טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
Ph.D Thesis
Ph.D StudentEfrat-Treister Dorit
SubjectHospital Aggression: A Multi-Cultural Perspective
DepartmentDepartment of Industrial Engineering and Management
Supervisor Professor Anat Rafaeli
Full Thesis textFull thesis text - English Version


Abstract

This research examines the importance of the cultural value dimension of individualism-collectivism to understanding the organizational consequences eliciting aggression in hospitals. The broad research question is how the cultural value dimension of individualism-collectivism relates to what types of situations people view as offensive and unjust and to whether and how people respond with aggression in these situations. The Study focuses specifically on potentially offensive situations and aggressive tendencies in hospital emergency rooms. Our prediction is that the cultural value dimension of individualism- collectivism can explain why situations offend people with different personal levels of individualism-collectivism, why these situations are perceived as unjust and therefore enhance the tendency of these people to act aggressively.

Study 1is a phenomena driven study, aimed at examining the within-country variations in the personal levels of individualism-collectivism. This Study maps the cultural value profile of the different cultural subgroups inhabiting Israel by comparing the personal (self-report) level of the cultural value dimension of individualism -collectivism among members of a representative sample of the cultural subgroups in the Israeli society (N=814).

Study 2 asked students (n=74) to rate the level of offense of various situations and correlated these ratings with the students' personal levels of individualism-collectivism, offering a connection between the level of offense of situations and peoples' values. This study resulted in a tool to be used in Study 3.

Study 3 builds on a survey of 503 hospital patients and escorts to identify hospital situations viewed as unjust, and thus as likely to yield aggressive reactions. The results confirm that peoples' cultural value dimension of individualism-collectivism explains which offensive situations they perceive as unjust, and whether people tend to endorse aggression.

The three studies fully support the predicted research model. The data confirm a significant mediation effect where perceived injustice explains why a potentially offensive situations leads to aggression. Data also show a significant moderated mediation, where the personal level on the cultural value dimension of individualism-collectivism is a double moderator, determining which situation is offensive to whom, and whether it is expected to lead to aggression. The research promotes understanding of the difficult and costly problem of hospital aggression by providing insight into when, whether and why aggression erupts.