SOCIAL BULLYING IN NURSING AND HEALTH SCIENCES ACADEMIA: A QUALITATIVE STUDY.

Background: Academic social bullying in nursing and health professions schools is an understudied area yet emerging research shows it is prevalent. Purpose: This qualitative study derived from two larger quantitative studies targeting the development and validation of an instrument measuring academic social bullying and whose purpose was to understand the phenomenon in greater depth from narrative comments. Methods: Survey design with open ended questions was utilized to obtain content and construct validation along with reliability data for a de-novo instrument measuring academic social bullying. Over 250 nurse academics and 417 health sciences educators in baccalaureate and higher degree programs in the United States responded. This qualitative study focused on analysis of narrative comments (N = 91 nurse respondents and N = 89 health sciences faculty respondents, respectively) provided in response to open ended questions. Results: Five qualitative themes emerged from narrative content analysis. Qualitative themes approximated the construct-validated factors in the quantitative studies but also expanded on them. The themes included: Bullying experiences, faculty issues, issues of academia, student bullying of faculty, and general comments about bullying. Conclusion: Academic social bullying is a significant phenomenon for nursing and health sciences educators affecting faculty well-being. This study's qualitative findings can help enrich understanding of the problem and augment future quantitative and qualitative studies with the hope of developing targeted interventions.

Psychometric Development of an Instrument Measuring Social Bullying in Nursing Academia: Item Development and Content Validation.

BACKGROUND: Social bullying in academic nursing schools is an understudied area, yet extant research shows it is prevalent. PURPOSE: The purpose of this study was to generate a formal definition for academic social bullying and content validate an instrument measuring it in academic nursing. METHODS: Classic psychometric theory and survey design were used to develop an instrument measuring academic social bullying. Extensive literature review and analysis of existing instruments were conducted; 108 items indicating bullying behaviors and organizational characteristics were created. This study targeted establishing initial content validity. Forty nurse experts who had experienced or published on academic bullying were invited; 24 responded. Experts rated agreement with relevance/appropriateness of items using a Likert scale and provided comments. RESULTS: Forty items with content validity indexes near 0.80 and supportive comments were retained. A formal definition was developed from experts' feedback. CONCLUSIONS: Insights regarding differences between bullying and incivility were obtained.

Body height and waist circumference of young Swiss men as assessed by 3D laser-based photonic scans and by manual anthropometric measurements.

Overweight and obesity are considered among the major health concerns worldwide. The body mass index is a frequently used measure for overweight and obesity and is associated with common non-communicable diseases such as diabetes type II, cardiovascular diseases and certain cancers. However, the body mass index does not account for the distribution of body fat and relative fat to muscle mass. 3D laser-based photonic full body scans provide detailed information on various body circumferences, surfaces, and volumes as well as body height and weight (using an integrated scale). In the literature, body scans showed good feasibility, reliability, and validity, while also demonstrating a good correlation with health parameters linked to the metabolic syndrome. However, systematic differences between body scan derived measurements and manual measurements remain an issue. This study aimed to assess these systematic differences for body height, waist circumference, and body mass index using cross-sectional data from a homogenous sample of 52 young Swiss male volunteers. In addition to 3D laser-based photonic full body scans and correlative manual measurements, body fat distribution was assessed through bioelectrical impedance analysis. Overall, an excellent correlation was found between measurements of waist circumference and body mass index, and good correlation between body mass index and total fat mass, as well as between waist circumference and visceral fat mass as assessed by bioelectrical impedance analysis. Volunteers were shorter in height measured by body scan when compared to manual measurements. This systematic difference became smaller when volunteers stood in the scanner in a completely upright position with their feet together. Waist circumference was slightly smaller for manual measurements than for body scan derived values. This systematic difference was larger in overweight volunteers compared to leaner volunteers.

Factors Related to Intimidation During Oxytocin Administration.

Patient's safety and quality are foremost issues in healthcare today and are often adversely influenced by communication and issues of perceived intimidation. Labor and delivery nurses are responsible for managing oxytocin infusions, but disagreements between providers and nurses related to the administration have been shown to cause tension and affect patient's care. The purpose of this study was to survey registered nurses in labor and delivery about perceived intimidation and how intimidation influenced actions and decisions. A total of 913 registered nurses who were members of the Association of Women's Health, Obstetric, and Neonatal Nurses and identified labor and delivery comprised the sample as their clinical focus. Nurses who met the inclusion criteria were invited to participate in the survey via e-mail invitation. An online survey assessing workplace intimidation by providers while managing oxytocin inductions, as well as demographic information was completed. Participants reported past issues with intimidation that influenced how they administered oxytocin. Nurses reported that past experiences with intimidation influenced their care and that they had been involved with medication errors where intimidation played a role. Organizational factors perceived supportive management, presence of an organizational code of conduct, and environment where collaboration was encouraged were associated with decreased reports of intimidation.

Psychometric Properties of the Survey of Workplace Intimidation Instrument.

BACKGROUND AND PURPOSE: The purpose of this study was to assess the psychometric properties of the Survey of Workplace Intimidation (SWI), including content and construct validity, factor structure, and internal consistency. METHODS: A cross-sectional, descriptive study design was used for this study. The final sample consisted of 237 labor and delivery nurses who completed the SWI and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Cronbach's alpha for the SWI was .930. RESULTS: Content validity was obtained and the scale content validity index (S-CVI) was .943. Convergent validity was calculated by comparing the SWI with the PES-NWI, and the result was .408 (p = .01). A factor analysis explained 61% of the variance and resulted in two factors: prescriber behaviors and nurses' responses to prescribers' behaviors. CONCLUSIONS: The SWI demonstrated acceptable reliability and validity.

Faculty perception of bullying in schools of nursing.

This article is a report of a study conducted to determine the prevalence of bullying among faculty members in schools or colleges of nursing. The issue of bullying of nursing faculty in the academic setting is of interest in terms of recruitment, retention, job satisfaction, and the overall quality of the work environment. This cross-sectional, descriptive study of faculty in three northeastern states of the United States was carried out in 2010. The Negative Acts Questionnaire-Revised (NAQ-R) was used to survey faculty members in schools of nursing who award a baccalaureate degree (or higher) in nursing. A total of 473 faculty members met the inclusion criteria and responded to the NAQ-R. An iterative exploratory principal components analysis with orthogonal rotation was performed. Of the original 22 items, 13 were retained to measure the experiences of negative acts in the nursing faculty workplaces. The mean total score for the 13-item instrument was 17.90 (SD = 6.07) and ranged from 13 to 56. The resulting components structure produced three clear subscales identifying the experiences of verbal abuse, physical abuse, and devaluing. The revised 13-item instrument had a Cronbach's alpha value of .88. Experiences of bullying were reported in 169 of the 473 (36%) respondents. A significant correlation was found between meeting frequency and the report of bullying (r = .18, P ≤ .001). Administrators and senior faculty were more likely than expected to be the perpetrators of bullying. If the leaders are identified as bullies, the environment cannot be perceived as supportive and healthy. These unhealthy environments may have serious consequences related to retaining nursing faculty.

Peak flow values by gestation in women with asthma.

Asthma is one of the most common medical complications of pregnancy. Asthma control is associated with improved perinatal outcomes. Peak flow measures have been recommended to determine the status of asthma, yet norms for peak flow values in women with asthma are missing from the literature. The purpose of this study was to determine average peak flow values in pregnant women with asthma. Forty-three women were recruited into the study prior to the 20th week of pregnancy. Demographic data, including age, ethnic background, and number of pregnancies, were collected. Type and severity of asthma, medications used for asthma, and past hospitalizations for asthma were recorded. Peak flow values increased across the three trimesters. Significant differences were found in peak flow values between the first and third trimesters (>.001) and the second and third trimesters (>.007). Findings from the present study contradict those of studies on pregnant women without asthma.

The effects of asthma on pregnancy and perinatal outcomes.

The objective of the study was to examine the perinatal outcomes of women who have asthma and to determine if peak flow values change during pregnancy. A retrospective chart audit was conducted analyzing records of 567 women with asthma who delivered between 1992 and 1997. The most common maternal complications were meconium-stained amniotic fluid, preterm labor or delivery this pregnancy, oligohydramnios, and pregnancy-induced hypertension. The most common neonatal complications were meconium staining, preterm infant, and intrauterine growth restriction. Women who required systemic steroids were more likely to have oligohydramnios, intrauterine growth restricted infant, meconium staining, or pregnancy-induced hypertension. Peak flow values did not change by trimester of pregnancy. While the percentage of women who smoked was higher than the general population, smoking was not correlated with increased adverse perinatal outcomes. This study suggests an increased incidence of oligohydramnios, intrauterine growth restriction, and meconium-stained amniotic fluid in women with asthma. More research is needed to further the understanding of the relationship between asthma and perinatal outcomes. Prior studies have shown an association between poor control and adverse outcomes. Education is a major nursing implication.

A descriptive study of women's perceptions of their asthma during pregnancy.

PURPOSE: To determine the impact of asthma during pregnancy from the perspective of the pregnant woman. STUDY DESIGN AND METHODS: A descriptive survey using the Internet for subject recruitment and data collection was conducted using an adaptation of the Cancer Survivors Survey Questionnaire. Women with asthma who were pregnant or who had recently given birth (n = 166) were the sample. Women responded from the United States, Canada, Europe, and Asia. Physical symptoms, emotional responses, and coping strategies to deal with the asthma were queried. RESULTS: Women reported a variety of respiratory difficulties including wheezing, coughing, and shortness of breath. They were concerned about avoiding triggers leading to acute asthma, the effect of the asthma medications on the fetus, and losing their jobs due to absenteeism. They wanted to know more about how to prevent an asthma attack and what effect their disease could have on their unborn infants. CLINICAL IMPLICATIONS: Women need education and support to help them deal with asthma during pregnancy. Nursing can have an important role in teaching these women and helping them monitor their asthma status during pregnancy.