Prevalence of Workplace Bullying and Its Associated Factors at a Multi-Regional Saudi Arabian Hospital: A Cross-Sectional Study

Abstract

Background

Workplace bullying (WPB) refers to any form of repeated and unreasonable verbal, physical or sexual harassment that an employee endures by a person or a group. In healthcare settings, practitioners are occasionally victims of WPB incidents. The aim of this study was to survey victims of WPB and determine factors associated with being a victim of WPB at a multiregional health care facility in Saudi Arabia.

Methods

This cross-sectional study was conducted in 2018, by distributing a self-administered questionnaire via a private electronic mail to all fulltime healthcare practitioners within a multi-regional hospital in Saudi Arabia. Healthcare practitioners included physicians, nurses, allied healthcare professionals and pharmacists who reported being exposed to WPB in the past year. Study outcomes were the prevalence rate ratio of WPB and its associated factors, such as victim, perpetrator and incident characteristics.

Results

WPB has been reported by 684 participants. Perpetrators were mainly patients (36.1%), their families/relatives (29.5%), and hospital staff (27.2%) or managers/supervisors (7.2%). The type of WPB incident was mostly verbal abuse (98.1%) followed by physical harassment (11.8%) and sexual connotations (5.8%). WPB was 30% more prevalent among younger nurses and 24% less prevalent among higher educated nurses compared to their counter groups, P<0.001 each. Among technicians and administrative employees, WPB was 54% more prevalent among females, 36% more prevalent among the younger group, and 25% more prevalent among expatriate workers compared to their counter groups P<0.014, P<0.001 and P=0.017, respectively. WPB was 20% less prevalent among higher educated allied health professionals, P=0.002. Among physicians, WPB was 33% more prevalent among females, P=0.041 and was 47% more prevalent among higher educated physicians compared to their counter groups, P=0.018.

Conclusion

WPB might occur any time, anywhere and by any person within health care facilities. The prevalence of WPB varies within health occupational groups. Gender, age, educational level, and nationality were significantly associated factors with WPB.

Keywords:

• nurse
• physician
• pharmacist
• bullying
• verbal
• physical
• sexual

Acknowledgments

This study was approved and monitored by King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. The authors would like to thank Mr. Mohamad Al-Assiri and Mrs. Lara Afesh for their tremendous support. The authors are grateful to the participants who shared the details of unfortunate WPB incidents. We hereby presented this valuable contribution for the sake of protecting healthcare practitioners from WPB incidents in the future.

Article Summary

Strengths and Limitations

• Workplace bullying has not been addressed sufficiently in Middle Eastern settings.

• It is imperative to all healthcare settings to detect any case of WPB, to analyze its characteristics, determine high-risk groups, and take the right action.

• This study analyzed the various characteristics of WPB incidents at a multi-regional healthcare facility in Saudi Arabia.

• Most WPB incidents remain under reported, so the recruited sample might not be exhaustive .

• Certain conflicts, among employees or between employees and patients/their families, might have been misinterpreted by the victims as an act of aggression or bullying.

Key Points

• Leading type of WPB in this healthcare setting is verbal abuse that occurred during day shifts.

• WPB seems more prevalent among females, young age group, and expatriates.

• WPB is more likely to occur at work stations or offices.

• WPB perpetrators were mainly patients, relatives of patients, employees or managers/supervisors.

Abbreviations

95% CI, 95% confidence interval; PRR, prevalence rate ratio; WPB, workplace bullying; WHO, World Health Organization.

Data Sharing Statement

The datasets generated and/or analyzed during the current study are not publicly available due to the institutional rules and regulations but are available from the corresponding author on reasonable request.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests for this work.

Additional information

Funding

There is no funding to report.