Perceptions Of Mistreatment Research Articles

Third-party perceptions of mistreatment: A meta-analysis and integrative model of reactions to perpetrators and victims.

Third parties have increasingly become the focus of research on mistreatment in organizations. Much of that work is grounded in deonance theory, which argues that third parties should react to the perpetrators of mistreatment with anger. Deonance theory is less explicit as to how third parties should react to the victims of mistreatment, though empirical work has pointed to empathy as one potential reaction. Deonance theory is less capable of explaining recent findings suggesting that third parties may react to mistreatment events with schadenfreude. The purpose of our study was to conduct a meta-analytic test of an integrative model specifying the relationships between third-party perceptions of mistreatment and reactions to perpetrators and victims. That model predicted that third-party perceptions of mistreatment would be associated with emotional reactions (anger toward the perpetrator, empathy toward the victim, schadenfreude from the event), cognitive reactions (evaluations of the perpetrator and victim), and behavioral reactions (antisocial and prosocial behaviors toward the perpetrator and victim). Our model testing provides the first quantitative synthesis of the third-party mistreatment literature while surfacing counterintuitive findings that would not be anticipated from deonance theory's arguments. We discuss the theoretical and practical implications of our work while providing guidance for future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"White" as a Racial Category, Perceptions of Mistreatment, and Health.

"White" as a Racial Category, Perceptions of Mistreatment, and Health.

Perceptions of mistreatment: a comparison of students at two geographically and culturally distinct graduate medical schools

Perceptions of mistreatment: a comparison of students at two geographically and culturally distinct graduate medical schools

Perception of mistreatment in resident physicians of a reference Hospital in Paraguay

Introducción: El maltrato es una problemática que el mundo viene sufriendo y sosteniendo desde siglos anteriores y el sector salud no queda exento de tal agravio. En Latinoamérica existe un alto índice de maltratos en médicos. Objetivos: Determinar la percepción sobre el maltrato en médicos residentes de un hospital de referencia nacional de Paraguay durante el 2020. Materiales y métodos: Se realizó un estudio observacional, descriptivo de corte transversal, dónde fueron incluidos 240 residentes de las diferentes especialidades de un hospital de referencia nacional. Resultados: Ingresaron al estudio 240 médicos residentes, con una edad promedio de 27,3 ±1,6. El 52,08% (125) fueron del sexo masculino. En cuanto al maltrato psicológico, el 98,33% (236) recibió críticas o humillaciones, el 92,08% (221) ha sido víctima de gritos y el 39% (94) de guardia como castigo. Lo que respecta al maltrato físico, el 9% (22) de los residentes recibió golpes o empujones. El 7,92% (19) refirió haber recibido comentarios sexuales sobre su cuerpo o parte de él y el 2% (5) haber sido expuesto a material pornográfico, evidenciando el maltrato de índole sexual. En relación al perpetrador del total de episodios de maltrato que corresponde al 56,78% (494), el Residente Superior ha sido señalado como principal autor. Conclusión: Existe una alarmante frecuencia de maltrato en la formación profesional de los médicos residentes. Se destaca el maltrato psicológico en mayor proporción y al Residente Superior como principal perpetrador.

Student and clinician perceptions of medical student mistreatment: a cross-sectional vignette survey

ObjectivesThe mistreatment of medical students remains pervasive in medical education. Understanding the extent to which clinicians and students recognise mistreatment can assist in creating targeted interventions that reduce mistreatment. The...

Model to Predict Healthcare Behaviors: Comparison of a Chilean and Mexican Sample.

(1) Background: Adherence to treatment and medical check-ups are important for health outcomes, but low adherence to treatment is a common phenomenon. Thus, we aimed to examine the role of cultural beliefs about physicians, perceived mistreatment, and emotions associated with the experience of mistreatment as an antecedent of healthcare behavior among Chilean and Mexican primary care patients using Betancourt’s model for the study of health behavior. (2) Methods: This is a multivariate cross-sectional study with a non-probabilistic sample of 326 Mexican and 337 Chilean participants. Multigroup structural equation modeling was used to test the structural relations among the cultural and psychological variables as determinants of healthcare avoidance behavior. (3) Results: The results revealed a pattern of associations that work in the same way for Chilean and Mexican samples. Negative cultural beliefs about physicians have a direct effect on avoidance behaviors in healthcare. In addition, this effect is mediated through psychological factors, such as perception of mistreatment and negative emotions associated with mistreatment. (4) Conclusions: A structural invariance test showed that the perception of mistreatment and negative emotions were less intense for Chileans than Mexicans. In contrast, the association between negative emotions and avoidance behaviors was less intense for Mexicans.

Perception of Medical Student Mistreatment: Does Specialty Matter?

Medical student mistreatment is pervasive, yet whether all physicians have a shared understanding of the problem is unclear. The authors presented professionally designed trigger videos to physicians from 6 different specialties to determine if they perceive mistreatment and its severity similarly. From October 2016 to August 2018, resident and attending physicians from 10 U.S. medical schools viewed 5 trigger videos showing behaviors that could be perceived as mistreatment. They completed a survey exploring their perceptions. The authors compared perceptions of mistreatment across specialties and, for each scenario, evaluated the relationship between specialty and perception of mistreatment. Six-hundred fifty resident and attending physicians participated. There were statistically significant differences in perception of mistreatment across specialties for 3 of the 5 scenarios: aggressive questioning (range, 74.1%-91.2%), negative feedback (range, 25.4%-63.7%), and assignment of inappropriate tasks (range, 5.5%-25.5%) (P ≤ .001, for all). After adjusting for gender, race, professional role, and prior mistreatment, physicians in surgery viewed 3 scenarios (aggressive questioning, negative feedback, and inappropriate tasks) as less likely to represent mistreatment compared with internal medicine physicians. Physicians from obstetrics-gynecology and "other" specialties perceived less mistreatment in 2 scenarios (aggressive questioning and negative feedback), while family physicians perceived more mistreatment in 1 scenario (negative feedback) compared with internal medicine physicians. The mean severity of perceived mistreatment on a 1 to 7 scale (7 most serious) also varied statistically significantly across the specialties for 3 scenarios: aggressive questioning (range, 4.4-5.4; P < .001), ethnic insensitivity (range, 5.1-6.1; P = .001), and sexual harassment (range, 5.5-6.3; P = .004). Specialty was associated with differences in the perception of mistreatment and rating of its severity. Further investigation is needed to understand why these perceptions of mistreatment vary among specialties and how to address these differences.

Medical students’ perception of behaviors in the clinical learning environment evolve with increasing clinical exposure as measured with situational video vignettes

This cross-sectional study involved matriculating, mid-level and graduating medical students (n = 723) who participated in specific transition courses in our medical school curriculum between August 2016 and March 2019. We used a mixed-methods approach (survey and analysis of narrative comments) to study the evolution in perception of the learning environment by medical students with increasing clinical exposure using four different video vignettes. Differences in student perceptions of mistreatment exists at various levels of training. Compared to graduating students, matriculating students were more likely to perceive reprimanding a student on being late as appropriate behavior (80.5% vs 53.3%, p = 0.001), whereas a significantly higher proportion of the graduating students (15.3%, p = 0.001) perceived it as mistreatment. A majority of the matriculating students (84%, p = 0.001) considered the case of an eager student as mistreatment, while a significantly higher proportion of the graduating students (59.5%, p = 0.001) did not think it was mistreatment. Qualitative analysis of comments from students at different stages of training displayed an increased appreciation of their professional responsibilities and nuanced appreciation of body language and tone as contributing factors in determining whether a situation represented inappropriate behavior. Our results demonstrate that students’ perceptions of inappropriate behaviors evolve with increased clinical exposure.

Impact of employee perceptions of mistreatment on organizational performance in the hotel industry

PurposeThis paper aims to investigate the impact of injustice, discrimination and incivility on organizational performance in the hotel industry. In addition to this, the study also investigates the mediating effects of discrimination and incivility between distributive injustice, procedural injustice and organizational performance.Design/methodology/approachA survey was conducted to collect the data from hotel industry employees on a structured questionnaire by using convenience sampling approach. PLS-SEM was used to analyze the useable data of 285 respondents. In addition to this, to evaluate the predictive performance of exogenous constructs newly suggested hold out sample approach in PLS-SEM was also considered.FindingsResults indicate that incivility and procedural injustice has a negative and significant effect on organizational performance, while the impact of distributive injustice and discrimination on organizational performance was insignificant. Further, incivility was found to be a significant mediator, while mediation of discrimination was not supported between distributive injustice, procedural injustice and organizational performance.Practical implicationsFindings are important for hotel managers to adjust their strategies to improve organizational performance.Originality/valueThis study contributes in existing literature by concentrating on predictors that undermine the organizational performance. To the best of the authors’ knowledge, this is one of the early studies to contribute in literature by investigating the impact of injustice perceptions on employee perceptions specifically perceived incivility and perceived discrimination on organizational performance. Further, it also investigated the mediating impact of perceived incivility and perceived discrimination between injustice perceptions and organizational performance. Such considerations have implications for researchers, students and practitioners. For researchers, this study helps to ponder on an alternative approach by considering those factors which may undermine organizational performance, instead of focusing only on those factors which enhance organizational performance. For research students, such contribution will bring a new avenue to consider further research. Managers will find help to control such factors which minimize organizational performance.

The Learning Environment in Surgery Clerkship: What are Faculty Perceptions?

Multiple efforts have sought to improve teaching effectiveness and the learning environment (LE), but prior research has not focused on attending physicians' perceptions of mistreatment or contribution to the LE. The purpose of this study was to assess the perception and role of surgical faculty in the medical student LE. A semistructured interview guide was developed using a comprehensive approach including extensive literature search and focus groups. Data were audio-recorded and transcribed verbatim. Content analysis was used to identify emergent themes. Beth Israel Deaconess Medical Center, an academic tertiary care facility located in Boston, Massachusetts. Fifteen faculty in the Department of Surgery underwent detailed interviews. Participants were selected using purposive-stratified criterion-based sampling. Multiple themes emerged: (1) The competing demands on medical student's time are a negative factor in the LE; (2) Faculty expectations conflict with the existing curriculum; (3) Faculty are concerned with the possibility of being reported for providing negative feedback; (4) Faculty remain unfamiliar with policies regarding the LE/mistreatment; (5) A motivated medical student makes the educational interaction more productive independent of specialty of choice. Faculty identified that the most important factors contributing to a negative LE were a mismatch between expectations of medical students and faculty, and the conflict between the current curriculum and the faculty member's perceived ideal educational framework. Importantly, faculties were largely unfamiliar with LE/mistreatment policies and standards. These findings suggest a need for targeted curricula for faculty to raise awareness of components of a positive LE and tools to teach effectively within the contemporary medical school curriculum.

Elder mistreatment and social network composition: an exploratory study

Elder mistreatment, affecting an estimated one in ten older adults, has devastating consequences for individuals, families and communities. The magnitude of the issue and known barriers to addressing it through formal systems necessitate innovative approaches to identification and response. This study explores network composition change following elder mistreatment in order to assess the viability of leveraging network members in future intervention efforts. Multiply imputed linear regression models show associations between elder mistreatment and small increases in net change and the number of specific network additions. No association between elder mistreatment and network member losses or network density were found. These findings highlight the complexity of social network change in older adulthood and point to a need for future research considering the influence of Adult Protective Service intervention as well as qualitative work assessing older adults’ own perceptions of mistreatment and network change.

Medical Student Mistreatment-an Obstetrics and Gynecology Perspective: a Pilot Study.

To determine if perception of mistreatment and severity in each of the professional videotaped vignettes was similar between participants of differing professional status (Ob/Gyn attending physicians, resident physicians, and medical students), previous mistreatment status, ethnic minority status, and gender. Three video vignettes were filmed portraying possible medical student mistreatment during an obstetrics and gynecology clerkship. Prior to watching the videos, all participants were asked to complete a questionnaire related to their prior experience with mistreatment as a medical student along with other demographic details. After viewing each video, participants were asked to rate the video as representing mistreatment (yes/no) and, if yes, the severity of medical student mistreatment. Eight attending physicians, ten resident physicians, and ten medical students participated in this study. Professional status, previous mistreatment status, ethnic minority status, and gender did not affect how participants perceived mistreatment or the severity of the video vignettes. Fifty percent (14/28) of participants reported previous mistreatment as a medical student, all of which occurred during their third year of medical school. Medical students, resident physicians, and attending physicians generally agreed which video vignettes represented medical student mistreatment and the level of severity of the event.

Use of Forum Theater to Improve the Clinical Learning Environment

PURPOSE: To practice difficult conversations between teachers and learners utilizing Forum Theater techniques exploring differences in perceptions of mistreatment. BACKGROUND: Reports of student mistreatment remain unacceptably high at Duke University School of Medicine. Addressing the learning environment with lectures, anonymous reporting and personal coaches has had little effect. The humanities have been used for building empathy in physicians. In interactive or Forum Theater, spectators have opportunities to express opinions and make decisions while the actors incorporate the suggestions as they re-play a scene over again. The technique of Forum Theater has been used for medical faculty development for improving handling of student multiculturalism with positive results. METHODS: After IRB approval, 2 Forum theater sessions were held as OB-Gyn Grand Rounds with scenes depicting interactive challenges. The learning environment dean led discussion on the scenes before re-enactment with audience input. A brief survey was collected on the Playbill regarding demographics, mistreatment attitudes and opinions on Forum Theater. Replies between students and residents were compared with Fishers Exact analysis. RESULTS: 110 attendees participated in 2 Forum Theater sessions. 41 participants completed surveys-12 medical students, 17 residents, 4 fellows and 8 faculty. Students agreed with statements that medical student mistreatment is prevalent at the school and in the department significantly more often than the residents. (P&lt;.05) There were no differences between responses on the learning environment in the clerkship. 83% of participants reported that Forum theater raised mistreatment awareness and could improve the learning environment. DISCUSSION: Forum Theater holds promise as a tool for addressing learning environment challenges.

Variability in student perceptions of mistreatment.

As medical schoolsstrive to improve thelearning environment, it isimportant to understand medical students' perceptions ofmistreatment. The purpose ofthis study was to explore student interpretations of previously reported mistreatment incidents to better understand how they conceptualise the interactions. Medical students were presented with case scenarios of previously reported instances of mistreatment and asked to indicate their agreement as to whether the scenarios demonstrated mistreatment, using a five-point Likert scale (1, strongly disagree; 5, strongly agree). It is important to understand medical student's perceptions of mistreatment RESULTS: One hundred and twenty-seven third-year medical students gave feedback on 21 mistreatment cases. There was variability in the categorisation of the scenarios as mistreatment. The highest degree of consensus (96% agreement) was for a scenario in which a resident claimed a student made statements about a patient's status that the student did not make. There was also relative consensus on three additional scenarios: (1) a patient making disparaging remarks about a student's role in health care in relation to the student's ethnicity (88% agreement); (2) a resident asking a student to run personal errands (86% agreement); and (3) a nurse calling a student an expletive in front of others (77% agreement). For the majority of the cases, there was no consensus amongst students as to whether mistreatment had occurred. Students self-identifying as minorities and students who had previously reported mistreatment were more likely to perceive mistreatment in the scenarios. There is remarkable variability, and in many cases a lack of agreement, in medical student perceptions of mistreatment. This inconsistency needs to be considered in order to effectively address and mitigate the issue.

Discrimination, Harassment, and Gendered Health Inequalities: Do Perceptions of Workplace Mistreatment Contribute to the Gender Gap in Self-reported Health?

This study examines the extent to which discrimination and harassment contribute to gendered health disparities. Analyzing data from the 2006, 2010, and 2014 General Social Surveys ( N = 3,724), we ask the following: (1) To what extent are perceptions of workplace gender discrimination and sexual harassment associated with self-reported mental and physical health? (2) How do multiple forms of workplace mistreatment (e.g., racism, ageism, and sexism) combine to structure workers' self-assessed health? and (3) To what extent do perceptions of mistreatment contribute to the gender gap in self-assessed health? Multivariate analyses show that among women, but not men, perceptions of workplace gender discrimination are negatively associated with poor mental health, and perceptions of sexual harassment are associated with poor physical health. Among men and women, perceptions of multiple forms of mistreatment are associated with worse mental health. Gender discrimination partially explains the gender gap in self-reported mental health.

Mistreatment of women during childbirth in Abuja, Nigeria: a qualitative study on perceptions and experiences of women and healthcare providers

BackgroundGlobal efforts have increased facility-based childbirth, but substantial barriers remain in some settings. In Nigeria, women report that poor provider attitudes influence their use of maternal health services. Evidence also suggests that women in Nigeria may experience mistreatment during childbirth; however, there is limited understanding of how and why mistreatment this occurs. This study uses qualitative methods to explore women and providers’ experiences and perceptions of mistreatment during childbirth in two health facilities and catchment areas in Abuja, Nigeria.MethodsIn-depth interviews (IDIs) and focus group discussions (FGDs) were used with a purposive sample of women of reproductive age, midwives, doctors and facility administrators. Instruments were semi-structured discussion guides. Participants were asked about their experiences and perceptions of, and perceived factors influencing mistreatment during childbirth. Thematic analysis was used to synthesize findings into meaningful sub-themes, narrative text and illustrative quotations, which were interpreted within the context of this study and an existing typology of mistreatment during childbirth.ResultsWomen and providers reported experiencing or witnessing physical abuse including slapping, physical restraint to a delivery bed, and detainment in the hospital and verbal abuse, such as shouting and threatening women with physical abuse. Women sometimes overcame tremendous barriers to reach a hospital, only to give birth on the floor, unattended by a provider. Participants identified three main factors contributing to mistreatment: poor provider attitudes, women’s behavior, and health systems constraints.ConclusionsMoving forward, findings from this study must be communicated to key stakeholders at the study facilities. Measurement tools to assess how often mistreatment occurs and in what manner must be developed for monitoring and evaluation. Any intervention to prevent mistreatment will need to be multifaceted, and implementers should consider lessons learned from related interventions, such as increasing audit and feedback including from women, promoting labor companionship and encouraging stress-coping training for providers.

Perceptions of mistreatment among trainees vary at different stages of clinical training

BackgroundMistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignettes, our aim was to assess the perceptions of trainees toward themes of potential mistreatment at different stages of training.MethodsBased on observations from external experts embedded in the clinical learning environment, six thematic areas of potential mistreatment were identified: verbal abuse, specialty-choice discrimination, non-educational tasks, withholding/denying learning opportunities, neglect and gender/racial insensitivity. Corresponding clinical vignettes were created and distributed to 1) medical students, 2) incoming interns, 3) residents/fellows. Perceptions of the appropriateness of the interactions depicted in the vignettes were measured on a 5-point Likert scale. Scores were categorized into neutral or appropriate (≤3) or inappropriate (i.e. mistreatment) (>3) and compared using chi-squared tests.ResultsFour hundred twenty seven trainees participated (182 students, 120 interns, 125 residents/fellows). Proportions of students perceiving mistreatment differed significantly from those of interns and residents/fellows in domains of verbal abuse, specialty discrimination and gender/racial insensitivity (p < 0.05). In scenarios comparing interns to residents/fellows, no significant differences were noted in perceptions of mistreatment in the domains of non-educational tasks, withholding learning and neglect.ConclusionsPerceptions of mistreatment differ at different developmental stages of medical training. After exposure to the clinical learning environment, perceptions of incoming interns did not differ from those of residents/fellows, implicating clinical rotations as a key period in indoctrinating students into the prevailing culture. More longitudinal studies are needed to confirm or better examine this phenomenon.

When Does Differential Treatment Become Perceived Discrimination? An Intersectional Analysis in a Southern Brazilian Population

Despite ideals of equality and “racial democracy,” high levels of social inequality persist in contemporary Brazil. In addition, while the majority of the Brazilian population acknowledges the persistence of racism, high proportions of socially disadvantaged groups do not regard themselves as victims of discrimination. This study seeks to shed light on this issue by investigating the processes through which individuals come to interpret their experiences of mistreatment as discrimination. We ask: (1) How frequently do respondents perceive being treated differently due to a variety of social statuses alone and in combination? and (2) What factors are associated with respondents interpreting this differential treatment as “discrimination”? Data come from an ongoing cohort investigation, which included a representative sample of adults living in the urban area of Florianópolis. Results show that 45 percent of respondents experienced mistreatment and attributed it to two or more factors, such as social class, age, gender, and race. Perceptions of mistreatment based on social class were positively correlated with perceived mistreatment due to gender, place of residence, weight, race, and the way one dresses. Regression analyses revealed that interpreting differential treatment as stemming from multiple social statuses was the strongest predictor of respondents classifying their mistreatment as discrimination. Our findings highlight the importance of disentangling perceptions of mistreatment from perceptions of discrimination and show that the relationship between the two is structured in large part by the ways in which individuals interpret their experiences at the intersection of multiple inequalities.

The conceptualization of mistreatment by older American Indians

ABSTRACTThe problem of how to conceptualize elder mistreatment goes back several decades, and is especially important for ethnic minority populations, who may have perspectives that differ from the dominant society. This community-based participatory research study, which examined perceptions of mistreatment by family among 100 urban and rural older American Indians, permits a rare glimpse into how Native elders themselves understand this issue. Here, good treatment was conceptualized in terms of being taken care of, having one’s needs met, and being respected. We found relatively high standards for how elders should be treated—such as the belief that an elder’s needs should be anticipated and met without the elder needing to ask—in the face of widespread accounts of the mistreatment of elders within the community, largely through various acts of financial exploitation and neglect. Substance abuse and culture loss were blamed formuch of the elder mistreatment occurring in contemporary Native communities.

Aligning perceptions of mistreatment among incoming medical trainees

BackgroundLearner mistreatment has been a long-standing example of unprofessional behavior in medical training. Alignment of perceptions of professional behavior is a critical component of developing a defined organizational culture. Clinical vignettes addressing learner mistreatment can help to achieve this goal. Our aim was to determine whether using clinical vignettes to address learner mistreatment during onboarding can reduce variability in the perceptions of mistreatment. Materials and methodsExternal experts in the field of labor and employment relations embedded in the clinical learning environment identified six thematic areas of potential mistreatment. Corresponding clinical case vignettes were developed and presented to incoming trainees during the onboarding process, followed by facilitated discussion. Perceptions of mistreatment before and after discussion were assessed on a Likert scale, with results compared using F-test and t-test. ResultsThere were 145 participants. Most participants reported previously witnessing or experiencing episodes of mistreatment before matriculation (84%), with the majority reporting multiple events. The most common offenders were faculty (57%), residents/fellows (49%), and nurses (33%). Only 10% of incoming trainees reported a previous incident of mistreatment. Postintervention scores demonstrated decreased variability (P < 0.05) in perceptions of mistreatment in all but one vignette (withholding learning opportunities). Two vignettes demonstrated higher perception of mistreatment after intervention (noneducational tasks and gender or racial discrimination, P < 0.05). ConclusionsMistreatment remains a prevalent phenomenon in medical training involving a wide cross-section of healthcare providers. Trainees arrive with discordant definitions of mistreatment. Alignment of individuals' definitions can be achieved through the use of carefully crafted clinical vignettes and facilitated discussion.