, to improve their mental health and quality of life.

Psychosocial challenges of Ukrainian healthcare professionals in wartime: Addressing the need for management support

BACKGROUND

The Russian-Ukrainian war has placed healthcare professionals (HPs) in Ukraine in a position of heightened responsibility and vulnerability. This study aimed to evaluate HPs' perceptions of the war's impact on their work, their expectations regarding management recognition of their situation, and to assess levels of psychological safety and incidents of bullying within their teams.

METHODS

Two open-ended questions were used to explore HP's perceptions of the war's impact on their work and their expectations from management. Psychological safety and bullying were assessed using the Safety Attitude Questionnaire-Short Form (SAQ-SF) and Negative Act Questionnaire-Revised (NAQ-R).

RESULTS

1,442 HPs participated in the study. A total of 70% reported a negative impact of the war on their work. The most expressed needs were for increased financial, moral, and emotional support from medical managers. While the majority of HPs did not report experiences of bullying, 13.1% reported frequent occurrences. Based on the SAQ-SF, job satisfaction was generally high, whereas stress recognition was low.

CONCLUSION

Despite the harrowing conditions of the war in Ukraine, HPs show extraordinary commitment to their profession and experience high levels of job satisfaction. However, there is an unmet need for increased moral and emotional support from medical leaders and financial assistance to counter the increase in cost of living, as these are the most pressing issues for HPs. Overall, these results suggest that the role of the management in addressing these challenges to improve psychological safety may be essential.

Tracking Workplace Violence over 20 Years

Introduction. Violence against healthcare workers (HCWs) is a widespread, underreported, and inadequately prevented problem. Only a few companies have efficient systems for assessing the extent of the phenomenon. Methods. In 2005, the health surveillance service of a public health company introduced a system that monitored violence experienced by HCWs by means of three items from the Violent Incident Form (VIF) integrated with departmental in-depth analyses using the participatory ergonomics group technique. Results. In 2005, the annual rate of physical assaults was 8.2%, that of threats was 12.0%, and the harassment rate was 19.6%. Over the past twenty years of observation (2005-2024), the percentage of workers who reported experiencing a physical attack in the previous year at their periodic medical examination has fluctuated between 5.8% and 11.1%, except for the years 2020 and 2021 when, during the COVID-19 pandemic, the rate was 3.9% and 3.2%, respectively. During the same pandemic period, the annual threat rate, which ranged from 9.4% to 20.1%, dropped to 7.7%, while the prevalence of harassment, which was between 13.5 and 19.6, fell to 7.2%. HCWs believe that (i) limiting visitor access, (ii) a better balance of the demand for services, and (iii) a better attitude towards HCWs were the causes of the reduced rate of violence during the pandemic. Conclusions. Recording the violence experienced during health surveillance is an economical, reliable, and sustainable risk assessment method.

The Effect of Ethical Leadership on Nurse Bullying, Burnout, and Turnover Intentions

The bullying of nurses by patients, doctors, and employees is common in the healthcare industry. Nurses who are bullied are more likely to experience burnout, and nurses who experience burnout are more likely to intend to quit. However, few studies investigate how leadership can mitigate workplace incivility and nurse bullying as a way to improve nurse retention. A cross-sectional study was conducted using a sample of 216 nurses recruited from various regions across the United States from different specialties. A moderated mediation model using path analysis was used to examine the relationships between bullying, burnout, and ethical leadership in predicting intentions to stay. Bullying significantly and positively related to burnout (β = 0.22, p=0.02), and burnout significantly and negatively related to intent to stay (β = -0.18,p=0.01). Perceived ethical leadership predicted intentions to stay (β = 0.62, p=0.00), and ethical leadership moderated the effect of bullying on burnout (β = 0.20, p=0.03). The results of our study also suggest that nurses are less likely to quit when ethical leadership is present, and ethical leadership weakens the effect of bullying on burnout.

Bullying Behaviors and Stress (Acute and Perceived) among Undergraduate Nursing and Midwifery Students: The Moderating Role of Gender and Academic Majors

BACKGROUND

Nursing and midwifery professionals' well-being may be affected by various factors, including the bullying of new nurses.

PURPOSE

To analyze the relationship between bullying behaviors, perceived stress, and acute stress among undergraduate nursing and midwifery students in Saudi Arabia, as well as the moderating role of gender and academic majors in this relationship.

METHOD

A cross-sectional correlation design was used, and data were collected from 322 undergraduate nursing and midwifery students enrolled in four major nursing universities in Saudi Arabia.

RESULTS

Educational level, environment, and personal attacks had a significant negative impact on perceived and acute stress (social and non-social), while hostility toward academic achievement and direct negative behaviors had significant positive impacts on perceived and acute stress (social and non-social). Female nursing students reported a stronger impact of bullying behavior on their perceived stress, while male students reported a greater impact on social and non-social stress. Nursing students reported a stronger impact of bullying on perceived stress, while midwifery students reported a greater impact on social and non-social stress.

DISCUSSION

Nursing educators should raise awareness about the harmful effects of bullying and emphasize the importance of creating a safe, supportive learning environment.

Impact of Workplace Bullying on Nursing Care Quality: A Comprehensive Review

Workplace bullying, commonly known as mobbing, persists as a significant problem across various industries, including the healthcare sector. To establish effective interventions and protocols for enhancing the well-being of healthcare workers and patients, it is vital to fully grasp the link between workplace bullying and the quality of nursing care. The analysis highlights the complex link between workplace bullying and nursing care quality, stressing the urgency of addressing this issue due to its wide-reaching impact on individuals and healthcare organizations, ultimately affecting patient safety. Emphasizing the significance of addressing workplace bullying across different professional settings is crucial for protecting the mental health and well-being of employees. The research identifies various forms of aggression and emphasizes the need to understand how these behaviors affect patient outcomes. Further investigation is needed to clarify nurses' responses to workplace violence, particularly in specialized settings like mental health facilities. The studies underscore the numerous challenges nurses encounter when trying to report incidents of workplace bullying. This insight is vital for developing effective reporting mechanisms and targeted interventions to combat bullying behaviors in medical environments. Ultimately, establishing a safer working environment for nurses is paramount. This article aims to review the associations between workplace bullying and the quality of nursing care.

Impact of workplace bullying on job burnout and turnover intention among nursing staff in Greece: Evidence after the COVID-19 pandemic

Introduction

The prevalence of workplace bullying, job burnout, and turnover intention among nursing staff increased during the COVID-19 pandemic. However, to the best of our knowledge, there are no studies that have measured the relationships among variables of interest after the pandemic.

Objective

Our intention is to investigate the effect of workplace bullying on job burnout and turnover intention in nursing staff.

Methods

We conducted a cross-sectional study during January-February 2024 in Greece. We obtained a convenience sample of 450 nurses. We used the 22-item Negative Acts Questionnaire-Revised to assess workplace bullying. We measured job burnout with the single-item burnout measure. We measured nurses' turnover intention with a valid 6-point Likert scale.

Results

The study sample included 450 nurses with the mean age of 39.1 years (standard deviation [SD] = 10.2). The mean workplace bullying score was 7.7 (SD = 2.0), while the mean job burnout score was 7.7 (SD = 2.0). Among our nurses, 57.3% showed a high level of turnover intention. After eliminating confounders, we found that increased workplace bullying (adjusted beta = 0.031, 95% confidence interval [CI] = 0.023 to 0.039, p < 0.001) was associated with increased job burnout. Moreover, multivariable logistic regression analysis showed that increased turnover intention was more common among nurses who experienced higher levels of workplace bullying (adjusted odds ratio = 1.057, 95% CI = 1.043 to 1.071, p < 0.001).

Conclusion

We found a positive relationship between workplace bullying, job burnout, and turnover intention. Nurse managers, organizations, and policy-makers ought to consider such findings to intervene and decrease workplace bullying by improving working conditions.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Exploring Work-Related Experiences of Newly Hired Hospital Nurses in Ghana: A Qualitative Study

Introduction

Early work-related experiences of newly hired employees can have important implications for their work performance over time and their future health and well-being trajectories. In health care work, such outcomes may hold implications for the services delivered and the patients whose lives depend on them.

Objectives

This study was conducted to explore the work-related experiences of newly hired hospital nurses in Ghana.

Methods

Using qualitative methods, thirty-six (36) newly hired nurses in three (3) hospitals in the Eastern Region of Ghana were purposively sampled and interviewed. Thematic network analyses were applied to the data collected.

Results

Five main themes emerged which summarized the experiences of the nurses. The themes indicated that newly hired nurses experienced the nursing profession as stressful and yet fulfilling, different from their preentry expectations with multiple sources of stressors and resources. Religion and faith, family support, and a perceived lack of suitable alternative sources of income emerged as the main motivators of the intention to stay.

Conclusion

The findings suggest a highly stressful and quite unpredictable work environment for newly hired nurses. Despite this, they are determined to stay on the job. Employee assistance programs that have specialized components targeted at providing emotional and psychosocial assistance to newly hired nurses are recommended.