Association of nurse managers' paternalistic leadership and nurses' perceived workplace bullying: The mediating effect of organizational climate.

AIMS: To explore the association between nurse managers' paternalistic leadership and nurses' perceived workplace bullying (WPB), as well as to examine the mediating role of organizational climate in this association. BACKGROUND: There is a lack of empirical evidence regarding the relationship between nurse managers' paternalistic leadership, organizational climate and nurses' perceived WPB. Clarifying this relationship is crucial to understand how paternalistic leadership influences WPB and for nursing managers to seek organizational-level solutions to prevent it. METHODS: A cross-sectional survey was performed from 4 January to 10 February 2022, in six tertiary hospitals in mainland China. Demographic information, Paternalistic Leadership Scale, Organizational Climate Scale and Negative Acts Questionnaire-Revised were used in the survey. Descriptive statistics, Spearman correlation analyses and a structural equation model were used for data analysis. RESULTS: A total of 5093 valid questionnaires were collected. Moral leadership and authoritarian leadership have both direct and indirect effects on WPB through the mediating effect of organizational climate. The former is negatively related to WPB and the latter is positively related to WPB. Benevolent leadership was only negatively associated with WPB via the mediating effect of organizational climate. CONCLUSION: The three components of paternalistic leadership have different effects on WPB through the mediating effect of organizational climate. Nurse managers are recommended to strengthen moral leadership, balance benevolent leadership, reduce authoritarian leadership and strive to create a positive organizational climate in their efforts to mitigate WPB among nurses. IMPACT: This study enhanced our comprehension of the relationship between different leadership styles and WPB. Greater emphasis should be placed on moral leadership in the promotion of nursing managers and nursing leadership training programs. Additionally, nursing managers should focus on establishing a positive organizational climate that helps to reduce WPB. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

Workplace bullying and its impact on the quality of healthcare and patient safety.

BACKGROUND: Workplace bullying (WPB) is a physical or emotional harm that may negatively affect healthcare services. The aim of this study was to determine to what extent healthcare practitioners in Saudi Arabia worry about WPB and whether it affects the quality of care and patient safety from their perception. METHODS: A cross-sectional study was conducted in 2018. An online survey was distributed among all practitioners at a multi-regional healthcare facility. A previously validated tool was sourced from an integrative literature review by Houck and Colbert. Responses to 15 themes were rated on a 5-point Likert scale, converted to percentage mean scores (PMS) and compared across participants' characteristics using bivariate and regression analyses. RESULTS: A total of 1074/1350 (79.5%) completed the questionnaire. The overall median [interquartile range] score of worrying about WPB was 81.7 [35.0]. Participants were mainly worried about the effect of WPB on their stress, work performance, and communication between staff members. A significant negative relationship developed between the quality of care and worrying about WPB, P < 0.001. More educated practitioners were 1.7 times more likely to be worried about WPB compared with their counter group, adj.P = 0.034. Junior practitioners were 1.6 times more likely to be worried about WPB, adj.P = 0.017. The group who has not been trained in handling WPB (1.7 times), and those who had been exposed to WPB (2.2 times) were both more likely to be worried about WPB compared with their counter groups, adj.P = 0.026 and adj.P < 0.001 respectively. CONCLUSIONS: Most healthcare practitioners worry about WPB, especially its negative impact on the quality of care and patient safety. A greater proportion of practitioners with higher levels of education and their less experienced counterparts were more worried about WPB. Previous exposure to a WPB incident amplifies the practitioners' worry, but being trained on how to counteract bullying incidents makes them less likely to be worried.

Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces.

BACKGROUND: Nurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces. METHODS: During 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis. RESULTS: A total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001). CONCLUSION: Allowing nurses greater choice of clinic to work in, the prevention of violence and addressing workloads could improve the practice environment and job satisfaction of PHC clinic nursing managers.

Assédio moral e precarização do trabalho em saúde / Harassment and precarious work in healthcare

INTRODUÇÃO: O Assédio Moral é considerado como "ato predatório" em que o agressor utiliza mecanismos perversos para dominar a vítima, por meio de atos que desvalorizam, humilham, isolam e constrangem. As condições de trabalho dos trabalhadores da saúde são precárias, em primeiro lugar em função da condição de instabilidade, de insegurança, de vulnerabilidade das formas de inserção. OJETIVO: Este estudo busca identificar a relação entre a ocorrência de assédio moral e as percepções sobre as condições de trabalho em trabalhadores da saúde das Unidades Básicas de Saúde da cidade de Fortaleza. Em segundo, em função da intensificação do trabalho e condições inadequadas dos locais de trabalho. MATERIAL E MÉTODO: Trata-se de uma pesquisa transversal de natureza exploratória e correlacional, utilizando metodologia quantitativa e qualitativa. Participaram da parte quantitativa do estudo 120 profissionais de nível médio da atenção primária, trabalhadores da Regional VI de Fortaleza. O instrumento utilizado contém perguntas sobre informações sócio demográficas; escala de estressores ocupacionais e; questionário sobre ocorrência de assédio moral (NAQ). Na parte qualitativa foram realizadas entrevista semiestruturada e observações dos locais de trabalho. RESULTADOS: Os resultados apontam que 2,5% dos participantes relatam terem se sentido assediados (referindo-se ao assédio subjetivo). Porém, 11,7% relatam terem sofrido atos negativos (referindo-se ao assédio objetivo) no trabalho com frequência semanal ou diária nos últimos seis meses. Os participantes percebem suas condições de trabalho como precárias, através de indicadores como a instabilidade no emprego, equipamentos escassos, baixos salários, jornadas extensas e condições estruturais depreciadas, submetendo o trabalhador a exercer suas atividades com prejuízo para a qualidade no atendimento à comunidade e à sua saúde. CONCLUSÃO: O estudo aponta para a necessidade de ações que levem a essa categoria de trabalhadores condições mais igualitárias quanto a vínculos, condições de trabalho, reconhecimento financeiro e social.

INTRODUCTION: Bullying is considered as a "Predatory Act" in which the attacker uses perverse mechanisms to dominate the victim, through actions that lead to devaluation, humiliation, isolation and constrainments. The working conditions of health professionals are precarious, firstly in view of their forms of insertion, condition of job instability, insecurity and vulnerability. Secondly, due to the intensification of work and inadequate conditions of workplaces OBJECTIVE: The study seeks to identify the relationship between the occurrence of bullying and perceptions about the working conditions of health workers in basic health units of the city of Fortaleza. MATERIAL AND METHODS: This is an exploratory cross-sectional survey with correlational analyses using a combination of quantitative and qualitative methods. Participated in the quantitative part 120 no graduated primary care professionals of Regional VI of Fortaleza. The instrument used contains questions about socioeconomic demographic information; an occupational stressors scale and; a bullying questionnaire (NAQ). For the qualitative research, semi-structured interviews were conducted and workplaces observations. RESULTS: The results show that 2.5% of participants reported they felt harassed (subjective bullying). However, 11.7% report they have suffered negative acts (objective bullying) at work weekly or daily in the last six months. Participants perceive their working conditions as precarious, through indicators such as employment instability, scarce equipment, low salaries, extensive journeys and inadequate structural conditions. These conditions lead professionals to exercise its activities with prejudice to the services provided to the community and to their health. CONCLUSION: The study points out the need for actions that can provide to this category of workers more egalitarian conditions in terms of work contracts and work conditions, besides recognition and financial and social return.