title: Mobbing among care workers in nursing homes: A cross-sectional secondary analysis of the Swiss Nursing Homes Human Resources Project.
abstract: BACKGROUND
  As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers.
  
  
  OBJECTIVE
  This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered nurse, licensed practical nurse, assistant nurse, nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing.
  
  
  METHODS
  A cross-sectional, multi-center sub-study of the Swiss Nursing Homes Human Resource Project (SHURP).
  
  
  METHODS
  Nursing homes in Switzerland's three language regions.
  
  
  METHODS
  A total of 162 randomly selected nursing homes with 20 or more beds, including 5311 care workers with various educational levels.
  
  
  METHODS
  Controlling for facility and care worker characteristics, generalized estimation equations were used to assess the relationships between mobbing and care workers' health status, job satisfaction, and intention to leave as well as the association of work environment factors with mobbing.
  
  
  RESULTS
  In Swiss nursing homes, 4.6% of surveyed care workers (n=242) reported mobbing experiences in the last 6 months. Compared to untargeted persons, those directly affected by mobbing had higher odds of health complaints (Odds Ratios (OR): 7.81, 95% CI 5.56-10.96) and intention to leave (OR: 5.12, 95% CI 3.81-6.88), and lower odds of high job satisfaction (OR: 0.19, 95% CI 0.14-0.26). Odds of mobbing occurrences increased with declining teamwork and safety climate (OR: 0.41, 95% CI 0.30-0.58), less supportive leadership (OR: 0.42, 95% CI 0.30-0.58), and higher perceived inadequacy of staffing resources (OR: 0.66, 95% CI 0.48-0.92).
  
  
  CONCLUSIONS
  Mobbing experiences in Swiss nursing homes are relatively rare. Alongside teamwork and safety climate, risk factors are strongly associated with superiors' leadership skills. Targeted training is necessary to sensitize managers to mobbing's indicators, effects and potential influencing factors.
authors.affiliation: Institute of Nursing Science, University of Basel, Bernoullistr. 28, 4056 Basel, Switzerland; Alterszentrum Aaheim, Mühlewiesestrasse 4, 8355 Aadorf, Switzerland. Electronic address: pflegeexpertin@aaheim.ch.
authors.forename: Myriam
authors.initials: M
authors.lastname: Tong
authors.affiliation: Institute of Nursing Science, University of Basel, Bernoullistr. 28, 4056 Basel, Switzerland; University Hopsital Basel, Patient Safety Office, Spitalstr. 22, 4031 Basel, Switzerland. Electronic address: rene.schwendimann@usb.ch.
authors.forename: René
authors.initials: R
authors.lastname: Schwendimann
authors.affiliation: Institute of Nursing Science, University of Basel, Bernoullistr. 28, 4056 Basel, Switzerland. Electronic address: franziska.zuniga@unibas.ch.
authors.forename: Franziska
authors.initials: F
authors.lastname: Zúñiga
mesh_terms: D058445:Bullying; D003430:Cross-Sectional Studies; D006282:Health Personnel; D006801:Humans; D009735:Nursing Homes; D013557:Switzerland; D000078329:Workforce
keywords: Bullying; Cross-sectional studies; Health status; Intention to leave; Job satisfaction; Lateral violence; Leadership; Mobbing; Nursing homes; Work environment