Disruptive Staff Interactions: A Serious Source of Inter-Provider Conflict and Stress in Health Care Settings

Stecker, Mona; Stecker, Mark M.

doi:10.3109/01612840.2014.891678

Cited by 29 publications

(21 citation statements)

References 25 publications

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“…Most people experience stress stemming from work, finances, children, illness, and disagreements with others (Randall and Bodenmann, 2016 ), whereas some people face additional stressors such as poverty, high crime rates, epidemics, hunger crises, and wars (Hilpert and Kimamo, 2016 ). Research shows that stress can have detrimental effects on an individual's mental (Thoits, 2010 ) and physical well-being (Larzelere and Jones, 2008 ).…”

Section: Stress and Stress-spill-over Processesmentioning

confidence: 99%

The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study

et al. 2016

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Objective: Theories about how couples help each other to cope with stress, such as the systemic transactional model of dyadic coping, suggest that the cultural context in which couples live influences how their coping behavior affects their relationship satisfaction. In contrast to the theoretical assumptions, a recent meta-analysis provides evidence that neither culture, nor gender, influences the association between dyadic coping and relationship satisfaction, at least based on their samples of couples living in North America and West Europe. Thus, it is an open questions whether the theoretical assumptions of cultural influences are false or whether cultural influences on couple behavior just occur in cultures outside of the Western world.Method: In order to examine the cultural influence, using a sample of married individuals (N = 7973) from 35 nations, we used multilevel modeling to test whether the positive association between dyadic coping and relationship satisfaction varies across nations and whether gender might moderate the association.Results: Results reveal that the association between dyadic coping and relationship satisfaction varies between nations. In addition, results show that in some nations the association is higher for men and in other nations it is higher for women.Conclusions: Cultural and gender differences across the globe influence how couples' coping behavior affects relationship outcomes. This crucial finding indicates that couple relationship education programs and interventions need to be culturally adapted, as skill trainings such as dyadic coping lead to differential effects on relationship satisfaction based on the culture in which couples live.

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Section: Stress and Stress-spill-over Processesmentioning

confidence: 99%

The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study

et al. 2016

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“…7 To develop strategies to reduce disruptive behaviour in the OR, it is important to establish the scope of the problem and to ascertain who is at higher risk of being exposed. Previous investigations in the OR have had methodological limitations relating to sampling frames, survey tool development, and statistical methodology.. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Appropriate tools to measure exposure to disruptive behaviour have only recently been created 21,24,25 and previous studies have not examined disruptive behaviour in a large international cohort of OR clinicians. There is also limited data on the socio-demographic predictors of exposure to disruptive behaviour.…”

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confidence: 99%

Prevalence and predictors of exposure to disruptive behaviour in the operating room

Villafranca

Hiebert

Hamlin

et al. 2019

Can J Anesth/J Can Anesth

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Prevalence and predictors of exposure to disruptive behaviour in the operating room Prévalence et prédicteurs d'exposition à des comportements perturbateurs en salle d'opération Abstract Purpose Disruptive intraoperative behaviour ranges from incivility to abuse. This behaviour can have deleterious effects on clinicians, students, institutions, and patients. Previous investigations of this behaviour used underdeveloped tools or small sampling frames. We therefore examined the prevalence and predictors of perceived exposure to disruptive behaviour in a multinational sample of operating room clinicians. Methods A total of 134 perioperative associations in seven countries were asked to distribute a survey examining five types of exposure to disruptive behaviour: personal, directed toward patients, directed toward colleagues, directed toward others, or undirected. To compare the average amount of exposure with each type, we used a Friedman's test with select post hoc Wilcoxon tests. A negative binomial regression model identified socio-demographic predictors of personal exposure. Results Of the 134 organizations approached, 23 (17%) complied. The total response rate was estimated to be 7.6% (7465/101,624). Almost all (97.0%; 95% confidence interval [CI], 96.6 to 97.4) of the respondents reported exposure to disruptive behaviour in the past year, with the average respondent experiencing 61 incidents per year (95% CI, 57 to 65). Groups reporting higher personal exposure included clinicians who were young, inexperienced, female, non-heterosexual, working as nurses, or working in clinics with private funding (all P \ 0.05). Conclusion Perceived exposure to disruptive behaviour was prevalent and frequent, with the most common behaviours involving speaking ill of clinicians and patients. These perceptions, whether accurate or not, can result in detrimental consequences. Greater efforts are required to eliminate disruptive intraoperative behaviour, with recognition that specific groups are more likely to report experiencing such behaviours. RésuméObjectif Les comportements perturbateurs en salle d'opération vont de l'incivilité à l'abus. Ce type de comportement peut avoir des effets délétères sur les cliniciens, les étudiants, les institutions et les patients. Les études précédentes de ce type de comportement se sont servies d'outils sous-développés ou de cadres d'échantillonnage restreints. Nous avons donc examiné la prévalence et les prédicteurs d'une exposition perçue à un

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“…Ubiquity represents the proportion of clinicians who engage in disruptive behaviour, while prevalence is the number of such behaviours reported by clinicians. The estimates of ubiquity are derived from surveys and reviews of disciplinary records,9,20,33-35 while estimates of prevalence are derived from survey studies 5,8,22,23,36-48. Most studies examining many types of disruptive behaviour focus on ubiquity.…”

Section: Frequencymentioning

confidence: 99%

Disruptive behaviour in the perioperative setting: a contemporary review

Villafranca

Hamlin

Enns

et al. 2016

Can J Anesth/J Can Anesth

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PurposeDisruptive behaviour, which we define as behaviour that does not show others an adequate level of respect and causes victims or witnesses to feel threatened, is a concern in the operating room. This review summarizes the current literature on disruptive behaviour as it applies to the perioperative domain.SourceSearches of MEDLINE®, Scopus™, and Google books identified articles and monographs of interest, with backreferencing used as a supplemental strategy.Principal findingsMuch of the data comes from studies outside the operating room and has significant methodological limitations. Disruptive behaviour has intrapersonal, interpersonal, and organizational causes. While fewer than 10% of clinicians display disruptive behaviour, up to 98% of clinicians report witnessing disruptive behaviour in the last year, 70% report being treated with incivility, and 36% report being bullied. This type of conduct can have many negative ramifications for clinicians, students, and institutions. Although the evidence regarding patient outcomes is primarily based on clinician perceptions, anecdotes, and expert opinion, this evidence supports the contention of an increase in morbidity and mortality. The plausible mechanism for this increase is social undermining of teamwork, communication, clinical decision-making, and technical performance. The behavioural responses of those who are exposed to such conduct can positively or adversely moderate the consequences of disruptive behaviour. All operating room professions are involved, with the rank order (from high to low) being surgeons, nurses, anesthesiologists, and “others”. The optimal approaches to the prevention and management of disruptive behaviour are uncertain, but they include preventative and professional development courses, training in soft skills and teamwork, institutional efforts to optimize the workplace, clinician contracts outlining the clinician’s (and institution’s) responsibilities, institutional policies that are monitored and enforced, regular performance feedback, and clinician coaching/remediation as required.ConclusionsDisruptive behaviour remains a part of operating room culture, with many associated deleterious effects. There is a widely accepted view that disruptive behaviour can lead to increased patient morbidity and mortality. This is mechanistically plausible, but more rigorous studies are required to confirm the effects and estimate their magnitude. An important measure that individual clinicians can take is to monitor and control their own behaviour, including their responses to disruptive behaviour.

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Disruptive Staff Interactions: A Serious Source of Inter-Provider Conflict and Stress in Health Care Settings

Cited by 29 publications

References 25 publications

The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study

The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study

Prevalence and predictors of exposure to disruptive behaviour in the operating room

Disruptive behaviour in the perioperative setting: a contemporary review

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