System justification theory as a foundation for understanding relations among toxic health care workplaces, bullying, and psychological safety.

IF 1.7 3区医学 Q3 HEALTH POLICY & SERVICES

Health Care Management Review Pub Date : 2023-11-28 DOI:10.1097/HMR.0000000000000391

Tracy H Porter, Cheryl Rathert, Ghadir Ishqaidef, Derick R Simmons

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引用次数: 0

Abstract

Background: Toxic work environments and bullying are rampant in health care organizations. The Joint Commission asserted that bullying is a threat to patient safety, and furthermore, it implied that bullying affects clinician psychological safety. However, after decades of trying to reduce bullying, it persists.

Purpose: The purpose of this study was to determine if system justification (SJ) theory can help explain the persistence of bullying in health care organizations. SJ theory posits that people are motivated to justify the systems with which they are embedded, even if those systems are dysfunctional or unfair.

Method: A cross-sectional survey of health care workers (n = 302) was used to test a moderated mediation model to examine relations between instrumental work climate perceptions and psychological safety, as mediated by SJ and moderated by experiences of workplace bullying.

Results: Analysis revealed that SJ fully mediated negative relations between instrumental climate and psychological safety; because of SJ the instrumental climate no longer had a direct negative association with psychological safety. Furthermore, bullying was found to play a moderating role in the instrumental climate-SJ relationship.

Conclusion: This study found some support for the role of SJ in perpetuating instrumental workplaces and workplace bullying in health care.

Practice implications: Some scholars have proposed that a focus on disrupting workplace contexts that trigger SJ in workers could help break patterns of behavior that enable toxic work environments and bullying to persist.

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系统辩护理论是理解有毒卫生保健工作场所、欺凌和心理安全之间关系的基础。

背景:在医疗机构中，有毒的工作环境和欺凌行为十分猖獗。联合委员会断言，欺凌是对患者安全的威胁，此外，它暗示欺凌影响临床医生的心理安全。然而，经过几十年的努力减少欺凌，它仍然存在。目的:本研究的目的是确定系统辩护(SJ)理论是否有助于解释医疗机构中持续存在的欺凌行为。SJ理论认为，人们有动机为他们所处的制度辩护，即使这些制度功能失调或不公平。方法:对302名卫生保健工作者进行横断面调查，检验一个有调节的中介模型，以检验工具性工作气候感知与心理安全之间的关系，该关系由SJ介导，并由工作场所欺凌经历调节。结果:SJ完全介导工具气候与心理安全之间的负向关系;由于SJ的存在，工具气候不再与心理安全有直接的负相关。此外，霸凌行为在工具性气候- sj关系中起调节作用。结论:本研究发现了SJ在医疗保健中维持工具性工作场所和工作场所欺凌中的作用。实践启示:一些学者提出，关注破坏触发员工SJ的工作环境，可以帮助打破导致有毒工作环境和欺凌持续存在的行为模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Care Management Review HEALTH POLICY & SERVICES-

CiteScore

4.70

自引率

8.00%

发文量

期刊介绍： Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.