Mutually Responsive Orientation: A novel observational assessment of mother-child mealtime interactions.

Mother-child mealtime interactions during preschool years is an important but overlooked factor when evaluating the influence of parent-child relationships on child eating and weight. This paper describes the validation of the Mutually Responsive Orientation (MRO) coding system adapted for assessing parent-child interactions during food preparation and consumption situations. Home-based mealtimes of 94 mothers and their children (3.03 ± 0.75 years) were filmed at two time points, 12-months apart. Filmed dimensions of mutual mother-child responsiveness, shared positive affect, maternal control relating to food and child compliance were assessed. Objective BMI and maternal reports of parenting, feeding, child eating, diet and child temperament were also collected. Correlations, repeated measures ANOVAs and regressions were performed to examine the validity of MRO variables and their stability across both time points. Validation analysis showed the MRO coding system performed as expected: dyads with higher MRO scores expressed lower control/power assertion, lower child non-compliance, and greater committed compliance. The measure demonstrated sensitivity to specific contexts: maternal responsiveness, mother and child positive affect were higher during food consumption compared to food preparation. Coded dimensions were stable across time points, with the exception of decreases in maternal responsiveness in food consumption and child non-compliance in food preparation. MRO and maternal dimensions were correlated with maternally reported parenting and feeding measures. Maternal responsiveness (inversely) and child responsiveness (positively) were concurrently associated with child fussy eating, and child refusal was prospectively and inversely associated with child fussy eating. Findings suggest the adapted MRO coding system is a useful measure for examining observed parent-child mealtime interactions potentially implicated in preschoolers' eating and weight development.

The impact of individual and organizational resources on nurse outcomes and intent to quit.

AIM: To examine the impact of an individual resource factor (psychological capital) and an organizational resource (management support) on nurses' intentions to quit. BACKGROUND: Nursing work can be stressful and as a consequence, nurses suffer greater stress and stress-related sickness, including depression, than the general population. Stress can be mitigated in the workplace depending on the availability of resources in the workplace. Resources can come from the organization or the individual themselves. DESIGN: The study is quantitative using a cross-sectional design. METHODS: The study analysed data from 242 nurses working in five Australian hospitals in the one regional network during 2013. FINDINGS: The predictors explained almost half of the variance of nurses' intent to quit. Psychological capital had the dual benefits of reducing nurses' perceptions of psychological distress and simultaneously increasing their job satisfaction. CONCLUSION: Psychological capital is an example of the personal resources a nurse brings to work. Nurse managers can now understand the impact of a new form of protective resources that influence the levels of strain felt by nurses. If nurses present with low psychological capital, then up-skilling nurses with these personal attributes will positively impact on their health and well-being and, in turn, enhance the care of patients.

Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants.

Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers.

Abusive supervision and links to nurse intentions to quit.

PURPOSE: To investigate forms of abusive supervision, namely personal attacks, task attacks, and isolation, and their links to outcomes for nurses, including job satisfaction, psychological strain, and intentions to quit. DESIGN: Cross-sectional survey design. Data collected from July to November 2012. METHODS: Two hundred and fifty public sector nurses employed at five general acute Australian hospitals completed the survey (response rate of 33%). FINDINGS: Structural equation modeling on the forms of abusive supervision (personal, task, isolation) and nurse outcomes indicated goodness of fit statistics that confirmed a well-fitting model, explaining 40% of the variance in intent to quit, 30% in job satisfaction, and 33% in strain. An indirect relationship from personal attacks to intentions to quit, via strain, was observed. Task attacks were related directly, and indirectly via job satisfaction, to increased intentions to quit. Surprisingly, isolation was positively related to job satisfaction. CONCLUSIONS: Abusive supervision impacted nurse outcomes. Specifically, personal abuse had personal and health impacts; work-focused abuse had work-oriented effects. Applying appraisal theory suggests that personal attacks are primarily assessed as stressful and unchangeable; task-oriented attacks are assessed as stressful, but changeable; and isolation is assessed as benign. The findings highlight the impact of abusive supervision, especially task attacks, on outcomes important to nurse retention. CLINICAL RELEVANCE: The findings can be used to devise programs to educate, train, and support supervisors and their subordinates to adhere to zero tolerance policies toward antisocial workplace behaviors and encourage reporting incidents.

Addressing workplace violence among nurses who care for the elderly.

OBJECTIVE: The objective of this study was to examine the social-situational (ie, Job Demands-Resource model) and individual (ie, negative affectivity) factors that might be associated with violence among nurses caring for the elderly (aged care nurses). BACKGROUND: Workplace violence is recognized as a serious issue among nurses. Effective intervention and prevention require an understanding of antecedent factors. METHODS: Nurses working in elderly care facilities across an Australian healthcare organization participated in a cross-sectional survey. RESULTS: Job demands were associated with all of the externally sourced types of violence. Low job control was linked with external emotional abuse and physical assault. Outside work support was related to external physical assault and verbal sexual harassment. Finally, high negative affectivity was linked to internal and external emotional abuse and threat of assault. CONCLUSIONS: Both the Job Demands-Resource model and negative affectivity were useful in identifying relationships with violence, supporting suggestions that situational and individual factors are associated with violence among nurses who care for the elderly.

Antecedents and consequences of workplace aggression in the allied health context.

Workplace aggression research has typically focused on groups in the health care industry considered to be high risk (e.g., nursing); however, aggression also occurs among other health care professional groups, such as those in allied health. This study aimed to investigate the antecedents and consequences of workplace aggression among allied health professionals. Allied health professionals working for an Australian health care organization were surveyed, with 134 (49%) responding. The largest group of allied health professionals surveyed were social workers (49%). Job demands, job control, and social support were linked to different types of aggression. Different sources of aggression were linked to various employee outcomes. The importance of considering stressors surrounding employee work conditions is highlighted.

Psychological and organizational impact of bullying over and above negative affectivity: a survey of two nursing contexts.

Limited research exists on the impact of bullying across psychological and/or organizationally orientated outcomes for nurses working within different nursing contexts. Research that has explored these outcomes has not considered the potential confounding effects of negative affectivity (NA). This study's aim was to examine the extent hospital and aged care nurses are impacted by bullying on these outcomes, while considering NA. A total of 267 hospital nurses/midwives and 168 aged care nurses from an Australian healthcare organization responded to a survey. The results revealed hospital nurses/midwives who experienced bullying reported higher levels of psychological distress, as well as lower commitment and job satisfaction levels. Aged care nurses who experienced bullying reported lower levels of well-being and commitment. NA was a significant covariate for most analyses. Thus, nurses across these contexts are affected by bullying in relation to psychological and organizational-orientated outcomes over and above the effects of NA, particularly for commitment.

The oppressive nature of work in healthcare: predictors of aggression against nurses and administrative staff.

AIMS: To assess the antecedents of workplace aggression (bullying and violence) among nurses and administration staff. BACKGROUND: As a result of power structures within the healthcare industry, nurses and administration staff may be more vulnerable to workplace aggression. Environmental and individual characteristics have been linked to the occurrence of such aggression among other groups. However, most research focuses on bullying, rarely extending these ideas to violence or nurses and administration staff specifically. METHODS: Surveys were distributed to nurses and administration staff employed by an Australian healthcare organisation. Aggression types (bullying and violence), as well as environmental (demands, control and support) and individual (negative affectivity, NA) characteristics were measured. RESULTS: External emotional abuse was most frequently reported for nurses (29%) and bullying for administration staff (27%). Demands, support and NA were associated with different aggression types in nurses, whereas for administration staff, control, support and NA were linked. CONCLUSION(S): Low support and high NA are particularly important to nurses and administration staff and their experiences of aggression. IMPLICATIONS FOR NURSING MANAGEMENT: Appropriate training for managers in providing support and acknowledging individual factors associated with aggression is essential. Further, managers should monitor aggression risk from patients and their associations towards staff in busy times.

Psychosocial antecedents and consequences of workplace aggression for hospital nurses.

PURPOSE: To test a full model of the antecedents to and consequences of various forms of workplace aggression, considering psychosocial factors, for hospital nursing staff. DESIGN: Cross-sectional survey design. METHODS: Two hundred and seven nurses and midwives working across wards within a medium to large Australian hospital completed the survey. The survey response rate was 26.9%. FINDINGS: High frequencies of nurses reported exposure to workplace bullying and internal and external emotional abuse violence types. In terms of antecedents, bullying was linked to high negative affectivity (NA), as well as low supervisor support and coworker support. Internal emotional abuse was associated with low levels of these support variables, as well as high outside work support and low job control. External threat of assault was related to high job demands and NA. In terms of consequences, bullying and verbal sexual harassment were linked to increased psychological distress levels. Bullying and internal emotional abuse were related to lowered organizational commitment. Changes in job satisfaction were not found for any of the workplace aggression types. NA was a significant covariate for all analyses examining consequences of aggression. CONCLUSIONS: Different combinations of work conditions (job demands-resources) and individual levels of NA predicted certain types of aggression. Further, nurse perceptions of psychological distress and organizational commitment were affected by exposure to several types of aggression, even after controlling for NA as a potential perceptual bias. This study therefore extends previous research on workplace bullying as a stressor to other types of workplace aggression for nurses. CLINICAL RELEVANCE: The findings highlight factors that are important in considering effective prevention and intervention of workplace aggression among nursing staff, particularly those working in hospital settings.

Oppression and exposure as differentiating predictors of types of workplace violence for nurses.

AIMS AND OBJECTIVES: To extend a model of the antecedents of workplace bullying to apply to a wider range of types of workplace aggression, including bullying and several types of violence, among nurses. BACKGROUND: Research that has focused on workplace bullying has found that the Demand-Control-Support model, negative affectivity and certain demographic factors play important roles as antecedents of bullying. DESIGN: A cross-sectional design. METHODS: A validated questionnaire was sent to the work addresses of all nursing and midwifery staff in a medium-to-large hospital in Australia. A total of 273 nurses and midwives returned their completed questionnaires. Ordinal regressions were conducted to assess the antecedents of workplace aggression across bullying and violence. RESULTS: Aspects of the Demand-Control-Support model and job tenure significantly predicted particular forms of violence, while negative affectivity and work schedule were significant for bullying. CONCLUSIONS: The patterns of the results suggest key mechanisms that characterise certain forms of violence and distinguish between bullying and types of violence across the range of workplace aggression. In particular, oppression and exposure appear to differentiate types of workplace violence. RELEVANCE TO CLINICAL PRACTICE: The study suggests ways in which nursing and hospital managers may act to reduce the likelihood of certain forms of aggression, particularly violence, from occurring.

The impact of bullying on health care administration staff: reduced commitment beyond the influences of negative affectivity.

BACKGROUND: Investigations of workplace bullying in health care settings have tended to focus on nurses or other clinical staff. However, the organizational and power structures enabling bullying in health care are present for all employees, including administrative staff. PURPOSES: : The purpose of this study was to specifically focus on health care administration staff and examine the prevalence and consequences of workplace bullying in this occupational group. METHODOLOGY/APPROACH: A cross-sectional study was conducted based on questionnaire data from health care administration staff who work across facilities within a medium to large health care organization in Australia. The questionnaire included measures of bullying, negative affectivity (NA), job satisfaction, organizational commitment, well-being, and psychological distress. The three hypotheses of the study were that (a) workplace bullying will be linked to negative employee outcomes, (b) individual differences on demographic factors will have an impact on these outcomes, and (c) individual differences in NA will be a significant covariate in the analyses. The hypotheses were tested using t tests and analyses of covariances. FINDINGS: A total of 150 health care administration staff completed the questionnaire (76% response rate). Significant main effects were found for workplace bullying, with lower organizational commitment and well-being with the effect on commitment remaining over and above NA. Main effects were found for age on job satisfaction and for employment type on psychological distress. A significant interaction between bullying and employment type for psychological distress was also observed. Negative affectivity was a significant covariate for all analyses of covariance. PRACTICE IMPLICATIONS: The applications of these results include the need to consider the occupations receiving attention in health care to include administration employees, that bullying is present across health care occupations, and that some employees, particularly part-time staff, may need to be managed slightly differently to the full-time workforce.

Supervisors are central to work characteristics affecting nurse outcomes.

PURPOSE: To examine the predictive capability of the demand-control-support (DCS) model, augmented by organizational justice variables, on attitudinal- and health-related outcomes for nurses caring for elderly patients. DESIGN: The study is based on a cross-sectional survey design and involved 168 nurses working with elderly patients in facilities of a medium to large Australian organization. METHOD: Participants were asked to complete a questionnaire consisting of scales designed for measuring independent (e.g., demand, control, support, organizational justice) and dependent (e.g., job satisfaction, organizational commitment, wellbeing and psychological distress) variables. Multiple regression analyses were undertaken to identify significant predictors of the outcome variables. FINDINGS: The DCS model explains the largest amount of variance across both the attitudinal and health outcomes with 27% of job satisfaction and 49% of organizational commitment, and 33% of psychological distress and 35% of wellbeing, respectively. Additional variance was explained by the justice variables for job satisfaction (5%), organizational commitment (4%), and psychological distress (23%). CONCLUSIONS: Using organizational justice variables to augment the DCS model was valuable in better understanding the work conditions experienced by nurses caring for elderly patients. Inclusion of curvilinear effects added clarity to the potentially artifactual nature of certain interaction variables. CLINICAL RELEVANCE: The results indicated practical implications for managers of nurses caring for elderly patients in terms of developing and maintaining levels of job control, support, and fairness, as well as monitoring levels of job demands. The results particularly show the importance of nurses' immediate supervisors.

The impact of the work conditions of allied health professionals on satisfaction, commitment and psychological distress.

BACKGROUND: Allied health professionals are integral to the effective delivery of hospital-based health care, yet little is known about the working conditions associated with the attitudinal and health outcomes of these employees. PURPOSE: The purpose of this study was to investigate the extent to which the demand-control-support model, in combination with organizational justice variables, predicts the employee-level outcomes of allied health professionals. METHODOLOGY/APPROACH: Allied health professionals from an Australian health care organization were surveyed, with 113 (52.6%) participating. The survey included measures of job demands, job control, social support, organizational justice, satisfaction, commitment and psychological distress. FINDINGS: Multiple regression analyses reveal that the additive demand-control-support model predicts the outcome variables of job satisfaction, organizational commitment and psychological distress, whereas the organizational justice variables predicted organizational commitment and psychological distress. Further, both work and nonwork sources of support, in addition to specific justice dimensions, were closely associated with employee-level outcomes. PRACTICAL IMPLICATIONS: When coupled with previous research involving social support and organizational justice, the findings from this study suggest that initiatives aimed at strengthening supervisor and nonwork support, while enhancing perceptions of organizational fairness, may offer useful avenues for increasing the levels of satisfaction, commitment and well-being experienced by allied health professionals.