Response Patterns of Nursing Unit Managers regarding Workplace Bullying: A Q Methodology Approach

Jin Kyu Choi; Byoungsook Lee

doi:10.4040/jkan.2019.49.5.562

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Choi and Lee: Response Patterns of Nursing Unit Managers regarding Workplace Bullying: A Q Methodology Approach

Original Article

J Korean Acad Nurs 2019;49(5):562-574.

Published online: 15 January 2019

DOI: https://doi.org/10.4040/jkan.2019.49.5.562

Response Patterns of Nursing Unit Managers regarding Workplace Bullying: A Q Methodology Approach

Jin Kyu Choi¹, Byoungsook Lee^2,

¹Emergency Room, Kyungpook National University Chilgok Hospital, Daegu

²College 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

Received 8 April 2019 Revised 24 June 2019 Accepted 15 July 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.

Keywords: Workplace, Bullying, Nurse

References

1. Lee YJ, Lee EJ. Conceptual development of workplace bullying: Focusing on hospital nurses. Korean Journal of Health Education and Promotion. 2014; 31(1):57–70. https://doi.org/10.14367/kjhep.2014.31.1.57.

2. Bosiu M. Positive ways to overcome workplace bullying. Canadian Manager. 2017; 42(1):16–19.

3. Lee YJ, Lee MH, Bernstein K. Effect of workplace bullying and job stress on turnover intention in hospital nurses. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2013; 22(2):77–87. https://doi.org/10.12934/jkpmhn.2013.22.2.77.

4. Yun SY, Kang JY. Factors affecting workplace bullying in Korean hospital nurses. Korean Journal of Adult Nursing. 2014; 26(5):553–562. https://doi.org/10.7475/kjan.2014.26.5.553.

5. Johnson SL, Rea RE. Workplace bullying: Concerns for nurse leaders. Journal of Nursing Administration. 2009; 39(2):84–90. https://doi.org/10.1097/NNA.0b013e318195a5fc.

6. Yildirim D. Bullying among nurses and its effects. International Nursing Review. 2009; 56(4):504–511.

7. Yokoyama M, Suzuki M, Takai Y, Igarashi A, Noguchi-Watanabe M, Yamamoto-Mitani N. Workplace bullying among nurses and their related factors in Japan: A cross-sectional survey. Journal of Clinical Nursing. 2016; 25(17-18):2478–2488.

8. Ma SC, Wang HH, Chien TW. Hospital nurses’ attitudes, negative perceptions, and negative acts regarding workplace bullying. Annals of General Psychiatry. 2017; 16:33. https://doi.org/10.1186/s12991-017-0156-0.

9. Seo MS, Kim JH. Effect of workplace bullying, job satisfaction and self-esteem on turnover intention in clinical nurses. Journal of the Korean Society for Wellness. 2017; 12(2):105–115. https://doi.org/10.21097/ksw.2017.05.12.2.105.

10. Skehan J. Nursing leaders: Strategies for eradicating bullying in the workforce. Nurse Leader. 2015; 13(2):60–62. https://doi.org/10.1016/j.mnl.2014.07.015.

11. Han EH, Ha YM. Relationships among self-esteem, social support, nursing organizational culture, experience of workplace bullying, and consequence of workplace bullying in hospital nurses. Journal of Korean Academy of Nursing Administration. 2016; 22(3):303–312. https://doi.org/10.11111/jkana.2016.22.3.303.

12. Kang JY, Lee MJ. The related factors to workplace bullying in nursing: A systematic review and meta-analysis. Korean Journal of Adult Nursing. 2016; 28(4):399–414. https://doi.org/10.7475/kjan.2016.28.4.399.

13. Lee BS, Kang SY, Kim MS, An HG, Lee EJ, Kwon HS, et al. Nursing management. 3rd ed. Seoul: Jeongdam Media;2016. p. 532–533.

14. Moon JH, Joo GE, Lee JH. Grounded theoretical analysis on the hospital accreditation experience of head nurses in general hospitals. Journal of Korean Academy of Nursing Administration. 2016; 22(5):437–447. https://doi.org/10.11111/jkana.2016.22.5.437.

15. Kang JY, Yun SY. A grounded theory approach on nurses’ experience with workplace bullying. Journal of Korean Academy of Nursing. 2016; 46(2):226–237. https://doi.org/10.4040/jkan.2016.46.2.226.

16. Kang J, Yun S, Won YH, An YS. Organizational culture and workplace bullying of intensive care unit nurses. Journal of Korean Critical Care Nursing. 2014; 7(2):24–33.

17. Choeng SH, Lee IS. Qualitative research on nurses experiencing Taeoom. Korean Journal of Occupational Health Nursing. 2016; 25(3):238–248. https://doi.org/10.5807/kjohn.2016.25.3.238.

18. Yeun EJ, Lee SH, Ko JA, Jeong GS, Shin HY, Seo MJ, et al. Attitude styles on workplace bullying among hospital nurses: A Q-methodology study. Journal of the Korean Society for Wellness. 2017; 12(2):1–13. https://doi.org/10.21097/ksw.2017.05.12.2.1.

19. Kim HK. Q Methodology: Philosophy, theories, analysis, and application. Seoul: Communicationbooks;2008. p. 86–125.

20. Lee YJ. Development of workplace bullying in nursing-consequence inventory (WPBN-CI). Journal of the Korea Aca- demia-Industrial cooperation Society. 2016; 17(2):479–488. https://doi.org/10.5762/KAIS.2016.17.2.479.

21. Lee YJ, Lee MH. Development and validity of workplace bullying in nursing-type inventory (WPBN-TI). Journal of Korean Academy of Nursing. 2014; 44(2):209–218. https://doi.org/10.4040/jkan.2014.44.2.209.

22. Nam W, Kim JW, Kim YK, Koo JW, Park CY. The reliability and validity of the negative acts questionnaire-revised (NAQ-R) for nurses for the assessment of workplace bullying. Korean Journal of Occupational and Environmental Medicine. 2010; 22(2):129–139.

23. Sune CJ, Jung MS. Concept analysis of workplace bullying in nursing. Journal of Korea Entertainment Industry Association. 2014; 8(4):299–308.

24. Sim WK, Cheon SM. Development and validation of nurse job-stress coping scale. Locality and Globality. 2016; 40(1):219–239.

25. Amirkhan JH. A factor analytically derived measure of coping: The coping strategy indicator. Journal of Personality and Social Psychology. 1990; 59(5):1066–1074. https://doi.org/10.1037/0022-3514.59.5.1066.

26. Lee YM. The work stress and coping type of nurses in hospital. Journal of the Korea Academia-Industrial Cooperation Society. 2016; 17(11):230–235. https://doi.org/10.5762/KAIS.2016.17.11.230.

27. Sim IO. Stress and its coping strategies among newly graduated nurses. Journal of Korean Society for the Scientific Study of Subjectivity. 2011; 23:147–162.

28. Yom YH, Noh SM, Kim KH. Clinical nurses’ experience of positive organizational culture. Journal of Korean Academy of Nursing Administration. 2014; 20(5):469–480. https://doi.org/10.11111/jkana.2014.20.5.469.

29. Lee YB, Lee HK. Role conflict and conflict management styles of hospital nurses. The Korean Journal of Stress Research. 2015; 23(3):147–158. https://doi.org/10.17547/kjsr.2015.23.3.147.

30. Kim IA. The type of leadership in head nurse and nursing outcome [dissertation]. Seoul: Korea University;2012. p. 1–122.

31. Salovey P, Mayer JD. Emotional intelligence. Imagination, Cognition and Personality. 1990; 9(3):185–211. https://doi.org/10.2190/DUGG-P24E-52WK-6CDG.

32. Jang MJ, Lee EN, Lee YH. Effect of nurses’ job stress on job satisfaction: Mediating effect of head nurses’ emotional leadership perceived by nurses. Journal of Korean Academy of Nursing Administration. 2015; 21(1):133–141. https://doi.org/10.11111/jkana.2015.21.1.133.

33. Yang IS, Lee SH, Lee DR. A study on the effects of coaching leadership on organizational effectiveness: The mediating role of subordinates’ emotional intelligence. Journal of Human Resource Management Research. 2015; 22(5):49–72.

34. Shin CW, Nam SH. A study on the moderating effects of trust between leadership style and organizational effectiveness. Korean Journal of Human Resource Development. 2006; 8(1):57–81.

35. Lee YS, Park SH. Nurses’ perceived organizational culture, verbal abuse and job stress. The Journal of the Korea Contents Association. 2015; 15(10):292–304. https://doi.org/10.5392/JKCA.2015.15.10.292.

36. Ceravolo DJ, Schwartz DG, Foltz-Ramos KM, Castner J. Strengthening communication to overcome lateral violence. Journal of Nursing Management. 2012; 20(5):599–606. https://doi.org/10.1111/j.1365-2834.2012.01402.x.

37. Roh MH, Lee JO. A study on the relationship between nursing officer’s leadership style and knowledge transfer: Focused on moderating effect of job characteristics. Health Policy and Management. 2012; 22(4):628–653. https://doi.org/10.4332/KJHPA.2012.22.4.628.

38. Brown ME, Treviño LK, Harrison DA. Ethical leadership: A social learning perspective for construct development and testing. Organizational Behavior and Human Decision Processes. 2005; 97(2):117–134. https://doi.org/10.1016/j.obhdp.2005.03.002.

39. Halim UA, Riding DM. Systematic review of the prevalence, impact and mitigating strategies for bullying, undermining behaviour and harassment in the surgical workplace. British Journal of Surgery. 2018; 105(11):1390–1397. https://doi.org/10.1002/bjs.10926.

40. Wilson JL. An exploration of bullying behaviours in nursing: A review of the literature. British Journal of Nursing. 2016; 25(6):303–306. https://doi.org/10.12968/bjon.2016.25.6.303.

41. Ahmad S. Can ethical leadership inhibit workplace bullying across East and West: Exploring cross-cultural interactional justice as a mediating mechanism. European Management Journal. 2018; 36(2):223–234. https://doi.org/10.1016/j.emj.2018.01.003.

42. Hwang YJ, Park MH. Middle school students’ perception on teacher’s communication and leadership style and its influence on the experience of peer violence. Korean Education Inquiry. 2013; 31(4):25–43.

43. Stagg SJ, Sheridan D, Jones RA, Speroni KG. Evaluation of a workplace bullying cognitive rehearsal program in a hospital setting. The Journal of Continuing Education in Nursing. 2011; 42(9):395–401. https://doi.org/10.3928/00220124-20110823-22.

44. Park SY, Shin HN, Cho YO, Kim S. Effectiveness of interventions for workplace bullying among nurses: A systematic review. Journal of Korean Academy of Nursing Administration. 2018; 24(4):339–351. https://doi.org/10.11111/jkana.2018.24.4.339.

Figure 1.

Q-sort table.

Table 1

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

Table 2.

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

Table 3.

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.

Table 4.

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

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