Influencing Factors Related to Workplace Bullying Among Nurses: A Systematic Review

Abstract

Researchers in the fields of psychology and business have studied workplace bullying since the 1980s, and more recently it has gained attention in the healthcare arena. It is of specific interest to nurses, as nurses are reported to have the highest prevalence rates among health professionals. Moreover, there are numerous consequences to individual well-being, work teams, health organizations, and patient care. Researchers have studied the relationships between influencing factors and exposure to workplace bullying; however, these findings have not yet been systematically reviewed. Therefore, the aim of this thesis is to examine what is known about factors that positively and negatively influence the risk or prevalence of workplace bullying among nurses, and systematically review the findings. Fourteen studies were selected for final inclusion in the review, including both quantitative and qualitative published studies that examined correlations between potential antecedent factors and risk of bullying among formally educated nurses. Quality assessments, data extraction, and analysis were completed for all included studies. Content analysis was conducted using the Theoretical Framework for the Study and Management of Bullying at Work as a baseline. The framework was then adapted to reflect the findings that nurses reported both enabling and inhibiting factors at the individual, social, and organizational levels. Additionally, organizational action in response to bullying behavior was reported as an important enabler of future bullying behavior. The findings of the review provide direction for multidimensional intervention strategies, management training, and policy development. Future research is needed to confirm the results of original studies, explore relationships among factors at various levels, examine antecedents from the perspective of the bully, and confirm or expand the remaining components of the framework for its overall applicability to nursing. More rigorous designs are also needed to study directionality and improve the strength of findings.