Workplace bullying in NHS community trust: staff questionnaire survey

British Medical Journal,  Jan 23, 1999  by Lyn Quine

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Subjects and methods

In 1996, as part of a larger survey of working life, a community NHS trust in south east England commissioned an examination of the prevalence of workplace bullying. The trust provides a range of mental health, learning disability, primary care, and child health services comprising residential care, multidisciplinary community and day service teams, health promotion, health visiting, school and community nursing services, occupational therapy, physiotherapy, speech and language therapy, and child and family psychiatry services.

We sent a questionnaire to all 1580 trust employees, together with a covering letter explaining the purpose of the research and a prepaid envelope. The questionnaire was anonymous to encourage participation. A reminder was sent after three weeks, a second questionnaire after a further three weeks, and then a final reminder. The data were then entered on to computer and analysed with SPSS for Unix.

Questionnaire

The first section of the questionnaire collected information about the participant's job, qualifications, professional group, hours worked, and supervisory responsibilities. The second contained several widely used scales to measure occupational health outcomes: job induced stress,[16] job satisfaction,[17] propensity to leave,[18] anxiety and depression,[19] and a scale to measure support at work.[20] The job induced stress scale contains seven items intended to measure the existence of tensions and pressures growing out of job requirements. The job satisfaction scale uses five items to tap a worker's general affective reaction to the job.[17] The propensity to leave scale provides a three item index of employees' intention to leave their job.[18] The hospital anxiety and depression scale has 14 items, seven of which measure anxiety and seven depression.[19] Cut off points are provided to give the best separation between non-cases (0-7), doubtful cases (8-10), and cases ([is greater than or equal to] 11) of clinical anxiety and depression.

Support at work was measured by a scale adapted from Payne.[20] Workers were asked to rate on a five point scale various resources in the work environment, including feedback and support from peers and managers, access to community resources, level of workplace morale, positive working practices, and physical work environment.

The third section of the questionnaire contained questions about staff experience of bullying in the trust and examined its consequences. To avoid some of the methodological problems inherent in previous definitions of bullying we separated out the experience of bullying behaviours from their effects. Twenty types of bullying behaviour were taken from the literature,[21 22] representing each of the categories defined by Rayner and Hoel.[7] Staff were asked to indicate by a yes/no response whether they had been persistently subjected to any of these behaviours in the past 12 months. The final section of the questionnaire asked for socio-demographic information--age, sex, educational level--and contained questions concerning smoking and drinking habits.