Impact of workplace bullying on missed nursing care and quality of care in the eldercare sector

  • Annie HoghEmail author
  • Marianne Baernholdt
  • Thomas Clausen
Original Article



To analyze the long-term impact of bullying among healthcare providers (T1) on missed nursing care and quality of care 2 years later (T2) and to test the potential mediating effect of affective organizational commitment.


Survey data from healthcare providers in the eldercare sector in 2006 (T1) and 2008 (T2). At T1, 9212 employees participated in the survey and 5202 participated in both T1 and T2. Including only participants who were directly engaged in the provision of care yielded 4000 providers, who were employed in 268 workgroups at T1 and T2. Associations between exposure to bullying (predictor) and the two outcomes (missed nursing care and quality of care) were investigated using multi-level linear regression analysis. Included covariates were age, gender, job position, work place and tenure.


We found a significant association between workplace bullying at T1 and missed nursing care at T2 but not for quality of care at T2. Affective organizational commitment did not mediate the association between bullying and the two outcomes. However, affective organizational commitment at T1 was associated with quality of care at T2.


Exposure to bullying at work may cause the provider to miss nursing care for clients. To improve, care administrators should consider implementing bullying prevention strategies at three levels: organizational, work group and individual.


Affective organizational commitment Bullying Missed nursing care Quality of care 



The Danish government supported the collection of the data.

Author contributions

Conception of the study: AH and MB; design: all authors; acquisition of data and analyses: TCL; interpretations, drafting and critically revising and final approval: all authors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
  2. 2.School of NursingVirginia Commonwealth UniversityVirginiaUSA
  3. 3.National Research Centre for the Working EnvironmentCopenhagenDenmark

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