Disruptive Behavior in a High-power Distance Culture and a Three-dimensional Framework for Curbing It

Overview

Journal Health Care Manage Rev

Specialty Health Services

Date 2021 May 19

PMID 34009832

Citations 2

Authors

Sandy Lim

E-Yang Goh

Eugene Tay

Yew Kwan Tong

Deborah Chung

Kamala Devi

Chay Hoon Tan

Inthrani Raja Indran

Affiliations

Soon will be listed here.

Abstract

Background: Disruptive behavior can harm high-quality care and is prevalent in many Western public health systems despite increasing spotlight on it. Comparatively less knowledge about it is available in Asia, a region commonly associated with high-power distance, which may limit its effectiveness in addressing disruptive behavior.

Purpose: The aim of this study was to develop a comprehensive framework for tackling disruptive behavior among health care professionals in a public health system.

Methodology: A nationwide cross-sectional study relying on the Nurse-Physician Relationship Survey was conducted in Singapore. Four hundred eighty-six public health care professionals responded.

Results: Two hundred ninety-eight doctors (95.5%) and 163 nurses (93.7%) had witnessed a form of disruptive behavior. Doctors observed disruptive behavior committed by other doctors and nurses much more frequently than did nurses. Doctors made stronger associations between disruptive behavior and negative employee outcomes and between disruptive behavior and negative patient outcomes. Qualitative analyses of participants' open-ended answers produced a multipronged three-dimensional approach for tackling disruptive behavior: (a) deterrent measures, (b) development of knowledge and skills, and (c) demonstration of organizational commitment through proper norms, empathizing with staff, and structural reforms.

Practice Implications: Disruptive behavior is a multifaceted problem requiring a multipronged approach. Our three-dimensional framework is a comprehensive approach for giving health care professionals the capability, opportunity, and motivation to address disruptive behavior effectively.

Citing Articles

Issues and Perspectives for the Study of Disruptive Clinician Behavior.

Fujimoto M Cureus. 2024; 16(6):e63314.

PMID: 38938907 PMC: 11210996. DOI: 10.7759/cureus.63314.

Kindness Isn't Just about Being Nice: The Value Proposition of Kindness as Viewed through the Lens of Incivility in the Healthcare Workplace.

Fryburg D Behav Sci (Basel). 2023; 13(6).

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