Disruptive behavior in a high-power distance culture and a three-dimensional framework for curbing it.

BACKGROUND: Disruptive behavior can harm high-quality care and is prevalent in many Western public health systems despite increasing spotlight on it. Comparatively less knowledge about it is available in Asia, a region commonly associated with high-power distance, which may limit its effectiveness in addressing disruptive behavior. PURPOSE: The aim of this study was to develop a comprehensive framework for tackling disruptive behavior among health care professionals in a public health system. METHODOLOGY: A nationwide cross-sectional study relying on the Nurse-Physician Relationship Survey was conducted in Singapore. Four hundred eighty-six public health care professionals responded. RESULTS: Two hundred ninety-eight doctors (95.5%) and 163 nurses (93.7%) had witnessed a form of disruptive behavior. Doctors observed disruptive behavior committed by other doctors and nurses much more frequently than did nurses. Doctors made stronger associations between disruptive behavior and negative employee outcomes and between disruptive behavior and negative patient outcomes. Qualitative analyses of participants' open-ended answers produced a multipronged three-dimensional approach for tackling disruptive behavior: (a) deterrent measures, (b) development of knowledge and skills, and (c) demonstration of organizational commitment through proper norms, empathizing with staff, and structural reforms. PRACTICE IMPLICATIONS: Disruptive behavior is a multifaceted problem requiring a multipronged approach. Our three-dimensional framework is a comprehensive approach for giving health care professionals the capability, opportunity, and motivation to address disruptive behavior effectively.

Fit to be good: Physical fitness is negatively associated with deviance.

While modern organizations generate economic value, they also produce negative externalities in terms of human physical fitness, such that workers globally are becoming physically unfit. In the current research, we focus on a significant but overlooked indirect cost that lack of physical fitness entails-deviance. In contrast to early (and methodologically limited) research in criminology, which suggests that physically fit people are more likely to behave in a deviant manner, we draw on self-control theory to suggest the opposite: That physically fit people are less likely to engage in deviance. In Study 1, we assembled a dataset on 50 metropolitan areas in the U.S. spanning a 9-year period, and found that physical fitness index of a metropolitan area is negatively related to deviance in that area in a concurrent as well as time-lagged fashion. We complemented this aggregate-level theory test with two studies testing the theory at the individual level. In Study 2, we collected multi-source data from 3,925 military recruits who underwent physical training and found that those who score higher on physical fitness test are less likely to engage in deviance. Study 3 conceptually replicated the effect with both concurrent and time-lagged models using a five-wave longitudinal design in a sample of employees working in service roles, and also found that ego depletion mediates the effect of physical activity on workplace deviance. We speculate on economic implications of the observed relationship between physical fitness and deviance and discuss its relevance for organizations and public policy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).