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There is an increased focus on healthcare workers' bullying due to various individual, organisational, and social factors that may elevate the risk of bullying among healthcare employees. This scoping review aims to identify knowledge gaps regarding the theorising of bullying and the prevention and management of bullying in healthcare settings.
A scoping review of systematic reviews and meta-analyses was conducted using PRISMA guidelines.
Systematic reviews and meta-analyses (N = 18) involving healthcare workers (i.e., doctors, nurses, and allied health professionals) were identified through a vigorous search of ProQuest Central, PubMed, PubMed Central, Google Scholar, Scopus, PsycINFO (PsycNet), and Web of Science databases.
The included reviews were explored to identify theoretical explanations of bullying and strategies for bullying prevention and management. Thematic analysis was applied to synthesise findings.
The results indicated that workplace culture, hierarchy within healthcare organisations, inactive institutional power, and conflict are key theoretical constructs that may explain bullying among healthcare workers. Further, a comprehensive approach of individual and organisational-level factors, involving organisational policies and procedures, creating awareness to promote effective reporting of bullying, and the role of leaders and managers, was identified as critical for preventing and managing bullying.
The scoping review emphasises the need for integrating theoretical frameworks that consider both individual and systemic aspects of bullying in healthcare organisations. Addressing these aspects can improve the effectiveness of strategies for bullying prevention and management.
Understanding the theoretical approaches to explain bullying of healthcare employees can provide a concrete foundation for targeted interventions and organisational policies that address bullying at multiple levels, therefore improving healthcare workers' wellbeing and workplace culture.
No direct patient or public contribution was related to the scoping review.
Oesophageal cancer (EC) is a common cause of cancer mortality. Evidence on the burden, risk factors and treatment outcomes is limited in low-income and middle-income countries. This study aimed to describe the features of EC cases and determine associated factors among patients attending surgical and oncology clinics in Garissa County Referral Hospital (GCRH).
We conducted a case–control study in which cases were patients with EC and positive histological confirmation and controls were patients admitted to GCRH for other diseases. Data on exposures were extracted from patient files. Data on tobacco and alcohol use were based on current or past use as documented in the records; hot tea intake referred to habitual consumption. Mixed-effect logistic regression model was used to determine EC-associated factors.
141 cases and 282 controls were recruited. Of the 141 cases, 59 (42%) had cancer in the lower third of the oesophagus, whereas 72 (51%) and 10 (7%) had cancers in the middle and upper thirds, respectively. EC was associated with tobacco use (adjusted OR (AOR), 21.02, 95% CI 5.41 to 81.69), consumption of hot tea (AOR 59.87, 95% CI 5.45 to 657.35), chewing khat (miraa, AOR 9.94, 95% CI 3.59 to 27.52), gastro-oesophageal reflux disease (GERD) (AOR 54.12, 95% CI 24.48 to 119.62), gastritis (AOR 17.89, 95% CI 2.94 to 108.989) and peptic ulcer disease (PUD) (AOR 69.31, 95% CI 14.09 to 340.9). Among the case group, 95 (65%) had surgery or gastrostomy tube placement as treatments for EC.
The study findings highlight modifiable risk factors for EC, including tobacco use, hot tea consumption, chewing miraa, GERD, gastritis and PUD. Targeted screening of high-risk patients may improve early detection and outcomes.
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