Workplace bullying and mental health of medical interns in KwaZulu-Natal Province, South Africa
DOI:
https://doi.org/10.7196/SAMJ.2025.v115i6.2589Keywords:
Workplace bullying, medical interns, anxiety, depression, South AfricaAbstract
Background. There is a silent epidemic of workplace bullying among medical doctors, with junior doctors being the most vulnerable. Little research has been conducted to establish the nature and extent of bullying of medical interns in KwaZulu-Natal (KZN) Province, South Africa.
Objectives. To describe the prevalence and types of workplace bullying, identify alleged perpetrators, and explore the association between bullying and the mental health and quality of life of medical interns in KZN.
Methods. A cross-sectional online survey was conducted across all state hospitals in KZN designated for training first- and second-year medical interns, from 1 June to 31 August 2023, using snowball sampling. Participants completed a newly designed sociodemographic, clinical and bullying questionnaire, the Negative Acts Questionnaire (NAQ), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) scale, and the World Health Organization Quality of Life scale.
Results. Of the 270 medical interns employed in KZN, 182 responded, and 135 were included in the study. All interns were classified as having experienced bullying according to the NAQ, and 61.8% screened positive for symptoms of anxiety and/or depression on the PHQ-9 and GAD-7. The most commonly reported somatic symptoms and work-related behaviours caused by workplace bullying were recurrent headaches (42.5%), chronic lethargy (79.3%), gastrointestinal illnesses (42.7%), sleep disturbances (67.8%), loss of interest in work (81.0%) and absenteeism from work (43.5%). Most participants (61.2%) did not report the bullying to senior staff, and most of those who did report were dissatisfied with the outcome of the investigation (91.2%).
Conclusion. Medical interns in KZN have a high prevalence of anxiety and depressive symptoms, with a negative impact on their quality of life. Bullying by senior medical and nursing staff is pervasive. However, it was not possible to explore the associations between bullying and mental health, as all participants had high bullying scores on the NAQ.
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