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Conflict Management in Healthcare; A Narrative Review
... These strategies play a crucial role regarding the development of effective communication, teamwork, and ultimately, the provision of quality patient care. Furthermore, the findings by another study seem to be harmonized with some of the external factors like setting, experience, and gender found in the current study, which affect nurses' adoption and employment of particular styles and strategies, including personal characteristics (marriage, level of education, etc.), contextual factors (private or public hospitals), and interpersonal conditions (professional relationships with head nurses or physicians) [49]. Female nurses are more likely to use integrating and less likely to use avoiding styles compared to their male counterparts. ...
... Female nurses are more likely to use integrating and less likely to use avoiding styles compared to their male counterparts. Moreover, the importance of effective communication and emotional intelligence as shown in the current study are harmonized with the findings of the recent review by Kiyumi (2023), according to which the conflict resolution capabilities of healthcare leaders are notably impacted by their professional communication skills and level of emotional intelligence [50]. ...
Objective: This systematic review aimed to identify the most prevalent conflict management styles and strategies employed by nurses in clinical settings and to examine the factors associated with their selection. Methods: A comprehensive literature search was conducted following the PRISMA guidelines. Databases searched included PUBMED, CINAHL, Medline, and ProQuest, focusing on articles published between 2014 and 2024. Inclusion criteria were primary data studies involving nurses, published in English. The search strategy utilized Boolean operators to combine keywords related to nursing, conflict management, and healthcare settings. A total of 174 articles were initially identified, with 22 meeting the inclusion criteria after screening. The quality of the included studies was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument Critical Appraisal Checklist. The results were synthesized using content analysis. Results: The main findings from the 22 articles reviewed indicate that accommodation and collaboration/integration are the most common conflict management styles and strategies among nurses, with compromising also frequently employed. Factors such as age, experience, educational level, and workplace culture significantly influence the choice of conflict management strategies. Discussion: Nurses employ a variety of conflict management strategies depending on the context, individual preferences, and situational factors. Effective conflict resolution is closely linked to collaboration and communication, with proactive strategies being more effective in preventing conflicts. The findings underscore the need for tailored conflict management training to enhance job satisfaction and work relations in nursing environments. We acknowledge several limitations that may affect the interpretation and generalizability of our findings such as the diversity of the tools and the methodologies used by the included studies.
... The ability to understand the nature of conflicts, to differentiate their components and to work towards their resolution is an important component of the professional profile of managers of healthcare organizations and health authorities (2,13,14). In healthcare organizations, failure to manage conflict is a major cause of stressful work environments, physical plays, patient and staff dissatisfaction, poor quality of care and increased costs (15)(16)(17). ...
Introduction
Attempts to address wicked public health problems can benefit from collaborative approaches to problem-solving, such as dialogue through structured conversations, that engage a wide range of stakeholders in deliberate inquiry to build trust and mutual understanding. This study seeks to assess the effects of participation in Reflective Structured Dialogue (RSD) on university students’ polarization-related attitudes.
Methods
The BYU Campus Conversations project held 27 structured conversations with 139 participants on three divisive public health topics: COVID-19, mental health, and racism. The conversation structure encouraged students to share their personal experiences and learn from others in an environment that promoted vulnerability and confidentiality.
Results
Pre- and post-conversation surveys measured participant outcomes and found that participation in conversations was strongly associated with improved attitudes related to openness, tribal identity, and moral disdain. Over 95% of participants reported that they enjoyed taking part in the conversations and that it helped them better understand the experiences of others.
Discussion
The results of this project indicate similar conversations could be an effective tool in helping build understanding around divisive public health issues in university and community settings.
An aging society is on the rise, leading to a variety of caregiving issues. The Taiwanese government has been implementing a home healthcare integration plan since 2015, aimed at integrating and forming interdisciplinary care teams with medical institutions. This study explores the internal conflict factors among hospital home healthcare team members at a district teaching hospital in Taichung, Taiwan, and it seeks a better collaboration model between them. Semi-structured in-depth interviews were conducted with seven hospital home healthcare team members. Data analysis was based on grounded theory, with research quality relying on the triangulation and consistency analysis methods. The results show that “work overload”, “resource overuse”, “inconsistent assessment”, “limited resources”, “communication cost”, and “lack of incentives” are the major conflicts among the team. This study proposed the following collaboration model, including “identifying the internal stakeholders of a home healthcare team” and “the key stakeholders as referral coordinators”, “patient-centered resource allocation”, and “teamwork orientation”. The study recommends that within a teamwork-oriented home healthcare team, its members should proactively demonstrate their role responsibilities and actively provide support to one another. Only through patient-centered resource allocation and mutual respect can the goal of seamless home healthcare be achieved. The content of the research and samples were approved by the hospital ethics committee (REC108-18).
Background
Conflict is inevitable on healthcare teams, yet few professional school curricula teach or assess conflict resolution skills. Little is known about the variation in conflict resolution styles across medical students and how these styles might impact conflict resolution skills.
Methods
This is a prospective, single blinded, group randomized quasi experimental trial to assess the impact of knowing one’s own conflict resolution style on conflict resolution skills in a simulated encounter. Graduating medical students completed a mandatory conflict resolution session with standardized patients acting as nurses during a transition to residency course. Coaches reviewed videotapes of the simulation, focusing on students’ skills with negotiation and emotional intelligence. Retrospectively, we assessed the impact of the students knowing their conflict resolution style prior to simulation, student gender, race, and intended field of practice on conflict resolution skills as judged by coaches.
Results
One hundred and eight students completed the simulated conflict session. Sixty-seven students completed the TKI before the simulated patient (SP) encounter and 41 after. The most common conflict resolution style was accommodating (n = 40). Knowing one’s conflict resolution style in advance of the simulation and one’s identified race/ethnicity did not impact skill as assessed by faculty coaches. Students pursuing diagnosis-based specialties had higher negotiation (p = 0.04) and emotional quotient (p = 0.006) scores than those pursuing procedural specialties. Females had higher emotional quotient scores (p = 0.02).
Conclusions
Conflict resolution styles vary among medical students. Male gender and future practice in a procedural specialty impacted conflict resolution skills but knowing conflict resolution style did not.
Everyday nursing work inevitably involves conflict. Healthcare workers may experience this as a result of diverse human beliefs, knowledge, values, or emotions. In order to effectively manage and lead the nursing staff in hospitals, a multitasking leader with a wide range of abilities is needed. Multiple elements, such as the leader's personality and overall workplace conditions, might influence effective managerial leadership. Effective management leadership is affected by multiple factors, such as the personality of the leader, the general conditions in the workplace, and the quality characteristics of employees. This study aimed to investigate the relationship between emotional intelligence and conflict management strategies from the head nurses’ perspective.
Methods
The study utilized a quantitative, cross-sectional correlation design. Twenty-one hospitals in the Aseer region that are affiliated with the Saudi Ministry of Health were included in this study. A non-probability sample consisted of 210 head nurses who have at least one year of experience working as head nurses or with managerial experience. An online questionnaire involving three sections - socio-demographic, trait emotional intelligence, and conflict management - were used.
Results
The study revealed that the level of emotional intelligence was average and that the level of conflict management strategies was high. Approximately three-quarters of the sample studied were female (78.1%), and for an educational level, the majority of participants had a bachelor's degree (62.4%). Regarding the working departments, 34.3% were in general wards, while 23.3% worked in critical care. Approximately two-thirds (62%) of the sample were married; 63.8% of the participants were Saudi, and 49% had fewer than three children. Also, gender identity and emotional intelligence were significantly correlated statistically. Likewise, the level of monthly income, marital status, and nationality are significantly correlated with conflict management strategies.
Conclusions
In the current study, emotional intelligence has no statistical correlation with strategies for resolving conflicts. While the relationship between subdomains of both main variables was negative, that ruled out an important positive relationship between cooperation and well-being. Teaching nurse managers about emotional intelligence might help them more effectively handle conflicts at work. Likewise, employing emotional intelligence practices requires nurse managers to lead by example, teaching their teams how to regulate their emotions and resolve frequent workplace conflicts.
This article addresses educational challenges posed by the future of work, examining “21st century skills”, their conception, assessment, and valorization. It focuses in particular on key soft skill competencies known as the “4Cs”: creativity, critical thinking, collaboration, and communication. In a section on each C, we provide an overview of assessment at the level of individual performance, before focusing on the less common assessment of systemic support for the development of the 4Cs that can be measured at the institutional level (i.e., in schools, universities, professional training programs, etc.). We then present the process of official assessment and certification known as “labelization”, suggesting it as a solution both for establishing a publicly trusted assessment of the 4Cs and for promoting their cultural valorization. Next, two variations of the “International Institute for Competency Development’s 21st Century Skills Framework” are presented. The first of these comprehensive systems allows for the assessment and labelization of the extent to which development of the 4Cs is supported by a formal educational program or institution. The second assesses informal educational or training experiences, such as playing a game. We discuss the overlap between the 4Cs and the challenges of teaching and institutionalizing them, both of which may be assisted by adopting a dynamic interactionist model of the 4Cs—playfully entitled “Crea-Critical-Collab-ication”—for pedagogical and policy-promotion purposes. We conclude by briefly discussing opportunities presented by future research and new technologies such as artificial intelligence and virtual reality.
Events and periods of strikes are inextricably linked to the history of higher education in Nigeria. Strikes of various types and for various reasons have become a common occurrence as the government and academia’s policymaking relationship has become increasingly inconsiderate. This study was necessitated by the apparent non-recognition and reluctance to plunge into interpersonal conflict in universities. Hence, this study investigated the influence of avoidance, dominating, compromise, obliging and integrating conflict management strategy on the commitment of faculty in selected public universities in Southwest Nigeria. Smart PLS 3.0 was used to analyse only 416 copies of the questionnaire, representing an 83% response rate. The findings demonstrate that conflict management methods such as avoidance, dominating, compromise, obliging, and integrating substantially impact academic faculty affective, normative, and continuance commitment. The study finds that academic staff at various universities should encourage compromising, integrating, and obliging conflict management tactics to be more involved in the settlement of the conflict. As a sequel to the findings, it was recommended that when settling conflicts, academic staff and management should always consider the feelings of other parties involved, as this will go a long way in satisfying all affected parties. Furthermore, parties in disagreement should be open-minded and willing to listen to each other to make the best and most sensible conclusion when resolving conflict. Universities administration should teach the different techniques of handling conflict so employees will be able to choose the appropriate approach when faced with conflict situations, especially when faced with interpersonal conflict.
Background:
Effective conflict management requires various skills. However, evidence suggests that nurses are unprepared to deal with conflicts at work. Accordingly, this study aimed to examine nurses' evaluations of their conflict management skills.
Materials and methods:
This cross-sectional descriptive study involved 202 nurses who were enrolled in short professional training courses at the Faculty of Nursing, Thai Nguyen University of Medicine and Pharmacy (TUMP). From March to June 2021, they completed self-administered questionnaires which included evaluations of ten common conflict management skills. The four-point rating scale ranged from very bad (0 points) to very good (3 points). Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, and Spearman's rho tests were used for data analysis.
Results:
The nurses ranked their ability to identify their and others' emotions and feelings as the highest [mean (SD): 1.99 (0.42)]. Their ability to self-manage conflict-induced stress was rated as the lowest [1.86 (0.56)], with managing own feelings and emotions [1.88 (0.56)], and negotiation [1.90 (0.53)] rated as second and third lowest, respectively. There were no differences in skills between nurses based on gender (Mann-Whitney U = 2814.50, p = 0.720), department (Kruskal-Wallis = 5.89, df = 3, p = 0.117), job position (Mann-Whitney U = 1502.50, p = 0.522), and education (Mann-Whitney U = 3304.00, p = 0.394). Additionally, nurses who demonstrated better skills reported higher effectiveness in previous conflict management (r = 0.45, p < 0.001).
Conclusions:
Conflict management skills varied and seemed suboptimal. Important areas that require proper attention include emotional intelligence and negotiations.
From the emotional perspective, this study explores how team leader’s conflict management styles affect team passion. A theoretical model is constructed which describes the mediating role of positive team emotional climate and the moderating impact of team emotional intelligence. We collect 101 teams paired data including 101 team leaders and 383 team members to test theoretical model. It is shown that leader’s cooperative conflict management style has a significant positive effect on both positive team emotional climate and team passion. Meanwhile, positive team emotional climate plays a mediating role between leader’s cooperative conflict management style and team passion. In addition, team emotional intelligence has a moderating effect between leader’s cooperative style and positive team emotional climate. This study not only provides a new perspective for follow-up research but also expands the research scope of impacts of conflict management styles. In addition, this study forms the underlying mechanism of team leader’s conflict management styles on team passion from the emotional perspective and investigates the mediating effect and moderating effect of emotional variable, which broadens the research on the mechanisms of conflict management styles on team outcomes to a certain extent.
Conflicts affect health care systems not only during but also well beyond periods of violence and immediate crises by draining resources, destroying infrastructure, and perpetrating human resource shortages. Improving health care worker retention is critical to limiting the strain placed on health systems already facing infrastructure and financial challenges. We reviewed the evidence on the retention of health care workers in fragile, conflict-affected, and post-conflict settings and evaluated strategies and their likely success in improving retention and reducing attrition. We conducted a systematic review of studies, following PRISMA guidelines. Included studies (1) described a context that is post-conflict, conflict-affected, or was transformed by war or crisis; (2) examined the retention of health care workers; (3) were available in English, Spanish, or French, and (4) were published between 1 January 2000 and 25 April 2021. We identified 410 articles, of which 25 studies, representing 17 countries, met the inclusion criteria. Most of the studies (22 out of 25) used observational study designs and qualitative methods to conduct research. Three studies were literature reviews. This review observed four main themes: migration intention, return migration, work experiences and conditions of service, and deployment policies. Using these themes, we identify a consolidated list of six push and pull factors contributing to health care worker attrition in fragile, conflict-affected, and post-conflict settings. The findings suggest that adopting policies that focus on improving financial incentives, providing professional development opportunities, establishing flexibility, and identifying staff with strong community links may ameliorate workforce attrition.
Aim:
The aim of this study was to determine nurse managers' level of ethical leadership perceived by nurses, and to examine its relationship with conflict management strategies.
Background:
Ethical leadership is about how managers use their power in their decisions and actions, and its source is based on moral and ethical authority. Therefore, it is important to understand the impact of ethical behaviors of nurse managers in the work environment on determining conflict management strategies.
Method:
The data of this descriptive, correlational and cross-sectional study were collected face-to-face from 285 nurses between April-June 2019. The data collection instruments included the introductory information form, the Ethical Leadership Scale and The Rahim Organizational Conflict Inventory-II.
Results:
Ethical leadership scores perceived by nurses in nurse managers were found 3.78, and the highest score was obtained from the behavioral ethics subscale (3.81±.91). In conflict management strategies perceived by nurses, it was determined that they got highest scores from collaborating style (3.76±.90), and lowest scores from competing style (2.90±.94). There was no significant relationship only between ethical leadership and its subscales and competing (r: -.038/-.041, p>0,05). In other subscales, there were positive, moderate and highly significant relationships (r: .466-.747, p<.001). The rate of explanatoriness of communicative ethics subscale in conflict management strategies ranged from 22.3% to 58.0%.
Conclusions:
The study shows that communicative ethics subscale significantly affects the conflict management strategies of nurse managers. Therefore, it is important for nurse managers to communicate bilaterally and be a role model for nurses.
Implications for nursing management:
Ethical leaders value trust and respect in their interactions with employees and reflect what appropriate behavior to the situation is. Nurses who perceive that their managers demonstrate ethical leadership behaviors will also evaluate their role in conflict resolution. On the other hand, the power-based, aggressive, non-compromising domination approach that the person imposes on others is not associated with the ethical leadership perception towards their managers by nurses and is a strategy that should not be preferred. Therefore, nurse managers who use appropriate conflict management strategies saw as a role model by nurses.
Based on the normative conflict model, this study proposes a dual-pathway model that is constituted of organizational identification and normative conflict, and examines the double-edged sword effect of ethical leadership on subordinates’ constructive deviance. According to the analysis of 449 questionnaires collected from Chinese employees, the results show that ethical leadership can promote employees’ constructive deviance by improving their constructive intention (Organizational identification), and it can weaken employees’ deviance motivation (normative conflict) to prevent their constructive deviance. Moreover, ethical leadership has different effects on different types of constructive deviance. This research further enriches the formation mechanism of constructive deviance and provides practical guidance to exert the effectiveness of constructive deviance in organizational management.
Background
While the organizational factors that account for firefighters’ burnout have been extensively explored, the individual factors related to how they regulate interpersonal conflicts and emotions remain to be investigated. Previous research has demonstrated the association between emotional intelligence and conflict management styles and burnout, but no study has looked at the interrelationships among these factors in high-risk sectors. The present exploratory study aimed to fill this research gap by investigating the relationships between conflict management style, emotional intelligence and burnout in a sample of firefighters.
Methods
A cross-sectional study was conducted with 240 French firefighters. Measures comprised validated scales of conflict management styles, emotional intelligence and burnout.
Results
Results showed that the integrating conflict style reduced burnout. They also revealed the effects of emotion regulation on burnout, whereby the awareness and management of one’s own emotions reduced burnout. Moreover, awareness of one’s own emotions moderated the relationship between integrating conflict resolution style and burnout, whereby the effect of integrating style on reduced burnout was higher when awareness of one’s own emotions was high.
Conclusion
These results reveal that strategies used by firefighters to regulate their emotions in order to meet the emotional demands specific to their job are important for reducing the emotional exhaustion component of burnout. Training programs for conflict and emotion management are needed to preserve the mental health of firefighters and ensure the safety of interventions.
Most research on the effect of leadership behavior on employees’ well-being and organizational outcomes is based on leadership frameworks that are not rooted in sound psychological theories of motivation and are limited to either an individual or organizational levels of analysis. The current paper investigates whether individual and team resources explain the impact of engaging leadership on work engagement and team effectiveness, respectively. Data were collected at two time points on N = 1,048 employees nested within 90 work teams. The Multilevel Structural Equation Modeling results revealed that personal resources (i.e., optimism, resiliency, self-efficacy, and flexibility) partially mediated the impact of T1 individual perceptions of engaging leadership on T2 work engagement. Furthermore, joint perceptions of engaging leadership among team members at T1 resulted in greater team effectiveness at T2. This association was fully mediated by team resources (i.e., performance feedback, trust in management, communication, and participation in decision-making). Moreover, team resources had a significant cross-level effect on individual levels of engagement. In practical terms, training and supporting leaders who inspire, strengthen, and connect their subordinates could significantly improve employees’ motivation and involvement and enable teams to pursue their common goals successfully.
Noise pollution is a leading cause of decreasing well-being of residents in both developed and developing countries. Improving residents’ well-being measured by life satisfaction is a key goal of government policy. Individuals with high life satisfaction usually have positive emotions, life orientation, and codes of conduct, which are positive and beneficial for individuals, families, and society as a whole. In order to supplement relevant research and provide policy suggestions for individuals, government, and societies, this study explores the relationship between noise pollution and the life satisfaction of Chinese residents. Based on data from 4869 observations from the Chinese Social Survey in 2019, the effect of noise pollution on life satisfaction is estimated by using ordinary least squares and propensity score matching methods. The results show that noise pollution has a significant negative effect on Chinese life satisfaction. Moreover, the effect is heterogeneous depending on individuals’ education levels and ages. Finally, residents’ living environment satisfaction is shown to be the potential mechanism by which noise pollution affects life satisfaction.
Background
Analysis of the biomedical workforce and graduate education have produced recommendations for modifications of pre-doctoral training to broadly prepare trainees for wider ranging scientific careers. Development of training in professional skills is widely recommended, but details of implementation are not widely available. In alignment with these recommendations, we have incorporated professional skills training into the biomedical science graduate curriculum at West Virginia University. An important component of the training is developing conflict resolution and negotiation skills. This training will provide useful skills for academic careers, non-academic careers and life situations outside of the workplace. Conflict resolution/negotiation skills are also relevant in managing issues in diversity, equity and inclusivity. We report our experience in developing this component of the training program, provide an overview of the approach to delivery and practice of skills, and provide an analysis of the reception and effectiveness of the training.
Methods
Evaluation of effectiveness of training used the principals of the Kirkpatrick Four Level Model of Evaluation. At the end of the course, students completed a questionnaire about their perceptions of training and were asked how they would respond to different scenarios requiring conflict resolution/negotiation skills. Several months later, students were surveyed to determine if they used some of these skills and/or witnessed situations where these skills would be useful.
Results
We report our experience in developing conflict resolution/negotiation training in our graduate curriculum, provide an overview of the approach to delivery and practice of skills, and provide an analysis of the reception and effectiveness of the training. The results suggest this training meets a need and is effective. Importantly, these materials provide a template for others wishing to implement similar training in their curricula.
Conclusions
Conflict resolution and negotiation training meets a need in graduate education. A mixed approach using didactic and interactive components spaced out over time appears to be an effective method of training.
Leadership plays an important role in employee well-being. In light of a growing research interest in leaders’ resources as determinants of healthy leadership, it is not yet clear how leaders’ be-havior regarding their own health (self-care) may trickle down to employees. Drawing on Con-servation of Resources Theory and the model of Health-Oriented Leadership, this study tests two mechanisms through which employees may benefit from self-caring leaders: (a) through staff care, that is, concern for their employees’ health (improved leadership hypothesis); and (b) through a direct relationship between leaders’ and employees’ self-care (role-modeling hypothesis). In turn, both staff care and employee self-care would relate positively to employee health. Multilevel path models based on a sample of N = 46 supervisors and 437 employees revealed that leader self-care was positively related to leader-rated staff care at Level 2, which was positively related to em-ployee-rated staff care at Level 1. In turn, employee-rated staff care was positively related to em-ployee health. The findings support the improved leadership hypothesis and underline the im-portance of leader self-care as a determinant of healthy leadership.
Organisations often engage Employee Assistance Programs (EAPs) to assist employees experiencing psychological distress, yet EAPs primarily focus on individual remedies rather than addressing the context of the problem (e.g., the corporate climate) which may render them limited in effectiveness. We investigated the effectiveness of EAPs and the role of organisation psychosocial safety climate (PSC) (the corporate climate for worker psychological health and safety) and client satisfaction in reducing client psychological distress. Client participants (Time 1, n = 100, Time 2, n = 28, Matched n = 25) from Australia and New Zealand entering an EAP took part in two online surveys, pre- and post-EAP, around five weeks apart. Multilevel analysis showed a significant reduction in psychological distress due to the EAP (individual effect) but particularly at high levels of PSC (organisational effect). Thus, EAPs could engender a more significant impact by also assisting organisations to improve their PSC (i.e., through implementation of policies, practices and procedures for worker psychological health and safety), in combination with individual interventions.
Interpersonal conflicts at workplace are increasing in relation to high competitiveness and pressures at work, mainly connected with labor market globalization. Their manifestation is multifaceted in relation to different working conditions and they not only hinder health, performance, and job satisfaction, but can also harm people's rights and dignity. The study analyses issues related to work conflicts and adverse health consequences in 1,493 workers who approached a hospital service for work-related stress and harassment over a 3-year period. The subjects were examined according to a broad protocol covering working conditions, sources of conflict and negative actions suffered, and resulting impact on health status. Many critical conditions were reported in all occupational sectors with some differentiation in relation to gender (women more at risk) and employment status. Higher qualified levels were more exposed to experiencing severe personal adversities aimed at their progressive expulsion or resignation, with consequent higher risk of chronic adjustment disorders, while lower levels reported more stressful conditions in terms of interpersonal disputes and greater interference in the home-work interface. The study can provide useful indications for a better understanding of workplace conflicts in order to set up the most appropriate actions to manage and prevent them.
The internal structure of ability emotional intelligence (EI) tests at item level has been hardly studied, and if studied often the predicted structure did not show. In the present study, an a priori model for responses to EI ability items using Likert response scales with a Situational Judgement Test (SJT) format is investigated with confirmatory factor analysis. The model consists of (1) a target EI ability factor, (2) an acquiescence factor, which is a method factor induced by the Likert response scales, and (3) design-based error covariances, which are induced by the SJT format. It is investigated whether this a priori model can account for the observed associations between the raw item responses of the Components of Emotion Understanding Test-24 (CEUT-24). The CEUT-24 is a new test developed to assess emotion understanding, a key aspect of the EI ability construct, based on the componential emotion framework. The sample consisted of 1184 participants (15–22 years old) from four European countries (United Kingdom, Belgium, Germany, and Spain) speaking four different languages (English, Dutch, German and Spanish). Findings showed that the a priori model fitted the data well in all four languages. Furthermore, measurement invariance testing gave evidence for a well-fitting configural, metric, and partial scalar invariance model. The conclusion is that within a regular CFA framework using raw observed items responses, method factors (acquiescence response style and scenario induced variance) can be disentangled from the targeted EI ability factor.
Introduction
The healthcare workforce is regarded as an essential component of any functioning health system, and a lack of optimal collaboration among this group can result to poor quality healthcare services to the population. In Nigerian setting, the health sector is faced with challenges of inter-professional conflict and rivalry. This study aimed at understanding knowledge, causes, and experience of inter-professional conflict and rivalry among healthcare professionals in Nigeria.
Methods
A cross sectional study was undertaken to administer questionnaires to healthcare personnel in various healthcare facilities in Nigeria. Data were analysed using Statistical Package for Social Sciences.
Results
A total of 2207 valid responses were received, and male participants were in majority as indicated by 63.7% of the sample. Collectively, doctors and pharmacists represented two-thirds of the sample, and majority of the participants were in the public sector (82.5%). Disparity in salary structure was the highest source of conflict. Whilst almost all the participants indicated that inter-professional rivalry and conflict are prevalent in health sector, about three-quarters of them (73.2%) disagreed that this practice is productive. A considerable number of the respondents had experienced inter-professional conflict and rivalry.
Conclusion
Evidence from this study can help policymakers in developing framework that can be utilised in addressing rivalry and conflict in the healthcare sector.
This study was conducted with the purpose of analyzing the combined and mediating effect of actor’s withdrawal–partner’s demand conflict resolution strategies between avoidance attachment dimension and relationship satisfaction. We conducted a dyadic study with 175 heterosexual couples (aged between 18 and 72 years) who filled in the questionnaires. Six hypotheses were tested using the actor–partner interdependence model with mediation analysis (APIMeM). Results showed that the avoidance dimension of attachment was more strongly associated with actor’s withdrawal strategy than with demand/aggression strategy. Furthermore, avoidance attachment was negatively associated with both actor’s and partner’s relationship satisfaction, the actor effect being higher. Withdrawal strategy was a mediator between actor’s avoidance and actor’s relationship satisfaction, but it was not a mediator for partner’s relationship satisfaction. The interactive pattern of actor’s withdrawal–partner’s demand/aggression was associated with low levels of both actor’s and partner’s relationship satisfaction. These results point out to the need of discerning the interactive pattern of conflict-solving strategies as well as their intertwined effect on relationship satisfaction.
Aim: To examine the conflict resolution styles used in the physician–nurse teamwork in primary health care, depending on individual characteristics, contextual factors, and organizational and sociocultural contexts.
Background: Conflicts significantly affect the quality of healthcare services and staffing challenges, and consequently the performance and efficiency of organizations. Their management plays an important role in any healthcare organizations and deserves the attention of researcher's healthcare management and team leaders.
Design: A descriptive, cross-sectional, correlational design.
Method: Thomas–Kilmann Conflict MODE Instrument was used on a sample comprising 173 nurses and 125 physicians working in teams at the Community Health Centre Ljubljana, Slovenia, in 2018.
Results: The most predominant conflict resolution styles were compromising and avoiding, followed by accommodating, collaborating and competing. The predominant resolution style among nurses was avoiding, and among physicians was compromising. There were statistically significant differences in the conflict resolution style according to gender (χ2 (1) = 0.035, p < .059), education (χ2 (1) = 0.014, p < .05) and tenure (χ2 (1) = 0.025, p < .05).
Conclusion: Our research results differed from those of other studies, possibly due to the difference in the sample and research setting. They indicated that the specifics of work and situation significantly moderate conflict in healthcare organizations.
Impact: The established divergence of results indicates the need for future research on conflict in healthcare settings to more consistently consider the situational context and the role of management and/or leadership.
Background: Equitable access to health services can be constrained in countries where private practitioners make up a large portion of primary care providers. Expanding purchasing arrangements has helped many countries integrate private providers into government-supported payment schemes, reducing financial barriers to care. However, private providers often must go through an onerous accreditation process to enroll in these schemes. The difficulties of this process are exacerbated where health policy is changed often and low-level bureaucrats must navigate these shifts at their own discretion. This paper analyzes one initiative to increase private provider accreditation with social health insurance (SHI) in Kenya by creating an intermediary between providers and “street-level” SHI bureaucrats.
Methods: This paper draws on 126 semi-structured interviews about SHI accreditation experience with private providers who were members of a franchise network in Kenya. It also draws on four focus group discussions conducted with franchise representatives who provided accreditation support to the providers and served as liaisons between the franchised providers and local SHI offices. There was a total of 20 participants across all four focus groups.
Results: In a governance environment where regulations are weak and impermanent, street-level bureaucrats often created an accreditation process that was inconsistent and opaque. Support from the implementing organizations increased communication between SHI officials and providers, which clarified rules and increased providers’ confidence in the system. The intermediaries also reduced bureaucrats’ ability to apply regulations at will and helped to standardize the accreditation process for both providers and bureaucrats.
Conclusions: We conclude that intermediary organizations can mitigate institutional weaknesses and facilitate process efficiency. However, intermediaries only have a temporary role to play where there is potential to: 1) directly increase private providers’ power in a complex regulatory system; 2) reform the system itself to be more responsive to the limitations of on-the-ground implementation.
Objective
To implement and evaluate the use of the conflict management framework (CMF) in four tertiary UK paediatric services.
Design
Mixed methods multisite evaluation including prospective pre and post intervention collection of conflict data alongside semistructured interviews.
Setting
Eight inpatient or day care wards across four tertiary UK paediatric services.
Interventions
The two-stage CMF was used in daily huddles to prompt the recognition and management of conflict.
Results
Conflicts were recorded for a total of 67 weeks before and 141 weeks after implementation of the CMF across the four sites. 1000 episodes of conflict involving 324 patients/families across the four sites were recorded. After implementation of the CMF, time spent managing episodes of conflict around the care of a patient was decreased by 24% (p<0.001) (from 73 min to 55 min) and the estimated cost of this staff time decreased by 20% (p<0.02) (from £26 to £21 sterling per episode of conflict). This reduction occurred despite conflict episodes after implementation of the CMF having similar severity to those before implementation. Semistructured interviews highlighted the importance of broad multidisciplinary leadership and training to embed a culture of proactive and collaborative conflict management.
Conclusions
The CMF offers an effective adjunct to conflict management training, reducing time spent managing conflict and the associated staff costs.
In 2020, everyday life changed dramatically for employees worldwide as a result of the outbreak of the Covid-19 pandemic, where an estimated 558 million employees started working from home. The pandemic, therefore, marks a fundamental shift of individuals’ work-nonwork boundaries, which can impact work-life conflict. In particular, the interplay between individuals’ enacted boundaries (degree to which they separate/segment or blend/integrate work-nonwork), preferred boundaries (degree of preferred segmentation or integration of work-nonwork), and perceived control over work-nonwork boundaries, may relate to work-life conflict. This study, the first to the best of our knowledge, examines whether different types and levels of work-nonwork boundary (in)congruence matter for work-life conflict, and whether perceived boundary control moderates these relationships. Boundary (in)congruence represents the degree of (mis)fit between enacted and preferred segmentation or integration. Several types of (in)congruence are distinguished: “segmentation congruence” (enacting and preferring segmentation); “integration congruence” (enacting and preferring integration); “intrusion” (enacting integration but preferring segmentation) and “distance” (enacting segmentation but preferring integration). Data from 1,229 managers working in public and private organizations in Sweden was analyzed using polynomial regression analysis with response surface modeling and moderation analysis in SPSS Process. Findings showed that “integration congruence” was related with higher work-life conflict than “segmentation congruence.” Moreover, a U-shaped relationship between incongruence and work-life conflict was found: the more incongruence, the more work-life conflict. Specifically, “intrusion” was related to higher work-life conflict than “distance.” Finally, boundary control mitigated the effect of incongruence (especially “intrusion”) on work-life conflict. From our findings, we may conclude that work-life conflict is impacted differently depending on the type and level of boundary (in)congruence. Particularly enacted and/or preferred integration may be problematic when it comes to work-life conflict, rather than just (in)congruence per se. Moreover, boundary control can be viewed as a key factor in combating work-life conflict, especially among individuals who enact integration, but prefer segmentation. Taken together, our study contributes new and substantial knowledge by showing the importance for research and HRM-policies that take into account different types and levels of boundary (in)congruence, as these are associated with different levels of work-life conflict, which, in turn, are moderated by boundary control.
Complex and rapidly evolving work contexts augment industry calls for future-capable graduates that can demonstrate enterprise capabilities such as critical thinking, problem-solving, collaboration, and value creation. Gaps between employers’ expectations and evaluations of higher education (HE) graduates’ enterprise capabilities continue to drive university curriculum renewal. There is a particular focus on work-integrated learning (WIL), a spectrum of industry-student engagement activities which provide valuable opportunities for developing and applying skills and knowledge, including enterprise capabilities. Despite small-to-medium enterprises (SMEs) offering fertile ground for enterprise learning, challenges limit their engagement in workplace-based WIL (internships/placements) due to resource and supervisory constraints. This study explores how co-working spaces may support SME engagement in WIL to develop enterprise capabilities, better preparing HE students for future work. It piloted two rounds of business student internships in the largest co-working space in Western Australia, surveying and interviewing both students and workplace supervisors to gauge development and understand enablers and challenges during WIL. Findings affirmed the synergistic value of SMEs and co-working spaces for fostering students’ enterprise capabilities, particularly communication and critical thinking skills, innovative behaviour, and building confidence. While some of the challenges which impact on SMEs engagement and outcomes in WIL remained, the co-working environment offered unique exposure to entrepreneurial mindsets and rich opportunities for collaboration, networking, and formal training. This study offers important insights on WIL design that increases participation among SMEs, a targeted objective of Australia’s national WIL strategy, and leverages co-working space environments to produce future-capable graduates.
Executive summary:
While the COVID-19 pandemic has added stressors to the lives of healthcare workers, it is unclear which factors represent the most useful targets for interventions to mitigate employee distress across the entire healthcare team. A survey was distributed to employees of a large healthcare system in the Southeastern United States, and 1,130 respondents participated. The survey measured overall distress using the 9-item Well-Being Index (WBI), work-related factors, moral distress, resilience, and organizational-level factors. Respondents were also asked to identify major work, clinical, and nonwork stressors. Multivariate regression was used to evaluate associations between employee characteristics and WBI distress score. Overall, 82% of employees reported high distress (WBI ≥ 2), with nurses, clinical support staff, and advanced practice providers reporting the highest average scores. Factors associated with higher distress included increased job demands or responsibilities, heavy workload or long hours, higher frequency of moral distress, and loneliness or social isolation. Factors associated with lower distress were perceived organizational support, work control, perceived fairness of salary cuts, and resilience. Most factors significantly associated with distress-heavy workloads and long hours, increased job demands, and moral distress, in particular-were work-related, indicating that efforts can be made to mitigate them. Resilience explained a small portion of the variance in distress relative to other work-related factors. Ensuring appropriate staffing levels may represent the single largest opportunity to significantly move the needle on distress. However, the financial impact of the COVID-19 pandemic on the healthcare system may represent a barrier to addressing these stressors.
The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during times of crisis and other challenging working conditions and to highlight the importance of prioritizing and protecting the mental health and well-being of the healthcare workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other mental health challenges among healthcare workers. Second, we consider how public health emergencies exacerbate these concerns, as reflected in emerging research on the negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further, we consider potential approaches for overcoming these threats to mental health by exploring the value of practicing self-care strategies, and implementing evidence based interventions and organizational measures to help protect and support the mental health and well-being of the healthcare workforce. Lastly, we highlight systemic changes to empower healthcare workers and protect their mental health and well-being in the long run, and propose policy recommendations to guide healthcare leaders and health systems in this endeavor. This paper acknowledges the stressors, burdens, and psychological needs of the healthcare workforce across health systems and disciplines, and calls for renewed efforts to mitigate these challenges among those working on the frontlines during public health emergencies such as the COVID-19 pandemic.
Background:
The health sector should adopt integrated quality systems because of the need to survive and develop in a highly competitive environment. Inefficiency of mechanistic procedures, along with inadequate administrative infrastructure, impose innovative appoaches to improve operations and increase revenues by reducing quality feilures.
Objective:
A health system that relies on quality healthcare services can directly benefit the entire society, may reduce mortality, disease severity, and increase life expectancy. The following literature review constitutes an attempt to assess the contribution of healthcare professionals in issues that relate to quality management over the course of recent years.
Methods:
This systematic review took place between May 2019 and June 2020 in the databases PubMed, Cochrane Library, Wiley Online Library, Web of Science, Google Scholar and Scopus search engine databases. Study Selection and Data Extraction: This review includes articles written in English language, which contain quantitative and qualitative analysis of healthcare professionals' involvement in quality activities. Correspondingly, the exclusion criteria were: languages other than English, secondary surveys (general and systematic reviews or post-analyses), letters to the publisher, and editorials or articles that did not illuminate the subject under study. After an extensive literature review, a standardised Excel spreadsheet was developed for data extraction from the included studies. The main characteristics of the studies were recorded (author's name, place and time of work, the article under study and the methodology) so that all research articles corresponding to the review could be included. 31 articles were included.
Results:
Healthcare professionals are engaged in quality improvement activities and there is high association between quality management strategies and clinical processes. A systematic approach on healthcare activities based on the input of healthcare professionals can help increase business performance, reduce errors, improve patient safety, and contribute to a more proactive care.
Conclusion:
Health professionals' contribution in the strategic planning of healthcare organisations that address quality activities can lead to better output, both in patient satisfaction and safety.
Background : Medical negligence is an increasing public health concern among healthcare providers worldwide as it affects patient safety. It poses a significant risk of patient injury, disease, disability, or death. The WHO has recognized deficiencies in patient safety as a global healthcare issue to be addressed. This study aimed to analyze various components of medical negligence research literature.
Methods : Bibliographic data visualizations tools like Biblioshiny (RStudio) and VOSviewer were used besides MS Excel to examine the types of documents, annual scientific production, top contributing authors and their impact, authorship patterns and collaboration, top contributing countries and organizations, most significant sources of publication, most cited documents, and most frequently used keywords. Bibliometric methods were used to analyze the bibliographic records of research output on medical negligence downloaded from the Web of Science Core Collection.
Results : The annual productivity of medical negligence research was increasing gradually. The most productive period for medical negligence research was 2011-2020. Bird contributed the highest number of publications to medical negligence literature while Brennan emerged as the highly cited author. Single-authored publications on medical negligence were not highly cited. The United States was the highest contributing country and the University of South Florida was the highest contributing organization while Harvard University was a highly cited organization. Nine out of the top ten contributing organizations were academic institutions and most of them belonged to the United States. The most important sources of publication on this topic were The Lancet and British Medical Journal. Localio et al . was the most important research article on medical negligence research.
Conclusion : Due to increasing attention on this topic, there was a sharp increase in the research output on medical negligence. This is of significance as the WHO set in motion a patient safety program almost two decades ago.
Background: Studies have demonstrated that empathic communication improves patient outcomes and helps doctors to deliver accurate symptom reports and diagnoses. These benefits emphasise the need for medical students to apply empathic communication skills during their interactions with patients. Focussed empathic communication skill workshops were introduced into the undergraduate medical students’ training at the Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. This study aimed to explore students’ perceptions of applying these empathic communication skills during their clinical practice. We were interested in determining the factors that might influence the development of empathic communication skills. The findings could help curriculum developers to optimise these workshops for inclusion in a formal medical curriculum.
Methods: This study followed a qualitative, descriptive enquiry, exploring the perceptions of medical students through focus-group discussions. The students (N = 18) were selected using convenience sampling techniques. Recordings were transcribed, and the data were thematically analysed.
Results: The two main themes identified relate to the students and the clinical learning environment. The students valued the knowledge and skills they acquired. However, feelings of emotional vulnerability, a lack of language proficiency and inadequate role modelling were highlighted as challenges when applying empathic communication during clinical practice.
Conclusion: The students reported positively on the workshops as these improved both their patient and personal interactions. However, for students to develop these skills further for clinical practice, they need more intentional and supervised opportunities to practise, reflect and receive constructive feedback. These learning opportunities could help medical schools deliver graduates who can competently communicate with their patients in an empathic manner.
Conflicts of interest (COI) exist in every step of life, including in medicine and science. Professionals who work in different areas of Health systems, such as physicians in care patient, in pharmaceutical and biomedical devices industries, in management positions, in teaching or in research, all must apply rigid ethical principles.
It is possible with these actions that COI were detected in several circumstances such as in the prescribing therapy, in production or employment of technology in services of Health system, in article publications, and in decision-making for those who have decided to occupy positions of responsibility in scientific and healthcare institutions, in industry or professional associations, among others. These actions must be consistent with the essential principles of Bioethics.
At present, COI disclosure has been irreversibly installed in Medicine. A detailed description of the classification of conflicts of interest and its ethical and legal implications in the practice of health sciences such as those that appear in the practice of clinical and laboratory medicine, pharmaceutical industry and also, research and publications are included. Final considerations on the management of COI are also included.
The issue of workplace accommodation is vital to employees with and without disabilities, as well as employers and organizations. Drawing on the self-efficacy theory, this paper examines the mechanism and contingency of the relationship between workplace accommodation and employee creative performance. Specifically, we argue that creative self-efficacy is the key factor through which workplace accommodation promotes employee creative performance. Aligning with the identity-blind diversity management, we hold a continuous view of disability that everyone has a certain level of disability ranging from zero to a high level of disability severity. Disability severity moderates the relationship between workplace accommodation and creative self-efficacy, and the aforementioned indirect effect, such that the positive relationship and the indirect effect are stronger for employees with a lower level of disability severity. Data collected from a multi-wave multisource field study with 300 participants provide general support for our hypotheses. This research contributes to the literature by (a) providing empirical support for the identity-blind diversity management, (b) extending the research on the psychological well-being and performance of employees with disabilities, and (c) enlarging the nomological network of workplace creativity. Practically, our research provides insights for practitioners to promote workplace accommodation practices, as workplace accommodation is not only essential for including employees with disabilities but also helpful in boosting the creative performance of all employees.
Purpose
This study aimed to investigate the effects of role demands on safety performance in mining companies under the mediating role of psychosocial stress symptoms. Three dimensions of safety leadership were also tested as moderators on the relationship between psychosocial stress symptoms and safety performance.
Methods
To collect data to analyze the hypothesized relationships in the present study, a total of 850 questionnaires were distributed to mineworkers in Ghana. Hierarchical regression analysis was employed as the main statistical technique in analyzing the data using SPSS version 21 software.
Findings
Results from hierarchical regression analysis showed that psychosocial stress symptoms fully mediated the relationship between role demands and safety compliance but showed no mediation on role demands and safety participation. Also, only safety coaching from safety leadership demonstrated to have a moderating effect on the relationship between psychosocial stress symptoms and safety compliance of safety performance.
Conclusion
The study proposes that it is important to examine the effects of role demands on specific job performance. The importance of safety coaching as a key element of planning to improve safety performance should not be underestimated.
The present study proposed an application of the Rahim' Model of Conflict Management, and aimed to explore the styles of handling interpersonal conflicts with students adopted by teachers from five European countries (Italy, Spain, Germany, Belgium, Austria), identifying specific patterns and evaluating potential differences according to teachers' Gender, Age, Working Seniority and Country of belonging. Overall, 589 secondary school teachers completed a questionnaire consisting of Socio-demographic characteristics and the Rahim Organizational Conflict Inventory-II (ROCI-II, Form B). Non-hierarchical k-means cluster analysis was employed to derive patterns of conflict management, identifying four patterns labelled as Multi-strategic and Engaged, Multi-strategic and Solution-Oriented, Control-Oriented and Avoidant, and Mediating. Significant differences between countries were found in the numbers of teachers grouped across the four patterns. Findings identified stable and meaningful patterns for evaluating teachers' styles of management of interpersonal conflicts with students and for promoting teachers' effectiveness in conflict management in the European school context.
There are few options available for school managers who wish to effectively tackle school
conflicts. The aim of the present work was to assess the issue of school conflict, its sources, and the
effectiveness of different conflict management styles in Secondary Education school units in Greece.
Teachers (n = 128) from twelve randomly selected schools in the region of Epirus, NW Greece,
participated in the present work. Teachers’ views on their school Principals’ leadership style as well
as the sources, the type(s), and the severity of conflict in their school unit were surveyed. Conflict
appeared to be a frequent issue in schools. Frequent sources of conflict included interpersonal and
organizational parameters. School leaders exhibited a range of conflict management styles.
Compromise and Collaborative styles were frequently observed, followed by Smoothing and Forcing.
Avoidance was less frequently exhibited by school leaders. The transformational and transactional
leadership styles exhibited were equally effective in successful conflict resolution, whereas a laissezfaire
leadership style was not. The results indicate that leadership and conflict management style
can be associated with the effectiveness of conflict management.
BACKGROUND: Providing the high-quality services in hospitals depends on to minimize conflict between all members within a health team. This study aimed to identify the causes of conflicts experienced by clinical and administrative staff in hospitals.
METHODS: A cross-sectional study was carried out in 2018. The sample included 320 clinical and administrative staff from six hospitals affiliated to Ardabil University of Medical Sciences that were selected using two-step clustering sampling method. Data collection was accomplished by self-administered questionnaires. Descriptive statistics, t-test, and ANOVA were used for data analysis.
RESULTS: Total conflict score revealed that clinical staff had higher levels of perceived conflict than administrative staff. In terms of organizational position, the study results showed a significant difference in the reported conflict between nurse groups and other groups (physicians and paramedical, administrative, financial, and logistic staff). The most important causes of conflict in the viewpoint of clinical staff were organizational and job characteristics (3.54 ± 1.28), poor management (3.51 ± 1.12), and inefficient communication system (3.42 ± 1.33). For administrative staff, on the other hand, poor management (3.18 ± 1.33), inefficient communication system (3.17 ± 1.36), and attitudes and perceptions (3.06 ± 1.41) were shown to be paramount factors.
CONCLUSION: Clinical and administrative staff of hospitals are like parts of a train track. The irrational relationship between them will result in distortion and lower quality of services. Therefore, effective strategies to decrease staffs' experience of conflict need to be developed. This might create a healthier and more productive work environment which positively affects the care quality.
Background: Workplace conflict is common among nurses globally. Learning how to manage it may reduce related adverse consequences. Inappropriate management of conflict is attributed to decreased productivity, poor morale and financial loss for organisations. Nurse unit managers can play a key role by effectively managing workplace conflict in the units.
Aims and objectives: To explore how nurse unit managers managed conflict in public hospitals. Subsequently to make recommendations on how to optimise conflict management skills of nurse unit managers.
Methods: A qualitative, explorative, descriptive and contextual study was conducted to explore how nurse unit managers managed conflict based on a scenario provided to them. Purposive sampling was used to select nurse unit managers working in three public hospitals. Eleven nurse unit managers participated in the study. Data was collected in two phases. In phase one; a conflict scenario was developed in consultation with experienced nurse managers. The conflict scenario was used during phase two, which involved individual face-to-face semi-structured interviews with nurse unit managers until data saturation. Tesch’s method of thematic synthesis was utilised to analyse data. Literature review was undertaken to ascertain what is considered as an appropriate intervention in conflict management.
Findings: Three themes emanated: nurse unit managers managed conflict appropriately, nurse unit managers avoided the conflict and nurse unit managers managed conflict inappropriately.
Conclusion: While some of the nurse unit managers managed conflict appropriately, additional and continuous education and training is required to optimise the capacity and develop their conflict management competency. The findings could be integrated into orientation, training and preparation of nurse managers by healthcare organisations and educational institutions.
Dealing with difficult personalities is a part of every nurse leader's career. Like many aspects of leadership, having a thoughtful and consistent approach can make all the difference. This article shares tips for effectively navigating interpersonal conflict.
The current dominant models of intervention design in the development sector do not account for the complexity and unpredictability of implementation challenges. Decision makers and implementers need timely feedback during implementation to respond to field realities and to course-correct. This letter calls for a new approach of “responsive feedback” or “feedback loops” that promotes interactions between project designers, implementers, researchers and decision-makers to enable course corrections needed to achieve intended outcomes. A responsive feedback approach, in theory, should be agile, flexible, adaptive, iterative, and actionable. There can be multiple challenges associated with incorporating this approach into practice including donor requirements, organizational structure and culture, concerns about the additional time required to adopt such an approach, resource and operational constraints, the absence of skill sets needed for such an approach within smaller organizations and inadequate inter-departmental communication. However, these barriers to adaptation can be overcome. For responsive feedback to become a part of the culture of development organizations, commitment is needed from donors, decision-makers, project designers and implementers. We believe that, to generate opportunities for learning and adaptation, donors should provide the stimulus to break down silos between implementers and researchers.
Traditional work-related securities that constitute the career-job model of employment have been in steep decline for several decades, affecting workers across industries and occupations. Still, insecure employment remains unequally distributed across the working population according to the major axes of social stratification, namely age, gender, race, and socioeconomic class. This study investigates patterns of exposure to work-related insecurity across the occupational hierarchy and whether these contribute to occupational gradients in health outcomes. Drawing on data from a national panel survey of the Canadian workforce, a multilevel growth curve modeling approach is used to examine the relationship between work-insecurity exposures and workers' self-rated health trajectories over 5 years. Findings show that work-related insecurity is associated with declines in self-rated health, although the type of insecurity as well as the magnitude, direction, and duration of the effect varies by occupational status-position. The application of pseudo-R2 tests confirmed this study's central hypothesis that gradients in health outcomes across occupational hierarchies are due, in part, to differences in exposure to work-related insecurity. Going forward, the development of effective health promotion interventions that can modify work-related health gradients, must work toward mitigating the risk of exposure to adverse work circumstances that is systemic to occupational hierarchies.
Objectives
To explore professionals' experiences and perceptions of whether, how, and what types of conflicts affected the quality of patient care.
Patients and Methods
We conducted 82 semistructured interviews with randomly selected health care professionals in a Swiss teaching hospital (October 2014 and March 2016). Participants related stories of team conflicts (intra-/interprofessional, among protagonists at the same or different hierarchical levels) and the perceived consequences for patient care. We analyzed quality of care using the dimensions of care proposed by the Institute of Medicine Committee on Quality of Health Care in America (safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity).
Results
Seventy-seven of 130 conflicts had no perceived consequences for patient care. Of the 53 conflicts (41%) with potential perceived consequences, the most common were care not provided in a timely manner to patients (delays, longer hospitalization), care not being patient-centered, and less efficient care. Intraprofessional conflicts were linked with less patient-centered care, whereas interprofessional conflicts were linked with less timely care. Conflicts among protagonists at the same hierarchical level were linked with less timely care and less patient-centered care. In some situations, perceived unsatisfactory quality of care generated team conflicts.
Conclusion
Based on participants' assessments, 4 of 10 conflict stories had potential consequences for the quality of patient care. The most common consequences were failure to provide timely, patient-centered, and efficient care. Management of hospitals should consider team conflicts as a potential threat to quality of care and support conflict management programs.
Background:
Having robust power sources and employing effective influence tactics are essential leadership skills for nurse managers in managing human resources, providing quality care, and managing workplace conflict among nurses.
Aims:
The present study aimed to investigate how bedside nurses perceived their nurse managers' power bases, influence tactics, and conflict management styles. Furthermore, the study investigated the relationship among power bases, influence tactics, and conflict management styles.
Methods:
A descriptive correlational study was conducted at the inpatient care unit of a Saudi hospital. A convenient sample of n = 230 nurses completed the Power Base scale, Influence Behavior Questionnaire (IBQ-R), and Rahim Organizational Conflict Inventory-II (ROCI-II).
Results:
Nurses believed their managers were most likely to use referent, legitimate, and expert sources to exercise their power; appreciation and consultation tactics to influence others; and an integrative style to manage conflict. Significant positive correlations were found between the perceived overall power bases and each of the influence behaviors and conflict management styles (r = .466, r = .383, p < .05, respectively). The values of the regression coefficient of power bases significantly contribute to the prediction of 67.8% and 42.2% of the explained variance of influence behaviors and conflict management styles, respectively. In addition, influence behaviors can play a mediating role in this prediction.
Linking evidence to action:
Nurse managers should be able to demonstrate the benefit of controlling a wide range of power bases and know how to use influence behaviors and conflict management styles skillfully in each situation to achieve desired goals.
Purpose
This paper aims to examine the influence of the interplay between servant leadership behaviors and Machiavellianism on leader effectiveness.
Design/methodology/approach
Drawing on trait activation theory and motivation to lead theory, the authors hypothesize that the effect of servant leadership behaviors on perceived leadership effectiveness is manifested differently in teams with high-Machiavellian vs. low-Machiavellian leaders. In teams with low-Machiavellian leaders, servant leadership behaviors are expected to be associated with a cooperative way of handling team conflicts, which enhances employees' leader effectiveness ratings. In contrast, in teams with high-Machiavellian leaders, this mediation role vanishes due to the incongruency between Machiavellian traits and the cooperative context. The authors conducted a two-wave survey-based study and tested the hypotheses with a matched supervisor-employee sample from 310 employees and their leaders in 91 teams.
Findings
The results showed that servant leadership behaviors positively impact leadership effectiveness and that this effect takes place through cooperative team conflict management (TCM) without controlling for leaders' Machiavellian trait. Further analysis shows this mediation mechanism is only strong and significant in teams led by low-Machiavellian leaders, but not high-Machiavellian leaders.
Originality/value
To the authors’ best knowledge, this is the first study that examines the interplay of servant leadership behaviors and Machiavellianism on perceived leader effectiveness.
Purpose
To examine the relationship between nurses' conflict management strategies and teamwork attitudes.
Method
This cross‐sectional, descriptive, and relational study was conducted with 228 nurses in a hospital in southern Turkey. Data were collected through The TeamSTEPPS Teamwork Attitudes Questionnaire and the Rahim Organizational Inventory‐II.
Results
Of all the nurses, 91.2% reported to have had conflicts. Nurses stated that they mostly used compromising and integrating strategies. Teamwork attitudes questionnaire mean score was 108.28 ± 11.45. Conflict management strategies are significant predictors of teamwork attitudes and these explain 46% (model 1; R ² = 0.46; P <.01), and education, gender, units, years of experience explain 2% of the total variance in teamwork attitudes (model 2; R ² = 0.48; P < .01).
Practice Implications
Mental health nurses together with manager nurses should focus on improving nurses' teamwork attitudes and constructive conflict management strategies within the team.
This meta-analysis aimed to address the association between personality traits and conflict handling styles. ProQuest, PsycINFO, Scopus, and Web of science and also Microsoft Academic, Science.gov, Science open were searched for all published and non-published studies through 17 October 2018. A literature search located 20 eligible studies, and 5337 total participants. The results of this review show that neuroticism and agreeableness are positively related to avoiding style. The positive associations are observed between agreeableness, extroversion, openness to experience, and conscientiousness with compromising style. There exist positive and negative relations between extroversion and agreeableness with dominating style, respectively. A positive link is identified between agreeableness and obliging style. Finally, agreeableness, extroversion, openness to experience, and conscientiousness are positively correlated with integrating style and neuroticism is negatively related to integrating style. The findings of moderator analysis indicate that there is a different pattern between work and academic setting concerning the relationship between agreeableness with compromising. Similarly, the results of the academic setting yielded the different population as the work setting when it comes to the link between neuroticism and compromising style.
Often, the senders and receivers of scientific communication have different knowledge bases. While such communication is essential for solving the complex social and technological problems that affect multiple stakeholders, a diversity of knowledge among communicators can create representational gaps (rGaps). rGaps occur when senders make assumptions that receivers do not, creating conflict over the meaning and value of the information communicated. Such conflict could, if managed, promote learning and innovation as communicators reconcile their assumptions. More often, however, rGaps cause conflict to transform from a debate that informs to an argument that divides. Managing rGap conflict so that it does not degrade communication requires relationship building to mitigate the negative by-products of persistent conflict while maintaining appropriate levels of cognitive distinctiveness among diverse stakeholders. Thus, we provide a framework for identifying and leveraging rGaps through managed conflict so that communication between those with different perspectives builds rather than burns bridges.