Joseph Olivia, Mir Ghazala, Fylan Beth, Essler Pam, Lawton Rebecca
Faculty of Medicine and Health, School of Psychology, University of Leeds, Leeds, UK.
National Institute for Health Research (NIHR) Yorkshire and Humber Patient Safety Research Collaboration, Bradford, UK.
Sociol Health Illn. 2025 Jan;47(1):e13760. doi: 10.1111/1467-9566.13760. Epub 2024 Mar 20.
Workplace incivility is a pervasive complex problem within health care. Incivility manifests as subtle disrespectful behaviours, which seem inconsequential. However, evidence demonstrates that incivility can be harmful to targets and witnesses through negative emotions, poorer mental health, reduced job satisfaction, diminished performance and compromised patient care. It is unclear to what extent existing research critically explores how ethnicity, culture and racism influence how hospital staff experience incivility. This global scoping review systematically analysed existing research exploring the specific ways incivility manifests and impacts racially minoritised hospital workers. Of 2636 academic and 101 grey literature articles, 32 were included. Incivility experiences were categorised into four themes: (1) Cultural control, (2) Rejection of work contributions, (3) Disempowerment at work and (4) Managerial indifference. The included articles highlighted detrimental consequences, such as negative emotions, silencing, withdrawal and reduced support-seeking behaviours. Few studies presented evidence regarding the negative impacts of incivility on patient care. Racialisation and racial dynamics are a significant factor for hospital-based incivility. Currently we do not know the extent to which racialised incivility is associated directly or, perhaps either via burnout or disengagement, indirectly with poorer care. This knowledge can inform the creation of comprehensive, evidence-based interventions to address this important issue.
职场不文明行为是医疗保健领域普遍存在的复杂问题。不文明行为表现为微妙的不尊重行为,看似无关紧要。然而,有证据表明,不文明行为会通过负面情绪、较差的心理健康状况、降低的工作满意度、下降的工作表现以及受损的患者护理对目标对象和目击者造成伤害。目前尚不清楚现有研究在多大程度上批判性地探讨了种族、文化和种族主义如何影响医院工作人员对不文明行为的体验。这项全球范围的综述系统地分析了现有研究,这些研究探讨了不文明行为表现的具体方式以及对少数族裔医院工作人员的影响。在2636篇学术文章和101篇灰色文献文章中,有32篇被纳入。不文明行为体验被分为四个主题:(1)文化控制,(2)对工作贡献的否定,(3)工作中的无权感,(4)管理层的冷漠。纳入的文章强调了有害后果,如负面情绪、沉默、退缩和减少寻求支持的行为。很少有研究提供关于不文明行为对患者护理负面影响的证据。种族化和种族动态是医院不文明行为的一个重要因素。目前我们不知道种族化的不文明行为在多大程度上直接相关,或者可能通过倦怠或脱离工作间接与较差的护理相关。这些知识可为制定全面的、基于证据的干预措施提供参考,以解决这一重要问题。