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Available online at www.sciencedirect.com
Procedia Computer Science 00 (2018) 000–000

ScienceDirect www.elsevier.com/locate/procedia

Procedia Computer Science 120 (2017) 931–938

9th9th International
International Conference
Conference onon Theory
Theory and
and Application
Application ofof Soft
Soft Computing,
Computing, Computing
Computing with
with
Words and Perception, ICSCCW 2017, 22-23 August 2017, Budapest, Hungary
Words and Perception, ICSCCW 2017, 24-25 August 2017, Budapest, Hungary

Healthcare professionals’ exposure to mobbing behaviors and

relation of mobbing with job satisfaction and organizational
commitment
Vesile Erdogana*, Aytolan Yildirim,b
a
Near East University, Faculty of Health Sciences, Department of Nursing, Lefkoşa,TRNC, Mersin10, Turkey
Istanbul University Florence Nightingale, Faculty of Nursing, Department of Management in Nursing, Istanbul, Turkey.
b

Abstract

To determine the healthcare professionals’ exposure to mobbing behaviors and the relation of mobbing with job satisfaction and
organizational commitment. Of 897 healthcare professionals, 715 subjects were reached and 479 participants precisely completed
the questionnaires were enrolled. Demographic and occupational information was obtained via a questionnaire structured by the
authors. The Mobbing Behaviors Scale, Minnesota Satisfaction Questionnaire, and Organizational Commitment Scale were also
administered. The mean age of the participants was 37.3±8.3 years; of the participants, 77% were female and 72.7% were nurses.
The rate of exposure to one of the sub-dimensions of mobbing scale at least once in the last year was 66.4% for isolation, 71.8%
for attack on professional status, 78.1% for attack on personality, and 28.4% for direct negative behaviors. Females as compared
with males and participants with low income as compared to high income were more exposed to mobbing. Postgraduate participants
less commonly suffered from mobbing. The nurses as compared with doctors were more exposed to mobbing and the individuals
with an occupational experience of >10 years were more exposed to mobbing. Exposure to mobbing was negatively correlated with
external and general job satisfaction. Attack on personality and direct negative behaviors sub-dimensions were negatively
correlated with internal satisfaction. Isolation, attack on personality, and direct negative behaviors sub-dimensions were positively
correlated with normative commitment. The rate of exposure to mobbing was quite high among healthcare professionals. Although
job satisfaction is lower among the victims of mobbing, organizational commitment was not influenced much.

© 2018 The Authors. Published by Elsevier B.V.

Peer-review under responsibility of the scientific committee of the 9th International Conference on Theory and application of Soft Computing,
Computing with Words and Perception.

Keywords: Mobbing; health care; organizational commitment; job satisfaction.

* Corresponding author. Tel.: +905321547869; fax: +902122366344.

E-mail address: vesileerdogan@hotmail.com

1877-0509 © 2018 The Authors. Published by Elsevier B.V.

Peer-review under responsibility of the scientific committee of the 9th International Conference on Theory and application of
Soft Computing, Computing with Words and Perception.

1877-0509 © 2018 The Authors. Published by Elsevier B.V.

Peer-review under responsibility of the scientific committee of the 9th International Conference on Theory and application of Soft
Computing, Computing with Words and Perception.
10.1016/j.procs.2017.11.328
932 Vesile Erdogan et al. / Procedia Computer Science 120 (2017) 931–938
2 Vesile Erdogan et al./ Procedia Computer Science 00 (2018) 000–000

1. Introduction

Nowadays, people spend a considerable proportion of their lifetimes at work. Presence of conditions that make the
employees feel valuable and support them in the working environment is important. Mobbing that is one of the
problems encountered at workplace has gained importance in recent years. Mobbing is defined as an employee or a
group being emotionally harassed, affronted, and finally made non-functional by co-workers, subordinates, or
superiors. Mobbing frustrates and suppresses the exposed employees and put them in a vulnerable and desperate
situation (Leymann 1990, Vartia 2002). Although workplace mobbing is influenced by certain factors such as age,
gender, education level, organizational problems, and cultural features, it is a problem that everyone indiscriminately
has the potential to be exposed (Einarsen and Skogstad 1996, Zapf 1999).
Job satisfaction is defined as an effective sensation that develops depending on the interaction between employees,
their personal characteristics, and their expectations from the workplace and organization (Cumbey and Alexander
1998). Job satisfaction comprises overall job-related dimensions such as work-related success and responsibility
together with the employee’s emotions or satisfaction concerning their current job (Chang and Chang 2007). Job
satisfaction is also defined as the coherence between what the employees expect and what they get from the job and
organization and includes the employees’ attitudes, knowledge, beliefs, emotions, behaviors, and assessments
concerning their job (Lu et al. 2005, Cortese 2007). Low job satisfaction negatively influences physical, emotional,
and social health of an employee, reduces the quality of work, and causes the employee to be estranged from the job
(Bourbonnais et al. 1998, Kirkcaldy and Martin 2000). Organizational commitment was defined by Meyer and Allen
(1991) as the emotional state characterized by the relation of an employee with the organization and that is affective
in employee’s decision whether his/her membership of organization will continue or not. Three different components
of organizational commitment have been defined reflecting a desire (affective commitment), a need (continuance
commitment) and an obligation (normative commitment) (Meyer and Allen 1991). It has been reported that
organizational commitment is influenced by age, gender, educational level, structure of the organization, and job
satisfaction (Vagharseyyedin 2016, Veličković et al. 2014). High level of organizational commitment is associated
with low turnover, being late for work less frequently, and low rate of absenteeism (Liou 2008, Somers 1995).
Mobbing is being reported as a problem encountered frequently in healthcare sector, which already has stressful
working environment, and increasingly gains importance (Ofluoğlu and Somunoğlu 2012, Picakciefe 2015). Exposure
to mobbing in healthcare sector negatively influences not only the health and performance of employees but also the
quality of medical staff of health organization (Josipovic-Jelic 2005).

2. Materials and Methods

A total of 897 healthcare professionals (doctor, nurse, physiotherapist, dietician, psychologist, and social service
worker) provide services in 5 state hospitals affiliated with the Ministry of Health in the TRNC. The target was
reaching to all healthcare professionals for the present study. The healthcare professionals were informed about the
study via face-to-face interview and their verbal consents were obtained. Approval of the Local Ethics Committee was
obtained and the study was conducted in accordance with the Helsinki Declaration. A total of 715 healthcare
professionals were reached (79.7% of overall healthcare professionals) and 479 participants (67% of the healthcare
professionals reached) who precisely completed the questionnaire forms were enrolled.

2.1. Survey Questionnaires

Personal Information Form: Demographic and occupational information of the participants and information about
the organization they have been working in were inquired via a questionnaire form structured by the authors.

Mobbing Behaviors Scale: The Mobbing Behaviors Scale is a questionnaire used to measure the psychological
violence exposed in the workplace and consists of 33 questions in 4 categories. The categories were as follows:
isolation (11 items), attack on personality (9 items), attack on professional status (9 items), and direct negative
behaviors (4 items) (Yildirim 2007). Exposure of the participants to mobbing within the last 12 months was inquired
 Vesile Erdogan et al. / Procedia Computer Science 120 (2017) 931–938 933
Vesile Erdogan et al./ Procedia Computer Science 00 (2018) 000–000 3

using a 6-point Likert scale (5=constantly, 4=frequently, 3=occasionally, 2=several times, 1=once, 0=never). A score
of 1 or higher indicated that the individual was directly exposed to mobbing behavior.

Minnesota Satisfaction Questionnaire: The Minnesota Satisfaction Questionnaire is a 20-item 5-point Likert scale
used to measure job satisfaction including intrinsic satisfaction (12 items), extrinsic satisfaction (8 items), and
general (intrinsic + extrinsic) satisfaction (Baycan 1985). The scoring is as follows: 1=not satisfied at all, 2=not
satisfied, 3=undecided, 4=satisfied, 5=very much satisfied, with high scores indicating high job satisfaction.

Organizational Commitment Scale: The Organizational Commitment Scale is a scale consisting of three components
(affective commitment, normative commitment, and continuance commitment) and 18 items (Wasti 2005).
Definitions in the scale are rated between 1 (strongly disagree) and 7 (strongly agree). Higher scores indicate higher
commitment.

2.2. Statistical Analysis

Data analysis was performed using the Statistical Package for the Social Sciences (SPSS, Inc., Chicago, IL, USA;
version 17.0) program. Descriptive statistics were expressed as number and percentage for categorical variables and
as mean, standard deviation, and minimum and maximum for numerical variables. Since the numerical variables were
not normally distributed, comparisons between two independent groups were performed by Mann-Whitney U test and
comparisons between multiple independent groups were performed by Kruskal-Wallis test. Subgroup analysis was
carried out using Mann-Whitney U test and interpreted with Bonferroni correction. The relation between non-normally
distributed numerical variables was analyzed using Spearman’s correlation analysis. The level of statistical
significance was considered as p<0.05.

3. Results

The mean age of the participants (n=479) was 37.3±8.3 years (range, 23-71 years) and 77% of them were female.
Nurses accounted for the great majority of study participants (72.7%). The mean scores of the participants obtained
from the Mobbing Behaviors Scale, Minnesota Satisfaction Questionnaire, and Organizational Commitment Scale are
summarized in Table 1.
The results of the present study revealed that there was no significant difference between the age groups (<30 years
vs. >30 years) in terms of exposure to mobbing behavior. On the other hand, females were more exposed to mobbing
behavior as compared with males and the participants with low income level were more exposed to mobbing behavior
than in those with high income level. The participants in the postgraduate group less commonly suffered from
mobbing. The mean scores of the participants obtained from the mobbing scale according to the demographic and
occupational characteristics are demonstrated in Table 2. It was determined that the nurses were more exposed to
mobbing behavior as compared with the doctors and the participants with an occupation duration of more than 10
years were also more exposed to mobbing behavior.
The relation of mobbing with job satisfaction and organizational commitment are demonstrated in Table3.
Exposure to all sub-dimensions of the mobbing scale was determined to be negatively correlated with extrinsic
satisfaction and thereby with general job satisfaction. The sub-dimensions of attack on personality and direct negative
behaviors showed negative correlation with intrinsic satisfaction. The sub-dimensions of isolation, attack on
personality, and direct negative behaviors were found to be positively correlated with normative commitment.
Mobbing was not determined to be significantly correlated with affective commitment and continuance commitment.

4. Discussion

Exposure to mobbing is a serious and growing problem among healthcare professionals and affects a substantial
proportion of them (Ariza-Montes 2013). The present study, which investigated healthcare professionals’ exposure to
mobbing in the TRNC, found the rate of mobbing considerably high. The rate of exposure to one of the sub-dimensions
of the Mobbing Behaviors Scale at least once in the last year was found as 66.4% for isolation, 71.8% for attack on
934 Vesile Erdogan et al. / Procedia Computer Science 120 (2017) 931–938
4 Vesile Erdogan et al./ Procedia Computer Science 00 (2018) 000–000

professional status, 78.1% for attack on personality, and 28.4% for direct negative behaviors. In the literature, reported
rates of exposure to mobbing behavior vary among healthcare professionals. In their study, Fşkn (2011) determined
that 58% of primary healthcare professionals were exposed to mobbing behaviors at least once. Yurdakul et al. (2011)
reported that one of every 5 midwives/nurses working in hospitals was exposed to mobbing behavior. Ayranc et al.
(2002) found that 50.8% of healthcare professionals working in various health institutions were exposed to one or
more types of violence at any moment while working. Xing et al. (2015) determined the prevalence of physical
violence against general practitioners and nurses to be 12.6% in a year. Askew et al. (2012) reported that 25% of the
doctors in the Australian medical workforce were exposed to bullying in one year.
Tutar and Akbolat (2012) evaluated perception of mobbing among healthcare professionals and determined that
male employees as compared with female employees had higher perception of mobbing concerning the dimensions
of bullying aiming at one’s private life and bullying aiming at prevention of self-improvementIn their study conducted
on health employees, Yldz et al. (2013) stated that males are exposed to mobbing behaviors more commonly than
females. The present study found significant differences among the education groups in all sub-dimensions of mobbing
scale and determined that the postgraduate group was exposed to less mobbing behavior. Zonp (2012) reported that
exposure to the behaviors that harm social dignity was more common among nurses with a postgraduate degree in
education. Şahin (2010) reported that employees with a postgraduate degree were more exposed to negative behaviors
in the dimensions of limitation of self-expression and communication skills, attack on social relationships, and attacks
on quality of life and professional status. Higher exposure to mobbing has been reported for the employees with low
monthly income (Çakl 2011). The present study also determined that the employees with low monthly income were
more exposed to mobbing behavior.
The present study demonstrated that nurses were more exposed to negative behaviors in all sub-dimensions of
mobbing scale as compared with doctors. Efe and Ayaz (2010) reported the frequency of exposure to mobbing
behavior among nurses as 9.7% according to the mobbing scale, whereas it was 33% according to their own
declarations. Yildirim and Yildirim (2007) reported that 86.5% of the nurses participated in their study were exposed
to mobbing behavior in the last year. In their longitudinal cohort study, Camerino et al. (2000) determined that work-
related negative factors were associated with the nurses’ exposure to violence in the workplace. It has been reported
that job satisfaction among nurses working in hospitals is rather associated with organizational features and work-
related factors than with personal characteristics (Adams and Bond 2000, Coomber and Barriball, 2007). Zonp (2012)
determined that night workers are more exposed to social dignity-harming behaviors and verbal, written, and visual
attacks, which directly affects the health, as compared with the other workers (day workers, shift workers, and
occasional shift workers). The present study determined no effect of daytime work or shift work on exposure to
mobbing. In the present study, it was determined that the healthcare professionals with an occupation duration of more
than 10 years were more exposed to negative behaviors in the dimensions of isolation, attack on personality, and direct
negative behaviors. Saraç (2011) found the rate of exposure to mobbing to be higher among healthcare professionals
with an occupational experience of 1-3 years and 4-6 years as compared with those with an occupational experience
of less than 1 year. Some studies have reported that healthcare professionals’ duration of employment has no effect
on exposure to mobbing (Tutar and Akbolat 2012, Yldz et al. 2013, Çakl 2011).
Studies investigating the relationship between mobbing and job satisfaction in healthcare sector have stated that
there is a negative correlation between mobbing and job satisfaction and that psychological violence negatively
influences the workers’ work life and decreases the productivity (Karcoğlu and Akbaş 2010, Vega and Comer 2005).
Studies in healthcare professionals have demonstrated that organizational commitment is increased with job
satisfaction (Çelik 2012, Top 2012). It has been stated that organizational commitment decreases and employee
withdrawal is encountered among those exposed to mobbing (Ergun et al. 2008). In the present study, evaluation of
the relation of mobbing with job satisfaction and organizational commitment revealed that all sub-dimensions of
mobbing scale were negatively correlated with intrinsic satisfaction and thereby with general job satisfaction. In
addition, it was determined that the sub-dimensions of isolation, attack on personality, and direct negative behaviors
showed positive correlation with normative commitment but no correlation with affective or continuance commitment.
Accordingly, we could state that job satisfaction was low; however, organizational commitment was not negatively
influenced in healthcare professionals exposed to mobbing behavior.
In conclusion, the present study determined that exposure to mobbing was quite high among healthcare
professionals in the TRNC. Females as compared with males and the employees with low income as compared with
 Vesile Erdogan et al. / Procedia Computer Science 120 (2017) 931–938 935
Vesile Erdogan et al./ Procedia Computer Science 00 (2018) 000–000 5

those with high income were more exposed to mobbing. Employees with a postgraduate degree in education were less
frequently the victims of mobbing. Moreover, it was found that the employees with an occupational duration of more
than 10 years and the nurses were more exposed to mobbing. It was determined that job satisfaction was low; however,
organizational commitment was not influenced in healthcare professionals exposed to mobbing behavior. In other
words, it could be stated that healthcare professionals exposed to mobbing behavior were committed to their
organizations (normative commitment) although their extrinsic job satisfaction (factors related to working
environment such as policy and administration of institution, type of audit, relationships with superiors, co-workers,
and subordinates, working conditions, and salary) was low because they felt obliged to. The behaviors that are likely
to be beneficial in preventing or reducing mobbing can be summarized as follows: providing in-service trainings to
increase awareness, enabling clear and effective communication between employees, determining the profiles of
employees having higher perception of mobbing and providing specific trainings for sensitive groups, and determining
organizational policies that would clearly exhibit the task, authorization, and responsibility of the employees.

Table 1. Mean scores of the participants obtained from the Mobbing Behaviors Scale, Minnesota
Satisfaction Questionnaire, and Organizational Commitment Scale
Score
Mean±Standard Deviation
Mobbing Behaviors Scale
Isolation 10.9±8.2
Attack on professional status 9.9±7.8
Attack on personality 8.9±6.8
Direct negative behaviors 4.0±3.4
Minnesota Satisfaction Questionnaire
Intrinsic satisfaction 41.6±9.5
Extrinsic satisfaction 24.6±6.3
General satisfaction 66.1±14.5
Organizational Commitment Scale
Affective commitment 23.5±6.5
Normative commitment 24.8±7.7
Continuance commitment 24.6±7.5

Table 2. Mean scores of the participants obtained from the Mobbing Behaviors Scale according to the
demographic and occupational characteristics
Scores
Mean±Standard Deviation
Attack on Direct
Attack on
Isolation professional negative
personality
status behaviors
Age, year
≤30 6.5±8.0 6.0±6.3 7.1±6.9 0.8±2.5
>30 7.5±8.5 6.3±7.3 7.0±7.2 1.2±2.6
p 0.689 0.843 0.559 0.164
Gender
Female 7.9±8.6 7.0±7.3 7.7±7.4 1.1±2.4
Male 5.1±7.5 3.7±5.4 4.7±5.4 1.1±3.0
p <0.001 <0.001 <0.001 0.077
Marital status
Married 6.9±8.0 6.1±7.1 6.6±7.0 1.2±2.5
Single 8.4±9.6 6.7±6.8 8.6±7.3 1.0±2.6
p 0.276 0.231 0.003 0.729
Having a child
Yes 7.1±7.7 6.4±7.1 7.1±7.0 1.2±2.6
No 7.6±10.0 5.9±7.0 6.8±7.4 0.9±2.5
p 0.353 0.400 0.382 0.113
Educational status*
High school 8.9±7.9d 6.1±5.9 6.6±5.5 2.2±3.6d
Associate degree 8.7±8.9d 7.5±7.4d 9.0±7.6d 1.7±2.4c,d
Graduate 7.4±8.6d 6.8±7.2d 7.6±7.4d 0.9±2.5b
936 Vesile Erdogan et al. / Procedia Computer Science 120 (2017) 931–938
6 Vesile Erdogan et al./ Procedia Computer Science 00 (2018) 000–000

Postgraduate 5.4±7.9a,b,c 4.9±7.0b,c 5.2±6.6b,c 0.7±1.9a,b

p 0.001 0.002 <0.001 <0.001
Monthly income, TL
≤4000 8.0±8.7 7.2±7.2 7.5±7.0 1.1±2.4
>4000 5.5±7.5 4.3±6.3 5.9±7.1 1.2±2.8
p <0.001 <0.001 0.002 0.290
Occupation**
Medical Doctor 3.3±6.3y 2.9±4.6y 4.4±6.6y 0.6±1.9y
Nurse 8.3±8.4x 7.4±7.4x 8.0±7.1x 1.3±2.7x
Other 9.0±12.3 4.7±5.9 4.7±5.4 0.5±1.3
p <0.001 <0.001 <0.001 0.001
Duration of occupation,
year**
≤5 6.6±8.3 5.7±6.3 5.9±6.7 0.7±2.5g
6-10 5.0±6.9g 4.9±6.2 6.0±6.5g 0.6±1.7g
>10 8.2±8.8f 6.9±7.5 7.7±7.4f 1.5±2.8e,f
p 0.005 0.068 0.027 0.001
Duration of
employment in the
same hospital, year
≤5 6.2±7.8 5.8±6.2 6.1±6.6 0.7±2.2
>5 7.6±8.6 6.4±7.3 7.3±7.2 1.3±2.6
p 0.254 0.962 0.120 0.004
Type of the job
Daytime 7.5±8.8 6.6±7.7 7.0±7.1 0.9±2.0
Daytime/Nighttime 7.1±8.2 6.1±6.7 7.0±7.1 1.3±2.8
p 0.827 0.980 0.685 0.135
a: Different from the high school group, b: Different from the associate degree group, c: Different from
the graduate group, d: Different from the postgraduate group; *p<0.008 for paired comparison with
Bonferroni correction.
x: Different from the doctor group, y: Different from the nurse group and e: Different from the
participants with a duration of occupation of ≤5 years, f: Different from the participants with a duration
of occupation of 6-10 years, g: Different from the participants with a duration of occupation of >10
years; **p<0.017 for paired comparison with Bonferroni correction.

Table 3. Relation of mobbing with job satisfaction and organizational commitment

Mobbing
Attack on
Attack on Direct negative
Isolation professional
personality behaviors
status
rho p rho p rho p rho p
Job
satisfaction
Intrinsic job -0.045 0.333 -0.077 0.096 -0.137 0.003 -0.161 <0.001
satisfaction
Extrinsic job -0.160 <0.001 -0.160 <0.001 -0.158 0.001 -0.15 0.012
satisfaction
General job -0.116 0.011 -0.138 0.003 -0.163 <0.001 -0.169 <0.001
satisfaction
Organizational
commitment
Affective -0.040 0.386 -0.010 0.833 -0.033 0.468 0.021 0.653
commitment
Normative 0.150 0.001 0.088 0.055 0.110 0.016 0.093 0.044
commitment
Continuance -0.005 0.916 0.050 0.276 -0.023 0.617 0.017 0.714
commitment
 Vesile Erdogan et al. / Procedia Computer Science 120 (2017) 931–938 937
Vesile Erdogan et al./ Procedia Computer Science 00 (2018) 000–000 7

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