title: Mobbing, stress, and work ability index among physicians in Bosnia and Herzegovina: survey study.
abstract: OBJECTIVE
  To assess the frequency of reported mobbing and the association among mobbing, working environment factors, stress, health outcome, personality type, and work ability index in a sample of physicians in Bosnia and Herzegovina.
  
  
  METHODS
  We conducted a questionnaire survey using a validated self-reported questionnaire among 511 physicians in national health sector of Bosnia and Herzegovina. The questions covered five major categories of mobbing behavior. Characteristics of the work, perceived work environment and its effects, stress, health, and satisfaction with work and life were assessed by the standardized abridged form of Occupational Stress Questionnaire (OSQ). A standardized questionnaire Work Ability Index (WAI) was used to determine the relation between mobbing and work ability.
  
  
  RESULTS
  Of 511 surveyed physicians, 387 (76%) physicians self-reported mobbing behavior in the working environment and 136 (26%) was exposed to persistent mobbing. More than a half of the physicians experienced threats to their professional status and almost a half felt isolated. Logistic regression analysis showed that lack of motivation, loss of self-esteem, loss of confidence, fatigue, and depressiveness were significantly associated with lack of support from colleagues. Intention to leave work was associated with lack of support from colleagues (OR 2.3, 95% CI, 1.065-3.535; t =4.296, P =0.003) and lack of support from superiors (OR 1.526, 95% CI, 0.976-2.076; t =5.753; P =0.001). Isolation or exclusion and threats to professional status were predictors for mental health symptoms. Persistent mobbing experience was a significant predictor for sick leave.
  
  
  CONCLUSIONS
  Exposure to persistent threat to professional status and isolation or exclusion as forms of mobbing are associated with mental health disturbances and lack of self-esteem and confidence. Setting up a system of support for physicians exposed to mobbing may have important benefits.
authors.affiliation: 1Department of Occupational Medicine, Tuzla University School of Medicine, Tuzla, Bosnia and Herzegovina. pranicnurka@hotmail.com
authors.forename: Nurka
authors.initials: N
authors.lastname: Pranjić
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Males-Bilić
authors.forename: Azijada
authors.initials: A
authors.lastname: Beganlić
authors.forename: Jadranka
authors.initials: J
authors.lastname: Mustajbegović
mesh_terms: D000328:Adult; D000378:Agonistic Behavior; D017522:Bosnia and Herzegovina; D005260:Female; D006304:Health Status; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*; D014938:Work Capacity Evaluation; D016526:Workload