Mistreatment of nurses by patients and its impact on their caring behaviors: The roles of psychological detachment and supervisor positive gossip

Int Nurs Rev. 2024 Apr 29. doi: 10.1111/inr.12970. Online ahead of print.

Abstract

Background: Mistreatment by patients is a detrimental phenomenon predominant in healthcare organizations. However, there is a lack of nursing literature regarding the underlying mechanisms and boundary conditions that exist between mistreatment by patients and its detrimental consequences.

Aim: By integrating the Job Demands-Resources Model and the Conservation of Resources Theory, the study aimed to unveil the mediating role of psychological detachment from work in the relationship between mistreatment by patients and nurses' caring behaviors, as well as the moderating effect of supervisor positive gossip.

Methods: This multicenter, cross-sectional study involved 341 nurses from five hospitals across two cities in Egypt. Data were collected using an introductory information form, the Mistreatment by Patients Scale, the Psychological Detachment Scale, the Caring Behaviors Scale, and the Supervisor Positive Gossip Scale. The study's hypotheses were tested using the PROCESS macro.

Results: The results showed that mistreatment by patients was negatively related to nurses' caring behaviors via an increased psychological detachment. Further, higher levels of supervisor positive gossip were shown to weaken the direct effect of mistreatment by patients in increasing nurses' psychological detachment, as well as the indirect negative effect of mistreatment by patients on nurses' caring behaviors via psychological detachment.

Conclusions: Mistreatment by patients contributes to nurses' psychological detachment and decreased caring behaviors; however, these negative outcomes can be mitigated by supervisor positive gossip.

Implication for nursing policymaking: Nursing managers should adopt strategies to deter the rise of mistreatment by patients, and utilize positive gossip to support nurses exposed to such mistreatment to alleviate its consequences.

Keywords: Caring behaviors; mistreatment by patients; nurses; psychological detachment; supervisor positive gossip.