A review of research on the prevalence,antecedents, consequences and prevention of workplace aggression in clinical medical practice

A broad-ranging review of the published research literature was undertaken on workplace aggression in clinical medical practice. Prevalence studies have found that 15–75% of survey respondents reported verbal aggression and 2–29% reported physical aggression in medical practice settings in the previous 6–24 months. In comparison, there was limited published research on the antecedents and consequences of clinician exposure to workplace aggression, and a dearth of published research on the prevention and minimization of workplace aggression in medical practice settings. Future research efforts need to investigate workplace aggression from all sources and across all medical clinician sub-populations in the diverse settings in which they work. Specific attention needs to be given to identifying key risk and protective factors for workplace aggression exposure, including in relation to clinician profiles, the settings and conditions of medical work, and the presence of key aggression prevention and minimization efforts, both individually and in combination. The impact of workplace aggression on clinician health, well-being, performance and work participation remains under-researched. Overall, a more extensive and robust evidence base is required to enable informed decision-making on reducing the likelihood and consequences of workplace aggression in clinical medical practice.     

职场孤独感的形成原因与作用机理：基于调节匹配理论视角

随着组织广泛的信息技术运用、工作强度增加,员工之间面对面的、真诚的社交开始呈下降趋势。职场孤独感成了困扰员工的普遍问题,引起了企业管理实践界高度重视。通过综述已有文献,本文指出过往研究虽揭示了职场孤独感带来的消极影响效应并有效提高了组织对职场孤独问题的关注度,但尚未系统回答“如何预防与应对职场孤独感”。为了引导员工对职场孤独感的科学应对,本文认为有必要将员工视为能动的主角而非被动的承受者,并探讨职场孤独感与员工应对行为的关系,为如何应对职场孤独感提供建设性对策。 除此之外,为了更好地预防与遏制职场孤独感,有必要系统性地探讨职场孤独感的形成原因。综合过往研究,本文发现职场孤独感区别于其他消极情绪的核心在于：职场孤独感源自于高质量职场人际关系的缺失。与此观点对应的是,Wright和Silard （2021）认为当员工实际的职场人际关系未达到预期水平,员工会认为职场人际关系存在缺陷,产生孤独的体验。Wright和Silard （2021）的观点反映了职场孤独感是一种员工未实现期望社交目标而导致的心理体验。循此逻辑,本文采用与目标实现过程相关的调节匹配理论来解释职场孤独感的产生原因和影响机制,为预防和应对职场孤独感提供对策。以调节匹配理论为框架,本项目拟解决三个问题：（1）领导与下属的调节焦点（不）匹配如何通过影响领导成员交换,进而影响职场孤独感;（2）员工与团队的调节焦点（不）匹配如何通过影响团队成员交换,进而影响职场孤独感;（3）员工如何依据不同的团队调节氛围来选择社交应对策略,以及社交应对策略对员工绩效的影响。通过新颖的多项式回归分析与曲面响应分析方法,本文力求重构传统的职场孤独感的研究思路,为职场孤独感的产生机制提供新的研究视角。除此之外,本文首次将调节匹配理论引入职场孤独感的研究,系统性地分析了职场孤独感的产生和应对,呈现了职场孤独感现象在组织中的动态演化的过程与机制。     

Antecedents and consequences of workplace bullying: a longitudinal analysis with a structural equation model

Most studies focusing on the antecedents and consequences of workplace bullying have used a cross-sectional design, which impedes determining the causality of the relationships. In the present work, we analyzed, by means of structural equation models, the relationship between workplace bullying and some variables that are considered antecedents (interpersonal conflicts, role ambiguity, role conflict, and workplace social support) or consequences (health complaints and inclination to absenteeism from work) of this phenomenon. Multicenter study with two phases. The sample consisted of 696 employees from 66 centers. Workplace bullying was assessed by means of the "Mobbing-UNIPSICO" questionnaire, and the other variables with frequency scales. The cross-sectional models indicated a significant association between role conflict, workplace social support, and workplace bullying in both study periods. Concerning the longitudinal relationships, only workplace social support was a significant predictor of workplace bullying, which, in turn, was a cross-sectional and longitudinal predictor of workers' health complaints. Our results show the mediating effect of workplace bullying between certain work conditions and health complaints, and it is recommendable to replicate these findings in a multi-occupational sample.     

The antecedents and consequences of interpersonal forgiveness: A meta‐analytic review

This article examines the antecedents and outcomes of forgiveness. The interpersonal forgiveness literature is qualitatively reviewed. Antecedents to forgiveness are classified by their proximity to forgiveness based on M. E. McCullough and colleagues, (1998) framework. From most distal to most proximal these antecedents are personality, relationship factors, offense‐specific factors, and social‐cognitive factors including empathy. The association of these antecedents and several consequences of forgiveness are quantitatively examined in meta‐analyses. All investigated variables were significantly related to forgiveness. Empathy was a stronger correlate of forgiveness than any other non‐social‐cognitive antecedent except for trait agreeableness. Methodological factors and the average age of subjects moderated the relationship between forgiveness and some of its correlates. Implications and future directions are considered.     

Workers' perception of workplace bullying: A cross-cultural study

This study is one of the first studies to approach workplace bullying cross-culturally. It sought to compare employees' understanding of workplace bullying in two different world regions: Central America and Southern Europe, regarding three aspects of workplace bullying: psychological vs. physical harassment, hierarchical vs. horizontal bullying, and direct vs. indirect aggression. A convenience sample of 246 workers provided their own definition of workplace bullying through a single, open-ended question. The results showed that employees from Central America emphasized the physical component of workplace bullying more than the Southern European employees. However, similarities in the conceptualization of workplace bullying across both cultures were found as well. Both Southern European and Central American employees defined workplace bullying mainly as a hierarchical phenomenon, where the aggression took the form of direct strategies. Such differences and similarities bring to the field some positive inputs for the development and implementation of different strategies for dealing effectively with this phenomenon.     

Coping with bullying in the workplace

The purpose of the study was to investigate the 1-year prevalence of bullying in the form of repeated exposure to slander and/or nasty teasing in Danish workplaces, and to analyse whether respondents subjected to bullying use the same coping strategies as respondents who are not subjected to bullying. The results show that approximately 2% of the Danish employees are subjected to bullying at work. We compared the use of coping strategies in three groups: a non-exposed group, a somewhat exposed group, and a very exposed group (i.e., bullied). The results showed no linear association between the three groups, but a difference between being exposed and not exposed. The results seem to indicate that it is not necessarily the quantity of the negative acts that cause the change in behaviour but more the fact of being exposed to such acts.     

Pink triangles: antecedents and consequences of perceived workplace discrimination against gay and lesbian employees.

A model of perceived sexual orientation discrimination was tested in a national sample of 534 gay and lesbian employees. The effects of legislation, organizational policies and practices, and work group composition on perceived sexual orientation discrimination were examined, as well as the attitudinal and organizational outcomes associated with discrimination. Gay employees were more likely to report discrimination when employed in groups that were primarily heterosexual and in organizations that lacked supportive policies and were not covered by protective legislation. Disclosure of sexual orientation at work was related to discrimination and antecedent variables. Perceived discrimination was associated with negative work attitudes and fewer promotions. Organizational policies and practices had the strongest impact on perceived discrimination and were directly related to outcomes.     

Racial/ethnic bullying: Exploring links between bullying and racism in the US workplace

This study examined relations between the incidence of workplace bullying and the everyday experiences of members of ethnic and racial minorities in the American workplace. Particular attention was paid to expressions of bullying that overtly or specifically refer to race or ethnicity, in the form of more or less subtle acts of discrimination and hostile treatment, introducing the term `racial/ethnic bullying.' Participants belonging to four racial/ethnic groups (Asians, African-Americans, Hispanics/Latinos, and whites) responded to a written survey of general and racial/ethnic bullying experiences, responses, and preferred modes and methods of internal organizational redress and dispute resolution. Very different profiles emerged between bullying perpetrated by supervisors/superiors versus co-workers/peers in the organization.     

Coping with bullying in the workplace: the effect of gender, age and type of bullying

A study of bullying, victimisation and the coping strategies employed to tackle it is presented in the first study of bullying in the workplace conducted in Iceland. Participants were 398 members of a union of store and office workers and members of a national organisation of bank-employees. A factor analysis of bullying items identified two factors: general bullying and work-related bullying. Males score higher on both factors, but when asked directly if they have been bullied or not, no significant gender difference appears. A measure of coping strategies when faced with bullying is presented. A factor analysis and multidimensional scaling of these strategies identified four clusters: assertive response, seek help, avoidance and do nothing. These can be arranged on a passive vs. active dimension, which may reflect the severity or duration of the bullying situation. Multiple regressions indicate that males seek help less and use avoidance less than females, and males are more likely to use assertive strategies, confirming gender stereotypes about what constitutes appropriate behaviour. Increased bullying is also associated with the use of avoidance and passive response (do nothing). These results are mainly in accordance with findings from schools. It is suggested that active coping styles are employed during the initial stages of bullying but that victims resort to more passive coping strategies as the bullying becomes more serious. The need for a longitudinal design is proposed to understand the relationship between duration and severity of the bullying experience and the choice of coping strategies.     

Conflict escalation and coping with workplace bullying: A replication and extension

Bullying or mobbing is used for systematically harassing a person for a long time. In the context of stress theory, bullying is a severe form of social stressors at work, whereas in terms of conflict theory, bullying signifies an unsolved social conflict having reached a high level of escalation and an increased imbalance of power. Based on a qualitative study with 20 semi-structured interviews with victims of bullying and a quantitative questionnaire study with a total of 149 victims of bullying and a control group (N = 81), it was investigated whether bullying victims use specific conflict management strategies more often compared with individuals who are not bullied, and whether coping strategies used by successful copers with bullying differ from those of the unsuccessful copers. Successful copers were those victims who believe that their situation at work has improved again as a result of their coping efforts. The qualitative data showed that most victims started with constructive conflict-solving strategies, changed their strategies several times, and finally tried to leave the organization. In the interviews, the victims of bullying most often recommended others in the same situation to leave the organization and to seek social support. They more often showed conflict avoidance in the quantitative study. Successful victims fought back with similar means less often, and less often used negative behaviour such as frequent absenteeism. Moreover, they obviously were better at recognizing and avoiding escalating behaviour, whereas in their fight for justice, the unsuccessful victims often contributed to the escalation of the bullying conflict.     

The aftermath of workplace violence among healthcare workers: A systematic literature review of the consequences

Workplace violence is an important health and safety issue. Healthcare workers are particularly at risk of experiencing workplace violence. Despite the research that was conducted in this domain, little is known about the consequences of being a victim of workplace violence, specifically in the healthcare sector. Therefore, this article aims to review the literature regarding the consequences of exposure to workplace violence in the healthcare sector. Sixty-eight studies were included in the review and they were evaluated according to 12 criteria recommended for systematic reviews. The studies identified seven categories of consequences of workplace violence: (1) physical, (2) psychological, (3) emotional, (4) work functioning, (5) relationship with patients/quality of care, (6) social/general, and (7) financial. Psychological (e.g., posttraumatic stress, depression) and emotional (e.g., anger, fear) consequences and impact on work functioning (e.g., sick leave, job satisfaction) were the most frequent and important effects of workplace violence. In conclusion, this paper recommends further research, particularly longitudinal studies, in order to better grasp the direct and indirect effects of workplace violence.     

Accounts of workplace bullying: The role of the organization

In over a decade of research into bullying at work, the focus has been on defining, measuring, and explaining the essential nature of the bullying phenomenon. This focus has positioned the individual as the main unit of analysis, with the organization acting as a facilitating backdrop. By assuming a critical research position as opposed to the dominant positivist tradition from which most of the bullying research emanates, attention can be drawn to additional and marginalized accounts. Our research does not offer a definition of bullying—rather, we examine the implications of the different ways in which the term bullying is used. This paper uses data from a case study in a large telecommunications company's call centres. We demonstrate that while employees use the pathologized individual and the facilitating environment to account for bullying, in addition they use the notion of the pathologized organization. This additional narrative brings issues of power and politics in organizations to the fore. Taking a critical management approach, we focus on employee accounts of the oppressive impact of power structures. We argue that marginalizing certain accounts functions to maintain the organizational power balance. By using the term bullying to describe their work experience, employees in this study sought to employ an emotive and highly charged term to highlight their discontent at increasingly difficult work situations.     

Job autonomy and workload as antecedents of workplace bullying: A two‐wave test of Karasek's Job Demand Control Model for targets and perpetrators

The current study aims to test the hypotheses that are central to Karasek's Job Demand Control Model in relation to workplace bullying. Particular contributions are, first, the focus upon both targets and perpetrators of workplace bullying, and second, the two‐wave design with a 6‐month time lag. We assume that (a) workload at Time 1 associates positively with being a target/perpetrator at Time 2, (b) job autonomy at Time 1 associates negatively with being a target/perpetrator at Time 2, and (c) the positive relationship between workload at Time 1 and being a target/perpetrator at Time 2 is stronger under the condition of low (vs. high) job autonomy at Time 1 (i.e., interaction between workload and job autonomy). Moderated hierarchical regression analyses (N= 320) revealed lagged main effects for being a target, and interaction effects for being a perpetrator. In particular, Time 1 workload was positively and Time 1 job autonomy negatively associated with being a target at Time 2. Job autonomy at Time 1 reduced the positive relationship between workload at Time 1 and being a perpetrator at Time 2. Overall, our results suggest that high strain jobs relate to both being a target and to being perpetrator of workplace bullying, yet through different processes: main effects and interactions, respectively.     

A meta-analysis of the regulatory focus nomological network: Work-related antecedents and consequences

Regulatory focus theory (Higgins, 1997, 1998) has received a great deal of recent attention in the organizational behavior literature. Despite the amount of new evidence surrounding regulatory focus and its relationships with other variables, a quantitative summary of this literature is lacking. The authors used meta-analysis to summarize correlations from 77 empirical studies that included self-report measures of promotion and prevention focus. Meta-analytic effect sizes between promotion and prevention focus and work-related variables are reported. In general, results indicated that promotion and prevention focus are orthogonal constructs and each construct is uniquely related to other theoretically relevant constructs. The results also demonstrate the importance of regulatory foci to organizational researchers as well as the need for a unified approach to their measurement.     

A review of research on bullying and peer victimization in school: An ecological system analysis

Bullying and peer victimization in school are serious concerns for students, parents, teachers, and school officials in the U.S. and around the world. This article reviews risk factors associated with bullying and peer victimization in school within the context of Bronfenbrenner's ecological framework. This review integrates empirical findings on the risk factors associated with bullying and peer victimization within the context of micro- (parent–youth relationships, inter-parental violence, relations with peers, school connectedness, and school environment), meso- (teacher involvement), exo- (exposure to media violence, neighborhood environment), macro- (cultural norms and beliefs, religious affiliation), and chronosystem (changes in family structure) levels. Theories that explain the relationships between the risk factors and bullying behavior are also included. We then discuss the efficacy of the current bullying prevention and intervention programs, which is followed by directions for future research.     

Leadership and approaches to the management of workplace bullying

Leadership behaviour has been identified as an important antecedent of workplace bullying since managers may prevent, permit, or engage in the mistreatment of others. However, the issue of how managers respond when bullying occurs has received limited attention. With this in mind, the aim of this study was to explore how managers behave when bullying occurs in their work group and to elucidate the contextual issues that underlie this behaviour. This was achieved through analysis of in-depth interviews with individuals involved in cases of bullying. The findings revealed a typology of four types of management behaviour in cases of bullying, each underpinned by contextual factors at the individual, group, and organizational levels. The study shows that the role of leadership in workplace bullying is more complex than previously thought and suggests several ways in which managers and organizations could deal with bullying behaviour.     

Women's experiences of workplace bullying: changes in social relationships

This article reports a qualitative study, which investigated social processes in workplace bullying, based on in‐depth interviews with ten British women professionals who were targets of workplace bullying. Data were analysed using grounded theory methods. The resulting analysis showed links between disclosures of bullying, reactions of others, and some impacts on targets' psychological health. Key themes which emerged from the data included ‘being heard’ which describes how others reacted to disclosures of bullying behaviours, and the ‘ripple effect’ which describes how bullying impacted upon targets' significant others; these predominantly describe relationships with others outside the workplace. The theme of ‘withdrawal’ describes how targets and others managed relationships within the workplace, and ‘denial’ and ‘personalizing problems’ describe how others within the workplace responded to knowledge of bullying behaviours. The theme ‘maintaining self’ describes how participants responded to changed relationships and struggled to maintain a coherent sense of self during and subsequent to bullying. This research emphasizes the role of social processes and social environments, rather than individual or personality characteristics, in explaining the development of workplace bullying and its impacts on targets. Copyright © 2004 John Wiley & Sons, Ltd.     

A meta-analysis of the antecedents and consequences of pay level satisfaction

This study reports results from a meta-analysis of 28 correlates of pay level satisfaction involving 240 samples from 203 studies conducted over the past 35 years. Results are presented in 4 categories: primary determinants, antecedents, correlates, and outcomes of pay satisfaction. The authors controlled for pay in examining relations between correlates and pay level satisfaction, as suggested by theory and when primary studies were available to do so. The authors found support for many of the relations suggested by a theoretical model and also note some limitations in the research that has tested this model. The authors recommend changes and additions to the model and suggest additional primary research in specific areas.