Disruptive behavior in a high-power distance culture and a three-dimensional framework for curbing it.

IF 1.7 3区 医学 Q3 HEALTH POLICY & SERVICES Health Care Management Review Pub Date : 2022-04-01 DOI:10.1097/HMR.0000000000000315
Sandy Lim, E-Yang Goh, Eugene Tay, Yew Kwan Tong, Deborah Chung, Kamala Devi, Chay Hoon Tan, Inthrani Raja Indran
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引用次数: 2

Abstract

Background: Disruptive behavior can harm high-quality care and is prevalent in many Western public health systems despite increasing spotlight on it. Comparatively less knowledge about it is available in Asia, a region commonly associated with high-power distance, which may limit its effectiveness in addressing disruptive behavior.

Purpose: The aim of this study was to develop a comprehensive framework for tackling disruptive behavior among health care professionals in a public health system.

Methodology: A nationwide cross-sectional study relying on the Nurse-Physician Relationship Survey was conducted in Singapore. Four hundred eighty-six public health care professionals responded.

Results: Two hundred ninety-eight doctors (95.5%) and 163 nurses (93.7%) had witnessed a form of disruptive behavior. Doctors observed disruptive behavior committed by other doctors and nurses much more frequently than did nurses. Doctors made stronger associations between disruptive behavior and negative employee outcomes and between disruptive behavior and negative patient outcomes. Qualitative analyses of participants' open-ended answers produced a multipronged three-dimensional approach for tackling disruptive behavior: (a) deterrent measures, (b) development of knowledge and skills, and (c) demonstration of organizational commitment through proper norms, empathizing with staff, and structural reforms.

Practice implications: Disruptive behavior is a multifaceted problem requiring a multipronged approach. Our three-dimensional framework is a comprehensive approach for giving health care professionals the capability, opportunity, and motivation to address disruptive behavior effectively.

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高权力距离文化中的破坏性行为及其三维约束框架。
背景:破坏性行为可能会损害高质量的护理,并且在许多西方公共卫生系统中普遍存在,尽管它越来越受到关注。相对而言,在亚洲这个通常与高权力距离联系在一起的地区,人们对其了解较少,这可能会限制其在解决破坏性行为方面的有效性。目的:本研究的目的是建立一个全面的框架,以解决公共卫生系统中卫生保健专业人员的破坏性行为。方法:在新加坡进行了一项全国性的横断面研究,该研究依赖于护士-医生关系调查。486名公共卫生保健专业人员做出了回应。结果:298名医生(95.5%)和163名护士(93.7%)曾目睹过某种形式的破坏性行为。医生比护士更频繁地观察到其他医生和护士的破坏性行为。医生们认为破坏性行为与员工的负面结果以及患者的负面结果之间存在更强的联系。对参与者的开放式回答进行定性分析,得出了解决破坏性行为的多管齐下的三维方法:(a)威慑措施,(b)知识和技能的发展,以及(c)通过适当的规范、对员工的同情和结构改革来展示组织承诺。实践启示:破坏性行为是一个多方面的问题,需要多管齐下的方法。我们的三维框架是一种全面的方法,为医疗保健专业人员提供了有效解决破坏性行为的能力、机会和动机。
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 Care Management Review HEALTH POLICY & SERVICES-
CiteScore
4.70
自引率
8.00%
发文量
48
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.
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