Sandy Lim, E-Yang Goh, Eugene Tay, Yew Kwan Tong, Deborah Chung, Kamala Devi, Chay Hoon Tan, Inthrani Raja Indran
{"title":"高权力距离文化中的破坏性行为及其三维约束框架。","authors":"Sandy Lim, E-Yang Goh, Eugene Tay, Yew Kwan Tong, Deborah Chung, Kamala Devi, Chay Hoon Tan, Inthrani Raja Indran","doi":"10.1097/HMR.0000000000000315","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>The aim of this study was to develop a comprehensive framework for tackling disruptive behavior among health care professionals in a public health system.</p><p><strong>Methodology: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Practice implications: </strong>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.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"47 2","pages":"133-143"},"PeriodicalIF":1.7000,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/91/hcm-47-133.PMC8876433.pdf","citationCount":"2","resultStr":"{\"title\":\"Disruptive behavior in a high-power distance culture and a three-dimensional framework for curbing it.\",\"authors\":\"Sandy Lim, E-Yang Goh, Eugene Tay, Yew Kwan Tong, Deborah Chung, Kamala Devi, Chay Hoon Tan, Inthrani Raja Indran\",\"doi\":\"10.1097/HMR.0000000000000315\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>The aim of this study was to develop a comprehensive framework for tackling disruptive behavior among health care professionals in a public health system.</p><p><strong>Methodology: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Practice implications: </strong>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.</p>\",\"PeriodicalId\":47778,\"journal\":{\"name\":\"Health Care Management Review\",\"volume\":\"47 2\",\"pages\":\"133-143\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2022-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/91/hcm-47-133.PMC8876433.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Care Management Review\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/HMR.0000000000000315\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Care Management Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HMR.0000000000000315","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
Disruptive behavior in a high-power distance culture and a three-dimensional framework for curbing it.
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.
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.