Nursing Publications


When Respect Deteriorates: Incivility as a Moderator of the Stressor–strain Relationship among Hospital Workers

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Journal of Nursing Management





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Aim  To test whether incivility at work exacerbates the relationship between stressors and strain for hospital workers.

Background  A climate of incivility and disrespect among colleagues was expected to heighten the impact of work stressors on the mental and physical health of care providers.

Methods  Members of 17 care-providing units from five hospital systems in Canada completed surveys, before and after a civility intervention (eight intervention vs. nine comparison units). Analyses tested whether (1) incivility moderated the stressor-strain relationship at baseline (n = 478), and (2) the stressor–strain relationship decreased for the intervention units relative to comparison units 6 months later (n = 361).

Results  (1) Pre-intervention, individuals reporting more incivility on their unit showed a stronger stressor–strain relationship. (2) The negative relationship between work overload and mental health was mitigated among intervention group staff 6 months after the introduction of a colleague-based civility programme.

Conclusions  Besides being a stressor itself, incivility exacerbates the relationship between existing job role stressors and strain among health care workers.

Implications for nursing management  Colleague civility and respect have an important ripple effect of buffering inevitable work stressors, helping health care providers respond to stress with greater health and resiliency.