Mistreatment, discrimination and burn-out in Neurosurgery.

OBJECTIVE: Issues concerning harassment, bullying and discrimination are not unknown to medical specialties and are likely to be present in neurosurgery as well. The aim of this study was to estimate the extent to which neurosurgeons are faced with issues pertaining to this mistreatment. METHODS: A survey consisting of fourteen questions was distributed among members of the Congress of Neurological Surgeons (CNS). The survey consisted of three parts: 1) demographics; 2) exposure to mistreatment; 3) experienced burnout symptoms. RESULTS: In total 503 out of the 5665 approached CNS members filled in a survey (response rate 8.9 %). Respondents consisted for 85.9 % out of neurosurgeons and for 13.9 % out of residents. Overall, 61.4 % of the respondents was a victim of form of abusive behavior, while 47.9 % was a victim of at least one form of discrimination. Most reported sources of these mistreatments were other neurosurgeons or (family of) patients. Overall, 49.9 % of the respondents experienced burnout symptoms. Multivariable logistic regression analysis showed that female respondents had higher odds of being a victim of abuse (OR 2.5, 95 % CI 1.4-4.6). Female respondents (OR 19.8, 95 % CI 8.9-43.9) and ethnic minorities (OR 3.8, 95 % CI 2.3-6.2) had higher odds of being a victim of discrimination. Furthermore, victims of abuse were at higher odds (OR 1.7, 95 % CI 1.1-2.6) of having burnout symptoms. CONCLUSIONS: Mistreatment and experiencing burnout symptoms frequently occurs among neurosurgeons and residents.

Women in Otolaryngology: Experiences of Being Female in the Specialty.

OBJECTIVES: A broad survey of women otolaryngologists on the current state of the field, including opportunities for advancement, support of family leave, and prevalence of harassment, has not been performed since 1998. An update on the experiences of female otolaryngologists is vital to continue to advance the specialty. STUDY DESIGN: Anonymous web-based survey. METHODS: Survey of members of the Women in Otolaryngology (WIO) section of the American Academy of Otolaryngology-Head and Neck Surgery (all members of the AAO-HNS that identify as female are automatically members of this section). Distributed via AAO-HNS. RESULTS: Five hundred thirty-five responses out of 2303 total WIO members (response rate of 23.2%). Respondents ranged in age from 25 to >65 years. Respondents reported that in the residency programs they attended, 29% of residents, 13% of faculty, and 7% of department leaders were women. Forty-four percent disagreed that their department leaders and 39% disagreed that their male co-residents were supportive of women starting families in training. Younger respondents were more likely to feel that their department leaders were supportive of female residents, maternity leave, etc. Harassment in the current work environment did not differ by age; 53% reported harassment-free, 31% subtle undertones, 8% noticeable tones, 2% significant harassment. Harassment in the workplace varied by region; the greatest level of harassment was in the Midwest. CONCLUSIONS: Women otolaryngologists continue to experience harassment in the workplace. It is encouraging that younger otolaryngologists feel more supported by their departments in both their careers and their personal lives. This survey highlights critical areas for continued growth within our specialty. LEVEL OF EVIDENCE: IV Laryngoscope, 131:E380-E387, 2021.

'You must acknowledge and address the toxic culture at Edinburgh's vet school'.

Edinburgh university's head of the College of Medicine and Veterinary Medicine, Moira Whyte, must identify the root cause of bullying and harassment at its vet school, says an academic insider.

'It comes with the territory' - Staff experience with violation and humiliation in mental health care - A mixed method study.

BACKGROUND: The aim of this study was to investigate staff's experiences with violation and humiliation during work in mental health care (MHC). A total of 1160 multi-professional MHC staff in Norway responded to an online questionnaire about their experiences with different kinds of violation and humiliation in the MHC setting. In addition, a sample of professionals (eight MHC nurses) were recruited for in-depth individual interviews. METHOD: The study used an explorative mixed method with a convergent parallel design; this included a web-based questionnaire to MHC staff in combination with individual interviews. The sample is considered to be equivalent to staff groups in MHC in Norway. RESULTS: Between 70 and 80% of the staff reported experiencing rejection, being treated with disrespect, condescending behaviour or verbal harassment. Male workers were significantly more often victims of serious physical violence, and women were significantly more often targets for sexual harassment. In interviews, participants said they considered being exposed to violence and humiliation to be part of the job when working in MHC, and that experience, as well as social support from colleagues, helped MHC practitioners to cope better with violent situations and feel less humiliated at work. DISCUSSION: A high amount of MHC staff report experiences of being violated and humiliated during work. The participants' perceptions of the users and their behaviour seem to influence their experience of feeling violated and humiliated. Knowledge about the dynamics of aggression between staff and users in MHC may be used in safeguarding staff and users, prevent coercion and heighten the quality of care.

Adaptação e análise da estrutura interna da Escala de Mobbing de Leymann (LIPT45) para o contexto português / Adaptation and analysis of the internal structure of the Leymann Inventory of Psychological Terror (LIPT45) for the Portuguese context / Adaptación y análisis de la estructura interna de la escala de mobbing de Leymann (LIPT45) para el contexto portugués

O objetivo deste trabalho consiste em adaptar e analisar a estrutura interna da versão portuguesa do Leymann Inventory of Psychological Terror (LIPT45). Foi utilizada uma amostra de 404 indivíduos (70,5% mulheres) entre os 18 e os 69 anos (M = 32,9; DP = 12.606). O LIPT45-PV é uma escala de autorrelato composta por 45 itens que avaliam o assédio moral nas organizações, divididos em cinco dimensões: efeitos na autoexpressão; efeitos sobre os contatos sociais; efeitos sobre a reputação pessoal; efeitos sobre a situação ocupacional e qualidade de vida, e efeitos sobre a saúde. Foi utilizada uma análise fatorial confirmatória e o Exploratory Structural Equation Modeling (ESEM), mediante os quais se avaliou um modelo de cinco dimensões, além da confiabilidade do construto e das pontuações. Em conformidade com os resultados da ESEM, o LIPT45-PV apresenta uma estrutura fatorial coerente, assim como uma maior diferenciação entre as suas dimensões. Da mesma forma, os indicadores de confiabilidade do construto e das pontuações foram adequados. Conclui-se que o LIPT45-PV revela características psicométricas (estrutura interna e confiabilidade) que o configura como um instrumento adequado para avaliar o respetivo constructo em adultos.(AU)

The aim of this work was to adapt and analyze the internal structure of the Portuguese version of the Leymann Inventory of Psychological Terror (LIPT45). A sample of 404 individuals (70.5% women) aged between 18 and 69 years (M = 32.9; SD = 12.606) was used. The LIPT45-PV is a self-report scale composed by 45 items that assess mobbing in organizations, divided into five dimensions: effects on self-expression; effects on social contacts; effects on personal reputation; effects on the occupational situation and quality of life, and effects on health. Confirmatory factor analysis and Exploratory Structural Equation Modeling (ESEM) were used, through which a five-dimensional model was evaluated, as well as the reliability of the construct and the scores. According to the results of the ESEM, the LIPT45-PV presents a coherent factor structure, as well as greater differentiation between its dimensions. Likewise, the reliability indicators of the construct and the results were adequate. We can conclude that the LIPT45-PV reveals psychometric characteristics (internal structure and reliability) that configure it as an adequate instrument to evaluate the respective construct in adults.(AU)

El objetivo de este trabajo consiste en adaptar y analizar la estructura interna de la versión portuguesa del Leymann Inventory of Psychological Terror (LIPT45). Fue utilizada una muestra de 404 individuos (70.5% mujeres) entre los 18 y 69 años (M= 32.9; DS = 12.606). El LIPT45-PV es una escala de autoinforme compuesta por 45 ítems que evalúan el acoso laboral en las organizaciones, divididos en cinco dimensiones: efectos en la autoexpresión; efectos sobre los contactos sociales; efectos sobre la reputación personal; efectos sobre la situación ocupacional y calidad de vida, y efectos sobre la salud. Fue utilizado un análisis factorial confirmatorio y el Exploratory Structural Equation Modeling (ESEM), a través de los cuales se evaluó un modelo de cinco dimensiones, además de la confiabilidad del constructo y de las puntuaciones. De acuerdo con los resultados del ESEM, el LIPT45-PV presenta una estructura factorial coherente, así como una mayor diferenciación entre sus dimensiones. Asimismo, los indicadores de confiabilidad del constructo y de las puntuaciones fueron adecuados. Se concluye que el LIPT45-PV presenta características psicométricas (estructura interna y confiabilidad) que lo configuran como un instrumento adecuado para evaluar el constructo mencionado en adultos.(AU)

Barriers to Firearm Injury Research.

INTRODUCTION: Firearm injuries and motor vehicle injuries are 2 leading causes of fatal injury in the U.S., each accounting for approximately 35,000 deaths annually. Research on firearm injuries is under-represented compared with research on motor vehicle collisions. This study seeks to identify perceived barriers to firearm injury research versus motor vehicle injury research. METHODS: This was a mixed-methods survey of corresponding authors of a minimum of 1 study, archived in PubMed, related to firearm injury or motor vehicle injury between 2014 and 2018. Analyses were performed in 2019. Electronic surveys included both closed- and open-ended questions to assess barriers to research. Bivariable and multivariable logistic regression was performed to identify differences in perceptions to barriers between the 2 groups. Qualitative analysis of free-text responses was performed through inductive derivation of themes. RESULTS: Surveys were distributed to 113 firearm injury researchers (42% response rate) and 241 motor vehicle injury researchers (31.5% response rate). After adjustment, firearm injury researchers were less likely to cite institutional support (AOR=0.3, 95% CI=0.1, 0.8) as a factor contributing to their success, than motor vehicle injury researchers. Firearm injury researchers were more likely to report fear of personal threats (AOR=10.4, 95% CI=2.4, 44.4) and experiencing personal threats (AOR=16.1, 95% CI=1.6, 165.4). Thematic analysis revealed 4 themes: career, political, funding, and harassment. CONCLUSIONS: When compared with motor vehicle injury researchers, firearm injury researchers are significantly more likely to report limited support and threats to personal safety as barriers to research. Further research to understand the impact of these barriers and methods to overcome them is needed.

Disruptive behaviors among nurses in Israel - association with listening, wellbeing and feeling as a victim: a cross-sectional study.

OBJECTIVES: To examine the association between listening and disruptive behaviors and the association between disruptive behavior and the wellbeing of the nurse. To test whether constructive and destructive listening has an incremental validity. METHODS: A structured questionnaire survey that measured the (constructive & destructive) listening climate at work, exposure to disruptive behaviors, well-being and feeling as a victim. We presented this survey using the Qualtrics software. RESULTS: Of the final sample of 567 respondents who reported that they were nurses, MAge = 38.41, 67% indicated that they were exposed to some form of disruptive behavior. Experiencing listening in the ward was associated with low levels of exposure to disruptive behaviors; exposure to disruptive behaviors, in turn, predicted reduction in the nurses' wellbeing; the reduction in wellbeing was especially pronounced among nurses who felt like a victim. Each of the facets of the listening measure-constructive listening and destructive listening-had incremental validity in predicting exposure to disruptive behaviors. Finally, the effect of exposure to disruptive behavior on wellbeing was curvilinear. CONCLUSIONS: Disruptive behavior is a major challenge to the workplace well-being for nurses. The victim mentality has an adverse impact on nurses. Preventive efforts aimed at reducing disruptive behaviors among nurses and decreasing their sense of victimization are crucial for the well-being of nurses.

Psychotherapists in danger: The ethics of responding to client threats, stalking, and harassment.

The ethics issues involved when clients threaten, stalk, or harass their psychotherapists have generally been neglected in the literature, leaving few psychologists prepared to manage such challenging situations. This article presents 3 clinical vignettes and recommendations resulting from a recent conference in Colorado on this important topic. In essence, the article seeks to address ways psychotherapists can balance the ethical challenges of simultaneously protecting clients and themselves. Each vignette is considered from ethical, clinical, and legal perspectives. Suggestions for the individual practitioner include reference to the principles and standards in the American Psychological Association's Ethics Code, professional consultation, and an increased emphasis on self-care. Recommendations for the profession involve ideas for the American Psychological Association's Ethics Code Task Force as well as a call for further research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Childhood maltreatment experiences and problematic sexual outcomes in adult males who have sexually offended: Further evidence of the potency of male caregiver psychological abuse.

BACKGROUND: Although research on the developmental antecedents of sexual offending has tended to focus on sexual abuse, recent research in juveniles and adults who have sexually offended suggests that psychological abuse perpetrated by a male caregiver may be a particularly important factor in the development of problematic sexual interests and behaviors. OBJECTIVE: This study aimed to extend previous findings by investigating the association between psychological abuse by a male caregiver and problematic sexual outcomes in a sample of adult males who had sexually offended. PARTICIPANTS: Participants were 529 adult males incarcerated for sexual offenses, 21% of whom were civilly committed. METHODS: Childhood maltreatment and problematic sexual outcomes were assessed using the Multidimensional Assessment of Sex and Aggression, a contingency-based inventory that assesses domains related to sexual aggression. Hierarchical regressions were calculated examining the association between childhood abuse types and sexual outcomes. RESULTS: Childhood sexual abuse was associated with child sexual (ß = .247, p < .001) and other paraphilic interests (ß = .189, p < .001). Male caregiver psychological abuse also emerged as marginally associated with child sexual interest (ß = .100, p = .059), even after controlling for other abuse types. CONCLUSIONS: These results partially replicate recent findings in a juvenile sample and challenge conventional developmental theories of sexual offending, by suggesting that male caregiver psychological abuse may play a role in the etiology of child sexual interest among males who have sexually offended. This study also suggests a possible gender symmetry effect moderating the developmental consequences of abuse.

Military hazing and suicidal ideation among active duty military personnel: Serial mediation effects of anger and depressive symptoms.

BACKGROUND: Military hazing is one of most serious problems affecting suicidal ideation (SI) among active duty personnel, but has received limited research attention. Studies on hazing and SI indicate anger and depressive symptoms as mediators for SI. METHODS: A sample of active duty military personnel (N = 944) completed an offline survey, consisting of the revised Conflict Tactics Scale-2, Composite International Diagnostic Interview Screening Scale, and revised Columbia Suicide Severity Rating Scale. Frequency, bivariate correlation, and serial mediation analyses were conducted to assess the serial effects of military hazing on SI, mediated via anger and depressive symptoms. RESULTS: Military hazing, anger, depressive symptoms, and SI were positively related to each other in bivariate analyses. In serial mediation analyses, hazing was found to be a significant predictor of higher levels of anger, consequently triggering depressive symptoms, which, in turn, were associated with greater SI. LIMITATIONS: Study limitations included the use of cross-sectional data with the use of retrospective self-report. CONCLUSION: Hazing in the military is prevalent (17.6%), and SI is associated with serial effects of hazing, anger, and depressive symptoms with full mediation path. Findings suggest that policies that address reducing hazing and implementing clinical interventions specifically focused on symptoms of anger and depression may be important for decreasing SI in military personnel.

Gender Differences in Veterans' Perceptions of Harassment on Veterans Health Administration Grounds.

PURPOSE: Stranger harassment at Veterans Health Administration (VA) facilities is prevalent, affecting one in four women veteran VA primary care users. Harassment interferes with health care quality and may result in veterans forgoing or delaying needed care. To better understand this phenomenon, gender-stratified discussion groups were held with men and women veterans. This article examines gender differences in veterans' perceptions and experiences of harassment on VA grounds. METHODS: We conducted a total of 15 discussion groups at four VA medical centers, eight with men (n = 57) and seven with women (n = 38). Transcripts were coded using the constant comparative method and analyzed for overarching themes. RESULTS: Awareness of harassment was not uniformly high among participants. Although women voiced clear understandings and experiences of specific behaviors constituting harassment (e.g., cat-calls, sexual comments), many men expressed confusion about how to differentiate between harassment, "harmless flirting," and general friendliness; they were unsure which behaviors "cross a line." Furthermore, men placed the onus on women for setting boundaries, whereas women indicated it was not their responsibility to "train" men about acceptable behavior. Men and women agreed that VA staff hold primary responsibility for preventing and managing harassment. CONCLUSIONS: Substantive gender differences in understandings of harassment exist among veteran VA users. To minimize harassment, veterans recommend education of men veteran VA users, and staff-oriented trainings. Privacy, safety, dignity, and security are the cornerstones of women veterans' health care, per VA policy. Harassment undermines these standards, impeding women's access to VA care and compromising both their health outcomes and health care experiences. Understanding harassment through a gendered lens is a critical step in designing comprehensive initiatives that respond to diverse viewpoints and experiences.

The Role of Neuroticism in Predicting Psychological Harassment in Nursing: A Longitudinal Study.

Psychological harassment is a serious occupational risk for nurses, but little is known about its related factors and possible predictors. The objective of the present study was to investigate whether nursing students' neuroticism trait and coping styles can predict psychological harassment at work when they later become nurses. A non-experimental, longitudinal, three-wave prospective study with a time lag of 6 years was carried out, following nursing students from three Spanish universities until they joined the health labor market. The age range of the sample was 20⁻48 years, and the mean age was 26.99 ± 5.72; the majority of the sample were women (88.5%). Predictor variables were neuroticism and coping styles (emotional and behavioral coping). The criterion variable was psychological harassment. To examine the model fit between the predictor and criterion variables, we conducted structural equation modelling. Results confirmed a high correlation between neuroticism and psychological harassment. In addition, a direct effect of neuroticism on psychological harassment was found; however, emotional and behavioral coping styles did not show a good fit. Proactive interventions to improve emotional self-control are needed in order to prevent negative effects of psychological harassment at work on nurses.

Assédio moral no ámbito da justiça brasileira: fatores do cenário produtores de volência psicológica / Mobbing in the field of justice: when the scenario produces psychological / Acoso moral en el ámbito de la justicia brasileña: cuando el escenario laboral produce violencia psicológica

Desde a última década do século XX têm se intensificado as pesquisas acerca do assédio moral no trabalho. O fenômeno está inserido em diversos cenários, com implicações nas organizações e, por conseguinte, na sociedade. Este estudo objetivou analisar quais fatores do contexto laboral se relacionam à presença de Assédio Moral em Instituição Judiciária brasileira. Trata-se de estudo quantitativo, de alcance transversal e correlacional. Obtiveram-se os dados por meio de questionário biossociodemográfico e laboral, do Questionário de Atos Nega-tivos (QAN) e da escala Avaliação do Contexto de Trabalho (EACT) do Inventário sobre o Trabalho e Risco de Acidente (ITRA). Os resultados apontaram correlações significativas positivas entre as dimensões contexto de trabalho, organização do trabalho e relações socioprofisssionais e a presença de assédio moral. Como causas preponderantes do fenômeno investigado emergiram fatores relacionados ao cenário onde é desenvolvido o trabalho, caracterizado por imposição de metas e cobrança de resultados. Considerando a abrangência desse tipo de violência no cotidiano laboral, são necessárias intervenções multidimensionais, a fim de prevenção e promoção de saúde ocupacional.

Since the last decade of the 20th century, due to the repercussions on worker's health, research about bullying at work has intensified. The phenomenon is inserted in numerous contexts, with implications in organizations and therefore, in society. The objective of this study is to analyze which work-related factors relate to the presence of harassment at the Brazilian Judicial Institution, as well as what variables can be associated with the public servants' health damage. The scope of this research was transversal and correlative. Data was obtained through a bio-socio-demographic survey from the Negative Acts Questionnaire (NAQ) and the Work Context Assessment Scale (EXACT) of the Work Inventory and Accident Risk (ITRA). Statistical analysis showed that the longer a public servant works, the more susceptible is to bullying practices. There were significant correlations between the dimensions of work context, work organization, social and professional relationships and the presence of harassment. Factors related to the workplace appeared as predominant causes of the phenomenon.

Desde la última década del siglo XX, debido a las repercusiones en la salud del trabajador, las investigaciones acerca del acoso moral se han intensificado. El fenómeno está inserto en diversos escenarios, con implicaciones en las organizaciones y por consiguiente, en la sociedad. Este estudio se propuso como objetivo analizar qué factores laborales se relacionan con la presencia de acoso moral en las instituciones del sistema judicial brasileño, así como qué variables pueden estar asociadas a los daños en la salud de sus funcionarios públicos. El alcance de la investigación fue transversal y correlacional. Se obtuvieron los datos por medio de un cuestionario bio-sociodemográfico y laboral, del Cuestionario de Actos Negativos (QAN) y la escala Evaluación del Contexto de Trabajo (EACT) del Inventario Laboral y Riesgo de Accidentes (ITRA). Los análisis estadísticos evidenciaron que cuanto mayor es el tiempo de servicio, más susceptible resulta el servidor público de sufrir prácticas de acoso moral. Hubo correlaciones significativas positivas entre las dimensiones Contexto de trabajo, Organización del trabajo y Relaciones socio-profesionales, y la presencia de acoso moral. Como causas preponderantes del fenómeno investigado surgieron factores relacionados al escenario laboral donde se desarrolla el trabajo

[Work related stress, sociological analysis]. / La souffrance au travail, réflexion sociologique.

Experienced on a personal and psychological level, work related stress nevertheless has social causes. New forms of management demand from staff an ever greater personal investment, but the growing intensification of the work often makes the missions they are given impossible to fulfil. This results in a feeling of having failed and of not being up to the job, which are in turn sources of suffering and stress.

[Moral harassment in the workplace and work related stress]. / Harcèlement moral en entreprise et souffrance au travail.

Work related stress may be caused by moral harassment or not. The law gives a precise definition of harassment, which constitutes a civil and criminal offence. This situation requires proof to be gathered and those responsible to be identified. In all cases, employees can protect themselves from harassment and seek help.