Predictors of moral harassment in nursing work in critical care units

a cross-sectional study conducted in a public hospital in Fortaleza, Ceará, with 167 nursing professionals in 2016. Sociodemographic/occupational questionnaire and Negative Acts Questionnaire Revised were applied. The analysis included descriptive statistics, measures of central tendency and dispersion, as well as Mann-Whitney, Kruskal-Wallis and Conover Inman U-tests for multiple comparisons.

Results:

there was a 33% prevalence of self-perception of moral harassment, highlighting personal/professional disqualification and work-related harassment. The predictors of moral harassment included age, time working in the job and time in the unit, employment relationship and sector.

Conclusions:

young professionals (< 30 years), cooperative, crowded in intensive care or emergency units, with less time working in the job (< 5 years) or greater time in the unit (above 10 years) are the biggest victims of moral harassment in the work of nursing in critical environments.

Descriptors:
Nursing; Work; Non-Sexual Harassment; Incivility; Critical Care

Factor	Mean (±SD^* * SD - standard deviation; )	Conover-Inman's p ≤ 0.05^ p Kruskal-Wallis test < 0.0001.
F1. Work-related harassment	1.73( ± 0.66)	F1 > F2 e > F4
F2. Personal harassment	1.47( ± 0.58)	F2 < F3 > F4 e
F3. Personal and professional disqualification	1.76( ± 0.82)	< Total Scale
F4. Physical intimidation	1.25( ± 0.54)	F3 > F4
Total Scale	1.59( ± 0.55)	F4 < Total Scale

Factor 1 - Work-related harassment		Harassment
Factor 1 - Work-related harassment		No (%)	Yes (%)
5	Gossip or rumors have been spread about you.	148 (88.6)	19 (11.4)
10	You've received tips or signals from others that you should give up your job.	155 (92.8)	12 (7.2)
11	You have received reminders of mistakes or mistakes made.	164 (98.2)	3 (1.8)
16	You have received tasks with impossible or irrational goals or deadlines.	148 (88.6)	19 (11.4)
17	Claims were made against you.	161 (96.4)	6 (3.6)
18	Excessive monitoring of your work is done .	141 (84.4)	26 (15.6)
19	You have received pressure not to claim your rights.	145 (86.8)	22 (13.2)
21	You have been exposed to an unmanageable workload.	153 (91.6)	14 (8.4)
Factor 2 - Personal harassment
2	You have been humiliated or ridiculed because of your work.	160 (95.8)	7 (4.2)
6	You have been ignored, excluded or isolated from the group.	162 (97.0)	5 (3.0)
7	You have received offensive comments about yourself.	157 (94.0)	10 (6.0)
8	You have been cursed or angered for no reason (or fury).	155 (92.8)	12 (7.2)
12	You were ignored or faced hostile reaction as you approached.	165 (98.8)	2 (1.2)
13	You have received persistent criticism regarding your work and effort.	159 (95.2)	8 (4.8)
15	Disrespectful jokes were made by people with whom you are not very close.	159 (95.2)	8 (4.8)
Factor 3 - Personal and professional disqualification
1	Someone withheld information that interfered with their performance.	152 (91.0)	15 (9.0)
3	You have been obliged to perform activities at a level below your capacity.	140 (83.8)	27 (16.2)
4	Its main areas of responsibility have been replaced by trivial or unpleasant activities.	152 (91.0)	15 (9.0)
14	Your opinions and points of view were ignored.	155 (92.8)	12 (7.2)
Factor 4 - Physical intimidation
9	You have suffered intimidating behavior, such as being pointed with your finger, invading your personal space, pushed, having your path blocked or barred.	161 (96.4)	6 (3.6)
20	You were the object of sarcasm and excessive provocation.	164 (98.2)	3 (1.8)
22	You have received threats of violence or physical abuse or real abuse.	163 (97.6)	4 (2.4)

Variables	Work-related harassment	Personal harassment	Personal and professional disqualification	Physical intimidation	General score
Sex
Male	1.73	1.51	1.71	1.31	1.60
Female	1.73	1.47	1.77	1.24	1.59
p value^* * Value of p: significance of Mann Whitney's U tests for comparison of two samples; and Kruskal Wallis for more than two samples.	0.975	0.839	0.751	0.715	0.871
Age group (years)
19 to 30	1.90	1.43	1.93	1.28	1.67
31 to 59	1.67	1.51	1.69	1.25	1.57
≥ 60	1.05	1.00	1.45	1.00	1.10
p value^* * Value of p: significance of Mann Whitney's U tests for comparison of two samples; and Kruskal Wallis for more than two samples.	0.001	0.005	0.065	0.268	0.008
Time working in the job (year)
1 to 4	1.91	1.48	1.94	1.32	1.70
5 to 10	1.69	1.42	1.73	1.17	1.54
11 to 20	1.77	1.70	1.70	1.37	1.68
≥ 21	1.30	1.29	1.50	1.12	1.31
p value^* * Value of p: significance of Mann Whitney's U tests for comparison of two samples; and Kruskal Wallis for more than two samples.	0.001	0.049	0.047	0.553	0.004
Time working in the unit (year)
1 to 4	1.83	1.46	1.85	1.24	1.63
5 to 10	1.65	1.51	1.72	1.25	1.56
11 to 20	1.86	1.85	1.82	1.53	1.81
≥ 21	1.25	1.16	1.38	1.11	1.23
p value^* * Value of p: significance of Mann Whitney's U tests for comparison of two samples; and Kruskal Wallis for more than two samples.	0.001	< 0.0001	0.100	0.574	0.001
Weekly workload
< 20	2.17	1.60	2.30	2.13	2.00
20 to 40	1.66	1.43	1.69	1.19	1.53
> 40	1.78	1.51	1.83	1.27	1.63
p value^* * Value of p: significance of Mann Whitney's U tests for comparison of two samples; and Kruskal Wallis for more than two samples.	0.276	0.782	0.234	0.194	0.376
Type of employment relationship
Cooperated	1.74	1.43	1.78	1.23	1.58
Public servant	1.56	1.54	1.67	1.16	1.52
p value^* * Value of p: significance of Mann Whitney's U tests for comparison of two samples; and Kruskal Wallis for more than two samples.	0.010	0.044	0.738	0.075	0.069
Sector
Emergency	1.86	1.46	1.85	1.32	1.66
Operating room	1.52	1.37	1.54	1.16	1.43
ICU	1.92	1.71	2.06	1.35	1.80
p value^* * Value of p: significance of Mann Whitney's U tests for comparison of two samples; and Kruskal Wallis for more than two samples.	< 0.0001	0.016	0.005	0.021	< 0.0001

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[1] Corresponding author: Roberta Meneses Oliveira. E-mail: robertameneses@ufc.br