Witnessed Incivility and Perceptions of Patients and Visitors in Hospitals

Vargas, Emily A; Mahalingam, Ramaswami; Marshall, Riley A.

doi:10.1177/23743735211028092

Cited by 7 publications

(5 citation statements)

References 46 publications

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“…For example, at the conceptual level, "incivility" was not consistent across studies and was sometimes treated as synonymous with disruptive behavior. 12,13 Rosenstein and Naylor 14 described disruptive behavior as encompassing concepts such as incivility, harassment, and violence. In addition to incivility and violence, psychological aggression is generally used as a category of disruptive behavior.…”

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confidence: 99%

“…However, it is difficult to eliminate the classifier’s subjectivity in content analysis. For example, at the conceptual level, “incivility” was not consistent across studies and was sometimes treated as synonymous with disruptive behavior 12,13 . Rosenstein and Naylor 14 described disruptive behavior as encompassing concepts such as incivility, harassment, and violence.…”

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confidence: 99%

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Development of a Psychological Scale for Measuring Disruptive Clinician Behavior

Fujimoto,

Shimamura,

Miyazaki

et al. 2023

J Patient Saf

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Objectives Disruptive clinician behavior worsens communication, information transfer, and teamwork, all of which negatively affect patient safety. Improving safety in medical care requires an accurate assessment of the damage caused by disruptive clinician behavior. Psychometric scales complement case reports, but existing scales have significant limitations. Therefore, this study developed a psychometric scale based on the psychological paradigm to assess disruptive clinician behavior. Methods The scale was developed through a sequence of steps. First, we used an open-ended questionnaire targeting 712 nurses, content analysis, and content validity assessment by 5 experts to determine valid items for disruptive clinical behavior. Next, an Internet questionnaire survey targeting 1000 health care staff, exploratory factor analysis, and subfactor analysis was conducted to identify necessary and sufficient factors. Then, we calculated difficulty level and discriminative power. We also conducted a field questionnaire survey targeting 84 staff in a hospital. Finally, we calculated ω coefficients and then used confirmatory factor analysis to verify the fit of the hypothesized model. Results Our open-ended survey involving 478 nurses identified 47 codes in 9 categories. The questionnaire survey involving hospital 1000 medical staff identified 6 factors, with 1 factor subdivided into 4 subfactors and 1 into 2 subfactors. The goodness of fit of the hypothesized 10-factor models with factor pairs and groups was confirmed. Conclusions We developed a psychometric scale measuring subjective assessments of harm covering various disruptive clinician behaviors. The scale complements interviews and case reports by generating valid, reliable scores for various disruptive clinician behaviors in health care institutions.

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confidence: 99%

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confidence: 99%

Development of a Psychological Scale for Measuring Disruptive Clinician Behavior

Fujimoto,

Shimamura,

Miyazaki

et al. 2023

J Patient Saf

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“…Stress stifles the ability to relate, understand, and empathise 22 . Empathy is further inhibited by increasingly dissatisfied patients 23 who may have been greeted by an unwelcoming receptionist 24 and made to wait for their appointment for an unacceptably long time.…”

Section: Beyond Empathy Training For Practitionersmentioning

confidence: 99%

Beyond empathy training for practitioners: Cultivating empathic healthcare systems and leadership

Howick,

de Zulueta,

Gray

2024

Evaluation Clinical Practice

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Empathic care benefits patients and practitioners, and empathy training for practitioners can enhance empathy. However, practitioners do not operate in a vacuum. For empathy to thrive, healthcare consultations must be situated in a nurturing milieu, guided by empathic, compassionate leaders. Empathy will be suppressed, or even reversed if practitioners are burned out and working in an unpleasant, under‐resourced environment with increasingly poorly served and dissatisfied patients. Efforts to enhance empathy must therefore go beyond training practitioners to address system‐level factors that foster empathy. These include patient education, cultivating empathic leadership, customer service training for reception staff, valuing cleaning and all ancillary staff, creating healing spaces, and using appropriate, efficiency saving technology to reduce the administrative burden on healthcare practitioners. We divide these elements into environmental factors, organisational factors, job factors, and individual characteristics.

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“…12 Practitioners also work with often inefficient and confusing electronic health records systems [13][14][15] that take up half of their time, 16 managerialism, 17 and a culture where bullying is common 18 and empathy is lacking. 19 These problems are exacerbated by increasingly dissatisfied patients 20 who may have been greeted by an unwelcoming receptionist 21 and made to wait for their appointment for an unacceptably long time.…”

Section: Introductionmentioning

confidence: 99%

Enhancing system empathy within a UK Emergency Department: A feasibility interprofessional priority setting exercise

Howick,

Ward,

Grantham

et al. 2024

Preprint

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Background: System-level barriers inhibit empathy in healthcare, and this can harm patients and practitioners. The barriers include burnout-inducing administrative workloads, burdensome protocols, lack of wellbeing spaces, un-empathic leadership, and not emphasising empathy as an institutional value. A workshop aimed at enhancing empathic systems was successfully delivered in Canada but has not been tested in the UK National Health Service (NHS) setting. Aim: To test the feasibility of an empathic systems workshop within the UK NHS setting. Methods: We conducted an interprofessional group of an emergency department (ED). We used a modified nominal group technique to prioritise actions to enhance empathy in the ED system. Satisfaction with the workshop and confidence that the workshop would lead to change were measured on a 10-point Likert scale. Results: Twenty-eight participants representing the following stakeholder groups attended the workshop: leaders, consultants, nurses, security, and porters. The group agreed to generating a better wellbeing action plan and implementing an effective secondary triage system. Seventy-three percent (73%) rated their satisfaction with the workshop as 8 or higher out of ten, and 63% reported being confident that the workshop would lead to positive change. Limitations: A doctors strike limited the range of stakeholders who were able to attend, and long-term follow up was not conducted. Conclusions: Participants in a UK setting were satisfied with a previously developed system empathy workshop and reported being confident that it would lead to positive change. Participants were able to prioritise changes that would improve system empathy and were confident that the changes would be effective.

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Witnessed Incivility and Perceptions of Patients and Visitors in Hospitals

Cited by 7 publications

References 46 publications

Development of a Psychological Scale for Measuring Disruptive Clinician Behavior

Development of a Psychological Scale for Measuring Disruptive Clinician Behavior

Beyond empathy training for practitioners: Cultivating empathic healthcare systems and leadership

Enhancing system empathy within a UK Emergency Department: A feasibility interprofessional priority setting exercise

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