Evans Dena
Associate Director, Undergraduate Division, UNC Charlotte School of Nursing, Charlotte, NC, USA.
J Nurs Scholarsh. 2017 Mar;49(2):214-222. doi: 10.1111/jnu.12275. Epub 2017 Jan 12.
To examine turnover intentions, as well as the prevalence and frequency of uncivil behaviors, from the perspective of registered nurses, respiratory therapists, and imaging professionals, using a new method to categorize exposure magnitude.
Data were collected using the 22-item Negative Acts Questionnaire-Revised (NAQ-R). Additional items, informed by Price and Mueller's causal model of turnover, were included, as were select demographic variables. The final sample included 170 healthcare professionals. Descriptive statistics were used to describe the sample, a chi-square test was constructed to test for significant differences in exposure to uncivil behavior based on demographics, and Cochran-Mantel-Haenszel statistics were used to test associations between variables and calculation of raw sum scores to implement a new method of analysis for the NAQ-R, allowing for categorization of exposure magnitude.
Exposure to uncivil behavior was reported more often among nursing staff than other healthcare professionals. Lack of exposure to uncivil behavior was a significant predictor of intention to stay. Perceptual differences were found between nurses prepared at the baccalaureate and associate degree levels. Lastly, no significant correlations between exposure to uncivil behavior and selected demographic variables were found, suggesting that exposure is not dependent upon age, race, unit type, or educational level.
Findings support prior research associating negative organizational climate with higher turnover intentions. Uncivil behavior was reported across the organization, most predominantly among units staffed with nurses. Finally, use of newly defined cutoff points for the NAQ-R provide organizations with the ability to use both subjective and objective data to identify targets of uncivil behaviors to construct meaningful interventions.
There is a need to develop more meaningful interventions to support targets of uncivil behaviors. Use of the NAQ-R, coupled with the proposed cutoff scores, allows for the identification of targets, the magnitude of exposure, and the construction of meaningful primary, secondary, and tertiary intervention programs that may improve turnover and quality of care.
从注册护士、呼吸治疗师和影像专业人员的角度，使用一种新的方法对暴露程度进行分类，来研究离职意图以及不文明行为的发生率和频率。
使用22项修订版负面行为问卷（NAQ-R）收集数据。纳入了受普莱斯和穆勒离职因果模型启发的其他项目，以及选定的人口统计学变量。最终样本包括170名医疗保健专业人员。描述性统计用于描述样本，构建卡方检验以检验基于人口统计学的不文明行为暴露的显著差异， Cochr an-Mantel-Haenszel统计用于检验变量之间的关联，并计算原始总分以实施NAQ-R的一种新分析方法，从而实现对暴露程度的分类。
与其他医疗保健专业人员相比，护理人员报告的不文明行为暴露更为频繁。未经历不文明行为是留任意向的一个重要预测因素。在拥有学士学位和副学士学位的护士之间发现了认知差异。最后，未发现不文明行为暴露与选定的人口统计学变量之间存在显著相关性，这表明暴露并不取决于年龄、种族、科室类型或教育水平。
研究结果支持了先前将负面组织氛围与较高离职意图相关联的研究。整个组织都存在不文明行为，最主要发生在有护士的科室。最后，使用NAQ-R新定义的临界值使组织能够利用主观和客观数据来识别不文明行为的目标，以构建有意义的干预措施。
需要制定更有意义的干预措施来支持不文明行为的目标人群。使用NAQ-R并结合提议的临界分数，能够识别目标人群、暴露程度，并构建有意义的一级、二级和三级干预项目，这可能会改善人员流动和护理质量。
