Quantitative strategy into place of work bullying in NHS

This section makes a circumstance for the utilization of the quantitative methodology to investigate work environment bullying in NHS psychologists. Participant selection, data collection and analysis procedures are specified, followed by a conversation about ethical issues. It will conclude with a brief discussion about some of the methodological issues and dilemmas encountered in the analysis (INCLUDE IF UNDER Vitality).

Before moving on to discuss the techniques used, it seems important to first critique the chosen paradigm in order to justify its appropriateness. Consequently, the following section will quickly consider the efforts of both qualitative and quantitative methods to the research field. Inevitably, both paradigms give you a tool for understanding the world and the phenomena which exist in it. For today's study, the task was to decide which procedure would meet the research questions best, and ensure the conclusions were meaningful to others.

Qualitative research

Researchers tend to discuss different research paradigms in conditions with their epistemological foundations (e. g. Guba & Lincoln, 1994). In its broadest sense, epistemology identifies the philosophical position underlying the research. Qualitative research is associated with interpretive epistemology. Essentially, this means it is thinking about understanding this is behind certain occurrence, as opposed to the prevalence of computer. The key aspect of qualitative data which makes it unique from quantitative is the fact it places the researcher within the framework of the problem. One could stipulate that the researcher is immersed in the study. Consequently, predictions are made based on the researchers' subjective understanding of the info.

Qualitative research has increased in reputation over recent years within the mindset field, producing a backlash against quantitative methods. Service individual and carer perspectives are actually encouraged in psychological research (Kuniavsky, 2003), which can explain the craze towards qualitative methods. Data collection is usually may be accomplished through a number of methods, including collaborative interviews, organised interviews and observations. Data is usually descriptive, and exists by means of written or spoken words (e. g. transcripts).

Within the context of workplace bullying, however, qualitative methods have seduced a number of criticisms. As Cowie (2003) rightly highlights, qualitative methods are not befitting investigative studies of place of work bullying. Additionally, data collection methods are usually labour-intensive and time-consuming, for participants and researchers similarly. This limitation noticed particularly salient for today's study, considering that it focused on a busy workforce population. Because of the sensitive character of the research issue, it was also noticed that qualitative data collection methods wouldn't normally achieve success. Face-to-face interviews or concentration groups, for illustration, would bargain the anonymity of the participants.

The present research was enthusiastic about increasing descriptive, comparative data. Because of this, and those just referred to, qualitative methodology was not chosen.

Quantitative research

In comparison, quantitative research is associated with positivist epistemology (Henderson, 1991), which refers to a search for the reality. Some contend the positivist paradigm parallels the traditionalist medical style of good care (Higgs & Jones, 2000), as research looks for to be technological and objective. The positivist researcher is designed to keep themselves individual using their research, to be able to ensure objectivity. Under the quantitative framework, analysts place focus on adherence to a standardised protocol (Kleinbaum et al. , 1982). Data can be collected utilizing a variety of methods, for example via research or organised tests. Larger samples are demanded than in qualitative research, in order to guarantee the generalisabilty of the conclusions. Under a positivist paradigm, the rigour of a report is usually evaluated by means of trustworthiness and validity (Clark-Carter, 1997).

The most work place bullying research has been conducted using quantitative methodologies based on a positivist perception system. The goal of the present analysis was to enhance understanding of the prevalence of workplace bullying in a set of companies within the NHS - the personnel. Prevalence studies of place of work bullying in NHS staff generally use self-report steps (e. g. Quine, 1999; Quine, 2001; Quine, 2002; Steadman, 2009). It's important to note that self-report options carry lots of limits within the work area bullying field, such as under-reporting and response biases (. . ). The inflexibility of questionnaires also means they only provide limited information about the interpersonal processes adjoining work area bullying (Cowie, 2003).

Nevertheless, they certainly supply the 'best fit' for prevalence studies. Self-report procedures allow usage of a wider test and therefore give tone of voice to multiple perspectives. This was deemed particularly very important to the present review considering the insufficient research with the psychologist labor force.

Given the top variables of interest in this analysis, a positivist, comparative way was deemed as most appropriate. A quantitative approach was selected because of this study since it best addressed the research questions regarding prevalence of bullying within the psychologist workforce and the factors that are associated with it.

Study design

The study was a combination sectional postal study design, in which participants were approached only one time, at an individual point in time. It investigated the prevalence of workplace bullying (negative acts) and associated occupational health benefits (i. e. job satisfaction, propensity to leave, well-being, resilience, mental problems).

Sample and recruitment

Participant characteristics

The inclusion standards for individuals were the following (there was no exclusion requirements)

Participants had to be a qualified scientific or counselling psychologist working in the NHS

Participants with a statement of equivalence were accepted

Recruitment strategy

The study adopted an opportunistic sampling method. Potential individuals fitting the addition criteria were primarily contacted by email via their NHS range manager/trust consultant (see method section for further details). Data was accumulated by means of a postal review, therefore there was no face-to-face connection with the participants.


An initial calculation by G-power showed a total test of 110 was necessary for the study to be valid.

Sample size and response rates

A total of five NHS trusts participated in the study over the region of South-East Great britain. The total concentrate on population was. . Table shows the labor force statistics for every single of the participating trusts.

In total, . . . . psychologists were sent the survey. Of the number, . completed and went back the study, which represented a response rate of. . Response rates for postal research change between. . . . and. . . . . % depending on attainability and accessibility of the sample population.

As defined in the participant information sheet (see Appendix. . ) all members were given a distinctive participant number. Participants were suggested to quote this number as long as they desire to withdraw their data at a later time. No individuals withdrew their data.


Hypothesis 1: Clinical and Counselling psychologists will experience negative workplace serves.

Hypothesis 2: There will be a new in the degrees of psychological distress between those members who've experienced negative works and those who have not

Hypothesis 3: There will be a difference in the levels of well-being and resilience between those members who've experienced negative functions and those who have not

Hypothesis 4: There will be a difference in the levels of job satisfaction and propensity to between those individuals who have experienced negative serves and those who've not


The following actions were used for the analysis were shown to individuals as a questionnaire pack. This pack was divided into four areas and included the self-report steps described below. Permission was achieved from all the authors before the study. The questionnaires were piloted on two trainee clinical psychologists and two trained teachers to ascertain how long they would take to complete. Opinions was received on display and simple completion and the questionnaires were amended appropriately. Packs took no more than 30 minutes to complete.

Section A - Demographic sheet

Section B - Despair Anxiety and Stress Scales (DASS), The Resilience Level (RS), The Warwick-Edinburgh Mental Well-being Range (WEMWBS)

Section C - Negative Functions Questionnaire-Revised (NAQ-R)

Section D - General Job Satisfaction Level (GJSS), Propensity to Leave Scale

Section A - Demographic sheet

The demographic sheet was a non-standard strategy used to gain a description of the sample. All questions were devised by the researcher and revised in line with direction from the honest committee. The questions achieved information about members' gender, years (in 10 12 months bands), professional subject (specialized medical or counselling psychologist), country of qualification, year of qualification, declaration of equivalence status, section of speciality and ethnic position (key categories only).

Section B - Occupational health measures

Bullying literature talks about the mental impact of bullying therefore it was considered important to be aware of the mental health status of the participants. As previously talked about, strengths-based options are also lacking in current literature. As such, three options were included in the second section which looked into psychological stress, well-being and resilience.

The Depression Stress and anxiety Stress Scales (DASS)

The DASS is 42-item standardised strategy with a set of three scales designed to gauge the negative emotional states of depression, anxiety and stress. Each subscale includes 14 items on the scale, and respondents are asked to use a 4-point frequency level to rate the scope to that they have observed each state within the last week. It ought to be observed that the DASS is based on a dimensional idea of psychological disorder. This means there are no direct implications for identification of unhappiness or anxiety with regards to DSM or ICD-10 standards. Nevertheless, the results can be sorted into different degrees of seriousness (. i. e. light, moderate, severe) for each emotional state.

It is well-established that the DASS has good-excellent psychometric properties. The DASS has been proven to obtain good internal persistence across a range of samples as measured by Cronbach's alpha (e. g. Brown et al. , 1997; Martin et al. , 1998, Crawford & Henry, 2003). When compared to two others methods of psychological problems, the DASS was found to obtain adequate convergent and discriminant validity (Crawford & Henry, 2003). This solution was chosen generally because it of its strong validity and stability. In addition, it was thought that psychologists would have had less contact with the DASS than other scales of emotional distress, including the Hospital Nervousness and Depression Level (HADS).

The Resilience Size (RS)

The Resilience Size (RS) was developed by Wagnild & Young (1993) and was the first device to evaluate resilience directly. The scale consists of 25 goods that mirror five key characteristics of resilience; self-reliance, so this means, equanimity, perseverance and existential aloneness. A detailed explanation of how each of the scale items relates to these characteristics are available in Appendix. . Total resilience results range between 25 (least score) to 175 (maximum). Low resilience is suggested by a complete credit score of under 120, whereas moderate-low resilience is mentioned by a total credit score from 121 - 145. Moderate-high, or high resilience is indicated by a total rating which is greater than 145. In the beginning, the size was tested on a sizable test (n=782) of American middle-aged and more aged adults (Wagnild & Young, 1993). Surveys were dispatched (n=1500) out utilizing a arbitrary sampling method and a reply rate of 54% was achieved. Interior reliability of the RS was strong (r=0. 91). Since that time, the RS has shown high internal reliability consistency, with alpha coefficients ranging from 0. 84 to 0. 94 (ref). Self-report measures need to demonstrate an internal persistence of at least 0. 6 to be looked at reliable (Mykletun et al. , 2001).

This solution was chosen for the present study primarily because it is a strength-based strategy. As reviewed in the advantages section, traditional procedures contained in bullying research have been deficit-based. In addition, the scale is simple to operate and quick to complete, which were important given the number of measures contained in the questionnaire load up.

Section C - Measure of workplace bullying

The third section included only the principal measure of the present review, the Negative Acts Questionnaire. This achieved information about the prevalence of different negative work place acts (work environment bullying).

Negative Acts Questionnaire-Revised (NAQ-R)

The Negative Functions Questionnaire (NAQ-R) is currently the most frequently-used self-report solution employed in UK work environment bullying research. The initial 23-item version originated by Einarsen et al. in 1994 and included items regarding personal and work-related bullying behaviours. Despite high interior regularity and validity in Norwegian studies, when the NAQ was translated several ethnic biases were found. As a result, a modified 22-item version originated (the NAQ-R) which overcame these shortcomings. The psychometric properties of the NAQ-R have been well-established. A recent study (Einarsen et al. , 2009) proved the internal reliability of the NAQ-R items to be high when measured by Cronbach's alpha (0. 90). Confirmatory factor research revealed three primary factors: person-orientated bullying, work-related bullying and physical intimidation. All factor loadings exceeded. 70, and there have been high correlations between the various factors.

Respondents are asked to rate the rate of recurrence of different negative office acts during the last six months. Some items are task-orientated, (e. g. 'consistent criticism of your work and work') others are person-orientated (e. g. 'someone withholding information which influences your performance') and two are related to physical intimidation (e. g. 'threats of violence or physical maltreatment or actual abuse'). No reference point was created to 'bullying' so respondents do not understand what the items are measuring. Regarding to Einarsen and his co-workers (2009) this allows a more objective estimation of bullying behaviours than "self-labelling approaches". After rating the 22 negative serves, respondents are given a concrete meaning of office bullying (see release section) and asked to verify if they have been bullied or not. Consequently, data derived from the NAQ-R provides information about the occurrence of objective bullying behaviours in addition to self-categorisation of bullying. The range will not provide any information about the severity of the bullying, nor about the personal information of perpetrators.

It is worth noting that no standardised procedures currently exist which measure workplace bullying. At the moment, the NAQ-R remains to be the most user-friendly measure of bullying at work. It has been used in lots of peer-reviewed publicized studies and has seduced various reward in recent articles. Therefore, it was chosen as the key measure for today's study.

Section D - Job-related measures

The last section included two methods of job-related benefits; job satisfaction and propensity to leave.

Generic Job Satisfaction Scale

Job satisfaction was assessed using the 10-item General Job Satisfaction Level (GJSS), a self-report non-standard strategy developed by Macdonald & MacIntyre (1997). The things assess the strength of job satisfaction utilizing a five-point scale in relation to the respondents' current position. Interpretation of the GJSS is dependant on the total report achieved, which falls into one of three categories; low job satisfaction, moderate job satisfaction and high job satisfaction. The GJSS has been validated for use with a range of occupational groups, as does apply to different age groups (Macdonald & MacIntyre, 1997). Interior persistence was found to be satisfactory as assessed by Cronbach's alpha (0. 77). Positive correlations were found between your scale items and overall pleasure. The size was adversely correlated with job stress, boredom, isolation and threat of illness or accident.

It was chosen as it is easy to make use of, relatively brief and taps aspects of job satisfaction deemed relevant to employed in the NHS. For example, it generates information about respondents' satisfaction with management, as well as their emotions about their supervisor and trust. In addition, it includes a question about job security/insecurity. Given the current financial environment and the fast-changing character of the NHS, these questions looked specifically poignant for the present study.

Propensity to Leave Scale

Propensity to Leave was assessed by using a 4-item self-report solution produced by Bluedorn in 1982. The items assess the probability of the person going out of their current position within confirmed time span (e. g. "How do you rate your likelihood of quitting within the next 90 days?"). Responses receive over a seven-point scale which range from 'dreadful' (i. e. No chance) (1) to 'very good' (i. e. particular chance) (7). A higher score indicates an increased odds of propensity to leave.

The Index has an internal consistency


In order to check out ethics committee guidelines, the process for reaching consent from participants was paid particular importance. Potential individuals were initially sent a contact from a consultant in their own trust (e. g. director of treatments) which presented the research (see Appendix. . . ). Potential participants could select in by replying to this email with a copy with their work address included. Honest guidelines stipulated that members should opt-in to get the questionnaire load up, rather than opt-out. So, only participants who consented to be delivered the information were directed a pack to the address given in the email. The pack was proclaimed 'private and confidential' on the envelope to be able to protect it being exposed by another member of staff.

The packages included a participant information sheet including details about the study (see Appendix. . . ), a covering letter (see Appendix. . . ), the questionnaire pack entitled 'Work Well-Being Survey'(see Appendix. . . ), a consent form (see Appendix. . . ), a freepost attended to envelope and a supportive information sheet (please see paragraph below for details). Once received, involvement was voluntary and required written consent. Individuals did not have to complete the questionnaire load up and only one mass reminder was delivered (from the trust representative) to potential members via email. Due to the content of the analysis the researcher wished to avoid making members feel pressured to participate in the analysis. All data was accumulated and firmly stored over a computer which only the researcher acquired access to.

Ethical considerations

Approval to execute the research was gained from the relevant NHS Ethics and Research and Development Committees, alongside the College or university Research Ethics Committee. This guaranteed that the protection under the law and dignity of most participants were guarded (see Appendix. . . for characters of agreement). This process involved submitting a credit card applicatoin to each committee in accordance with their individual requirements.

It is clear that the study posed some ethical considerations for participants. The sensitive mother nature of the study may have made some participants feel uncomfortable or distressed after doing the questions, particularly if they had disclosed being truly a concentrate on of bullying. Given these ethical considerations, the following measures were devote destination to ensure that members were best recognized.

A cell phone hotline quantity where individuals could contact the researcher any week day from 9-5pm to go over their concerns

Contact details for an independent person (research employee at the University of Surrey) whom participants could contact as long as they have any concerns about the project which they could not discuss with the researcher

A set of supportive organisations related to workplace bullying and harassment (see Appendix. . . ). This sheet included details of where to find their trust plans on workplace bullying.

Data Analysis

Data analysis happened after data collection.

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