Chambers Charlotte N L, Frampton Christopher M A, McKee Martin, Barclay Murray
Association of Salaried Medical Specialists, Wellington, New Zealand.
University of Otago, Christchurch, New Zealand.
BMJ Open. 2018 Mar 19;8(3):e020158. doi: 10.1136/bmjopen-2017-020158.
To estimate prevalence of and factors contributing to bullying among senior doctors and dentists in New Zealand's public health system, to ascertain rates of reporting bullying behaviour, perceived barriers to reporting and the effects of bullying professionally and personally.
Cross-sectional, mixed methods study.
New Zealand.
Members of the Association of Salaried Medical Specialists (40.8% response rate).
Prevalence of bullying was measured using the Negative Acts Questionnaire (revised) (NAQ-r). Workplace demands and level of peer and managerial support were measured with the Health and Safety Executive Management Standards Analysis tool. Categories of perpetrators for self-reported and witnessed bullying and barriers to reporting bullying were obtained and qualitative data detailing the consequence of bullying were analysed thematically.
The overall prevalence of bullying, measured by the NAQ-r, was 38% (at least one negative act on a weekly or daily basis), 37.2% self-reported and 67.5% witnessed. There were significant differences in rates of bullying by specialty (P=0.001) with emergency medicine reporting the highest bullying prevalence (47.9%). The most commonly cited perpetrators were other senior medical or dental specialists. 69.6% declined to report their bullying. Bullying across all measures was significantly associated with increasing work demands and lower peer and managerial support (P=0.001). Consequences of bullying were wide ranging, affecting workplace environments, personal well-being and subjective quality of patient care.
Bullying is prevalent in New Zealand's senior medical workforce and is associated with high workloads and low peer and managerial support. These findings help identify conditions and pressures that may encourage bullying and highlight the significant risk of bullying for individuals and their patients.
评估新西兰公共卫生系统中 senior doctors 和牙医遭受欺凌的患病率及相关因素，确定欺凌行为的举报率、举报的感知障碍以及欺凌对职业和个人的影响。
横断面混合方法研究。
新西兰。
受薪医学专家协会成员（回复率为40.8%）。
使用修订后的负面行为问卷（NAQ-r）测量欺凌的患病率。使用健康与安全执行管理标准分析工具测量工作场所需求以及同事和管理层的支持水平。获取自我报告和目睹的欺凌行为的肇事者类别以及举报欺凌行为的障碍，并对详细描述欺凌后果的定性数据进行主题分析。
通过NAQ-r测量，欺凌的总体患病率为38%（每周或每天至少发生一次负面行为），其中37.2%为自我报告，67.5%为目睹。不同专业的欺凌发生率存在显著差异（P = 0.001），急诊医学的欺凌患病率最高（47.9%）。最常被提及的肇事者是其他 senior medical 或牙科专家。69.6%的人拒绝举报他们所遭受的欺凌。所有测量指标中的欺凌行为都与工作需求增加以及同事和管理层支持减少显著相关（P = 0.001）。欺凌的后果广泛，影响工作场所环境、个人幸福感和患者护理的主观质量。
欺凌在新西兰 senior medical 劳动力中普遍存在，并且与高工作量以及同事和管理层支持不足有关。这些发现有助于识别可能助长欺凌行为的条件和压力，并突出欺凌行为对个人及其患者的重大风险。
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