Jou nal o Clinical Nu sing, 2025; 0:1–17
h ps://doi.o g/10.1111/jocn.17834
1 o 17
Jou nal o Clinical Nu sing
INTEGRATIVE REVIEW OPEN ACCESS
Unde s anding he P edisposing Fac o s o Nu se- o- Nu se
Ho izon al Violence in Hospi al Se ings: An
In eg a i e Re iew
C is inaRegue a-Ca asco1 | NiciadelRocíoSan ana-Be langa1,2 | Se gioBa ien os-T igo1
1Depa men o Nu sing, Facul y o Nu sing, Physio he apy, and Podia y, Uni e sidad de Se illa, Se ille, Spain | 2Sain John o God Alja a e Hospi al,
Bo mujos (Se ille),Spain
Co espondence: Nicia del Rocío San ana- Be langa (nsan [email protected])
Recei ed: 13 Augus 2024 | Re ised: 2 May 2025 | Accep ed: 21 May 2025
Funding: The au ho s ecei ed no speci ic unding o his wo k.
Keywo ds: ho izon al iolence| hospi al nu sing s a | in eg a i e e iew| wo k en i onmen
ABSTRACT
In oduc ion: Nu se- o- nu se ho izon al iolence is a highly p e alen issue in heal hca e, signi ican ly a ec ing nu ses' well-
being, job sa is ac ion and p o essional pe o mance. Despi e i s widesp ead occu ence, i emains la gely in isible due o o -
ganisa ional cul u e, no malisa ion and unde epo ing. Recognising and add essing his phenomenon is a p io i y o imp o e
wo kplace en i onmen s and sa egua d bo h nu ses and pa ien ca e.
Aim: The aim was o syn hesise he exis ing e idence on he main p edisposing ac o s o nu se- o- nu se ho izon al iolence in
a hospi al se ing.
Design: An in eg a i e e iew.
Da a Sou ce: Fou da abases: PubMed, CINAHL, Scopus and Web o Science.
Me hods: This in eg a i e e iew ollowed Whi emo e and Kna l's app oach and was epo ed acco ding o SWiM checklis .
Da abase sea ches occu ed om Sep embe 2022 o Feb ua y 2023, including s udies published be ween 2013 and 2023. A icles
we e sc eened by i le, abs ac and ull ex based on se c i e ia. Addi ional a icles we e iden i ied h ough backwa d ci a ion
sea ching. Quali y was app aised using Joanna B iggs ins umen s, and a na a i e syn hesis summa ised he indings.
Resul s: Fi een a icles we e e iewed, ocusing on nu se- o- nu se ho izon al iolence. Mos s udies used he Re ised Nega i e
Ac s Ques ionnai e and we e a ed as ‘good quali y’. The p edisposing ac o s iden i ied we e g ouped in o h ee ca ego ies: o -
ganisa ional, p o essional and wo k ela ed.
Conclusion: The indings highligh ha he p edisposing ac o s o nu se- o- nu se ho izon al iolence a e mul idimensional
and in e ela ed. Add essing his issue equi es a comp ehensi e and coo dina ed app oach ha s eng hens leade ship and im-
plemen s s anda dised ea ly de ec ion and measu emen ools o de elop e ec i e p e en i e s a egies.
Implica ions o he P o essional P ac ice and Pa ien Ca e: Ho izon al iolence p omo es dis up i e wo k en i onmen s.
Managemen - ela ed issues, p o essional hie a chies and unheal hy wo king condi ions con ibu e o i s occu ence. The e o e,
s eng hening leade ship, p omo ing pee suppo and imp o ing wo k en i onmen s a e key o mi iga ing i s impac and en-
hancing nu se well- being and ca e quali y.
T ial Regis a ion: PROSPERO: CRD42023396684
This is an open access a icle unde he e ms o he C ea i e Commons A ibu ion-NonComme cial-NoDe i s License, which pe mi s use and dis ibu ion in any
medium, p o ided he o iginal wo k is p ope ly ci ed, he use is non-comme cial and no modi ica ions o adap a ions a e made.
© 2025 The Au ho (s). Jou nal o Clinical Nu sing published by John Wiley & Sons L d.
2 o 17 Jou nal o Clinical Nu sing, 2025
1 | In oduc ion
Nu se- o- nu se ho izon al iolence (HV) e e s o dis up i e,
agg essi e o hos ile beha iou s, whe he occasional o ecu -
en , ha occu among nu ses o he same hie a chical le el
wi hin heal hca e se ings (Lee e al.2022; Noo e al.2022).
These beha iou s can ake a ious o ms, anging om e bal
hos ili y o physical agg ession wi h he in en o deg ade o de-
mean he ecipien (Wei e al.2024; Vidal- Al es e al.2021; Zap
e al.2020; Sanne - S ieh and Wa d- Smi h2017). Mos au ho s
classi y ho izon al iolence in o physical, psychological and
e bal (T a aini e al.2024; Desha nais e al.2023). Also, some
s udies dis inguish be ween o e and co e iolence, whe e
o e iolence includes insul s, h ea s and wo kplace sabo age,
whe eas co e iolence mani es s h ough mic oagg essions,
social exclusion and he delibe a e wi hholding o c i ical in o -
ma ion (Desha nais e al.2023).
The p e alence o ho izon al iolence among nu ses is es i-
ma ed o ange om 30% o 85% and is widely documen ed in
coun ies such as he USA, Canada, I aly, Tu key, Taiwan and
Pakis an (T a aini e al.2024; Wei e al.2024; Noo , Rehman,
Ahmed e al. 2023; Desha nais e al.2023; Wilson e al. 2020).
Al hough i can occu in a ious heal hca e con ex s, i is
pa icula ly common in hospi al se ings, whe e hie a chical
s uc u es, high pa ien acui y and demanding wo kloads con-
ibu e o i s pe sis ence and nega i e impac on s a (T a aini
e al.2024; Desha nais e al.2023). Despi e di e ences ac oss
heal hca e sys ems, he unde lying causes end o be simila ,
o en ela ed o hie a chical o ganisa ional cul u es and in-
su icien manage ial esponse. In high- p essu e uni s such as
c i ical ca e o su gical wa ds, his phenomenon is equen ly
exace ba ed (Lambe e al.2025; Beche and Viso sky 2012).
Simila ly, in I aly, high p e alence has been linked o shi
o e load and ole ambigui y (Bambi e al.2018), whe eas in
Tu key and Pakis an i is associa ed wi h in e pe sonal i-
al y, pee en y and limi ed mechanisms o con lic es-
olu ion (Lambe e al. 2025). Despi e i s high p e alence,
ho izon al iolence o en emains unde epo ed by nu ses.
Ba ie s such as ea o e alia ion, he no malisa ion o
iolen beha iou and he lack o ins i u ional suppo hinde
o mal epo ing, pa icula ly in highly s ess ul con ex s like
he COVID- 19 pandemic. This in isibili y limi s ecogni ion
o he p oblem and delays he implemen a ion o p e en i e
measu es (Ch is ensen e al.2024; Byon e al.2021; McKenna
e al.2003).
In his ega d, om a heo e ical pe spec i e, ho izon al io-
lence in nu sing is no jus an in e pe sonal issue bu is deeply
embedded in he o ganisa ional s uc u e and powe dynam-
ics wi hin heal hca e (A i e al.2024; Noo e al.2022; Noo ,
Rehman, Ahmed, e al.2023). F ei e's heo y o opp ession
desc ibes how subo dina ed g oups in e nalise hei posi ion
and ep oduce opp ession wi hin hei g oup ins ead o chal-
lenging hose in powe (F ei e1972). The his o ical e olu ion
o nu sing exempli ies his pa e n, as in he ea ly 20 h cen-
u y, signi ican social and s uc u al ans o ma ions led o
he inc eased subo dina ion o nu ses. The p o essionalisa ion
and bu eauc a isa ion o heal hca e sys ems and he expan-
sion o hospi al ca e unde a medical model we e he leading
causes (Kennedy 2020). Opp essed g oup beha iou heo y
ex ends his idea by explaining how nu ses edi ec hei us-
a ions la e ally wi hin his igid powe dynamic a he han
challenging he s uc u es ha opp ess hem. Fu he mo e,
his is suppo ed by Fa me 's heo y o s uc u al iolence,
which also highligh s how un a ou able en i onmen s lead
o ho izon al iolence and es ablishes his iolence as cyclical
(Fa me e al.2006).
Beyond he s uc u al causes con ibu ing o ho izon al iolence,
an addi ional challenge lies in he lack o a uni e sally accep ed
de ini ion. Despi e i s ecogni ion by in e na ional o ganisa ions
such as he WHO and ILO since he ea ly 2000s, a ious ap-
p oaches con ibu e o concep ual o e lap be ween ho izon al
iolence and o he e ms such as mobbing, inci ili y o bullying
(Ka açay and O laz2022). Among hese, he e m bullying is
mos commonly used in e changeably, pa icula ly in s udies
om Canada, ollowed by inci ili y in he Uni ed S a es and
mobbing in coun ies such as Swi ze land (Lambe e al.2025).
Howe e , hei meanings no being equi alen because mobbing
is cha ac e ised by sys ema ic and p olonged ha assmen by a
g oup owa ds an indi idual, and bullying in ol es an appa -
en powe asymme y whe e one pa y domina es ano he (Peng
e al.2022; Tedone2020; Alsheh y e al.2019). Consequen ly,
his concep ual ambigui y has hinde ed he ecogni ion o he
phenomenon, complica ing ea ly de ec ion (Vidal- Al es 2023;
Esca ín- Solanelles e al. 2010) and also con ibu es o i s
no malisa ion wi hin wo kplace cul u e (Kim e al. 2024;
Kennedy2020).
In addi ion, inc eased ho izon al iolence has been associ-
a ed wi h nega i e nu se and pa ien heal h ou comes (Noo
e al.2024; Desha nais e al.2023; Doo and Kim2020). On
he one hand, ho izon al iolence nega i ely impac s pa-
ien sa e y by dis up ing wo k low e iciency and os e ing
a oxic wo k en i onmen (Jabe e al. 2023; Cayuela Ruiz
e al. 2022). I con ibu es o communica ion ailu es and
impai s clinical judgemen , which has been linked o in-
c eased pa ien mo ali y, complica ion a es and eadmis-
sions (Desha nais e al.2023; Noo , Rehman, and Gull2023;
Doo and Kim2020; Copani sanou e al.2017). On he o he
Summa y
• Wha does his pape add?
○ Ho izon al iolence among nu ses is d i en by man-
age ial, p o essional and wo k- ela ed ac o s, deeply
embedded in wo kplace cul u e. This e iew ca ego-
ises hese p edisposing ac o s, p o iding a s uc-
u ed amewo k o ecogni ion and in e en ion.
○ This e iew enhances isibili y o ho izon al io-
lence by cla i ying i s concep ual bounda ies and
add essing he lack o consensus in e minology.
This con ibu es o ea ly de ec ion and imp o ed
epo ing.
○ This s udy suppo s o ganisa ional decision- making
and he de elopmen o e ec i e p e en i e s a e-
gies agains ho izon al nu se pee - o- pee iolence.
This will ha e an impac on he wo k clima e, im-
p o ing ela ionships be ween nu ses and sa e-
gua ding hei well- being.
13652702, 0, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1111/jocn.17834 by Readcube (Lab i a Inc.), Wiley Online Lib a y on [04/06/2025]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
3 o 17
hand, nu ses may su e om psychological, psychosoma ic
and social dis u bances which can signi ican ly impac
hei well- being and p o essional pe o mance (Al- Nawa leh
e al.2024; Noo e al.2024; Lee e al.2022; Le e e al.2019).
These dis u bances o en mani es as anxie y, dep ession
and pos - auma ic s ess diso de (Desha nais e al. 2023;
Noo , Faisal, e al.2023; Vidal- Al es2023; Noo e al.2022;
D'E o e e al.2018), as well as physical symp oms such as a-
igue, insomnia and ch onic illnesses (Desha nais e al.2023).
Fu he mo e, ho izon al iolence has been di ec ly linked
o absen eeism, wo kplace acciden s and an inc ease in he
u no e a e (Al- Nawa leh e al.2024; Noo e al.2024). This
end exace ba es he global sho age o heal hca e p o es-
sionals, a ec ing app oxima ely 5.9 million wo ke s wo ld-
wide (Wo ld Heal h O ganiza ion 2020). Consequen ly, he
economic bu den o high nu se u no e in he Uni ed S a es
alone has been es ima ed a 1.4–2.1 billion USD annually,
placing signi ican inancial s ain on heal hca e ins i u ions
(Ko ne e al.2014).
In ecen yea s, he e has been a no able inc ease in publica ions
add essing ho izon al iolence, e lec ing a g owing ecogni-
ion o i s p e alence in clinical p ac ice and a di e si ica ion o
me hodological app oaches. Howe e , he lack o a s anda dised
de ini ion and he in e changeable use o ela ed e ms c ea e
u he ambigui y, making i challenging o dis inguish s udies
speci ically add essing ho izon al iolence om hose explo ing
o he o ms o wo kplace agg ession. This e olu ion highligh s
he need o an in eg a i e li e a u e e iew ha syn hesises he
cu en e idence, including quali a i e and quan i a i e s udies,
o cla i y he causes o nu se- o- nu se ho izon al iolence in hos-
pi al se ings. Such syn hesis no only p o ides a solid ounda ion
o u u e esea ch and concep ual model de elopmen bu also
o e s ac ionable insigh s o hospi al adminis a o s o design
a ge ed s a egies and p e en i e in e en ions aimed a educ-
ing he occu ence and impac o his phenomenon.
2 | Aim
The aim was o syn hesise he exis ing e idence on he main
p edisposing ac o s o nu se- o- nu se ho izon al iolence in a
hospi al se ing.
3 | Me hods
3.1 | Design
An in eg a i e e iew was conduc ed using he p ocess posi ed
by Whi emo e and Kna l(2005): p oblem iden i ica ion, li e -
a u e sea ch, da a e alua ion, da a analysis and p esen a ion.
Gi en he agmen ed na u e o he li e a u e on ho izon al i-
olence in nu sing, esul ing om he absence o a s anda dised
de ini ion and he in e changeable use o ela ed e ms, his
app oach p o ides a amewo k o syn hesising quali a i e,
quan i a i e and mixed- me hod s udies. This me hodological
choice allows o a comp ehensi e e iew o exis ing e idence,
in eg a ing indings om a ious pe spec i es o ensu e a s uc-
u ed unde s anding o he ac o s con ibu ing o ho izon al i-
olence (Hopia e al.2016). The indings we e epo ed acco ding
o he Syn hesis Wi hou Me a- analysis (SWiM) guideline
(AppendixS3) (Campbell e al.2020).
3.2 | Sea ch S a egy
A h ee- s ep sea ch s a egy was conduc ed, ollowing he ec-
ommenda ions o he Johanna B iggs Ins i u e(2017). Fi s ly, an
ini ial limi ed sea ch was conduc ed in PubMed o iden i y ele-
an s udies and e ine sea ch e ms, including Medical Subjec
Headings (MeSH) and ee- ex keywo ds. This p elimina y
sea ch ensu ed ha all ele an e minology was inco po a ed
in o he inal sea ch s a egy. Secondly, a comp ehensi e sea ch
was hen pe o med in ou majo da abases: PubMed, CINAHL,
Scopus and Web o Science, using he inalised se o MeSH
e ms and ee- ex keywo ds. The sea ch p ocess ook place be-
ween 10 Sep embe 2022 and 05 Feb ua y 2023, co esponding
o he pe iod du ing which he sys ema ic da a collec ion o his
e iew was execu ed. Las ly, addi ional sou ces we e sc eened by
e iewing he e e ence lis s o selec ed s udies o iden i y u -
he ele an li e a u e. Addi ionally, PROSPERO was sc eened
o iden i y any egis e ed p o ocols o ongoing sys ema ic o in-
eg a i e e iews on his opic, ensu ing ha ou s udy did no
duplica e exis ing e o s. Also, be o e commencing da a analy-
sis, a inal sea ch was pe o med o iden i y any newly published
s udies mee ing he inclusion c i e ia. This s ep ensu ed ha he
mos up- o- da e e idence on he causes o ho izon al iolence
was inco po a ed in o he e iew.
The sea ch s a egy included MeSH e ms sou ced om he
Na ional Lib a y o Medicine's con olled ocabula y hesau us,
as well as ee- ex e ms ela ed o he esea ch opic (Na ional
Lib a y o Medicine2025). T unca ion and Boolean ope a o s
we e applied o e ine he esul s. The sea ch s a egy used in
each da abase is gi en in AppendixS1.
3.3 | Inclusion and Exclusion C i e ia
A icles we e included i hey me he ollowing c i e ia: (1) ex-
amined he p edisposing ac o s o pee - o- pee ho izon al i-
olence, (2) ocused on hospi al- based nu sing p o essionals, (3)
we e published in English o Spanish, (4) p o ided disagg e-
ga ed da a in mul iple o ms o wo kplace iolence ha we e an-
alysed (5) be ween 2013 and 2023. This ime ame was chosen
o p o ide a b oade pe spec i e on his phenomenon's e olu ion
and allow o he iden i ica ion o po en ial ends and pa e ns
in i s causes.
The exclusion c i e ia we e as ollows: (1) lack o ull- ex a ail-
abili y, (2) ocus on he p edisposing ac o s o ho izon al io-
lence be ween nu ses wi h di e en hie a chical oles (e.g.,
supe iso s, nu se manage s o clinical educa o s) o (3) second-
a y sou ces wi hou empi ical da a, such as na a i e e iews
lacking a sys ema ic me hodology o edi o ials.
3.4 | Sc eening
Two esea che s independen ly managed a icle selec ion
using RAYYAN sys ema ic e iew so wa e, a ool speci ically
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4 o 17 Jou nal o Clinical Nu sing, 2025
designed o o ganise e e ences (Kelly2024). They i s sc eened
e e ences by e iewing i les and abs ac s o iden i y po en ial
s udies. Then, ull- ex e iews we e conduc ed on selec ed a i-
cles ha me he ini ial sc eening c i e ia.
3.5 | Quali y App aisal
To e alua e he quali y o he e iewed a icles, he Joanna
B iggs Ins i u e's ools we e u ilised depending on he me hod
used in he s udy. The quali y o all s udies in his e iew was
e alua ed by wo esea che s who independen ly app aised each
a icle and discussed he impo ance and quali y o he a icles
o consis ency. Disag eemen s we e se led by consul ing a
hi d esea che . S udies we e classi ied based on he pe cen -
age o ‘yes’ esponses ob ained du ing he app aisal p ocess.
A icles sco ing below 50% we e ca ego ised as ‘poo quali y’,
hose sco ing be ween 50% and 75% as ‘good quali y’, and hose
exceeding 75% as ‘high quali y’ (Johanna B iggs Ins i u e2020;
Jo dan e al.2019).
3.6 | Da a Ex ac ion
Two e iewe s independen ly conduc ed da a ex ac ion using
a cus omised da a ex ac ion o m adap ed om he Coch ane
Handbook o Sys ema ic Re iews o In e en ions (Higgins
e al.2019). Bo h e iewe s pilo es ed he o m wi h a sub-
se o i e s udies o ensu e ele an da a was ex ac ed. The
ollowing da a we e ex ac ed: design, au ho , yea o publi-
ca ion, coun y, a ge popula ion, ou come measu e and he
main esul s.
3.7 | Analysis and Syn hesis
Due o he di e se ange o measu es and ou come assessmen s
in he included s udies, a sys ema ic con en analysis was con-
duc ed. The p ocess in ol es da a educ ion, display, compa i-
son and conclusion d awing and e i ica ion (Whi emo e and
Kna l2005). A e da a educ ion and coding o he p ima y doc-
umen da a, he ex ac ed da a we e abula ed. This acili a ed
he compa ison o da a o iden i y ac o s and ela ionships. An
i e a i e p ocess was unde aken in which au ho s indi idually
analysed he da a and discussed hei indings o each a con-
sensus. This collabo a i e p ocess educed subjec i e bias and
p ema u e analy ical closu e. In addi ion, i allowed he esul s
o be e i ied and ca ego ised in o h ee main hemes guided by
he e iew's objec i es.
4 | Resul s
4.1 | Iden i ica ion S udies
A o al o 2769 a icles we e iden i ied. A e applying il e s
and emo ing duplica es, he i les and abs ac s o 1722 a icles
we e examined. In o al, 1669 a icles we e emo ed due o i el-
e an i les, w ong popula ions o di e en ou comes. The ull
ex o 53 a icles was hen sc eened o eligibili y. O hese, 38
a icles we e excluded due o di e en popula ions, un ela ed o
he opic o add essing o he ypes o iolence.
Addi ionally, a manual sea ch was conduc ed among he e e -
ences o he ull- ex a icles. Finally, 15 a icles we e included
in he e iew, and hei ull ex s we e analysed. Figu e1 shows
FIGURE 1 | Flow diag am. G aphic desc ip ion o he sea ch and selec ion o da a in he di e en da abases.
Reco ds iden i ied om
da abases be o e applying il e s
(n = 2769)
Pubmed (973)
Cinahl (521)
Scopus(638)
WOS (637)
Reco ds emo ed be o e
sc eening:
Duplica e eco ds emo ed
(n = 444)
Reco ds sc eened
(n = 1722)
Reco ds excluded
(n = 1669)
Repo s assessed o eligibili y
(n =53)
Repo s excluded:
Di e en popula ion (n =16)
No ela ed o opic (n = 13)
Type o iolence (n = 10)
Reco dsiden i ied om:
Ci a ion sea ching(n =447)
Duplica e eco ds emo ed
(n =7)
Repo sassessed o eligibili y
(n =17) Repo sexcluded:
-Language (n =1).
-Di e en popula ion (n =2).
-No ela ed o opics (n =13)
Repo s o included s udies:
-Da abases: (n =14)
-Ci a ion sea ching: (n= 1)
To al included: (n=15)
Iden i ica ion o s udies ia da abases and egis e sIden i ica ion o s udies ia o he me hods
noi aci i nedI
Sc eening
Included
Repo ssough o e ie al
(n =440)
Repo sno e ie ed
(n =423)
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5 o 17
a PRISMA low cha wi h he esul s o he li e a u e sea ch
s a egy.
4.2 | Cha ac e is ics o Included S udies
The main cha ac e is ics o he included s udies a e sum-
ma ised in Table1. All s udies we e in English. Mos o he
s udies we e c oss- sec ional (n = 10), while he emainde
we e quali a i e s udies (2) and sys ema ic e iews (3). Th ee
s udies we e conduc ed in he Uni ed S a es and Ko ea, wo in
Tu key and Canada and one in Japan, Po ugal, B azil, Jo dan
and Aus alia. The sample size anged om 16 o 993 indi-
iduals, and he esea ch subjec s we e always nu ses. Mos
s udies included ho izon al iolence among egis e ed nu ses,
al hough some included s a nu ses, midwi es and licensed
p ac ical nu ses (Yokoyama e al.2016). These p o essionals
we e included as hey ope a ed in pee - le el oles wi hin hos-
pi al uni s. Se en wo kplace iolence measu emen ools we e
used, and he only speci ic one o measu e ho izon al iolence
was he La e al Violence in Nu sing Su ey. The p ima y ool
used was he Nega i e Ac s Ques ionnai e- Re ised (n = 8).
In addi ion, many o he alida ed scales we e used, such
as Wo kplace Cybe bullying Measu emen , he Wo kplace
Inci ili y Scale, he Scale o Mobbing Beha iou s a he
Wo kplace, he Mobbing Scale Wo kplace, La e al Violence
in Nu sing Su ey and he S aigh o wa d Inci ili y Scale. A
non- alida ed ques ionnai e was also used (n = 2). Ho izon al
iolence (n = 5) and bullying (n = 5) we e he main e ms used
o e e o nu se- o- nu se iolence. Howe e , la e al iolence,
co- wo ke inci ili y, mobbing and wo kplace iolence we e
also used. In addi ion, he included a icles analyse many
di e en p edisposing ac o s o ho izon al iolence, such as
o ganisa ional cul u e, wo kplace en i onmen , pe pe a o s'
and ic ims' cha ac e is ics, wo king condi ions, p o essional
expe ience, demog aphic cha ac e is ics, p o essional cha ac-
e is ics and ins i u ion/uni ype.
4.3 | Quali y Assessmen
The majo i y (n = 8) o a icles we e assessed as ‘good quali y’,
being he mos a ec ed domains ela ed o he con ounding
ac o assessed, he in luence o he esea che on he esea ch
and he likelihood o publica ion bias assessed. They we e iden-
i ied based on he equency o ‘no’ o ‘unclea ’ esponses in
he JBI c i ical app aisal checklis s. In addi ion, six a icles
we e assessed as high quali y and, inally, one as poo quali y,
being unclea in a leas ou domains ela ed o inclusion and
exclusion c i e ia, measu emen c i e ia and ou come measu es
(João e al. 2023). The quali y app aisal esul s a e shown in
AppendixS2.
4.4 | P edisposing Fac o s o Nu se- o- Nu se
Ho izon al Violence
Th ough a na a i e summa y, his s udy in eg a ed he main
p edisposing ac o s o ho izon al iolence among nu ses in
he hospi al se ing. These ac o s ha e been g ouped in o h ee
ca ego ies: managemen , nu sing p o essional and wo k- ela ed
ai s. This ca ego isa ion is p esen ed in Table2, p o iding a
amewo k o he de ailed analysis ha ollows.
4.4.1 | Managemen - Rela ed P edisposing Fac o s
Se e al managemen ac o s we e iden i ied as con ibu -
ing o he occu ence o ho izon al iolence. Speci ically, his
ype o iolence was obse ed o be p e alen in se ings wi h
a hie a chical o ganisa ional cul u e by cen alised decision-
making, igid ole de ini ion and op- down communica ion
(Choi and Pa k2019; Blacks ock e al.2018; An and Kang2016).
Speci ically, An and Kang (2016) epo a p e alence o ho i-
zon al iolence o 45.5% in hese se ings. In his s udy, pa ic-
ipan s who pe cei ed hei o ganisa ional cul u e as hie a chy
o ien ed (cha ac e ised by o mali y, s ic ole sepa a ion and
au ho i y- based ela ionships) we e signi ican ly mo e likely
o epo expe iences o ho izon al iolence compa ed o hose
in ela ion- o ien ed en i onmen s, which emphasise in e pe -
sonal ha mony and collabo a ion (OR = 2.58; p < 0.026) (An
and Kang2016). Simila ly, Choi and Pa k(2019) ound ha a
hie a chy- o ien ed cul u e signi ican ly inc eased he isk o
ho izon al iolence (β = 0.178; p = 0.002). On he o he hand,
uni s wi h a mo e posi i e, eam- o ien ed o ganisa ional cul-
u e epo ed lowe le els o ho izon al iolence ( = −0.398;
p < 0.05), especially conce ning communica ion ( = −0.396) and
s a pa icipa ion ( = −0.356), hus educing he isk o hos ile
beha iou s among nu ses (Te zioglu e al.2016). Simila ly, Choi
and Pa k(2019) ound ha a ela ion- o ien ed cul u e signi i-
can ly educed i (β = −0.184; p = 0.002), suppo ing he idea ha
collabo a i e and lexible o ganisa ional en i onmen s a e p o-
ec i e ac o s.
Ano he p edisposing ac o iden i ied in he li e a u e was he
in luence o he nu se uni manage and hei leade ship s yle.
The nu se uni manage was depic ed as an in luen ial igu e
wi h conside able in luence o e he a i ude o s a wi hin
a clinical a ea (Hawkins e al. 2019; Yokoyama e al. 2016)
showed hei esul s ha bullying was signi ican ly associa ed
wi h lowe sco es on he nu se manage abili y, leade ship and
suppo o nu ses (OR = 0.59; CI: 0.39–0.90; p < 0.01). This ind-
ing sugges s ha leade ship may ac as a p o ec i e ac o , as
s onge manage ial suppo is associa ed wi h a lowe likeli-
hood o ho izon al iolence. In addi ion, nu ses who ha e expe-
ienced ho izon al iolence pe cei e hei hospi al as ha ing a
mo e pe missi e wo kplace iolence cul u e (Mye s e al.2016).
Howe e , Bloom(2019) indica ed ha manage ial suppo was
lacking, and 49.3% ecommended ha nu se manage s become
mo e in ol ed. In ac , 77.3% o he su eyed nu ses iden i ied
manage ial suppo as he mos e ec i e s a egy o educe ho -
izon al iolence. This is suppo ed by he in eg a i e e iew by
Blacks ock e al. (2018), which ound ha a common inding
ac oss se e al e iewed s udies was ha nu se leade s lacked
au ho i y o au onomy in key a eas such as scheduling, o gani-
sa ional p io i ies, wo kload dis ibu ion and nu sing oles. This
lack o leade ship au onomy was associa ed wi h an inc eased
isk o ho izon al iolence due o weakened o e sigh , lim-
i ed in e en ion capaci y and educed ole cla i y (Blacks ock
e al.2018). Finally, Choi and Pa k(2019) epo ed ha a po -
ion o nu ses had ecei ed aining in wo kplace iolence p e-
en ion (1.42 ± 0.70) and wo kplace cybe bullying p e en ion
13652702, 0, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1111/jocn.17834 by Readcube (Lab i a Inc.), Wiley Online Lib a y on [04/06/2025]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
6 o 17 Jou nal o Clinical Nu sing, 2025
TABLE 1 | Main esul s o he p edisposing ac o s o ho izon al iolence.
Au ho (yea ), coun y
S udy
design Sample size
Ho izon al iolence
measu e Main esul s Ou comes
Mye s e al.(2016), EEUU Quali a i e 126 RN Non- alida ed ques ionnai e The p edisposing ac o o HV
mos commen ed by esponden s
was he pe missi e o ganisa ional
cul u e in e ms o iolence.
I is obse ed ha nu ses who ha e
expe ienced HV, eel ha hey a e in a
hospi al ha main ains a mo e pe missi e
cul u e wi h iolence, whe e hei
supe iso s do no con empla e solu ions.
HV ou come measu ed:
– Ho izon al iolence
Main a iables:
– O ganisa ional cul u e
Choi and Pa k(2019), Ko ea C oss-
sec ional
226 SN NAQ- R
WCM
Bullying and cybe bullying a e ela ed
wi h he nu sing o ganisa ional cul u e
which explains he 6.3% o bullying
and he 4.3% o he cybe bullying. In
addi ion, hie a chy- o ien ed cul u e was
signi ican ly posi i ely co ela ed wi h
ace- o- ace bullying ( = 0.196, p = 0.003).
Also, ace- o- ace bullying is ela ed o a
sho e leng h o ca ee (F = 2.85, p = 0.025)
and he educa ional expe ience o p e en
iolence (F = 2.85, p = 0.025). Rela ed o
cybe bullying, male nu ses (1.29 ± 0.66),
nu ses who ecei ed educa ion o
wo kplace iolence p e en ion (1.42 ± 0.70)
and wo kplace cybe bullying p e en ion
(1.62 ± 0.98) had highe sco es.
HV ou come measu ed
– Bullying
– Cybe bullying
Main a iables:
– O ganisa ional cul u e
– Demog aphic ac o s
– Educa ional expe ience
(Con inues)
13652702, 0, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1111/jocn.17834 by Readcube (Lab i a Inc.), Wiley Online Lib a y on [04/06/2025]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
7 o 17
Au ho (yea ), coun y
S udy
design Sample size
Ho izon al iolence
measu e Main esul s Ou comes
Taylo (2016), Uni ed Kingdom Quali a i e 80 RN Non- alida ed ques ionnai e The nu ses e balised h ee ypes o
p edisposing p o iles o ho izon al
iolence: ‘ he pa hological bully’,
‘ he sel - jus i ied bully’ and ‘ he
unp o essional co- wo ke ’.
In he case o he pa hological bully, he
o she in lic s ha m consciously and wi h
malice. This was he leas p e alen . On
he o he hand, he sel - jus i ied bully
is usually ound in e e ing nu ses o
supe iso s and is he one who masks
he iolence behind wo k objec i es
and/o pa ien needs. Finally, he
unp o essional co- wo ke usually occu s
spo adically and wi hou being awa e o
he ha m caused, being a consequence o
a no malisa ion o dis up i e beha iou
wi hin he nu sing p o ession.
HV ou come measu ed:
– Ho izon al iolence
Main a iables:
– Enac o s
Oh e al.(2016), Ko ea C oss-
sec ional
255 RN NAQ- R
LVNS
La e al iolence is speci ied in h ee
subca ego ies ( e bal abuse, physical
h ea and physical assaul ).
The e bal abuse p edic o was ela ed
posi i ely wi h indi idual cha ac e is ics o
he p o essionals, like he nega i e a ec
and pe sonal indi idualism (β = 0.27;
β = 0.45, p < 0.001). In addi ion, i was also
posi i ely ela ed o wo king mo e han
41 h pe week (β = 0.28; p < 0.05) and mo e
han 51 h pe week (β = 0.33; p < 0.001).
Ano he p edic o o wo k- ela ed bullying
was specialised uni s (β = 0.13; p < 0.05).
HV ou come measu ed:
– La e al iolence
Main a iables:
– Uni ype
– Wo king condi ions
– P o essional cha ac e is ics
(Con inues)
TABLE 1 | (Con inued)
13652702, 0, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1111/jocn.17834 by Readcube (Lab i a Inc.), Wiley Online Lib a y on [04/06/2025]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
8 o 17 Jou nal o Clinical Nu sing, 2025
Au ho (yea ), coun y
S udy
design Sample size
Ho izon al iolence
measu e Main esul s Ou comes
Bloom(2019), EEUU Quali a i e 78 RN LVNS modi ied Fac o s ha inc eased HV we e ela ed
o h ee a eas: wo kplace en i onmen ,
o ganisa ional suppo and p o essional
expe ience. The ac o s we e wo kload/
s ess (72%), accep ed p ac ice on he uni
(62.8%) and he manage a i ude (49.3%).
HV ou come measu ed:
– Ho izon al iolence
Main a iables:
– Wo kplace en i onmen
– O ganisa ional cul u e
– P o essional expe ience
An and Kang(2016), Sou h
Ko ea
C oss-
sec ional
298 RN Ko ean e sion o NAQ- R The p e alence o wo kplace bullying
in his s udy signi ican ly di e ed
by mon hly sala y, ype o hospi al
and wo king uni . The p e alence o
wo kplace bullying ic im also di e ed
acco ding o o ganisa ional cul u e ype
(χ2 = 9.89, p < 0.019). Speci ically, he
p e alence was highes among pa icipan s
who conside ed hei o ganisa ion
as hie a chy o ien ed, a 22.2%.
Acco ding o he likelihood a io, he odds
o being a wo kplace bullying ic im we e
2.58 imes as high among pa icipan s
who epo ed a hie a chical o ien a ion
as among hose who epo ed a ela ion
o ien a ion (95% CI: 1.12–5.94; p < 0.026).
HV ou come measu ed:
– Bullying
Main a iables:
– O ganisa ional cul u e ype
– Uni ype
– Wo king condi ions
Yokoyama e al.(2016), Japón C oss-
sec ional
825 CNM
and LPN
NAQ- R Thi een demog aphic and wo k- ela ed
cha ac e is ics we e associa ed wi h being
bullied in he bi a ia e analyses (p < 010).
A logis ic eg ession analysis indica ed
ha ‘bullied’ we e associa ed wi h
low sco es on wo wo k en i onmen
domains: nu se manage abili y (OR:
0.93; CI: 0.87–0.99), leade ship and
suppo o nu ses and s a ing (OR:
0 59; CI: 0.39–0.90) and esou ce
adequacy (OR: 0.55; CI: 0.34–0.90).
HV ou come measu ed:
– Bullying
Main a iables:
– O ganisa ional cul u e
– Demog aphic cha ac e is ics
– Wo king condi ions
(Con inues)
TABLE 1 | (Con inued)
13652702, 0, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1111/jocn.17834 by Readcube (Lab i a Inc.), Wiley Online Lib a y on [04/06/2025]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
9 o 17
Au ho (yea ), coun y
S udy
design Sample size
Ho izon al iolence
measu e Main esul s Ou comes
Al- Ghabeesh and
Qa om(2019), Jo dán
C oss-
sec ional
120 RN NAQ- R The leng h o expe ience in he Eme gency
Depa men (ED) was posi i ely and
signi ican ly co ela ed wi h bullying a
wo kplace ( = 0.20, p < 0.01); The e o e,
he ewe he yea s o expe ience wo king
in he ED he mo e likely a nu se will
expe ience, o be exposed o, bullying.
None o he o he examined a iables,
o example, heigh , weigh , age and
yea s o expe ience in nu sing, ype o
hospi al, wo king shi o educa ion
le el was signi ican ly co ela ed
wi h bullying a wo kplace.
HV ou come measu ed:
– Bullying
Main a iables:
– P o essional expe ience
Laschinge and Read(2016),
Canadá
C oss-
sec ional
993 NG SIS Bu nou and co- wo ke inci ili y we e
posi i ely ela ed ( = 0.34; p < 0.05).
Also, he awa eness o ci ili y no ms
we e signi ican p edic o s o lowe
co- wo ke inci ili y (β = −0.62).
HV ou come measu ed:
– Co- wo ke inci ili y
Main a iables:
– Wo kplace en i onmen
Hawkins e al.(2019),
Aus alia
In eg a i e
e iew
16 a icles NAQ- R
WIS
The p ecipi a ing ac o s included ac o s
such as he new g adua es' pe cei ed
lack o capabili y and magni ying
powe and hie a chy. The es ablished
hie a chical cul u e has made hose
nu ses who a e pe cei ed as incapable
easy a ge s o HV, usually pe pe a ed
by mo e expe ienced nu ses.
HV ou come measu ed:
– Ho izon al iolence
Main a iables:
– O ganisa ional cul u e
– P o essional cha ac e is ics
Blacks ock e al.(2018),
Canadá
In eg a i e
e iew
22 a icles — The main p edic o s ound we e he
in luence o wo king condi ions,
ela ional aspec s o eams and leade ship,
o ganisa ional cul u e, clima e and ole
o s uc u al p ocesses, leade ship ole
and decision- making au ho i y and he
ela ionship o o ganisa ional s uc u es
o an i- ho izon al iolence policy.
HV ou come measu ed:
– Ho izon al iolence
Main a iables:
– O ganisa ional cul u e
– Wo kplace en i onmen
(Con inues)
TABLE 1 | (Con inued)
13652702, 0, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1111/jocn.17834 by Readcube (Lab i a Inc.), Wiley Online Lib a y on [04/06/2025]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
16 o 17 Jou nal o Clinical Nu sing, 2025
Esca ín- Solanelles, J., C. A ie a- Salas, and Á. Rod íguez- Ca ballei a.
2010. “Mobbing o acoso labo al: Re isión de los p incipales aspec-
os eó ico- me odológicos que di icul an su es udio.” Ac ualidades en
Psicología 23–24, no. 1: 1–19.
Fa me , P. E., B. Nizeye, S. S ulac, and S. Kesha jee. 2006. “S uc u al
Violence and Clinical Medicine.” PLoS Medicine 3, no. 10: e449. h ps://
doi. o g/ 10. 1371/ jou n al. pmed. 0030449.
F ei e, P. 1972. Pedagogy o he Opp essed. Penguin Ha mondswo h.
G inbe g, K., C. Re ach, and G. Lipsman. 2022. “Violence in Hospi als
and Bu nou Among Nu sing S a .” In e na ional Eme gency Nu sing
65: 101230. h ps:// doi. o g/ 10. 1016/j. ienj. 2022. 101230.
Habibzadeh, H., F. Namadi, and M. Mahdi- Akhga . 2023. “Nu se- o-
Nu se Ho izon al Violence Du ing he Co id- 19 Pandemic and I s
Impac on Tu no e In en ion: A C oss- Sec ional S udy.” Nu sing Open
10, no. 4: 2631–2637. h ps:// doi. o g/ 10. 1002/ nop2. 1523.
Ha aei, F., N. Adhami, X. Tang, e al. 2023. “Wo kplace P edic o s
o Violence Agains Nu ses Using Machine Lea ning Techniques: A
C oss- Sec ional S udy U ilizing he Na ional S anda d o Psychological
Wo kplace Heal h and Sa e y.” Heal hca e (Basel) 11, no. 7: 1008. h ps://
doi. o g/ 10. 3390/ heal hca e 11071008.
Hawkins, N., S. Jeong, and T. Smi h. 2019. “New G adua e Regis e ed
Nu ses' Exposu e o Nega i e Wo kplace Beha iou in he Acu e Ca e
Se ing: An In eg a i e Re iew.” In e na ional Jou nal o Nu sing
S udies 93: 41–54. h ps:// doi. o g/ 10. 1016/j. ijnu s u. 2018. 09. 020.
Higgins, J., J. Thomas, J. Chandle , e al. 2019. Coch ane Handbook o
Sys ema ic Re iews o In e en ions. Coch ane. h ps:// doi. o g/ 10. 1002/
97811 19536604.
Homayuni, A., Z. Hosseini, T. Aghamolaei, and S. Shahini. 2021.
“Which Nu ses a e Vic ims o Bullying: The Role o Nega i e A ec ,
Co e Sel - E alua ions, Role Con lic and Bullying in he Nu sing S a .”
BMC Nu sing 20, no. 1: 57. h ps:// doi. o g/ 10. 1186/ s12912- 021- 00578- 3.
Hopia, H., E. La ala, and L. Liima ainen. 2016. “Re iewing he
Me hodology o an In eg a i e Re iew.” Scandina ian Jou nal o Ca ing
Sciences 30, no. 4: 662–669. h ps:// doi. o g/ 10. 1111/ scs. 12327 .
Jabe , H. J., G. M. A. Shosha, M. T. Al- Kalaldeh, e al. 2023. “Pe cei ed
Rela ionship Be ween Ho izon al Violence and Pa ien Sa e y Cul u e
Among Nu ses.” Risk Managemen and Heal hca e Policy 16: 1545–
1553. h ps:// doi. o g/ 10. 2147/ RMHP. S419309.
João, A., C. Vicen e, and A. Po elada. 2023. “Impac o e p e alência do
assédio no abalho no con ex o de en e magem em Po ugal.” Re is a
de En e magem Re e ência 6, no. 2: 1–8. h ps:// doi. o g/ 10. 12707/
RVI22059.
Johanna B iggs Ins i u e. 2017. “Home Page.” JBI. h ps:// jbi. global/ .
Johanna B iggs Ins i u e. 2020. “C i ical App aisal Tools.” h ps:// jbi.
global/ c i i cal- app a isal- ools .
Jo dan, Z., C. Lockwood, Z. Munn, and E. A oma a is. 2019. “The
Upda ed Joanna B iggs Ins i u e Model o E idence- Based Heal hca e.”
In e na ional Jou nal o E idence- Based Heal hca e 17, no. 1: 58–71.
h ps:// doi. o g/ 10. 1097/ XEB. 00000 00000 000155.
Ka açay, P., and F. O laz. 2022. “Explo ing Facul y- o- Facul y Inci ili y
Among Nu sing Facul y: Rela ed Fac o s, Reasons and Solu ions.”
Jou nal o Nu sing Managemen 30, no. 6: 1415–1423. h ps:// doi. o g/ 10.
1111/ jonm. 13375 .
Kelly, S. 2024. “Sys ema ic Re iews: So wa e: Rayyan.ai.” h ps://
guides. lib. olemi ss. edu/ sys e ma ic e ie ws/ so w a e- ayya n- ai.
Kennedy, B. 2020. “The Psychological De elopmen o Ho izon al
(La e al) Violence in Heal h Se ices.” BRK Global Heal hca e Jou nal
4. h ps:// doi. o g/ 10. 35455/ b k12 34567 8912.
Kim, K., S. S. W. Choi, and C. Im. 2024. “Explo ing Bys ande Beha io
Types as a De e minan o Wo kplace Violence in Nu sing O ganiza ions
Focusing on Nu se- o- Nu se Bullying: A Quali a i e Focus G oup
S udy.” Jou nal o Nu sing Managemen 2024, no. 1: 4653042. h ps://
doi. o g/ 10. 1155/ 2024/ 4653042.
Ko ne , C. T., C. S. B ewe , F. Fa ehi, and J. Jun. 2014. “Wha Does
Nu se Tu no e Ra e Mean and Wha Is he Ra e?” Policy, Poli ics &
Nu sing P ac ice 15, no. 3–4: 64–71. h ps:// doi. o g/ 10. 1177/ 15271 54414
547953.
K u , B. A., C. M. Laing, N. J. Moules, and A. Es e an. 2021. “The
Impac o Ho izon al Violence on he Indi idual Nu se: A Quali a i e
Resea ch S udy.” Nu se Educa ion in P ac ice 54: 103079. h ps:// doi.
o g/ 10. 1016/j. nep . 2021. 103079.
Lambe , K., K. F ancis, and K. To i. 2025. “Va iabili y o Te minology
Used o Desc ibe Unwan ed Wo kplace Beha io s in Nu sing: A Scoping
Re iew.” Wes e n Jou nal o Nu sing Resea ch 47: 423–432. h ps:// doi.
o g/ 10. 1177/ 01939 45925 1323680.
Laschinge , H. K. S., and E. A. Read. 2016. “The E ec o Au hen ic
Leade ship, Pe son- Job Fi , and Ci ili y No ms on New G adua e
Nu ses' Expe iences o Cowo ke Inci ili y and Bu nou .” JONA: The
Jou nal o Nu sing Adminis a ion 46, no. 11: 574–580. h ps:// doi. o g/
10. 1097/ NNA. 00000 00000 000407.
Lee, H., Y. M. Ryu, M. Yu, H. Kim, and S. Oh. 2022. “A Quali a i e
Me a- Syn hesis o S udies on Wo kplace Bullying Among Nu ses.”
In e na ional Jou nal o En i onmen al Resea ch and Public Heal h 19,
no. 21: 14120. h ps:// doi. o g/ 10. 3390/ ije p h1921 14120 .
Le e , I., D. Dyball, N. G eenbe g, and S. A. M. S e elink. 2019. “Heal h
Consequences o Bullying in he Heal hca e Wo kplace: A Sys ema ic
Re iew.” Jou nal o Ad anced Nu sing 75, no. 12: 3195–3209. h ps:// doi.
o g/ 10. 1111/ jan. 13986 .
Liu, J., J. Zheng, K. Liu, e al. 2019. “Wo kplace Violence Agains Nu ses,
Job Sa is ac ion, Bu nou , and Pa ien Sa e y in Chinese Hospi als.”
Nu sing Ou look 67, no. 5: 558–566. h ps:// doi. o g/ 10. 1016/j. ou lo ok.
2019. 04. 006.
Longo, J., and D. Newman. 2014. “The De elopmen and Psychome ic
Tes ing o he Ho izon al Violence Scale.” Issues in Men al Heal h
Nu sing 35: 924–933.
McKenna, B. G., N. A. Smi h, S. J. Poole, and J. H. Co e dale. 2003.
“Ho izon al Violence: Expe iences o Regis e ed Nu ses in Thei Fi s
Yea o P ac ice.” Jou nal o Ad anced Nu sing 42, no. 1: 90–96. h ps://
doi. o g/ 10. 1046/j. 1365- 2648. 2003. 02583. x.
McNama a, S. 2012. “Inci ili y in Nu sing: Unsa e Nu se, Unsa e
Pa ien s.” AORN Jou nal 95, no. 4: 535–540. h ps:// doi. o g/ 10. 1016/j.
ao n. 2012. 01. 020.
Mye s, G., D. Cô é- A senaul , P. Wo al, e al. 2016. “A C oss- Hospi al
Explo a ion o Nu ses' Expe iences Wi h Ho izon al Violence.” Jou nal
o Nu sing Managemen 24, no. 5: 624–633. h ps:// doi. o g/ 10. 1111/
jonm. 12365 .
Naja i, B., and A. Nasi i. 2023. “Suppo Expe iences o No ice Nu ses
in he Wo kplace: A Quali a i e Analysis.” SAGE Open Nu sing 9:
23779608231169212. h ps:// doi. o g/ 10. 1177/ 23779 60823 1169212.
Na ional Lib a y o Medicine. 2025. Medical Subjec Headings [P oduc ,
P og am, and P ojec Desc ip ions]. U.S. Na ional Lib a y o Medicine.
h ps:// www. nlm. nih. go / mesh/ meshh ome. h ml.
Noo , N., F. Faisal, R. Al a , and S. Rehman. 2023. “Psychological Heal h
o Female Nu ses: An Explo a ion o O ganiza ional and Indi idual
Fac o s o Ho izon al Hos ili y.” Pakis an Jou nal o Humani ies and
Social Sciences 2, no. 1: 217–246.
Noo , N., M. Jamil, and Y. Ahmed. 2022. “Opp ession Among Female
Nu ses: A Concep Analysis.” Jou nal o De elopmen and Social Sciences
3, no. 4: 358–369. h ps:// doi. o g/ 10. 47205/ jdss. 2022(3- IV) 35.
Noo , N., S. Rehman, Y. Ahmed, S. Rizwan, and M. Sa mad. 2024. “Why
Do Nu ses Lea e Thei Jobs? Unde s anding Pe son- Rela ed Hos ili y
in he Heal hca e Sec o o Pakis an.” PLoS One 19, no. 6: e0298581.
h ps:// doi. o g/ 10. 1371/ jou n al. pone. 0298581.
13652702, 0, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1111/jocn.17834 by Readcube (Lab i a Inc.), Wiley Online Lib a y on [04/06/2025]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
17 o 17
Noo , N., S. Rehman, Y. Ahmed, M. Sa mad, and R. Mehmood. 2023.
“Disc imina o y P ac ices and Poo Job Pe o mance: A S udy o
Pe son- Rela ed Hos ili y Among Nu sing S a .” Heliyon 9, no. 3: e14351.
h ps:// doi. o g/ 10. 1016/j. heliy on. 2023. e14351.
Noo , N., S. Rehman, and M. Gull. 2023. “De e minan s o Wo k- Rela ed
S ess Among Nu sing P o essionals.” Pakis an Jou nal o Humani ies
and Social Sciences 11, no. 2: 1836–1849. h ps:// doi. o g/ 10. 52131/ pjhss.
2023. 1102. 0486.
Oh, H., D. Uhm, and Y. J. Yoon. 2016. “Wo kplace Bullying, Job S ess,
In en o Lea e, and Nu ses' Pe cep ions o Pa ien Sa e y in Sou h
Ko ean Hospi als.” Nu sing Resea ch 65, no. 5: 380–388. h ps:// doi. o g/
10. 1097/ NNR. 00000 00000 000175.
Peng, X., Y. Gan, Q. Zeng, e al. 2022. “Nu se- o- Nu se Ho izon al
Violence in Chinese Hospi als and he P o ec i e Role o Head Nu se's
Ca ing and Nu ses' G oup Beha iou on I : A C oss- Sec ional S udy.”
Jou nal o Nu sing Managemen 30, no. 6: 1590–1599. h ps:// doi. o g/ 10.
1111/ jonm. 13498 .
Rangel- Flo es, Y., C. Magdalena Ma ínez- Villa, and V. Jiménez- A oyo.
2022. “Rela ions o Powe and Opp ession Wi hin he Deli e y Room:
Nu sing Na a i es.” Re is a da Escola de En e magem da USP 56:
e20210476. h ps:// doi. o g/ 10. 1590/ 1980- 220X- REEUS P- 2021- 0476en.
Rauman, P. A. 2023. “Con lic ing Wo king Rela ionships Among
Nu ses: The In e sec ion o Should Nu sing, Double Domina ion, and
he Big Pic u e.” Canadian Jou nal o Nu sing Resea ch 55, no. 2: 230–
240. h ps:// doi. o g/ 10. 1177/ 08445 62122 1115250.
Rosi, I. M., A. Con iguglia, K. R. Millama, and S. Ranca i. 2020. “Newly
G adua ed Nu ses' Expe iences o Ho izon al Violence.” Nu sing E hics
27, no. 7: 1556–1568. h ps:// doi. o g/ 10. 1177/ 09697 33020 929063.
Sanne - S ieh , E., and P. Wa d- Smi h. 2017. “La e al Violence in
Nu sing: Implica ions and S a egies o Nu se Educa o s.” Jou nal o
P o essional Nu sing 33, no. 2: 113–118. h ps:// doi. o g/ 10. 1016/j. p o n
u s. 2016. 08. 007.
Small, M. M., J. Lindo, J. Aiken, and C. Chin. 2017. “La e al Violence
Among Nu ses a a Jamaican Hospi al: A Mixed Me hods S udy.”
In e na ional Jou nal o Ad anced Nu sing S udies 6: 85–91. h ps:// doi.
o g/ 10. 14419/ ijans. 6i2. 8264.
Sousa, L. S. D., R. M. Oli ei a, J. C. D. S. San iago, e al. 2021. “P edic o s
o Mo al Ha assmen in Nu sing Wo k in C i ical Ca e Uni s.” Re is a
B asilei a de En e magem 74, no. 3: e20200442. h ps:// doi. o g/ 10. 1590/
0034- 7167- 2020- 0442.
Taylo , R. 2016. “Nu ses' Pe cep ions o Ho izon al Violence.” Global
Quali a i e Nu sing Resea ch 3: 2333393616641002. h ps:// doi. o g/ 10.
1177/ 23333 93616 641002.
Tedone, D. A. 2020. “Elimina ing Ho izon al Violence F om he
Wo kplace.” Nu sing 50, no. 8: 57. h ps:// doi. o g/ 10. 1097/ 01. NURSE.
00006 68440. 64732. 39.
Te zioglu, F., S. Temel, and F. Uslu Sahan. 2016. “Fac o s A ec ing
Pe o mance and P oduc i i y o Nu ses: P o essional A i ude,
O ganisa ional Jus ice, O ganisa ional Cul u e and Mobbing.” Jou nal
o Nu sing Managemen 24, no. 6: 735–744. h ps:// doi. o g/ 10. 1111/
jonm. 12377 .
T a aini, G. V., E. Flu i, M. So oco nola, e al. 2024. “E idence o
Ho izon al Violence in Heal hca e Se ings: A Na a i e Re iew.”
Nu sing Repo s (Pa ia, I aly) 14, no. 3: 1647–1660. h ps:// doi. o g/ 10.
3390/ nu s ep140 30123 .
Vessey, J. A., R. DeMa co, and R. DiFazio. 2010. “Bullying, Ha assmen ,
and Ho izon al Violence in he Nu sing Wo k o ce: The S a e o he
Science.” Annual Re iew o Nu sing Resea ch 28: 133–157.
Vidal- Al es, M. J. 2023. “Wo kplace Violence, Bu nou and Heal h o
Nu sing P o essionals in Hospi al Se ing.” Doc o al hesis, Uni e sidad
de Mu cia, Reposi o io de esis de la Uni e sidad de Mu cia. h ps://
digi um. um. es/ digi um/ handle/ 10201/ 136654.
Vidal- Al es, M. J., D. Pina, E. Puen e- López, e al. 2021. “Tough Lo e
Lessons: La e al Violence Among Hospi al Nu ses.” In e na ional
Jou nal o En i onmen al Resea ch and Public Heal h 18, no. 17: 9183.
Vidal- Al es, M. J., D. Pina, J. A. Ruiz- He nández, E. Puen e- López, D.
Paniagua, and B. Ma ínez- Ja e a. 2022. “(Un)b oken: La e al Violence
Among Hospi al Nu ses, Use Violence, Bu nou , and Gene al Heal h:
A S uc u al Equa ion Modeling Analysis.” F on ie s in Medicine 9:
1045574. h ps:// doi. o g/ 10. 3389/ med. 2022. 1045574.
Wei, H., M. Liu, Z. Wang, e al. 2024. “Anxie y, Dep ession, and Pos -
T auma ic S ess Diso de in Nu ses Exposed o Ho izon al Violence: A
Ne wo k Analysis.” BMC Nu sing 23, no. 1: 750. h ps:// doi. o g/ 10. 1186/
s1291 2- 024- 02408 - 8.
Whi emo e, R., and K. Kna l. 2005. “The In eg a i e Re iew: Upda ed
Me hodology.” Jou nal o Ad anced Nu sing 52, no. 5: 546–553. h ps://
doi. o g/ 10. 1111/j. 1365- 2648. 2005. 03621. x.
Wilson, D. M., F. Ana i, E. Kusi- Appiah, E. M. Da ko, K. Deck, and
B. E as i- Iba ondo. 2020. “De e mining i Nu ses a e In ol ed in
Poli ical Ac ion o Poli ics: A Scoping Li e a u e Re iew.” Applied
Nu sing Resea ch 54: 151279. h ps:// doi. o g/ 10. 1016/j. apn . 2020.
151279.
Wo ld Heal h O ganiza ion. 2020. “Si uación de la en e me ía en el
mundo 2020.” 116. h ps:// www. who. in / es/ publi ca io ns/i/ i em/ 97892
40003279.
Wu, Y., J. Wang, J. Liu, e al. 2020. “The Impac o Wo k En i onmen
on Wo kplace Violence, Bu nou and Wo k A i udes o Hospi al
Nu ses: A S uc u al Equa ion Modelling Analysis.” Jou nal o Nu sing
Managemen 28, no. 3: 495–503. h ps:// doi. o g/ 10. 1111/ jonm. 12947 .
Yokoyama, M., M. Suzuki, Y. Takai, A. Iga ashi, M. Noguchi- Wa anabe,
and N. Yamamo o- Mi ani. 2016. “Wo kplace Bullying Among Nu ses
and Thei Rela ed Fac o s in Japan: A C oss- Sec ional Su ey.” Jou nal
o Clinical Nu sing 25, no. 17–18: 2478–2488. h ps:// doi. o g/ 10. 1111/
jocn. 13270 .
Ys aas, L. M. K., M. Niki a a, S. Ghob ial, E. La zou akis, G. Polych onis,
and C. S. Cons an inou. 2023. “The Impac o T ans o ma ional
Leade ship in he Nu sing Wo k En i onmen and Pa ien s' Ou comes:
A Sys ema ic Re iew.” Nu sing Repo s (Pa ia, I aly) 13, no. 3: 1271–
1290. h ps:// doi. o g/ 10. 3390/ nu s ep130 30108 .
Zahlquis , L., J. He land, G. No elae s, M. Rosande , and S. V. Eina sen.
2023. “When he Going Ge s Tough and he En i onmen Is Rough: The
Role o Depa men al Le el Hos ile Wo k Clima e in he Rela ionships
Be ween Job S esso s and Wo kplace Bullying.” In e na ional Jou nal
o En i onmen al Resea ch and Public Heal h 20, no. 5: 44–65. h ps://
doi. o g/ 10. 3390/ ije p h2005 4464.
Zap , D., J. Esca in, M. Scheppa- Lahyani, S. V. Eina sen, H. Hoel, and
M. Va ia. 2020. “Empi ical Findings on P e alence and Risk G oups
o Bullying in he Wo kplace.” In Bullying and Ha assmen in he
Wo kplace, 105–162. Taylo and F ancis.
Zhang, Y., R. Yin, J. Lu, e al. 2022. “Associa ion Be ween Ho izon al
Violence and Tu no e In en ion in Nu ses: A Sys ema ic Re iew and
Me a- Analysis.” F on ie s in Public Heal h 10: 964629. h ps:// doi. o g/
10. 3389/ pubh. 2022. 964629.
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