The aggressive behavior of clients toward employees in service organizations is an alarming phenomenon, which harms employees and damages the organization itself. Employees all over the public sector, especially in social service departments, are continuously exposed to aggressive behavior by clients. The focus of the current study is on understanding the short-and long-term implications of aggressive client behavior on social workers and the organization in which they operate. A qualitative approach was used to understand the perspective of the workers exposed to aggressive client behavior as well as its organizational implications. In-depth interviews were conducted with the 40 participants between February and May, 2009. The participants included district managers, agency managers, supervisors, social workers, and administrators, in 17 agencies all over the country. The study findings identified negative impacts of client aggression on several levels and on several focal areas. On the emotional, cognitive, and behavioral levels, both short-term and long-term consequences can be seen, which affect not only the attacked individual but also resonate throughout the organization. Individual events may diffuse to affect other levels of the service process by Article 1124 Journal of Interpersonal Violence 28 (6) role-learning, imitation of behavior, and by noticing that the organization provides incentives for client aggression, while providing disincentives for assertiveness and self-protective actions on the part of workers.
The professional habitus and values of social work, are challenged when social workers encounter client aggression. The current study was set up to understand the ways by which workers confront and cope with client aggression. In-depth interviews were conducted with 40 social workers in general municipal services. The participants included district managers, agency managers, supervisors, social workers and administrators. We identified a process consisting of four stages: (1) Rationalization, minimization, and denial of client aggression, including self-blame; (2) Emotional reactions, including hurt, anger, helplessness and shame; (3) Reevaluation of one's beliefs, attitudes and values; (4) Behavioral transformation. The process of going through the four stages is not always linear, and workers may go back and forth between stages. The results are discussed in terms of the gaps between social workers' values and the reality they are facing. Such gaps serve as an engine of change, explicated by theoretical concepts of social judgment theory.
Background Employee personality is an important factor that affects healthcare service delivery. It appears from the literature that customers perceive employees with personality traits of conscientiousness and agreeableness as more reliable and empathetic and therefore will rank higher service quality. Relationships between team members also affect the perception of service quality. The research examined whether healthcare employees' personality traits (conscientiousness and agreeableness) are related to their perception of service quality, mediated by the quality of team relationships (trust among team members, peer support, and participation in decision-making). Methods First, 35 nurses (Israeli college students completing their BA) were asked to rate 22 items based on the Big Five Personality Traits, that most influence employee relationships. The two prominent personality traits were conscientiousness and agreeableness. Next, 174 self-administered questionnaires were completed by nurses who are college students completing their BA (72% return rate). The questionnaire examined personality traits (conscientiousness and agreeableness), service quality, and employee relationships (trust among team members, peer support, and participation in decision-making). Results The mediation model was significant [F(4, 169)=35.03, p < 0.001, R Square=0.45]. However, only trust among team members was found as a mediator between employee personality and perceptions of service quality. Conclusions Employee personality characterized by conscientiousness and agreeableness encourages trust-based employee relationship, which in turn positively affect the quality of service provided. Healthcare organizations should consider this in their human resources policies and procedures, in order to improve healthcare services. Key messages Employee's personality traits are relevant to healthcare service quality. Nurturing trust among healthcare employees may result in improved healthcare services.
PurposeProviding health care services requires collaboration between several occupations. This study aimed to reveal how three occupational groups (nurses, physicians, and administrators) perceive human resources management practices (HRMP) and whether these practices are differently associated with trust in the clinic manager.Design/methodology/approachThe study included 290 employees from 29 primary care clinics, all affiliated with a health care organisation that operates in the public sector. Self-reporting questionnaires measured participants’ perceptions of six HRMP across occupations and their association with trust in the clinic manager. Variation between occupational groups was analysed through one-way analysis of variance (for groups’ perceptions of HRMP and trust in manager) and t-tests (for the association between perceived HRMP and trust in manager).FindingsThe results indicate some differences in perceived HRMP and trust across groups. Also, some differences were found across occupations regarding the relationship between HRMP and trust in the clinic manager: Nurses’ perceptions significantly differed from those of physicians and administrators, yet there was no significant difference between the two latter groups.Practical implicationsHealth care organisations should expand their human resources architecture and customise their HRMP for each occupational group based on that group’s perceptions of the workplace. This can nurture trust in managers and create a climate for trust as a mechanism that encourages employees from distinct occupational groups to work together for the benefit of their clinic, organisation, and patients.Originality/valueThis study contributes to the discussion about the contextualisation of HRMP, providing insights regarding perceptions of HRMP as an enabler of an organisation’s strategy.
Purpose The purpose of the research was to develop a tool for measuring antecedents of customer aggressive behavior (CAB) in healthcare service settings, by identifying its roots in organizational and interpersonal dynamics. Design/methodology/approach Four studies were conducted. In Studies 1 and 2, antecedents of CAB were identified through analysis of internet reader comments and a questionnaire was distributed to students. In Study 3, scenarios were used to validate the findings of the previous studies. Finally, in Study 4, a scale was developed and validated for measuring organization- and person-related triggers of CAB using samples of 477 employees and 579 customers. Findings The concept of CAB was conceptualized and validated. In total, 18 items were identified across five dimensions: personal characteristics, uncomfortable environment, aggressive role models, reinforcement of aggressive behavior and aversive treatment. The scale demonstrated good psychometric results. Research limitations/implications The research relies mainly on customer perspective. Employees and additional stakeholders should be included to achieve more accurate information that could contribute to a better understanding of CAB and its roots. Practical implications Exploring social and organizational antecedents that trigger CAB could help healthcare managers evaluate and proactively manage CAB and its implications within their organization. Originality/value This measurement scale is the first comprehensive tool, based on Bandura’s social learning theory (1973), that may identify and measure antecedents of CAB, and could be used to reduce CAB in healthcare service settings.
Background Conflictual interactions with patients’ relatives are prevalent in the work of hospital nurses. These situations may increase burnout and result in intentions to leave the nursing profession and high rates of turnover. It is important to understand the coping mechanisms and behaviours that nurses employ in such conflicts, to help them develop more adequate strategies that could prevent these outcomes. This study aimed at revealing how nurses’ attachment styles colour their behavioural coping mechanisms when dealing with such interactions with patients’ relatives, and how they are related to burnout and intentions to leave the profession. Methods An online survey was completed by 140 hospital nurses that included three scenarios of typical conflicts with patients’ relatives. Each scenario was followed by questions that assess stress and inadequacy when handling such situations, and behaviours: problem-solving responses, emotional support seeking, avoidance, and escalating responses. The survey also included self-reports of attachment styles, burnout, and intentions to leave nursing. Data were analysed using SEM (Amos 23). Results The model shows an acceptable fit (χ2(24) = 39.33, p = .025; CFI = .963; RMSEA = .068). Higher anxious attachment was associated with higher stress and feelings of inadequacy in handling the situation, which in turn were associated with more emotional support seeking, avoidance, and escalating responses. Escalating responses were indirectly associated with intentions to leave the nursing profession via higher burnout. Higher avoidant attachment was associated with fewer problem-solving responses. Conclusions Evaluating nurses’ attachment style, cognitions, and behaviours in conflicts with patients’ relatives is imperative for understanding burnout and intentions to leave nursing. Nursing training should include simulations of conflictual interactions with patients’ relatives to help modify maladaptive coping. Key messages • Evaluating nurses’ attachment style, cognitions, and behaviours in conflicts with patients’ relatives is imperative for understanding burnout and intentions to leave nursing. • Training for nursing staff should consider nurses’ awareness of their attachment style to modify maladaptive cognitions and behaviours in conflicts with patients’ relatives.
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