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The purpose of this study was to develop a hypothetical model to describe the association between workplace violence and occupational well-being and issues related to these. The purpose was also to develop an instrument to assess the incidence of violence in psychiatric nursing. The study included three phases: (I) the development of an instrument, (II) empirical cross-sectional research and (III) the development of the hypothetical model. The empirical data was collected by the developed VIA-Q instrument and the Nordic Questionnaire for Monitoring the Age Diverse Workforce (QPSNordic-ADW) instrument from nurses working in Finnish psychiatric outpatient settings in psychiatric specialized medical care. In phase I, the structure of the developed instrument was based on a systematic literature review, which indicated that violence in psychiatric outpatient settings is a complex phenomenon. In phase II, the empirical research revealed that nurses (n = 181) faced most often psychological violence from patients, but also internal violence and harassment were reported. As consequences of psychological violence, nurses reported fatigue, feelings of violated integrity, anxiety, and depression. Occupational well-being was evaluated as mainly good. Nurses were most critical of interaction between the immediate superior and gained support. Organizational values were evaluated as contradictory against nurses’ own values. The consequences of psychological violence were influenced by individual background characteristics. The violence faced, especially harassment, was related to many psychological symptoms. Working experience was related to the consequences of violence and the evaluated occupational well-being. In phase III, the developed hypothetical model was based on the results of this study, previous research, and the literature. The main concepts of the hypothetical model were background factors, violence, symptoms, and occupational well-being. This study provides knowledge about the incidence of violence and occupational well-being in psychiatric outpatient settings. The results of this study can be exploited when developing interventions to increase nurses’ occupational well-being or interventions to decrease workplace violence. The hypothetical model provides a perspective to investigate a complex phenomenon. Tiivistelmä Tämän tutkimuksen tarkoituksena oli rakentaa hypoteettinen malli kuvaamaan työssä kohdatun väkivallan ja työhyvinvoinnin välistä yhteyttä sekä näihin yhteydessä olevia tekijöitä. Lisäksi tarkoituksena oli kehittää ja validoida mittari väkivallan ilmenemisen arviointiin psykiatrisessa hoitotyössä. Tutkimus koostui kolmesta vaiheesta: I mittarin kehittäminen, II empiirinen poikkileikkaustutkimus ja III hypoteettisen mallin rakentaminen. Empiirinen tutkimusaineisto kerättiin psykiatrisen erikoissairaanhoidon avohoidossa työskenteleviltä sairaanhoitajilta tutkimuksessa kehitetyllä VIA-Q-mittarilla sekä Nordic Questionnaire for Monitoring the Age Diverse Workforce (QPSNordic-ADW) -mittarilla. Vaiheessa I kehitetyn mittarin sisältö perustuu systemaattiseen kirjallisuuskatsaukseen, joka osoitti väkivallan psykiatrisessa avohoidossa olevan kompleksinen ilmiö. Vaiheen II empiirinen tutkimus osoitti, että sairaanhoitajat (n = 181) kohtaavat työssään useimmiten potilaiden taholta tulevaa psyykkistä väkivaltaa mutta myös työyhteisön sisäistä väkivaltaa ja häirintää. Psyykkisen väkivallan seurauksina raportoitiin uupumusta, tunteita henkilökohtaisen koskemattomuuden loukkaamisesta, ahdistuneisuutta ja masennusta. Työhyvinvointi arvioitiin pääosin hyväksi, ja suurin kritiikki kohdistui vuorovaikutukseen lähijohtajan kanssa ja lähijohtajalta saadun tuen puutteeseen sekä organisaation tapaan huolehtia työntekijöiden työhyvinvoinnista. Organisaation arvot arvioitiin jossain määrin ristiriitaisiksi omien arvojen kanssa. Väkivallan kohtaamisesta aiheutuvat psyykkiset oireet muodostuivat yksilöllisesti erilaisten taustatekijöiden vaikutuksesta. Kohdatusta väkivallasta erityisesti häirintä oli yhteydessä useisiin erilaisiin psyykkisiin oireisiin. Lisäksi työkokemus oli yhteydessä kohdatusta väkivallasta aiheutuneisiin seurauksiin ja arvioituun työhyvinvointiin. Vaiheessa III rakennettiin tutkimuksen tulosten, aiemman tutkimuksen ja kirjallisuuden perusteella hypoteettinen malli. Sen pääkäsitteet ovat taustatekijät, väkivalta, oireet ja työhyvinvointi. Tutkimus tuottaa uutta tietoa väkivallan ilmenemisestä ja työhyvinvoinnista psykiatrisessa avohoidossa. Tutkimuksesta saatua tietoa voidaan hyödyntää sairaanhoitajien työhyvinvoinnin lisäämiseen sekä väkivallan vähentämiseen tähtäävien interventioiden kehittämisessä. Hypoteettinen malli mahdollistaa kompleksisen ilmiön tarkastelun.

The aim of this study was to offer an additional point of view of the age political discourse on work endurance, initiated by Finland’s public administration in the early 2000s. The personal experiences of the staff of a multi-professional work community were exploited to find clues to occupational well-being and endurance at work. Seventeen employees aged 45—64 at the actual work community were chosen as data or material for study, i.e. to be interviewed. A phenomenological-hermeneutical approach was applied to shed light on how to create well-being at work. Personal experiences of work endurance were analyzed and interpreted along the guidelines of the stepwise method used in phenomenology. The analysis and interpretation of the data showed that the nature of work had changed and the consequences constituted a risk to occupational well-being. The interviewees felt that they had also changed; as seniors they had become unique and different from each other. Their experiences of work endurance were also different. Meaningful work was to almost everyone the most important factor that promoted work endurance and well-being. Meaningful work made people feel at home and commit themselves. It protected against too much haste and pressure at work, and it supported the balance between work and private life, important for endurance. The supportive measures and practices of the work community promoted work endurance, and the official measures were completed by people’s personal means of endurance as well as their personal qualities. What was experienced as meaningful was daily team work and mutual support from peers; both these factors promoted life- long learning and one’s personal growth at work, and compensated for loss of social communication that had been reduced by too much haste. Analysis and explanation of negative experiences proved to be essential in promoting well-being at work. A stress factor that had not been analyzed remained unsolved, consumed a person’s strength and undermined the balance he or she had attained. The years of midlife (40—60/65) included two successive transitions in development; on one hand, the period of individualizing growth with new resources and new plans, on the other hand, the period of giving up with feelings of loss at retirement. In both transition periods, allocated guidance and support would have been needed. In the former case, the resources, ex- perience and new plans of the seniors should have been made use of. In the latter, support would have been needed to cope with feelings of loss and fear that were roused by leaving a work community and its human relationships, as well as anticipated loneliness of old age

The research investigated the associations between ethical organizational cul ture, ethical strain (stress caused by ethical dilemmas) and job turnover. The first study investigated differences in employees’ ethical strain and their evalua tions of the ethical culture of their organizations between a public sector city organization (n = 3,123), an engineering firm (n = 287) and a bank (n = 187). In the second study, the connections between resources and personal authority for ethical actions (one dimension of the ethical culture of an organization) and eth ical strain in social affairs and health services in a public sector city organization were analyzed at the work-unit (n = 142) level as well as at the employee (n = 1,243) level. In the third study, profiles of employees’ ethical dilemmas in a public sector city organization (n = 2,470) were identified and differences in job burnout in these profiles were examined. The fourth study examined the asso ciations between ethical organizational culture and managers’ (n = 453) job turnover. The findings showed that the organizations differed in their ethical culture and employees´ ethical strain. In all organizations, a high ethical culture was associated with employees’ low ethical strain. In those social affairs and health work units where the resources and personal authority were considered low, the ethical strain was higher than it was in other work units. Furthermore, the weaker the evaluations of possibilities to act ethically were, the more often ethical dilemmas were faced and the more stress was experienced. The third study, which was based on a person-oriented approach, showed that for the profile in which ethical dilemmas were faced weekly, employees reported sig nificantly more job burnout symptoms than employees in other profiles did. The study concerning managers indicated that the more weakly the managers evaluated the congruency of their supervisors’ and upper managements’ ethical role modelling, the greater the probability of manager turnover was. Overall, the results showed that ethical organizational culture has a significant role in promoting occupational well-being and in remaining in the same workplace.

Tässä pilottitutkimuksessa tutkittiin laadullisesti johtajien työssään kokemia eettisesti haastavia tilanteita (sisällöt, kontekstit) sekä niissä koettuja ristiriitakokemuksia. Työtilanteita luokiteltiin laadullisen aineiston pohjalta. Aineisto kerättiin 16 suomalaisen johtajan fokusryhmäkeskusteluista (neljä ryhmää). Tulokset osoittivat, että johtajat kohtasivat usein työssään erilaisia eettisesti haastavia tilanteita suhteessa organisaation sidosryhmiin. Näitä sidosryhmiä olivat organisaation toimintaympäristö eli yhteiskunta, asiakkaat, omistajat sekä henkilöstö (johto, kollegat ja alaiset). Haastavien tilanteiden sisällöt jakautuivat viiteen luokkaan: 1) monimutkaiset työtilanteet, 2) rehellisyys, 3) oma toiminta, 4) vuorovaikutussuhteet ja 5) oikeudenmukaisuus. Psykologisen stressiteorian mukaisesti johtajat kokivat tilanteet kuormittaviksi, jos johtajan ja sidosryhmien välillä vallitsi ristiriitakokemus. Ristiriitoja koettiin johtajan omien arvojen ja ympäristön tarjoamien mahdollisuuksien välillä, sekä ympäristön odotusten ja omien resurssien välillä. Tutkimuksessamme nousi esille myös uusi ristiriitatilanne, joka syntyy, kun johtaja toimii tinkimättömästi omien arvojensa mukaan ulkopuolisia odotuksia vastaan. peerReviewed