Fear Of Retaliation Research Articles

18 Workplace Violence Reporting Behaviors in Emergency Departments across a Health System

To establish reporting behaviors of workplace violence among multidisciplinary emergency department (ED) staff within a regional health system. Anonymous survey study of all multidisciplinary ED staff at twenty Midwestern EDs encompassing a large health system between 11/18/2020 and 12/31/2020. Cohort included clinicians, nursing staff, care team assistants, ancillary testing services, registration/finance staff, paramedics/emergency medical technicians, social workers, respiratory therapy, environmental services (janitorial) staff, management, and security officers. Frequency and methods of reporting of workplace violence were solicited, as well as respondent beliefs on why violence goes unreported. Chi-squared and Fisher’s exact tests were used to analyze the results. This study was deemed exempt by Mayo Clinic Institutional Review Board. A total of 833 respondents completed the survey with 598 (71.6%) indicating some form of violence experienced in the preceding 6 months. The majority (77.3%) indicated never (57.0%) or rarely (20.3%) reporting incidents in the preceding 6 months. Security personnel had the highest rates of reporting, with only 4% indicating that they never report violence, compared with 60% for non-security personnel (p < .001). Additionally, 32% of security personnel indicated that they always report violence compared with 3% for non-security personnel (p < .001). Sixty-two percent of security personnel indicated being extremely familiar with reporting procedures, compared with 7% of non-security personnel (p < .001). When asked how they would report (or have reported) workplace violence, 59.0% indicated with hospital security, 53.2% to their supervisor, 43.0% ED charge nurse, 37.1% through the employee incident report (EIR), 25.6% through the Medical Information Data Analysis System (MIDAS) event reporting (a tool used for patient safety incident reporting), 27.1% to law enforcement, and 3.4% through some other means. Respondents were asked to indicate why they felt abuse in the ED is not typically reported with responses including no physical injury sustained (52.7%), abuse comes with the job (47.4%), too busy during shift (47.3%), inconvenience (41.2%), report won’t be taken seriously (22.3%), not wanting perpetrator to have full name (17.2%), fear of retaliation (16.8%), and may affect customer service scores (7.1%). Our findings indicate poor reporting behaviors of workplace violence among multidisciplinary ED staff, including unfamiliarity with proper reporting methods with less than 2 out of 5 respondents indicating the compliant institutional process of reporting incidents (through the EIR). Respondents indicated that longstanding beliefs towards violence (eg, “being part of the job”) persist. As health systems seek to prioritize the safety of their employees in violence-prone areas, including EDs, it is imperative that they understand staff barriers to violent incident reporting and that continued education and encouragement is needed to adapt longstanding sentiments held by staff that contribute towards underreporting.

Moving toward health equity: A journey

Moving toward health equity: A journey

Perceived severity, fear of retaliation, and suspect report intention of general public during COVID-19 pandemic: A moderated moderation analysis.

Management of COVID‐19 largely depends on the reporting of suspected or confirmed positive cases. This study examined public's suspect report intention during COVID‐19 using and extending the theory of planned behavior by adding two incident‐specific variables such as perceived severity of COVID‐19 and fear of retaliation. Direct association of attitude, subjective norm, and perceived behavioral control with suspect report intention and moderating role of perceived severity of COVID‐19 and fear of retaliation were probed. This study also investigated whether the moderation of perceived severity of COVID‐19 (primary moderator) varies with different level of fear of retaliation (secondary moderator) using moderated moderation analysis. Analyzing data collected from 554 Indian citizens provides evidence that attitude, subjective norm, and perceived behavioral control were positively associated with suspect report intention. Perceived severity of COVID‐19 and fear of retaliation negatively moderated such associations. When fear of retaliation was high, high perceived severity of COVID‐19 did not positively moderate the association of attitude, subjective norm, and perceived behavioral control with suspect report intention. Perceived behavioral control was the most potent facilitator and fear of retaliation was the strongest inhibitor of suspect report intention. Understanding people's suspect report intention can assist in implementing awareness programs to encourage suspect report intention and stop the community spread of COVID‐19.

POSSIBILITY TO CORRECT THE FREEDOM OF SPEECH IN INDONESIAN LAW: COMPARISON BETWEEN SINGAPORE LAW AND INDONESIAN LAW ON BROADCASTING

Freedom of speech is a principle that supports the freedom of an individual or a community to articulate their opinions and ideas without fear of retaliation, censorship, or legal sanction. This principle is one of the Human Rights principles that are necessary for the progress of humanity itself. But its existence has always triggered a dispute because of the abuse of the right. The abuse of the rights consists of Hate Speech and Hoaxes. This research is normative legal research that uses a comparative approach and conceptual approach. And also, this research will compare the Freedom of Speech and Broadcasting laws in Indonesia and Singapore, especially law in the broadcasting sector. Theoretically, the benefits of this research are to answer the problem of correcting Freedom of Speech, especially in broadcasting law. Practically, it is helpful for society to know much more about hate speech and hoaxes also the possibility to correct the broadcasting law in Indonesia based on the same regulation in Singapore.

Medical errors during training: how do residents cope?: a descriptive study

BackgroundPhysicians’ self-perceived medical errors lead to substantial emotional distress, which has been termed the “second victim phenomenon.” Medical errors during residency are associated with increased burnout and depression. It is important to know how residents cope with self-perceived medical errors and how they gain personal and emotional support in order to develop effective interventions.ObjectiveTo assess the impact of self-perceived medical errors on residents’ well-being, the range of coping strategies during training, and the extent of personal and institutional support.MethodsAn online cross-sectional survey was administered via email in October 2018 to 286 residents across all specialties in a 548-bed single urban academic medical center. The survey covered three domains focusing on residents’ most serious self-perceived medical error: (1) emotional response, (2) coping strategies using the BRIEF COPE Inventory, and (3) personal and institutional support.Results109/286 residents from various specialties responded. Internal Medicine, Pediatrics and Emergency Medicine constituting 80 % of respondents. Self-perceived medical errors during residency were widespread (95 %). One in five medical errors was classified as moderate to severe. Most residents acknowledged a sense of guilt, remorse and/or inadequacy. Use of maladaptive coping strategies was high. Open-ended responses pointed to fear of retaliation, judgement, shame and retribution. Most residents disclosed their error to a senior resident but did not discuss it with the patient’s family. Only 32 % of residents participated in a debriefing session.ConclusionsMost residents were directly involved in medical errors, which affected their emotional well-being. The use of maladaptive coping strategies was high. Residents’ fear of consequences prevented disclosure and discussion of self-perceived medical errors. This information is relevant to implement targeted interventions.

Factors associated with intimate partner violence and barriers to reporting it, among female who use drugs in Malaysia

Females who use drugs (FWUDs) are vulnerable to intimate partner violence (IPV). This study was initiated to identify factors that evoke IPV, and identify barriers that preclude FWUDs from seeking help. Two-hundred FWUDs were recruited from a mandatory drug rehabilitation centre (CCRC) for this cross-sectional study. The data were collected through face-to-face interviews using a semi-structured questionnaire. The majority in our sample was Malay (86%, n = 171/200), and their mean age was 32.3 years (SD = 8.61). The lifetime IPV prevalence rate in the sample was 53% (n = 105/200), far exceeding the reported rate for non-drug dependent married women in Malaysia. The prevalence rates for physical, psychological, and sexual violence in the sample were 41%, 29%, and 24%, respectively. Lifetime IPV incidence among FWUDs was associated with living away from parents/family, having a regular intimate male partner who uses drugs, and having been a victim of underage rape. The main reasons for not reporting IPV were the lack of knowledge of one’s rights, not knowing how to access legal counsel, and the fear of retaliation from one’s partner. Our findings may be useful in designing interventions to minimize the occurrence of IPV and promote the seeking of assistance and treatment by FWUDs.

Nervous nation: Fear, conflict and narratives of fortified domestic architecture on the Queensland frontier

The frontier of nineteenth- and twentieth-century Australia was a place in which colonists routinely lived in fear of retaliation by the Aboriginal peoples whose traditional lands they had forcibly dispossessed. It has been suggested this concern manifested itself in domestic architecture, in both active and passive defensive strategies designed to afford protection against various forms of potential attack. Yet there remains a lack of substantive research to support such assertions. In this article, we present an analysis of accounts drawn from a range of sources of 97 domestic structures across Queensland with claims for defensive features. Although suggesting that fortified domestic structures were more common than previously envisaged, our review indicates that defensive features were usually minimal – holes in walls and barrable doors, windows or other ports of entry – reflecting the often expedient nature of the structures themselves. First-hand accounts of these buildings are rare, although not entirely absent, with most written accounts being reminiscences told in hindsight by later descendants, resulting in both distortions and myth-building. Accounts of fortified domestic structures peak in the decades following Federation and through both World Wars as the newly minted Australian nation explicitly engaged in nation-building and constructing the ‘glorious pioneer’ narrative.

Taking it outside: A study of legal contexts and external whistleblowing in China and India

Whistleblowing is regularly identified as corporate control mechanism to prevent and uncover fraud. We review and compare the legal situation for whistleblowers in the People’s Republic of China and India. In a survey of 942 employees from private companies in both countries, we take a look at the status quo of whistleblowing system implementation, explore preference of channels to disclose fraud or corruption, and analyze under which conditions and what kind of employees prefer external over internal whistleblowing. We find that provisions for mandatory whistleblowing systems can be found in the law of both countries. In China in particular, protection is scattered across many different laws in the private sector. Indian companies seem to have systems in place more often, although this difference becomes smaller the larger the company. The general preference of internal over external channels is similar across countries. Our regression models suggest that external channels are preferred over internal ones when fear of retaliatory measures is higher, the company is smaller, and the whistleblower is female. In line with prior literature, the effect of fear of retaliation is moderated by gender: women are less influenced by retaliation. All in all, implementation of whistleblowing systems seems ubiquitous in both countries; legal protection and comprehensive measures to decrease retaliation are lacking. Additional implications of findings are discussed.

Protecting providers and patients: results of an Internet survey of health care workers\u2019 risk perceptions and ethical concerns during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic has generated worldwide scarcity of critical resources to protect against and treat disease. Shortages of face masks and other protective equipment place health workers, already on the frontline of the disease, at higher risk. Moral distress from making difficult decisions about allocating scarce resources and care to patients ill with COVID-19 can further add to burdens health workers face. This study investigates clinical health workers’ risk perceptions and concerns about the ethics of their clinical decision-making, the actions of their institutions to address resource scarcity concerns during the COVID-19 pandemic, and their ability to voice safety concerns, as well as their own views on how scarce resources should be allocated.MethodsAn online survey was open to health care workers who provide clinical care to patients, with no specialty training or geographic location requirements, from May 19 to June 30, 2020. Participants were recruited through purposive sampling using medical association and institutional email lists, and by snowball sampling.ResultsOf 839 participants, a majority were physicians (540, 69.4%) working in academic medical centers (270, 35.2%) or private health systems in the community (234, 30.5%) in the USA (760, 90.7%). Most reported being concerned about their own health (494, 73.6%) and about the possibility of spreading COVID-19 to family and friends (534, 85.9%) during the pandemic. All respondents reported shortages or rationing of at least one type of medical resource (e.g., sanitizing supplies and personal protective equipment). More than half of respondents (351, 53.9%) did not feel they received sufficient training in how to allocate scarce resources in the pandemic. Many felt moral distress related to conflicts between institutional constraints and what they believed was right (459, 66.5%). Though a majority (459, 67.7%) reported feeling “comfortable” internally communicating with their administration about safety issues, far fewer reported feeling “confident” speaking publicly about safety issues without retaliation from their institution (255, 37.3%).ConclusionsIn the face of limited resources, surveyed health care workers reported concern about their own and their families’ health from exposure. Securing adequate protective equipment must be a high priority for pandemic management. In addition, more governmental and facility-level ethical guidance is required for allocation of resources given ongoing scarcity, and facilities must create conditions so health care workers can speak openly about safety issues without fear of retaliation.

Perceived Value of Using a Digital Tool to Screen for Elder Mistreatment in the Emergency Department

A major barrier to reducing Elder Mistreatment (EM) is an inability to accurately identify victims. We conducted a qualitative study to evaluate stakeholders’ perceived value and likelihood of adopting a tablet-based digital health tool to facilitate screening and prompt self-disclosure of EM in emergency departments (ED). The interactive tool utilizes virtual coaching, interactive multimedia libraries (graphics, animations, etc.), electronic screening, and brief motivational interviewing designed to enhance identifying EM among older adults. We conducted 3 focus groups with stakeholders, including 24 adults 60+ years, 2 social workers, 2 caregivers, and 2 ED clinicians. Two focus groups included only older adults, while one included representatives of all stakeholders. The main findings include: using a female voice for the tool narrator, larger font size, more multimedia, and headphones for privacy; and making a person available during screening if assistance is needed. Stakeholders indicated that it is difficult for victims to ask for help and any type of mistreatment screening would be helpful. On a 7-point Likert scale ranging from “1=Very Comfortable” to “ 7=Very Uncomfortable”, older adults scored 2.8 on average for whether they would feel comfortable using a tablet to screen for EM. Some said digital screening would maintain privacy and anonymity. Stakeholders highlighted the need to explain community resources available to older adults once EM is disclosed, especially resources offering help to the caregiver. In summary, this qualitative study supported using tablet-based screening for EM and highlighted the need to target stigma related to EM disclosure and fear of retaliation.

A Resident-Centered View of Sexual Expression in Long-Term Care

Contrary to societal beliefs, older adults residing in nursing homes continue to have sexual interests. However, the right and need to engage in intimate relationships are often ignored in nursing homes, erring on the side of safety and prohibiting intimacy. This is due to ageist sexual stigma, under-educated providers, complexities of care, and fear of retaliation. Nursing homes are not attending to resident preference/choice when it comes to sexuality and intimacy, which ignores the consumer of services and is wholly inconsistent with person-centered care. However, in order to craft resident-centered/informed policies and practices, we must understand the needs and preferences of the resident/consumer. The following presentation will highlight findings from three separate mixed-methods studies that address the consumer, or how now and future residents understand and evaluate intimacy and sexuality in long-term care. We will address potential challenges, areas for intervention, and a unique consumer-oriented solution— sexual advance directives.

Digital health screening tool for identification of elder mistreatment.

It is estimated that 15.7% of people aged 60 years and older were subjected to some form of Elder Mistreatment (EM) globally (Yon et al., 2017). In the USA, as many as 1 in 24 EM cases are left unidentified by professionals, with a 300% increased mortality risk for older adults who do not receive help (National Center on Elder Abuse, n.d.; Dong, 2009). Current methods of screening tend to miss less obvious signs of EM and may discourage older adults from disclosing EM, due to either a lack of understanding of what constitutes mistreatment or fear of retaliation from the perpetrator. Our approach shifts the focus of EM identification to the older adults themselves through an automated tablet-based tool. The Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) tool includes various multimedia components such as videos, audio, and animations designed to educate and enhance screening. Patients screened as positive are guided through a Brief Negotiated Interview (BNI) utilizing motivational interviewing to assist in self-identification (recognize that they are experiencing elder mistreatment) or self-disclosure (inform others about their elder mistreatment experiences). During tool development, we conducted a qualitative study to evaluate the perceived value and likelihood of adopting a tablet-based approach to facilitate screening and self-disclosure of EM in the ED. We held 3 focus groups with stakeholders, including 24 adults 60 years or over, 2 social workers, 2 caregivers, and 2 ED clinicians. We used the findings from the focus groups and User-Centered Design approach (UCD) to develop the tablet-based screening tool. Once the tool was ready, we tested its usability and acceptability with 14 older adults. Focus group participants supported use of a tablet-based tool to screen for EM, indicating that digital screening benefits from feelings of privacy and anonymity. On a 7-point Likert scale ranging from "1=Very Comfortable" to "7=Very Uncomfortable", older adults scored 2.8 on average for whether they would feel comfortable using a tablet device to screen for EM. Prominent suggestions made by older adults included using a female voice for the tool narrator, larger font size, more multimedia, headphones for privacy; and having someone available during screening for assistance if needed. Participants indicated that it is difficult for older adults experiencing EM to ask for help and that any type of mistreatment screening would be helpful. They also highlighted the need to explain community resources available to older adults once EM is disclosed, especially resources offering help to the caregiver. Participants of the usability evaluation rated the tool a mean score of 86.6 (median= 88.8, iQR =18.1) on the System Usability Scale (SUS), far above the benchmark SUS score of 68, which indicates that the system is "good" or "acceptable" (Bangor et al., 2008). Shifting the focus from the provider to the older adult may encourage self-disclosure of EM by addressing major barriers to traditional screening processes. In summary, this study supported the use of self-administered automated tablet-based screening for EM. Participants generally believed that the use of digital health tools to facilitate the screening process would be beneficial in the ED setting.

Challenges of Seeking Reproductive Health Care in People Experiencing Intimate Partner Violence.

Title X is a federally funded family planning initiative that provides low-cost and confidential reproductive health services to its clients. In recent years, Title X has been the subject of debate as its core tenants have been revised by the current administration. Though advocates have fought against these changes, the voices of survivors on intimate partner violence are absent from this conversation. This study was designed to elicit the opinions and experiences on survivors of intimate partner violence on reproductive decision-making, their access to care, and their opinions about political efforts to restrict this access. Twenty-six semi-structured interviews were conducted with women who were seeking services for intimate partner violence. These interviews were audio-recorded, transcribed, and coded. Codes were then organized into themes. Participants endorsed the need for confidential services due to experiences of coercion from their partners and the fear of retaliation against them. Participants largely supported accessible contraception but reported the need for contraception to be reliable. Participants addressed pregnancy and its many complexities and advocated for nondirective options-counseling. Overall, participants spoke about their challenges with reproductive health care and their opinions on how best to service survivors of intimate partner violence. This study asserts the need for advocates for survivors to advocate for the preservation of Title X and establishes the need for future studies on the prevalence of intimate partner violence in Title X clinics.

A behavioral analysis of whistleblowing at Japanese firms

This paper analyzes the background to whistleblowing—one of the key means by which a spate of corporate misdeeds have been revealed at established Japanese firms—by applying a framework of psychology and organizational behavior to people’s decisions and judgments. The paper first analyzes the organizational aspects of whistleblowing, such as fear of retaliation within firms, and the psychological aspects, such as conflicts of interest that unconsciously favor sponsors. Despite such internal restraints, observed phenomena of whistleblowing paint a more nuanced picture of human psychology. Along with moral concerns, people have the desire to exhibit an appreciation of social trust and fairness, even when their actions are inconsistent with an economic calculus. Traditional Japanese firms are characterized by a collectivist culture featuring a meticulously crafted, closely knit internal order and lifetime employment. Information technology, however, has led to a more liquid flow of information on corporate misconduct, making it hard to conceal misdeeds that blur organizational boundaries and relativizing internal norms. These changes tip the psychological balance of people within firms and prompt firms to adapt. Changes in the corporate governance code, and a law requiring firms to introduce internal control systems, give whistleblowers the organizational protection which is key to according them psychological safety and encouraging constructive dissent. Advances in research from the behavioral perspective promise to deepen our understanding of Japanese corporate phenomena and behaviors.

Gender-Based Pay Discrimination in Otolaryngology.

Male and female otolaryngologists all attend the same accredited medical schools, complete the same accredited residency programs, and take the same board certification exams; however, female otolaryngologist are paid 77 cents on the dollar compared to their male colleagues. Even after accounting for age, experience, faculty rank, research productivity, and clinical revenue, significant gender pay gaps exist across all professor levels. The goal of this review is to improve our understanding of how and why the gender pay gap and discrimination exists, the harm caused by tolerance of policies that perpetuate gender pay inequity, and what is and can be done to correct gender-based pay gaps and discrimination. The review presents the current status of gender pay inequity in the United States and reports on how otolaryngology compares to other professions both within and outside of healthcare. The gender pay gap is shown to have a negative impact on economic growth, institutional reputation and financial success, retention and recruitment of faculty, and patient care. Many historically incorrect reasons used to explain the causes of the gender pay gap, including that women work less, have less research productivity, or produce lower-quality care, have been be disproved by evaluation of current research. Potential causes of gender pay inequities, such as gender bias, organization culture, fear of retaliation, promotions inequalities, lack of transparency, and senior leadership not being held accountable for equity and diversity concerns, will be explored. Finally, examples of best practices to achieve pay equity will be presented. Laryngoscope, 131:989-995, 2021.

An Examination of Women’s Experiences with Reporting Sexual Victimization Behind Prison Walls

Women inmates in a southern women’s minimum security facility were interviewed to explore their perceptions of and experiences with reporting sexual victimization in the context of the post-PREA era. The interviewees identified stigma and gossip, officer camaraderie, and fear of retaliation as the dominant barriers to reporting and investigating incidents of sexual assault. The article concludes with recommendations to improve sexual assault training and education in women’s correctional institutions.

Denying the Animosity: Understanding Narratives of Harmony from the Nellie Massacre, 1983

This article tries to understand through oral narratives from the Nellie Massacre of 1983 to reflect on how societies in India adhere to a narrative of harmony between different communities and a familial structure before a conflict breaks out, denying the existence of any palpable enmity amongst the communities. It will see how and why the assertions of peaceful co-existence may differ in case of the majority and minority in India. While there may be genuine assertions of harmony, such assertions may also be based on different factors such as majority strength, fear of retaliation and the compulsions of co-existence.

Interpersonal violence against people with disabilities: Additional concerns and considerations in the COVID-19 pandemic.

This article reviews the literature on violence against people with disabilities as well as emerging literature on the COVID-19 pandemic and its social and medical consequences. The COVID-19 pandemic magnifies existing issues and barriers facing people with disabilities who are experiencing interpersonal violence. These issues include reliance on the perpetrator for care and assistance, barriers to reporting abuse and seeking help, fear of retaliation and other negative consequences if abuse is reported, emotional abuse related to disability, and exacerbation of secondary physical and mental health sequalae of abuse. The COVID-19 pandemic and its consequences enhance the already increased risk for abuse among people with disabilities. Providers who work with individuals with disabilities should address these issues at both the individual client and systems levels. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Domestic violence in the perceptions of university students in Poland and Belarus

:Background:Domestic violence is a social phenomenon where a family member, husband, wife or another cohabiting person in the household tries to dominate, physically or mentally, the other partner, children, parents, grandparents, in-laws, etc., using their physical advantage, threats, blackmail, with the intention of harm. The aim of the study was find the perceptions of university students regarding the phenomenon of violence and to show similarities and differences in this respect between students from Poland and Belarus (PL and BY).Methods:A total of 482 persons took part in the study, including 251 students from Szczecin (Poland) and 231 students from Grodno (Belarus). The method was a diagnostic survey using the authors’ original questionnaire. The questionnaire consisted of two parts: the first, containing 6 demographic questions, and the second containing 25 mainly closed-ended questions.Results:In the perceptions of the respondents from Poland and Belarus, women are statistically more likely to experience violence, and men are more likely to use it. The responses of students from Poland and Belarus show statistical connections regarding such behaviors as a single spank, shouting, refusing to talk – recognizing them mostly as a form of violence. The respondents from both countries also show a convergent position concerning quarrelling and forcing a person to drink alcohol or smoke cigarettes, recognizing them as violent behavior. Significant differences can also be observed with regard to such behaviors as throwing objects, name-calling and mocking, which do not indicate violence in the opinions of the majority of students from Belarus, in contrast to the Polish students, who perceive these behaviors as violent.Conclusions:Students from both countries acknowledge that the concealment of domestic violence by victims mainly results from fear of worsening their already difficult situation as well as from fear of retaliation by the perpetrator.

The effects of retaliation on whistleblowing intentions in China banking industry

PurposeThis paper aims to examine the predictors of whistleblowing behaviors by comparing the importance of a negative perception – fear of whistleblowing – relative to positive perceptions such as ethical orientation, professional identity and supervisor trust.Design/methodology/approachThe proposed hypotheses were tested using relative regression analysis with data collected from 471 banking employees in nine Chinese organizations.FindingsThe findings conclude that fear of retaliation was dominant in predicting external, but not internal, whistleblowing, and the beneficial effects of positive perceptions on internal whistleblowing are contingent on employees’ fear of retaliation. Therefore, organizations should survey employees’ perceptions of whistleblowing and their company retaliation policies to accomplish the goal of promoting ethical behaviors while discouraging unethical behaviors.Practical implicationsThe findings suggest that efforts to promote whistleblowing in organizations may be most successful if the focus is placed on deterring retaliation and highlighting for employees that they will be protected from retaliation.Originality/valueThe relative weights analyses suggest that fear of retaliation from whistleblowing is the dominant predictor of external whistleblowing; as fear of retaliation increases, so does the desire to blow the whistle externally.