急诊科护士欺凌现象扎根理论的验证

Validation of a grounded theory of nurse bullying in emergency department settings.

作者信息

Wolf Lisa A, Perhats Cydne, Delao Altair M, Martinovich Zoran

机构信息

Institute for Emergency Nursing Research, Emergency Nurses Association, Schaumburg, IL, United States.

出版信息

Int Emerg Nurs. 2021 May;56:100992. doi: 10.1016/j.ienj.2021.100992. Epub 2021 Mar 21.

DOI:10.1016/j.ienj.2021.100992

PMID:33761372

Abstract

BACKGROUND

Workplace bullying in health care settings, including emergency departments (EDs), is a significant and negative factor in the dynamics of patient care, nursing work culture, and nurse retention. Specifically, workplace bullying has a significant and negative effect on patient care, with both direct (errors and substandard care) and indirect sequelae (high turnover and inexperienced nursing staff hired to replace those nurses who have left to escape bullying behavior). The purpose of this study was to determine the theoretical coherence of the ENA model of nurse bullying in emergency department and its impact on emergency nurses' intent to leave their job.

METHODS

Correlational study using the Practice Environment Scale of the Nursing Work Index (PES-NWI), the Secondary Traumatic Stress Scale (STSS), and the Short Negative Acts Questionnaire (SNAQ) in a cross-sectional sample of emergency nurses working in the United States.

RESULTS

Extremely high intent to leave the current ED (PD1) rates were associated with nurses' reported exposure to daily bullying (PD1 rate = 67.6%, zero-order OR = 4.77, Nr = 3.2%, p < .001) and bullying multiple times per week (49.1%, zero-order OR = 2.31, Nr = 2.6%, p < .001). Nurses who reported no exposure to bullying at work had a distinctly below average PD1 rate (22.9%, OR = 0.47, Nr = 3.9%, p < .001).

CONCLUSIONS

The relationships between the tested elements of the model (specifically, the influence of bullying on nurse intent to leave) as constructed appear to adequately reflect the phenomenon of workplace bullying and its effects on nurse retention in emergency care settings.

摘要

背景

包括急诊科在内的医疗环境中的职场霸凌，是患者护理动态、护理工作文化和护士留用率的一个重要负面因素。具体而言，职场霸凌对患者护理有重大负面影响，既有直接后果（失误和护理不达标），也有间接后果（高离职率以及为取代那些因逃避霸凌行为而离职的护士而雇佣缺乏经验的护理人员）。本研究的目的是确定急诊科护士霸凌的ENA模型的理论连贯性及其对急诊护士离职意愿的影响。

方法

在美国对急诊护士的横断面样本使用护理工作指数实践环境量表（PES-NWI）、继发性创伤应激量表（STSS）和简短负面行为问卷（SNAQ）进行相关性研究。

结果

极高的当前急诊科离职意愿（PD1）率与护士报告的日常霸凌暴露相关（PD1率 = 67.6%，零阶OR = 4.77，Nr = 3.2%，p <.001）以及每周多次霸凌（49.1%，零阶OR = 2.31，Nr = 2.6%，p <.001）。报告在工作中未遭受霸凌的护士的PD1率明显低于平均水平（22.9%，OR = 0.47，Nr = 3.9%，p <.001）。