Workplace bullying among nurses and their related factors in Japan: a cross-sectional survey

Aims and objectives. To explore the association between workplace bullying and workplace environment factors among nurses in Japan. Background. Workplace bullying among nurses is increasing globally and occurs more frequently than among other professions. However, there is little information on the impact of workplace environment factors on nurse bullying in Japan. Design. A cross-sectional survey using a self-administered questionnaire. Methods. Participants were 1152 nurses recruited at seminars or training courses outside of their workplaces in Tokyo. Workplace bullying was measured using the Negative Acts Questionnaire-Revised. Participants were considered to have been 'bullied' if they reported experiencing at least one negative act on a daily or weekly basis. Workplace environment factors were measured using the Practice Environment Scale of the Nursing Work Index, which comprises five domains: nurse participation in hospital affairs; nursing foundations for quality of care; nurse manager ability, leadership and support of nurses; staffing and resource adequacy; and collegial nurse-physician relationships. Results. A total of 898 (78.0%) questionnaires were returned, of which 825 (71.6%) were analysed. Altogether, 153 (18.5%) nurses were considered 'bullied.' The three most frequent negative acts reported as occurring on a weekly or daily basis were 'someone withholding information which affects your performance' (6.7%), 'being exposed to an unmanageable workload' (4.4%) and 'being shouted at or being the target of spontaneous anger (or rage)' (3.6%). Logistic regression analysis indicated that 'bullied' were associated with low scores on two work environment domains: nurse manager ability, leadership and support of nurses and staffing and resource adequacy. Conclusions. Effective nurse manager leadership and support as well as appropriate staffing management may positively influence workplace bullying among nurses in Japan. Authentic leadership styles and allowing nurses to easily request days off might also be important. Relevance to clinical practice. Nurse managers' leadership may influence nurses' workplace bullying.