WORKFORCE ISSUES

Development and psychometric evaluation of workplace

psychologically violent behaviours instrument
Yildirim Dilek
Gazi University, Nursing School, Etiler, Ankara, Turkey

Yildirim Aytolan
Department of Nursing Administration, IU Florence Nightingale College of Nursing, Istanbul, Turkey

Submitted for publication: 18 July 2007

Accepted for publication: 10 November 2007

Correspondence:
Dilek Yildirim
Gazi University
Nursing School
Etiler
Ankara 06330
Turkey
Telephone: +90 312 202 33 53
E-mail: dilekyildirim2005@hotmail.com

D I L E K Y & A Y T O L A N Y ( 2 0 0 8 ) Journal of Clinical Nursing 17, 13611370

Development and psychometric evaluation of workplace psychologically violent
behaviours instrument
Aim. To develop an instrument to determine nurses perceptions of psychologically
violent behaviours that they are exposed to in the workplace.
Background. According to Leymann, psychological terror or mobbing in work life
involves hostile and unethical communication, which is directed in a systematic way
towards one individual who, due to mobbing, is pushed into a helpless and defenceless position, and being held there by means of continuing mobbing activities.
Design. Survey.
Methods. Because nurses who work in hospitals are generally the principle victims
of physical, emotional and verbal violence due to the nature of their work environment, the research sample comprised 476 hospital nurses. Data were collected
via self-administered questionnaires.
Results. The instrument to determine the perception of workplace psychologically
violent behaviours contains 33 items and four factors (individuals isolation from
work, attack on professional status, attack on personality and direct attack). All
items have shown statistically significant correlation (p < 001); the instruments
total Cronbachs a internal consistency coefficient was found to be 093.
Conclusions. The findings show that the instruments validity and reliability
are within the limits of an acceptable level and that it is an instrument that will
encourage more studies on this subject.
Relevance to practice. Defining the psychological pressure that nurses are exposed to
in the workplace and determining its negative effects on the victim of workplace
psychological pressure and on the institution will make it possible to protect
individuals and the institution from psychological violence with both individual
and institutional practices.

Key words: instrument development, mobbing, nurses, nursing, psychological

terror, psychometrics

 2008 The Authors. Journal compilation  2008 Blackwell Publishing Ltd

doi: 10.1111/j.1365-2702.2007.02262.x

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Y Dilek and Y Aytolan

In the last decade research conducted in many different

cultures has shown that workplace psychological violence is a
very widespread and serious problem (Leymann 1990, 1996,
Bjorkqvist et al. 1994, Quine 1999, Fox & Stallworth 2003,
Rutherford & Rissel 2004, Bilgel et al. 2006, Hansen et al.
2006). The concept of workplace psychological violence
(mobbing) was defined for the first time in the 1980s by
Heinz Leymann (Davenport et al. 1999). Leymann (1996)
defined workplace psychological violence as a type of
psychological terror that arises in the form of systematic,
directed, unethical communication and antagonistic behaviour by one or more individuals towards one individual.
Psychological abuse has become more widespread because of
legal regulations, particularly in public facilities, against
physical violence. For this reason, victims of mobbing are
subjected to attitudes and behaviours that can be psychologically abusive, such as, terrorising, annoying, excluding,
being a target, belittling, being deprived of some organisation
resources, isolating, being treated unjustly in the use of
organisational resources, being prevented from or delayed
from claiming rights, being spoken about behind ones back
by saying bad things that are not true about the individual
and spreading rumours that someone is psychologically
unstable (Leymann 1990, Einarsen 2000, Cowie et al.
2002, Tutar 2004). These behaviours towards the individual
can be from the facilitys management, superiors, coworkers
in the same position or subordinates (Einarsen 2000, Fox &
Stallworth 2003). The individual or individuals acting
psychologically abusive, mount an organized front against
the individual with systematic, long term, frequently occurring bullying behaviours that also affect others. Others who
work in the facility act as if they do not see these behaviours,
close their eyes to them or even provoke them. The victim
feels helpless facing so many powerful people and mobbing
occurs (Leymann 1990, Einarsen 2000, Cowie et al. 2002,
Tutar 2004).

professional competency is questioned, at the same time the

victims professional identity comes up for discussion and a
circle of distrust is created around the individual. According
to the individual/individuals administering the psychological
violence, if the employee or their work is not trustworthy,
then the work they do is worthless and the individual him/
herself is made to feel worthless. Following this, the victim is
continually and systematically bothered by behaviours that
are controlling and have bad intentions which are directed at
belittling and embarrassing the victim with negative communication (Leymann 1990, 1996, Davenport et al. 1999, Tutar
2004, Tnaz 2006). Brodsky (1976; cited in Einarsen 2000)
identified five forms of harassment: scapegoating, name
calling, physical abuse, work pressure and sexual harassment.
At the same time, Leymann (1996) identified five different
categories of terrorising behaviours that victims of workplace
psychological violence may face. These are:
1 Effects on the victims possibilities to communicate adequately;
2 Effects on the victims possibilities to maintain social
contacts;
3 Effects on the victims possibilities to maintain their personal reputation;
4 Effects on the victims occupational situation;
5 Effects on the victims physical health.
In the literature, there is no completely accepted, general
definition for workplace mobbing, or psychological violence
(Einarsen 2000, Cowie et al. 2002). In addition, Adams
(1992) emphasises that workers behaviours that include
continuous unjust criticism and attacks on personality and
professional status are done in front of others and within a
group, but that it is difficult to determine this tactic clearly
and that this is related to the perception of this situation by
the victim of this behaviour. For this reason more than the
contents of the negative behaviour the victim is exposed to,
the difficulty that the person experiences in protecting him/
herself against these attacks is emerging an important
conceptual factor.

The behaviours involved

Frequency of behaviours

It is accepted that workplace psychologically violent actions

are found almost all over the world. The International
Labour Organization has determined that, because there are
more victims of bullying than other forms of violence and
harassment, in the new millennium, the most important
problem to be faced in the workplace are acts of psychological violence (Chappell & Di Martino 2000). In general, in
psychological violence, there are actions that demean the
employees image, professional ethics and competency. When

The victim is affected by the frequency, repetitiveness and

length of the bullying activities. As psychological violence
and its duration increase, its effect also increases (Einarsen
2000, Salin 2003a). Everyone has a different limit of
endurance for psychological violence. A situation that one
person could tolerate may seriously damage another person
who may be psychologically injured. Psychological violence
that continues for a long period has negative psychological,
physiological and social effects on the victim (Einarsen 2000,

Introduction

1362

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Workforce issues

Bjorkqvist 2001, Salin 2003b). It has been reported that

individuals who are exposed to long-term and continuous
workplace bullying in the work place have decreased selfrespect (Einarsen 2000, Randle 2003) and experience
anxiety, depression and rage (Quine 1999, Bilgel et al.
2006). Some workplace bullying victims show symptoms of
Post Traumatic Stress Disorder (Leymann 1996, Fox &
Stallworth 2003, Bilgel et al. 2006) and some victims even
attempt suicide (Leymann 1990, 1996). To balance and
decrease the pressure exerted on individuals exposed to
workplace bullying, individuals begin to call in sick to work,
resign either by their own choice or by force, are fired, or are
forced into early retirement (Davenport et al. 1999, Jackson
et al. 2002, Tnaz 2006).

Literature review
The number of research studies on psychological violence
that harms an individual in work and social life is increasing
(Bjorkqvist et al. 1994, Hoel & Cooper 2000, Fox &
Stallworth 2003, Ferrinho et al. 2003, Rutherford & Rissel
2004, Hansen et al. 2006). One study conducted by Fox and
Stallworth (2003) with members of ethnic groups in America
found that 97% of the participants had encountered some
form of workplace psychological violence in the last five
years. In a study conducted in South Africa, 78% of the
participants reported that they had been exposed to workplace psychological violence sometime during their own
careers (Steinman 2000). In a study by Bjorkqvist et al.
(1994) with university employees, it was determined that
26% of women and 17% of men had faced workplace
psychological violence. In a study by Bilgel et al. (2006)
conducted in Turkey, 55% of the participants had endured
one or more types of bullying in the last year and 47% had
witnessed one or more types of bullying in their places of
work in the last year. The importance of workplace
harassment in health care institutions has begun to be
recognised. In a study by Matthiesen et al. (1989), 10% of
nurses had been exposed to workplace psychological
violence. Niedl (1996) determined that 27% of nurses face
antagonistic behaviour in the workplace one or more times a
week. In a study conducted in the health care sector in
Portugal, 51% of the health care professionals had encountered verbal abuse in the last 12 months and 60% had been
exposed to psychological violence in the workplace (Ferrinho
et al. 2003). In a study conducted in Australia by Rutherford
and Rissel (2004), it was determined that 50% of nurses had
been exposed to one or more instances of workplace
psychologically violent behaviours (WPVB) within the last
12 months. Mayhew and Chappell (2001) determined that

Workplace psychologically violent behaviours

because the majority of nurses are women, they are exposed

to more workplace harassment than other health care
workers. Ferrinho et al. (2003) reported that every type of
violent behaviour in health care facilities is experienced more
by women than by men. Until May 2007, in Turkey, only
women could legally be employed in the nursing profession
and the nursing profession, was, therefore, considered a
woman-dominant profession.

Aim of the research

Even if instruments used in research show differences, the
common result obtained in various studies in different
cultures is that workplace psychological violence is a problem
and that there are very similar types of behaviours in different
cultures. For this reason we planned to develop an instrument
that would have a part in researching the perception of
workplace psychological violence in our country and would
be beneficial for future research. Although WPVB are seen in
every sector, it has been determined that they are more
common in social service institutions, health care institutions
and universities (Chappell & Di Martino 2000). Based on
this fact, our research sample was comprised of nurses, who
represent an important part of the workforce in the health
sector. Nurses who work in hospitals are generally the
principle victims of physical, emotional and verbal violence
due to the nature of their work environment. In studies about
nurses exposure to violence, it has been seen that nurses are
at greater risk for being exposed to workplace violence than
other health care workers and that the basic sources of
violence are patients, patients relatives, physicians and other
health care workers (Jackson et al. 2002, Alcelik et al. 2005,
Ayranci 2005, Rowe & Sherlock 2005, Yes ildal 2005). As
mentioned previously in research conducted on subjects of
workplace psychological violence it has been seen that nurses
frequently experienced psychological violence. For this
reason, nurses were used for the research sample. However,
there was no valid and reliable instrument that had been
developed for determining workplace psychological violence
to which nurses are exposed. This inadequacy makes it more
difficult to determine the workplace psychological violence
that nurses experience and, therefore, more difficult for both
the individual and the institution to cope with it. The goal in
our study was to develop an instrument that would primarily
have an important part in research on this subject and that
would be beneficial for future research. With this goal, this
research was planned for the purpose of developing an
instrument to determine nurses perceptions of psychologically violent behaviours that they experience in the workplace.

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1363

Y Dilek and Y Aytolan

Method
Sampling
The hospital in which we planned to conduct the research
was sent a written request explaining the purpose and
method of the study and after receiving permission from the
institution, data collection begun. When data were collected,
the purpose of the study was explained and the nurses verbal
consent was obtained. The total number of nurses employed
at the hospital at the time of the research was 690, of those
640 were given the survey and 476 responses were obtained
(74% response rate). There were 50 nurses who could not be
reached because they were on vacation or illness leave or
because of their work schedules. The data were collected by
the researchers between February and April 2006. (When
data were collected, the nurses were given information about
the purpose of the study by the researchers/nurse academicians and their verbal consent was received. In addition, the
participants were informed that the data obtained would be
kept confidential, their names would not be revealed and it
was suggested that they complete the forms at a time and
place that was convenient for them. After completing the
forms, they were asked to fold and place them in an
envelope, then seal the opening and give them to the same
researcher one week later. When participants could not be
found on the date arranged, the researcher went to the unit
again four days later until all participants were reached.
During data collection 50 participants were asked to write a
nickname that they could remember on the data collection
form, so they could be found again. Four weeks later, only 49
of these 50 participants could be reached.) At the time of this
research, in accordance with the 1954 Nursing Law, only
women could be employed as nurses and for that reason all
of the participants were women. To determine the perception
of psychological violence in the workplace using instruments
testretest reliability, 49 of the participants were reached
four weeks later and the same instrument was administered
again.

Development of list of workplace psychologically

violent behaviours
The behaviour list developed for the purpose of determining
nurses perception of WPVB is presented in Table 1. When
preparing the list of bullying behaviours, first individual indepth interviews were conducted with clinicians and academician nurses (12 individuals who reached them by network
sampling) who had experienced or were still experiencing
workplace bullying. The participants gave their permission
1364

for the interviews to be tape recorded. The tape-recorded

interviews were transcribed and every one was read
individually. Then the WPVB were categorised and related
concepts were determined. Based on the categories and
concepts determined, the interview texts were analysed
descriptively and systematically. A framework of WPVB
was created according to the results of the analysis. In
addition, behaviours and concepts related to psychological
violence were determined from previous research on the
subject of workplace psychological violence/mobbing and
from previously developed instruments (Leymann 1990,
Niedl 1996, Zapf et al. 1996, Davenport et al. 1999, Fox
& Stallworth 2003). An item pool of psychologically violent
behaviours was then created from the results of the in-depth
interviews and literature analysis. Then there were 53
statements in the item pool that were considered to be
psychologically violent behaviours. This prepared psychologically violent behaviour item pool was sent to seven experts
on the subject of workplace psychological violence, primarily
in health related areas (two psychiatric nursing professors,
three professors in management and behavioural science, one
professor and one assistant professor of nursing management). The experts were asked to examine every item in the
item pool to evaluate whether or not it reflected the subject
determined for measurement, its clarity for understanding
and the items logical appropriateness for the key target.
When the experts evaluated the items they evaluated them as,
very appropriate, item needs to be put into an appropriate
form, appropriate but needs minor changes or not
appropriate. Using the opinions given by the experts
regarding each item the items comprehensive validity rate
was determined. Based on the determined rates, taking into
consideration the questions in every factor, a factors
comprehensive validity index was created. Then, to determine the most accurate and understandable statements and
to minimise the risk of error, a panel was organized of the
experts who had given their opinions; however, only four of
the seven experts were able to participate in the panel. The
opinions and recommendation of the panel and seven
experts were evaluated and 20 inappropriate items were
removed from the item pool and 12 items were rewritten as
statements. The items that were presented for expert
opinion but which were later removed or combined with
other items were these: not recognising your status and
treating you as if you have a lower status, being blamed
unjustly, considering work you have done to be meaningless and unnecessary, having your work supervised by
someone in a lower position than you, not valuing your
work, giving heavier assignments than you can do, in a
demeaning manner, giving you jobs that are below your

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Workforce issues

Workplace psychologically violent behaviours

Table 1 Mean, SD and item analysis of workplace bullying (n = 476)

M
A. Individuals isolation from work
A1. Being treated in your workplace as if you arent seen and dont exist
A2. Not being able to get an answer to your request for a meeting and to talk
A3. Having duties that you are responsible for taken from you and given to
others in lower positions
A4. Not being giving an opportunity to prove yourself
A5. Not being informed about social meetings that are organized
A6. Having the decisions and recommendations you have made criticized and
rejected
A7. Being inspected by others in positions below yours
A8. Frequently being interrupted while you are speaking
A9. Pressuring you to quit your job or change your workplace
A10. Not receiving an answer to e-mail you have sent and telephone calls
A11. Hiding information, documents and material from you that you need
for your job
B. Attack on professional status
B1. Always having errors found in your work and work results
B2. Holding you responsible for work more than your capacity
B3. Being held responsible for negative results of work done with others
B4. Being blamed for things you are not responsible for
B5. Always having your professional adequacy questioned in the work
you do
B6. Considering the work you have done as without value and importance
B7. Always having your performance evaluated negatively
B8. Having you feel like you and your work are being controlled
B9. Being forced to do a job that will negatively affect your self-confidence
C. Attack on personality
C1. Facing behaviours such as slamming fist onto table
C2. Having untrue things said about you
C3. Being verbally threatened
C4. Having someone speak about you in a belittling and demeaning manner
in the presence of others
C5. Having someone behave in a demeaning manner (using body language)
towards you in the presence of others
C6. Having false rumours said about your private life
C7. Having someone suggest that you are not psychologically well
C8. Having your honesty and reliability questioned
C9. Having unfair reports written about you
D. Direct Negative Behaviours
D1. Having physical violence used
D2. Harming your personal things
D3. When you enter an area knowingly leaving the area where you are
D4. Preventing or forbidding coworkers from talking with you
Total mobbing behaviours

qualifications, blaming you for results even though you are

not the only person responsible for the results, putting
pressure on you to quit work or change your place of work,
having your worksite and the work you do directly
supervised. Based on expert opinion about the 53 items
in the item pool and after necessary revisions were made a
final list of 33 items of mobbing behaviours was prepared
(Table 1).

SD

Total item
correlation (p < 0001)

Cronbachs a r
(p < 0001)

081
051
030

111
121
090

062
056
057

068
064
066

089
068
116

133
142
142

063
058
064

070
063
074

052
089
041
038
032

101
126
096
072
065

057
065
049
062
057

067
062
051
069
059

123
098
099
132
064

126
152
138
120
113

049
048
052
057
059

066
066
065
058
067

131
076
153
082

158
108
149
112

051
063
038
059

045
069
056
057

064
136
084
143

091
122
125
152

046
059
049
068

049
065
066
074

095

137

065

069

057
046
083
027

121
074
101
067

050
054
055
044

062
063
065
053

025
019
033
029
2335

042
053
062
071
2086

047
044
051
055
Total a093

049
057
059
063

Workplace psychologically violent behaviours instrument

In a study by Rivers (University of Surrey, UK, unpublished
PhD Thesis) with 60 lesbians, gay men and bisexual men
and women, they were asked about bullying behaviours they
had been exposed to and that they could remember in the last
1214 months (1999; cited in Cowie et al. 2002). In the
examination of studies conducted on this subject, some ask

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1365

Y Dilek and Y Aytolan

the participants about workplace mobbing behaviours they

had been exposed to in the last six months and other studies
consider the last 12 months (Bjorkqvist et al. 1994, Einarsen
& Skogstad 1996, Einarsen & Raknes 1997, Fox &
Stallworth 2003). Based on this, the nurses were asked to
mark the frequency within the last 12 months that they had
faced items on the list they were given of workplace
antagonistic and unethical behaviours that have a negative
effect on work performance and to mark by whom every
behaviour they had been exposed to had come from (supervisor, coworker, subordinate and other). A six-point Likert
type scale was used for the determination of frequency of
behaviours with 0 = I have never faced, 1 = I have faced
once, 2 = I face this sometimes, 3 = I have faced several
times, 4 = I frequently face this, 5 = I constantly face this.
Individuals who receive a score from the scale divided by
the number of items (total score/33) that is one or greater can
be said to have faced intentional workplace mobbing
behaviours.

Statistical measurements
The WPVB Instruments total and subgroups internal consistence reliability were measured using Cronbachs a coefficient. The Pearsons correlation coefficient was examined for
testretest analysis. For the construct validity of the WPVB
instrument, first the datas homogeneity was tested with
Kaiser-Meyer-Olkin (KMO) Measure of Sampling Adequacy
test. Because the test result was 0962, the data which were
used for factor analysis were seen to be homogeneous. In
addition, Bartletts test of sphericity, which tests whether the
correlation matrix is an identity matrix was significant
(p < 0001). Next, the WPVB instruments construct validity
was calculated using the rotational factor analysis technique.
Principle Component technique and Varimax rotation method
were used for this analysis. The Eigenvalue and explained
percentage in factor analysis were examined for the purpose of
determining which items were in how many factors. The
relationships between the subgroups on the instrument were
analysed using the Promax Rotation Method.

Results
Demographic characteristics
In the examination of the participating nurses demographic
characteristics, it was determined that their mean age
was 2934 (SD 873), total years of employment was 1096
(SD 635) and years of employment at their current
institution 733 (SD 912). The majority of the nurses had a
1366

baccalaureate degree (41%) followed by an associate (two

year university) degree (32%). A significant number (47%) of
the participating nurses were clinic nurses (worked as bedside
nurses on wards) and 26% of the nurses worked in special
care areas (such as, intensive care unit, operating room).

Workplace psychologically violent behaviours

instruments reliability
The instruments reliability was measured with Cronbachs a
coefficient. The instruments subdimensions item-total score
correlations and Cronbachs a values are shown in Table 1.
In this study, the instruments item-total score correlations
varied between 038068. The instruments total score mean
from all items was 2335 (minimum of 0 and maximum of
113) and the standard deviation was 2086. All items were
found to have a statistically significant correlation
(p < 001). The instruments total Cronbachs a internal
consistency value was found to be 093.
The instruments four factors consistency over time was
examined with the testretest technique. To accomplish this,
a 49 person sub-sample was selected and Pearson correlation
coefficients were calculated. These coefficient values were
found to be 088 for individuals isolation from work, 086
for attack on professional status, 078 for attack on
personality, and 070 for direct attack. These results show
that in nurses workplaces the WPVB Instrument has internal
consistency and continuity.

Workplace psychologically violent behaviours

instruments construct validity
To test the instruments construct validity factor analysis
with rotation was implemented. The factor matrix with
rotation showed that it has a four-factor, 33-item construct.
The items factor load values varied from 044071. All of
the instruments factors eigenvalues were >1 and the
explained variance was found to be 58% (Table 2). The
correlations of the instruments factors with each other are
given in Table 3:
The first factor (factor 1) comprised 11 items related to
individuals isolation from work. The explained variance
was 1635% and the internal consistency was at a very
high level (091).
The second factor (factor 2) comprised nine items related
to attack on professional status. The explained variance
was 1526% and the internal consistency was 090.
The third factor (factor 3) comprised nine items related to
attack on personality. The explained variance was
1524% and the internal consistency was 087.

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Workforce issues

Workplace psychologically violent behaviours

Table 2 Rotated factor matrix of psychological violent behaviour instrument (n = 476)

Loading on primary factor
A. Individuals isolation from work (eigenvalue 4275, explained variance 1685, Cronbachs a 091)
A1.Being treated in your workplace as if you arent seen and dont exist
A2. Not being able to get an answer to your request for a meeting and to talk
A3. Having duties that you are responsible for taken from you and given to others in lower positions
A4. Not being giving an opportunity to prove yourself
A5. Not being informed about social meetings that are organized
A6. Having the decisions and recommendations you have made criticized and rejected
A7. Being inspected by others in positions below yours
A8. Frequently being interrupted while you are speaking
A9. Pressuring you to quit your job or change your workplace
A10. Not receiving an answer to e-mail you have sent and telephone calls
A11. Hiding information, documents and material from you that you need for your job
B. Attack on professional status (eigenvalue 590, explained variance 1526, Cronbachs a 090)
B1. Always having errors found in your work and work results
B2. Holding you responsible for work more than your capacity
B3. Being held responsible for negative results of work done with others
B4. Being blamed for things you are not responsible for
B5. Always having your professional adequacy questioned in the work you do
B6. Considering the work you have done as without value and importance
B7. Always having your performance evaluated negatively
B8. Having you feel like you and your work are being controlled
B9. Being forced to do a job that will negatively affect your self-confidence
C. Attack on personality (eigenvalue 402, explained variance 1524, Cronbachs a 087)
C1. Facing behaviours such as slamming fist onto table
C2. Having untrue things said about you
C3. Being verbally threatened
C4. Having someone speak about you in a belittling and demeaning manner
in the presence of others
C5. Having someone behave in a demeaning manner (using body language)
towards you in the presence of others
C6. Having false rumours said about your private life
C7. Having someone suggest that you are not psychologically well
C8. Having your honesty and reliability questioned
C9. Having unfair reports written about you
D. Direct negative behaviours (eigenvalue 402, explained variance
1035, Cronbachs a 072)
D1. Having physical violence used
D2. Harming your personal things
D3. When you enter an area knowingly leaving the area where you are
D4. Preventing or forbidding coworkers from talking with you

The fourth factor (factor 4) comprised four items related to

direct attack. The explained variance was 10% and the
internal consistency was 072.

Discussion
Workplace psychologically violent behaviours
instruments reliability
Since there is no instrument in Turkey for measuring nurses
perception of workplace psychological violence inflicted on
them by their managers, coworkers and/or subordinates, this

0712
0679
0668
0659
0612
0594
0581
0532
0518
0516
0508
0714
0687
0654
0610
0579
0546
0540
0507
0500
0638
0636
0620
0615
0608
0527
0514
0509
0503

0705
0701
0565
0526

was the first study conducted nationally on this subject. In

addition, the WPVB Instruments Cronbachs a value was
found to be high (093). The Cronbachs a coefficient is a
measurement of the internal consistency (homogeneity) of
items in an instrument. The size of a instruments Cronbachs a
coefficient expresses whether that instrument has been
comprised of items that are consistent with each other and
have the same characteristics (Tezbas aran 1997). In addition
for an instrument to be considered reliable the item-total
correlation needs to be greater than 030. A total Cronbachs a
level greater than 080 is considered to be very adequate and
greater that 070 is considered adequate (Erefe 2002). In our

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Y Dilek and Y Aytolan

Factors

Factor 1 Isolation
from work

Factor 2 Attack on
professional status

Factor 3 Attack on
personality

Factor 4 Direct
attack

Factor
Factor
Factor
Factor

1000
077
076
069

1000
079
057

1000
062

1000

1
2
3
4

research, the instruments item-total score correlation varied

between 038068 and the subgroups Cronbachs a consistency varied between 091072, which shows that the instrument has an adequate level for the desired criteria. The alpha
coefficients were at an acceptable level for the instruments
internal consistency and the testretest correlations also showed that the instrument had acceptable consistency. Tezbas aran
(1997) determined that items having high correlation with each
other and with the instrument scores show that the measurement was made for the same dimension. The distribution of the
instruments correlations of subfactors with each other was
between 079 and 057 (Table 3), which shows that the
instrument was measuring the same dimension. These results
show that this instrument is able to measure the concept of
nurses perception of psychological violence in the workplace.

Workplace psychologically violent behaviours

instruments construct validity
This instrument which determines the WPVB is comprised of
33 items and shows a four-factor construct. On this
instrument, the 11 items related to individuals isolation
from work (Cronbachs a = 091), nine items related to
attack on professional status (Cronbachs a = 090), the
nine items related to attack on personality (Cronbachs
a = 087) and the four items related to direct attack
(Cronbachs a = 072), other than direct attack, were shown
to have quite high levels of internal consistency of the
instruments factor structure. Tezbas aran (1997) stated that
when the item-total correlation number is 0 or close to 0 that
item is considered to be inadequate for measuring at the same
level as the other items and this item needs to be removed
from the instrument. Accordingly, since all of the WPVB
instruments factor load values were between 071050, it
was not necessary to remove any items from the instrument
and the instruments items remained the same.
The findings related to factor analysis show that the
instrument has a multi-factor construct. This construct shows
that the psychologically violent behaviours that employees are
exposed to are made up of different and distinguishable groups
and that one type of attack cannot be considered. Similarly
Leymann (1990) divided psychological terror actions at work
into five forms. The dimensions proposed by Leymann are:
1368

Table 3 Correlation between factors for

determination of workplace psychologically
violent behaviours instruments subgroups
after Promax Rotation

1 The victims reputation;

2 His/her possibilities of performing the work task;
3 Victims possibilities of communicating with his/her coworkers adequately;
4 His/her social circumstances;
5 The behaviours involving physical coercion or assaults,
which are the basic dimensions obtained by individuals
who have conducted research on this subject.
In addition, in the comparison of factor analyses conducted
for other tools that have been developed, the statements are
not completely the same but they are similar. In the workplace
violence perceptions instrument that has been developed there
are close similarities between the factor, individuals isolation
from work and the behaviour described in Leymanns
dimension of his/her possibilities of performing the work
task, between the factor, attack on personality and the
victims reputation, between the factor, direct negative
behaviours and the behaviours involving physical coercion
or assaults and victims possibilities of communicating with
his/her coworkers adequately. In the Work Harassment
Scale developed by Bjorkqvist et al. (1994) there is a 24 item
harassment list. Within this list there are 14 items contained in
the Workplace Violence Perception that also have similar
statements. These are: lies about you told to others; unduly
criticised; exposure to insulting comments about your private
life; isolated; exposure to direct threats; refusal to speak with
you; treated as non-existent; belittling of your opinions;
refusal to hear you; given insulting tasks; malicious rumours
spread behind your back; your work is judged in an incorrect
and insulting manner; your sense of judgment has been
questioned; exposure to accusations of being mentally
disturbed. In the mobbing scales developed by Zapf et al.
(1996) there are also close similarities in the organizational
measures dimension that has the factor, individuals isolation
from work, in the Isolation and physical violence dimensions that have a direct negative behaviours factor and in the
attacking private life and attacking attitudes dimensions
which have an attack on personality factor. Similarly Rayner
and Hoel (1997) grouped workplace bullying into five
categories: threat to professional status (e.g. belittling opinion,
public professional humiliation, accusation regarding lack of
effort); threat to personal standing (e.g. name-calling, insults,
intimidation, devaluing with reference to age); isolation (e.g.

 2008 The Authors. Journal compilation  2008 Blackwell Publishing Ltd

Workforce issues

preventing access to opportunities, physical or social isolation,

withholding of information); overwork (e.g. undue pressure,
impossible deadlines, unnecessary disruptions); and destabilization (e.g. failure to give credit when due, meaningless
tasks, removal of responsibility, repeated reminders of
blunders, setting up to fail).
In addition, in a study conducted by Bjorkqvist et al. (1994)
about aggression among university employees, the work
harassment scale that was developed had 24 items and was
found to have a reliability (Cronbachs a) value of 095. In the
factor analysis, the work harassment scale was determined
to be divided into two sub-categories, rational-appearing
aggression (Cronbachs a = 070) and social manipulation
(Cronbachs a = 082). The Negative Acts Questionnaire used
by Einarsen and Raknes (1997) was determined to have 22
items and three main factors. According to this the factors
were divided into personal derogation (Cronbachs a = 085),
work related harassment (Cronbachs a = 057) and social
exclusion (Cronbachs a = 033).
Brodsky (1976; cited in Einarsen 1999) subdivides this
experience into subjective harassment, referring to awareness
of harassment by the target and objective harassment which
is where the external evidence of harassment is found. This
allows the investigator to be able to look at absolute
behaviours (whether or not someone finds them bullying) as
well as victims reactions to situations (whether or not an
outsider would judge them as bullying), which is a very useful
dichotomy (1976; cited in Einarsen 1999). Mobbing is seen
as systematic and repeated aggression and violence targeted
towards one or more individuals by one individual or by a
group. The major difference between experienced bullying
and intentional bullying is the frequency and longevity of
the negative behaviours. For the label bullying (or mobbing)
to be applied to a particular activity, interaction or process, it
has to occur repeatedly and regularly (e.g. weekly) and over a
period of time (e.g. about six months) (Einarsen et al. 2003).
Similarly, Einarsen and Skogstad (1996) consider the bullying
behaviours that have taken place within the last six months
now and then or weekly can be defined as bullying.
Bjorkqvist et al. (1994) and Fox and Stallworth (2003)
include persistent and unethical behaviours within the past
year. For this reason the research participants were asked to
mark the instrument for the frequency of mobbing behaviours they had faced within the last year. When the number
of these behaviours that a victim is exposed to in a year
increases it shows that the individual is a mobbing victim. In
addition, high scores in all of the dimensions on the
instrument points out the negative variety and negative
perceptions of psychological violence that nurses are exposed
to in the workplace.

Workplace psychologically violent behaviours

Conclusion
The use of this instrument in psychological studies is extremely
important. The inadequate number of measurement instruments that have proven validity and reliability in our country
increases the importance of studies that will be conducted on
this subject. In addition, because there is no other instrument
in our country for the measurement of psychological violence
that nurses are exposed to in the workplace it is suggested that
this instrument will fill a significant void. In conclusion, this
instrument can be considered to be a valid and reliable
instrument for measuring the psychologically violent behaviours that nurses are exposed to in the workplace.
It is suggested that research conducted using this instrument
will make significant contributions in this area. Firstly, in our
country it will lay the foundation for broadening the limited
information on the subject of what kind of psychologically
violent behaviours workers, primarily nurses, are exposed to
in the workplace and with what frequency in which
dimensions. In addition, defining the psychological pressure
that nurses are exposed to in the workplace and determining
its negative effects on the victim of workplace psychological
pressure and on the institution will make it possible to protect
individuals and the institution from psychological violence
with both individual and institutional practices.
In conclusion, the findings show that the instruments
validity and reliability are within the limits of an acceptable
level and that it is a instrument that will encourage more
studies on this subject.

Limitations
Conducting this study with nurses could be considered to be a
significant limitation. Our study was only conducted with
female participants in the nursing, female-dominant, profession. Said another way, because it was conducted with a
professional group that only includes women (at that time in
our country) it is limited from the aspect of profession and
gender. Even though the largest university hospital in Istanbul
was chosen for data collection it is another limitation of the
research that data were only collected from one hospital. It is
suggested that determining whether men in different professional groups or nurses in different samples have different
perceptions would make an important contribution. However, it is thought that because the tool was developed from
data collected from nurses in Turkey it reflects the cultural
characteristics of the society in which it was developed. For
this reason, it is recommended that this instrument be tested
in samples of nurses with different cultural characteristics
and with different professional groups.

 2008 The Authors. Journal compilation  2008 Blackwell Publishing Ltd

1369

Y Dilek and Y Aytolan

Contributions
Study design: DY, AY; data analysis: DY and manuscript
preparation: DY, AY.

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