Department of Psychology, University of Copenhagen, Oester Farimagsgade 2A, 1353, Copenhagen, Denmark.
School of Nursing, Virginia Commonwealth University, Virginia, USA.
Int Arch Occup Environ Health. 2018 Nov;91(8):963-970. doi: 10.1007/s00420-018-1337-0. Epub 2018 Jul 11.
To analyze the long-term impact of bullying among healthcare providers (T1) on missed nursing care and quality of care 2 years later (T2) and to test the potential mediating effect of affective organizational commitment.
Survey data from healthcare providers in the eldercare sector in 2006 (T1) and 2008 (T2). At T1, 9212 employees participated in the survey and 5202 participated in both T1 and T2. Including only participants who were directly engaged in the provision of care yielded 4000 providers, who were employed in 268 workgroups at T1 and T2. Associations between exposure to bullying (predictor) and the two outcomes (missed nursing care and quality of care) were investigated using multi-level linear regression analysis. Included covariates were age, gender, job position, work place and tenure.
We found a significant association between workplace bullying at T1 and missed nursing care at T2 but not for quality of care at T2. Affective organizational commitment did not mediate the association between bullying and the two outcomes. However, affective organizational commitment at T1 was associated with quality of care at T2.
Exposure to bullying at work may cause the provider to miss nursing care for clients. To improve, care administrators should consider implementing bullying prevention strategies at three levels: organizational, work group and individual.
分析医疗保健提供者（T1）之间的长期欺凌行为对护理服务缺失和 2 年后护理质量（T2）的影响，并检验情感组织承诺的潜在中介作用。
2006 年（T1）和 2008 年（T2）对老年护理行业医疗保健提供者的调查数据。在 T1 时，有 9212 名员工参与了调查，其中 5202 名员工同时参与了 T1 和 T2。仅包括直接参与护理服务的参与者产生了 4000 名提供者，他们在 T1 和 T2 时在 268 个工作团队中工作。使用多层次线性回归分析调查了暴露于欺凌（预测因素）与两个结果（护理服务缺失和护理质量）之间的关联。纳入的协变量包括年龄、性别、职位、工作场所和任期。
我们发现 T1 时的工作场所欺凌与 T2 时的护理服务缺失之间存在显著关联，但与 T2 时的护理质量无关。情感组织承诺并没有中介欺凌与两个结果之间的关系。然而，T1 时的情感组织承诺与 T2 时的护理质量有关。
工作场所的欺凌行为可能导致提供者对客户的护理服务缺失。为了改进，护理管理人员应考虑在组织、工作团队和个人三个层面实施欺凌预防策略。
