in recent years , workplace bullying has become an important , interesting , and popular topic for many organizational behavior researchers and a large number of popular as well as academic books and articles have been published in many countries throughout the world , such as canada , the usa , the uk , denmark , norway , turkey , india , and australia . workplace bullying ,  there is no simple definition that encompasses all the various dimensions of this phenomenon , although one popular definition suggests that  workplace bullying is a repeated physical , psychological , or sexual abuse , harassment , or hostility within workplaces and consists of behavior that is known , or ought to be known , to be offensive , or unwelcome .  thus , a bully is an individual who repeatedly causes negative reactions in the targets ( the so - called victims ) of his or her behaviors . although superiors , colleagues , or even subordinates and clients can bully others , previous research has shown that superiors are the typical perpetrators . besides bully and victim , other players of this unpleasant incident whereas this phenomenon is usually referred to as workplace bullying , it was initially called  mobbing  when it was first termed in the 1970s by a norwegian researcher olweus . later on , in the 1980s , a swedish psychologist heinz leymann , and in the early 1990s , a uk journalist andrea adams ( 1992 ) began to study this phenomenon in sweden and the uk and then , this concept spread to other countries during the late 1990s . a review of the bullying literature reveals that several expressions such as silent epidemic , harassment , lateral or horizontal violence , and incivility are used to explain this phenomenon . moreover , different terms are used around the world to describe the workplace bullying , such as  mobbing  ( in france and germany ) ,  harassment  ( in finland ) , and  aggression  and  emotional abuse  ( in the usa ) ; also , the term workplace bullying  is used primarily in australia , the uk , and northern europe . several studies to date have focused upon the identification of the consequences of workplace bullying . prior studies show that workplace bullying affects negatively the target , the bystanders or witnesses , organization , and even the bully . bullying has a range of negative emotional , psychological , and physical effects on the targets . these effects include anxiety , depression , and stress , sleep problems such as insomnia and nightmare , headache , blood pressure , and sweating or shaking , or even suicide in extreme cases . the negative impacts of workplace bullying can also extend to the bully itself , the organizational bystanders or witnesses , the target 's family and friends , the organization , and eventually the society as a whole . unfortunately , bullying at work seems to be a phenomenon that is prevalent in many organizations , and one of the worrisome issues facing organizations throughout the world is the occurrence of bullying amongst employees . in the preceding years , a large number of studies have been published on workplace bullying and violent behaviors in a variety of professions , such as among schoolteachers , prison officers , general employees , and even constabulary employees . workplace bullying has also widely been discussed in the field of nursing . in the nursing workplace , reports show that all types of workplace bullying are prevalent . for instance , in a seminal research , cox reported that nearly 97% of nurses have been exposed to verbal violence . rosenstein and odaniel reported that in their hospital survey , 72% of nurses who participated reported witnessing disrupted behavior ( i.e. any inappropriate behavior , confrontation , or conflict ranging from verbal abuse to physical and sexual harassment ) perpetrated by other nurses . recently , yldrm carried out a study to explore the prevalence rate of workplace bullying amongst 286 turkish nurses . she found that 21% of nurses who participated in her study had been exposed to workplace bullying during the last 12 months . more recently , in a study of 447 jordanian nurses , prevalence of verbal and physical abuse was 37.1% and 18.3% , respectively . some other systematic surveys of bullying and abusive behaviors conducted in nursing workplaces confirm the prevalence and seriousness of the problem that is summarized in table 1 . prevalence of workplace bullying in the nursing sector an important conclusion can be drawn from table 1 , that is , nurses of all the countries shown in the table experience high rates of workplace bullying and other abusive behaviors . many of these nurses may suffer from mental , emotional , psychological , and even physical problems that have , in turn , negative impact on the organizations they work for . nurses in iran make up a significant portion of the employees in the healthcare system . in iran , modern nursing was introduced by the american missionaries , who established iran 's first nursing school in tabriz in 1916 . they initiated medical services for local residents and trained a number of natives in the care of patients in hospitals . in 1943 , the iranian nursing association ( ina ) was established by a group of iranian nurses who were educated abroad and returned to the country . in 1952 , for the first time , the ministry of health established the nursing division as a part of its structure and now , after many years , the iranian nursing organization ( ino ) has got the legal responsibility to represent all nurses in all sectors of nursing from 2002 . from a managerial perspective , over the past years , very little research has been carried out in iran on the human resource management in the nursing sector . in the authors opinion , this is a major omission in managing the healthcare system . since 1980 , there has not been any position within the iranian healthcare organizations that is assigned the responsibility of the management of human resources . therefore , more research is needed to generate a greater understanding of the nature and extent of the organizational problems such as deviant behaviors of employees . as stated above accordingly , it is easy to guess that bullying occurs in many iranian organizations , particularly within nursing sector . but workplace bullying is a new topic in iran and little research has been done in iran on this phenomenon . to the knowledge of the authors , yet no study in iran has examined the prevalence of workplace bullying in the field of nursing . all in all , little is known about this phenomenon in iran . in line with these arguments , the current study aims to determine the prevalence rate of workplace bullying among a sample of nurses who worked in iranian hospitals . the data were collected from 162 nurses of four iranian hospitals located in west azerbaijan province . participants were selected by employing a random sampling method . to achieve the purposes of the study , approximately 200 questionnaires were distributed . overall , 162 questionnaires were returned , giving a response rate of 81% . to measure the nurses perception of bullying in the hospital , participants were asked to mark the frequency in which they had encountered the items listed as bullying behaviors in the workplace in the last year . the measure included four sets of items : verbal bullying , nonverbal bullying , practical bullying , and performance - related bullying ( adapted from oade , 2009 ) . the items were evaluated on a 3-point likert - type scale from 0 ( never ) to 1 ( occasionally ) and to 3 ( frequently ) . internal consistency reliability was 0.92 for the verbal bullying scale , 0.94 for the nonverbal bullying scale , 0.90 for the practical bullying scale , and 0.96 for the performance - related bullying scale . the questionnaire used in this study also included questions on the demographic characteristics of the respondents , such as gender , age , length of service , and educational level . the statistical package for social sciences ( spss ) version 18 ( pasw ) was used to analyze the data from the questionnaire . in order to achieve the purposes of the study , descriptive statistical methods were used . this study was also approved by the hospital directors and head nurses of the staff nurses who participated in this study . this study was also approved by the hospital directors and head nurses of the staff nurses who participated in this study . table 2 shows the sample profile of this study . of the 162 nurses who participated in the study , 17% were males and 83% were females . the mean age of these nurses was 32.8 years . except for a few nurses who did not disclose their education ( 4% ) , it was observed that 74% of nurses were undergraduates and 22% of them had a post - graduation degree . participants characteristics as shown in table 3 , the results indicate that of the 162 nurses participating in the research , 69% had never been exposed to workplace bullying , 9% was frequently bullied , and 22% was occasionally bullied during the last year . the most common type of workplace bullying experienced by nurses was verbal bullying ; 40% of the nurses reported exposure to verbal bullying behavior frequently or occasionally . in contrast , an overwhelming majority ( 83% ) of the nurses reported that they had never encountered practical bullying . likewise , the results show that 11% of the nurses experienced practical bullying occasionally and only 6% experienced this type of bullying frequently . moreover , the prevalence of nonverbal and performance - related bullying ( occasionally or frequently ) was 34% and 31% , respectively . nowadays , we are moving toward a global understanding that workplace bullying poses a serious threat to workers , organizations , and societies as a whole . bullying is present in all sectors of work and in all types of organizations , and nobody can consider him / herself safe from bullying . the accurate extent of bullying and other types of this behavior such as harassment , abusive behaviors , violence , aggression , and so forth in the workplace is unknown , but it may be true that these negative behaviors have the potential to affect negatively most workers during the course of their working career . on a review of the literature of bullying at nursing place of work , it can be concluded that bullying has a broad range of negative and detrimental emotional , psychological , mental , physiological , and physical effects on targeted nurses as well as bystanders of this behavior , which in turn have negative impacts on organizations . however , given the importance of recognizing workplace bullying , few studies have considered this phenomenon in the nursing s etup in iran . this article presents the first study on the professional - ethical dilemma of workplace bullying in the field of nursing in iran . this study adds to the growing literature on workplace bullying by investigating the prevalence rate of bullying among nurses , employing a sample of the iranian nurses . the findings of this study suggest that workplace bullying is a relatively prevalent behavior in iran 's hospitals and among nurses . based on a sample of 162 iranian nurses , the researchers concluded that approximately one - third of nurses who participated in this study reported being bullied in the job during the previous year . a comparison between findings of this study and the literature shows similar conclusions have frequently been reached in similar studies in other countries ; that is , nurses portray a high risk of being a target of bullying in their place of work . overall , the findings of this study demonstrate that the prevalence rate of workplace bullying among nurses was not very high or at a worrisome level . however , this result shows that workplace bullying is a reality in nurses place of work in iran . it should be noted that workplace bullying is an inevitable reality of workplace in today 's world , especially in the nursing profession . nurses form an important part of the healthcare system , just like physicians , radiologists , midwives , and accountants of a hospital . without the nurses endeavors necessary to implement strategic plans of the hospitals , they will never meet their goals and objectives . however , negative and deviant behaviors , such as workplace bullying , pose a risk and may create an atmosphere that will negatively affect the organization . those nurses who had been bullied during the last year had a higher risk of physical , mental , emotional , and psychological health problems ; thus , appropriate actions must be taken to prevent or minimize bullying in the nursing setup . these may represent a unique subset of the broader iranian hospital nurses population , and it is unclear to what extent these findings may be generalized to the country as a whole . second , demographic variables such as age , education level , position level , organizational tenure , gender , and religious preference have not been linked to the perception of bullying among participants . a further limitation of this study is that it relied exclusively on self - report measures ; future research should make use of other sources of data such as behavioral observations . these may represent a unique subset of the broader iranian hospital nurses population , and it is unclear to what extent these findings may be generalized to the country as a whole . second , demographic variables such as age , education level , position level , organizational tenure , gender , and religious preference have not been linked to the perception of bullying among participants . a further limitation of this study is that it relied exclusively on self - report measures ; future research should make use of other sources of data such as behavioral observations . managing bullying in organizations , especially in nursing sector , involves three related levels of investigation . first , managers need to know the extent of bullying behaviors among their staff in order to provide information for risk assessment . this study has attempted to answer this question by revealing the prevalence and potential risks of bullying in the nursing sector of iran . bullying is a phenomenon involving at least three social actors , each of whom takes actions in response to the others : bullies , who bully their colleagues ; victims , who are exposed to bullying behaviors ; and witnesses , who observe the bullying behavior . third , managers will need to understand the real causes of workplace bullying . only by understanding the root causes and antecedents of workplace bullying it should be noted that bullying is a complex phenomenon and there tend to be many causes and antecedents for this behavior in the places of work . it is also likely that several antecedents ( individual , social , and organizational ) together contribute to the development of bullying at workplace . as a final summary statement , what this study has to offer is that workplace bullying affects negatively thousands of employees in many large and small organizations each year . it is on the increase and more and more people witness it , are exposed to it , and are affected negatively by it in all sectors of work and in all types of organizations . so , to be able to intervene with bullying behavior in the workplace , there is a need for paying greater attention to the problem by of the entire range of managers , lawyers , industrial - organizational psychologists , counselors , social workers , and local authorities .
background : workplace bullying is a significant issue confronting the nursing profession both in iran and internationally . 
 this study examined workplace bullying among a group of iranian nurses.materials and methods : the prevalence rate of bullying behavior among nurses was determined . 
 data were collected from 162 nurses who worked in four hospitals located in west azerbaijan province , iran.results:results showed that only 9% of nurses who participated in this study had frequently been exposed to bullying behavior , 22% had occasionally been bullied , and 69% had never been exposed to these behaviors during the last year . 
 the most common type of workplace bullying experienced by nurses was verbal bullying . 
 forty percent of the nurses reported exposure to verbal bullying behavior frequently or occasionally.conclusions:to be able to intervene with bullying behavior in the workplace , there is a need to pay greater attention to the problem by the entire range of managers , lawyers , industrial  organizational psychologists , counselors , social workers , and local authorities .