JKAN Journal of Korean Academy of Nursing J Korean Acad Nurs 2005-3673 2093-758X Korean Society of Nursing Science 10.4040/jkan.2019.49.5.562 jkan-49-562 Original Article Response Patterns of Nursing Unit Managers regarding Workplace Bullying: A Q Methodology Approach ChoiJin Kyu1 LeeByoungsook2 Emergency Room, Kyungpook National University Chilgok Hospital, Daegu College of Nursing, Keimyung University, Daegu, Korea Address reprint requests to : Lee, Byoungsook College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Korea Tel: +82-53-580-3908 Fax: +82-53-580-3916 E-mail: lbs@gw.kmu.ac.kr 012019 15012019 495 562574 080420192406201915072019 Copyright © 2019 Korean Society of Nursing Science 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium. Abstract Purpose

The purpose of this study was to identify the response patterns of nursing unit managers regarding workplace bullying.

 Methods

Q methodology was used to identify the response patterns. Thirty-six Q samples were selected from the Q population of 210 that included literature reviews and in-depth interviews with clinical nurses and nursing managers. Participants were 30 nursing unit managers who had experience managing workplace bullying and they classified the Q samples into a normal distribution frame measured on a nine-point scale. The data were analyzed using the PC-QUANL program.

 Results

Five types of response patterns were identified: (1) sympathetic-understanding acceleration, (2) harmonious-team approach, (3) preventive-organizational management, (4) passive observation, and (5) leading-active intervention. The preventive-organizational management type was most frequently used by the nursing unit managers.

 Conclusion

The results of this study indicated that nursing unit managers attempted to prevent and solve workplace bullying in various ways. Therefore, it is necessary to develop and conduct leadership training and intervention programs that appropriately address the response patterns of nursing unit managers, such as those identified in this study.

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Tables

Q-sort table.

1. Q Statements on Response Patterns regarding Workplace Bullying and Z-scores (N=30)

Q statement Z-score
TypeⅠ TypeⅡ TypeⅢ TypeⅣ TypeⅤ
(n=5) (n=9) (n=10) (n=2) (n=4)
Q1 I apply responding manual for workplace bullying. -0.81 -0.35 0.00 -0.46 -1.12
Q2 Workplace bullying indicates serious problems of organization. 0.18 0.55 1.24 0.00 0.25
Q3 It is difficult to approach the problem that many people bully a person. -1.21 -0.14 -0.89 0.14 0.18
Q4 I encourage the good parts of harassed nurse. 1.23 1.22 0.68 0.99 1.14
Q5 I ask for time to endure to both victim and perpetrator. 0.21 -1.17 -0.75 1.59 0.05
Q6 Workplace bullying can be solved by nursing unit manager. -0.14 -0.57 0.32 -0.44 -0.47
Q7 I create atmosphere that workplace bullying can be reported to nursing unit manager. 0.80 1.28 1.25 0.99 0.04
Q8 I hope that the parties being involved the problem solve themselves, and do not ruin the working atmosphere. 0.49 0.67 -1.09 -1.29 -0.84
Q9 Prevention is most important for workplace bullying. 0.91 0.97 1.34 0.23 0.24
Q10 I invite each person involved separately to listen the story. 1.62 1.84 0.90 -0.30 1.30
Q11 I create the atmosphere that allows the victim to feel a sense of belonging as a member of the department. 1.49 1.65 1.22 0.60 0.74
Q12 It is difficult to identify if workplace bullying is not reported. 0.37 -0.41 -0.58 -0.30 0.12
Q13 Workplace bullying can occur while educating nursing works. -1.22 -1.38 -1.06 -1.66 -1.40
Q14 I conduct surveillance and observation regularly for workplace bullying. -0.19 0.32 1.53 -0.83 1.10
Q15 I plan activities promote the fellowship among the members of department for preventing workplace bullying. 0.50 1.25 0.89 0.07 0.30
Q16 It is a issue that do not concerned about usually. -1.35 -1.64 -1.45 0.16 -1.54
Q17 Workplace bullying is unevitable for a certain degree for nursing job adaptation and patient safety. -1.29 -0.79 -0.70 -2.12 -1.41
Q18 I observe the facial expressions and behaviors of the members to check workplace bullying. 0.88 1.29 1.25 1.52 1.88
Q19 Workplace bullying is the problem of the entire organization as well as a person involved. 1.04 0.98 1.87 0.76 1.21
Q20 It is good that the people involved solves workplace bullying by themselves. 0.09 -1.29 -0.99 -1.13 -1.66
Q21 I emphasize nurses that workplace bullying is unacceptable behavior. 1.09 0.85 0.96 1.43 0.53
Q22 I immediately report the situation of workplace bullying to supervisor. 0.53 -0.81 0.41 -1.29 -0.39
Q23 People who being bullied in workplace are mostly inexperienced to work. -1.50 -0.08 -0.47 1.36 1.65
Q24 I let senior nurse help the nurse who is bullied in the workplace. 0.48 1.29 0.55 -0.67 1.23
Q25 I often hesitate to intervene because it takes much time for solving. -1.40 -1.22 -1.49 0.83 -0.75
Q26 Nursing unit managers need a education for workplace bullying and how responds. 0.18 0.95 0.80 1.66 0.62
Q27 I seek dedicated advices of the superiors from the beginnings of workplace bullying. -0.27 -0.85 -0.49 -0.69 -1.30
Q28 I immediately intervene when workplace bullying is recognized. 1.15 -0.62 0.49 -0.46 1.27
Q29 Depending on the point of view, workplace bullying may be not harassment to others. -0.79 -0.61 -0.95 1.82 -1.20
Q30 I alert and warn the situation to entire members when workplace bullying occurs. 0.82 -0.52 0.49 -0.37 -0.46
Q31 I scold persons even during interview if their faults are found. -0.96 -1.49 -1.14 -1.52 -0.69
Q32 I conceal problems of the department from showing outside. -1.84 -1.40 -1.36 -0.76 -0.97
Q33 I talk to the perpetrator indirectly to think about their behaviors. 1.29 0.53 -0.36 -0.30 1.01
Q34 I reflect the problems of workplace bullying to work evaluation. -1.48 -0.37 -0.08 0.07 0.40
Q35 I am concerned about workplace bullying may occur in my department. 0.34 0.26 -0.67 0.00 0.17
Q36 It is hard to intervene the workplace bullying, because interventions may make more difficult to solve the problem. -1.23 -0.18 -1.64 0.37 -1.23

Eigen Values, Variances, Cumulative Percentages and Cor-

Variable Type I Type II Type III Type IV Type V
Eigen value 15.60 2.17 1.46 1.35 1.16
Variance (%) 52.0 7.2 4.9 4.5 3.9
Cumulative 52.0 59.2 64.1 68.6 72.5
Correlation
Type I 1.00
Type II .70 1.00
Type III .70 .75 1.00
Type IV .19 .38 .26 1.00
Type V .57 .71 .68 .43 1.00

Demographic Characteristics and Factor Weights for P-Samples (N=30)

Type No. Factor weight Working department Education Total clinical experience (yr) Nurse unit manager career (yr)
Type I (n=5) 28 1.49  Medical ward ≥Master 30 8
15 1.45  Others ≥Master 30 2
16 1.07  ICU ≥Master 30 9
5 0.94  Others ≥Master 33 4
25 0.78  Others Bachelor 26 15
Type II (n=9) 17 1.57  Others Bachelor 30 3
8 1.41  Others ≥Master 28 7
9 1.38  Surgical Ward ≥Master 20 2
7 1.29  Medical Ward ≥Master 29 5
6 1.24  Medical Ward ≥Master 23 6
12 1.02  Others ≥Master 26 4
21 0.95  Others ≥Master 34 5
18 0.95  Others ≥Master 34 10
23 0.70  Surgical Ward Bachelor 16 4
Type III (n=10) 14 2.39  Surgical Ward ≥Master 28 7
30 1.25  Surgical Ward ≥Master 28 3
2 1.16  Medical Ward ≥Master 29 5
11 1.06  Others ≥Master 28 8
29 1.00  Surgical Ward ≥Master 26 5
1 0.96  ER ≥Master 27 3
22 0.90  ER Bachelor 20 8
20 0.82  Others Bachelor 30 7
13 0.72  Others ≥Master 34 8
26 0.70  Medical Ward Bachelor 25 17
Type IV (n=2) 19 1.93  ICU ≥Master 22 3
4 1.49  ICU ≥Master 34 5
Type V (n=4) 27 2.23  Others Bachelor 27 2
10 0.98  Surgical Ward ≥Master 27 8
24 0.79  Medical Ward Bachelor 25 16
3 0.69  Medical Ward ≥Master 37 9

ICU=Intensive care unit; OR=Operating room; ER=Emergency room.

Consensus Items and Average Z-score

Q statement Z-score
Q18 I observe the facial expressions and behaviors of the members to check workplace bullying. 1.37
Q4 I encourage the good parts of harassed nurse. 1.05
Q21 I emphasize nurses that workplace bullying is unacceptable behavior. 0.97
Q12 It is difficult to identify if workplace bullying is not reported. -0.16
Q6 Workplace bullying can be solved by nursing unit manager. -0.26
Q31 I scold persons even during interview if their faults are found. -1.16
Q13 Workplace bullying can occur while educating nursing works. -1.34