Abstract
Purpose
To analyze the long-term impact of bullying among healthcare providers (T1) on missed nursing care and quality of care 2 years later (T2) and to test the potential mediating effect of affective organizational commitment.
Methods
Survey data from healthcare providers in the eldercare sector in 2006 (T1) and 2008 (T2). At T1, 9212 employees participated in the survey and 5202 participated in both T1 and T2. Including only participants who were directly engaged in the provision of care yielded 4000 providers, who were employed in 268 workgroups at T1 and T2. Associations between exposure to bullying (predictor) and the two outcomes (missed nursing care and quality of care) were investigated using multi-level linear regression analysis. Included covariates were age, gender, job position, work place and tenure.
Results
We found a significant association between workplace bullying at T1 and missed nursing care at T2 but not for quality of care at T2. Affective organizational commitment did not mediate the association between bullying and the two outcomes. However, affective organizational commitment at T1 was associated with quality of care at T2.
Conclusion
Exposure to bullying at work may cause the provider to miss nursing care for clients. To improve, care administrators should consider implementing bullying prevention strategies at three levels: organizational, work group and individual.
Similar content being viewed by others
References
Aiken LH, Sloane D, Griffiths P, Rafferty AM, Bruyneel L, McHugh M, Maier CB, Moreno-Casbas T, Ball JE, Ausserhofer D, Sermeus W (2016) Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality Safety Nov 26(7):559–568
Ball JE, Griffiths P, Raffety AM, Lindqvist R, Murrells T, Tishelman C (2016) A cross-sectional study of ‘care left undone’ on nursing shift in hospitals. J Adv Nurs 72:2086–2097
Clausen T, Borg V (2010) Psychosocial work characteristics as predictors of Affective Organisational Commitment: a longitudinal multi-level analysis of occupational well-being. Appl Psychol Health Well-Being 2:182–203
Clausen T, Hogh A, Borg V (2012) Acts of offensive behaviour and risk of longterm sickness absence in the Danish elder-care services: a prospective analysis of register-based outcomes. Int Arch Occup Environ Health 85:382–387
Clausen T, Hogh A, Carneiro IG, Borg V (2013) Does psychological well-being mediate the association between experiences of acts of offensive behavior and turnover among care workers? A longitudinal analysis. J Adv Nurs 69:1301–1313
Cohen A, Keren D (2008) Individual values and social exchange variables: Examining their relationship to and mutual effect on in-role performance and organizational citizenship behavior. Group Org Manage 33(4):425–452
Dabney BW, Kalisch BJ (2015) Nurse staffing levels and patient-reported missed nursing care. J Nurs Care Qual 30:306–312
Dang D, Bae SH, Karlowicz KA, Kim MT (2016) Do clinician disruptive behaviors make an unsafe environment for patients. J Nurs Care Qual 31:115–123
Diez Roux AV (2004) The study of group-level factors in epidemiology: rethinking variables, study designs, and analytic approaches. Epidemiol Rev 26: 104–111
Einarsen S, Hoel H, Zapf D, Cooper CL (2011) The concept of bullying and harassment at work: The European tradition. In: S.Einarsen H, Hoel D, Zapf, Cooper CL (eds) Bullying and harassment in the workplace. developments in theory, research, and practice, 2nd edn. CRC Press, Taylor and Francis Group, Boca Raton, pp 3–39
Eskildsen A, Andersen LP, Pedersen AD, Vandborg SK, Andersen JH (2015) Work-related stress is associated with impaired neuropsychological test performance: a clinical cross-sectional study. Stress 18:198–207 (The International Journal for the Biology of Stress, Early online, p 1–10)
Fayers PJ, Machin D (2000) Quality of life. Assessment, analysis and interpretation. Wiley, Chichester
Hogh A, Hoel H, Carneiro IC (2011a) Bullying and employee turnover among healthcare workers: a three-wave prospective study. J Nurs Manag 19:742–751
Hogh A, Mikkelsen EG, Hansen AM (2011b) Individual consequences of workplace bullying/mobbing. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Workplace bullying: development in theory, research and practice, 2nd edn. CRC Press. Taylor & Francis Group, Boca Raton, pp 107–128
Hogh A, Hansen ÅM, Mikkelsen EG, Persson R (2012) Exposure to negative acts at work, psychological stress reactions and physiological stress response. J Psychosom Res 73:47–52
Kahn RL, Byosiere PB (1992) Stress in organizations. In: Dunnette MD, Hugh LM (eds) Handbook of industrial and organizational psychology. Consulting Psychologists Press, Palo Alto, CA, pp 571–650
Laschinger HKS (2014) Impact of workplace mistreatment on patient safety risk and nurse-assessed patient ouctomes. J Nurs administration 44:284–290
McHugh MD, Stumpfel AW (2012) Nurse reports quality of care: a measure of hospital quality. Res Nurs Health 35:566–575
Meyer JP, Allen NJ (1997) Commitment in the workplace. Theory, research, and application. Sage Publications, Thousands Oaks
Nielsen MB, Notelaers G, Einarsen S (2011) Measuring exposure to workplace bullying. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Bullying and harassment in the workplace. developments in theory, research, and practice, 2nd edn. SRC Press. Taylor & Francis Group, Boca Raton, pp 149–174
Nielsen MB, Tangen T, Idsoe T, Matthiesen SB, Magerøy N (2015) Post-traumatic stress disorder as a consequence of bullying at work and at school. A literature review and meta-analysis. Aggress Violent Beh 21:17–24
Pejtersen JH, Kristensen TS, Borg V, Bjorner JB (2010) The second version of the Copenhagen Psychosocial Questionnaire. Scand J Public Health 38:8–24
Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP (2003) Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol 88:879–903
Reknes I, Pallesen S, Magerøy N, Moen BE, Bjorvatn B, Einarsen S (2014) Exposure to bullying behaviors as a predictor of mental health problems among Norwegian nurses: results from the prospective SUSSH-survey. Int J Nurs Stud 51:479–487
Roch G, Dubois CA, Clarke SP (2014) Organizational climate and hospital nurses’ caring practices: a mixed methods study. Res Nurs Health 37:229–240
Rodwell J, Brunetto Y, Demir D, Shacklock K, Farr-Wharton R (2014) Abusive supervision and links to nurse intention to quit. J Nurs Scholarsh 46:357–365
Rugulies R, Madsen IEH, Hjarsbech PU, Hogh A, Borg V (2012) Bullying at work and onset of a major depressive episode among Danish female eldercare workers. Scand J Work Environ Health 38:218–227
Schubert M, Glass TR, Clarke SP, Aiken LH, Schaffert-Witvliet B, Sloane DM et al (2008) Rationing of nurse care and its relationship to patient outcomes: the Swiss extension of the international hospital outcomes study. Int J Qual Health Care 20:227–237
Smeds-Alenius L, Tishelman C, Runesdottir S, McHugh MD (2016) Assessments of excellent quality of care and patient safety are associated with significantly lower odds of 30-day inpatient mortality: a national cross-sectional study of acute-care hospitals. Int J Nurs Stud 61:117–124
Taris TW, Kompier M (2006) Games researchers play—extreme groups analysis and mediation analysis in longitudinal occupational research. Scand J Work Environ Health 32:463–472
Trépanier S, Fernet C, Austin S (2013) Workplace bullying and psychological health at work: the mediating role of satisfaction of needs for autonomy, competence and relatedness. Work Stress 27:123–140
Trépanier S, Fernet C, Austin S, Boudrais V (2016) Work environment antecedents of bullying: a review and integrative model applied to registered nurses. Int J Nurs 55:85–97
Acknowledgements
The Danish government supported the collection of the data.
Author information
Authors and Affiliations
Contributions
Conception of the study: AH and MB; design: all authors; acquisition of data and analyses: TCL; interpretations, drafting and critically revising and final approval: all authors.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Hogh, A., Baernholdt, M. & Clausen, T. Impact of workplace bullying on missed nursing care and quality of care in the eldercare sector. Int Arch Occup Environ Health 91, 963–970 (2018). https://doi.org/10.1007/s00420-018-1337-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-018-1337-0