The mediating effect of job satisfaction on the relationship between workplace bullying and organizational citizenship behavior in nurses

Abstract

BACKGROUND:

Establishing strategies for improving nursing shortages, which are labor challenges in the current health care industry.

OBJECTIVE:

This study aimed to examine the correlation between workplace bullying and organizational citizenship behavior (OCB) in nurses and the mediating effects of job satisfaction on this relationship.

METHODS:

A total of 164 valid samples were obtained. The Negative Acts Questionnaire-Revised, the Minnesota Satisfaction Questionnaire, and an OCB scale were measured.

RESULTS:

The results indicate that a significantly larger proportion of nurses working in operating rooms (Δ odds ratio, odds = 2.30, p = 0.043), the emergency room, and the ICU (Δ odds = 2.79, p = 0.019) had suffered workplace bullying compared with nurses working in patient wards. No experience of workplace bullying exerted a positive and significant effect on job satisfaction (p < 0.001), and job satisfaction exerted a positive and significant effect on overall OCB (p < 0.001). No experience of workplace bullying exerted a significant mediating effect on the influence of job satisfaction on overall OCB (p < 0.001).

CONCLUSIONS:

The department of service in which a nurse works influences the occurrence of workplace bullying, previous experience with bullying reduces job satisfaction, and greater job satisfaction promotes higher OCB performance. Based on the study results, we advise that nursing executives address and prevent workplace bullying to increase the job satisfaction of nurses so that nurses are willing to display OCB, apply their expertise, and expand the role and functions of nursing.

Keywords

Organizations workplace bullying satisfaction staff nurse

1 Introduction

Workplace bullying is a regular concern in health care environments that can result in nurses feeling insecure at work, which affects their work efforts and the quality of patient care [1]. Workplace bullying often occurs in the form of overbearing workloads, rumors, indifference, disregard, or lack of assignments [2]. Research has shown that workplace bullying can adversely affect the physical and mental status of employees and can result in work dissatisfaction, resignation, and even physical and mental health warnings to the employees [3].

In another aspect, OCB is a spontaneous employee behavior that cannot be controlled by organizations through official reward and punishment systems [4]. Presently, in academia, it is widely believed that organizational success relies on employees actively going above and beyond the scope of their duties [5]. Indeed, organizations are able to attain their goals only when their employees display OCBs such as being dedicated, helping others, and proactively offering suggestions [6].

In studies on OCB, researchers have focused on defining OCB and the relationships among various variables. Among the antecedent variables influencing OCB, job satisfaction is one of the most common variables cited by researchers [7, 8]. In one meta-analysis, Podsakoff et al. revealed that job satisfaction is one of the variables that is most highly correlated to OCB [9]. Thus, job satisfaction is a crucial index in research on organizations, because the degree of job satisfaction influences employees’ work attitude and their behavior toward organizations. Based on the aforementioned findings, this study evaluated the influence of job satisfaction on OCB.

Gunay discovered a strong positive correlation between group job satisfaction and OCB; greater satisfaction means more apparent OCB and also indicates that the positive attitudes shared within groups may create a concept with which group members agree, which influences the group collaborative behaviors of employees [10]. At present, few studies have explored workplace bullying, job satisfaction, and OCB among nurses. Whether nurses display negative work attitudes due to workplace bullying and thereby present poorer OCB and whether job satisfaction mediates the relationship between workplace bullying and OCB require further investigation.

This study focused on workplace bullying, job satisfaction, and OCB. Specifically, the influence of workplace bullying on the job satisfaction and OCB of clinical nurses was investigated. We compiled theories and literature relevant to OCB, workplace bullying, and job satisfaction, and used them to formulate our research hypotheses. Figure 1 displays our research framework, and the research hypotheses were as follows:

H1: Personal background variables significantly influence whether an employee is bullied.

H2: Whether an employee is bullied is a predictor of their job satisfaction.

H3: Job satisfaction is significantly correlated to OCB.

H4: Job satisfaction mediates the influence of workplace bullying on the OCB of an employee.

Fig. 1

Research framework. Abbreviations: OCBO, organizational citizenship behavior toward organization; OCBJ, organizational citizenship behavior toward job; OCBC, organizational citizenship behavior toward co-worker; OCB, organizational citizenship behavior.

2 Methods

2.1 Sample

We adopted a cross-sectional and correlational research design. The sampling targets were nurses at a regional teaching hospital in Taiwan. After approval was obtained from the Institutional Review Board (IRB), we excluded nurses with ranks higher than assistant head nurse. Using convenience sampling, we surveyed nurses in clinics, the emergency room (ER), the intensive care unit (ICU), operating rooms (OR), patient wards, and six other departments. To ensure that the information contained in the survey remained confidential, every completed questionnaire was sealed within dedicated envelopes and handed to a third party (i.e., the researchers). No direct supervisors handled the questionnaires. The following note was placed at the start of the questionnaire as an assurance for the respondents: “The content of this questionnaire is for research purposes only. Your direct supervisor and place of employment will have no access to the responses in this questionnaire. Your responses will not be handled separately nor disclosed and will never be shown to your supervisor. Please be assured that all information and responses are completely confidential.” The survey was also anonymous to protect the privacy of the respondents, and the questionnaires were retrieved after two weeks. The questionnaires were circulated and recovered between January 1 and February 29, 2016. A total of 200 questionnaires were distributed during this two-month period; at the end of this period, 197 questionnaires were recovered. After excluding 33 invalid questionnaires that were incomplete or contained obvious contradictions, we obtained a total of 164 valid questionnaires, resulting in a valid recovery rate of 82%.

2.2 Data collection

The questionnaire contained four parts: the Negative Acts Questionnaire-Revised (NAQ-R), the short form of the Minnesota Satisfaction Questionnaire (MSQ), the OCB scale, and a demographic attribute questionnaire. These parts are described in detail in the following paragraphs.

The NAQ was developed by Einarsen and Raknes based on a literature review and opinions from victims of workplace bullying [11]. The questionnaire measures the frequency of improper or unreasonable behavior from coworkers or supervisors that the respondent experienced within the previous 6 months. Einarsen and Raknes later developed the NAQ-R, which contains 22 items that are measured using a 5-point Likert scale. A total NAQ-R score of more than 23 is interpreted as being bullied. The Cronbach’s α of this scale has ranged from 0.88 to 0.92 [12]; for the Chinese version of the NAQ-R, the Cronbach’s α was 0.98, indicating high reliability [13].

The short form of the MSQ [14] contains 20 items, and the responses to these items are evaluated using a 5-point Likert scale, with 1 indicating strong dissatisfaction and 5 indicating strong satisfaction [14]. The total score represents the overall satisfaction of the respondents with their job at the time of evaluation. A higher score indicates a greater degree of satisfaction. Regarding internal consistency, Cronbach’s α was 0.90 for the original MSQ and 0.93 for the Chinese version of the MSQ [15].

The OCB scale, developed by Williams and Anderson [16], is divided into two constructs: organizational citizenship behavior toward organization (OCBO), which is OCBs that directly benefit certain individuals and make indirect contributions to the organization, and organizational citizenship behavior toward individual (OCBI), which is OCBs that benefit the individuals directly [16]. Subsequently, Chen et al. [17] divided the original OCB scale into three constructs: organizational citizenship behavior toward job (OCBJ), organizational citizenship behavior toward organization (OCBO), and organizational citizenship behavior toward co-worker (OCBC). OCBJ refers to the degree to which members follow organizational rules, fulfill their obligations and responsibilities, voluntarily take on tasks beyond what their supervisors ask, and achieve beyond the goals set by the organization. OCBO encompasses acts that benefit the organization. OCBC encompasses all citizenship behaviors that help and benefit coworkers [17]. These constructs are measured using a 5-point Likert scale, with a higher score indicating a greater degree of OCB. Cronbach’s α has been measured as 0.79, 0.82, and 0.80, respectively [18].

Finally, the demographic questionnaire collected information on various demographic variables, including gender, age, marital status, educational background, department of service, and years of service.

2.3 Statistical methods

Upon reception, the questionnaires were verified and organized. We then numbered and filed the valid questionnaires and analyzed them using IBM SPSS 22.0. We first used the Cramer’s V method in the chi-square test to obtain the intercorrelations between different nurse attributes. Using a chi-square test, we examined whether experiences of workplace bullying of nurses varied across different demographic attributes. The degrees of correlation between different departments of service and experiences of workplace bullying were examined using binary logistic regression. Using an independent sample t-test and one-way analysis of variance (ANOVA), we also explored whether job satisfaction, various aspects of OCB, and the overall OCB of the nurses varied across different attributes. Subsequently, we used a simple regression analysis to determine the degree of influence of the variables and the correlations among them using SPSS and the macro PROCESS v2.16 developed by Hayes [19]. In the PROCESS interface, we selected the mediation model for analysis. Additionally, we adopted the Sobel test to determine significance and the bootstrap method to verify significance [20, 21].

3 Results

3.1 Intercorrelations between different nurse attributes

Out of the 164 valid questionnaires, 160 of the respondents were female nurses, accounting for 97.6% of the respondents. The largest age group comprised nurses between the ages of 21 and 25 (53 respondents, 32.3%). The vast majority of the respondents were single or divorced (131 respondents, 79.9%). In terms of educational background, 100 respondents (61.0%) graduated from university or higher. For the department of service, 78 respondents worked in patient wards (47.6%). In total years of service, the largest group had less than three years of experience (57 respondents, 34.8%). Among the basic attributes of nurses, age was significantly correlated with marital status, educational background, department of service, and years of service. Marital status was significantly correlated with years of service, and department of service was significantly correlated with years of service (Table 1).

Table 1
Descriptive statistics and intercorrelations among different attributes of nurses (N = 164)

Demographic information N % 1 2 3 4 5 6

1.Gender Female 160 97.6 – 0.11 0.12 0.13 0.05 0.22

Male 4 2.4

2. Age (years) 21–25 53 32.3 – – 0.51^*** 0.27^* 0.22^* 0.69^*

26–30 49 29.9

31–35 41 25.0

≥36 21 12.8

3. Marital status Single or divorced 131 79.9 – – – 0.09 0.18 0.44^*

Married 33 20.1

4. Educational background Junior college 64 39.0 – – – – 0.07 0.14

University or above 100 61.0

5. Department of service Clinic 12 7.3 – – – – – 0.19^*

ER and ICU 33 20.1

OR 41 25.0

Patient ward 78 47.6

6. Years of service < 3 57 34.8 – – – – – –

3 to < 7 40 24.4

7 to < 11 39 23.8

≥11 28 17.0

Demographic information	N	%	1	2	3	4	5	6
1.Gender	Female	160	97.6	–	0.11	0.12	0.13	0.05	0.22
	Male	4	2.4
2. Age (years)	21–25	53	32.3	–	–	0.51^***	0.27^*	0.22^*	0.69^***
	26–30	49	29.9
	31–35	41	25.0
	≥36	21	12.8
3. Marital status	Single or divorced	131	79.9	–	–	–	0.09	0.18	0.44^***
	Married	33	20.1
4. Educational background	Junior college	64	39.0	–	–	–	–	0.07	0.14
	University or above	100	61.0
5. Department of service	Clinic	12	7.3	–	–	–	–	–	0.19^*
	ER and ICU	33	20.1
	OR	41	25.0
	Patient ward	78	47.6
6. Years of service	< 3	57	34.8	–	–	–	–	–	–
	3 to < 7	40	24.4
	7 to < 11	39	23.8
	≥11	28	17.0

^*p < 0.05, ^***p < 0.001. Abbreviations: ER, emergency room; ICU, intensive care unit; OR, operating room.

3.2 Differences in experiences of workplace bullying of nurses across different attributes

As shown in Table 2, the chi-square test results reached significance for experience of workplace bullying only for department of service (p < 0.05). This finding implied that experiences of workplace bullying of the nurses varied significantly depending on the department in which they worked. Specifically, experiences of workplace bullying were significantly more common in OR (70.73%) and in the ER and ICU (75.76%) than in the clinics (50.00%) or patient wards (51.28%). By contrast, the chi-square test results for gender, age, marital status, educational background, and years of service did not reach significance. (Table 2).

Table 2
Chi-square test results of differences in experiences of workplace bullying of nurses and job satisfaction across different attributes (N = 164)

Demographic information Number of people No bullying experienced Bullying experienced χ² Job satisfaction F/t

N % N % Mean SD

Gender 0.21 –0.70

Female 160 62 38.75 98 61.25 70.87 11.09

Male 4 2 50.00 2 50.00 74.75 6.02

Age (years) 2.53 1.00

21–25 53 23 43.40 30 56.60 70.04 11.42

26–30 49 20 40.82 29 59.18 69.96 10.06

31–35 41 16 39.02 25 60.98 71.59 11.54

≥36 21 5 23.81 16 76.19 74.43 10.92

Marital status 1.32 –1.61

Single or divorced 131 54 41.22 77 58.78 70.27 10.91

Married 33 10 30.30 23 69.70 73.70 11.10

Educational background 0.08 –1.20

Junior college 64 26 40.63 38 59.38 69.72 12.01

University or above 99 38 38.38 61 61.62 71.84 10.30

Department of service 8.36^* 2.55

Clinic 12 6 50.00 6 50.00 79.17 11.55

ER and ICU 33 8 24.24 25 75.76 70.91 10.03

OR 41 12 29.27 29 70.73 69.68 10.28

Patient ward 78 38 48.72 40 51.28 70.40 11.34

Years of service 7.69 0.22

< 3 57 24 42.11 33 57.89 71.02 11.12

3 to < 7 40 10 25.00 30 75.00 70.33 10.69

7 to < 11 39 21 53.85 18 46.15 70.51 12.13

≥11 28 9 32.14 19 67.86 72.39 9.91

Demographic information	Number of people	No bullying experienced	Bullying experienced	χ²	Job satisfaction	F/t
Gender						0.21			–0.70
Female	160	62	38.75	98	61.25		70.87	11.09
Male	4	2	50.00	2	50.00		74.75	6.02
Age (years)						2.53			1.00
21–25	53	23	43.40	30	56.60		70.04	11.42
26–30	49	20	40.82	29	59.18		69.96	10.06
31–35	41	16	39.02	25	60.98		71.59	11.54
≥36	21	5	23.81	16	76.19		74.43	10.92
Marital status						1.32			–1.61
Single or divorced	131	54	41.22	77	58.78		70.27	10.91
Married	33	10	30.30	23	69.70		73.70	11.10
Educational background						0.08			–1.20
Junior college	64	26	40.63	38	59.38		69.72	12.01
University or above	99	38	38.38	61	61.62		71.84	10.30
Department of service						8.36^*			2.55
Clinic	12	6	50.00	6	50.00		79.17	11.55
ER and ICU	33	8	24.24	25	75.76		70.91	10.03
OR	41	12	29.27	29	70.73		69.68	10.28
Patient ward	78	38	48.72	40	51.28		70.40	11.34
Years of service						7.69			0.22
< 3	57	24	42.11	33	57.89		71.02	11.12
3 to < 7	40	10	25.00	30	75.00		70.33	10.69
7 to < 11	39	21	53.85	18	46.15		70.51	12.13
≥11	28	9	32.14	19	67.86		72.39	9.91

^*p < 0.05. Abbreviations: SD, standard deviation; ER, emergency room; ICU, intensive care unit; OR, operating room.

The model results in Table 4 show that the department of service in which a nurse worked exerted a significant impact on experience of workplace bullying (Cox & Snell R² = 19.66, p = 0.036), where Exp (B) = 2.97 (p = 0.019) for ER and ICU vs Patient ward. In other words, Δodds ratio (odds) = 2.79, indicating that the odds of ER and ICU nurses experiencing workplace bullying was 2.79 times higher than that of patient ward nurses. For OR vs Patient ward, Exp (B) = 2.30 (p = 0.043). In other words, Δodds = 2.30, indicating that the odds of OR nurses experiencing workplace bullying was 2.30 times higher than that of patient ward nurses.

Table 4

Summary table of regression coefficients regarding influence of department of service on experience of workplace bullying of nurses (N = 164)

Variable	B	Exp (B)	p
Constant	0.05	1.05	0.821
Department of service
Clinic vs Patient ward	–0.05	0.95	0.934
ER and ICU vs Patient ward	1.09	2.97	0.019^*
OR vs Patient ward	0.83	2.30	0.043^*
Model summary
Cox & Snell R²		0.05
p		0.036^*

^*p < 0.05, ^***p < 0.001.

3.3 Differences in nurses’ job satisfaction across different attributes

Results following t-tests and one-way analysis of variance (ANOVA) for gender, age, marital status, educational background, and years of service did not reach significance. In addition, job satisfaction scores of the nurses were not significantly different across gender, age, marital status, educational background, department of service, or years of service (Table 2).

3.4 Differences in nurses’ OCB across different attributes

For the various aspects of OCB and overall OCB, t-test results for gender, marital status, educational background, and years of service did not reach significance. By contrast, the F statistic for age reached significance for OCBO (p < 0.05). A comparison of the means showed that the OCBO scores of nurses aged 36 years or older (M = 18.71, SD = 3.21) were significantly higher than those of nurses aged between 21 and 25 years (M = 15.83, SD = 3.04). Thus, older nurses displayed higher performance in behaviors that benefitted the organization (Table 3).

Table 3
Summary of analyses of overall organizational citizenship behavior (OCB) and aspects of nurses across different ages and department (N = 164)

Aspect Age (years) Number of people post hoc comparison Mean (SD) F Scheffe’s Department Number of people Mean (SD) F Scheffe’s post hoc comparison

OCBO 21–25 53 15.83 (3.04) 4.67^ 4 > 1 Clinic 12 18.00 (2.30) 1.50

26–30 49 17.06 (2.66) ER and ICU 33 16.21 (3.95)

31–35 41 16.59 (3.46) OR 41 17.29 (2.93)

≥36 21 18.71 (3.21) Patient ward 78 16.51 (3.00)

OCBJ 21–25 53 31.09 (4.67) 0.93 Clinic 12 36.00 (3.89) 7.24^* 1 > 3, 4

26–30 49 31.80 (4.17) ER and ICU 33 32.42 (4.33)

31–35 41 31.22 (4.30) OR 41 31.88 (3.93)

≥36 21 32.86 (4.58) Patient ward 78 30.35 (4.29)

OCBC 21–25 53 16.04 (2.62) 0.32 Clinic 12 18.33 (2.10) 4.60^ 1 > 3, 4

26–30 49 16.24 (2.08) ER and ICU 33 16.42 (2.56)

31–35 41 16.39 (2.30) OR 41 16.00 (1.92)

≥36 21 15.86 (2.22) Patient ward 78 15.81 (2.29)

Overall OCB 21–25 53 62.96 (9.16) 1.50 Clinic 12 72.33 (7.00) 5.00^ 1 > 4

26–30 49 65.10 (7.43) ER and ICU 33 65.06 (9.52)

31–35 41 64.20 (8.47) OR 41 65.17 (7.54)

≥36 21 67.43 (9.41) Patient ward 78 62.67 (8.26)

Aspect	Age (years)	Number of people post hoc comparison	Mean (SD)	F	Scheffe’s	Department	Number of people	Mean (SD)	F	Scheffe’s post hoc comparison
OCBO	21–25	53	15.83 (3.04)	4.67^**	4 > 1	Clinic	12	18.00 (2.30)	1.50
	26–30	49	17.06 (2.66)			ER and ICU	33	16.21 (3.95)
	31–35	41	16.59 (3.46)			OR	41	17.29 (2.93)
	≥36	21	18.71 (3.21)			Patient ward	78	16.51 (3.00)
OCBJ	21–25	53	31.09 (4.67)	0.93		Clinic	12	36.00 (3.89)	7.24^***	1 > 3, 4
	26–30	49	31.80 (4.17)			ER and ICU	33	32.42 (4.33)
	31–35	41	31.22 (4.30)			OR	41	31.88 (3.93)
	≥36	21	32.86 (4.58)			Patient ward	78	30.35 (4.29)
OCBC	21–25	53	16.04 (2.62)	0.32		Clinic	12	18.33 (2.10)	4.60^**	1 > 3, 4
	26–30	49	16.24 (2.08)			ER and ICU	33	16.42 (2.56)
	31–35	41	16.39 (2.30)			OR	41	16.00 (1.92)
	≥36	21	15.86 (2.22)			Patient ward	78	15.81 (2.29)
Overall OCB	21–25	53	62.96 (9.16)	1.50		Clinic	12	72.33 (7.00)	5.00^**	1 > 4
	26–30	49	65.10 (7.43)			ER and ICU	33	65.06 (9.52)
	31–35	41	64.20 (8.47)			OR	41	65.17 (7.54)
	≥36	21	67.43 (9.41)			Patient ward	78	62.67 (8.26)

^**p < 0.01, ^***p < 0.001. Abbreviations: OCBO, organizational citizenship behavior toward organization; OCBJ, organizational citizenship behavior toward job; OCBC, organizational citizenship behavior toward co-worker; OCB, organizational citizenship behavior. SD, standard deviation; ER, emergency room; ICU, intensive care unit; OR, operating room.

Furthermore, OCBJ, OCBC, and overall OCB scores were not significantly different. The F test results for the department of service reached significance for OCBJ, OCBC, and overall OCB (p < 0.05). Scheffe’s post hoc comparison revealed that clinic nurses (M = 36.00, SD = 3.89) scored significantly higher in OCBJ than did those in the OR (M = 31.88, SD = 3.93) and patient wards (M = 30.35, SD = 4.29). Clinic nurses (M = 18.33, SD = 2.10) also scored significantly higher in OCBC than did nurses in the OR (M = 16.00, SD = 1.92) and patient wards (M = 15.81, SD = 2.29). Additionally, clinic nurses (M = 72.33, SD = 7.00) scored significantly higher in overall OCB than did those in patient wards (M = 62.67, SD = 8.26). In summary, clinic nurses displayed higher OCB performance than did nurses in the OR and patient wards (Table 3).

3.5 Influence of experience of workplace bullying on job satisfaction and influence of job satisfaction on OCB

Whether nurses had experienced workplace bullying was not significantly connected to OCB (Table 5). Shrout and Bolger believe that this does not affect the mediating effect of job satisfaction on the relationship between workplace bullying and OCB [21]. The results in Table 5 show that having an experience of workplace bullying exerted a significant and negative effect on job satisfaction (β= –0.27, p < 0.001), with 7.2% explanatory power. Furthermore, job satisfaction exerted a significant and positive effect on OCBJ (β= 0.54, p < 0.001), OCBO (β= 0.55, p < 0.001), OCBC (β= 0.50, p < 0.001), and overall OCB (β= 0.62, p < 0.001), with 29.0%, 30.6%, 24.6%, and 38.3% explanatory power, respectively (Table 4).

Table 5
Summary of regression coefficients for relationships between variables (N = 164)

Independent variable Dependent B SE β t R ²

variable

Experience of workplace bullying OCBJ –0.46 0.71 –0.05 –0.66 0.003

OCBO –0.73 0.51 –0.11 –1.45 0.013

OCBC –0.65 0.37 –0.14 –1.77 0.019

Overall OCB –1.85 1.37 –0.11 –1.35 0.011

Experience of workplace bullying Job satisfaction –6.03 1.70 –0.27 –3.55^* 0.072

Job satisfaction OCBJ 0.16 0.02 0.54 8.14^* 0.290

OCBO 0.22 0.03 0.55 8.46^* 0.306

OCBC 0.11 0.01 0.50 7.28^* 0.246

Overall OCB 0.48 0.05 0.62 10.02^*** 0.383

Independent variable	Dependent	B	SE	β	t	R ²
Experience of workplace bullying	OCBJ	–0.46	0.71	–0.05	–0.66	0.003
	OCBO	–0.73	0.51	–0.11	–1.45	0.013
	OCBC	–0.65	0.37	–0.14	–1.77	0.019
	Overall OCB	–1.85	1.37	–0.11	–1.35	0.011
Experience of workplace bullying	Job satisfaction	–6.03	1.70	–0.27	–3.55^***	0.072
Job satisfaction	OCBJ	0.16	0.02	0.54	8.14^***	0.290
	OCBO	0.22	0.03	0.55	8.46^***	0.306
	OCBC	0.11	0.01	0.50	7.28^***	0.246
	Overall OCB	0.48	0.05	0.62	10.02^***	0.383

Note: B, SE, and β respectively denote the unstandardized regression coefficient, standard error, and standardized regression coefficient. ^*p < 0.05, ^***p < 0.001. Abbreviations: OCBJ, organizational citizenship behavior toward job; OCBO, organizational citizenship behavior toward organization; OCBC, organizational citizenship behavior toward co-worker; OCB, organizational citizenship behavior.

3.4 Mediation of job satisfaction on the influence of experience of workplace bullying on OCB

Table 6 reveals the bootstrap and Sobel test results regarding the mediation of job satisfaction on the influence of workplace bullying on OCBJ, OCBO, OCBC, and overall OCB. For OCBJ, the 95% confidence interval (95% CI) between –1.63 and –0.41, and the Sobel test results indicated that the mediation reached significance (Z = –3.22, p < 0.01). This finding implied that job satisfaction is a mediator of the influence of experience of workplace bullying on OCBJ. For OCBO, the bootstrap results showed that the 95% CI was between –2.32 and –0.57, and the Sobel test results indicated that the mediation reached significance (Z = –3.26, p < 0.01). This finding implied that job satisfaction is a mediator of the influence of experience of workplace bullying on OCBO. For OCBC, the bootstrap results showed that the 95% CI between –1.11 and –0.27, and the Sobel test results indicated that the mediation reached significance (Z = –3.13, p < 0.01). This finding implied that job satisfaction is a mediator of the influence of experience of workplace bullying on OCBC. Finally, for overall OCB, the bootstrap results revealed that the 95% CI was between –4.99 and –1.29; the Sobel test results also indicated that the mediation reached significance (Z = –3.32, p < 0.01). This finding implied that job satisfaction is a mediator of the influence of experience of workplace bullying on overall OCB.

Table 6
Summary of indirect result (N = 164)

Indirect paths X→M M→Y^Note 1 a×b Sobel Z

B SE B SE 95% CI

Experience of workplace bullying → Job satisfaction → OCBJ –6.03^* 1.70 0.16^* 0.02 –1.63 to –0.41 –3.22^

Experience of workplace bullying → Job satisfaction → OCBO –6.03^* 1.70 0.23^* 0.03 –2.32 to –0.57 –3.26^

Experience of workplace bullying → Job satisfaction → OCBC –6.03^* 1.70 0.10^* 0.01 –1.11 to –0.27 –3.13^

Experience of workplace bullying → Job satisfaction → Overall OCB –6.03^* 1.70 0.50^* 0.05 –4.99 to –1.29 –3.32^*

Indirect paths	X→M	M→Y^Note 1	a×b	Sobel Z
Experience of workplace bullying → Job satisfaction → OCBJ	–6.03^***	1.70	0.16^***	0.02	–1.63 to –0.41	–3.22^**
Experience of workplace bullying → Job satisfaction → OCBO	–6.03^***	1.70	0.23^***	0.03	–2.32 to –0.57	–3.26^**
Experience of workplace bullying → Job satisfaction → OCBC	–6.03^***	1.70	0.10^***	0.01	–1.11 to –0.27	–3.13^**
Experience of workplace bullying → Job satisfaction → Overall OCB	–6.03^***	1.70	0.50^***	0.05	–4.99 to –1.29	–3.32^***

Note 1: The regression coefficient of M with regard to Y refers to the result from a controlled X and refers to the regression coefficient of M in the X+M→Y model. Note 2: X, M, and Y respectively denote the independent variable, mediation variable, and dependent variable. Note 3: B, SE, and p respectively denote the unstandardized regression coefficient, standard error, and significance. ^**p < 0.01, ^***p < 0.001. Abbreviations: OCBO, organizational citizenship behavior toward organization; OCBJ, organizational citizenship behavior toward job; OCBC, organizational citizenship behavior toward co-worker; OCB, organizational citizenship behavior.

4 Discussion

The study results indicated that a significantly higher proportion of nurses working in ORs, the ER, and the ICU experienced workplace bullying than did those working in patient wards, the findings of which are similar to previous studies. Thus, H1 was supported, meaning that personal background variables significantly influence whether an employee is bullied. In busy and stressful work environments, excessive time and work pressure are both predictors of a high risk of workplace bullying [22 –24]. Nursing in ORs is particularly busy and fast-paced and involves long hours; thus, ORs are indeed highly stressful work environments [25]. Two other studies also found that the ER and ICU are high-risk venues for workplace bullying [26, 27]. Yun et al. investigated 134 ICU nurses in five hospitals and found that 94.0% of the nurses had encountered negative behavior in the preceding 6 months, and work-related bullying was the most common negative behavior [28].

Studies have found that being bullied in the workplace can exert a negative effect on an individual’s mentality, causing anxiety, depression, and post-traumatic syndrome [29, 30]. Studies have also indicated that workplace bullying can promote absenteeism, affect job satisfaction, and increase turnover, all of which create an even more unstable work environment [31, 32]. These aforementioned results indicate that encountering bullying induces a lower level of job satisfaction, which is consistent with the current study findings. It is worth noting that cultural factors can also reinforce perceptions of workplace bullying. An investigation by Loh et al. on workplace bullying among Australian and Singaporean employees found that employees bullied in the workplace had low job satisfaction and that the two had a negative relationship. Furthermore, those researchers observed that after being bullied in the workplace, Australian employees displayed lower job satisfaction than did Singaporean employees [33]. Note that the nurses participating in this study were all Taiwanese.

Workplace bullying indirectly affects organizations, individuals, and the work environment. Numerous studies have found that bullying adversely affects physical and mental health. It triggers fear, anxiety, reduced confidence, and depression in the bullied individuals, and can lead to chronic fatigue, sore muscles, cardiovascular diseases, or sleep disorders [34 –36]. Sharma asserted that the influence of workplace bullying on individuals can be observed at the organizational level, reducing positivity and creativity on the whole and substantially increasing errors [37]. Workplace bullying also decreases the satisfaction that employees derive from their job and the organization and increases turnover. Research has also confirmed that workplace bullying adversely affects organization operations by resulting in fewer organizational citizenship relations among employees, poorer interactions among coworkers, and less team spirit and motivation to help each other [38]. The aforementioned results demonstrate that encountering bullying prompts a lower level of job satisfaction and restrains OCB, supporting the findings of the current study. Thus, H2 was supported, which means that whether an employee is bullied is a predictor of their job satisfaction.

The present study results also indicated that nurses who are more satisfied with their job demonstrate higher performance in overall OCB and in the various aspects of OCB, namely OCBJ, OCBO, and OCBC. Thus, H3 was supported, indicating that job satisfaction is significantly correlated to OCB. Employees who feel a higher degree of job satisfaction view their workplace in a more positive light, are more willing to help others, and display higher work performance [39]. Furthermore, highly satisfied employees acted in the interests of the organization and devoted effort toward improving the organization. Some studies have also indicated that the degree of job satisfaction experienced by nurses can be used to predict their work conditions, the amount of their job security, their interactive relationships with coworkers and supervisors, their salary, the amount of responsibility borne, and the time spent on work [40, 41].

Baillien et al. proposed a three-way model for workplace bullying and indicated that employees often adopt ineffective ways (i.e., active aggression, which means becoming perpetrators, and/or passive aggression, which involves gradually decreasing one’s work performance or one’s trust in the organization) of coping with frustrations felt from being bullied in the workplace. These result in poorer job satisfaction and may increase negative interpersonal behavior; thus, poor workplace environments and cultures slowly develop. Furthermore, a lack of trust within organizations affects OCB [42]. Aside from this study finding in which a direct causal relationship exists between experiences of workplace bullying and OCB among nurses, the mediation model indicated that being bullied in the workplace also affects job satisfaction of nurses, which then influences their OCB via job satisfaction (mediator). Thus, job satisfaction (mediator) can be used to elucidate the relationship between being bullied and OCB, supporting H4. The OCB of nurses who have not experienced workplace bullying can be enhanced by increasing their job satisfaction, which can then generate more effective organizational operations.

4.1 Study strengths and limitations

This study demonstrated that job satisfaction is a mediator of the influence of workplace bullying on OCB, which highlights the importance of immediately addressing workplace bullying. Bullying in the nursing profession not only affects the job satisfaction of the nurses being bullied but also affects the positive behavior among nurses in the entire organization and their efforts for the group. However, this study was a cross-sectional study and could only demonstrate that correlations exist among workplace bullying, job satisfaction, and OCB for nurses but could not determine what the causal relationships among the variables were. Furthermore, we adopted convenience sampling in a single organization. Most of the participating nurses were younger women, which may affect the generalizability of the study results to other hospitals or countries. In addition, data were collected from questionnaires that the respondents filled out themselves; therefore, we had no control over the environment in which they filled out the questionnaire and could not immediately answer any questions that they may have had about the question items. Thus, this may have affected the quality of the recovered questionnaires.

5 Conclusion

The study results indicate that the department of service influences the occurrence of workplace bullying. A significantly higher proportion of nurses working in ORs, the ER, and the ICU experience workplace bullying than do those working in patient wards. Moreover, the OCB performance of nurses also varies depending on the department in which they work, and a previous experience of bullying reduces job satisfaction and affects overall OCB. By contrast, greater job satisfaction promotes higher OCB performance. Based on the study results, we advise that nursing executives address and prevent workplace bullying to increase the job satisfaction of nurses so that nurses are willing to display OCB, apply their expertise, and expand the role and functions of nursing.

In summary, experience of workplace bullying is correlated with job satisfaction; furthermore, work ability, rotating shifts, and cognitive failures of nurses also influence their job satisfaction [43 –45]. We therefore suggest that future studies add such variables to their investigations.

Footnotes

Acknowledgments

The authors thank the anonymous reviewers and editor for their comments.

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical approval

This study was the subproject of a larger project. Data collection and analysis were performed after obtaining approval from the Institutional Review Board of Chi Mei Hospital (Approval number 10409-001).

Funding

This was a personal study with no additional funding.

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