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Predictors and triggers of incivility within healthcare teams: a systematic review of the literature
OBJECTIVES: To explore predictors and triggers of incivility in medical teams, defined as behaviours that violate norms of respect but whose intent to harm is ambiguous. DESIGN: Systematic literature review of quantitative and qualitative empirical studies. DATA SOURCES: Database searches according...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282335/ https://www.ncbi.nlm.nih.gov/pubmed/32513884 http://dx.doi.org/10.1136/bmjopen-2019-035471 |
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author | Keller, Sandra Yule, Steven Zagarese, Vivian Henrickson Parker, Sarah |
author_facet | Keller, Sandra Yule, Steven Zagarese, Vivian Henrickson Parker, Sarah |
author_sort | Keller, Sandra |
collection | PubMed |
description | OBJECTIVES: To explore predictors and triggers of incivility in medical teams, defined as behaviours that violate norms of respect but whose intent to harm is ambiguous. DESIGN: Systematic literature review of quantitative and qualitative empirical studies. DATA SOURCES: Database searches according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline in Medline, CINHAL, PsychInfo, Web of Science and Embase up to January 2020. ELIGIBILITY CRITERIA: Original empirical quantitative and qualitative studies focusing on predictors and triggers of incivilities in hospital healthcare teams, excluding psychiatric care. DATA EXTRACTION AND SYNTHESIS: Of the 1397 publications screened, 53 were included (44 quantitative and 9 qualitative studies); publication date ranged from 2002 to January 2020. RESULTS: Based on the Medical Education Research Study Quality Instrument (MERSQI) scores, the quality of the quantitative studies were relatively low overall (mean MERSQI score of 9.93), but quality of studies increased with publication year (r=0.52; p<0.001). Initiators of incivility were consistently described as having a difficult personality, yet few studies investigated their other characteristics and motivations. Results were mostly inconsistent regarding individual characteristics of targets of incivilities (eg, age, gender, ethnicity), but less experienced healthcare professionals were more exposed to incivility. In most studies, participants reported experiencing incivilities mainly within their own professional discipline (eg, nurse to nurse) rather than across disciplines (eg, physician to nurse). Evidence of specific medical specialties particularly affected by incivility was poor, with surgery as one of the most cited uncivil specialties. Finally, situational and cultural predictors of higher incivility levels included high workload, communication or coordination issues, patient safety concerns, lack of support and poor leadership. CONCLUSIONS: Although a wide range of predictors and triggers of incivilities are reported in the literature, identifying characteristics of initiators and the targets of incivilities yielded inconsistent results. The use of diverse and high-quality methods is needed to explore the dynamic nature of situational and cultural triggers of incivility. |
format | Online Article Text |
id | pubmed-7282335 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-72823352020-06-15 Predictors and triggers of incivility within healthcare teams: a systematic review of the literature Keller, Sandra Yule, Steven Zagarese, Vivian Henrickson Parker, Sarah BMJ Open Medical Education and Training OBJECTIVES: To explore predictors and triggers of incivility in medical teams, defined as behaviours that violate norms of respect but whose intent to harm is ambiguous. DESIGN: Systematic literature review of quantitative and qualitative empirical studies. DATA SOURCES: Database searches according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline in Medline, CINHAL, PsychInfo, Web of Science and Embase up to January 2020. ELIGIBILITY CRITERIA: Original empirical quantitative and qualitative studies focusing on predictors and triggers of incivilities in hospital healthcare teams, excluding psychiatric care. DATA EXTRACTION AND SYNTHESIS: Of the 1397 publications screened, 53 were included (44 quantitative and 9 qualitative studies); publication date ranged from 2002 to January 2020. RESULTS: Based on the Medical Education Research Study Quality Instrument (MERSQI) scores, the quality of the quantitative studies were relatively low overall (mean MERSQI score of 9.93), but quality of studies increased with publication year (r=0.52; p<0.001). Initiators of incivility were consistently described as having a difficult personality, yet few studies investigated their other characteristics and motivations. Results were mostly inconsistent regarding individual characteristics of targets of incivilities (eg, age, gender, ethnicity), but less experienced healthcare professionals were more exposed to incivility. In most studies, participants reported experiencing incivilities mainly within their own professional discipline (eg, nurse to nurse) rather than across disciplines (eg, physician to nurse). Evidence of specific medical specialties particularly affected by incivility was poor, with surgery as one of the most cited uncivil specialties. Finally, situational and cultural predictors of higher incivility levels included high workload, communication or coordination issues, patient safety concerns, lack of support and poor leadership. CONCLUSIONS: Although a wide range of predictors and triggers of incivilities are reported in the literature, identifying characteristics of initiators and the targets of incivilities yielded inconsistent results. The use of diverse and high-quality methods is needed to explore the dynamic nature of situational and cultural triggers of incivility. BMJ Publishing Group 2020-06-07 /pmc/articles/PMC7282335/ /pubmed/32513884 http://dx.doi.org/10.1136/bmjopen-2019-035471 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Medical Education and Training Keller, Sandra Yule, Steven Zagarese, Vivian Henrickson Parker, Sarah Predictors and triggers of incivility within healthcare teams: a systematic review of the literature |
title | Predictors and triggers of incivility within healthcare teams: a systematic review of the literature |
title_full | Predictors and triggers of incivility within healthcare teams: a systematic review of the literature |
title_fullStr | Predictors and triggers of incivility within healthcare teams: a systematic review of the literature |
title_full_unstemmed | Predictors and triggers of incivility within healthcare teams: a systematic review of the literature |
title_short | Predictors and triggers of incivility within healthcare teams: a systematic review of the literature |
title_sort | predictors and triggers of incivility within healthcare teams: a systematic review of the literature |
topic | Medical Education and Training |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282335/ https://www.ncbi.nlm.nih.gov/pubmed/32513884 http://dx.doi.org/10.1136/bmjopen-2019-035471 |
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