Lyn Quine

Workplace bullying in NHS community trust: staff questionnaire survey.

Abstract Objectives: To determine the prevalence of workplace bullying in an NHS community trust; to examine the association between bullying and occupational health outcomes; and to investigate the relation between support at work and bullying. Design: Questionnaire survey. Setting: NHS community trust in the south east of England. Subjects: Trust employees. Main outcome measures: Measures included a 20item inventory of bullying behaviours designed for the study, the job induced stress scale, the hospital anxiety and depression scale, the overall job satisfaction scale, the support at work scale, and the propensity to leave scale. Results: 1100 employees returned questionnaires—a response rate of 70%. 421(38%) employees reported experiencing one or more types of bullying in the previous year. 460(42%) had witnessed the bullying of others. When bullying occurred it was most likely to be by a manager. Two thirds of the victims of bullying had tried to take action when the bullying occurred, but most were dissatisfied with the outcome. Staff who had been bullied had significantly lower levels of job satisfaction (mean 10.5(SD 2.7) v 12.2(2.3), P<0.001) and higher levels of job induced stress (mean 22.5(SD 6.1) v 16.9(5.8), P<0.001), depression (8% (33) v 1% (7), P<0.001), anxiety (30% (125) v 9% (60), P<0.001), and intention to leave the job (8.5(2.9) v 7.0(2.7), P<0.001). Support at work seemed to protect people from some of the damaging effects of bullying. Conclusions: Bullying is a serious problem. Setting up systems for supporting staff and for dealing with interpersonal conflict may have benefits for both employers and staff.

Workplace Bullying in Nurses

The article reports a study of workplace bullying in community nurses in an NHS trust. The aims were to determine the prevalence of bullying, to examine the association between bullying and occupational health outcomes, and to investigate whether support at work could moderate the effects of bullying. Forty-four percent of nurses reported experiencing one or more types of bullying in the previous 12 months, compared to 35 percent of other staff. Fifty percent of nurses had witnessed the bullying of others. Nurses who had been bullied reported significantly lower levels of job satisfaction and significantly higher levels of anxiety, depression and propensity to leave. They were also more critical of aspects of the organizational climate of the trust. Support at work was able to protect nurses from some of the damaging effects of bullying.

Workplace bullying in junior doctors: questionnaire survey

In the United Kingdom a growing literature has identified workplace bullying as a major occupational stressor among health professionals. A study carried out in an NHS community trust found that 1 in 3 staff reported being bullied in the previous year,1 while a report by the Kings Fund, an independent health think tank, found that bullying, racial harassment, and discrimination were daily experiences for black and Asian doctors. In the United States several studies have reported that medical students suffer high levels of mistreatment or bullying during training, which increase with progression through medical school, spilling over into the early training years.2–4 We report here findings from a study of workplace bullying among junior doctors in the United Kingdom. An …

Predicting and understanding safety helmet use among schoolboy cyclists: A comparison of the theory of planned behaviour and the health belief model

Abstract The paper reports a prospective longitudinal comparison of the Health Belief Model (Rosenstock, 1966) and the Theory of Planned Behaviour (Ajzen, 1985) in which the ability of the models to predict and understand the factors determining use of protective helmets among 162 schoolboy cyclists was examined by path analysis. The TPB emerged with greater economy and less redundancy than the HBM. A second path analysis examined whether intention, which is not included among the original components of the HBM, might mediate the links between the predictor variables and behaviour, and this proved to be correct. Lastly, the effects of prior behaviour were examined and found to have a significant effect on helmet use in both models. It was concluded that the TPB had greater predictive utility than the HBM. The implications of the findings are discussed and suggestions for future research are offered.

Inequalities in pregnancy outcome: A review of psychosocial and behavioural mediators

The purpose of this paper is to review the literature on psychosocial factors in pregnancy outcome and to present a model which attempts to integrate the findings theoretically. There are four sections. The first presents published data on the incidence of early childhood mortality and low birth weight. Changes over time and differences between countries are noted and attention is drawn to the marked inequalities between occupational groups in the British data. The second section reviews the evidence that a variety of psychosocial risk factors influence pregnancy outcome, notably social, emotional, cognitive and behavioural factors. The third section develops the theme of inequalities and examines theories which have been advanced to account for the differences in adult mortality. We argue that material deprivation goes some way towards explaining inequalities in pregnancy outcome, but that any proper account will have to explain the links between inputs and outcomes--the processes and mechanisms by which material deprivation is translated into observable mortality and morbidity. In the concluding section, we argue that some of the principal links are the psychosocial risk factors described in the second section, and we present a model which traces the pathways of mediation.

Persuading school-age cyclists to use safety helmets: Effectiveness of an intervention based on the Theory of Planned Behaviour.

OBJECTIVES: To design and evaluate a theory-based intervention to encourage the use of protective helmets in school-age cyclists. DESIGN: Two-by-three mixed design on 97 cyclists who did not initially use a helmet: Condition (intervention/control) x Time (pre-intervention/immediately post-intervention/5-month follow-up). METHOD: The intervention builds on a previous study using the Theory of Planned Behaviour in which we identified a small number of salient beliefs that predict intention to use a safety helmet and helmet use (Quine et al., 1998). Participants were randomly assigned to intervention or control conditions. The intervention group was presented with a booklet containing a series of persuasive messages based on the identified salient beliefs, and the control group was presented with a different series of messages concerning a cycling proficiency and bicycle maintenance course. Initial beliefs were measured just before the intervention at Time 1, by questionnaire. The immediate effects of the intervention were evaluated by questionnaire at Time 2. Five months later, at Time 3, the long-term effects of the intervention on beliefs, intentions, and behaviour were assessed. RESULTS: The behavioural, normative and control beliefs and intentions of intervention participants became more positive than those of control participants, and the effect was maintained over time. There was also a significant effect on behaviour: at 5-month follow-up, none of the 49 control children had taken up helmet wearing, while 12 (25%) of the 48 intervention children had. CONCLUSIONS: The results suggest that in order to promote lasting helmet use in young cyclists, we need to change their beliefs. The intervention reported here may present an inexpensive solution to the problem of persuading adolescents to use safety helmets. The results point to the value of social cognition theories such as the Theory of Planned Behaviour in the design of effective interventions to change health behaviours.

First diagnosis of severe mental handicap: characteristics of unsatisfactory encounters between doctors and parents.

This paper presents data from a study of 190 parents and discusses their reactions to being told that their child was likely to be severely mentally handicapped. Dissatisfaction was related to the childs age when the parents were first told about the impairment, which was itself related to the diagnosis of the childs condition. Parents of children with non-specific handicap were often not informed about the impairment until the second or third year of the childs life, while parents of children with Downs Syndrome were usually informed within a week of birth. The paper compares these two groups of parents and discusses the reasons for their dissatisfaction. The study showed that parents valued early acknowledgement of the problem, a sympathetic approach on the part of medical professionals, and the sharing of information and uncertainty. The reasons why parents of mentally handicapped children may continue to feel dissatisfied are discussed in the light of the theoretical literature on doctor-patient communication.

Behaviour problems in severely mentally handicapped children

A population study was undertaken in two health districts of children with severe mental handicap. Prevalence figures for behaviour problems are presented. A stratified random sample of 200 families was drawn from the population. Detailed structured interviews were carried out with the childrens parents. The children were divided into two groups, comprising those with behaviour problems and those with no problems. There was a significant association between behaviour disorder and incontinence, lack of self-help skills, poor reading, writing and counting skills, and poor communication skills. Environmental correlates were few. There were no differences between groups in family size, birth order, age of parents, marital discord, social class or income. However, behaviour problems were more common in one-parent families. An association was found between maternal stress and problem behaviour. The possible mechanisms underlying this association are discussed.

Workplace bullying, psychological distress, and job satisfaction in junior doctors

Workplace bullying has been recognized as a major occupational stressor since the mid 1980s. A number of different terms have been used to describe it, including employee abuse, emotional abuse, mistreatment and neglect at work, mobbing, and harassment. In the United Kingdom, a number of reports from trades unions illustrating the pain, psychological distress, physical illness, and career damage suffered by the victims of bullying first drew attention to the issue. However, academic interest in the issue began only recently, and there are still few empirical studies. The most systematic research comes from Scandinavia, where there is strong public awareness and antibullying legislation.

Predicting safe riding behaviour and accidents: Demography, beliefs, and behaviour in motorcycling safety

Abstract A prospective national survey of British motorcyclists was designed, to examine the relationships between beliefs about safe riding, behaviour on the roads, and accidents and spills. At Time 1, 4100 riders were sent a postal questionnaire to tap their beliefs about safe riding and their self-reported behaviour on the roads in the previous year. Half the sample received a questionnaire based on the Theory of Reasoned Action (Fishbein and Ajzen, 1975) and half received a questionnaire based on the Health Belief Model (Rosenstock, 1966; Janz and Becker, 1984). Twelve months later, at Time 2, respondents were asked to complete a second questionnaire, in which they reported their behaviour and accident history in the intervening period. The most important behavioural predictor of spills and accidents was found to be a factor which measured violations - breaking the law and rules about safe riding. Law and rule breaking was strongly predicted by demographic factors, particularly age, sex, and experienc...