Defne Demir

Psychosocial Antecedents and Consequences of Workplace Aggression for Hospital Nurses

PURPOSE To test a full model of the antecedents to and consequences of various forms of workplace aggression, considering psychosocial factors, for hospital nursing staff. DESIGN Cross-sectional survey design. METHODS Two hundred and seven nurses and midwives working across wards within a medium to large Australian hospital completed the survey. The survey response rate was 26.9%. FINDINGS High frequencies of nurses reported exposure to workplace bullying and internal and external emotional abuse violence types. In terms of antecedents, bullying was linked to high negative affectivity (NA), as well as low supervisor support and coworker support. Internal emotional abuse was associated with low levels of these support variables, as well as high outside work support and low job control. External threat of assault was related to high job demands and NA. In terms of consequences, bullying and verbal sexual harassment were linked to increased psychological distress levels. Bullying and internal emotional abuse were related to lowered organizational commitment. Changes in job satisfaction were not found for any of the workplace aggression types. NA was a significant covariate for all analyses examining consequences of aggression. CONCLUSIONS Different combinations of work conditions (job demands-resources) and individual levels of NA predicted certain types of aggression. Further, nurse perceptions of psychological distress and organizational commitment were affected by exposure to several types of aggression, even after controlling for NA as a potential perceptual bias. This study therefore extends previous research on workplace bullying as a stressor to other types of workplace aggression for nurses. CLINICAL RELEVANCE The findings highlight factors that are important in considering effective prevention and intervention of workplace aggression among nursing staff, particularly those working in hospital settings.

Oppression and exposure as differentiating predictors of types of workplace violence for nurses

AIMS AND OBJECTIVES To extend a model of the antecedents of workplace bullying to apply to a wider range of types of workplace aggression, including bullying and several types of violence, among nurses. BACKGROUND Research that has focused on workplace bullying has found that the Demand-Control-Support model, negative affectivity and certain demographic factors play important roles as antecedents of bullying. DESIGN A cross-sectional design. METHODS A validated questionnaire was sent to the work addresses of all nursing and midwifery staff in a medium-to-large hospital in Australia. A total of 273 nurses and midwives returned their completed questionnaires. Ordinal regressions were conducted to assess the antecedents of workplace aggression across bullying and violence. RESULTS Aspects of the Demand-Control-Support model and job tenure significantly predicted particular forms of violence, while negative affectivity and work schedule were significant for bullying. CONCLUSIONS The patterns of the results suggest key mechanisms that characterise certain forms of violence and distinguish between bullying and types of violence across the range of workplace aggression. In particular, oppression and exposure appear to differentiate types of workplace violence. RELEVANCE TO CLINICAL PRACTICE The study suggests ways in which nursing and hospital managers may act to reduce the likelihood of certain forms of aggression, particularly violence, from occurring.

Psychological consequences of bullying for hospital and aged care nurses

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.

The impact of the work conditions of allied health professionals on satisfaction, commitment and psychological distress

Background: Allied health professionals are integral to the effective delivery of hospital-based health care, yet little is known about the working conditions associated with the attitudinal and health outcomes of these employees. Purpose: The purpose of this study was to investigate the extent to which the demand-control-support model, in combination with organizational justice variables, predicts the employee-level outcomes of allied health professionals. Methodology/Approach: Allied health professionals from an Australian health care organization were surveyed, with 113 (52.6%) participating. The survey included measures of job demands, job control, social support, organizational justice, satisfaction, commitment and psychological distress. Findings: Multiple regression analyses reveal that the additive demand-control-support model predicts the outcome variables of job satisfaction, organizational commitment and psychological distress, whereas the organizational justice variables predicted organizational commitment and psychological distress. Further, both work and nonwork sources of support, in addition to specific justice dimensions, were closely associated with employee-level outcomes. Practical Implications: When coupled with previous research involving social support and organizational justice, the findings from this study suggest that initiatives aimed at strengthening supervisor and nonwork support, while enhancing perceptions of organizational fairness, may offer useful avenues for increasing the levels of satisfaction, commitment and well-being experienced by allied health professionals.

The oppressive nature of work in healthcare: predictors of aggression against nurses and administrative staff

AIMS To assess the antecedents of workplace aggression (bullying and violence) among nurses and administration staff. BACKGROUND As a result of power structures within the healthcare industry, nurses and administration staff may be more vulnerable to workplace aggression. Environmental and individual characteristics have been linked to the occurrence of such aggression among other groups. However, most research focuses on bullying, rarely extending these ideas to violence or nurses and administration staff specifically. METHODS Surveys were distributed to nurses and administration staff employed by an Australian healthcare organisation. Aggression types (bullying and violence), as well as environmental (demands, control and support) and individual (negative affectivity, NA) characteristics were measured. RESULTS External emotional abuse was most frequently reported for nurses (29%) and bullying for administration staff (27%). Demands, support and NA were associated with different aggression types in nurses, whereas for administration staff, control, support and NA were linked. CONCLUSION(S) Low support and high NA are particularly important to nurses and administration staff and their experiences of aggression. IMPLICATIONS FOR NURSING MANAGEMENT Appropriate training for managers in providing support and acknowledging individual factors associated with aggression is essential. Further, managers should monitor aggression risk from patients and their associations towards staff in busy times.

Abusive supervision and links to nurse intentions to quit

PURPOSE To investigate forms of abusive supervision, namely personal attacks, task attacks, and isolation, and their links to outcomes for nurses, including job satisfaction, psychological strain, and intentions to quit. DESIGN Cross-sectional survey design. Data collected from July to November 2012. METHODS Two hundred and fifty public sector nurses employed at five general acute Australian hospitals completed the survey (response rate of 33%). FINDINGS Structural equation modeling on the forms of abusive supervision (personal, task, isolation) and nurse outcomes indicated goodness of fit statistics that confirmed a well-fitting model, explaining 40% of the variance in intent to quit, 30% in job satisfaction, and 33% in strain. An indirect relationship from personal attacks to intentions to quit, via strain, was observed. Task attacks were related directly, and indirectly via job satisfaction, to increased intentions to quit. Surprisingly, isolation was positively related to job satisfaction. CONCLUSIONS Abusive supervision impacted nurse outcomes. Specifically, personal abuse had personal and health impacts; work-focused abuse had work-oriented effects. Applying appraisal theory suggests that personal attacks are primarily assessed as stressful and unchangeable; task-oriented attacks are assessed as stressful, but changeable; and isolation is assessed as benign. The findings highlight the impact of abusive supervision, especially task attacks, on outcomes important to nurse retention. CLINICAL RELEVANCE The findings can be used to devise programs to educate, train, and support supervisors and their subordinates to adhere to zero tolerance policies toward antisocial workplace behaviors and encourage reporting incidents.

An Observational Approach to Testing Bi-Directional Parent-Child Interactions as Influential to Child Eating and Weight.

Obesity among children has been on the rise globally for the past few decades. Previous research has centred mainly on self/parent-reported measures examining only uni-directional parental feeding styles and practices. Recent discussions in the literature have raised the importance of bi-directional parent–child interactions in influencing childrens weight status. The aims of this paper are to highlight the importance of an observational approach when investigating positive bi-directional parent–child interactions during mealtimes and to outline how these interactions may be linked to positive child eating and weight outcomes. We examine the current literature on self-reported parental patterns and argue for the influential roles of responsiveness, affect and parental control dimensions within the parent–child dyad. Information about the ways in which the parent and the child can influence each other on these dimensions, as observed in parent–child interactions around food, is likely to provide greater insights into the aetiology of childhood obesity.

The Blurring of Attractive Work Practices Across Health Care Sectors

Magnet-style characteristics are considered important to the recruitment and retention of nurses. Little is known about nurses’ perceptions of these characteristics across public, private, and third sector health care organizations. The primary aim of this paper is to examine these characteristics across sectors to determine whether differences in key Magnet-style characteristics exist. Given the employee-level focus, demographic factors were also considered. Australian nurses (n = 459) were recruited using an online panel. No differences between sectors on work environment dimensions were found. Gender, age, employment type, and tenure revealed significant relationships with various work characteristics. Similarities in the work perceptions across sectors implies no specific sector will be differentially impacted by the increasing nurse shortages. An increasing emphasis on contemporary work environments will increase the presence of Magnet-like characteristics irrespective of sector. These results highlight the potential of practice permeability occurring, particularly in a system with common policy and operational drivers.

Workplace bullying among allied health professionals: prevalence, causes and consequences

Workplace bullying is an occupational hazard in the healthcare industry. Allied health professionals form an important, yet underresearched, part of this industry. The aim of this study was to investigate the antecedents and consequences of bullying within the allied health context. Data were collected from 166 allied health professionals working in a large Australian healthcare organisation (response rate = 76%). Logistic regression and analyses of covariance were conducted. Almost a quarter (24%) of respondents reported experiences of workplace bullying. In testing the antecedents of bullying, low levels of supervisor support and high negative affectivity were associated with bullying. In terms of consequences, bullying, along with tenure, employment type and age, influenced levels of depression and psychological distress. Findings may assist in informing effective strategies that aim to reduce and target the occurrence of such negative workplace behaviour.

Psychological and organizational impact of bullying over and above negative affectivity: A survey of two nursing contexts

Limited research exists on the impact of bullying across psychological and/or organizationally orientated outcomes for nurses working within different nursing contexts. Research that has explored these outcomes has not considered the potential confounding effects of negative affectivity (NA). This studys aim was to examine the extent hospital and aged care nurses are impacted by bullying on these outcomes, while considering NA. A total of 267 hospital nurses/midwives and 168 aged care nurses from an Australian healthcare organization responded to a survey. The results revealed hospital nurses/midwives who experienced bullying reported higher levels of psychological distress, as well as lower commitment and job satisfaction levels. Aged care nurses who experienced bullying reported lower levels of well-being and commitment. NA was a significant covariate for most analyses. Thus, nurses across these contexts are affected by bullying in relation to psychological and organizational-orientated outcomes over and above the effects of NA, particularly for commitment.