Published April 3, 2026 | Version v1
Journal article Open

The Association Between Patient Family Members' Incivility and Ongoing Patient Care Outcomes in Critical Care Settings at Tertiary Care Hospital, Swat

Description

Background: The shift towards family-centered care, while beneficial, has heightened the risk of interpersonal conflict in hospitals. Incivility from patients' families is characterized by low- intensity disrespectful behaviors is a growing systemic concern, particularly in high-stress environments like intensive care units (ICUs). Such behavior is hypothesized to impair clinician cognition, increase stress, and disrupt care processes, posing a direct threat to patient safety and healthcare outcomes. However, empirical evidence quantifying this specific association, especially in resource-constrained settings, remains limited.

Objective: This study aimed to assess and analyze the association between family member incivility and ongoing patient care outcomes within a critical care hospital swat.

Methodology: A cross-sectional study was conducted among 74 registered nurses working in ICU, coronary care unit (CCU), emergency room (ER), and high dependency unit (HDU). Data were collected using a structured questionnaire incorporating an adapted Nursing Incivility Scale and a tool measuring care disruption. Analysis was performed using statistical package for the social sciences (SPSS) version 27 with descriptive statistics and Chi-square testing.

Results: Approximately 25.7% of nurses reported frequent exposure to family incivility, while 40.5% reported frequent disruptions in patient care. A significant association was observed between incivility and care disruptions (χ²=3.69, p=0.055).

Conclusion: Family incivility is a significant risk factor affecting patient care processes, necessitating targeted institutional interventions.

Files

Files (49.3 kB)

Name Size Download all
md5:d8abfbb99c3e4be5504007750e7bd4a9
49.3 kB Download

Additional details

Related works

Is published in
Journal: 3065-9892 (ISSN)

Dates

Accepted
2026-04-03

References

  • 1. Freedman B, Li WW, Liang Z, Hartin P, Biedermann N. The prevalence of incivility in hospitals and the effects of incivility on patient safety culture and outcomes: A systematic review and meta-analysis. J Adv Nurs. 2025;81(9):5603-5622. doi:10.1111/jan.16111 PubMed | Crossref | Google Scholar
  • 2. Alsadaan N, Ramadan OME, Alqahtani M. From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes. BMC Nurs. 2024;23(1):325. doi:10.1186/s12912-024-01996-9 PubMed | Crossref | Google Scholar
  • 3. Keller S, Yule S, Zagarese V, Henrickson Parker S. Predictors and triggers of incivility within healthcare teams: a systematic review of the literature. BMJ Open. 2020;10(6):e035471. doi:10.1136/bmjopen-2019-035471 PubMed | Crossref | Google Scholar
  • 4. Sridharan V, Leung KC, Peisah C. Understanding aggression displayed by patients and families towards intensive care staff: A systematic review. J Intensive Care Soc. 2024;25(3):266-278. doi:10.1177/17511437241231707 PubMed | Crossref | Google Scholar
  • 5. Alquwez N. Association between nurses' experiences of workplace incivility and the culture of safety of hospitals: A cross-sectional Study. J Clin Nurs. 2023;32(1-2):320-331. doi:10.1111/jocn.16230 PubMed | Crossref | Google Scholar
  • 6. Lewis C. The impact of interprofessional incivility on medical performance, service and patient care: a systematic review. Future Healthc J. 2023;10(1):69-77. doi:10.7861/fhj.2022-0092 PubMed | Crossref | Google Scholar
  • 7. Aljuaid NH, Alharbi MF. The Relationship Between Workplace Incivility and Patient Safety in Pediatric Nurses. J Nurs Care Qual. 2023;38(3):211-219. doi:10.1097/NCQ.0000000000000685 PubMed | Crossref | Google Scholar
  • 8. Joseph O, Mir G, Fylan B, Essler P, Lawton R. Incivility experiences of racially minoritised hospital staff, consequences for them and implications for patient care: An international scoping review. Sociol Health Illn. 2025;47(1):e13760. doi:10.1111/1467-9566.13760 PubMed | Crossref | Google Scholar
  • 9. Martin LD, Zadinsky JK. Frequency and outcomes of workplace incivility in healthcare: A scoping review of the literature. J Nurs Manag. 2022;30(7):3496-3518. doi:10.1111/jonm.13783 PubMed | Crossref | Google Scholar
  • 10. Shah H, Atta U, Arif U. Nurses' experiences with ethical dilemmas in critical care settings: A mixed-method study at Saidu Teaching Hospital. medtigo J Med. 2025;3(1):e30623135. doi:10.63096/medtigo30623135 Crossref | Google Scholar
  • 11. Allari RS, Hamdan K, Atout M, Shaheen AM, Albqoor MA. Association Between Nurses' Experiences of Workplace Incivility and Caring Responsibilities: A Cross-Sectional Study. SAGE Open Nurs. 2025;11:23779608251340682. doi:10.1177/23779608251340682 PubMed | Crossref | Google Scholar
  • 12. Alquwez N. Examining the Influence of Workplace Incivility on Nurses' Patient Safety Competence. J Nurs Scholarsh. 2020;52(3):292-300. doi:10.1111/jnu.12553 PubMed | Crossref | Google Scholar
  • 13. Lama A, Nwamu H, Kim Y. Interventions to Address Clinical Incivility in Nursing: A Systematic Review. Nurs Rep. 2025;15(6):199. doi:10.3390/nursrep15060199 PubMed | Crossref | Google Scholar
  • 14. Yan Z, Mansor ZD, Choo WC. Family incivility, emotional exhaustion, and hotel employees' outcomes: a moderated mediation model. Int J Contemp Hosp Manag. 2023;35(9):3053-3076. doi:10.1108/IJCHM-05-2022-0573 Crossref | Google Scholar
  • 15. Cooke HA, Baumbusch J. Not Just How Many but Who Is on Shift: The Impact of Workplace Incivility and Bullying on Care Delivery in Nursing Homes. Gerontologist. 2021;61(4):563-572. doi:10.1093/geront/gnaa203 PubMed | Crossref | Google Scholar
  • 16. Gosselin TK, Ireland AM. Addressing Incivility and Bullying in the Practice Environment. Semin Oncol Nurs. 2020;36(3):151023. doi:10.1016/j.soncn.2020.151023 PubMed | Crossref | Google Scholar
  • 17. Sole ML, Klein DG, Moseley MJ. Introduction to Critical Care Nursing. 8th ed. Elsevier; 2020. Introduction to Critical Care Nursing
  • 18. Schoville R, Aebersold M. How workplace bullying and incivility impacts patient safety: a qualitative simulation study using BSN students. Clin Simul Nurs. 2020;45:1-6. doi:10.1016/j.ecns.2020.01.003 Crossref | Google Scholar
  • 19. Basu S, Preisz A. Family conflict and aggression in the paediatric intensive care unit: responding to challenges in practice. Clin Ethics. 2022;18(3):297-304. doi:10.1177/14777509221091081 Crossref | Google Scholar
  • 20. Fowler KR, Loera GM, Castanon-Ortiz A. Do Nurse Leaders Influence the Perception of Incivility?. Nurs Adm Q. doi:10.1097/NAQ.0000000000000691 PubMed | Crossref | Google Scholar
  • 21. Secunda KE, Kruser JM. Patient-Centered and Family-Centered Care in the Intensive Care Unit. Clin Chest Med. 2022;43(3):539-550. doi:10.1016/j.ccm.2022.05.008 PubMed | Crossref | Google Scholar
  • 22. Alkubati SA, Alrashidi OA, Albaqawi H, et al. The mediating effect of resilience and job satisfaction on the relationship between critical care nurses' stress-and task performance: findings to improve nursing care. BMC Nurs. 2025;24(1):579. doi:10.1186/s12912-025-03225-3 PubMed | Crossref | Google Scholar