title: Categorizing the Magnitude and Frequency of Exposure to Uncivil Behaviors: A New Approach for More Meaningful Interventions.
abstract: To examine turnover intentions, as well as the prevalence and frequency of uncivil behaviors, from the perspective of registered nurses, respiratory therapists, and imaging professionals, using a new method to categorize exposure magnitude.
  
  
  
  Data were collected using the 22-item Negative Acts Questionnaire-Revised (NAQ-R). Additional items, informed by Price and Mueller's causal model of turnover, were included, as were select demographic variables. The final sample included 170 healthcare professionals. Descriptive statistics were used to describe the sample, a chi-square test was constructed to test for significant differences in exposure to uncivil behavior based on demographics, and Cochran-Mantel-Haenszel statistics were used to test associations between variables and calculation of raw sum scores to implement a new method of analysis for the NAQ-R, allowing for categorization of exposure magnitude.
  
  
  
  Exposure to uncivil behavior was reported more often among nursing staff than other healthcare professionals. Lack of exposure to uncivil behavior was a significant predictor of intention to stay. Perceptual differences were found between nurses prepared at the baccalaureate and associate degree levels. Lastly, no significant correlations between exposure to uncivil behavior and selected demographic variables were found, suggesting that exposure is not dependent upon age, race, unit type, or educational level.
  
  
  
  Findings support prior research associating negative organizational climate with higher turnover intentions. Uncivil behavior was reported across the organization, most predominantly among units staffed with nurses. Finally, use of newly defined cutoff points for the NAQ-R provide organizations with the ability to use both subjective and objective data to identify targets of uncivil behaviors to construct meaningful interventions.
  
  
  
  There is a need to develop more meaningful interventions to support targets of uncivil behaviors. Use of the NAQ-R, coupled with the proposed cutoff scores, allows for the identification of targets, the magnitude of exposure, and the construction of meaningful primary, secondary, and tertiary intervention programs that may improve turnover and quality of care.
authors.affiliation: Associate Director, Undergraduate Division, UNC Charlotte School of Nursing, Charlotte, NC, USA.
authors.forename: Dena
authors.initials: D
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000075282:Incivility / Q000706:statistics & numerical data*; D033182:Intention; D007400:Interprofessional Relations; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D010563:Personnel Turnover; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Bullying; health care; incivility; intention; interventions