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欺凌对护士离职意愿、患者护理及躯体健康投诉的影响:探究人员配备充足和压力心态的重要性

The effects of bullying on nurses' turnover intentions, patient care, and somatic health complaints: Examining the importance of staffing adequacy and stress mindsets.

作者信息

Paustian-Underdahl Samantha, Li Yingge, Whyte James, De La Haye D C

机构信息

Management Department, Florida State University, Tallahassee, FL.

Management Department, Indiana University, Bloomington, IN.

出版信息

Nurs Outlook. 2025 May-Jun;73(3):102398. doi: 10.1016/j.outlook.2025.102398. Epub 2025 Apr 17.

Abstract

BACKGROUND

Bullying in nursing is a pervasive and persistent problem that contributes to elevated stress levels and a range of negative employee outcomes, including poor job attitudes and deteriorating well-being. Prior research has largely focused on the harmful consequences of bullying, with limited attention to the factors that may buffer these effects. Addressing this gap is critical for identifying pathways to support nurses and improve healthcare environments.

PURPOSE

This study examines how organizational and individual resources can mitigate the adverse outcomes of workplace bullying among nurses. Specifically, it investigates whether staffing adequacy (an organizational resource) and stress mindset (an individual resource) moderate the indirect effects of bullying on turnover intentions, perceived patient care quality, and health complaints, via stress.

METHODS

A two-wave survey was conducted with 422 nurses employed in various healthcare settings across the United States. The study employed a moderated mediation model to test the relationships among workplace bullying, stress, and outcome variables, while examining the moderating roles of staffing adequacy and stress mindset. Stress mindset refers to an individual's belief that stress can either be enhancing or debilitating.

DISCUSSION

Findings reveal that bullying indirectly increases turnover intentions, diminishes perceived quality of patient care, and elevates health complaints by increasing stress. Importantly, both adequate staffing and a stress-is-enhancing mindset can buffer nurses against these negative effects. However, the protective effects of a stress-is-enhancing mindset are only evident when staffing is perceived to be moderately to highly adequate. When staffing is low, a positive stress mindset alone is insufficient to offset the consequences of bullying.

CONCLUSION

This study highlights the importance of both organizational and psychological resources in reducing the harmful effects of workplace bullying in nursing. Bullying exerts its influence through stress, but this pathway is moderated by both staffing adequacy and stress mindset. To safeguard nurse well-being and performance, healthcare organizations should prioritize adequate staffing levels and support interventions aimed at cultivating more adaptive stress mindsets among nursing staff.

摘要

背景

护理工作中的欺凌是一个普遍且持续存在的问题,会导致压力水平升高以及一系列负面的员工后果,包括工作态度不佳和幸福感下降。先前的研究主要集中在欺凌的有害后果上,而对可能缓冲这些影响的因素关注有限。弥补这一差距对于确定支持护士和改善医疗环境的途径至关重要。

目的

本研究探讨组织资源和个人资源如何减轻护士工作场所欺凌的不良后果。具体而言,它调查人员配备充足(一种组织资源)和压力心态(一种个人资源)是否通过压力来调节欺凌对离职意图、感知患者护理质量和健康投诉的间接影响。

方法

对美国各地不同医疗环境中工作的422名护士进行了两阶段调查。该研究采用了有调节的中介模型来测试工作场所欺凌、压力和结果变量之间的关系,同时考察人员配备充足和压力心态的调节作用。压力心态是指个人认为压力既可以增强能力也可以削弱能力的信念。

讨论

研究结果表明,欺凌通过增加压力间接增加离职意图、降低感知的患者护理质量并增加健康投诉。重要的是,充足的人员配备和压力增强型心态都可以缓冲护士免受这些负面影响。然而,压力增强型心态的保护作用仅在人员配备被认为适度到高度充足时才明显。当人员配备不足时,仅积极的压力心态不足以抵消欺凌的后果。

结论

本研究强调了组织资源和心理资源在减少护理工作场所欺凌有害影响方面的重要性。欺凌通过压力发挥其影响,但这一途径受到人员配备充足和压力心态的调节。为了保障护士的幸福感和工作表现,医疗组织应优先确保充足的人员配备水平,并支持旨在培养护理人员更具适应性压力心态的干预措施。

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