The bystander effect, or bystander apathy, occurs at the scene of road traffic accidents. It is a theory that states that individuals are less likely to offer help to a victim when there are other people present. This study aims to perform a concept analysis of the bystander effect at the scene of road traffic accidents in the Iranian context.
A concept analysis was performed using a hybrid method recommended by Schwartz-Barcott in three phases: a theoretical analysis, field work and final analysis. In the theoretical phase, a literature review was conducted using the databases PubMed, Scopus, Elsevier, Ovi and Iran-doc, with the relevant studies analysed. In the field work, interviews were carried out with eight medical emergency personnel followed by a qualitative content analysis of the transcriptions. In the last phase, the final analysis was performed to provide a clear definition of the concept.
In the theoretical phase related to the concept of the bystander effect, some characteristics, such as the presence of strangers, social influence, pluralistic ignorance, self-safety, victim’s unstable conditions, lack of awareness and presence of medical emergency personnel were identified. In the final analysis phase, a definition was achieved to be provided in the following sections, by integrating the two theoretical and field work phases.
The results of this study could pave the way for future studies to further develop the concept of the bystander effect in different cultures and help develop a tool for the further assessment of this phenomenon.
Elbashir K, Gore RJ, Abuaaraki T, et al. Prehospital emergency care and injury prevention in Sudan. Afr J Emerg Med 2014;4:170-3.
Hall A, Wooton K, Hutton A. Bystander experiences at and after a motor vehicle accident: a review of the literature. Australasian Journal of Paramedicine 2013;10.
Hortensius R, Schutter DJ, Gelder B. Personal distress and the influence of bystanders on responding to an emergency. Cogn Affect Behav Neurosci 2016;1-17.
Available at: www.dictionary.com/browse/bystander
Bickman L. Social influence and diffusion of responsibility in an emergency. J Exp Soc Psychol 1972;8:438-45.
Available at: https://en.wikipedia.org/wiki/Bystander_effect
Schneider FW, Gruman JA, Coutts LM, editors. Applied social psychology: understanding and addressing social and practical problems. 2nd edn. Sage. London: 2011.
Darley JM, Latane B. Bystander intervention in emergencies: diffusion of responsibility. J Pers Soc Psychol 1968;8:377.
Latané B, Nida S. Ten years of research on group size and helping. Psychol Bull 1981;89:308.
Darley JM. The unresponsive bystander: why doesn't he help? New York: Appleton-Century Crofts, 1970.
Mason D, Allen BP. The bystander effect as a function of ambiguity and emergency character. J Soc Psychol 1976;100:145-6.
Gottlieb J, Carver CS. Anticipation of future interaction and the bystander effect. J Exp Soc Psychol 1980;16:253-60.
van Bommel M, van Prooijen J-W, Elffers H, Van Lange PA. Be aware to care: public self-awareness leads to a reversal of the bystander effect. ibid. 2012;48:926-30.
Hardy CL, Van Vugt M. Nice guys finish first: the competitive altruism hypothesis. Pers Soc Psychol Bull 2006;32:1402-13.
Garcia SM, Weaver K, Moskowitz GB, Darley JM. Crowded minds: the implicit bystander effect. J Pers Soc Psychol 2002;83:843.
Darley JM, Teger AI, Lewis LD. Do groups always inhibit individuals' responses to potential emergencies? ibid. 1973;26:395.
Cramer RE, McMaster MR, Bartell PA, Dragna M. Subject competence and minimization of the bystander effect. J Appl Soc Psychol 1988;18:1133-48.
Chekroun P, Brauer M. The bystander effect and social control behavior: the effect of the presence of others on people's reactions to norm violations. Eur J Soc Psychol 2002;32:853-67.
Alinia S, Khankeh H, Maddah SSB, Negarandeh R. Barriers of pre-hospital services in road traffic injuries in Tehran: the viewpoint of service providers. Int J Community Based Nurs Midwifery 2015;3:272.
Haghparast-Bidgoli H, Hasselberg M, Khankeh H, Khorasani-Zavareh D, Johansson E. Barriers and facilitators to provide effective pre-hospital trauma care for road traffic injury victims in Iran: a grounded theory approach. BMC Emerg Med 2010;10:1.
Khorasani-Zavareh D, Khankeh HR, Mohammadi R, et al. Post-crash management of road traffic injury victims in Iran. Stakeholders' views on current barriers and potential facilitators. ibid. 2009;9:8.
Khankeh HR, Khorasani-Zavareh D, Masoumi G. Why the prominent improvement in prehospital medical response in Iran couldn't decrease the number of death related road traffic injuries. J Trauma Treat 2012;e103.
Rodgers BL. Philosophical foundations of concept development. Concept development in nursing. 2nd edn. Philadelphia: Saunders 2000;7-37.
Alligood MR. Nursing theory: utilization & application: Elsevier Health Sciences; 2013.
Schwartz-Barcott D. An expansion and elaboration of the hybrid model of concept development. In: Concept Development in Nursing Foundations, Techniques, and Applications 2000;129-59.
Broome M, Rodgers B, Knafl K. Integrative literature reviews for the development of concepts. ibid. 2000.
York Cornwell E, Currit A. Racial and social disparities in bystander support during medical emergencies on US Streets. Am J Public Health 2016;106:1049-51.
Pallavisarji U, Gururaj G, Girish RN. Practice and perception of first aid among lay first responders in a southern district of India. Arch Trauma Res 2013;1:155-60.
Fawcett J. Concept development in nursing: foundations, techniques, and applications. Nurs Res 1994;43:186.
Latane B, Rodin J. A lady in distress: inhibiting effects of friends and strangers on bystander intervention. J Exp Soc Psychol 1969;5:189-202.
Pourshaikhian M, Khorasani-Zavareh D, Gorji HA, Aryankhesal A, Barati A. Workplace violence process against emergency medical services staffs: a grounded theory. Glob J Health Sci 2016;8:213.
Fischer P, Krueger JI, Greitemeyer T, et al. The bystander-effect: a meta-analytic review on bystander intervention in dangerous and non-dangerous emergencies. Psychol Bull 2011;137:517.
Dovidio JF, Piliavin JA, Gaertner SL, Schroeder DA, Clark III RD. The arousal: Cost-reward model and the process of intervention: a review of the evidence. 1991. In: Clark MS, editor. Review of personality and social psychology. Vol. 12. Prosocial behavior. Sage Publications, Inc.
Levine M, Prosser A, Evans D, Reicher S. Identity and emergency intervention: how social group membership and inclusiveness of group boundaries shape helping behavior. Pers Soc Psychol Bull 2005;31:443-53.
Lepper MR, Greene D. The hidden costs of reward: new perspectives on the psychology of human motivation: Psychology Press; 2015.
Bickman L. The effect of another bystander's ability to help on bystander intervention in an emergency. J Exp Soc Psychol 1971;7:367-79.
Batson CD, Ahmad N, Lishner DA, Tsang J. Empathy and altruism. In: Oxford handbook of hypo-egoic phenomena: theory and research on the quiet ego. Brown KW, Leary MR, editors. 2016;161-74.
Batson CD, Lishner DA, Stocks EL. The empathy-altruism hypothesis. In: The Oxford handbook of prosocial behavior 2015;259-68.
Persson BN, Kajonius PJ. Empathy and universal values explicated by the empathy-altruism hypothesis. J Soc Psychol 2016;156:610-9.