马来西亚初级医生中的职场霸凌：一项多中心横断面研究。
Workplace Bullying Among Junior Doctors in Malaysia: A Multicentre Cross-Sectional Study.
作者信息
Samsudin Ely Zarina, Isahak Marzuki, Rampal Sanjay, Rosnah Ismail, Zakaria Mohd Idzwan
机构信息
Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
出版信息
Malays J Med Sci. 2021 Apr;28(2):142-156. doi: 10.21315/mjms2021.28.2.13. Epub 2021 Apr 21.
BACKGROUND
Research suggests that junior doctors often experience workplace bullying, which may have adverse impacts on medical training and delivery of quality healthcare. However, evidence among local population has not been established. The present study aims to examine the prevalence of workplace bullying among Malaysian junior doctors and explore its associated sociodemographic and employment factors.
METHODS
A multicentre cross-sectional study was conducted in 12 government hospitals accredited for housemanship training within the central zone of Malaysia. The study included a total of 1,074 house officers who had been working for at least 6 months in various housemanship rotations. The Negative Acts Questionnaire-Revised (NAQ-R was used to examine workplace bullying.
RESULTS
The 6-month prevalence of workplace bullying among study participants was 13%. Work-related bullying such as 'being ordered to do work below your level of competence', person-related bullying such as 'being humiliated or ridiculed in connection with your work', and physically intimidating bullying such as 'being shouted at or being the target of spontaneous anger' were commonly reported by study participants. Medical officers were reported to be the commonest perpetrators of negative actions at the workplace. Study participants who graduated from Eastern European medical schools (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI]: 1.27, 4.07) and worked in surgical-based rotation (AOR 1.83; 95% CI: 1.13, 2.97) had higher odds of bullying compared to those who graduated from local medical schools and worked in medical-based rotation, whereas study participants with good English proficiency (AOR 0.14; 95% CI: 0.02, 0.94) had lower odds of bullying compared to those with poor English proficiency.
CONCLUSION
The present study shows that workplace bullying is prevalent among Malaysian junior doctors. Considering the gravity of its consequences, impactful strategies should be developed and implemented promptly in order to tackle this serious occupational hazard.
背景
研究表明，初级医生经常遭受职场霸凌，这可能会对医学培训和高质量医疗服务的提供产生不利影响。然而，当地人群中的相关证据尚未确立。本研究旨在调查马来西亚初级医生职场霸凌的患病率，并探讨其相关的社会人口学和就业因素。
方法
在马来西亚中部地区12家获得住院医师培训认证的政府医院进行了一项多中心横断面研究。该研究共纳入了1074名住院医师，他们在不同的住院医师轮转岗位上工作了至少6个月。采用修订后的负面行为问卷（NAQ-R）来调查职场霸凌情况。
结果
研究参与者中职场霸凌的6个月患病率为13%。研究参与者普遍报告了与工作相关的霸凌行为，如“被命令做低于你能力水平的工作”；与个人相关的霸凌行为，如“在工作中受到羞辱或嘲笑”；以及身体上的恐吓霸凌行为，如“被大声呵斥或成为无端愤怒的对象”。据报告，医务人员是职场负面行为最常见的实施者。与毕业于当地医学院并在以医疗为主的轮转岗位工作的参与者相比，毕业于东欧医学院（调整后的优势比[AOR]为2.27；95%置信区间[CI]：1.27，4.07）且在以外科为主的轮转岗位工作的研究参与者遭受霸凌的几率更高，而英语水平良好的研究参与者（AOR为0.14；95%CI：0.02，0.94）与英语水平较差的参与者相比，遭受霸凌的几率更低。
结论
本研究表明，职场霸凌在马来西亚初级医生中很普遍。鉴于其后果的严重性，应迅速制定并实施有效的策略来应对这一严重的职业危害。
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