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Development of Vignettes to Explore Workplace Bullying
Abstract
Incivility and bullying in healthcare can impact care delivery and quality. There are challenges in research to making a direct link between the behaviors and patient outcomes. One way to address the challenges is through the creation of bullying vignettes that induce mood changes that reflect a feeling of being bullied. The purpose of this study was to develop workplace bullying textual vignettes and to test content validity. Cognitive interviewing was used by engaging content experts to rate 21 author-created vignettes for relevance, realism, and severity. Eleven vignettes were identified and have potential use in research, education, and practice.
... Organizational bullying includes organizational cultural bullying, bully processing, and senior team bullying (from senior peers' tactics) [44,45]. Leymann [46] introduced the concept of organizational bullying, which has been adopted in different sectors and countries with different styles [44,47,48]. A toxic workplace environment and bullying create and accelerate work depression, stress, low levels of work engagement, a high ratio of absenteeism, a lack of work performance, and work destruction [49]. ...
... Liu and Chang argued that due to work depression, workers cannot sleep well and they have headaches, and these health problems decrease their productivity [110]. Devonish examined the operations of five wholesale and large-sized retail organizations in the small developing nation of Barbados located in the English-speaking Caribbean region, and the outcomes of his study indicate that work-related depression mediates the relationship between a toxic workplace environment and worker task productivity [48]. The findings of these studies support our study. ...
This study determined how a toxic workplace environment can influence worker productivity, directly and indirectly, using work depression as a mediating variable. A toxic workplace environment with multiple dimensions (harassment, bullying, ostracism, and incivility) was used in this study. We used a questionnaire survey approach to evaluate the data. A total of 53 items were used in the questionnaire with a five-point Likert scale. The data were collected from 23 branches of five Chinese banks in the vicinity of Shanghai. The authors distributed 250 questionnaires among targeted employees (senior managers, middle managers, and administrative staff) and received 186 filled questionnaires, among which six were incomplete. Thus, the completed sample size of the research was 180, and the overall response rate was 72%. To estimate the proposed relationships in the research model, we used partial least-squares structural equation modeling (PLS-SEM 3.2). The outcomes of this study indicate that for direct and indirect relationships, a toxic workplace environment negatively influences worker productivity. Moreover, the outcomes of this study also show that work depression negatively impacts worker productivity. The study concludes with a discussion, limitations, and future research directions.
... Initially, this concept was introduced by Leymann Heinz in 1996 [49] and has been adopted in different organizations, industries, sectors, and countries [50]. As an indicator of a toxic workplace environment, bullying may result in job stressors, job burnout, buffering resources, negative work environment, work destruction, and low productivity [51,52]. ...
Purpose: This empirical study aims to determine the effects of a toxic workplace environment, which can negatively impact the job productivity of an employee. Methodology: Three hundred questionnaires were randomly distributed among the staff members of seven private universities in Pakistan with a final response rate of 89%. For analysis purposes, AMOS 22 was used to study the direct and indirect effects of the toxic workplace environment on job productivity. Confirmatory Factor Analysis (CFA) was conducted to ensure the convergent and discriminant validity of the factors, while the Hayes mediation approach was used to verify the mediating role of job burnout between the four dimensions of toxic workplace environment and job productivity. A toxic workplace with multiple dimensions, such as workplace ostracism, workplace incivility, workplace harassment, and workplace bullying, was used in this study. Findings: By using the multiple statistical tools and techniques, it has been proven that ostracism, incivility, harassment, and bullying have direct negative significant effects on job productivity, while job burnout was shown to be a statistical significant mediator between the dimensions of a toxic workplace environment and job productivity. Finally, we concluded that organizations need to eradicate the factors of toxic workplace environments to ensure their prosperity and success. Practical Implications: This study encourages managers, leaders, and top management to adopt appropriate policies for enhancing employees’ productivity. Limitations: This study was conducted by using a cross-sectional research design. Future research aims to expand the study by using a longitudinal research design.
The purpose of this study was to examine the influence of reading workplace bullying vignettes on negative affect. A within-subjects descriptive design and convenience sample was used. Fifty participants completed the Negative Affect Scale after reading written bullying vignettes and completed the Transportation Narrative questionnaire. Results provide evidence that the participants were transported into the vignettes. Additionally, descriptive statistics and a repeated measure ANOVA revealed a significant increase in negative affect over time. Written vignettes can provide a means to better understand how workplace events can impact cognitive performance. Practical and theoretical implications are discussed.
We examined teacher characteristics predicting likelihood of intervening in indirect bullying (N=55) and piloted a 45-minute educational presentation about its mental health impact. Teachers' global empathy and perceived seriousness of indirect bullying vignettes were predictors of their likelihood of intervening, but knowledge of mental health impact was not. The presentation increased knowledge of impact and perceived seriousness, immediately and seven weeks later, compared with a treated control group. However, empathy for victims and likelihood of intervening did not increase. Recommendations include adding skills-based material, a self-efficacy measure and a focus on increasing global empathy rather than specific empathy for victims.
The current study investigated the influence of type of aggression (cyberbullying or traditional bullying) and participant role (bystander or perpetrator) on children and adolescents’ self-attribution of moral emotions and judgments, while examining the influence of chronological age. Participants (N = 122, 8–16 years) evaluated vignettes and were asked to self-attribute the emotions they would feel in the role of the perpetrator or bystander. Results revealed that participants were more likely to self-attribute morally responsible emotions compared to morally disengaged emotions across contexts. A significant moderation model revealed that the effect of morally disengaged emotions on moral evaluations depends on participants’ chronological age, while controlling for social desirability. The findings are discussed in terms of implications for school violence and victimization.
To support their efforts to promote high quality and efficient care, policymakers need to better understand the key factors associated with variations in physicians' decisions, and in particular, physician deviations from evidence-based care. Clinical vignette survey instruments hold potential for research in this area as an approach that both allows for practical, large-scale study and overcomes the data quality challenges posed by analysis of clinical data. These surveys present respondents with a narrative description of a hypothetical patient case and solicit responses to one or more questions regarding the care of the patient. In this review, we describe various methods for measuring variations in physicians' decisions and highlight a range of design features researchers should consider when developing a clinical vignette survey. We conclude by identifying areas for future research.
According to Weiner’s model, help giving has various determinants such as social and individual causes, affective reactions, and responsibility. The aim of this study was (1) to examine the influence of bullying acts, the victim’s behavior at work, and revictimization on equity judgments and the perceived responsibility of perpetrators and victims; and (2) to test the determinants of help decisions. Twelve vignettes of bullying at work submitted to 133 participants varied according to the severity of bullying, the victim’s pro- or antisocial behaviors, and the victim’s antecedents. The results showed that the situation was judged less equitable, the victim less responsible, and the perpetrator more responsible, and the intention of help was increased, (1) when the perpetrator’s acts were serious, and (2) when the bullied person had shown prosocial behavior versus antisocial behavior. The help increased more (1) when the perpetrator’s acts were harmful and (2) when the victim had shown prosocial behaviors.
Extensive bullying research has primarily focused on activities between peers in school settings, but some evidence suggests bullying may occur in other situations. If so, other contexts could potentially benefit from the wealth of peer bullying research. A sample of 392 young adults answered questions about their experiences with sibling and peer bullying behaviors. Participants also provided responses concerning a sibling or peer vignette that focused on reporting bullying behaviors. Results indicated that participants view bullying behaviors between peers and siblings as somewhat similar, but sibling bullying behaviors compared to peer bullying behaviors are reported to be perpetrated and experienced more often. When considering a hypothetical situation such sibling bullying behaviors, however, are less likely to be reported outside the family than peer bullying behaviors. Additionally, females are more likely than males to report outside the family. Participants who had more prior involvement in bullying are less likely to say they would report the described sibling bullying behaviors. Considering sibling bullying may not be thought of as bullying and may not be reported outside the family, implications for policy and future research are discussed.
Vignette-based methodologies are frequently used to examine judgments and decision-making processes, including clinical judgments made by health professionals. Concerns are sometimes raised that vignettes do not accurately reflect “real world” phenomena, and that this affects the validity of results and conclusions of these studies. This article provides an overview of the defining features, design variations, strengths, and weaknesses of vignette studies as a way of examining how health professionals form clinical judgments (e.g., assigning diagnoses, selecting treatments). As a “hybrid” of traditional survey and experimental methods, vignette studies can offer aspects of both the high internal validity of experiments and the high external validity of survey research in order to disentangle multiple predictors of clinician behavior. When vignette studies are well designed to test specific questions about judgments and decision-making, they can be highly generalizable to “real life” behavior, while overcoming the ethical, practical, and scientific limitations associated with alternative methods (e.g., observation, self-report, standardized patients, archival analysis). We conclude with methodological recommendations and a description of how vignette methodologies are being used to investigate clinicians’ diagnostic decisions in case-controlled field studies for the ICD-11 classification of mental and behavioural disorders, and how these studies illustrate the preceding concepts and recommendations
Ten years ago, Griffin wrote an article on the use of cognitive rehearsal as a shield for lateral violence. Since then, cognitive rehearsal has been used successfully in several studies as an evidence-based strategy to address uncivil and bullying behaviors in nursing. In the original study, 26 newly licensed nurses learned about lateral violence and used cognitive rehearsal techniques as an intervention for nurse-to-nurse incivility. The newly licensed nurses described using the rehearsed strategies as difficult, yet successful in reducing or eliminating incivility and lateral violence. This article updates the literature on cognitive rehearsal and reviews the use of cognitive rehearsal as an evidence-based strategy to address incivility and bullying behaviors in nursing. J Contin Educ Nurs. 2014;45(x):xxx-xxx.
Copyright 2014, SLACK Incorporated.
Although previous studies have linked workplace incivility with various negative outcomes, they mainly focused on the long-term effects of chronic exposure to workplace incivility, whereas targets' short-term reactions to incivility episodes have been largely neglected. Using a daily diary design, the current study examined effects of daily workplace incivility on end-of-work negative affect and explored potential individual and organizational moderators. Data collected from 76 full-time employees across 10 consecutive working days revealed that daily workplace incivility positively predicted end-of-work negative affect while controlling for before-work negative affect. Further, the relationship was stronger for people with low emotional stability, high hostile attribution bias, external locus of control, and people experiencing low chronic workload and more chronic organizational constraints, as compared with people with high emotional stability, low hostile attribution bias, internal locus of control, and people experiencing high chronic workload and fewer chronic organizational constraints, respectively. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
The goal of this US study was to determine the frequency of horizontal violence in a perinatal service and its effect on patient outcomes. A 24-question survey instrument was completed online by 63 nurses. The results indicated that labour and delivery wards experience a higher frequency of horizontal violence than other units in the perinatal service. They also showed that the mother and baby unit demonstrates a higher frequency of recipient or victim behaviours. A relationship between horizontal violence and ineffective communication, as well as a relationship between horizontal violence and poor patient outcomes or near misses, was demonstrated.
The present study tested the interplay between mood and attentional deployment by examining attention to positive (i.e., happy faces) and negative (i.e., angry and sad faces) stimuli in response to experimental inductions of sad and happy mood. Participants underwent a negative, neutral, or positive mood induction procedure (MIP) which was followed by an assessment of their attentional deployment to emotional faces using eye-tracking technology. Faces were selected from the Karolinska Directed Emotional Faces (KDEF) database (Lundqvist, Flykt, & Öhman, 1998). In the positive MIP condition, analyses revealed a mood-congruent relation between positive mood and greater attentional deployment to happy faces. In the negative MIP condition, however, analyses revealed a mood-incongruent relation between increased negative mood and greater attentional deployment to happy faces. Furthermore, attentional deployment to happy faces after the negative MIP predicted participants' mood recovery at the end of the experimental session. These results suggest that attentional processing of positive information may play a role in mood repair, which may have important clinical implications. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
This study explored the relationships among perceived workplace incivility, stress, burnout, perceived turnover intentions, and perceived level of psychological empowerment among acute care nurses (medical-surgical and critical care) in community and tertiary hospitals through the lens of complexity science. An exploratory study was conducted, and findings demonstrate significant relationships among workplace incivility, stress, burnout, turnover intentions, total years of nursing experience, and RN education levels. Creating targeted retention strategies and policies that will be sensitive to the needs and interests of nurses at high risk for leaving their organizations is imperative for nurse executives.
In this study, perceptions of the severity of various bullying behaviours in the workplace are investigated. The main aims are (1) to obtain the assessments of workers regarding the severity of the various types of behaviour that constitute bullying (psychological abuse), and (2) to examine whether the degree of involvement with the phenomenon (represented by three different groups: victims, witnesses and employees with no previous experience of bullying) influences the severity assessments. A sample of 300 workers from various branches of four organizations in Spain (191 women and 109 men aged between 21 and 66 years) completed a questionnaire. The results showed that assessments of the perceived severity of the different types of bullying behaviour varied. Bullying behaviours fell into six categories, with various types of emotional abuse proving to be perceived as the most severe category. Moreover, the results showed that there was no significant difference in the perceived severity of bullying behaviour among victims, witnesses and employees without previous experience of bullying. The consequences of these results and how they can influence theory, future research and practice are discussed.
Across days, individuals experience varying levels of negative affect, control of attention, and motivation. We investigated whether this intraindividual variability was coupled with daily fluctuations in working memory (WM) performance. In 100 days, 101 younger individuals worked on a spatial N-back task and rated negative affect, control of attention, and motivation. Results showed that individuals differed in how reliably WM performance fluctuated across days, and that subjective experiences were primarily linked to performance accuracy. WM performance was lower on days with higher levels of negative affect, reduced control of attention, and reduced task-related motivation. Thus, variables that were found to predict WM in between-subjects designs showed important relationships to WM at the within-person level. In addition, there was shared predictive variance among predictors of WM. Days with increased negative affect and reduced performance were also days with reduced control of attention and reduced motivation to work on tasks. These findings are in line with proposed mechanisms linking negative affect and cognitive performance.
Transportation was proposed as a mechanism whereby narratives can affect beliefs. Defined as absorption into a story, transportation entails imagery, affect, and attentional focus. A transportation scale was developed and validated. Experiment 1 (N = 97) demonstrated that extent of transportation augmented story-consistent beliefs and favorable evaluations of protagonists. Experiment 2 (N = 69) showed that highly transported readers found fewer false notes in a story than less-transported readers. Experiments 3 (N = 274) and 4 (N = 258) again replicated the effects of transportation on beliefs and evaluations; in the latter study, transportation was directly manipulated by using processing instructions. Reduced transportation led to reduced story-consistent beliefs and evaluations. The studies also showed that transportation and corresponding beliefs were generally unaffected by labeling a story as fact or as fiction.
The last decade has witnessed a rapidly growing public and academic interest in medical error, an interest that has culminated in the emergence of the science of error prevention in health care. The impact of this new science will be felt in all areas of medicine but perhaps especially in emergency medicine (EM). The emergency department’s unique operating characteristics make it a natural laboratory for the study of error. These characteristics, combined with the complex and myriad activities of EM, predict vulnerability to a multitude of errors. Overcrowding and other resource limitations impair continuous quality improvement, and many errors result from high decision density, excessive cognitive load and flawed thinking in the decision-making process. A large proportion of these errors have serious outcomes but an even higher proportion are preventable.
The historical practice of blaming individuals for errors needs to be replaced by root-cause analysis that identifies process and systemic weaknesses. Quantitative and qualitative methods are needed to detect, describe and classify error at all levels in the system. Research is needed into the processes that underlie EM error. Educational initiatives should be developed at all levels, for everyone from undergraduate trainees to practicing emergency physicians. Changes in societal attitudes will be an important component of the new culture of patient safety.
A nationwide reporting system is proposed to disseminate error information expediently. Canadian EM providers are in a pivotal position to provide leadership to the Canadian health care system in this important area.
Nurse researchers typically provide evidence of content validity for instruments by computing a content validity index (CVI), based on experts' ratings of item relevance. We compared the CVI to alternative indexes and concluded that the widely-used CVI has advantages with regard to ease of computation, understandability, focus on agreement of relevance rather than agreement per se, focus on consensus rather than consistency, and provision of both item and scale information. One weakness is its failure to adjust for chance agreement. We solved this by translating item-level CVIs (I-CVIs) into values of a modified kappa statistic. Our translation suggests that items with an I-CVI of .78 or higher for three or more experts could be considered evidence of good content validity.
Aim:
To increase understanding of workplace bullying and its relation to work climate and different outcomes among nurses. Examine a proposed bullying model including both job resource and job demands, as well as nurse outcomes reflected in job performance, job satisfaction, and work ability.
Background:
Workplace bullying has been identified as some of the most damaging mechanisms in workplace settings. It is important to increase understanding of workplace bullying in relation to work climate and different outcomes among nurses.
Design:
This study adopted a cross-sectional web based survey design.
Method:
A sample of 2946 registered nurses from four public Norwegian hospitals were collected during October 2014. We analysed data using descriptive statistics, correlations Cronbach's alpa, confirmatory factor analyses and structural equation modelling.
Results:
The majority of work climate characteristics confirmed to influence workplace bullying, and additionally had direct influence on nurse outcomes; job performance, job satisfaction, and work ability. Bullying had a mediational role between most of the work climate dimensions and nurse outcomes.
Conclusion:
This study increases our understanding of organisational antecedent of bullying among nurses. Workplace bullying among nurses functions as a mediator between the majority of work climate dimensions and outcomes related to job satisfaction and work ability. Strategies to reduce bullying should look at the study finding and specifically job resources and job demands that influence bullying and nurse outcomes. This article is protected by copyright. All rights reserved.
Purpose: The purpose of this pilot study was to explore rural nurses’ perceptions regarding disruptive behavior and its impacts on interdisciplinary relationships, patient safety, and patient outcomes. Methods: Montana nurses working at either of two rural facilities, one a small hospital and the other a critical access facility, participated in the study. The study replicated a larger study conducted by Rosenstein and O’Daniel (2005) in the VHA West Coast hospital network. A questionnaire was sent to nurses electronically via their agency’s email system to assess perceptions of disruptive behavior and its effects on patient outcomes. Findings: Fifty-seven nurses participated in the study, yielding a 47.5% response rate. Disruptive behavior was reported to be displayed more often by nurses than physicians in this study. Nurses perceived that disruptive behavior is linked to adverse events, and may also have a negative impact on patient safety and satisfaction. In addition, participants perceived a link between disruptive behavior and the psychological and behavioral variables impacting individual nurses. Finally, the majority of respondents indicated that their facility lacked appropriate reporting and counseling policies for addressing disruptive behavior. Conclusions: Like their VHA West Coast counterparts, nurses working in rural settings experience disruptive behavior and believe there is a link between disruptive behavior and negative patient outcomes. However, results from this pilot study suggest that disruptive behavior by nurses in rural settings is more prevalent than that of physicians, findings that contradict previous work. DOI: http://dx.doi.org/10.14574/ojrnhc.v14i1.300 Key words : Disruptive behavior, workplace incivility, patient outcomes, patient safety, rural nursing
Background:
Negative work environments influence the ability of nurses to provide optimal patient care in a safe environment.
Aim:
The purpose of the study was to test a model linking workplace bullying (WPB) and lateral violence (LV) with job stress, intent to leave, and, subsequently, nurse-assessed patient adverse outcomes (safety issues).
Design:
This descriptive-correlational study examined the relationships between study variables and used a structural equation model to test the validity of the proposed theoretical framework.
Methods:
A convenience sample of 508 clinical nurses working in eight general hospitals in Daejeon, South Korea, completed a questionnaire on measures of WPB, LV, job stress, intent to leave, and nurse-assessed patient safety. Analysis of moment structures was used to estimate a set of three models with competing measurement structures for WPB and LV and the same structural model. Akaike Information Criterion was used for model selection.
Results:
Among the three proposed models, the model with complex factor loadings was selected (WPB and LV were both associated with verbal abuse and physical threat). WPB directly and indirectly influenced nurse-assessed patient safety. Job stress directly influenced intent to leave, and intent to leave directly influenced nurse-assessed patient safety.
Conclusions:
The results of the study support the proposition that WPB, job stress, and intent to leave may be associated with nurse-perceived adverse outcomes (patient safety issues) in hospitals. Nurse perceptions of WPB were associated with nurse-assessed patient safety outcomes (adverse events) directly and through mediating job stress and intent to leave. LV was not associated with the mediators or nurse-assessed adverse outcomes (safety).
Workplace bullying is strongly associated with negative nursing outcomes, such as work dissatisfaction, turnover, and intent to leave; however, results of studies examining associations with specific patient safety outcomes are limited or nonspecific. This integrative review explores and synthesizes the published articles that address the impact of workplace nurse bullying on patient safety.
In this article we introduce the concept of workplace incivility and explain how incivility can potentially spiral into increasingly intense aggressive behaviors. To gain an understanding of the mechanisms that underlie an "incivility spiral," we examine what happens at key points: the starting and tipping points. Furthermore, we describe several factors that can facilitate the occurrence and escalation of an incivility spiral and the secondary spirals that can result. We offer research propositions and discuss implications of workplace incivility for researchers and practitioners.
A series of 48 vignettes of bullying was constructed by crossing (a) four kinds of social contact (physical aggression, verbal aggression, relational aggression, and non-aggression) with (b) male and female bullies, (c) male and female and victims, and (d) reaction of the victim (aggressive, passive, and no reaction). Teachers rated vignettes for seriousness. Physical aggression was perceived as more serious than any other kind of bullying, and vignettes that depicted female bullies and male victims were perceived as least serious across all kinds of bullying. Results are discussed in terms of applied implications for teachers in school settings and directions for future research.
When will bystanders of workplace mobbing show antisocial or prosocial behaviour toward the victim? Results of a 2 × 2 vignette study (N = 177) suggest that high perceived responsibility of the victim for the onset of the mobbing evokes anger and consequently antisocial bystander behaviour, whereas low perceived responsibility generates sympathy and consequently prosocial bystander behaviour. The results further indicate that bystanders will show more antisocial behaviour and less prosocial behaviour toward the victim when they anticipate stigma by association. The implications of these results for interventions seeking to influence bystanders' behaviour in the context of workplace mobbing and for further research on this bystander behaviour are discussed. Copyright © 2015 John Wiley & Sons, Ltd.
Inappropriate behaviors of healthcare workers can threaten the delivery of safe, quality care. The purpose of this research was to develop a research instrument specific to the construct of horizontal violence and conduct foundational psychometric testing of the newly developed instrument. The overall findings on the fit indices suggest that this model does adequately measure the underlying construct of horizontal violence. The instrument can be used as a way to determine the existence and extent of horizontal violence in practice settings and used to augment the study of the work environment, particularly in relation to healthy work environments.
AimsThe aim of the study was to examine the relationship between bullying and burnout and the potential buffering effect psychological detachment might have on this relationship.Background
There is evidence to suggest that bullying is relatively widespread in the nursing profession, with previous studies indicating that bullying is associated with higher levels of burnout. There is, however, limited research focusing on potential moderators of the relationship between bullying and burnout.DesignA cross-sectional quantitative study conducted with self-completed, anonymous questionnaires.Methods
The study was conducted in 2011 with 762 Registered Nurses in Australia. Two hypotheses were tested with validated measures of bullying, psychological detachment and burnout. The hypotheses were tested using hierarchical regression.ResultsBullying is positively associated with burnout. Psychological detachment does not significantly moderate the relationship between bullying and burnout.Conclusion
The results indicate that bullying exacts a strong negative toll on nurses. Ensuring there are workplace policies and practices in place in healthcare organizations to reduce the instances of bullying and proactively address it when it does occur would therefore seem crucial. Individuals may also lower their risk of burning out by psychologically detaching from work.
In the present study, attitudes of elementary school teachers toward different types of bullying (verbal, physical, and relational) were investigated. Six written vignettes describing all types of bullying were given to 405 elementary school teachers (F = 218; M = 187). Results indicated that teachers perceived relational bullying, specifically, social exclusion, less serious than verbal and physical bullying. Unlike previous findings, however, the teachers considered verbal bullying behaviors more serious than physical bullying behaviors and were also more empathetic toward the victim physically bullied and the victim verbally bullied than the victim relationally bullied. Coherent with the findings of empathy, they were also more likely to intervene in verbal and physical bullying behaviors than relational bullying behaviors. Gender of the participant was a significant factor for all variables. The most rated intervention strategy was having a serious talk with the bully, regardless of the type of victimization. Multiple regression analysis illustrated that seriousness and empathy scores both predicted the need for intervention scores significantly in all types of bullying. The findings of this study highlight the importance of increasing teachers’ awareness and knowledge about all types of bullying, their consequences, and intervention skills to lessen bullying behaviors.
The aim of this study was to investigate the impact of subtle forms of workplace mistreatment (bullying and incivility) on Canadian nurses' perceptions of patient safety risk and, ultimately, nurse-assessed quality and prevalence of adverse events.
Workplace mistreatment is known to have detrimental effects on job performance and in nursing may threaten patient care quality.
A total of 336 nurses from acute care settings across Ontario responded to a questionnaire that was mailed to their home address in early 2013, with a response rate of 52%.
Bullying and incivility from nurses, physicians, and supervisors have significant direct and indirect effects on nurse-assessed adverse events (R = 0.03-0.06) and perceptions of patient care quality (R = 0.04-0.07), primarily through perceptions of increased patient safety risk.
Bullying and workplace incivility have unfavorable effects on nurse-assessed patient quality through their effect on perceptions of patient safety risk.
AIM:: The aim of this article is to examine the relationship between three types of bullying (person-related, work-related, and physically intimidating) with two types of outcomes (psychological/behavioral responses of nurses and medical errors). In addition, it investigates if the three types of bullying behaviors vary with age or gender of nurses and if the extent of bullying varies across different facilities in an institution.
Nurses play an integral role in achieving safe and effective health care. To ensure nurses are functioning at their optimal level, health care organizations need to reduce negative components that impact nurses' job performance and their mental and physical health. Mitigating bullying from the workplace may be necessary to create and maintain a high-performing, caring, and safe hospital culture.
Using an internal e-mail system, an e-mail requesting the participants to complete the questionnaire on Survey Monkey was sent to a sample of 1,078 nurses employed across three facilities at a university hospital system in Midwest. Two hundred forty-one completed questionnaires were received with a response rate of 23%. Bullying was measured utilizing the Negative Acts Questionnaire-Revised (NAQ-R). Outcomes (psychological/behavioral responses of nurses and medical errors) were measured using Rosenstein and O'Daniel's (2008) modified scales.
Person-related bullying showed significant positive relationships with psychological/behavioral responses and medical errors. Work-related bullying showed a significant positive relationship with psychological/behavioral responses, but not with medical errors. Physically intimidating bullying did not show a significant relationship to either outcome. Whereas person-related bullying was found to be negatively associated with age of nurses, physically intimidating bullying was positively associated with age. Male nurses experienced higher work-related bullying than female nurses.
Findings from this study suggest that bullying behaviors exist and affect psychological/behavioral responses of nurses such as stress and anxiety and medical errors. Health care organizations should identify bullying behaviors and implement bullying prevention strategies to reduce those behaviors and the adverse effects that they may have on psychological/behavioral responses of nurses and medical errors.
Research on workplace bullying, which has just recently passed the 20 year mark, has grown significantly over this duration of time. We provide an extensive review of the extant literature, with a focus on the antecedents and consequences of workplace bullying. We organize our review of the extant literature by level of analysis, which allows us to understand workplace bullying from each major level of analysis, while simultaneously identifying those levels at which research has been sparse. We then develop a conceptual model based on our review that similarly depicts theoretical and/or empirical findings from the extant literature, but in a succinct manner. Based on our review and conceptual model, we identify and highlight a number of key avenues for future research that will help extend the current workplace bullying literature.
Vignettes refer to stimuli, including text and images, which research participants are invited to respond. Drawing on a range of social science sources, this paper focuses on two substantive areas concerning the use of vignettes in research. Considered first is the development and construction of vignettes. This section is concerned with internal reliability; research topics; participants; and interest, relevance, realism and timing. Considered second are vignette interpretations and responses, in particular open and closed questioning; vignette perspectives; and difficulties with interpreting and responding to vignettes. Together these explorations contribute to the wider appreciation of vignette methodologies used within the social sciences. The paper concludes by outlining the limitations of using vignettes in social research.
RODWELL J. & DEMIR D. (2012) Psychological consequences of bullying for hospital and aged care nurses. International Nursing Review
Aim: This study examines the psychological consequences of workplace bullying by negative affectivity (NA) and demographics for hospital and aged care nurses.
Introduction/Background: Nurses are particularly vulnerable to workplace bullying, with suggestions that oppressed group behaviours may play a role. Bullying is a potent stressor that can negatively impact psychological well-being, which, with NA and demographics, may be important in understanding the consequences of nurse bullying. Such factors are yet to be examined together across different nursing contexts.
Methods: A cross-sectional survey was conducted across hospital and aged care nurses working within a medium to large Australian healthcare organization in October 2009. The sample comprised 233 (29.1%) hospital and 208 (43.8%) aged care nurses. Analyses of covariance were used to evaluate the data.
Results: For hospital nurses, psychological distress was noted as an impact of bullying, while depression was the impact for aged care nurses. Full-time aged care nurses reporting bullying had higher psychological distress scores, compared with part-time workers in the same area. NA was a significant covariate across both outcomes in both contexts.
Discussion/Conclusion: This study demonstrates that bullying has detrimental consequences for the mental health of nurses in both hospital and aged care contexts. The results support the suggestion that nurses are an oppressed group at high risk of bullying, confirm the intrinsic nature of NA to the bullying process, and highlight the importance of employment type for aged care nurses. Given the shortage of nurses, managers need to give higher priority to addressing workplace bullying and implementing zero tolerance policies.
A growing body of research suggests that smoking portrayals in movies influence adolescent tobacco use. However, the mechanism for this influence remains unclear. The aim of this paper is to provide an overview of research on narrative transportation theory, particularly as applied to movies and smoking. We propose that this theory can provide a valuable framework for guiding research on the role of entertainment media in smoking and other addictive behaviors.
We review empirical work on transportation theory and highlight the psychological mechanisms underlying transportation effects. ‘Transportation into narrative worlds’ refers to cognitive, emotional and imagery engagement into a narrative (including movies and entertainment media). We link this work with research on the effects of movie smoking.
Research suggests that individuals who are more highly transported into narratives show greater attitude, belief and behavior change. Transportation effects work through reducing counterarguing, creating connections (identification and liking) with characters and increasing perceptions of realism and emotional involvement. We propose several future directions and research challenges for applying a transportation framework to the issue of entertainment media effects on smoking and tobacco disparities. Understanding factors contributing to transportation may provide a more nuanced view of who will be affected by movie smoking, and understanding the psychological processes underlying narrative persuasion may guide intervention efforts.
Narrative transportation theory suggests that individuals' cognitive, emotional and imagery immersion in a narrative is a key mechanism of attitude, belief and behavior change. This theory provides a potentially generative and psychologically grounded framework for increasing knowledge about the boundary conditions and processes underlying the effects of entertainment media on tobacco use.
Vie, T. L., Glasø, L. & Einarsen, S. (2012). How does it feel? Workplace bullying, emotions and musculoskeletal complaints. Scandinavian Journal of Psychology 53, 165–173.
The present study examines experienced emotions among self-labelled victims of ongoing workplace bullying and tests whether emotions mediate the relationship between exposure to bullying and health in the form of musculoskeletal complaints. A total of 1,024 employees from a Norwegian public transport company participated in the study, in which 116 self-labelled victims were identified. Ten positive and 10 negative emotions were measured (PANAS). The results showed significant differences in emotional experiences between victims and non-victims regarding all 10 negative emotions and one out of 10 positive emotions. Victims felt less “interested” and more “afraid,”“upset,”“angry,”“guilty,”“nervous,”“hostile,”“frustrated,”“ashamed,”“scared” and “stressed” than did non-victims. Further, the results pointed to both positive and negative emotions as mediators of the relationship between exposure to bullying and musculoskeletal complaints. In particular the negative emotion “stress” acted as a significant mediator regarding this relationship. Hence, emotions seem to be central to understanding the detrimental effects of bullying on the victims’ health.
Drawing on social identity theory and intergroup emotion theory (IET), we examined group processes underlying bullying behaviour. Children were randomly assigned to one of three groups: a perpetrator's group, a target's group, or a third party group. They then read a gender-consistent scenario in which the norm of the perpetrator's group (to be kind or unkind towards others) was manipulated, and an instance of cyberbullying between the perpetrator's group and a member of the target's group was described. It was found that group membership, group norms, and the proposed antecedents of the group-based emotions of pride, shame, and anger (but not guilt) influenced group-based emotions and action tendencies in ways predicted by social identity and IET. The results underline the importance of understanding group-level emotional reactions when it comes to tackling bullying, and show that being part of a group can be helpful in overcoming the negative effects of bullying.
The arbitrary assertion of two of three experts does not establish content validity. Application of a two-stage process that incorporates rigorous instrument development practices and quantifies the aspects of content validity is required. In the first stage of this process, the content domain or dimensions are identified and items are generated to reflect the scope of the content domain of a cognitive variable or each of the dimensions of an affective variable. Once generated, the items are assembled in a usable, testable format. The instrument and domain or dimension specifications are then presented to a panel of experts, the size of which is an a priori decision, for their judgment of the items using a 4-point ordinal rating scale. Using the item evaluation, CVI calculations are applied to both the items and the entire instrument. The experts are asked, as a part of the content validity assessment, to identify areas of omission and to suggest areas of item improvement or modification. Admittedly, there are times when adherence to such rigor may not be feasible. When less stringent methods of determining validity are applied, it should not be said that content validity has been determined. Opponents of the process described in this article might argue that these applications and expectations exceed practical application and that this process is therefore too rigorous. Content validity, by its nature and definition, demands rigor in its assessment, and its assessment is, in fact, critical. Such a rigorous process for content validity determination is offered because content validity is an inexpendable form of validity which is rapidly losing credibility due to its less than standardized and rigorous assessments. Content validity, different from all other forms of validity, is crucial to the understanding of research findings and their practical or theoretical applications. It is worth the rigor.
Vignettes are simulations of real events which can be used in research studies to elicit subject's knowledge, attitudes or opinions according to how they state they would behave in the hypothetical situation depicted. Advantages associated with the use of vignettes as research tools include: the ability to collect information simultaneously from large numbers of subjects, to manipulate a number of variables at once in a manner that would not be possible in observation studies, absence of observer effect and avoidance of the ethical dilemmas commonly encountered during observation. Difficulties include problems establishing reliability and validity, especially external validity. This paper considers the advantages and disadvantages associated with the use of vignettes as data collection tools, concluding with a check-list to help critique vignettes studies.
Instrument content validity is often established through qualitative expert reviews, yet quantitative analysis of reviewer agreements is also advocated in the literature. Two quantitative approaches to content validity estimations were compared and contrasted using a newly developed instrument called the Osteoporosis Risk Assessment Tool (ORAT). Data obtained from a panel of eight expert judges were analyzed. A Content Validity Index (CVI) initially determined that only one item lacked interrater proportion agreement about its relevance to the instrument as a whole (CVI = 0.57). Concern that higher proportion agreement ratings might be due to random chance stimulated further analysis using a multirater kappa coefficient of agreement. An additional seven items had low kappas, ranging from 0.29 to 0.48 and indicating poor agreement among the experts. The findings supported the elimination or revision of eight items. Pros and cons to using both proportion agreement and kappa coefficient analysis are examined.
Recent literature defines lateral violence as nurses covertly or overtly directing their dissatisfaction inward toward each other, toward themselves, and toward those less powerful than themselves. Newly licensed nurses are an identified group that is vulnerable to lateral violence during their socialization to nursing practice. The use of cognitive rehearsal, an applied cognitive-behavioral technique, was used as an intervention and the theoretical underpinning for this study.
Twenty-six newly licensed nurses hired by a large acute care tertiary hospital in Boston, Massachusetts, participated in an exploratory descriptive study. They were taught about lateral violence in nursing practice and the use of cognitive rehearsal techniques as a shield from the negative effects of lateral violence on learning and socialization. Small laminated cueing cards with written visual cues for the appropriate responses to the most common forms of lateral violence were provided. One year later, videotaped focus groups designed to collect qualitative data about the applied intervention were conducted.
Twenty-six newly licensed nurses in three different focus groups were videotaped responding to six open-ended questions designed to elicit information on their experience with lateral violence, use of cognitive rehearsal as an intervention, and the overall socialization process.
Knowledge of lateral violence in nursing appeared to allow newly licensed nurses to depersonalize it, thus allowing them to ask questions and continue to learn. The learned cognitive responses helped them confront the lateral violence offender. Confrontation was described as difficult but resulted in the resolution of the lateral violence behavior. Overall, the retention rate in this study population was positively affected.
Clinical vignette-based surveys have been used for more than 30 years to measure variation in physicians' approaches to the diagnosis and treatment of patients with similar health problems. Vignettes offer advantages over medical record reviews, analysis of claims data, and standardized patients. A vignette-based survey can be completed more quickly than a record review or standardized patient program. Research has shown that vignette-based surveys produce better measures of quality of care than medical record reviews when used to measure differential diagnosis, selection of tests, and treatment decisions. Although standardized patients are preferred when measuring communication and physical examination skills, vignettes are more cost-effective than standardized patients when assessing clinical physicians' decision making. Vignettes offer better opportunities to isolate physicians' decision making and to control case-mix variation than do analyses of claims data sets. Clinical vignette-based surveys are simple and economical tools that can be used to characterize physicians' practice variation.
Face-toface and online: An investigation of children's and adolescents' bullying behavior through the lens of moral emotions and judgments
- L Conway
- C Gomez-Garibello
- V Tlawar
- S Shariff
Conway, L., Gomez-Garibello, C., Tlawar, V., & Shariff, S. (2016). Face-toface and online: An investigation of children's and adolescents' bullying
behavior through the lens of moral emotions and judgments. Journal of
School Violence, 15(4), 503-522. doi:10.1080/15388220.2015.1112805
20 years of workplace bullying research: A review of the antecedents and consequences of bullying in the workplace. Aggression and Violence Behavior
- A Samnani
- P Singh
Samnani, A., & Singh, P. (2012). 20 years of workplace bullying
research: A review of the antecedents and consequences of bullying in the workplace. Aggression and Violence Behavior, 17, 581-589.
doi:10.1016/j.avb.2012.08.004