The effects of hierarchical relationship on well-being of surgical team members in operating theaters: Prospective cohort study

Tümer M., DALĞAR İ.

Medicine, vol.103, no.10, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 103 Issue: 10
  • Publication Date: 2024
  • Doi Number: 10.1097/md.0000000000037327
  • Journal Name: Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, CINAHL, Veterinary Science Database, Directory of Open Access Journals
  • Istanbul Medipol University Affiliated: No


Although there are many studies about wellbeing on healthcare professionals, the relationship between hierarchy and well-being has not been studied much. In this study, we focused on surgical branch professionals (anesthesiologists, surgeons, nurses) as organized in a strict hierarchy. We explored the association between the position within the organizational hierarchy in operating theaters and well-being. Data were collected in 2 parts as cross-sectional (baseline) and daily surveys (for 15 days). A total of 226 participants participated in the baseline study and 156 participants in the daily surveys. How hierarchical positions, in-group identification and personality traits were related to the well-being and experiences of surgical team members were investigated. System justification, social dominance orientation, and personality theories were used to investigate personality traits. Emotional stability and identification with other healthcare professionals were positively associated with positive experience and well-being. Daily hierarchical relationship when the team members were in a superior position was positively associated with that day's well-being, positive experience, enjoying working, and motivation to work on the following day. Conversely, the negative effects of daily hierarchical relationships on outcomes were not seen when the participants were in a subordinate position. Our findings were parallel to the literature that perceived autonomy in the workplace has positive impacts on the well-being. Furthermore, we found that in-group identification can protect surgical branch professionals from the adverse effects of the organizational hierarchy. We suppose our findings can contribute to the literature to evaluate organizational structure of operating theaters.