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      Workplace incivility, lateral violence and bullying among nurses. A review about their prevalence and related factors

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          Background: Negative interactions among nurses are well recognized and reported in scientific literature, even because the issues may have major consequences on professional and private lives of the victims. The aim of this paper is to detect specifically the prevalence of workplace incivility (WI), lateral violence (LV) and bullying among nurses. Furthermore, it addresses the potential related factors and their impact on the psychological and professional spheres of the victims. Methods: A review of the literature was performed through the research of papers on three databases: Medline, CINAHL, and Embase. Results: Seventy-nine original papers were included. WI has a range between 67.5% and 90.4% (if WI among peers, above 75%). LV has a prevalence ranging from 1% to 87.4%, while bullying prevalence varies between 2.4% and 81%. Physical and mental sequelae can affect up to 75% of the victims. The 10% of bullied nurses develop Post-Traumatic Stress Disorder Symptoms. Bullying is a predictive factor for burnout (β=0.37 p<0.001) and shows a negative correlation with job efficiency (r=-0 322, p<0.01). Victims of bullying recorded absenteeism 1.5 times higher in comparison to non-victimized peers (95% CI: 1.3-1.7). 78.5% of bullied nurses with length of service lower than 5 years has resigned to move to other jobs. Conclusions: There is lack of evidence about policies and programmes to eradicate workplace incivility, lateral violence and bullying among nurses. Prevention of these matters should start from spreading information inside continue educational settings and university nursing courses.

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          Most cited references 86

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          The content and development of mobbing at work

           Heinz Leymann (1996)
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            Workplace bullying and sickness absence in hospital staff.

             Mika Kivimaki (2000)
            In the past, evidence on the negative consequences of workplace bullying has been limited to cross sectional studies of self reported bullying. In this study, these consequences were examined prospectively by focusing on sickness absence in hospital staff. The Poisson regression analyses of medically certified spells (>/=4 days) and self certified spells (1-3 days) of sickness absence, relating to bullying and other predictors of health, were based on a cohort of 674 male and 4981 female hospital employees aged 19-63 years. Data on sickness absence were gathered from employers' registers. Bullying and other predictors of health were measured by a questionnaire survey. 302 (5%) of the employees reported being victims of bullying. They did not differ from the other employees in terms of sex, age, occupation, type of job contract, hours of work, income, smoking, alcohol consumption, or physical activity. Victims of bullying had higher body mass and prevalence of chronic disease, and their rates of medically and self certified spells of sickness absence were 1.5 (95% confidence interval (95% CI) 1.3 to 1.7) and 1.2 (1.1 to 1.4) times higher than those of the rest of the staff. The rate ratios remained significant after adjustment for demographic data, occupational background, behaviour involving risks to health, baseline health status, and sickness absence. Workplace bullying is associated with an increase in the sickness absenteeism of the hospital staff. Targets of bullying seem not to belong to any distinct group with certain demographic characteristics or occupational background.
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              Work-related factors and violence among nursing staff in the European NEXT study: a longitudinal cohort study.

              The occurrence of workplace violence is rather frequent within the nursing profession, with well-known consequences on the psychological health of victims. This study is aimed at assessing the relationships between relevant individual, organizational, and psychosocial factors, and the frequency of several types of workplace violence; the direct as well as the interactive impact of violence and psychosocial factors on organizational commitment and perceived health. Questionnaire-based cross-sectional and longitudinal survey designs were employed for the two study objectives, respectively. Five hundred and sixty-five healthcare institutions from eight European countries participated in the Nurses' Early Exit Study. The 34,107 participants were nursing staff holding different qualifications. The response rate was 55.1% in the cross-sectional part and 40.5% in the follow-up phase. At baseline, the respondents were mostly female (89.3%), in the age group 30-44 years (52.9%), registered or specialized nurses (67.0%), working mainly in medico-surgical wards (36.3%), and employed full-time (72.8%). In the cross-sectional analysis, the relationship between the predictor variables and frequency of violence was assessed by means of a hierarchical multiple linear regression. In the longitudinal analysis, main direct and interactive effects of violence and psychosocial factors on perceived health and organizational commitment were assessed by means of hierarchical multiple linear regression analyses with interaction terms. Higher levels of adverse work-related factors were significantly associated with higher frequency of the distinguished types of violence. Significant interactions were found between psychosocial factors and violence only in predicting organizational commitment, even if effect sizes were very low. No interactions were observed for perceived health. The prevalence of the distinguished types of violence varied across the participating countries according to the presence of adverse work- and non-work-related factors. These findings suggest the necessity of interventions both over working conditions conducive to violence and violent behaviours themselves.

                Author and article information

                Acta Biomed
                Acta Biomed
                Acta bio-medica : Atenei Parmensis
                Mattioli 1885 (Italy )
                : 89
                : Suppl 6
                : 51-79
                [1 ] Medical & Surgical Intensive Care Unit, Careggi Teaching Hospital, Florence, Italy
                [2 ] Department of Medicine and Surgery, University of Parma, Italy
                [3 ] Clinical Nurse Coordinator, IMCU, Saint James Hospital, Sliema, Malta
                [4 ] Nurse Chief, General Intensive Care Unit, ASST Monza - S. Gerardo Hospital, University of Milan-Bicocca, Italy
                [5 ] Department of Education and Psychology, University of Florence, Italy
                [6 ] Associate Professor in Nursing Science, Department of Health Sciences, University of Florence, Italy
                Author notes
                Correspondence: Stefano Bambi - RN, MSN, Ph.D; Medical & Surgical Intensive Care Unit, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50134 Florence (Italy) E-mail: stebam@ ; bambis@

                This work is licensed under a Creative Commons Attribution 4.0 International License

                Original Article: Organizational Features in the Healthcare Environment


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