ArticleBMC nursing2025
The prevalence and experience of upward bullying of nurse managers in China: a multicenter mixed methods survey.
Article in BMC nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrevious studies have shown that upward bullying affects both organizational efficiency and the harmony of the work environment. However, the prevalence of upward bullying and its contributory factors remain unclear in Chinese nurse managers. This study aimed to explore the prevalence of upward bullying and its contributory factors as experienced by nurse managers in Chinese healthcare settings, together with an investigation of their specific experiences.
methodsThis study used a comprehensive, sequential, explanatory mixed methods design. The research was carried out in 12 provinces of China and included nurse managers working from various healthcare settings. The data collection involved an online survey completed by 210 nurse managers during the quantitative phase, followed by 17 semi-structured interviews during the qualitative phase. Our comprehensive approach, using both quantitative and qualitative methods, allowed us to gain a deep understanding of the prevalence and experiences of upward bullying among nurse managers, providing a robust foundation for our findings.
resultsOverall, 24.76% of nurse managers reported experiences of upward bullying and 40.38% of cases were classified as severe. Their upward bullying experiences were classified into nine categories and refined into four themes (perception of upward bullying by nurse managers, facilitators of upward bullying, calls for organizational support, and recovery and growth).
conclusionsA considerable proportion of nurse managers in China experience upward bullying, which affects their physical and mental health and management effectiveness, impacting healthcare quality. Developing a supportive environment emphasizing respect, open communication, and professional development is crucial to mitigate upward bullying. Such a setting can help nurse managers cope with upward bullying and improve work culture.
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