Influencing Factors and Consequences of Workplace Bullying among Nurses: A Structural Equation Modeling

PURPOSE: The purpose of this study was to build and test a model outlining the factors related to workplace bullying among nurses. The hypothesized model included authentic leadership and a relationship-oriented organizational culture as influencing factors, symptom experience and turnover intention as consequences, and positive psychological capital as a mediator of workplace bullying among nurses. METHODS: We obtained structured questionnaire data from 301 nurses working at hospitals in South Korea. Based on these data, the developed model was verified via a structural equation modeling analysis using SPSS and AMOS program. RESULTS: The fit indices of the hypothesized model satisfied recommended levels; χ2 = 397.58 (p < .001), normed χ2 (χ2/df) = 1.82, RMR = .05, TLI = .93, CFI = .94, RMSEA = .05. A relationship-oriented organizational culture had a direct effect on workplace bullying (β = −.48, p < .001). Furthermore, workplace bullying had a direct effect on symptom experience (β = .36, p < .001), and this relationship was mediated by positive psychological capital (β = .15, p = .003). Workplace bullying also had an indirect effect on turnover intention (β = .20, p = .007). Finally, symptom experience had a direct effect on turnover intention (β = .31, p = .002). CONCLUSIONS: These results suggest that workplace bullying among nurses may be prevented by constructing a relationship-oriented organizational culture, as long as employees have sufficient positive psychological capital. In this regard, workplace bullying among nurses should be addressed using a comprehensive strategy that considers both individual and organizational factors.

Development and Validation of a Measurement to Assess Person-centered Critical Care Nursing

PURPOSE: The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity. METHODS: A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program. RESULTS: EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p < .001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's α=.84. CONCLUSION: The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing.

Effects of a Cognitive Rehearsal Program on Interpersonal Relationships, Workplace Bullying, Symptom Experience, and Turnover Intention among Nurses: A Randomized Controlled Trial

PURPOSE: This research aimed to investigate the effects of a cognitive rehearsal program (CRP) on workplace bullying among nurses. METHODS: A randomized controlled trial was performed. Participants were 40 nurses working in different university hospitals in B city, South Korea. The experimental group was provided with a 20-hour CRP comprising scenarios on bullying situations, standard communication, and role-playing. To evaluate effects of the CRP, we measured interpersonal relationships, workplace bullying, symptom experience, and turnover intention at preand post-intervention. Follow-up effect was measured in the experimental group only at 4 weeks after the intervention. RESULTS: After the intervention, there were significant differences in interpersonal relationships (F=6.21, p=.022) and turnover intention (F=5.55, p=.024) between experimental and wait-list groups. However, there was no significant difference in workplace bullying or symptom experience between the 2 groups. The beneficial effects on interpersonal relationships and turnover intention lasted at least up to 4 weeks after CRP. CONCLUSION: The CRP for workplace bullying improves interpersonal relationships and decreases turnover intention. So it can be utilized as one of the personal coping strategies to reduce the the turnover among nurses. Further studies on the effects of unit- or hospital-based CRP and on the long-term effects of CRP are necessary.

A Grounded Theory Approach on Nurses' Experience with Workplace Bullying

PURPOSE: The purpose of this qualitative study was to explore the workplace bullying experience of Korean nurses. METHODS: Participants were twenty current or former hospital nurses who had experienced workplace bullying. Data were collected through focus group and individual in-depth interviews from February to May, 2015. Theoretical sampling method was applied to the point of theoretical saturation. Transcribed interview contents were analyzed using Corbin and Strauss's grounded theory method. RESULTS: A total of 110 concepts, 48 sub-categories, and 17 categories were identified through the open coding process. As a result of axial coding based on the paradigm model, the central phenomenon of nurses' workplace bullying experience was revealed as 'teaching that has become bullying', and the core category was extracted as 'surviving in love-hate teaching' consisting of a four-step process: confronting reality, trial and error, relationship formation, and settlement. The relationship formation was considered to be the key phase to proceed to the positive settlement phase, and the participants utilized various strategies such as having an open mind, developing human relationships, understanding each other in this phase. CONCLUSION: The in-depth understanding of the workplace bullying experience has highlighted the importance of effective communication for cultivating desirable human relationships between nurses.

Factors Affecting Prostate Cancer Screening Behavior

PURPOSE: This study was to examine the factors affecting prostate cancer screening behavior in Korean men using the health belief model (HBM). METHODS: It was a descriptive cross-sectional survey. A total of 121 participants answered questionnaires which included general characteristics, knowledge, and HBM variables related to prostate cancer and prostate cancer screening tests. RESULTS: Only 18 participants (14.9%) had had a prostate cancer screening test before. Participants who had had a prostate cancer screening test were more likely to perceive lower health status (odds ratio: 0.61 [95% confidence interval: 0.39, 0.93]), higher perceived sensitivity (odds ratio: 3.55 [95% confidence interval: 1.11, 11.36]), and higher self-efficacy (odds ratio: 5.77 [95% confidence interval: 1.51, 22.08]) than participants who had not had a test. CONCLUSION: We recommend developing an educational program which can increase the level of perceived sensitivity and self-efficacy to involve themselves in prostate cancer screening test actively.

Work Environment and Workplace Bullying among Korean Intensive Care Unit Nurses

PURPOSE: The purpose of this study was to examine the relationship between perceived work environment and workplace bullying among Korean intensive care units (ICU) nurses. METHODS: This is a descriptive survey research, with 134 ICU nurses from five hospitals in Korea. The work environment was measured by the Korean Nursing Work Environment Scale. Workplace bullying was measured with the Korean version of the Negative Acts Questionnaire-Revised. RESULTS: ICU nurses reported moderate satisfaction with their work environment, with perception of the basic work system receiving the highest scores. A total of 94.0% of ICU nurses have experienced at least one negative act within the past 6 months, and the prevalence of bullying was 17.2% according to operational bullying criteria. The ICU nurses reported that they experienced more work-related bullying than other types of bullying. Significant negative correlations between the nursing work environment and workplace bullying were found. CONCLUSION: These findings indicate that the better the nursing work environment, the less workplace bullying nurses will experience. Further research needs to be done to identify factors that influence bullying in the nurses and to develop an intervention that prevents workplace bullying.