从被排斥到越轨:通过情感耗竭和防御性沉默理解职场排斥对护士越轨行为的影响

From exclusion to deviance: understanding the impact of workplace ostracism on nurses' deviant behaviors through emotional exhaustion and defensive silence.

作者信息

Attia Nora Mahdy, Saleh Manal Saleh Moustafa, El-Sayed Sahar Hamdy, Ali El-Slamoni Marwa Abd El-Fatah, Ahmed Elnabawy Mona Gamal Abd Elnaser, Ata Azza Abdeldayem, Hendy Abdelaziz, Bassuni Enas M, Mohamed Hanan Meslhy

机构信息

Nursing Administration, Faculty of Nursing, Zagazig University, Zagazig, Egypt.

Department of Nursing Sciences, College of Applied Medical Science, Shaqra University, Shaqra, Saudi Arabia.

出版信息

BMC Nurs. 2025 Jul 1;24(1):786. doi: 10.1186/s12912-025-03427-9.

Abstract

BACKGROUND

The workplace ostracism phenomenon is gaining more attention and adversely affects organizational outcomes, individual behaviors, and performance. It can directly lead to deviant work behaviors as a retaliatory response. Also, perceived workplace ostracism can lead to emotional exhaustion that can mediate between ostracism and other outcomes. Nurses experiencing emotional exhaustion might adopt defensive silence as a coping strategy, which can contribute to a cycle where unresolved issues and unspoken concerns lead to frustration and disengagement, potentially culminating in deviant work behaviors.

AIM

This study aimed to examine the association between workplace ostracism and nurses' deviant work behaviors, highlighting the mediating roles of emotional exhaustion and defensive silence in this relationship.

SUBJECTS AND METHODS

A descriptive correlational design was used to describe and examine relationships among these variables in a governmental hospital (Al-Ahrar Teaching Hospitals) in Egypt. Four standardized scales were used to assess workplace ostracism, deviant work behaviors, emotional exhaustion, and defensive silence among nurses; 257 nurses were surveyed randomly. AMOS structural equation modeling (SEM) was used to examine the hypothetical model of the study.

RESULTS

Workplace ostracism had a significant direct effect on emotional exhaustion (β = 0.57, p < 0.001), defensive silence (β = 0.47, p < 0.001), and deviant work behavior among nurses (β = 0.41, p < 0.001). The indirect effect of workplace ostracism on nurses' deviant work behavior, mediated by emotional exhaustion (β = 0.627, p = 0.001). Correspondingly, the indirect effect of workplace ostracism on nurses' deviant work behavior; mediated by defensive silence (β = 0.033, p = 0.041). Also, the overall indirect effect of workplace ostracism on nurses' deviant work behavior; mediated serially by emotional exhaustion and defensive silence (β = 0.660, p = 0.001).

CONCLUSIONS

The findings demonstrate that workplace ostracism influences deviant behavior among nurses both directly and indirectly through emotional exhaustion and defensive silence. These results highlight the crucial role of social interaction and trust in minimizing negative workplace behaviors within healthcare settings.

IMPLICATIONS FOR NURSING MANAGEMENT AND LEADERSHIP

Addressing workplace ostracism is essential for nursing management to mitigate its negative impact on nurses' well-being and organizational outcomes. To effectively tackle this issue, nursing managers can implement the following actionable strategies, such as​ creating clear policies that define workplace ostracism and outline procedures for reporting and addressing such behaviors.​ Set up anonymous channels for nurses to report incidents of ostracism without fear of retaliation.​ Regularly monitor and address reports to demonstrate a commitment to a supportive workplace culture.​ Offer workshops focused on communication, empathy, and teamwork to enhance staff interactions and reduce misunderstandings.​ Encourage regular team meetings where nurses can voice concerns, share ideas, and discuss challenges.​ Foster a culture where feedback is welcomed and valued, reducing the likelihood of defensive silence.​ Assess and adjust workloads to ensure they are manageable, thereby reducing stress and emotional exhaustion among staff.​ Acknowledge and reward behaviors that contribute to a positive and inclusive work environment. Celebrate teamwork and collaborative achievements to reinforce a sense of belonging. Implement surveys and assessments to gauge the prevalence of ostracism and its impact on staff.​.

CLINICAL TRIAL

Not applicable.

摘要

背景

职场排斥现象日益受到关注,它会对组织成果、个体行为和绩效产生不利影响。它可直接导致偏差工作行为,作为一种报复性反应。此外,感知到的职场排斥会导致情绪耗竭,而情绪耗竭会在排斥与其他结果之间起中介作用。经历情绪耗竭的护士可能会采取防御性沉默作为应对策略,这可能会导致一个循环,即未解决的问题和未表达的担忧会导致挫败感和工作投入度降低,最终可能导致偏差工作行为。

目的

本研究旨在探讨职场排斥与护士偏差工作行为之间的关联,强调情绪耗竭和防御性沉默在这种关系中的中介作用。

对象与方法

采用描述性相关性设计来描述和检验埃及一家政府医院(阿赫拉尔教学医院)中这些变量之间的关系。使用四个标准化量表来评估护士的职场排斥、偏差工作行为、情绪耗竭和防御性沉默;对257名护士进行了随机调查。采用AMOS结构方程模型(SEM)来检验本研究的假设模型。

结果

职场排斥对护士的情绪耗竭(β = 0.57,p < 0.001)、防御性沉默(β = 0.47,p < 0.001)和偏差工作行为(β = 0.41,p < 0.001)有显著的直接影响。职场排斥通过情绪耗竭对护士偏差工作行为的间接效应(β = 0.627,p = 0.001)。相应地,职场排斥通过防御性沉默对护士偏差工作行为的间接效应(β = 0.033,p = 0.041)。此外,职场排斥通过情绪耗竭和防御性沉默依次中介对护士偏差工作行为的总体间接效应(β = 0.660,p = 0.001)。

结论

研究结果表明,职场排斥通过情绪耗竭和防御性沉默直接和间接地影响护士的偏差行为。这些结果凸显了社会互动和信任在减少医疗环境中负面职场行为方面的关键作用。

对护理管理和领导的启示

解决职场排斥问题对于护理管理减轻其对护士幸福感和组织成果的负面影响至关重要。为有效解决这一问题,护理管理者可实施以下可操作策略,例如制定明确的政策,界定职场排斥并概述报告和处理此类行为的程序。为护士设立匿名渠道,以便他们举报排斥事件而不必担心报复。定期监测并处理举报,以表明对支持性职场文化的承诺。提供专注于沟通、同理心和团队合作的工作坊,以加强员工互动并减少误解。鼓励定期召开团队会议,让护士能够表达担忧、分享想法并讨论挑战。营造一种欢迎和重视反馈的文化,降低防御性沉默的可能性。评估并调整工作量,以确保其可控,从而减轻员工的压力和情绪耗竭。认可并奖励有助于营造积极包容工作环境的行为。表彰团队合作和协作成就,以强化归属感。开展调查和评估,以衡量排斥的普遍性及其对员工的影响。

临床试验

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a7d/12211462/78a83a19789e/12912_2025_3427_Fig1_HTML.jpg

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