Perceived violence climate: A new construct and its relationship to workplace physical violence and verbal aggression, and their potential consequences

Workplace accidents and violence are both potential sources of employee injuries that have been dealt with in entirely separate literatures. In this study we adapted the concept of safety climate from the accident/injury literature to violence in developing the concept of perceived violence climate. A scale was developed to assess perceived violence climate, including items about management attention, concern, and policies designed to keep employees safe from violence. Data were collected from a sample of 198 nurses from a US Hospital. Perceived violence climate was found to correlate significantly with both physical violence and verbal aggression experienced by the nurses, injury from violence, and perceptions of workplace danger. Furthermore, regression analyses showed that climate explained additional variance in psychological strain and perceptions of danger over experienced violence. These results have implications for interventions aimed at producing a good perceived violence climate in order to reduce the incidence of violence and aggression within an organization.     

Perceived violence climate: A new construct and its relationship to workplace physical violence and verbal aggression,and their potential consequences

Abstract

Workplace accidents and violence are both potential sources of employee injuries that have been dealt with in entirely separate literatures. In this study we adapted the concept of safety climate from the accident/injury literature to violence in developing the concept of perceived violence climate. A scale was developed to assess perceived violence climate, including items about management attention, concern, and policies designed to keep employees safe from violence. Data were collected from a sample of 198 nurses from a US Hospital. Perceived violence climate was found to correlate significantly with both physical violence and verbal aggression experienced by the nurses, injury from violence, and perceptions of workplace danger. Furthermore, regression analyses showed that climate explained additional variance in psychological strain and perceptions of danger over experienced violence. These results have implications for interventions aimed at producing a good perceived violence climate in order to reduce the incidence of violence and aggression within an organization.     

Exposure to occupational violence and the buffering effects of intra-oranizational support

This paper presents a conceptually distinct analysis of the data first reported by Leather et al. Specifically, it investigates the effects of exposure to a variety of forms of work-related violence upon work attitudes and general well-being within a sample of UK public house licensees—individuals who manage public houses and hold the licence permitting the sale of alcoholic drinks on the premises. In addition, it examines the role of social support in moderating such effects. Based upon a sample of 242 licensees, it reports a consistent interaction between exposure to such violence and the availability of perceived intra-organizational support in determining the size of any negative effects upon individual well-being, job satisfaction and organizational commitment. It is argued that exposure to all forms of work-related violence, including intimidation, verbal abuse and threat, should be seen as a potential stressor within the work environment, the negative effects of which are buffered by perceived support from within the organization, but not by that perceived to be available from informal sources such as family and friends.     

The nature, extent and determinants of violence against psychiatric personnel

Violence against psychiatric staff seems to be on the increase. Such abuse can lead to mental health consequences for the staff and a reluctance to be closely involved with patients. Few Swedish investigations have examined violence against mental nurses and psychiatrists, or undertaken comparative studies between them. In this study we examined the extent, nature and determinants (i.e. risk factors) of violence against psychiatric nurses (n = 731) and psychiatrists (n = 320) working in the eight health care districts of Stockholm. These caregivers were assessed cross-sectionally by means of a questionnaire covering various areas (e.g. violence and work environment). The majority of the participants (85%) reported having been exposed to violence during their careers, with 57% being victimized in the past 12 months. Physical violence was common, and factors such as negative attitudes to work and diminished sense of autonomy were associated with an increased vulnerability to violence. Nurses and psychiatrists did not differ in violence variables. In spite of the weaknesses of the design (cross-sectional self-selecting sample), this study corroborates previous findings and identifies personal factors associated with violence that have received little attention in the literature (e.g. lack of respect for the organization of care).     

The nature,extent and determinants of violence against psychiatric personnel

Violence against psychiatric staff seems to be on the increase. Such abuse can lead to mental health consequences for the staff and a reluctance to be closely involved with patients. Few Swedish investigations have examined violence against mental nurses and psychiatrists, or undertaken comparative studies between them. In this study we examined the extent, nature and determinants (i.e. risk factors) of violence against psychiatric nurses (n = 731) and psychiatrists (n = 320) working in the eight health care districts of Stockholm. These caregivers were assessed cross-sectionally by means of a questionnaire covering various areas (e.g. violence and work environment). The majority of the participants (85%) reported having been exposed to violence during their careers, with 57% being victimized in the past 12 months. Physical violence was common, and factors such as negative attitudes to work and diminished sense of autonomy were associated with an increased vulnerability to violence. Nurses and psychiatrists did not differ in violence variables. In spite of the weaknesses of the design (cross-sectional self-selecting sample), this study corroborates previous findings and identifies personal factors associated with violence that have received little attention in the literature (e.g. lack of respect for the organization of care).     

Violence towards psychiatric staff: a comparison of gender, job and environmental characteristics in England and Sweden

Workplace violence is receiving increasing attention world-wide, and studies suggest that, for example, nurses and women may be more abused at work than psychiatrists and men. However, there is a lack of cross-cultural data on the topic. Further, relatively few studies have addressed the influence of environmental factors in the occurrence of violence and within a cross-cultural context. The present study compares among other things the nature of violence encountered by female/male staff (nurses and psychiatrists) in Sweden and England. Psychiatric personnel from England (301 nurses; 74 psychiatrists) and Sweden (745 nurses; 306 psychiatrists) were assessed cross-sectionally by means of a questionnaire covering various areas (e.g. nature of violence). The univariate analyses showed an association between being abused and male gender, young age, being British and a nurse, physical and psychological strain. The multivariate logistic regression confirmed that British nurses and male nurses were the main risk group for exposure to violence. Further, the multivariate analysis indicated that the odds of being abused increased with increasing age, physical strain and dissatisfaction with quality of care. Interventions thus need to be sensitive to gender differences, societal context, professional roles and interactions between them. Further, clinical supervision and team functioning, organizational and environmentally friendly settings may help to reduce violence in mental health care.     

Violence towards psychiatric staff: a comparison of gender,job and environmental characteristics in England and Sweden

Workplace violence is receiving increasing attention world-wide, and studies suggest that, for example, nurses and women may be more abused at work than psychiatrists and men. However, there is a lack of cross-cultural data on the topic. Further, relatively few studies have addressed the influence of environmental factors in the occurrence of violence and within a cross-cultural context. The present study compares among other things the nature of violence encountered by female/male staff (nurses and psychiatrists) in Sweden and England. Psychiatric personnel from England (301 nurses; 74 psychiatrists) and Sweden (745 nurses; 306 psychiatrists) were assessed cross-sectionally by means of a questionnaire covering various areas (e.g. nature of violence). The univariate analyses showed an association between being abused and male gender, young age, being British and a nurse, physical and psychological strain. The multivariate logistic regression confirmed that British nurses and male nurses were the main risk group for exposure to violence. Further, the multivariate analysis indicated that the odds of being abused increased with increasing age, physical strain and dissatisfaction with quality of care. Interventions thus need to be sensitive to gender differences, societal context, professional roles and interactions between them. Further, clinical supervision and team functioning, organizational and environmentally friendly settings may help to reduce violence in mental health care.     

Psychosocial safety climate as an antecedent of work characteristics and psychological strain: A multilevel model

Abstract

Psychosocial safety climate (PSC) refers to a specific organizational climate for the psychological health of workers. It is largely determined by management and at low levels is proposed as a latent pathogen for psychosocial risk factors and psychological strain. Using an extended Job Demands-Control-Support framework, we predicted the (24 month) cross-level effects of PSC on psychological strain via work conditions. We used a novel design whereby data from two unrelated samples of nurses working in remote areas were used across time (N=202, Time 1; N=163, Time 2), matched at the work unit level (N= 48). Using hierarchical linear modelling we found that unit PSC assessed by nurses predicted work conditions (workload, control, supervisor support) and psychological strain in different nurses in the same work unit 24 months later. There was evidence that the between-group relationship between unit PSC and psychological strain was mediated via Time 2 work conditions (workload, job control) as well as Time 1 emotional demands. The results support a multilevel work stress model with PSC as a plausible primary cause, or “cause of the causes”, of work-related strain. The study adds to the literature that identifies organizational contextual factors as origins of the work stress process.     

Effects of exposure to occupational violence and the mediating impact of fear

This paper examines the consequences of exposure to work-related violence and in particular, focuses upon the role of fear (of violence) as a mediating variable. The sample comprises UK public house licensees-individuals who manage public houses and hold the licence permitting the sale of alcoholic drinks on the premises. Questionnaires were sent to 479 licensees and a response rate of 51% was achieved. Each questionnaire measured exposure to a range of violent assaults, fear of violence, general well-being, job satisfaction and organizational commitment. Based upon a final sample of 242 pub licensees, regression analyses showed that as the severity of the violence to which licensees were exposed increased, so fear of becoming a victim and symptoms of impaired well-being increased, while job satisfaction and organizational commitment decreased. Hierarchical analyses showed that fear of violence fully mediated the negative impact of exposure upon each of these other variables. It is argued that the management of fear appraisals should be integrated into organizational responses to work-place violence.     

Psychosocial safety climate,psychosocial and physical factors in the aetiology of musculoskeletal disorder symptoms and workplace injury compensation claims

Causal agents for workers' compensation claims and physical injury have largely been identified as physical demands. We proposed an integrated theory of physical injury (i.e. musculoskeletal disorder symptoms [MSDs]) and workers' compensation claims, which combined psychosocial and physical mechanisms. A random, population-based sample of 1095 Australian workers completed a telephone interview on two occasions 12 months apart. As expected, the physical mechanism was confirmed; physical demands were related to MSDs, which in turn predicted workers' compensation claims. Further, a novel psychosocial mechanism was confirmed. Psychosocial safety climate (PSC; perceptions about the organisation's climate for psychological health) was a precursor to psychosocial risks (e.g. harassment, violence, bullying and work pressure). In turn, these psychosocial risks were related to emotional exhaustion, MSDs and then workers' compensation claims. Evidence was therefore provided for psychosocial-physical processes in explaining MSDs and workers' compensation for claims for physical injury. Occupational health and safety legislators and policy makers should be aware that, beyond physical demands, factors usually associated with risk for mental stress claims (e.g. harassment, bullying, and violence) may additionally manifest in physical health problems and workers' compensation injury claims. Focusing on modifying the PSC in an organisation, “the cause of the causes”, may be an effective injury prevention and intervention strategy.     

Presenteeism and health over time among Chinese employees: The moderating role of self-efficacy

The aim of this study was two-fold: first, to examine both the immediate and the lasting effects of presenteeism on health; second, to explore the moderating effect of self-efficacy on the presenteeism-health relationship in a Chinese context. We employed a two-wave study design in which presenteeism, health (i.e. physical health, mental health and exhaustion), and self-efficacy were assessed at Time 1; health was measured again at Time 2 three months later. We surveyed a diverse sample of 345 full-time Chinese employees working in Taiwan and mainland China. Hierarchical regression analyses showed that presenteeism over the previous six months was negatively related to employees' physical health, mental health and exhaustion at Time 1. However, we found no association between presenteeism and health at Time 2, after controlling for the baseline level of health, indicating that presenteeism may not have a lasting effect. Self-efficacy was found to moderate the relationships between presenteeism and all three aspects of health at Time 2, suggesting that for some individuals presenteeism may not on balance be a bad thing. The study sheds light on the association between presenteeism and health. The findings on self-efficacy also extend the literature to incorporate individual characteristics in the presenteeism context.     

Violence in the nursing profession: Occupational and lifestyle risk factors in Swedish nurses

In a national study of the work environment, physical, and mental well-being of more than 2600 Swedish nurses, 30% reported having experienced violence at work. Possible association between violence and a range of occupational, demographic, and lifestyle characteristics were studied. Stepwise multiple linear and logistic regressions were used to further examine risk factors for violence. Occupational factors with significant correlations to workplace violence were nursing discipline (type of ward or facility), years of work experience, supervisory responsibilities, night work, work dissatisfaction, work-related musculoskeletal injury, and frequency of patient handling. Demographic/lifestyle factors related to violence were age, gender, smoking, coffee consumption at work, and use of alcohol to relax after work. The best fit linear regression model explained 17% of the variance in violence, 13%, of the variance in threat of violence. The logistic regression model confirmed an increased risk of violence and threats in psychiatric and geriatric settings. However, much remains unexplained about the aetiology of violencc in health carc settings. This report provides the basis for a pilot intervention study currently in progress.     

Ethical leadership and group in-role performance: The mediating roles of group conscientiousness and group voice

In this paper, we propose that ethical leadership will lead to higher group in-role performance. Building from and integrating several different research streams, we argue that two key mechanisms for this effect are group conscientiousness (an emergent state) and group voice (a group process). We collected survey data at three points in time from 80 groups of nurses and the groups' leaders. The results provide support for all of our hypotheses. There was a positive relationship between employee ratings of ethical leadership (Time 1) and leader ratings of group in-role performance (Time 3). Group conscientiousness and group voice (Time 2) both partially mediated this relationship. These results contribute to our understanding of leadership and group effectiveness not only by showing that ethical leadership has a positive influence on group in-role performance, but also by identifying specific norms and group-level behaviors that help to account for this relationship.     

Violence in the nursing profession: Occupational and lifestyle risk factors in Swedish nurses

Abstract

In a national study of the work environment, physical, and mental well-being of more than 2600 Swedish nurses, 30% reported having experienced violence at work. Possible association between violence and a range of occupational, demographic, and lifestyle characteristics were studied. Stepwise multiple linear and logistic regressions were used to further examine risk factors for violence. Occupational factors with significant correlations to workplace violence were nursing discipline (type of ward or facility), years of work experience, supervisory responsibilities, night work, work dissatisfaction, work-related musculoskeletal injury, and frequency of patient handling. Demographic/lifestyle factors related to violence were age, gender, smoking, coffee consumption at work, and use of alcohol to relax after work. The best fit linear regression model explained 17% of the variance in violence, 13%, of the variance in threat of violence. The logistic regression model confirmed an increased risk of violence and threats in psychiatric and geriatric settings. However, much remains unexplained about the aetiology of violencc in health carc settings. This report provides the basis for a pilot intervention study currently in progress.     

Collective Leadership and Circles: Not Invented Here

Issues like police-community relations, violence—from neighborhood to global levels, economic inequality, and climate change have been only minimally addressed within behavior analysis, despite the oft repeated mantra that they are all at root behavioral. Disciplines determine the scope of their interests; behavior analysis and behavioral systems analysis have long claimed at least potential expertise in changing not only individual behavior, but also the collective and interlocking functioning of larger institutions and systems. In this paper we note that standard organizational behavior management (OBM) practices primarily emphasizing centralized leadership are unlikely to be adequate for such work. We therefore argue that collective leadership, a strategy that has not been emphasized in OBM, will be required to operationalize behavioral systems interventions in situations where centralized leadership is impossible or dangerous, and suggest circle processes as one behaviorally specifiable approach to constructing collective leadership, an approach that behavioral systems analysts are well-positioned to test and refine.     

Nurse safety: How is safety climate related to affect and attitude?

Occupational accidents and injuries continue to be a critical concern for nurses, given the hazardous healthcare environment. This study advances the research on workplace safety by studying the process variables (i.e. job-related negative affect (JRNA) and job satisfaction) in explaining the relationship between safety climate and various safety criteria in nurses. Based on survey data from 326 nurses, our findings suggest that psychological safety climate is negatively related to JRNA, turnover intentions, safety workarounds, and workplace hazards. In addition, structural equation modelling indicated general support for a model in which psychological safety climate influences employee strain through job attitudes, including JRNA and job satisfaction. More specifically, job attitudes were found to mediate the relationship between psychological safety climate and turnover intentions, experience of hazards, and injuries. Safety workarounds did not significantly relate to injuries. The present study contributes to the ongoing improvement of interventions aimed at mitigating nurses’ injuries by integrating job attitudes into the safety climate–safety outcome framework.     

The Violent Incident Form (VIF): A practical instrument for the registration of violent incidents in the health care workplace

The Violent Incident Form (VIF) is a practical instrument that has been developed for the registration of all types of threatening and violent behaviour directed toward staff in health care work environments. The instrument uses a broad definition of violence that encompasses verbal aggression and threats. A 1-page checklist, the VIF, summarizes key aspects of the violent incident, identifying the circumstances, perpetrator, event, and consequences. Results from a 15-week pilot study as well as a follow-up study of the instrument's test-retest reliability are presented. The VIF was then introduced at 47 health care workplaces and used for a period of 12 months. During this period, 684 incidents were recorded by 32 workplaces. Of these, only 147 incidents (21 %) were also filed as official work injury reports. The checklist is based on the principle that all kinds of violent events must be included if an accurate assessment of violence at the workplace is to be made. The VIF is not intended as a replacement for official work injury reports, but as a complement, focusing more specifically on the nature of the violent incident. It is presented here as a research tool for studying violence in today's health care environments. Further work is needed to assess the use of the VIF as a learning tool, and as a possible catalyst for the development of effective violence management programmes.     

Combined workplace stressors and their relationship with mood, physiology, and performance

The majority of working individuals are exposed to low levels of a large number of potential stressors. Although each is unlikely to be particularly detrimental in itself, such stressors may be harmful cumulatively. The aim of this study was to investigate whether exposures to combinations of stressors were associated with harmful levels on some measures of mood, physiology, and performance. The study was conducted with 84 participants, all employed, mostly “white-collar” workers. A questionnaire was administered and physiological outcome measures were taken on four occasions: before and after work on the first and last days of one working week (repeated measures, within-subjects factor). Workers were categorized as exposed to either: (1) no stressors, (2) temporal stressors only, (3) physical stressors only, or (4) both temporal and physical stressors (between-subjects factor). Data were analysed using mixed design ANOVAs. Key significant between-subjects effects were found for blood pressure and salivary cortisol; participants exposed to a combination of stressors had significantly elevated levels of both. The identified physiological differences are tentatively supported by the literature and can be explained by increased subjective stress levels. Significant differences in performance were not found. This may be explained by methodological issues, or participants' increased effort expended to perform on the tasks. It is concluded that the consideration of combined (low level) stressors and cumulative exposure is important in assessing the health risk associated with the work environment.     

Work-to-family conflict and its relationship with satisfaction and well-being: a one-year longitudinal study on gender differences

The present study produced new knowledge about gender differences with respect to work-to-family conflict and its longitudinal relations with indicators of satisfaction and well-being. The study examined the longitudinal relations between work-to-family conflict and self-reported satisfaction and well-being in the domains of work (job satisfaction), family (marital satisfaction, parental distress) as well as overall (psychological and physical) symptoms. Data were obtained from a random sample of Finnish men (n=208) and women (n=218) who were employed and had either a partner or/and children. A survey was conducted at two points in time, in 1999 (Time 1), and one year later, in 2000 (Time 2). The results revealed that, among women, work-to-family conflict perceived at Time 1 significantly predicted job dissatisfaction, parental distress as well as psychological symptoms at Time 2. However, among men, a low level of satisfaction or well-being at Time 1 (marital dissatisfaction, parental distress, psychological and physical symptoms) functioned as a precursor of work-to-family conflict perceived at Time 2. In addition, the experience of work-to-family conflict turned out to be relatively stable for both genders over the time period of one year. It is likely that work-to-family conflict will continue to affect employees, and should be a central focus for organizations.     

Effort-reward imbalance and work-home interference: a two-wave study among European male nurses

ABSTRACT

This one-year follow-up study among 1,421 male nurses from seven European countries tested the validity of the Effort-Reward Imbalance (ERI) model in predicting prospective vital exhaustion and work-home interference. We hypothesised that effort and lack of reward would have both main and interactive effects on future outcomes. Results of structural equation modelling (SEM) showed that effort was positively related to exhaustion and work-home interference, both simultaneously and over time. Lack of reward predicted increased exhaustion at follow-up, but effort-reward imbalance did not influence the outcomes. Additionally, Time 1 exhaustion predicted increased work-home interference and exhaustion at follow-up. These results do not support the ERI model, which postulates a primacy of effort-reward imbalance over main effects. Instead, the findings are in line with dual path models of job stress and work-home interference. Multi-group SEM showed partial cross-cultural metric invariance for the ERI measure of effort, but the ERI measure of rewards showed no metric measurement invariance, indicating its meaning is qualitatively different across cultures. Nevertheless, the main conclusions were markedly similar for each national sub-sample. We discuss the theoretical and practical implications of our study.