The overall fractions of coronary heart diseases and depression attributable to multiple dependent psychosocial work factors in Europe

OBJECTIVES

The literature is nonexistent on the assessment of overall fractions of diseases attributable to multiple dependent psychosocial work factors. The objectives of the study were to calculate the overall fractions of coronary heart diseases (CHD) and depression attributable to multiple dependent psychosocial work factors in 35 European countries.

METHODS

We used already published fractions of CHD and depression attributable to each of the following psychosocial work factors: job strain, effort-reward imbalance, job insecurity, long working hours, and workplace bullying. We took all exposures and their correlations into account to calculate overall attributable fractions. Wald tests were performed to test differences in these overall attributable fractions between genders and between countries.

RESULTS

The overall fractions of CHD and depression attributable to all studied psychosocial work factors together were found to be 8.1% [95% CI: 2.0-13.9] and 26.3% [95% CI: 16.2-35.5] respectively in the 35 European countries. There was no difference between genders and between countries.

CONCLUSION

Our study showed that the overall fractions attributable to all studied psychosocial work factors were substantial especially for depression. These overall attributable fractions may be particularly useful to evaluate the burden and costs attributable to psychosocial work factors, and also to inform policies makers at European level.

Personality traits and workplace bullying among contract trainee doctors in Malaysia

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.

How tyrannical leadership relates to workplace bullying and turnover intention over time: The role of coworker support

INTRODUCTION

In light of the deleterious consequences associated with workplace bullying, it is important to identify the work-related factors that can contribute to the presence of bullying behaviors over time. Up to now, most research on the topic has investigated job characteristics (presence of job demands, absence of job resources) as contributing factors of workplace bullying. Given the key role leadership plays in shaping employees' work environment, this study aims to better understand how harmful forms of leadership relate to bullying behaviors over time and, subsequently, to employee functioning.

METHODS

More specifically, this longitudinal study (two data collections over a 3-month period) conducted among a sample of Canadian employees (T1 n = 600, T2 n = 422) assesses the temporal relationship between tyrannical leadership, exposure to bullying behaviors, and turnover intention, as well as the moderating role of perceived coworker support in the relationship between tyrannical leadership and bullying behaviors.

RESULTS

Results from cross-lagged analyses show that, controlling for baseline effects, T1 tyrannical leadership positively predicts T2 exposure to bullying behaviors and that T1 bullying behaviors positively predict T2 turnover intention. T1 coworker support did not significantly buffer the relationship between T1 tyrannical leadership and T2 exposure to bullying behaviors, although it did significantly predict, negatively so, T2 turnover intention.

CONCLUSION

The present study provides valuable insight into the social contextual determinants of bullying behaviors and highlights the destructive nature of tyrannical leadership. Furthermore, this study illustrates the importance of fostering supportive behaviors between colleagues, as this important social resource can play a key role in reducing turnover intention over time.

The mediating role of coping styles between nurses' workplace bullying and professional quality of life

AIMS

This study aimed to explore the relationship between workplace bullying among nurses and their professional quality of life, as well as the mediating role of coping styles between the two factors.

BACKGROUND

In China, the overall status of nurses' professional quality of life is not optimistic, and the problems of low compassion satisfaction and high compassion fatigue persist. Workplace bullying, which is a serious global issue, can negatively impact the mental health and professional quality of nurses. However, it has still not attracted enough attention from managers.

METHODS

The study used a cross-sectional research design and surveyed 297 clinical nurses from two tertiary grade A hospitals in Wuhan, China. Data were collected through an online questionnaire survey from March to May 2022. The data were analyzed using descriptive statistical methods, including Pearson correlation analysis and structural equation modeling.

RESULTS

The score for nurses' workplace bullying was 38.72 ± 12.30. The scores for the three dimensions of professional quality of life were 27.56 ± 4.79 for compassion satisfaction, 30.51 ± 4.33 for burnout, and 28.47 ± 4.65 for secondary trauma stress. The scores for positive coping style and negative coping style were 34.59 ± 5.72 and 20.34 ± 5.08 points, respectively. Workplace bullying had a direct negative effect on compassion satisfaction, as well as positive direct effects on burnout and secondary traumatic stress. Coping styles played a mediating effect between workplace bullying and the pairwise relationships of compassion satisfaction, burnout, and secondary trauma stress.

CONCLUSION

Workplace bullying hurts nurses' professional quality of life while coping styles plays an mediating role between workplace bullying and professional quality of life. Nursing managers can improve nurses' professional quality of life by reducing workplace bullying and enhancing positive coping style.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers can employ management wisdom and techniques to mitigate the presence and detrimental effects of workplace bullying. This, in turn, promotes a positive work environment and enhances the professional quality of life for nurses.

The effect of workplace bullying on fatigue in school teachers: the moderating roles of gender and spirituality

Workplace bullying is quite prevalent and has been linked to many health complaints. The relationship between workplace bullying and fatigue was documented in previous studies. However, knowledge on how this relationship develops with the interplaying factors of spirituality and gender was not investigated before especially among schoolteachers. The aim of this study is to explore the relationship between workplace bullying and fatigue as moderated by spirituality and gender among schoolteachers in Lebanon. This is a cross-sectional study, where 215 schoolteachers aged 18 till 64 and employed for a minimum of 6 months were recruited through systematic sampling. Six private and six public schools in Beirut participated in the study. Online questionnaires using validated scales were used. Both simple and multiple ordinal logistic regression were performed for the statistical analysis. Results showed that workplace bullying is a predictor of fatigue with an odds ratio of 2.74 and p-value 0.008. Gender was found to be an effect modifier for this relationship, mainly among females (OR 2.66, p-value 0.047) but not among males. Anxiety and depression also predicted higher levels of fatigue (OR 5.75, p-value 0.017). Spirituality did not moderate this relationship.

Workplace bullying in pharmacy - a study on prevalence, impacts and barriers to reporting

PURPOSE

The study aims to estimate the prevalence of workplace bullying, personal and work-related impacts, reporting practices for bullying, and the reasons for not reporting bullying incidents in the New Zealand pharmacy sector.

DESIGN/METHODOLOGY/APPROACH

An online survey was conducted among registered pharmacists and pharmacist interns in New Zealand from June to August 2020. The questionnaire comprises both close-ended and semi-structured free-text questions. Goldberg's 12-item General Health Questionnaire (GHQ-12) assessed the respondents' general psychological health status, and a 22-item Negative Acts Questionnaire-Revised (NAQ-R) was used to estimate bullying prevalence together with the self-rated/self-labeled questions. The qualitative information obtained from the free-text responses was used to support and elaborate on the quantitative results.

FINDINGS

The self-labeled prevalence of workplace bullying was 36.9%, with almost 10% reporting it occurring almost daily to several times per week. The 54.7% prevalence based on the NAQ-R assessment compares well with the prevalence of witnessing the incidents (58.5%). Psychological distress symptoms were experienced by 37.1% in pre-COVID and 45.3% during COVID-year 1. Supervisors or direct managers were the commonest perpetrators (32.7%). Only 28.8% of those who experienced bullying had reported the incidents formally.

RESEARCH LIMITATIONS/IMPLICATIONS

This study is cross-sectional, and the relationships indicated are bi-directional. The consistency of the results is reassuring, however inferring causality of effect is challenging. Future studies and analyses should focus on this. This study suggests that in the pharmacy environment bullying from the top is reasonably prevalent, is not commonly reported and requires the design and implementation of prevention and management strategies that take into account and mitigate these bullying factors. Professional pharmacy leadership organizations, National Health Authority and Pharmacy regulators could play a significant role in awareness and training to reduce bullying with the development and promotion of strategies to curb it and improve reporting.

ORIGINALITY/VALUE

This is the first paper to describe the prevalence and impact of workplace bullying, and the practices of reporting bullying incidents in the New Zealand pharmacy sector. Based on empirical evidence, pharmacists represent a small share of total healthcare workforce, yet the overall prevalence of bullying is consistent with professions with much larger numbers such as medicine and nursing.

The mediating role of organizational commitment between workplace bullying and turnover intention among clinical nurses in China: a cross-sectional study

BACKGROUND

Workplace bullying experienced by clinical nurses is a critical and pervasive issue that not only detrimentally impacts nurses but also poses a significant threat to the overall quality of nursing services and patient care. This study aimed to determine the mediating role of organizational commitment in the relationship between workplace bullying and turnover intention among clinical nurses in China.

METHODS

Participants were recruited from 40 hospitals in various provinces of China from December 2, 2021 to February 25, 2023, using convenience sampling. After obtaining hospital ethical approval and participants' informed consent, clinical nurses (n = 585) from different nursing departments in different hospitals completed the questionnaire. The Socio-demographic Questionnaire, Negative Acts Qestionnaire, Chinese Workers' Organizational Commitment Scale and Turnover Intention Questionnaire were used to collect general demographic data of nurses and assess workplace bullying they experienced, their level of organizational commitment and turnover intention. Descriptive statistics, Pearson correlation analyses and structural equation model were adopted to analyze the data.

RESULTS

Pearson's correlation analysis showed that that workplace bullying was significantly negatively correlated with organizational commitment (r = - 0.512, P<0.01) and significantly positively correlated with turnover intention (r = 0.558, P<0.01), organizational commitment was significantly negatively correlated with turnover intention (r = - 0.539, P<0.01). Mediation analysis indicated organizational commitment partially mediated the association between workplace bullying and turnover intention. The total effect (β = 0.69) of workplace bullying on turnover intention consisted of its direct effect (β = 0.41) and the indirect effect mediated through organizational commitment (β = 0.280), with the mediating effect accounting for 40.58% of the total effect.

CONCLUSION

Organizational commitment mediated the associations of workplace bullying and turnover intention. Therefore, healthcare organizations and nursing managers should develop appropriate strategies to enhance nurses' organizational commitment in order to reduce their turnover intention.

Magnitude and Impact of Workplace Violence Against Obstetric Healthcare Personnel: A Multicentre Cross-Sectional Study

Background

Workplace violence is defined by the World Health Organization (WHO) as incidents where staff is abused, threatened or assaulted in work settings. In emergency predominated branch like obstetrics, there is a need to study the magnitude and impact of violence against healthcare workers (HCW). Materials and Methodology: This cross-sectional study was conducted in the Department of Obstetrics at 2 centres in Lucknow district, for a period of 6 months. The study population included trainee residents, senior residents, nursing staff and consultants. Standard definitions from the WHO were used to define the types of violence. The validated questionnaire was designed in English with 25 questions to understand the incidence of workplace violence, prevention policy, reporting and follow-ups of incidents and impact of violence.

Results

With a response rate of 90%, 274 HCW participated in the study. In total, 172 HCW (62.7%) either faced physical or verbal assault. In 70% of incidents, patient, their relatives or public were perpetrators of violence, and the rest 30% incidents were by colleagues or management. Majority of the incidents were in emergency areas. Only 22% of the abused reported to the concerned authorities. At least 123 (71.5%) HCW were extremely dissatisfied with the action taken. Action was taken against only 9.8% of the perpetrators. None of the respondents received any training to handle workplace violence.

Conclusion

There is an alarming high prevalence of workplace violence by patients and colleagues. Adequate training to handle these incidents, improvement of working environment and unconditional support from management will bring a positive work experience.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13224-023-01809-0.

Workplace bullying and suicidal ideation and behaviour: a systematic review and meta-analysis

OBJECTIVES

Suicidal ideation and behaviour are potential outcomes of workplace bullying. This review aimed to determine the extent of the association between workplace bullying and suicidal ideation and behaviour.

STUDY DESIGN

The study incorporated a systematic review and meta-analysis.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed to conduct a comprehensive systematic review and meta-analysis. A combination of subject terms and free words was used to search nine electronic databases. Two reviewers independently screened articles and extracted information according to the inclusion criteria. A meta-analysis was performed with averaged weighted correlations across samples using the STATA software (version 16.0) from pooled estimates of the main results from all studies.

RESULTS

In total, 25 articles of high or medium quality were included in the systematic review; 15 of these were included in the meta-analysis. The prevalence of suicidal ideation and behaviour was 18% and 4%, respectively. Individuals who experienced workplace bullying had 2.03-times and 2.67-times higher odds of reporting suicidal ideation and behaviour, respectively, after adjustment for confounding factors. Moderating and mediating factors may help reduce the risk of suicidal ideation and behaviour for individuals experiencing workplace bullying.

CONCLUSION

This study indicated that exposure to workplace bullying significantly increased the risk of suicidal ideation and behaviour.

Effects of chronic workplace harassment on mental health and alcohol misuse: a long-term follow-up

BACKGROUND

Research on the impacts of exposure to workplace harassment (WH) is largely cross-sectional, and existing prospective studies generally are between two and five years of follow-up, with the longest US study being 10 years. However, the effects of exposure to WH may persist longer, particularly if exposure has been chronic. This study fills this gap by examining effects of prior exposure to chronic sexual and generalized WH on psychological distress and alcohol misuse over an approximately 25 year study period.

METHODS

Individuals originally recruited from a university-employed sample in the United States were surveyed at 8 time points from 1996-2007 and again in 2020-2021. A series of hybrid path analyses were tested on a sample of 2352 individuals, regressing recent outcomes on latent classes of harassment derived from earlier survey waves, controlling baseline outcomes and demographics. Model fit was assessed using a variety of fit statistics, and standardized regression coefficients were used to assess significance of individual pathways.

RESULTS

Prior exposure to chronic sexual harassment had significant direct associations with psychological distress, alcohol misuse, and recent stressors at follow-up. Prior exposure to chronic generalized harassment had significant direct associations with lower income and alcohol misuse. Both forms of WH were significantly indirectly associated with psychological distress through recent stressors at follow-up.

CONCLUSIONS

Exposure to chronic WH is associated with long-term effects on psychological distress and alcohol misuse in a sample representing a wide variety of job types and racial/ethnic identities. Enforcement of anti-sexual harassment law and policies and enactment of policies and laws to prevent generalized harassment/workplace bullying are imperative for the protection of worker health.

Associations of Workplace Violence With Cardiovascular Disease Among United States Workers: Findings From a National Survey

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.

Workplace Bullying in Pathology and Laboratory Medicine

OBJECTIVES

The specific aims of the study are to explore the prevalence of workplace bullying and to understand the impact of bullying on individual wellness in order to facilitate the development of future organizational solutions to mitigate workplace incivility.

METHODS

Cross-sectional data were collected via a web-based survey to gather exploratory demographic information and to assess the relationships between intensity of the exposure to the negative acts with laboratory productivity. Associations between laboratories offering resources to employees and their impacts on productivity and professional job fulfillment were also explored.

RESULTS

Results of the survey showed that over two-thirds of laboratorians (68.56%) were classified as victims of workplace bullying, and the perpetrator is most likely a peer of the victim (55.3%). The study revealed the intensity of workplace incivility was positively correlated with the number of sick days taken by the laboratory practitioner (F(2, 217) = 24.245, P < .001). Facilities with a supportive work environment were also associated with a reduction in the number of sick mental days taken (P < .001), a proxy for improved work and health outcomes.

CONCLUSIONS

The results of this study shed light on the prevalence of incivility at the workplace and offer evidence on the importance of providing a supportive work environment toward reducing workplace bullying.

How are witnessed workplace bullying and bystander roles related to perceived care quality, work engagement, and turnover intentions in the healthcare sector? A longitudinal study

BACKGROUND

Workplace bullying is widespread in the healthcare sector and the negative effects are well known. However, less attention has been paid to bystanders who witness bullying in the workplace. Bystanders can affect the bullying process by engaging in active, passive, or destructive behaviors. There is a need to study work-related and organizational consequences of witnessing bullying and bystander behaviors.

OBJECTIVE

The aim was to explore how witnessed workplace bullying and bystander behaviors are associated with work-related and organizational consequences, such as perceived quality of care, work engagement, and turnover intentions, among healthcare workers over time.

DESIGN

Longitudinal design. An online questionnaire was administered twice over the course of six months.

SETTING(S)

Employees in the healthcare sector in Sweden, such as physicians, nurses, and assistant nurses, responded to the questionnaire.

PARTICIPANTS

1144 participants provided longitudinal data.

METHODS

Structural equation modeling was used to explore the associations between witnessed bullying, bystander behavior, work-related and organizational factors over time.

RESULTS

Witnessed workplace bullying (B = -0.18, 95 % CI [-0.23 to -0.12]) and the bystander outsider role (B = -0.24, 95 % CI [-0.29 to -0.19]) were statistically significantly related to a decrease in perceived quality of care. Work engagement was statistically significantly predicted by all three bystander roles over time; positively by the defender role (B = 0.11, 95 % CI [0.05-0.17]), and negatively by the outsider role (B = -0.23, 95 % CI [-0.29 to -0.16]), and the assistant role (B = -0.32, 95 % CI [-0.41 to -0.24]). The outsider role (B = 0.12, 95 % CI [0.02-0.22]), the assistant role (B = 0.17, 95 % CI [0.03-0.30]), and witnessed workplace bullying (B = 0.18, 95 % CI [0.08-0.29]), all positively predicted increased turnover intentions at a subsequent time point.

CONCLUSIONS

In addition to the direct negative impact workplace bullying has on those targeted by it, witnessing bullying and taking different bystander roles can have work-related and organizational consequences by influencing perceived care quality, employees' work engagement, and their intention to leave the organization.

The prevalence and mental health correlates of exposure to offensive behaviours at work in Hungary: results of a national representative survey

BACKGROUND

Within the last decades, a substantial number of reports have established bullying behaviours as a severe risk to the health and safety of workers. However, in Hungary, the severity of this issue remains largely unknown. Therefore, the current study aimed to 1) determine the prevalence of offensive workplace behaviours in the Hungarian working population and 2) examine the relationship between exposure to these offensive behaviours and certain mental health indicators.

METHODS

The cross-sectional analyses of the present study are based on a sample of 13,104 active workers being representative of the Hungarian working population according to gender, age, educational level, and 18 occupational sectors. The mid-length version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) was used to measure workplace offensive behaviours (bullying, sexual harassment, threats of violence, and physical violence) in the 12 months preceding the survey. Examined mental health correlates included depressive symptomatology (Beck Depression Inventory), functional somatic symptoms (PHQ-15), perceived stress (Perceived Stress Scale), and general well-being (WHO Well-being Index).

RESULTS

Almost half (48.7%) of the sample reported exposure to some form of offensive behaviour; 37.6% of participants reported occasional-, while 11.1% reported weekly or daily exposure. More women than men were exposed to offensive workplace behaviours, and those targeted the most were individuals aged 18-29 and in companies employing 20-49 employees. Top managers reported the lowest amount of bullying, while unskilled labourers reported the most frequent exposure. A moderately strong relationship was discovered between exposure to workplace offensive behaviours and all indicators of mental health.

CONCLUSION

Workplace bullying was revealed to be a significant public health concern according to this large, representative data set from Hungary. Strategies to reduce the occurrence and impact of these behaviours on employee health should be a priority for occupational health and safety interventions.

Study of the variation of the 12-month prevalence of exposure to workplace bullying across national French working population subgroups

OBJECTIVES

The studies are lacking on the variation of the prevalence of exposure to workplace bullying according to subgroups of national working populations. The objectives were to assess the 12-month prevalence of bullying in the national French working population, to describe the reported reasons for bullying, and to study its variation according to various employment variables.

METHODS

The study was based on the data of the 2013 national French working conditions survey. The study sample included 25,769 employees aged 15-65 working in the same job within the last 12 months. The 12-month prevalence of bullying was assessed using a 9-item questionnaire. Employment variables included: occupation, economic activity of the company, public/private sector, company size, permanent/temporary work contract, and full/part-time work. The analyses were performed using statistical methods for weighted survey data.

RESULTS

The 12-month prevalence of bullying was 26.7% and 28.7% for men and women, respectively. The most prevalent forms of bullying were criticisms, exclusion, and deprivation of right of expression. The leading reasons for being bullied were related to occupation, age, and gender. The prevalence of bullying was higher among the younger employees, the employees working in medium/large companies (including the public sector), and among employees working full time. Though significant, the variations according to occupations and economic activities of the company were small.

CONCLUSION

Workplace bullying appeared as a widespread phenomenon in France. More attention should be given to young employees and the employees working in medium/large companies. Preventive measures should also target the whole working population comprehensively.

Prediction of bullying at work: A data-driven analysis of the Finnish public sector cohort study

AIM

To determine the extent to which change in (i.e., start and end of) workplace bullying can be predicted by employee responses to standard workplace surveys.

METHODS

Responses to an 87-item survey from 48,537 Finnish public sector employees at T1 (2017-2018) and T2 (2019-2020) were analyzed with least-absolute-shrinkage-and-selection-operator (LASSO) regression. The predictors were modelled both at the individual- and the work unit level. Outcomes included both the start and the end of bullying. Predictive performance was evaluated with C-indices and density plots.

RESULTS

The model with best predictive ability predicted the start of bullying with individual-level predictors, had a C-index of 0.68 and included 25 variables, of which 6 remained in a more parsimonious model: discrimination at work unit, unreasonably high workload, threat that some work tasks will be terminated, working in a work unit where everyone did not feel they are understood and accepted, having a supervisor who was not highly trusted, and a shorter time in current position. Other models performed even worse, either from the point of view of predictive performance, or practical useability.

DISCUSSION

While many bivariate associations between socioeconomic characteristics, work characteristics, leadership, team climate, and job satisfaction were observed, reliable individualized detection of individuals at risk of becoming bullied at workplace was not successful. The predictive performance of the developed risk scores was suboptimal, and we do not recommend their use as an individual-level risk prediction tool. However, they might be useful tool to inform decision-making when planning the contents of interventions to prevent bullying at an organizational level.

Assessment of workplace bullying in Italy by INAIL: forensic and occupational medicine considerations

Abstract

The Authors, after a broad examination of the operating methods of inail (National Institute for Accident Insurance at Work) for the correct assessment and indentification of workplace bullying, carried out a comparative evaluation on the various diagnostic tests in the forensic psychiatric field for this occupational problem.

Investigating Mobbing Syndrome's Incidence in the Working Environment of a Public and a Private Greek Hospital

To investigate the phenomenon of moral harassment (mobbing) as well as the effect of demographic and occupational characteristics of healthcare professionals working in a public provincial general hospital and a private hospital in Athens a cross-sectional survey was designed. The study was conducted from November to December 2021 through the application of the Leymann Inventory of Psychological Terror (LIPT) a widely recognized research tool for the quantitative investigation of ethical harassment in the workplace. 264 fully completed questionnaires were collected out of the 300 that were distributed in both hospitals (response rates: 92% for the public hospital and 83.3% for the private). It was observed that private hospital's employees were morally harassed to a greater extent and for a longer time than the employees of a public hospital. The levels of moral harassment were quite high, indicating the necessity of thorough audit by the management in both hospitals.

Do personal resilience, coping styles, and social support prevent future psychological distress when experiencing workplace bullying? Evidence from a 1-year prospective study

BACKGROUND

Although previous studies have identified that workplace bullying causes serious mental health problems to the victims, it is not yet fully investigated moderating factors on the association between workplace bullying and psychological distress. This longitudinal study, therefore, examined the moderating role of organizational resources such as supervisor support or coworker support as well as individual resources such as stress coping styles or personal resilience on the association.

METHODS

A prospective cohort study for 2036 civil servants was conducted with a one-year time lag (follow-up rate: 77.2%). At baseline, Negative Acts Questionnaire-Revised, Connor-Davidson Resilience Scale, Brief Scales for Coping Profile, and Brief Job Stress Questionnaire were used to measure workplace bullying, personal resilience, stress coping styles, and social support, respectively. Psychological distress was measured using K6 both at baseline and follow-up.

RESULTS

The results of hierarchical multiple regression analyses showed that workplace bullying was associated with subsequent increased psychological distress even after adjusting for individual and occupational characteristics, but its association disappeared after adjusting for psychological distress at baseline. After adjusting for psychological distress at baseline, greater resilience, greater seeking help, greater changing view, and lower avoidance were associated with lower subsequent psychological distress when being bullied. In contrast, worksite social support and family/friends support was not associated with lower subsequent psychological distress when being bullied. A significant interaction effect of workplace bullying and changing mood was observed on subsequent psychological distress.

CONCLUSIONS

The effects or moderating factors were limited on the longitudinal association between bullying and mental health because psychological distress at baseline was the strongest predictor of subsequent psychological distress.

Healing the wounds of workplace bullying: Evaluating mental health and workplace participation among victims seeking treatment for common mental disorders

BACKGROUND

Victims of workplace bullying represent a group characterised by severe negative health complaints at risk of losing their foothold in working life. To date, very few studies have investigated the effect of psychological treatment of the health-related problems often facing victims of bullying.

OBJECTIVE

The aim was to investigate if victims of workplace bullying suffering from common mental disorders (CMD) benefit from clinical treatment for their mental health problems at an outpatient clinic treating patients using Metacognitive or Cognitive Behavioural Therapy with work-focus. Criteria were symptom reduction and change in workplace participation. Comparisons were made between the victims of workplace bullying with CMD, a wait-list control group consisting of patients who had also been exposed to bullying yet now awaiting treatment, and other patients not exposed to bullying.

METHODS

The sample comprised of 405 patients from an outpatient clinic in Norway. The study used a naturalistic observational design and data was collected pre-treatment and post-treatment.

RESULTS

The results showed the treatment to be effective in symptom reduction for victims of bullying to a similar degree as patients otherwise not exposed to bullying. Even more, victims receiving treatment had a larger improvement compared to the wait-list control group (p < 0.001). Yet, among patients on sick leave pre-treatment, fewer victims of bullying were fully working by the end of treatment compared to the patients not exposed to workplace bullying.

CONCLUSION

The findings provide ground for optimism for this treatment as an efficient way of dealing with the aftermath of workplace bullying.

Workplace incivility as a risk factor for workplace bullying and psychological well-being: a longitudinal study of targets and bystanders in a sample of swedish engineers

BACKGROUND

The aim of the present study is to explore whether (experienced and witnessed) workplace incivility is a risk factor for (experienced and witnessed) workplace bullying. An additional aim is to explore whether experienced workplace incivility is associated with psychological well-being above and beyond the influence of (experienced and witnessed) workplace bullying on well-being.

METHODS

A survey was distributed via e-mail to a panel of Swedish engineers. The survey was administered at three time points over one year. In total, N = 1005 engineers responded to the survey. Of these, N = 341 responded to more than one survey, providing longitudinal data. N = 111 responded to all three surveys.

RESULTS

The results showed that the likelihood of being targeted by workplace bullying was higher for those who had previously experienced incivility, even when taking previous bullying exposure into account. There was also partial support for a higher likelihood of witnessing bullying at a later time point for those that had previously witnessed incivility. Additionally, the results showed that experienced workplace incivility was negatively related to psychological well-being over time, even when controlling for previous levels of experienced and witnessed workplace bullying and well-being. However, this result was only found over one of the two time lags.

CONCLUSION

The findings of the present study suggests that workplace incivility can be a risk factor for future bullying. In addition, the findings suggest that experienced workplace incivility exerts a unique negative effect on psychological well-being, even when accounting for exposure to workplace bullying.

The role of workplace bullying in the relationship between occupational burnout and turnover intentions of clinical nurses

AIM

To identify the effect of workplace bullying on the relationship between occupational burnout and turnover intentions among clinical nurses.

BACKGROUND

Recent evidence showed that a sense of burnout may cause workplace bullying; nevertheless; few studies have explored the effects of occupational burnout on workplace bullying. Furthermore, whether the experience of workplace bullying can aggregate the effect of occupational burnout on turnover intentions remains unclear.

METHODS

A cross-sectional study was conducted to recruit nursing staff from two general hospitals in Taiwan. Data measurements comprised demographic characteristics, workplace bullying (Negative Acts Questionnaire-Revised), occupational burnout (occupational burnout inventory), and turnover intentions (employee turnover intentions and job destination choice). A hierarchical linear regression model and indirect effect test were conducted to examine the effect of workplace bullying on the relationship between occupational burnout and turnover intentions.

RESULTS

An indirect effect test confirmed that workplace bullying can exacerbate the effect of occupational burnout on turnover intentions. Nearly one in ten nurses with occupational burnout may have experienced bullying at work, which increased their turnover intentions.

CONCLUSIONS

Reducing workplace bullying should be considered an important strategy for lowering turnover rates in nursing environments. Nursing mangers should develop appropriate strategies and establish mandatory regulations to create a respectful work environment. Moreover, continuous education and training to empower nursing staff to confront and eliminate workplace bullying are required in healthcare institutions.

Workplace Bullying in Early Childhood Education Settings: Prevalence and Protective Factors

Workplace bullying in the early childhood education and care (ECEC) sector is a pervasive and significant issue in Australia and globally. Workplace bullying can negatively impact early childhood professionals' mental health, contributing to staff turnover and attrition. Given the current, and predicted, future shortages of ECEC staff, it is critical that strategies be implemented to support staff well-being and maintain healthy and safe workplaces. The aims of this study were to examine the current prevalence of workplace bullying in the ECEC sector in Australia and to identify protective workplace factors associated with lower prevalence of workplace bullying. Using a convergent parallel mixed methods design, findings are drawn from qualitative and quantitative survey questions within a large study on ECEC educators' well-being conducted in Australia. Participants were 591 early childhood professionals working in ECEC a variety of ECEC settings. Findings indicated that 24.6% of respondents reported experiencing workplace bullying and that most bullying was perpetrated by co-workers. Some workplace factors were related to lower rates of bullying, including positive teamwork, better supervisor relations, lower work-related stressors and having greater influence on workplace decisions. Implications of the findings are discussed in relation to informing policy and practices to address workplace bullying in the ECEC sector by identifying aspects of the workplace that serve as protective factors.

Association of Workplace Bullying with Suicide Ideation and Attempt Among Chinese Nurses During the COVID-19 Pandemic

Nurses experience a high incidence of workplace bullying and are at a higher risk of suicide than the general population. However, there is no empirical evidence on how exposure to workplace bullying is associated with suicide ideation and attempts among nurses. Nurses were recruited from tertiary hospitals in Shandong Province, China, using stratified cluster sampling. Suicide ideation and attempts were assessed using two items, and the Workplace Psychologically Violent Behaviors Instrument was used to measure subtypes of workplace bullying. The prevalence of workplace bullying, suicide ideation, and suicide attempts was 30.6%, 16.8%, and 10.8%, respectively. After adjusting for covariates, victims of workplace bullying were at a high risk of suicide ideation and attempts. Among workplace bullying subtypes, individuals’ isolation from work and direct negative behaviors were predictors of both suicide ideation and attempts; attack on personality only predicted suicide attempts. The more bullying subtypes experienced by nurses, the greater their likelihood of suicide ideation and attempts. These findings suggested that workplace bullying was associated with an increased risk of suicide ideation and attempts in nurses, with both independent and cumulative risks. Interventions should focus on prevention and managing the effects of workplace bullying among nurses.

Workplace bullying: individual hostility, poor work environment or both? Exploring competing explanatory models in a single longitudinal study

PURPOSE

A central focus of research and literature on workplace bullying is the importance of explanatory factors such as individual dispositions (i.e., the vulnerability hypothesis) and work environment factors (i.e., the work environment hypothesis). Although several studies address the importance of the two approaches, as well as their individual and combined effects, the unique contribution of each of the competing approaches remain unexplored in a single longitudinal study.

METHODS

Based on Affective Events Theory, we explore the contribution of work environment and individual hostility in the occurrence of workplace bullying over time, using two-wave survey data, collected with a 6-month time lag among 152 employees from 7 private and public workplaces.

RESULTS

Results confirmed that work environment factors predicted later exposure to bullying. Exposure to workplace bullying at T1 was also related to a poor work environment at T2. Results further showed that higher exposure to workplace bullying at T1 and T2 was related to higher levels of almost all aspects of individual hostility over time. Moreover, poor working conditions especially in T1 predicted individual hostility at T2.

CONCLUSION

The present study thus documents that a poor work environment fosters bullying, and when bullying exists in a workplace, this elicits interpersonal hostility. Results points to the importance of addressing, through research and practice, work environment factors as predictors of workplace bullying.

Measuring Bullying in Sexual Minorities: Testing Two Bullying Scales in an LGB Sample

The working experience for those in the sexual minority is not well understood, particularly with respect to interpersonal mistreatment based on sexual orientation. This study breaks new ground by utilizing a sample of 416 LGB working adults to assess the relative usefulness of two bullying measures (the Negative Acts Questionnaire-Revised (Person-Related) and the Homophobic Bullying Scale) to determine their convergent, discriminant, and criterion validity in predicting organizational commitment, turnover, and post-traumatic stress disorder (PTSD). Results show that discriminant and convergent validity exist between these scales and both measure similar levels of perceived bullying (from the victim's perspective). We concluded that although there are similarities and differences between these measures, more research is needed to determine the most appropriate instrument to assess perceived bullying in a sexual minority population. Several areas for subsequent research are noted.

Prevalence, characteristics, and psychological outcomes of workplace cyberbullying during the COVID-19 pandemic in Japan: a cross-sectional online survey

Background

The rapid introduction of teleworking due to the coronavirus disease 2019 pandemic has led to concerns about increases in cyberbullying (CB) worldwide. However, little is known about workplace CB in non-Western countries. The first objective was to clarify the prevalence and characteristics regarding workplace CB victimization in Japan. The second objective was to demonstrate the psychological outcomes of CB victimization in combination with traditional bullying (TB).

Methods

We conducted an anonymous, cross-sectional, Internet-based survey targeting regular employees in Japan (N = 1200) in January 2021. We investigated CB victimization using the Inventory of Cyberbullying Acts at Work and TB victimization by using the Short Negative Act Questionnaire. Possible explanatory factors for TB/CB victimization were sociodemographic variables, personality trait, chronic occupational stress, organizational climate, and gratitude at work. We also measured psychological distress, insomnia, and loneliness to assess adverse effects of workplace bullying. Two-step cluster analysis was used in determining the patterns combined with TB and CB victimization. Hierarchical binomial logistic regression analysis was used.

Results

In total, 8.0% of employees reported experiencing CB on a weekly basis. CB victimization was associated with younger age, managerial position, higher qualitative workload, and active information dissemination via the Internet, and frequency of teleworking. Three clusters based on TB and CB victimization patterns were identified: those who belong to the first cluster suffered neither from TB and CB (81.0%), the second cluster suffered only from TB (14.3%), and the third cluster suffered from both TB and CB (4.8%). The third cluster exhibited higher odds ratios (ORs) and 95% confidence intervals (CIs) for psychological distress (OR = 12.63, 95% CI = 4.20–38.03), insomnia (OR = 6.26, 95% CI = 2.80–14.01), and loneliness (OR = 3.24, 95% CI = 1.74–6.04) compared to the first cluster.

Conclusions

These findings firstly clarify the prevalence and correlated factors of CB victimization among employees in Japan. Further, we showed that psychological wellbeing can be impaired by the coexistence of TB and CB. Our research could be the first step to develop the effective countermeasures against workplace CB.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13481-6.

Association between workplace bullying and common mental disorders in civil servants from a middle-income country

Workplace bullying (WB) is associated with Common mental disorders (CMD) in high-income countries, but there is a lack of evidence relating to this subject in low- and middle-income countries. Therefore, this study aimed to investigate the association between bullying and CMD in Brazil. A cross-sectional study with 907 judicial civil servants from Porto Alegre, southern Brazil, was carried out. WB was measured by the Negative Acts Questionnaire (NAQ-r) and CMD by the Self-Reporting Questionnaire (SRQ-20). Logistic regression was used to analyse data and test hypotheses. The overall prevalence of CMD was 32.8%, while the overall prevalence of bullying was 18.3%. WB was strongly associated with CMD, even after controlling for confounders. After adjustment for sociodemographic, personality and occupational confounders, weekly and daily exposures to negative acts increased 4.32 (95% CI: 2.00-9.33) and 6.80 (95% CI: 3.42-13.51) times the risk of CMD, respectively. Considering the operational definition, bullied workers had a 3.45 (95% CI: 2.26-5.25) higher risk of CMD. The results are consistent with studies from high-income countries. Different ways of categorising exposure to WB and testing association with CMD are suggested. Interventions to prevent bullying, focusing on work processes and psychosocial factors at work, could reduce the risk of mental health problems.

Bullying behavior and employee well-being: how do different forms of social support buffer against depression, anxiety and exhaustion?

PURPOSE

Workplace bullying has severe negative consequences for the well-being of targeted employees. Previous research suggests that social support may buffer against such adverse effects. However, it remains unclear if different forms of support have equally strong effects and if support buffers equally effectively against different outcomes. Further, little is known about social support as a mitigating factor in remote occupational groups such as seafarers. This study examines the buffering effects of four forms of support (instrumental and emotional peer support, company support, non-work support) on three aspects of employee well-being (depression, anxiety, and exhaustion) among seafarers.

METHODS

Responses to a cross-sectional online survey from a convenience sample of 414 seafarers on international commercial vessels were analyzed using moderated regression analyses with PROCESS.

RESULTS

Exposure to workplace bullying behavior increased seafarers' depression, anxiety and exhaustion. Instrumental peer support and non-work support buffered the negative impact of bullying on depression. The impact of bullying on exhaustion was buffered by company support. The impact of bullying on anxiety was not buffered by any of the four forms of support.

CONCLUSION

Extending previous research, the findings suggest that the interaction between workplace bullying and support depends not only on the source of support, but also on the type of support and the outcome considered. While support from colleagues on board was important for seafarers, company and non-work support must not be overlooked. Interventions should, therefore, encourage the development of peer support and ensure access to shore-based support for workers in remote locations.

Suicidal ideation and related factors in construction industry apprentices

BACKGROUND

Suicide rates within the construction industry are disproportionately high and there is accumulating evidence suggesting that young apprentices working in this industry may be particularly vulnerable. This study examined the presence of suicidal ideation and exposure to suicidal behaviours in construction industry apprentices, and explored associations between suicidal ideation and other demographic, workplace, and psychosocial factors.

METHODS

A large sample of apprentices were recruited for the study (N = 1402). The study employed a cross-sectional survey design. In addition to demographic items, the survey asked questions relating to suicidal ideation in the past year, exposure to suicidal behaviours, substance use, stress management, workplace bullying, psychological distress, and well-being.

RESULTS

Nearly one third of apprentices reported suicidal ideation in the previous year, and approximately half to two-thirds knew someone who had either attempted or died by suicide. Suicidal ideation was associated with knowing someone who had attempted suicide, greater psychological distress, substance use, and poorer well-being.

LIMITATIONS

The response rate was low. There were also portions of missing data. Multiple imputation was used to help overcome this, and results from the sensitivity analyses are presented. The cross-sectional design is another limitation.

CONCLUSION

Suicidal ideation in construction apprentices is common and is associated with poorer overall mental health and well-being, substance use, and knowing others who have attempted suicide. These findings can help inform the development of tailored workplace suicide prevention activities for apprentices at-risk of suicide and poor mental health.

The Role of Workplace Bullying in Low Back Pain: A Study With Civil Servants From a Middle-Income Country

This is a cross-sectional study that analysed the association between workplace bullying and LBP. The participants were 894 judicial civil servants from Porto Alegre, southern Brazil. Workplace Bullying was measured by the Negative Acts Questionnaire (NAQ-r) and Low Back Pain by the Nordic Questionnaire for Musculoskeletal Symptoms (NQMS). Logistic Regression was used to analyse data and test hypotheses. The prevalence of LBP in the last 7 days was 50.1%, while the overall prevalence of Chronic LBP was 19.3%. Some psychosocial factors at work were strongly associated with both outcomes. Workplace bullying was strongly associated with LBP, even after adjustment for several covariates. The odds of LBP in the last 7 days among bullied workers was 1.89 (95% CI: 1.31-2.71) times higher, compared to non-bullied. Workplace bullying was also associated with chronic LBP after adjustment for sociodemographic, behavioural and some occupational factors (OR = 1.60; 95% CI: 1.05-2.44). Psychosocial factors at work, and particularly workplace bullying, were strong risk factors for LBP, in contrast to most individual factors, and dose-response patterns were showed. Positive associations between bullying and LBP raise hypotheses on causation, and the role of psychosocial factors at work are discussed. Further longitudinal studies should address these hypotheses, investigating causal paths, mechanisms and possible mediation. Perspectives: As a psychosocial risk, workplace bullying may play a role in low back pain and can be focus of interventions to prevent LBP. Dose-response patterns on the association between workplace bullying and low back pain are discussed and hypotheses are raised. The paper addresses different ways of measuring and categorising bullying at work, in order to study the relationship between bullying and pain.

Associations between workplace bullying and later benefit recipiency among workers with common mental disorders

OBJECTIVE

In this study, we examined exposure to workplace bullying as a predictor of registry-based benefit recipiency among workers struggling with work participation due to common mental disorders. Further, we examined if the experience of receiving social support moderated the association between workplace bullying and benefit recipiency.

DESIGN

Secondary analyses of a randomized controlled trial.

PATIENTS

People struggling with work participation due to common mental disorders (CMD).

METHODS

Study participants (n = 1193) were from a randomized controlled trial (The At Work and Coping trial (AWaC), trial registration http://www.clinicaltrials.gov NCT01146730), and self-reported CMD as a main obstacle for work participation. Participants were at risk of sickness absence, currently on sickness absence or on long-term benefits. Benefit recipiency indicated sickness absence and/or long-term benefits (i.e., disability pension) at 6-month follow-up.

RESULTS

Of the 1193 participants, 36% reported exposure to workplace bullying. Workplace bullying was significantly associated with benefit recipiency at 6-month follow-up (OR 1.41, CI 1.11-1.79). Social support did not moderate the association between bullying and benefit recipiency.

CONCLUSIONS

The finding that workplace bullying increases the risk of later benefit recipiency suggest that bullying is a significant obstacle for work participation.

Workplace bullying and turnover intentions of nurses: the multi-theoretic perspective of underlying mechanisms in higher-order moderated-serial-mediation model

PURPOSE

This study examines the relationship between workplace bullying (WPB) and the turnover intentions (TIs) of nurses, both directly and indirectly, i.e. through serial mediation of psychological contract violation (PCV) and poor employee wellbeing (EWB). And that with the moderating effect of servant leadership (SL) on its final path to TIs of nurses.

DESIGN/METHODOLOGY/APPROACH

A total of 285 nurses voluntarily participated in the survey through convenient sampling from 13 different district hospitals. The authors performed partial least squares structural equation modeling (PLS-SEM) to test the study's measurement and structural models.

FINDINGS

Overall, results indicated 62% prevalence rate of WPB and TIs of nurses had 67% variance explained by the exogenous factors. Workplace bullying was found to have direct as well as indirect relationship with TIs of nurses. For the latter, PCV and poor EWB were found to have partially mediated, both singly and serially. The moderating effect of SL on the serial mediation pathway was negative and significant.

ORIGINALITY/VALUE

Drawing on a tripartite theoretical perspective, this study illuminates the mechanism underlying WPB-TIs relationship with an advanced multivariate statistical technique in the nursing work setting in a developing country.

Exposure to bullying behaviours, resilience, and return to work self-efficacy in patients on or at risk of sick leave

The study investigated relationships between exposure to bullying behaviours, return to work self-efficacy (RTW-SE) and resilience, and if resilience moderates the bullying-RTW-SE relationship among patients on sick leave or at risk of sick leave due to common mental disorders (CMD). A sample of 675 patients treated in an outpatient clinic was analysed using regressions and moderation analyses by employing SPSS and the Process macro SPSS supplement. The results showed a negative relationship between exposure to bullying behaviours and RTW-SE. There was also a positive main effect for resilience, as patients with high resilience score significantly higher on RTW-SE than patients with low resilience irrespective of levels of bullying. Further, the resilience sub-dimension personal resilience moderated the bullying-RTW-SE relationship, while the sub-dimension interpersonal resilience did not. Patients high on personal resilience showed relatively lower RTW-SE scores when exposed to bullying behaviours, compared to those that were not bullied with high personal resilience levels. Hence, one should take note of the fact that even if resilience may strengthen RTW-SE, bullying is an adverse event which particularly affects individuals who present with relatively high levels of resilience resources, at least when it comes to RTW-SE.

Workplace gender-based violence and associated factors among university women in Enugu, South-East Nigeria: an institutional-based cross-sectional study

Background

Exposure to workplace gender-based violence (GBV) can affect women's mental and physical health and work productivity in higher educational settings. Therefore, this study aimed to examine the prevalence of GBV (workplace incivility, bullying, sexual harassment), and associated factors among Nigerian university women.

Methods

The study was an institutional-based cross-sectional survey. The multi-stage sampling technique was used to select 339 female staff from public and private universities in Enugu, south-east Nigeria. Data was collected using the Workplace Incivility Scale (WIS), Modified Workplace Incivility Scale (MWIS), Negative Acts Questionnaire-Revised (NAQ-R), and Sexual Experiences Questionnaire (SEQ). Descriptive statistics, independent samples t-test, Pearson’s Chi-square test, univariate ANOVA, bivariate, and multivariable logistic regression analyses were conducted at 0.05 level of significance.

Results

The prevalence of workplace incivility, bullying, and sexual harassment (SH) was 63.8%, 53.5%, and 40.5%. The 12-month experience of the supervisor, coworker, and instigated incivilities was 67.4%, 58.8%, and 52.8%, respectively. Also, 47.5% of the participants initiated personal bullying, 62.5% experienced work-related bullying, and 42.2% experienced physical bullying. The 12-month experience of gender harassment, unwanted sexual attention, and sexual coercion were 36.5%, 25.6%, and 26.6%, respectively. Being aged 35–49 years (AOR 0.15; 95% CI (0.06, 0.40), and ≥ 50 years (AOR 0.04; 95% CI (0.01, 0.14) were associated with workplace incivility among female staff. Having a temporary appointment (AOR 7.79, 95% CI (2.26, 26.91) and casual/contract employment status (AOR 29.93, 95% CI (4.57, 192.2) were reported to be associated with workplace bullying. Having a doctoral degree (AOR 3.57, 95% CI (1.24, 10.34), temporary appointment (AOR 91.26, 95% CI (14.27, 583.4) and casual/contract employment status (AOR 73.81, 95% CI (7.26, 750.78) were associated with workplace SH.

Conclusions

The prevalence of GBV was high. There is an urgent need for workplace interventions to eliminate different forms of GBV and address associated factors to reduce the adverse mental, physical, and social health outcomes among university women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01273-w.

Workplace bullying in the nursing profession: A cross-cultural scoping review

BACKGROUND

Globally, nurses are at high risk of exposure to workplace bullying, and there is a growing body of literature addressing bullying in the nursing profession. Yet, our understanding of cross-cultural variations in bullying among nurses is lacking. An analysis of what is currently known about bullying in different parts of the world is critical for our understanding of cross-cultural effects of bullying among nurses.

OBJECTIVES

We aimed to examine workplace bullying research among nurses with the focus on sources, antecedents, outcomes and coping responses from a cross-cultural perspective during the years 2001-2019.

DESIGN

This is a scoping review of published literature on workplace bullying among nurses.

DATA SOURCES

A literature search was conducted using the CINAHL, PubMed, PsychINFO and Web of Science databases. A total of 166 articles provided data from the following cultural clusters: Anglo, Latin Europe, Eastern Europe, Nordic Europe, Middle East, Latin America, Confucian Asia, Southern Asia and Sub-Saharan Africa.

PROCEDURE

Studies were identified through a database search. Relevant data were extracted using a narrative approach. Categories were thematically organized according to the study topics. Cultural differences regarding the variation in the perceptions of and responses to bullying were analysed in relation to the cultural dimensions: power distance, assertiveness, in-group collectivism and performance orientation.

RESULTS

Research was mostly conducted in the Anglo cluster. Antecedents and outcomes of bullying were the most often studied topics across all cultural clusters. Vertical bullying was most prevalent in higher power distance cultures, whereas horizontal bullying was either more or equally prevalent in lower power distance cultures. The risk of bullying decreased as nurses' length of service and age increased in most of the clusters. Individual antecedents were more frequently reported in high in-group collectivist cultures. Organizational antecedents such as lack of bullying prevention measures, unsupportive leadership and stressful work characteristics were frequently reported across different cultural clusters. Yet, an organizational culture that tolerates bullying was most commonly addressed in Anglo, a highly performance-oriented culture. Negative outcomes of bullying were very similar across the world. Nurses used emotion-focused coping strategies more frequently almost in all clusters; yet, there were reports of problem-focused coping strategies especially in relatively higher assertiveness cultures.

CONCLUSIONS

Analysis revealed both similarities and differences in the nurses' reports of bullying by world region. Cultural factors were found to be important for understanding the variation in the nurses' perceptions of and responses to bullying.

Standing up against workplace bullying behavior: Recommendations from newly licensed nurses

Objective

Workplace bullying exists in today's healthcare system and often targets newly licensed nurses. Experiences of workplace bullying behavior may negatively affect the nurses' physical and psychological health and impact job satisfaction and staff turnover rates at an organizational level. The purpose of this study was to explore strategies suggested by newly licensed nurses to prevent and intervene during incidents of workplace bullying behavior.

Methods

An exploratory qualitative design guided this study. Three open-ended questions asked included: What do you think could be done to prevent a future, similar incident of workplace bullying? If you or someone else attempted to the stop the bullying incident, please describe the actions taken. If you or someone else did not attempt to stop the bullying incident, please state what would need to happen for you to intervene on behalf of yourself or someone else. Surveys were distributed electronically to newly licensed nurses from three baccalaureate nursing programs who had participated in a workplace bullying education intervention study as students. A total of 79 responses were received. Responses to three open-ended questions about recent incidents of workplace bullying behavior were coded and analyzed. Then the Social-Ecological Model was used to organize results into individual, relationship, and organizational level strategies.

Results

Most respondents reported experiencing workplace bullying behaviors in the previous six months. Three domains of strategies were identified: Preventing Future Bullying Behavior, Stopping Incidents of Bullying Behavior, and Promoting Others to Act.

Conclusions

Results indicated newly licensed nurses desire to be supported by their peers and organization as well as strategies to intervene when bullying behaviors occur. Implications for clinical practice and education are presented.

Exposure to bullying behaviours and support from co-workers and supervisors: a three-way interaction and the effect on health and well-being

PURPOSE

Workplace bullying can be very stressful and it has detrimental effects on health and well-being which makes it an important area of study. Social support has traditionally been seen as important in moderating work-related stress. It was hypothesised that the negative association between exposure to bullying behaviours, and health and well-being is moderated by (a) perceived support from close co-workers and (b) perceived supportive leadership. In the study, we also investigated a three-way interaction between exposure to bullying behaviours, perceived support from close co-workers and perceived supportive leadership. This association has not been studied before and add new knowledge to the research field.

METHODS

We used a moderated moderation analysis of workplace bullying, co-worker support and supervisor support using cross-sectional data from a work environment survey with 1383 respondents (75% response rate).

RESULTS

The moderated moderation analysis confirmed the moderating effect of perceived co-worker support but not the moderating effect of perceived supervisor support. There was a three-way interaction, but not in the case of the lowest 12.6% of perceived supervisor support scores.

CONCLUSIONS

These results indicate that the negative effect of workplace bullying on health and well-being is weaker if victims perceive that they have co-worker support, but this protective effect seems to be conditional on the perceived level of supervisor support. In other words, lack of supportive leadership may block the beneficial effect of perceived co-worker support.

Workplace bullies, not their victims, score high on the Dark Triad and Extraversion, and low on Agreeableness and Honesty-Humility

Most past research has focused mainly on the personality of the victims of bullying and not on the personality of workplace bullies. Some researchers have suggested that bullies and their victims may share bully-typifying personality traits. The aims of this study were to find out what characterizes the personalities of workplace bullies and their victims, and to investigate the relationship between the Dark Triad, HEXACO and workplace bullying. We tested three hypotheses. H1: Machiavellianism and Psychopathy, but not Narcissism, predict the use of bullying tactics (i.e., bullying perpetration). H2: (Low) Honesty-Humility, (low) Agreeableness and (high) Extraversion predict the use of bullying tactics. H3: Honesty-Humility moderates the association between Machiavellianism and the use of bullying tactics. Employees in southwestern Sweden (N = 172; 99 women) across various occupations and organizations were surveyed. Negative Acts Questionnaire-Perpetrators (NAQ-P) and Negative Acts Questionnaire-Revised (NAQ-R) were used to assess the use of bullying tactics and victimization. NAQ-P was correlated with NAQ-R (r = .27), indicating some overlap between the use of bullying tactics and victimization. NAQ-P was correlated with Machiavellianism (.60), Psychopathy (.58), Narcissism (.54), Agreeableness (-.34), Honesty-Humility (-.29) and Extraversion (.28). The results of linear regressions confirmed H1, but only partially confirmed H2: Machiavellianism, Psychopathy, (low) Agreeableness and (high) Extraversion explained 32%, 25%, 27% and 19%, respectively, of the variation in the NAQ-P. Replicating past research, NAQ-R was correlated with Neuroticism (.27), Extraversion (-.22), Openness (-.19) and Conscientiousness (-.16). Neuroticism explained 25% and (low) Extraversion 17% of the variation in the NAQ-R. Confirming H3, Honesty-Humility moderated the relationship between the NAQ-P and Machiavellianism. We conclude that bullies, but not their victims, are callous, manipulative, extravert and disagreeable, and that dishonest Machiavellians are the biggest bullies of all. In practice, the victims of workplace bullying need strong and supportive leadership to protect them from bullies with exploitative and manipulative personality profiles.

How Workplace Bullying Relates to Facades of Conformity and Work-Family Conflict: The Mediating Role of Psychological Strain

This study examined the effects of workplace bullying on facades of conformity in the work domain and on work-family conflict in the family domain. In this research, workplace bullying is seen as a reality in organizations, and this study considers individuals' judgments concerning various features of their workplace situations. Employees' experiences of workplace bullying influence their creation of facades of conformity and crosses over to influence their partners' family life through psychological strain. Psychological strain mediates the influence of workplace bullying on facades of conformity and on partners' work-family life. A total of 569 employee-partner dyads from a large plastics corporation in Taiwan demonstrated significant relationships between workplace bullying and its outcomes at work and at home. The results of this study demonstrate that psychological strain is an important mechanism between workplace bullying and its consequences, both at work and at home. A time-lag study design and two different sources (i.e., employees and their married partners) were utilized to reduce common method bias in this study. The main theoretical and practical implications of the findings for future research are discussed.

Workplace bullying and its preventive measures and productivity among emergency department nurses

Background

Workplace bullying has adverse effects on nurses’ productivity and emotional well-being and increases nurses’ desire to leave their jobs. Bullying is a common phenomenon that has been reported worldwide. Emergency Department (ED) nurses are particularly exposed to bullying as a result of their job stressors and demands.

Purposes

To examine the prevalence of bullying and the impact of preventive measures on productivity among Jordanian ED nurses; and to examine bullying in relation to personal and organizational factors.

Methods

We surveyed ED nurses in five hospitals in Amman, Jordan – two government hospitals and three private hospitals. The eligibility criteria for the study, met by 134 persons, were having at least an associate degree and having worked in the ED for at least six months. We used a four-part questionnaire that included demographic data, the Negative Acts Questionnaire, questions on prevention of bullying, and a health and productivity survey. Data analysis included descriptive and inferential statistics.

Results

A total of 120 ED nurses joined the study, an 89.6% response rate. The majority of participants were male (65%) and their mean age was 29.4 years. Ninety percent of the participants reported being bullied. Nurses with less experience in the ED were exposed to more bullying compared to other nurses. Of nurses who reported being bullied, 61.7% reported associated decreased productivity, including the ability to respond to cognitive demands, provide support, appropriate communication, safe care, and competent care. The overall mean score for the prevention of bullying questionnaire was 94.51 out of 168 (SD = 23.43). Drilling down, the highest mean score was for the “Individual sub-scale”, and the highest item mean score was for “I know the process of how to report bullying”.

Conclusion

Bullying is prevalent among ED nurses in Jordan; it has significantly influenced the nurses’ perception of their productivity and the quality of care they provide. Although nurses reported adopting measures to prevent bullying, they were insufficient to address this widespread problem.

Implications for nursing and health policy

Bullying is a common occurrence in nursing practice in Jordan, as in other places. It has a detrimental effect on the quality of health care. Accordingly, interventions, which we describe, should be undertaken to minimize the incidence and impact of bullying.

Workplace bullying and psychological distress of employees across socioeconomic strata: a cross-sectional study

Background

1Little is known of the extent of workplace bullying in Malaysia, despite its growing recognition worldwide as a serious public health issue in the workplace. Workplace bullying is linked to stress-related health issues, as well as socioeconomic consequences which may include absenteeism due to sick days and unemployment. We sought to examine the prevalence of workplace bullying and its association with socioeconomic factors and psychological distress in a large observational study of Malaysian employees.

Methods

This study employed cross-sectional, self-reported survey methodology. We used the 6-item Kessler screening scale (K6) to assess psychological distress (cutoff score ≥ 13, range 0–24, with higher scores indicating greater psychological distress). Participants self-reported their perceptions of whether they had been bullied at work and how frequently this occurred. A multivariate logistic regression was conducted with ever bullying and never bullying as dichotomous categories.

Results

There were a total of 5235 participants (62.3% female). Participant ages ranged from 18 to 85, mean ± standard deviation (M ± SD): 33.88 ± 8.83. A total of 2045 (39.1%) participants reported ever being bullied. Of these, 731 (14.0%) reported being subject to at least occasional bullying, while another 194 (3.7%) reported it as a common occurrence. Across all income strata, mean scores for psychological distress were significantly higher for ever bullied employees (M ± SD: 8.69 ± 4.83) compared to those never bullied (M ± SD: 5.75 ± 4.49). Regression analysis indicated significant associations (p < 0.001) between workplace bullying with being female (Adjusted OR (aOR) = 1.27, 95% CI 1.12–1.44), higher individual income levels of between RM4,000 to RM7,999 (aOR =1.24, 95% CI 1.06–1.45) and RM8,000 and above (aOR = 1.31, 95% CI 1.10–1.56), and psychological distress (aOR = 1.15, 95% CI 1.13–1.16).

Conclusions

More than one in three employees reported having experienced workplace bullying, which was found to be specifically associated with being female, drawing a higher income, and greater psychological distress. In general, low individual income was associated with greater psychological distress. However, higher income employees were far more likely to report experiencing workplace bullying. Findings from this study offer relevant insight into the associations between socioeconomic status and psychological distress in workplace bullying.

Workplace bullying and its preventive measures and productivity among emergency department nurses

BACKGROUND

Workplace bullying has adverse effects on nurses' productivity and emotional well-being and increases nurses' desire to leave their jobs. Bullying is a common phenomenon that has been reported worldwide. Emergency Department (ED) nurses are particularly exposed to bullying as a result of their job stressors and demands.

PURPOSES

To examine the prevalence of bullying and the impact of preventive measures on productivity among Jordanian ED nurses; and to examine bullying in relation to personal and organizational factors.

METHODS

We surveyed ED nurses in five hospitals in Amman, Jordan - two government hospitals and three private hospitals. The eligibility criteria for the study, met by 134 persons, were having at least an associate degree and having worked in the ED for at least six months. We used a four-part questionnaire that included demographic data, the Negative Acts Questionnaire, questions on prevention of bullying, and a health and productivity survey. Data analysis included descriptive and inferential statistics.

RESULTS

A total of 120 ED nurses joined the study, an 89.6% response rate. The majority of participants were male (65%) and their mean age was 29.4 years. Ninety percent of the participants reported being bullied. Nurses with less experience in the ED were exposed to more bullying compared to other nurses. Of nurses who reported being bullied, 61.7% reported associated decreased productivity, including the ability to respond to cognitive demands, provide support, appropriate communication, safe care, and competent care. The overall mean score for the prevention of bullying questionnaire was 94.51 out of 168 (SD = 23.43). Drilling down, the highest mean score was for the "Individual sub-scale", and the highest item mean score was for "I know the process of how to report bullying".

CONCLUSION

Bullying is prevalent among ED nurses in Jordan; it has significantly influenced the nurses' perception of their productivity and the quality of care they provide. Although nurses reported adopting measures to prevent bullying, they were insufficient to address this widespread problem.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Bullying is a common occurrence in nursing practice in Jordan, as in other places. It has a detrimental effect on the quality of health care. Accordingly, interventions, which we describe, should be undertaken to minimize the incidence and impact of bullying.

Job Demands-Resources and Flourishing: Exploring Workplace Bullying as a Potential Mediator

Flourishing in the workplace can bring about various positive outcomes for individual and organizational well-being. This study explored the interactional effect of workplace bullying on the relationship between job demands-resources and flourishing. A convenience sample of 1102 employees was selected, and these employees completed an online survey that explored this relationship. Mediation analysis revealed that low job demands were linked to lower levels of workplace bullying, which in turn correlated with higher levels of flourishing. Workplace bullying partially mediated the job demands-flourishing relationship, but not the job resources-flourishing relation. The results were interpreted based on the job demands-resources theory, followed by recommendations for practice and future research.

Resident bullying in diagnostic radiology

PURPOSE

Workplace bullying has been reported in multiple medical specialties outside of diagnostic radiology within the United States. The purpose of this study was to survey diagnostic radiology residents in the United States to determine if: (1) residents had experienced bullying, (2) residents had witnessed bullying of other residents, (3) residents were aware of zero-tolerance policy for workplace bullying at their institution, (4) residents were aware of no retaliation policies for reporting bullying at their institution.

MATERIALS AND METHODS

In December 2017, a weekly E-mail for 4 weeks was sent to diagnostic radiology residents in the United States (residents) who had attended the July 2017, September 2017 and October 2017 4-week American Institute for Radiologic Pathology (AIRP) resident course to participate in an online, anonymous, voluntary survey.

RESULTS

28% of radiology resident respondents reported workplace bullying during their residency. One third of radiology residents have witnessed workplace bullying of another radiology resident at their facility. Approximately one half (48%) of respondents did not know if their institution had a zero-tolerance policy for workplace bullying, and approximately one half (55%) of respondents did not know if their institution had a no retaliation policy for reporting workplace bullying.

CONCLUSION

Our survey of diagnostic radiology residents across the United States confirms workplace bullying during residency, and the opportunity for implementation of zero-tolerance and zero retaliation policies for reporting workplace bullying in residency training institutions.

Effects of workplace bullying on Chinese children's health, behaviours and school adjustment via parenting: study protocol for a longitudinal study

Background

Bullying in the workplace is a serious public health issue. As a chronic work stress, workplace bullying places the victims’ physical and mental health at risk which, in extreme cases, may lead to suicidal ideation. The high prevalence rate of workplace bullying has been reported and documented globally. However, a major limitation of the existing literature is that studies essentially focus on the consequences of workplace bullying on victims, including the psychological, physiological and socioeconomic impacts, and on the factors causing workplace bullying, but research on the impact of workplace bullying on the victims’ families is lacking. It is however evident that the consequences of workplace bullying have a spillover effect on the victims’ family members. Since many victims have children and given that children are particularly vulnerable to a negative family environment, examining the impacts of the type of parental stress induced by workplace bullying on children’s health including physical and psychological health (depression and self-esteem), externalizing problem behaviors (aggression, lying, disrespect) and school adjustment (academic performance and school conduct) is urgently needed. The overall aim of this study is to examine how health, externalizing problem behaviors and school adjustment of children whose parents are victims of workplace bullying may be associated with the impact that workplace bullying has on parenting practices.

Methods

It is a longitudinal study. Quantitative data will be collected from multi-informants, including currently employed Chinese parents, their children aged between 6 and 12 years old, and their class teachers at two time points, separated by a 1-year interval. One primary school will be recruited from each district of Hong Kong including participants with different socioeconomic backgrounds. At least 837 dyads (parents and children) from 18 primary schools will join the study.

Discussion

Workplace bullying not only affects victims but can also be harmful to their families as it alters the victims temper in the family environment. Results will be informative for the government and corporations to make concerted efforts and find strategies to prevent workplace bullying and to heighten the awareness of the importance of promoting safe and respectful workplaces for workers.

Combined effects of workplace bullying and perceived organizational support on employee behaviors: does resource availability help?

BACKGROUND AND OBJECTIVE

This research examines the detrimental effects of workplace bullying as a social stressor on employees' job performance, organizational retaliatory behaviors, and organizational citizenship behaviors and how the availability of support can reduce the negative impact of bullying. Using social exchange theory and the conservation of resources theory as theoretical frameworks, we propose that workplace bullying drains personal resources, leading to reduced job performance, low citizenship behaviors, and increased organizational retaliatory behaviors. We also propose that perceived organizational support acts as moderator, such that it reduces the detrimental effects of bullying on employee behaviors.

RESEARCH DESIGN AND METHODS

We tested our hypotheses in two field studies (N = 478 and N = 395) conducted in Pakistan.

RESULTS

The results of both studies supported the assertion that workplace bullying exacerbates employees' job performance, reduces organizational citizenship behaviors and intensifies organizational retaliatory behaviors. The idea that perceived organizational support would moderate the bullying-work behavior relationships found mixed support. While perceptions of organizational support reinforced the bullying-job performance and bullying-retaliatory behaviors relationships, it did not moderate the bullying-citizenship behaviors relationship in the suggested direction.

CONCLUSION

The findings show that workplace bullying leads to more organizational citizenship behaviors when employee's perceptions of organizational support is high.

The incidence and outcomes of nurse bullying in the Russian Federation

AIM

The aim of this study was to describe bullying experienced by professional nurses working in the Russian Federation. The frequency and type of bullying behaviours experienced, the personal and professional consequences of bullying and the actions taken to address bullying were all examined.

BACKGROUND/INTRODUCTION

Workplace bullying negatively affects nurses, patients and healthcare organizations. To date, no research has been conducted on workplace bullying among nurses in the Russian Federation.

METHODS

This was a descriptive study using survey methodology. Members of the Russian Nurses Association were invited to participate via email and social media. Participants completed the 26-item, web-based Bullying in the Workplace Survey. Data were analysed using descriptive statistics.

RESULTS

Of the 438 participants, 63% reported being bullied at some point during their career. The majority were female and worked fulltime for an average of 20 years. Over half the nurses were working in staff positions when bullying occurred, and administrators were most commonly identified as the bully. Bullying caused moderate to severe distress in 73.5%. Half of the nurses reported that bullying affected their work, and 83.3% reported that it affected their health. Just over 70% took action to address the bullying situation; 59% of those who did were dissatisfied with the outcome.

CONCLUSION

Bullying is prevalent in the nursing workplace in the Russian Federation. The perpetrators were most frequently the nurse administrator or physician administrator. Workplace bullying negatively affects nurses' ability to function and subsequently impacts nursing teamwork and patient care.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Identifying bullying, its antecedents and consequences in the Russian Federation are a requisite for developing meaningful interventions and contributing to shaping local and international policy.

Acceptance of Workplace Bullying Behaviors and Job Satisfaction: Moderated Mediation Analysis With Coping Self-Efficacy and Exposure to Bullying

Previous research explored workplace climate as a factor of workplace bullying and coping with workplace bullying, but these concepts were not closely related to workplace bullying behaviors (WBBs). To examine whether the perceived exposure to bullying mediates the relationship between the climate of accepting WBBs and job satisfaction under the condition of different levels of WBBs coping self-efficacy beliefs, we performed moderated mediation analysis. The Negative Acts Questionnaire - Revised was given to 329 employees from Serbia for assessing perceived exposure to bullying. Leaving the original scale items, the instruction of the original Negative Acts Questionnaire - Revised was modified for assessing (1) the climate of accepting WBBs and (2) WBBs coping self-efficacy beliefs. There was a significant negative relationship between exposure to bullying and job satisfaction. WBB acceptance climate was positively related to exposure to workplace bullying and negatively related to job satisfaction. WBB acceptance climate had an indirect relationship with job satisfaction through bullying exposure, and the relationship between WBB acceptance and exposure to bullying was weaker among those who believed that they were more efficient in coping with workplace bullying. Workplace bullying could be sustained by WBB acceptance climate which threatens the job-related outcomes. WBBs coping self-efficacy beliefs have some buffering effects.

[Effect of workplace bullying on posttraumatic stress disorder in nursing staff]

Objective: To investigate the relationship between workplace bullying and posttraumatic stress disorder (PTSD) in nursing staff, and to analyze the role of psychological capital between workplace bullying and PTSD. Methods: From December 2014 to June 2015, convenience sampling was used to collect 496 nurses from 5 grade A tertiary hospitals in a province of China. Their workplace bullying, psychological capital, and PTSD status were assessed using the Negative Acts Questionnaire, Psychological Capital Questionnaire, and Posttraumatic Stress Disorder Self-Rating Scale, respectively. The correlation between variables was analyzed using a structural equation model. Results: Among these nurses, the scores of negative acts, psychological capital, and PTSD were 37.15±12.83, 78.81±16.54, and 34.56±12.52, respectively. The score on each dimension of negative acts was positively correlated with that on each dimension of PTSD (P<0.01) ; the score on each dimension of psychological capital was negatively correlated with that on each dimension of PTSD and negative acts (P<0.01). Negative acts had a positive predictive effect on PTSD (β=0.539, P<0.01) , which was reduced after inclusion of psychological capital (β=0.513, P<0.01). The path coefficient was 0.62 for the effect of negative acts on PTSD, -0.18 for the effect of negative acts on psychological capital, and -0.11 for the effect of psychological capital on PTSD (P<0.05) . Conclusion: Workplace bullying is a predictive factor for PTSD, and psychological capital plays a mediating role between workplace bullying and PTSD. The manager should reduce workplace bullying to improve the psychological capital in nursing staff and to prevent and reduce PTSD.