Download - Workplace bullying among allied health professionals: prevalence, causes and consequences

Workplace bullying among allied healthprofessionals: prevalence, causes andconsequences

Defne Demir Australian Catholic University, Australia

John Rodwell Australian Catholic University, Australia

Rebecca Flower Australian Catholic University, Australia

Workplace bullying is an occupational hazard in the healthcare industry. Allied health professionals

form an important, yet underresearched, part of this industry. The aim of this study was to investi-

gate the antecedents and consequences of bullying within the allied health context. Data were col-

lected from 166 allied health professionals working in a large Australian healthcare organisation

(response rate = 76%). Logistic regression and analyses of covariance were conducted. Almost a

quarter (24%) of respondents reported experiences of workplace bullying. In testing the antecedents

of bullying, low levels of supervisor support and high negative affectivity were associated with bully-

ing. In terms of consequences, bullying, along with tenure, employment type and age, influenced

levels of depression and psychological distress. Findings may assist in informing effective strategies

that aim to reduce and target the occurrence of such negative workplace behaviour.

Keywords: allied health professionals, bullying, depression, negative affect and psychological

distress

Negative anti-social behaviour such as workplace bullying is a significant issue foremployees, organisations, unions and government agencies (O’Driscoll et al. 2011).Employees working in the healthcare industry are at high risk of workplace bullying

Correspondence: Ms Defne Demir, Research Fellow, Faculty of Business, Australian CatholicUniversity, Locked Bag 4115 Fitzroy, Vic 3065, Australia; e-mail: [email protected]

Accepted for publication 27 February 2013.

Key points1 Workplace bullying is an issue for allied health professionals who appear to be at

risk of exposure.

2 Work and personality characteristics of social support and negative affectivity play

important roles in the development of bullying for these professionals.

3 The negative consequences of bullying are particularly related to the mental health

(depression and psychological distress) of these professionals.

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Asia Pacific Journal of Human Resources (2013) 51, 392–405 doi:10.1111/1744-7941.12002

© 2013 Australian Human Resources Institute

(Behar et al. 2008; Hutchinson et al. 2006; Stubbs and Sengupta 2008), particularly withinnursing (Camerino et al. 2008; Farrell, Bobrowski and Bobrowski 2006; Quine 2001).Other healthcare professionals, such as allied health professionals, may also be at risk,especially considering that these professionals often work in multidisciplinary teams thatinclude nurses (Keane et al. 2008). Allied health professionals represent a variety of healthservices, including dieticians, social workers and occupational therapists (Keane et al.2008). Approximately 18% of the Australian healthcare workforce is comprised of alliedhealth professionals (Australian Institute of Health and Welfare 2010). These professionalsare considered an integral component of effective treatment (Keane et al. 2008). However,there has been relatively little research conducted on this group within the Australianworkforce (Keane et al. 2008).

The demand–control–support (DCS) model has been suggested as important to con-sider regarding the antecedents of workplace bullying (e.g. Notelaers et al. 2012; Takakiet al. 2010; Tuckey et al. 2009). Further, research that explores the consequences of work-place bullying has illustrated that bullying not only negatively impacts the work attitudesof the employee, but also their mental health (e.g. Hansen et al. 2006; Kivimäki et al. 2003;Quine 2001), which can lead to organisational costs (O’Driscoll et al. 2011). Individualand demographic characteristics (e.g. negative affectivity and age) have been shown toplay an important role in these links (e.g. Baillien et al. 2011; Spector et al. 2000). Toenhance our understanding of workplace bullying in the healthcare industry, the aim ofthe study was to examine the antecedents and consequences of bullying for allied healthprofessionals, specifically focusing on these work and individual characteristics thatappear to be influential for other occupational groups.

Workplace bullying

The definition of workplace bullying continues to be clarified; however the term canbroadly be defined as behaviour that is persistent and repeated, occurring over a period oftime, whereby individuals on the receiving end perceive the behaviour as negative andhave difficulty in defending themselves (Hoel and Cooper 2000). Workplace bullying ismore often psychological in nature, rather than physical, and may include behaviour suchas harassment, social exclusion, threats, or teasing (Einarsen et al. 2011). Over time, bully-ing often increases in frequency, in turn engendering a feeling of inferiority in the victim(Notelaers et al. 2012). Workplace bullying can be the cause of great concern for organisa-tions, particularly within the healthcare system, whereby the performance of staff may benegatively influenced, with effects that flow on to patients (Yildirim 2009). In Australia,workplace bullying is treated as a serious issue, with certain behaviours treated as criminaloffences. Recent reforms to the legislation have included the Victorian Crimes Amendment(Bullying) Bill 2011, which broadened the definition of behaviour considered as bullying,and introduced a potential 10-year jail sentence for convicted offenders. While legislationcurrently varies by state, the introduction of this law may lead to similar nationwidelegislation.

Defne Demir, John Rodwell and Rebecca Flower

© 2013 Australian Human Resources Institute 393

Many existing studies have investigated either the antecedents or consequences ofworkplace bullying, rarely examining both in the same sample. In terms of the character-istics of the antecedents, a model that may be helpful in understanding factors thatincrease the likelihood of bullying is the DCS (Johnson and Hall 1988; Karasek 1979). TheDCS model posits that a combination of different levels of demands, control and socialsupport can lead to particular employee outcomes. Instances where demands are high,while control and social support are low, tend to lead to more negative experiences, suchas distress and depression (Mikkelsen and Einarsen 2002; Quine 2001).

Research that examines a range of occupational groups has illustrated that the DCScomponents may be associated with experiences of workplace bullying. In particular, highjob demands and low job control have been associated with reports of bullying (Notelaerset al. 2012; Takaki et al. 2010; Tuckey et al. 2009). Indirect support for the DCS model hasalso been demonstrated with job control (Agervold and Mikkelsen 2004) and socialsupport (Hansen et al. 2006) being associated with employee reports of bullying.

Researchers have attempted to understand why variations in certain characteristics ofthe work environment (namely demand, control, and support) can foster an environmentwhere bullying is likely to occur. An explanation provided by Baillien et al. (2009) suggeststhat individuals who are under strain and cope in an inefficient, passive manner mayviolate social, work or organisational norms. This violation may result in negative atti-tudes toward the individual and lead to an increased likelihood of becoming a target ofbullying.

In addition to work-related characteristics described as part of the DCS model, thepersonality characteristic of negative affectivity (NA) may be important to consider. Indi-viduals with high NA tend to be more distressed, upset, and hold a negative view of boththemselves and the world (Watson and Clark 1984). Indeed, research investigating therelationship between NA and bullying has found associations between both state and traitNA with workplace bullying (Hansen et al. 2006; Mikkelsen and Einarsen 2002). Individu-als with high NA may be more sensitive to their surrounding environment (Spector et al.2000), and thus may be more likely to magnify negative events and perceive the behaviourof others as bullying (Hansen et al. 2006). Subsequently, this study will consider this traitwhen examining antecedents of workplace bullying, in combination with the work-relatedcharacteristics of the DCS model. To the best of our knowledge, no studies have investi-gated if and how these issues might be important for allied health professionals as ante-cedents to experiences of bullying.

The negative consequences associated with bullying in the workplace for occupationalgroups other than allied health professionals appear to be well documented. Bullying hasbeen associated with both negative changes in job attitudes such as job satisfaction, andthe mental health of employees, such as anxiety and depression (Hansen et al. 2006;Kivimäki et al. 2003; Quine 2001).

An understanding of the association between bullying and such negative consequencesmay be gained through attribution processes. Victims of workplace harassment mayattribute the blame to themselves, the perpetrator of the behaviour or the organisation for

Asia Pacific Journal of Human Resources 51

© 2013 Australian Human Resources Institute394

which they work (Bowling and Beehr 2006). Negative consequences such as depression aremore likely to occur when the victim attributes the blame to themselves, while changes inattitudes surrounding one’s job are more likely to occur when the victim attributes theblame to the organisation (Bowling and Beehr 2006). These two particular attributionprocesses may explain why changes in work-related and mental health outcomes havebeen observed in other studies.

Further, NA may be important to consider, given that individuals high on the trait mayhave more negative perceptions of experiences, particularly regarding outcomes such asstress and strain (Burke, Brief and George 1993). One potential explanation suggested hasbeen that individuals considered as having high NA might respond to stressors, such asworkplace bullying, in an exaggerated manner. That is, they may experience a greater levelof strain in response to a stressor than individuals with low NA (Spector et al. 2000).

Finally, certain demographic characteristics have been linked with workplace bullyingand may also be important for consideration. For example, Baillien et al. (2011) foundthat younger participants report more bullying than older participants. Similarly, Quine(1999) found that both age and employment type were associated with bullying preva-lence in the healthcare context. Further, coping style has been suggested to change withage (Johannsdottir and Olafsson 2004), whereby the consequences of bullying may differacross age groups. Associations between bullying and tenure have also indicated thatlength of employment may influence outcomes such as job satisfaction and psychologicaldistress (Decker 1997). Therefore, it may be important to consider whether these demo-graphic characteristics play a role in determining the consequences of workplace bullyingfor allied health professionals.

Current study

The principal aim of the current study was to add to the sparse amount of literatureregarding allied health professionals and workplace bullying by investigating both theantecedents and consequences of bullying for these professionals. The hypotheses of thestudy are outlined below.

Hypothesis 1a: High levels of job demands, as well as low levels of job control andsocial support will be associated with higher reports of bullying.

Hypothesis 1b: High levels of trait NA will be linked to higher reports of bullying.

Hypothesis 2a: Reports of bullying will be associated with the negative consequencesof lowered job satisfaction, as well as higher psychological distress and depression.

Hypothesis 3a: Trait NA will covary with reports of bullying consequences.

Hypothesis 3b: Demographic variables of age, employment type and tenure willimpact the consequences associated with reports of bullying (i.e. job satisfaction,psychological distress, and depression).



Method

Participants and proceduresThe sample for this study consisted of 166 allied health professionals, employed at a largeAustralian healthcare organisation. Allied health professionals across a number of facilities(e.g. maternity, hospital and residential aged care facilities) were invited to participate inthe study via surveys. The response rate for participation was 76%. The majority ofrespondents were female (86%), and aged 35 years or older (75%). In terms of tenure, theproportions were more evenly spread, with 20% of respondents having worked for theorganisation for less than 1 year, 32% for 1–4 years, 21% for 5–9 years, and the remaining27% for 10 years or more.

Measures

DemandWorkload was examined using an 11-item scale developed by Caplan et al. (1980). Eachitem asked participants to respond using a 5-point scale. The scale ranged from 1 (‘veryoften’) to 5 (‘rarely’) for four questions, and 1 (‘a great deal’) to 5 (‘hardly any’) for theremaining seven questions. The Cronbach’s alpha for this scale in this study was 0.88.

ControlA 9-item scale developed by Karasek (1985) was adopted as a measure of job control. Eachitem asked participants to respond using a 5-point scale ranging from 1 (‘strongly dis-agree’) to 5 (‘strongly agree’). In present study, the Cronbach’s alpha for this scale was0.79.

SupportSocial support was assessed using a 4-item scale developed by Caplan et al. (1980). Eachitem sought three responses from participants, one related to the support received fromtheir immediate supervisor, another related to the support received from co-workers, andthe final response related to support received from family and friends. These responseswere rated on a 5-point scale ranging from 4 (‘very much’) to 0 (‘don’t have any suchperson’). Three subscales were then formed using the responses (i.e. supervisor,co-workers and family/friends support). The Cronbach’s alpha coefficients for the sub-scales of support from supervisors, co-workers, and family/friends were 0.87, 0.84, and0.78 respectively.

Negative affectThe 10-item negative affect subscale from the positive and negative affect schedule(PANAS), developed by Watson, Clark and Tellegen (1988), was utilised as a measure oftrait NA. Each item presented a negative emotion (e.g. distressed, nervous, upset), andasked participants to provide a response related to the degree to which they had felt eachemotion over the past week. Responses were made using a 5-point scale that ranged from1 (‘very slightly or not at all’) to 5 (‘very much’). The Cronbach’s alpha of NA for thisstudy was 0.85.



BullyingBullying was assessed using a single-item scale developed by Hoel and Cooper (2000). Adefinition of bullying was provided as a part of the item and participants were asked torate the frequency of bullying they had experienced within the 6 months prior, given thisdefinition. Bullying was defined as a situation where individuals perceive themselves per-sistently, over a period of time, as the recipient of negative actions from one or morepersons and have difficulty in defending themselves. For the purposes of the survey, one-off incidents were not referred to as bullying. Responses were on a 6-point scale rangingfrom 1 (‘no’) to 6 (‘yes, almost daily’).

DepressionDepression was measured using a 9-item shortened version of the Centre for Epidemio-logical Studies Depression Scale (CES-D; Santor and Coyne 1997). Participants rated howfrequently they had experienced each of the items relating to depression (e.g. ‘could notshake off the blues’) over the past week using a 4-point scale. The scale ranged from 0(‘rarely or none of the time’) to 3 (‘most or all of the time’). The Cronbach’s alpha for thisdepression scale was 0.86.

Job satisfactionA 6-item scale was utilised to measure job satisfaction (Agho, Price and Mueller 1992).Each item asked participants to respond on a 5-point scale, ranging from 1 (‘strongly dis-agree’) to 5 (‘strongly agree’). The Cronbach’s alpha for this job satisfaction scale was 0.84.

Psychological distressThe psychological distress of each participant was examined using the 10-item Kessler –10 scale developed by Kessler and Mroczek (1994). Participants responded regarding howthey had felt in the past 30 days (e.g. ‘feel so nervous nothing could calm you down’). Eachitem asked participants to respond on a 5-point scale which ranged from 1 (‘all of thetime’) to 5 (‘none of the time’). The Cronbach’s alpha for this psychological distress scalewas 0.92.

Results

Reports of bullyingThirty-six (24%) respondents reported having experienced workplace bullying, whetherrarely or frequently, and 114 (76%) reported that they had not experienced workplace bul-lying at all. Reported frequencies of bullying across all response options are presented inTable 1. Due to the limited number of bullying responses in some categories, the responsesindicating an experience of bullying were combined, creating a ‘yes’ response category.Analyses were performed using the dichotomous categories ‘no’ and ‘yes’.

Analyses of antecedentsPrior to undertaking regression analyses, 12 cases were excluded from the sample, 10 ofwhich were due to missing values and 2 for having a support subscale total of zero. Four



univariate outliers were also excluded, leaving 150 cases remaining for analysis. A logisticregression was conducted using demand, control, support (supervisor, co-worker, family/friends support), and NA as the antecedents of bullying. Significant relationships werefound between workplace bullying and supervisor support (b = -0.19, p � 0.01), andworkplace bullying and NA (b = 0.14, p � 0.01). Low levels of support and high levels ofNA were associated with bullying.

Analyses of consequencesIn order to investigate the relationship between bullying and its consequences, a further 6cases were excluded due to missing data. Once again, univariate outliers were excluded forthe analyses separately. Thus, 145 cases remained for the analyses involving job satisfactionand depression, and 142 cases for psychological distress. To ensure sample sizes wereadequate across demographic categories, age was re-coded into two categories (i.e.younger than 45, 45 and older), employment type into two categories (i.e. full-time, part-time/casual), and tenure into three categories (i.e. less than 5 years, 5 to 9 years, and 10years or more). One 2 ¥ 3 analysis of covariance (ANCOVA), and two 2 ¥ 2 ANCOVAswere conducted, whereby differences in bullying responses (no and yes) and each demo-graphic variable (age, employment type, and tenure) for dependent variables (job satisfac-tion, depression, and psychological distress) were assessed, while also controlling for theeffect of NA. The means and standard errors of the demographic variables included in theANCOVAs are presented in Table 2.

The bullying and demographic characteristics were not statistically significant for jobsatisfaction. For psychological distress, an interaction between bullying and age group wasobserved (F(1, 137) = 4.26, p = 0.04, hp

2 = 0.03), whereby participants who reported ‘yes’to bullying and who were 45 years or older reported higher psychological distress, as com-pared to those aged 44 or younger. For this particular ANCOVA, there was a violation ofthe assumption of homogeneity of variance according to the Levene test. A non-parametric test (the Freidman test) was therefore conducted, which produced the sameresult as the ANCOVA, indicating that this violation did not impact the results.

The analyses on depression revealed a main effect of tenure (F(2, 138) = 3.99, p = 0.02,hp

2 = 0.06), whereby participants who had been employed for less than 5 years (M = 4.39,

Table 1 Frequencies and percentages of bullying responses

Bullying response n %

No 114 76

Yes, very rarely 15 10

Yes, now and then 19 12.7

Yes, several times month 1 0.7

Yes, several times a week 1 0.7

Yes, almost daily 0 0



SE = 0.48) reported lower depression than those who had been employed for 5–9 years(M = 7.06, SE = 0.99). There was also a main effect of employment type (F(1, 140) = 5.21,p = 0.024, hp

2 = 0.04), whereby participants who were employed on a part-time/casualbasis (M = 5.84, SE = 0.64) reported higher levels of depression than those employed ona full-time basis (M = 4.23, SE = 0.55). An interaction between bullying and employ-ment type was also observed for depression (F(1, 140) = 7.78, p = 0.01, hp

2 = 0.05). Morespecifically, participants who reported ‘yes’ to bullying and were employed on a part-time/casual basis reported higher depression scores than those participants who were employedon a full-time basis. NA was a significant covariate for all analyses, with the exception ofthe analyses related to job satisfaction.

Discussion

This study investigated both the antecedents (i.e. demand, control, support) andconsequences (i.e. job satisfaction, psychological distress, and depression) of workplace

Table 2 Means and standard errors for across groups and variables, with negative affect as a

covariate

Variables Job satisfaction Psychological distress Depression

Bullying Bullying Bullying

Yes No Yes No Yes No

Age

�45 years 21.12

(1.16)

22.01

(.62)

14.17†

(.97)

14.60

(.49)

5.20

(.89)

5.05

(.48)

45 years and above 23.03

(1.16)

22.96

(.65)

16.91*

(.93)

14.24†

(.52)

6.04

(.90)

4.65

(.50)

Employment type

Full-time 21.66

(1.33)

22.31

(.66)

14.8

(1.06)

14.30

(.53)

3.40†

(.99)

5.05

(.94)

Part- time/casual 22.35

(1.05)

22.59

(.62)

16.35

(.88)

14.56

(.50)

7.00*

(.79)

4.69†

(.46)

Tenure

�5 years 22.48

(1.12)

22.32

(.62)

14.82

(.90)

14.05

(.49)

4.31

(.83)

4.47

(.46)

5–9 years 21.07

(2.53)

22.20

(.95)

13.10

(2.29)

14.98

(.75)

8.58

(1.89)

5.54

(.71)

10 years or more 21.69

(1.43)

23.07

(.95)

17.24

(1.13)

14.89

(.75)

6.80

(1.07)

5.03

(.71)

Standard errors are presented in parentheses.

* = High scoring cell was significantly different from a († =) low scoring cell for the interaction

effects.



bullying, while also considering the role of NA and demographic variables (i.e. age,employment type and tenure) for allied health professionals. Almost a quarter (24%) ofthose surveyed reported experiences of workplace bullying, indicating that bullying isindeed an issue among allied health professionals within the healthcare industry. The ratesreported in this study were high enough to raise concerns, particularly given that health-care organisations typically implement a zero-tolerance policy to workplace bullying.

Antecedents of workplace bullyingThe results on the antecedents of workplace bullying for allied health professionalsrevealed partial support for the first hypothesis of the study (hypothesis 1a), in that thosewho reported low levels of supervisor support were more likely to report bullying. Thisparticular finding is in accordance with Hansen et al. (2006), who also found an associa-tion between bullying and social support. However, in contrast to the past literature ondemand and control (Notelaers et al. 2012; Takaki et al. 2010), neither of these workfactors were predictors of bullying. This finding indicates that social support, or more spe-cifically supervisor support, may be more important for allied health professionals.Drawing on the research conducted by Baillien et al. (2009), it is possible that allied healthprofessionals who experience bullying are coping in a passive manner, and rather thanseeking support from their supervisors are violating norms, which is leading to the forma-tion of negative attitudes from others. Future research that measures individual copingstyles (i.e. passive or active) could be helpful in understanding whether or not this mech-anism is a key.

Findings also indicated that bullying was associated with NA, providing support forthe hypothesis regarding this trait (hypothesis 1b). Thus, NA is an important antecedentof bullying for allied health professionals, extending past research that highlights thecentral role of NA in workplace bullying for other professionals (Hansen et al. 2006;Mikkelsen and Einarsen 2002). This finding highlights how allied health professionalswith high levels of NA may be more likely to magnify negative experiences and perceivethe behaviour of others as more negative and bullying (Hansen et al. 2006). The results ofthis study therefore suggest that both work-related factors specific to social support andpersonality factors related to a negative worldview may play important roles in the devel-opment of a context where bullying occurs among allied health professionals.

Consequences of workplace bullyingIn relation to the consequences of bullying, this study found that the mental health ofallied health professionals was affected, while attitudinal changes in perceptions of workwere not. This finding is in concordance with previous research of an association betweenbullying and mental health issues such as depression and psychological distress (Hansenet al. 2006; Kivimäki et al. 2003), partially supporting our hypothesis (hypothesis 2a).Considering attribution processes (Bowling and Beehr 2006), allied health professionalswho are victims of bullying may be more inclined to attribute blame towards themselves,which results in higher levels of depression and psychological distress. In contrast to the



previous literature conducted on other professionals within the healthcare industry (e.g.nurses; Quine 2001), job satisfaction was not associated with bullying in this study, sug-gesting that allied health professionals are less likely to place blame on the organisationwhen bullying occurs.

NA was a significant covariate for the majority of the analyses (with only one excep-tion), strongly suggesting NA may influence the response to stressors (e.g. bullying) due tomore negative perceptions (Burke, Brief and George 1993), or an exaggerated response(Spector et al. 2000). This finding supports the hypothesis of the study linking NA to con-sequences (hypothesis 3a) and adds weight to the argument suggesting the effect of NAshould be controlled for when investigating the consequences associated with workplacebullying.

The final hypothesis (hypothesis 3b) regarding demographic characteristics foundseveral significant relationships. Employees who experienced bullying and were in theolder age range reported higher levels of psychological distress. A possible explanation isdue to links between coping and age where as one ages, the coping style becomes morepassive when dealing with stressors such as bullying (Johannsdottir and Olafsson 2004).Similarly, older adults may be more sensitive to stressors than younger adults, causingthem to be more vulnerable to the negative consequences associated with stressors(Mroczek and Almeida 2004). The increased sensitivity of older adults may be becausethey are less exposed to stress on a daily basis than younger adults and are not as pre-pared to cope (Mroczek and Almeida 2004). These interpretations would lend to a rec-ommendation for future research regarding coping styles across the age span.

A further finding of the study related to the demographic characteristics of alliedhealth professionals was that employees who reported bullying and were employed on apart-time/casual basis reported higher depression scores than full-time bullied employees.This effect of employment type was also evident among all participants, regardless ofwhether or not bullying was experienced. The differences between part-time and full-timeemployees in terms of depression scores may be due to a number of reasons. Whenattending shifts only a few days per week, part-time workers may not receive as muchinformation regarding their role and may not have the same opportunities as full-timeworkers to attend training. Full-time workers may also be given first preference regardingthe allocation of shifts.

Another finding of the study regarding demographic characteristics was that oftenure. Bullying did not influence depression due to differences in tenure; however,across tenure groups, those who had been employed for the organisation between 5 and9 years reported higher depression than those employed for 4 years or less. There couldbe a number of reasons as to why tenure of a greater number of years is related tohigher depression scores for allied health professionals. For example, factors such asfatigue or becoming blocked from further career progression may be involved. Futureresearch is required to determine whether or not these or other factors may be playing arole in the observed relationship. This study was conclusive in ruling out bullying as apotential reason.



Limitations and future directionsFor several reasons, caution must be taken when interpreting the results of this study. Thestudy is cross-sectional in nature. To gain a better understanding of the antecedents andconsequences of bullying, it would be beneficial for future studies to be conducted using alongitudinal design. Additionally, although working in a variety of departments, all par-ticipants of the study were employees of the same organisation. Thus, being able to gen-eralise the results to allied health professionals across other organisations may be an issue.Further, the allied health occupational category consists of a number of varied professions,rendering it difficult to determine if there were specific occupational categories where bul-lying was a problem. Research that examines separate allied health professionals across arange of healthcare organisations would be worthwhile in allowing more specific andcomparative data.

Another limitation of the study is the use of the single-item measure of bullying byHoel and Cooper (2000) that measures self-labelled bullying. However, this measure hasbeen shown to correlate strongly with other validated measures of behaviourally-definedbullying, including the Negative Acts Questionnaire-Revised (NAQ-R; Einarsen, Hoeland Notelaers 2009). Further, the focus of this study was on self-identified perceptionsof bullying and therefore Hoel and Cooper’s item was appropriate. Future research thatuses self-labelling in conjunction with the behavioural experience method is encouragedand could extend the findings of the current study. Future research that also examinesindividual coping styles is necessary and may add to our knowledge about how indi-vidual characteristics may play a role in workplace bullying. Finally, while this paperaddressed calls from within the literature regarding the need for additional bullyingresearch with Australia samples (O’Driscoll et al. 2011), a shortage still remains and isfurther encouraged here.

Practical implications and suggestionsThe prevalence rates for bullying in this study indicate that, while there may be a zero-tolerance policy, bullying among staff is occurring and thus current organisationalstrategies are failing. Organisations need to be aware of the legal implications of bullyingbehaviour, which, in certain states of Australia, can include jail terms.

Knowledge gained in this study regarding the antecedents of bullying can inform bothprimary and secondary interventions (Tetrick, Quick and Quick 2005). Specifically, man-agers may implement primary and secondary interventions related to workplace bullyingamong allied health professionals by addressing work characteristics (e.g. low supervisorsupport) that may create risky environments for these employees. Further, managers canuse secondary interventions to address the stress response of allied health professionals byaltering these characteristics. For instance, human resources departments could ensurethat the individuals selected for supervisory roles are appropriately trained to providesuch support, and it may be beneficial to find a means of monitoring this ongoingsupport. Further, ensuring that employees who work on a part-time/casual basis aretreated in the same manner as full-time employees (e.g. appropriate allocation of shifts,



adequate handovers) is necessary to remove possibilities that certain behaviours are per-ceived as bullying. To assist in doing so, additional communication with allied health pro-fessionals may be helpful in understanding as to why part-time and causal employeesexperience higher levels of depression than their full-time counterparts. Moreover, theresults surrounding the consequences of bullying illustrate points of tertiary interventionsfor managers (Tetrick, Quick and Quick 2005). For allied health professionals, psycho-logical distress and depression levels were highlighted as the types of individual effects ofworkplace bullying that managers need to assess for and target.

ConclusionThis study examined both the antecedents and consequences associated with workplacebullying in allied health professionals, highlighting that bullying is indeed an issue for thisgroup. This research was helpful in identifying some of the work and individual character-istics that may be important to consider when investigating the antecedents of bullyingamong allied health professionals. The study enhances our understanding of the conse-quences of bullying, particularly on the mental health of these professionals. Futureresearch on both the antecedents and consequences of bullying could be beneficial infurther informing effective prevention and intervention strategies that reduce and targetthe occurrence of such negative and anti-social workplace behaviour.

Defne Demir is a research fellow working within the Faculty of Business at Australian Catholic Uni-

versity, Fitzroy, Victoria. Her research interests include employee-level issues, such as workplace

stress and aggression (bullying and violence).

John Rodwell (PhD) is a professor of management within the Faculty of Business at Australian

Catholic University, Fitzroy, Victoria. His research focuses on health services management.

Rebecca Flower is a research assistant working within the Faculty of Business at Australian Catholic

University, Fitzroy, Victoria.

References

Agervold M and EG Mikkelsen (2004) Relationships between bullying, psychosocial work environ-

ment an individual stress reactions. Work and Stress 18(4), 336–351.

Agho AO, JL Price and CW Mueller (1992) Discriminant validity of measures of job satisfaction,

positive affectivity and negative affectivity. Journal of Occupational and Organizational Psychology

65(3), 185–196.

Australian Institute of Health and Welfare (2010) Australia’s health 2010. Australia’s health series no.

12. Cat. no. AUS 122. AIHW, Canberra.

Baillien E, I Neyens, H De and N De (2009) A qualitative study on the development of workplace

bullying: Towards a three way model. Journal of Community & Applied Social Psychology 19(1),

1–16.

Baillien E, A Rodríguez-Muñoz, HD Witte, G Notelaers and B Moreno-Jiménez (2011) The

demand–control model and target’s reports of bullying at work: A test within Spanish and



Belgian blue-collar workers. European Journal of Work and Organizational Psychology 20(2), 157–

177.

Behar M, B Van der Heijden, D Camerino, C Fry, OL Nezet, PM Conway and HM Hasselhorn

(2008) Violence risks in nursing- Results from the European NEXT study. Occupational Medicine

58(2), 107–114.

Bowling NA and TA Beehr (2006) Workplace harassment from the victim’s perspective: A theoret-

ical model and meta-analysis. Journal of Applied Psychology 91(5), 998–1012.

Burke MJ, AP Brief and JM George (1993) The role of negative affectivity in understanding relations

between self-reports of stressors and strains: A comment on the applied psychology literature.

Journal of Applied Psychology 78(3), 402–412.

Camerino D, M Estryn-Behar, PM Conway, BIJM Van Der Heijden and H Hasselhorn (2008) Work-

related factors and violence among nursing staff in the European NEXT study: A longitudinal

cohort study. International Journal of Nursing Studies 45(1), 35–50.

Caplan RS, S Cobb, J French Jr, R Harrison and S Pinneau (1980) Job demands and worker health:

Main effects and occupational differences. The Institute for Social Research, Ann Arbour, MI.

Decker FH (1997) Occupational and nonoccupational factors in job satisfaction and psychological

distress among nurses. Research in Nursing and Health 20(5), 453–464.

Einarsen S, H Hoel and G Notelaers (2009) Measuring exposure to bullying and harassment at work:

Validity, factor structure and psychometric properties of the negative acts questionnaire-revised.

Work and Stress 23(1), 24–44.

Einarsen S, H Hoel, D Zapf and CL Cooper (2011) The concept of bullying and harrassment at

work: The European tradition. In S Einarsen, H Hoel, D Zapf and CL Cooper (eds) Bullying and

harrassment in the workplace: Developments in theory, research and practice, 2nd edn, 3–39. CRC

Press, Boca Raton, FL.

Farrell GA, C Bobrowski and P Bobrowski (2006) Scoping workplace aggression in nursing: Findings

from an Australian study. Journal of Advanced Nursing 55(6), 778–787.

Hansen AM, A Hogh, R Persson, B Karlson, AH Garde and P Orbaek (2006) Bullying at work, health

outcomes, and physiological stress response. Journal of Psychosomatic Research 60(1), 63–72.

Hoel H and CL Cooper (2000) Destructive conflict and bullying at work. University of Manchester

Institute of Science and Technology (UMIST). http://www.rowleyassoc.com/wp-content/

uploads/Conflict-Bullying-at-Work.pdf

Hutchinson M, M Vickers, D Jackson and L Wilkes (2006) Workplace bullying in nursing: Towards a

more crucial organisational perspective. Nursing Inquiry 13(2), 118–126.

Johannsdottir HL and RF Olafsson (2004) Coping with bullying in the workplace: The effect of

gender, age, and type of bullying. British Journal of Guidance and Counselling 32(3), 319–333.

Johnson JV and EM Hall (1988) Job strain, work place social support, and cardiovascular disease: A

cross-sectional study of a random sample of the Swedish working population. American Journal

of Public Health 78(10), 1336–1342.

Karasek R (1979) Job demands, job decision latitude, and mental strain: Implications for job

redesign. Administrative Science Quarterly 24(2), 285–308.

Karasek R (1985) Job content instrument: Questionnaire and user’s guide, revision 1.1. University of

Southern California, Los Angeles, CA.

Keane S, TN Smith, M Lincoln, SR Wagner and SE Lowe (2008) The rural allied health workforce

study (RAHWS): Background, rationale and questionnaire development. Rural and Remote

health 8(4), 1–12.



Kessler R and D Mroczek (1994) Final versions of our non-specific psychological distress scale. Survey

Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI.

Kivimäki M, M Virtanen, M Vartia, M Elovainio, J Vahtera and L Keltikangas-Järvinen (2003) Work-

place bullying and the risk of cardiovascular disease and depression. Occupational and Environ-

mental Medicine 60(10), 779–783.

Mikkelsen EG and S Einarsen (2002) Relationships between exposure to bullying at work and psy-

chological and psychosomatic health complaints: The role of state negative affectivity and gener-

alized self-efficacy. Scandinavian Journal of Psychology 43(5), 397–405.

Mroczek DK and DM Almeida (2004) The effect of daily stress, personality, and age on daily nega-

tive affect. Journal of Personality and Social Psychology 72(2), 355–378.

Notelaers G, E Baillien, HD Witte, S Einarsen and JK Vermunt (2012) Testing the strain hypothesis

of the demand control support model to explain severe bullying at work. Economic and Industrial

Democracy 34(1), 69–87.

O’Driscoll M, HD Cooper-Thomas, T Bentley, BE Catley, DH Gardner and L Trenberth (2011)

Workplace bullying in New Zealand: A survey of employee perceptions and attitudes. Asia Pacific

Journal of Human Resources 49(4), 390–408.

Quine L (1999) Workplace bullying in NHS community trust: Staff questionnaire survey. BMJ

(Clinical Research Edition) 318(7178), 228–232.

Quine L (2001) Workplace bullying in nurses. Journal of Health Psychology 6(1), 73–84.

Santor DA and JC Coyne (1997) Shortening the CES-D to improve its ability to detect cases of

depression. Psychological Assessment 9(3), 233–243.

Spector PE, D Zapf, PY Chen and M Frese (2000) Why negative affectivity should not be controlled

in job stress research: Don’t throw out the baby with the bath water. Journal of Organizational

Behavior 21(1), 79–95.

Stubbs B and S Sengupta (2008) Aggression: Is it a problem for occupational therapists? British

Journal of Occupational Therapy 71(8), 313.

Takaki J, T Taniguchi, E Fukuokam, Y Fujii, A Tsutsumi, K Nakajime and K Hirokawa (2010) Work-

place bullying could play important roles in the relationships between job strain and symptoms

of depression and sleep disturbance. Journal of Occupational Health 52(6), 367–374.

Tetrick LE, JC Quick and JD Quick (2005) Prevention perspectives in occupational health psychol-

ogy. In A-SG Antoniou and CL Cooper (eds) Research companion to organizational health psychol-

ogy, 209–217. Edward Elgar Publishing, Northampton, MA.

Tuckey MR, MF Dollard, PJ Hosking and AH Winefield (2009) Workplace bullying: The role of psy-

chosocial work environment factors. International Journal of Stress Management 16(3), 215–232.

Vittinghoff E and CE McCulloch (2006) Relaxing the rule of ten events per variable in logistic and

cox regression. American Journal of Epidemiology 165(6), 710–718.

Watson D and LA Clark (1984) Negative affectivity: The disposition to experience aversive emo-

tional states. Psychological Bulletin 96(3), 465–490.

Watson D, LA Clark and A Tellegen (1988) Development and validation of brief measures of posi-

tive and negative affect: The PANAS scales. Journal of Personality and Social Psychology 54(6),

1063–1070.

Yildirim D (2009) Bullying among nurses and its effects. International Nursing Review 56(4), 504–

511.



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