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Horizontal violence (HV), or nonphysical intergroup conflict expressed in overt and covert behaviors of hostility, is pervasive in nursing and has been discussed in the literature for more than two decades. It is costly and has potentially devastating effects including high nurse turnover rates, increased illness, decreased productivity, and decreased quality of patient care. Recognizing how these behaviors are established and sustained is necessary if nurses are to overcome these types of behaviors. This mixed methods study used an online survey to examine 76 hospital nurses' experiences and responses to episodes of HV as well as its effects on job performance. Seven of these nurses answered more in‐depth questions during a follow‐up interview. Nurses in this study recognize HV as a phenomenon that occurred early in their careers as novice nurses. The literature suggests that these behaviors are evident during nursing education. The academic environment is an ideal place to teach the skills necessary to respond appropriately to HV with peer support being essential. Nurses also reported that manager and staff support and workplace education were the most helpful in reducing HV. Increased workload and stress and HV being accepted practice on the unit were factors identified as most important in promoting HV. Further, nurses cited reasons why they continue in their jobs after episodes of HV. Intervention studies are needed to test effective ways of reducing this very difficult behavior among nurses in the workplace. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine patient- and parent-perceived factors that impact adherence to inflammatory bowel disease treatment using a qualitative descriptive individual interview approach. Sixteen adolescents and their parents were recruited from May through August 2007 and interviewed about medication adherence using an open-ended semi-structured interview format. Interviews were audio recorded, transcribed, and coded into themes. Parent-child dyads identified forgetting, interfering activities, parent-child conflict and oppositional behaviour and inadequate planning for treatment as challenges to adherence. Participants reported that family support and good parent-child relationships, routines, monitoring and reminding and organisational tools such as pill boxes facilitated treatment adherence. Other issues that emerged included immediacy of treatment effects and parent-adolescent responsibility for treatment. Patients and parents experience a number of challenges related to adherence within behavioural, educational, organisational and health belief domains. Behavioural interventions should focus on these issues, reduction of perceived barriers, and effective transition of responsibility for treatment adherence. Future research considerations are discussed. [ABSTRACT FROM AUTHOR]