ABSTRACT
BACKGROUND: Nurse-to-nurse (N2N) horizontal violence has been documented among the main determinants of nurses' turnover intention. Even with its utmost importance, inadequate attention has been thus far drawn to the way crisis-induced pressure added to work environments, such as the coronavirus disease 2019 (COVID-19) pandemic, can impact horizontal violence, and then give rise to turnover intention. AIM: The present study was to investigate the relationship between N2N horizontal violence along with its dimensions and turnover intention among clinical nurses. METHODS: A cross-sectional survey was conducted utilizing the Turnover Intention Questionnaire (TIQ), developed by Kim et al. (2007), and the Negative Acts Questionnaire-Revised (NAQ-R; Einarsen, Hoel, & Notelaers, 2009). The participants, recruited by random sampling, included 295 clinical nurses working in referral hospitals for COVID-19. The data were also analysed using the SPSS software package (ver. 19), via descriptive and inferential statistics, Pearson correlation test and multiple linear regression. RESULTS: The study participants obtained the mean scores of 52.50 ± 11.85 and 45.38 ± 13.24 for turnover intention and horizontal violence, respectively. Among the dimensions of horizontal violence, the highest value belonged to "work-related bullying," with the mean score of 51.04 ± 15.23, and the lowest was associated with the "physically intimidating bullying" dimension, with the mean value of 15.90 ± 5.96. The Pearson correlation test results correspondingly showed that turnover intention was positively correlated with work-related bullying (r = 0.73), person-oriented bullying (r = 0.72), physically intimidating bullying (r = 0.53) and overall horizontal violence (r = 0.74). The regression analysis outcomes additionally demonstrated that the work-related and person-oriented bullying dimensions of N2N horizontal violence could predict turnover intention in nurses (F = 184.66, p < 0.001). IMPLICATIONS: The study findings help nursing managers and policymakers to immediately formulate sound measures and guidelines to prevent or at least manage the problems, viz., N2N horizontal violence and turnover intention. These measures can be thus in the form of training programs focused on communication, stress reduction and conflict resolution techniques, especially during crises, together with obvious procedures for reporting the incidents of horizontal violence.
ABSTRACT
Background: Dignity is a fundamental concept that has been threatened by the COVID-19 pandemic. Several factors threaten the dignity of COVID-19 patients, whether in palliative care departments, medical or surgery wards, intensive care units, or long-term care facilities. This threat is exacerbated by the increasing number of affected patients, the high transmission of the virus and problems such as limited resources, shortage of workforce, and ineffective communication. Recognizing the threats and challenges that currently affect the patients' dignity and managing them can help maintain the patients' dignity and increase their satisfaction. Research objective: This study seeks to explain the threats to the dignity of hospitalized COVID-19 patients. Research design: This qualitative study was conducted using conventional content analysis. Data were collected through in-depth, semi-structured, face-to-face interviews with 21 COVID-19 patients with maximum variation. Data were analyzed using Graneheim and Lundman's conventional content analysis and encoded with MAXQDA-10 software. The participants had already recovered from COVID-19 when the interviews were held. Ethical considerations: The study protocol was approved by the Research Ethics Committee of medical universities in northwestern Iran (IR.UMSU.REC.1399.345). Ethical principles were observed during the study. Findings: The analysis of the interviews revealed three main categories and 11 subcategories for the threats to the dignity of COVID-19 patients. The main categories included facing imposed conditions (five subcategories), facing unprofessional performance (four subcategories), and ineffective communication (two subcategories). Conclusion: The findings of the present study can help health officials and policymakers in taking positive steps to maintain patients' dignity by designing and implementing beneficial programs.