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ANTECEDENTS AND CONSEQUENCES OF INTRAGROUP CONFLICT
AMONG NURSES IN ACUTE CARE SETTINGS
By
Joan Marie Almost
A thesis submitted in conformity with the requirements
for the degree of Doctor of Philosophy
Graduate Department of the Faculty of Nursing
University of Toronto
© Copyright by Joan Almost 2010
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ABSTRACT
Antecedents and Consequences of Intragroup Conflict Among Nurses in Acute Care Settings
Joan Almost
Graduate Department of the Faculty of Nursing
University of Toronto
PhD 2010
One of the contributing factors to the current nursing shortage is job dissatisfaction due
to conflict in the workplace. In order to develop strategies to reduce conflict, research is
needed to understand the causes and outcomes of conflict in nursing work environments. This
study tested a theoretical model linking antecedent variables (core self-evaluation, complexity of
nursing care, unit size, interactional justice, managerial support, unit morale) to intragroup
conflict, followed by conflict management, and ultimately, job stress and job satisfaction.
A predictive, non-experimental design was used in a random sample of 277 acute care
nurses in Ontario. Structural equation modeling techniques were used to analyze the
hypothesized model. Final analysis revealed relatively good fit of data to the hypothesized
model (χ² = 211.7, df = 80, CFI = .92, RMSEA=0.07). Lower core self-evaluation, higher
complexity of nursing care, lower interactional justice, and poor unit morale resulted in higher
intragroup relationship conflict, and ultimately a less ‘agreeable’ conflict management style,
higher stress and job dissatisfaction. Conflict management style partially mediated the
relationship between conflict and job satisfaction. Job stress also had a direct effect on job
satisfaction and core self-evaluation had a direct effect on job stress.
The study results suggest that conflict and its associated outcomes is a complex process,
affected by dispositional, contextual and interpersonal factors. Nurses’ core self-evaluations,
complexity of nursing care and relationships with managers and nursing colleagues influences
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the level of conflict they experience. How nurses manage conflict may not prevent the negative
effects of conflict on job stress and job satisfaction, however learning to manage conflict using
collaboration and accommodation may help nurses feel more satisfied with their jobs. In
addition, education programs that contribute to an individual’s ability to feel more confident
about their ability to manage conflict may help them cope more effectively with the stress
generated by conflict.
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ACKNOWLEDGEMENTS
I am blessed to have had the support of so many during this journey. I wish to express
my sincere gratitude and appreciation to the members of my dissertation committee. First, I
extend thanks to my supervisor, Dr. Diane Doran, for her guidance, limitless support and
endless encouragement. I also thank my committee members, Dr. Linda McGillis-Hall and Dr.
Heather Laschinger. The sharing of their expertise, insights, time and support were invaluable.
All of you have not only supported my doctoral work but have been instrumental in the
development of my career. Special thanks are also extended to my external examiners, Dr. Sean
Clarke and Dr. Richard Redman. I am appreciative of their thoughtful and insightful comments.
I would like to thank all of the nurses who participated in the study. The study could not
have happened without the generous giving of their time and the careful completion of the
questionnaires.
I would like to thank all of the funding agencies that have provided me with financial
support through my years of study. I have been very fortunate to have received funding from
the Canadian Institutes for Health Research Fellowship, Dr. Dorothy J. Kergin Fellowship
(Canadian Nurses’ Foundation), Gail Donner Ontario Graduate Scholarship, University of
Toronto Doctoral Fellowship, University of Toronto Kathleen King Doctoral Fellowship,
Nursing Research Interest Group Scholarship (Registered Nurses Association of Ontario), and
Nursing Health Services Research Unit Small Grants (University of Toronto Site).
I am so very thankful to my many friends and colleagues who have stood on the
sidelines and cheered me along the way. I am indebted to all of you for being there for me
during the good and bad times. You are my greatest fans who have supported me through the
challenging times and celebrated my successes. I could never have achieved this
accomplishment without any of you.
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Table of Contents Chapter 1: Introduction ................................................................................................................... 1
Significance ................................................................................................................................. 3
Chapter 2: Literature Review ......................................................................................................... 5
Conflict Within the Workplace Violence Literature ................................................................... 5
Definition of Intragroup Conflict................................................................................................. 6
Defining Attributes of Intragroup Conflict .................................................................................. 6
Types of Conflict ......................................................................................................................... 7
Theoretical Bodies of Knowledge Studying Conflict in Organizations ...................................... 8
Models of Conflict ....................................................................................................................... 9
Cox’s Model of Intragroup Conflict .......................................................................................... 10
Theoretical Model Used In This Study ...................................................................................... 16
Chapter 3: Theoretical Framework ................................................................................................ 19
Antecedents of Intragroup Conflict ........................................................................................... 19
Dispositional Characteristics ................................................................................................. 19
Core Self-Evaluation. ....................................................................................................... 19
Contextual Characteristics ..................................................................................................... 21
Complexity of Nursing Care. ............................................................................................ 21
Unit Size. .......................................................................................................................... 22
Interpersonal Characteristics ............................................................................................ 23
Managerial Support. ......................................................................................................... 23
Interactional Justice. ......................................................................................................... 25
Unit Morale and Interpersonal Relations. ......................................................................... 26
Group Cohesion. ............................................................................................................... 27
Intragroup Conflict .................................................................................................................... 28
Barki and Hartwick’s Framework ......................................................................................... 29
Conflict Management Style ....................................................................................................... 31
Activeness and Agreeableness ............................................................................................... 33
Mediator or Moderator .......................................................................................................... 34
Outcomes ................................................................................................................................... 35
Job Stress ............................................................................................................................... 35
Job Satisfaction ...................................................................................................................... 36
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Overview of Theoretical Framework......................................................................................... 38
Hypotheses ................................................................................................................................. 38
Chapter 4: Methods ....................................................................................................................... 43
Setting and Sample .................................................................................................................... 43
Criteria for Sample Selection................................................................................................. 43
Sample and Sample Size ........................................................................................................ 43
Data Collection Procedure ......................................................................................................... 45
Data Collection Instruments .................................................................................................. 45
Core Self-Evaluation ........................................................................................................ 45
Complexity of Nursing Care ............................................................................................. 46
Unit Size ........................................................................................................................... 48
Managerial Support .......................................................................................................... 48
Interactional justice ........................................................................................................... 48
Unit Morale and Interpersonal Relations .......................................................................... 49
Group Cohesion ................................................................................................................ 50
Intragroup conflict ............................................................................................................ 50
Conflict management style ............................................................................................... 52
Job Stress .......................................................................................................................... 53
Job Satisfaction ................................................................................................................. 54
Demographics ................................................................................................................... 55
Data Analysis ............................................................................................................................. 55
Missing Data ......................................................................................................................... 55
Outliers ................................................................................................................................. 56
Distribution normality .......................................................................................................... 57
Multicollinearity ................................................................................................................... 57
Reliability ............................................................................................................................. 58
Structural Equation Modeling Analysis .................................................................................... 58
Measurement Model .............................................................................................................. 59
Confirmatory Factor Analysis ............................................................................................... 59
Structural Equation Model ..................................................................................................... 59
Ethical Considerations ............................................................................................................... 65
Chapter 5: Results ......................................................................................................................... 66
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Characteristics of the Sample .................................................................................................... 66
Ontario Region Distribution .................................................................................................. 66
Demographics ........................................................................................................................ 66
Descriptive Statistics ................................................................................................................. 67
Correlations ............................................................................................................................... 68
Measurement Model .................................................................................................................. 70
Alternative Relationship Subscale of the Intragroup Conflict Scale ..................................... 71
Structural Equation Model ......................................................................................................... 74
Alternative Model .................................................................................................................. 76
Test of the Mediator............................................................................................................... 82
Hypothesis Testing .................................................................................................................... 83
Summary .................................................................................................................................... 83
Chapter 6: Discussion of the Findings .......................................................................................... 85
Overview of Intragroup Relationship Conflict .......................................................................... 85
Overview of Theoretical Framework......................................................................................... 88
Discussion of the Tests of the Hypothesis ................................................................................. 89
Antecedents of Intragroup Relationship Conflict ...................................................................... 89
Dispositional Characteristic ................................................................................................... 89
Core self-evaluation .......................................................................................................... 89
Contextual Characteristics ..................................................................................................... 91
Complexity of nursing care.. ............................................................................................ 91
Unit Size. .......................................................................................................................... 92
Interpersonal Characteristics ................................................................................................. 93
Managerial Support.. ........................................................................................................ 93
Interactional Justice. ......................................................................................................... 93
Unit Morale and Interpersonal Relations.. ........................................................................ 94
Group Cohesion ................................................................................................................ 95
Conflict Management Style ................................................................................................... 96
Outcomes ............................................................................................................................... 97
Job Stress .......................................................................................................................... 97
Job Satisfaction ................................................................................................................. 98
Implications for Nursing Practice .............................................................................................. 99
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Implications for Nursing Administration ................................................................................ 101
Implications for Nursing Education ........................................................................................ 103
Implications for Nursing Research .......................................................................................... 105
Limitations ............................................................................................................................... 107
Summary .................................................................................................................................. 109
References.................................................................................................................................... 111
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List of Tables
Table 1: Evolution of Cox’s (1997) Model ............................................................................... 12
Table 2: Barki & Hartwick’s (2004) Typology for Conceptualizing Conflict .......................... 17
Table 3. Means and Standard Deviations for Major Study Variables ....................................... 63
Table 4. Correlations Among Major Study Variables ............................................................... 69
Table 5: Barki & Hartwick’s (2004) Typology for Conceptualizing Conflict .......................... 73
Table 6. Model Variables Standardized Total Effects ............................................................... 80
Table 7. Significance Testing of Mediator Model ...................................................................... 82
Table 8. Parameter Estimates of Final Model and Hypotheses .................................................. 84
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List of Figures
Figure 1a: Cox’s Original Model ............................................................................................... 15
Figure 1b: Cox’s Final Model ................................................................................................... 15
Figure 2: Theoretical Model: Antecedents and Consequences of Conflict .............................. 18
Figure 3: Theoretical Model: Antecedents and Consequences of Conflict .............................. 39
Figure 4. Structural Equation Model ......................................................................................... 61
Figure 5. CFA of Alternative Relationship Subscale: 3 Factors, 9-items ................................. 72
Figure 6. CFA of Alternative Relationship Subscale: 1 Factor, 9-items ................................... 73
Figure 7. Revised Structural Equation Model ........................................................................... 75
Figure 8. Revised Structural Equation Model with Modification Indices ................................. 77
Figure 9. Alternative SEM Model ............................................................................................. 79
Figure 10. Final Model .............................................................................................................. 81
Figure 11. CFA of Intragroup Conflict Scale ......................................................................... 156
Figure 12. CFA of Three Factor, 11-item Relationship Subscale of ICS ............................... 172
Figure 13. CFA of Two Factor, 11-item Relationship Subscale of ICS ................................. 173
Figure 14. CFA of One Factor, 11-item Relationship Subscale of ICS ................................. 174
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List of Appendices
Appendix A: Letters of Information ........................................................................................... 148
Appendix B. Demographics of Study Participants ..................................................................... 152
Appendix C. Confirmatory Factor Analysis 48-item Intragroup Conflict Scale ........................ 153
Appendix D. Confirmatory Factor Analysis of 11-item Relationship Subscale ........................ 171
1
Chapter 1: Introduction
Conflict is unavoidable in any work environment due to differences among individuals’
perceptions, ideas, needs, and desires. Work environments within hospitals may be more
susceptible to conflict due to stressful environments, constant changes, challenging and difficult
work, large number of staff, and diversity of interactions. In several studies, nurses working in
acute care settings have indicated that conflict is occurring more frequently in their current work
environment than in the past (Hesketh, Duncan, Estabrooks, Reimer, Giovannetti, Hyndman et
al., 2003; Rolleman, 2001; Warner, 2001). Workplace relationships that consist of conflict,
rather than collaboration and support, leave nurses feeling angry, betrayed, frustrated and
dismayed (Bishop, 2004). However, collaborative relationships that resolve conflict through the
acceptance, understanding and integration of one another’s ideas, needs, and expectations,
create a foundation for resolving future conflicts as well as solid working relationships in a more
relaxed work environment (Van de Vliert, Euwema, & Huismans, 1994).
Nurses have often reported conflict with doctors, nurse colleagues, managers, families,
and patients (Boychuck-Duchscher & Cowin, 2004; Gray-Toft & Anderson, 1981; Hillhouse &
Adler, 1997; Hipwell, Tyler, & Wilson, 1989; Kushell & Ruh, 1996). However, recent studies
have found that nurses identify their managers and nursing colleagues as the most common
source of conflict, and that conflict with nursing colleagues is also the most stressful type
(Bishop, 2004; Lawrence & Callan, 2006; Warner, 2001). Therefore, the focus of this study was
intragroup conflict or conflict among nurses within their nursing units. In the literature this is
also referred to as interpersonal conflict or conflict between individual members of a group. For
the purposes of this research, intragroup and interpersonal conflicts within the context of a
workgroup are used interchangeably, and hereafter will be referred to as intragroup conflict.
A review of the nursing literature found that nursing research has focused mainly on the
management of conflict with very few studies examining causes, elements and effects of
conflict. Nursing studies have examined the conflict management style of nurse managers
(Barton, 1991; Marriner, 1982), staff nurses (Cavanaugh, 1988, 1991; Hightower, 1986;
Morrison, 2008a; Rolleman, 2001; Siu, Laschinger & Finegan, 2008; Valentine, 2001), and
deans of schools of nursing (Woodtli, 1987). More recently, three qualitative studies examining
conflict in Canadian acute care settings (Bishop, 2004; Rolleman, 2001; Warner, 2001)
2
identified several causes of conflict, including individual perceptions of interactions, lack of
managerial respect (minimizing and ignoring nursing concerns, lack of input into decision
making, lack of acknowledgement), lack of managerial support (lack of concern, absent or
inadequate communication), time pressure, and heavy workloads. In a study of intragroup
conflict among nurses, Cox (2001) found that low unit morale and poor interpersonal relations
were the most significant predictors of intragroup conflict.
In the majority of nursing research, the term ‘conflict’ is often not defined or is poorly
defined ranging from gossiping to physical violence and the majority of studies examining
conflict do not use theoretical frameworks to guide the research. In addition, a large amount of
research is based on the assumption that situational variables are perceived and responded to
similarly and consistently (Peters & O’Connor, 1980; Spector, 1982). How nurses respond to
everyday encounters, including conflict situations is affected by dispositional factors such as
their core beliefs or self-evaluation about themselves and their ability to function (Judge, Locke
& Durham, 1997). The review of the nursing research literature identified a noticeable gap
related to causes and effects of conflict, including dispositional factors. This lack of research
testing causal explanations for intragroup conflict based on a theoretical framework was a major
impetus for this study. Thus, the purpose of this study was the testing of a theoretical model
linking selected dispositional, contextual and interpersonal variables to intragroup conflict,
which subsequently, results in conflict management (mediator variable), and, ultimately, the
selected outcome variables.
The theoretical framework developed by Kathleen Cox (1997), as well as recent
qualitative studies (Bishop, 2004; Rolleman, 2001; Warner, 2001), and concept analysis
(Almost, 2006) provided a basis for understanding the meaning of conflict between nurses, as
well as the antecedents and consequences of conflict. The theoretical model guiding this study
is based on a modified version of the model developed by Cox (1997) and is discussed in more
detail in Chapters 2 and 3. This study contributes to the sparse body of knowledge on the nature
of conflict within acute care nursing settings by testing a theoretical model derived from the
literature that provides insight into: 1) previously unexamined causes and effects of intragroup
conflict among nurses; and 2) the mediating effect of conflict management style on the
relationship between intragroup conflict and the selected outcomes, a relationship that has not
been examined previously in nursing research.
3
Significance
With the aging nursing workforce and nursing shortage, creating work environments
emphasizing positive relationships that will retain nurses is important. In order to develop
strategies that will reduce conflict, research is needed to define more thoroughly the concept of
conflict in nursing work environments, specifically the causes and impact of conflict on nurses.
While conflict is inevitable, frequent conflict is detrimental to the quality of nurses’ work
environments (Canadian Nurses Advisory Committee, 2002; Baumann, O’Brien-Pallas,
Armstrong-Stassen, Blythe, Bourbonnais, Cameron, et al., 2001). One of the contributing
factors to the current nursing shortage is job dissatisfaction among nurses due to conflict in the
workplace creating an unpleasant and stressful work environment (Hesketh, et al., 2003; Taylor,
2001; Warner, 2001). Nurses who have less than satisfactory relationships with their coworkers
are more likely to leave their jobs (Lambert, Lambert & Ito, 2004; Thomas, 1992).
Overall, the consequences of conflict are serious and have the potential to have a
negative impact on the retention of qualified staff, clinical outcomes of patients, and patients’
satisfaction (Institute of Medicine, 2004). In one study, several nurses admitted they reduced
their hours of work because of conflict with coworkers (Warner, 2001). New nursing graduates
in New Zealand reported high levels of conflict with their nursing colleagues within one year
after graduation (McKenna, Smith, Pool, & Coverdale, 2003). Over half of these new graduates
felt undervalued by other nurses and distressed by the conflict they observed among their
colleagues. Similarly, new graduates in Australia reported being overwhelmed by the way
nurses spoke to each other and the lack of unity within the profession. Findings revealed that
participants experienced verbal abuse, bullying, and conflict with other nurses and nurse
managers during their final year of University and during their first month of employment
(Kelly & Ahern, 2009). Other direct and indirect costs of ongoing conflict include employee
grievances, diversion of management time, and disruption of professional relationships (Forte,
1997; Slaikeu & Hasson, 1998).
A review of the literature indicated that there are numerous definitions of conflict, many
different types of conflict, and a variety of approaches to the study of conflict (Almost, 2006).
In chapter 2, an overview of the broader conflict literature is discussed. In addition, the model
that guided this research is presented. Chapter 3 discusses the model in more detail with a
review of the empirical studies, including nursing research, that provide rationale for the model
4
concepts and the hypotheses. Chapter 4 describes the methodology used in this study, including
the research design, setting, sample, instrumentation, and data analysis plan. Chapter 5
discusses the results of the data analyses, including the analyses of the measurement model and
structural equation model. The final chapter discusses the study findings, implications and
limitations of this study.
5
Chapter 2: Literature Review
Conflict has been studied in many different ways, referring to different forms of conflict
(e.g., racial, ethnic, political, marital), different levels of involvement (e.g., within the
individual, between individuals, within groups, between groups), and different situations (e.g., at
home, in organizations) (Deutsch, 1990; Thomas, 1992). As mentioned in Chapter 1, this study
will focus on intragroup conflict, therefore the literature review focuses on intragroup conflict as
well as interpersonal conflict. The first section in this review provides a brief overview of how
conflict is situated in the workplace violence literature. The second section describes the
defining attributes then the definitions of intragroup conflict. The third section reviews the
types of conflict found in organizational settings. The fourth section provides an overview of
the theoretical bodies of knowledge used to study conflict, followed by an overview of the
model that will guide this research study.
Conflict Within the Workplace Violence Literature
Over the past 10-15 years, attempts to expand the concept of workplace violence beyond
overt physical attacks has led to a variety of constructs encompassing a wide array of negative
acts or ‘dark-side’ behaviour at work. Overarching constructs such as workplace aggression
(Neuman & Baron, 1998), psychological aggression (Bowie, Fisher & Cooper, 2005), negative
behaviour (Hutton, 2006), and negative relationships (Morrison, 2008b) encompass physical
violence, harassment, bullying, emotional abuse, abusive supervision, and workplace incivility.
Interestingly, very few of these constructs have included conflict at work. Raver and Barling
(2008) recently theorized conflict as a broader term that encompasses workplace aggression
with workplace aggression being construed as a particular form of conflict at work. In a meta-
analysis of workplace aggression, Hershcovis, Turner, Barling, Arnold, Dupre, Inness, et al.
(2007) found that interpersonal conflict was a significant predictor of interpersonal and
organizational aggression. Farkas and Johnson (2002) also suggested that unresolved conflict is
one of many factors that can trigger uncivil behaviour or incivility.
According to DeDreu and Gelfand (2008), conflict is distinct from other ‘dark-side’
constructs that exist including aggression, incivility, and bullying. Although these constructs
share the fact that parties are interdependent and have opposing interests, values, or beliefs,
conflict need not involve intent to harm another party and need not cause negative outcomes.
6
Although it is recognized that conflict does have negative outcomes, particularly if based upon
personality disagreements, one of the most important recent contributions of the conflict
literature has been to enhance understanding of the conditions under which conflict exerts
positive outcomes (De Dreu, 1997; Jehn, 1995; Jehn & Mannix, 2001).
Definition of Intragroup Conflict
In general, conflict is defined as an antagonistic state of opposition, disagreement or
incompatibility between two or more parties (Merriam-Webster Online Dictionary, 2006-2007).
Conrad (1990) indicated that conflicts are interactions among interdependent people who
perceive that their interests are incompatible, inconsistent or in tension. In this study, conflict is
defined as a phenomenon occurring between interdependent parties as they experience negative
emotional reactions to perceived disagreements and interference with the attainment of their
goals (Barki & Hartwick, 2001). Conflict is more likely to occur when a variety of background,
situational, and dispositional conditions exist (Pondy, 1967; Thomas, 1992; Wall & Callister,
1995).
Defining Attributes of Intragroup Conflict
Defining attributes make it possible to identify and characterize situations that fall under
the concept (Rodgers, 1989). In a synthesis of the numerous conceptualizations and definitions
of conflict, Barki and Hartwick (2004) developed a two-dimensional framework of conflict
which is used this study. The first dimension of their framework identifies disagreement,
interference, and negative emotion as the three properties generally associated with a conflict
situation. Disagreement is the key cognitive component of conflict. When a divergence of
values, needs, interests, opinions, goals or objectives exists between individuals, there is
disagreement. However, disagreement alone is not enough for conflict to exist. If the
disagreement is over something irrelevant or unimportant, conflict will not be experienced (e.g.,
when there is no interdependence, or when the areas of disagreement are minor). It is only
when the behaviours of one individual interferes with or opposes another’s achievement of their
own interests, objectives or goals that conflict is said to exist. Behaviours such as debate,
undermining, backstabbing, aggression, and hostility have been associated with conflict (Cox,
2008). Many researchers believe that the core process of interpersonal conflict is the behaviour
where one or more individual opposes another's interests or goals (Wall & Callister 1995).
7
Finally, while a number of affective states have been associated with conflict, overwhelmingly,
it has been negative emotions such as fear, jealousy, anger, anxiety and frustration that have
been used to characterize interpersonal conflict (Amason, 1996; Barki & Hartwick, 2004; Jehn,
1995; Pinkley, 1990; Pondy, 1967; Thomas, 1992).
To examine the construct of conflict and these hypothesized dimensional indicators,
Barki and Hartwick (2001) conducted a study with 265 Information Systems staff and 272 users
working in Information System Development projects. The results supported the hypothesized
model with 95% of the variance in individuals’ perceptions of conflict (as measured through
assessment of conflict frequency and intensity) explained by perceptions of disagreement,
negative emotion, and interference (Barki & Hartwick, 2001).
Types of Conflict
In addition to the defining attributes, most research has identified three types of
intragroup conflict: task, process, and relationship conflict (Amason & Schweiger, 1994; Jehn,
1995; Pinkley, 1990). There is, however, considerable conceptual overlap between these
different types (Dirks & Parks, 2003). Relationship conflicts exists when there are interpersonal
incompatibilities among group members, including personality clashes, tension, animosity, and
annoyance (Jehn, 1995). This type of conflict produces negative individual emotions, such as,
anxiety, mistrust, or resentment (Jehn, 1995), frustration, tension, and fear of being rejected by
other team members (Murnigham & Conlon, 1991). Within a team, high levels of relationship
conflict can result in 1) team dysfunction, 2) lower organizational commitment (Jehn,
Northcraft, & Neale, 1999), 3) communication problems (Baron, 1991), 4) diminished work
satisfaction (Jehn, 1995; Jehn, et al., 1997), and 5) increased stress levels (Friedman, Tidd,
Currall, & Tsai, 2000).
Task conflicts are disagreements about the content of a task and work goals, such as
distribution of resources, procedures, and interpretation of facts (Jehn, 1995, 1997). Task
conflicts include differences in viewpoints, ideas, and opinions, and may coincide with animated
discussions and personal excitement. In contrast to relationship conflict, findings concerning
task conflict are not as conclusive. Task conflict has been associated with several beneficial
effects, such as improving the use of debate within a team (Jehn, et al., 1999), which results in
quality ideas and innovation (Amason, 1996; West & Anderson, 1996), and leads to better
8
service delivery (Tjosvold, Dann, & Wong, 1992). In addition, studies have shown that task
conflict can also be associated with several harmful effects, such as, job dissatisfaction, lack of
teamwork (Kabanoff, 1991; Jehn, et al., 1997), increased anxiety (Jehn, 1997), and turnover
(Jehn, 1995).
Process conflicts refer to disagreements about how a task should be accomplished,
individual’s responsibilities, and delegation (Jehn & Mannix, 2001). For example, when group
members disagree about whose responsibility it is to complete a specific duty. Process conflict
has been associated with lower morale, decreased productivity (Jehn, 1997), and poor team
performance (Jehn, et al., 1999). Jehn (1997) also noted that process conflict might interfere
with the quality of task content and change the focus of a group to irrelevant discussions of
member ability.
While research supports these three types of intragroup conflict, the boundaries between
task, process, and relationship conflict are neither clear nor precise. Task conflict may become
transformed into relationship conflict, such as might occur in situations where disagreement
over the content of a task is perceived as a personal criticism (Amason, 1996). Similarly,
relationship conflict can lead to task conflict, such as might occur when personal criticisms lead
to a discussion of task interpretation. In addition, some researchers argue that process conflict is
not a third type of conflict but rather another component of task conflict because task conflict
generally concerns one of two sets of issues: what is to be done and how it is done (Barki &
Hartwick 2004). As a result the types of conflict often appear to be entangled, with inconsistent
empirical evidence and overlapping measurement. All three types of conflict will be examined
in this study as part of the second dimension of the framework developed by Barki and Hartwick
(2004), however as discussed in Chapter 1, the main focus is on intragroup conflict, which is
similar to the relationship conflict described by Jehn (1997).
Theoretical Bodies of Knowledge Studying Conflict in Organizations
In a review of the research literature on organizational conflict and conflict resolution,
Lewicki, Weiss and Lewin (1992) identified six major bodies of knowledge that have studied
conflict. The labour relations approach focuses on issues pertaining to the employment
relationship. The bargaining and negotiation approach arose from the frequent use of these
processes in labour and international relations. The third party dispute resolution approach
9
evaluates the actions taken by external parties to resolve conflict or restore effective
negotiations. The economic analysis approach applies models of economic rationality to
individual decision-making and complex social behaviour. The macro-level (sociological)
approach focuses on conflict between groups, departments, and entire organizations as units of
analysis for understanding conflict. Finally, the micro-level (psychological) approach, has
concentrated on conflict within and among individuals, specifically on intrapersonal,
interpersonal, and small group behaviour variables that affect conflict causes, dynamics, and
outcomes (Nye, 1973). This approach forms the theoretical foundation for this study. Several
models within the micro-level approach are described in the next section.
Models of Conflict
Within the micro-level conflict approach, Lewicki et al. (1992) distinguished between
two types of models: normative and descriptive. Normative models examine the conflict
process and dynamics, with the view that conflict is fundamentally bad and destructive. These
models describe actions for individuals to use in order to positively change conflict behaviour,
especially using cooperation and collaboration. A key assumption is that conflict be managed
with respect to its consequences, rather than its causes. Because the focus of this study is to
describe and test an explanatory model of the antecedents and consequences of intragroup
conflict, normative models are less helpful in leading the research plan for this study.
Descriptive models of conflict, which attempt to combine both causes and dynamics, are more
applicable to the purpose of this study. These will be described in the next section.
Descriptive models describe and predict conflict dynamics across a temporal sequence of
stages or phases. Three key assumptions underlie descriptive models of conflict: conflict
originates from a variety of possible sources; conflict follows a predictable course; and, conflict
has both positive and negative outcomes. Stage models (Pondy, 1967; Filley, 1975; Robbins,
1979; Wall & Callister, 1995) describe conflict dynamics across a temporal sequence of stages
or phases. While none of these models have been directly tested in their entirety, many
researchers refer to them while others have attempted to refine and build on them. Four models
will be discussed briefly in the next section with more detail provided in Table 1, followed by a
description of the synthesis of elements from these models used by Cox (1997) in the
development of her theoretical model to study intragroup conflict within nursing work
environments.
10
According to Lewicki, et al. (1992), Pondy’s (1967) five-stage model of organizational
conflict has been dominant in the study of conflict in organizations, even though it has never
been tested. Pondy (1967) defined conflict as a dynamic process consisting of a series of
episodes between two or more individuals. Pondy (1967) indicated that “the term refers neither
to antecedent conditions, nor to individual awareness of it, nor certain affective states, nor its
overt manifestations, nor its residues of feeling, precedent, or structure, but to all of these taken
together” (p. 319). Pondy’s early work provided further support for viewing conflict as a
combination of disagreement, negative emotion, and interference. Filley (1975) expanded
Pondy’s model with the insertion of an additional stage, described as conflict resolution.
Robbins (1979) further refined this model into a four-stage model. Then in 1995, Wall and
Callister introduced a general three-stage model, which fit all of the major pieces of the conflict
puzzle together.
All of these models describe the predictable course that conflict follows, but differ as to
the number of identifiable stages along this course. The following elements, however, are
identified in all models: a) antecedents or conditions that occur prior to conflict, b) affective
states or the awareness by the involved parties that results in some kind of feeling or emotional
response, c) behaviours or manifest conflict, ranging from very subtle to violent, and finally, d)
outcomes, such as job stress, and job dissatisfaction. Several models also discuss the role of
conflict management style in determining whether conflict has positive or negative effects.
Cox’s Model of Intragroup Conflict
As shown in Table 1 and Figure 1, Cox (1997) developed a theoretical model integrating
all of these stages into three components: antecedents, core process, and outcomes. Antecedents
are consistent with Filley’s (1975) stage one, Pondy’s (1967) latency stage and Robbins’ (1979)
notions of potential opposition or conditions that create opportunities for conflict to arise. The
core process component includes the individual’s view of conflict, affective state and behaviour
that occurs during the conflict. An individual’s reaction or their style of managing conflict is
impacted by their view of conflict (constructive and healthy or destructive and unhealthy)
(Rahim, 1992). Individuals are aware of the potential for conflict to occur (Robbins, 1979),
become emotionally involved and experience anxiety, tenseness, or frustration (Pondy, 1967;
Filley, 1975). With the conflict out in the open, behaviours range from subtle, indirect, and
11
highly controlled forms of interference to direct and aggressive behaviours (Pondy, 1967; Filley,
1975; Robbins, 1979). Finally, outcomes of conflict are functional or dysfunctional.
Using a non-random sample drawn from one acute care hospital in the United States,
Cox (1997) surveyed 141 nurses (response rate 49%) from 13 units. In her original proposed
model (Figure 1a), individual (age, education, tenure in nursing unit, and experience) and
contextual variables (complexity of nursing care, unit size, and skill mix) were conceptualized
as the antecedent variables predicted to affect intragroup conflict, which in turn, was
conceptualized to affect the selected outcomes (job satisfaction, team performance effectiveness,
and turnover). Structural equation modeling analysis with all variables entered in the model
indicated a poor fit between the model and observed data (χ² = 958.32, df = 436, GFI = .73).
Due to weak causal effects in the measurement model testing, complexity of nursing
care, tenure, all subscales of the job satisfaction measure except satisfaction with pay, and all of
the items in the effectiveness of team performance measure except unit morale and interpersonal
relations were eliminated. In the revised model which eliminated these items and variables,
individual (age, education, and experience) and contextual variables (unit size, skill mix) were
conceptualized as the antecedents predicted to affect intragroup conflict, which in turn, was
conceptualized to affect satisfaction with pay, perceptions of unit morale and interpersonal
relations, and turnover.
Structural equation modeling analysis indicated a better fit between the model and
observed data (χ² = 143.79, df = 103, p = .005, GFI = .91, RMSEA = .04) with significant paths
identified between intragroup conflict and satisfaction with pay, and conflict and unit morale
and interpersonal relations. According to Cox, however, 70% of variance in intragroup conflict
was not explained by the factors in this model, and although the model was a better fit, it
provided little understanding of the antecedents of intragroup conflict.
After considering several different structural equation models that were theoretically
grounded, a third model was constructed by changing the sequence of the endogenous variables.
As shown in Figure 1b, the team performance effectiveness dimension of perceptions of unit
morale and interpersonal relations was now hypothesized to be a predictor of intragroup
conflict, which was conceptualized to be an outcome of unit morale and interpersonal relations
12
Table 1. Evolution of Cox’s (1997) Model
Pondy (1967)
5 stages
Filley (1975)
6 stages
Robbins (1979)
4 stages
Wall & Callister
(1995) 3 stages
Cox (1997)
Definition Dynamic process
consisting of a
sequence of conflict
episodes between two
or more individuals.
A process between
two or more parties
with different or
competing goals.
A process beginning
when one party
perceives another part
negatively affecting
something that the
first party cares about.
A process in which one
party perceives that its
interests are being
opposed or negatively
affected by another
party.
Opposition processes
within a group in several
forms such as hostility,
decreased communication,
distrust, verbal abuse
(Walton, 1966).
Antecedent 1) Latency –
conditions present but
not recognized
1) Antecedent
conditions present
1) Conditions create
opportunities for
conflict to arise
1) Cause
Individual
Interpersonal
Issues
Conditions that occur prior
to conflict. Characteristics
of a situation, which
generally lead to conflict
Core
Process
2) Perceived – aware
of conflict
2) Perceived –
recognize
conditions
2) Cognition and
personalization –
aware of antecedent
conditions,
2) Conflict Episodes
Views of conflict
Perceptions of affective
states
Wall and Callister: Views
of conflict, perceptions of
affective states and
13
Pondy (1967)
5 stages
Filley (1975)
6 stages
Robbins (1979)
4 stages
Wall & Callister
(1995) 3 stages
Cox (1997)
Core
Process
3) Felt – conflict
personalized, feel
anxious, tensions
build, but conflict not
in open
4) Manifest – conflict
enacted through
behaviours, obvious to
others
3) Felt – conflict
personalized, feel
hostility, mistrust
4) Manifest –
conflict enacted
through behaviours
ranging from
aggression to
problem solving
5) Resolution –
conflict stopped
emotionally involved,
experience anxiety,
frustration,
3) Overt – conflict in
the open; behaviour
ranges from subtle,
indirect to direct,
aggressive, violence
Perceptions of
behaviours
behaviour
Outcomes 5) Aftermath
Conflict management
style determines
positive or negative
effects.
6) Aftermath 4) Functional or
dysfunctional
outcomes
3) Effects
Conflict management
style determines
positive or negative
effects.
Effects of conflict
Functional or
dysfunctional
14
rather than a predictor of these dimensions. Structural equation modeling analysis indicated a
better fit between the model and observed data (χ² = 66.90, df = 59, p = .22, GFI = .95, RMSEA
= .03) and a greater proportion of the variance in intragroup conflict was explained (54%).
The results showed a significant negative relationship between intragroup conflict and
unit morale and interpersonal relations indicating lower levels of unit morale and interpersonal
relations result in higher levels of conflict. As well, the percent of registered nurses (RNs) had a
significant direct relationship with unit morale and interpersonal relations, as well as intragroup
conflict. Therefore, units with a larger percent of RNs reported higher levels of unit morale and
interpersonal relations and higher levels of intragroup conflict. Percent of RNs also had an
indirect relationship with intragroup conflict through unit morale and interpersonal relations.
Units with a larger percentage of RNs reported higher levels of unit morale and interpersonal
relations, which subsequently resulted in lower levels of intragroup conflict. Similarly, unit size
had an indirect relationship with intragroup conflict through unit morale and interpersonal
relations, indicating that larger units reported higher levels of unit morale and interpersonal
relations, which subsequently resulted in lower levels of intragroup conflict. Larger units and
larger percentage of RNs resulted in lower levels of intragroup conflict when mediated by unit
morale and interpersonal relations. However, the results also revealed a strong negative
correlation between beds per unit and percent of RNs indicating that units with a higher
percentage of RNs were smaller units, such as coronary care, which also reported lower levels
of unit morale and interpersonal relations, and subsequently resulted in higher levels of conflict.
Cox suggested that it was the complexity of the nursing care in smaller units, rather than
the higher percent of RNs, that resulted in higher levels of conflict. She further suggested that
other environmental factors found in small units may explain the effect of percentage of RNs
and unit size on intragroup conflict, such as environmental turbulence, patient acuity,
admissions, and transfers. In this study, to test this new/revised theoretical model for the first
time, a sample of only registered nurses (RNs) working only on inpatient units were used to
reduce the likelihood of extraneous variables having an impact on the research results, for
instance different roles and working relationships between RNs and Registered Practical Nurses
and other health care professionals. Therefore in this proposed study, skill mix will not be
examined, and unit size will be examined further, with the addition of a different measure of
15
γ=.32*
γ= -.36**
γ=.26*
γ= .29*
γ= .41**
γ= -.25*
γ= .31**
γ= -.18*
β= -.53**
β= -.69**
β= .29**
Figure 1a. Cox’s (1997) Original Model
Figure 1b. Cox’s (1997) Final Model
Individual CharacteristicsAge
Education Experience
Tenure
Contextual FactorsComplexity of Care
Beds per unit Percent RNs
Intragroup
Conflict
Work Satisfaction
Anticipated Turnover
Team Performance Effectiveness
Age
Anticipated Turnover
Unit Morale & Interpersonal
Relations Percent RNs
Beds Per Unit
Education
Experience
Satisfaction with Pay
Intragroup Conflict
θ=-.74**
* p<.05 **p<.01
16
nursing care complexity that will capture other potential explanatory factors outlined by Cox.
This present study extends the work of Cox (1997) in several ways. First, this study
examined, in more detail, the effect of interpersonal relationship factors on intragroup conflict.
In her final model Cox found that perceptions of unit morale and interpersonal relationships had
a direct effect on intragroup conflict. However, the questions about morale and relationships
were general and did not focus on any specific aspect. Nurses have frequently identified
interpersonal factors, such as lack of managerial support, and lack of managerial respect, as
significant causes of conflict with peers (Bishop, 2004; Rolleman, 2001; Warner, 2001). Cox
suggested additional investigation with a larger sample in order to provide a greater
understanding of the nature of this relationship. Second, the measurement model for complexity
of nursing care showed low factor loadings possibly due to the sample being collected from one
setting in which little variability was observed. This limited the findings significantly as the
majority of measures were not used in the final model, possibly due to the small sample size.
Third, a large percent of variance of intragroup conflict was not explained in Cox’s final model.
The variables used in this present study may explain more of the variance and provide a better
understanding to the antecedents of conflict. Fourth, while Cox’s study makes sense as an
explanatory model and is supported by the literature, her study was not able to test all of the
dimensions of her model fully due to poor factor loadings in her measurement models. As a
result, she suggested the need for modifications that would better test the model. This
recommendation was addressed in this study by collecting data from a larger sample of nurses
randomly selected from multiple acute care settings, and by the inclusion of additional
indicators in a more comprehensive model of intragroup conflict. In addition to the variables
examined by Cox, this study examined dispositional characteristics, interactional justice,
managerial support, and group cohesion as antecedents of conflict, and added another
explanatory variable, agreeable style of conflict management, as a mediator variable. As a
result, this study provides a more comprehensive view of conflict within nursing settings.
Theoretical Model Used In This Study
The purpose of this study was to test a theoretical model (Figure 2) linking selected
antecedent variables to intragroup conflict, which results in conflict management (mediator
variable), and, ultimately, the selected outcome variables. Antecedents of intragroup conflict
17
include dispositional, contextual, and interpersonal characteristics. The dispositional variable
was core self-evaluation, which reflects an individual’s self-esteem, self-efficacy, locus of
control and neuroticism. The contextual variables were the complexity of nursing care and unit
size (number of beds). The interpersonal variables were perceptions of managerial support,
interactional justice, unit morale and interpersonal relations, and group cohesion. Intragroup
conflict consisted of Barki and Hartwick’s (2004) two-dimensional framework and typology of
conflict (Table 2). As previously discussed, the first dimension of their framework identifies
disagreement, interference, and negative emotion as the three properties generally associated
with conflict situations. The second dimension of the framework identifies relationship conflict
and the task content or task process as two targets of conflict encountered in organizational
settings. The outcomes of intragroup conflict were job stress and job satisfaction. Finally, the
relationship between perceived conflict and the selected outcomes was mediated by an
individual’s agreeable style of conflict management. In the next section, the model will be
discussed in more detail with a review of the empirical studies, including nursing research, that
provide rationale for the model concepts and the hypotheses.
Table 2. Barki and Hartwick’s (2004) Typology for Conceptualizing Conflict
Focus of Conflict
Task Content or Task Process Interpersonal Relationship
Prop
ertie
s of C
onfli
ct
Cognition/
Disagreement
Disagreement about what should be
done in a task or how a task should
be done
Disagreement about personal
values, views, preferences, etc
Behaviour/
Interference
Preventing the other from doing
what they think should be done in a
task or how a task should be done
Preventing the other from doing
things unrelated to a task
Affect/Negative
Emotion
Anger and frustration directed to
the other about what should be
done in a task or how a task should
be done
Anger and frustration directed to
the other as a person
Source: Cox (2008).
18
Figure 2: Theoretical Model: Antecedents and Consequences of Conflict
Antecedents Consequences
Contextual Characteristics Complexity of Nursing Care
Unit Size
Interpersonal Characteristics Managerial Support Interactional Justice
Unit Morale/Interpersonal Relations
Group Cohesion
Intragroup
Conflict
Job Stress
Core Process
Dispositional Characteristics
Core Self-evaluation
Job Satisfaction
Agreeable Style of Conflict
Management
19
Chapter 3: Theoretical Framework
In this chapter, the review is specific to intragroup or interpersonal conflict. The first
section examines the variables identified as antecedents and includes dispositional (core self-
evaluations), contextual (complexity of nursing care and unit size) and interpersonal
characteristics (managerial support, interactional justice, unit morale and interpersonal relations,
and group cohesion). The second section examines intragroup conflict as well as the mediator,
agreeable conflict management style. The third section examines the two selected outcomes,
job stress and job satisfaction. The chapter concludes with an overview of the theoretical model
and hypotheses in this study.
Antecedents of Intragroup Conflict
In her study of 141 RNs working in 13 inpatient units, Cox (1997) found that unit morale
and interpersonal relations were significant negative predictors of intragroup conflict. Three
qualitative studies recently examined conflict among acute care nurses in Canada. Nurses in all
three studies identified similar antecedents of conflict in their work environments: dispositional
characteristics, contextual factors such as workload, and interpersonal characteristics such as
lack of managerial respect, and lack of managerial support (Bishop, 2004; Rolleman, 2001;
Warner, 2001). These four studies (Bishop, 2004; Cox, 1997; Rolleman, 2001; Warner, 2001)
provide support for the hypothesized antecedents of conflict in nursing workplaces in this study.
Dispositional Characteristics
Core Self-Evaluation. A large amount of research is based on the assumption that
situational variables are perceived and responded to similarly and consistently (Peters &
O’Connor, 1980; Spector, 1982). However, how individuals respond to everyday encounters is
affected by their core beliefs about themselves and their ability to function (Judge, Locke &
Durham, 1997). A broad personality construct called core self-evaluation is based on four well-
established personality traits. Self-esteem refers to the overall value a person places on oneself
(Harter, 1990). Generalized self-efficacy refers to an individual’s ability to cope, perform, and
achieve success (Locke, McClear, & Knight, 1996). Locus of control refers to an individual’s
belief that they have control over events in their lives, rather than the events being controlled by
the environment or fate (Rotter, 1966). Neuroticism refers to how much an individual focuses
20
on their negative aspects, or has a negativistic cognitive/explanatory style (Watson, 2000).
Individuals who are well adjusted, positive and confident, with a strong belief in him/herself
have been found to be more motivated (Judge, Erez, & Bono, 1998). This suggests that core
self-evaluation may influence an individual’s decision to engage in behaviours, such as
choosing a positive style of conflict management, how much effort to expend, and whether to
persist in the face of setback or failure.
The majority of studies that have examined core self evaluations have been conducted in
the management literature. In these studies, CSE has been found to positively predict individual
outcomes including motivation to set goals, job satisfaction, less burnout, and job performance
(Erez & Judge, 2001; Judge, Bono & Locke, 2000; Best, Stapleton & Downey, 2005). In a
study with 141 hospital-based nurse managers, Laschinger, Purdy and Almost (2007) found that
CSE was a positive predictor of quality leader-member relationships, structural and
psychological empowerment, and job satisfaction for nurse managers.
While no research studies were found that examined core self-evaluation and intragroup
conflict, one study was found that examined CSE and conflict management. In a study with 678
staff nurses in community hospitals, Siu, Laschinger and Finegan (2008) found that positive
professional practice environments (autonomy, nursing model, leadership, collaboration) and
high core self-evaluations predicted constructive conflict management and, in turn, a more
effective unit. Other studies were found that linked neuroticism and conflict. After reviewing
experimental studies on personality and conflict, Terhune (1970) reported that aggressive,
dominating and suspicious personality characteristics produced more conflict, while individuals
that were more trusting and open-minded produced less conflict. In a study with college
students, Furr and Funder (1998) found that during social interactions, individuals with higher
levels of ‘personal negativity’ kept their distance from others, acted irritated, and blamed others.
As a result, their interaction partners in the study exhibited condescending behaviour, also acted
irritated, while remaining detached but dominating the interaction. Furr and Funder concluded
that if a pattern of ‘personal negativity’ was repeated over time, a person with high negativity
might live in an environment with higher levels of conflict.
In summary, an individual’s response to the everyday encounters in their worklife is
influenced by their level of confidence, belief in themselves, control in their life, and negative
cognition. Core self-evaluation may influence an individual’s belief that their actions can
21
change a situation related to conflict Individuals who are well adjusted, positive, self-
confident, and efficacious with a strong belief in themselves will bring a ‘positive frame’ to
situations and, subsequently, will experience less conflict with others, less job stress and
ultimately more job satisfaction.
Contextual Characteristics
Complexity of Nursing Care. Nurses have identified situational causes such as time
pressure and high workloads as sources of conflict (Bishop, 2004; Warner, 2001). Unit
technology is a construct that has been used to measure the dimensions and complexity of
nursing care on different nursing units (Cox, 1997; Overton, Schneck, & Hazlett, 1977; Leatt &
Schneck, 1981). In the study by Cox (1997) complexity of nursing care (unit technology) was
predicted to affect conflict, however, the complexity of care variable was not used in the final
structural model due to weak causal effects in the measurement model. Her study did find that
specialty units with higher patient acuity also indirectly reported higher levels of conflict, as
well as lower unit morale and interpersonal relations. No other studies were found that
examined the relationship between complexity of nursing care and intragroup conflict.
However, several researchers have applied the concept of unit technology to the description of
nursing care on a unit (Overton, et al., 1977; Leatt & Schneck, 1981; Alexander & Randolph,
1985; Mark & Hagenmueller, 1994; Cumbey & Alexander, 1998). While the original concept is
referred to as ‘unit technology’, unit technology and complexity of nursing care are used
interchangeably in this study, and hereafter will be referred to as complexity of nursing care.
In a study of the differences between nursing units in hospitals, Overton, et al. (1977)
conducted a factor analysis that described three dimensions related to the complexity of nursing
care: instability, variability, and uncertainty. Instability describes the fluctuation of nurses’
practice due to unpredictable changes on the unit. Variability refers to nurses’ engagement in
different tasks resulting from patient differences. Uncertainty describes the difficulty and
complexity of the work. The complexity is said to be complex when there are high levels of
instability, variability, and uncertainty. Using responses from nurses on 71 nursing units, a Q-
factor analysis showed that intensive care units were high in instability and uncertainty but low
in variability, while rehabilitation, paediatric, surgical and obstetric units were rated low in
uncertainty. Leatt and Schneck (1981) replicated this study by measuring complexity of nursing
22
care on 157 units in 24 hospitals in Alberta. Similar to the study by Overton, et al. (1977), the
factor analysis confirmed that nursing complexity had three dimensions (instability, variability,
and uncertainty) and a similar pattern of differences was found among the nursing units. In a
longitudinal study with data collected between 1980 and 1990, Alexander and Kroposki (2001)
found that the complexity of nursing care changed over the 10-year period, possibly due to the
hospital restructuring that took place during this time period. Overall, instability and
uncertainty had increased as increasing patient complexity required high levels of critical
thinking. Interestingly, variability in nurses’ tasks resulting from differences in patients
decreased, possibly due to the shortened length of stay in acute care facilities.
Leatt and Schneck (1985) examined the impact of the complexity of nursing care on
different types of stress on hospital units. In intensive care units, high instability was strongly
related to high levels of traumatic emotional stress associated with complex patients, trauma,
and death. Stress from unclear responsibilities and conflict within nursing team was a
significant problem on all units. Thirteen percent of the variance in stress was explained by
measures of nursing care complexity, unit size, environment and context. Biggest predictors of
stress were lack of cooperation among nurses, level of communication and quality of leadership.
In summary, fluctuations due to unpredictable changes, knowledge required for different
patient populations, and complex work may limit the amount of time and energy that nurses
have to resolve conflict. The complexity may also prevent the resolution of the underlying
causes of conflict (Fisher & Brown, 1988), and as a result, higher levels of conflict will exist.
Unit Size. Unit size (number of beds) has been found to affect the amount of conflict
experienced on nursing units. Size of teams has been demonstrated to make a difference. If a
group is too large, it becomes unwieldy and communication is difficult to maintain. However,
in the study by Cox (1997), units with a smaller number of beds reported higher levels of
intragroup conflict. However, a closer look revealed that the smaller units were specialty units
with higher patient acuity and higher levels of stress, as well as lower unit morale and
interpersonal relations. Cox concluded that the unit size alone did not account for the higher
levels of conflict. No other studies were found that examined the relationship between
intragroup conflict and nursing unit size. However, studies have examined the relationship
between team size and conflict. Team size (number of nurses) and unit size (number of
beds/patients) in acute care settings are related concepts as units with a larger number of beds
23
require a larger number of nurses working per shift, and, subsequently a larger team overall, to
provide nursing care to the patients.
In contrast with Cox’s (1997) findings, Amason and Sapienza (1997) found that larger
teams reported more conflict in a study with top management teams. Due to a greater number of
views and opinions, larger teams have a greater potential for dissimilarity, and less potential for
reaching a true consensus on decisions (Bantel & Jackson, 1989; Smith, Smith, Olian, Sims,
O’Bannon & Scully, 1994; Wiersema & Bantel, 1992). If a group is too large, communication
becomes difficult, which may make it difficult to resolve conflict. A larger group also
encourages the formation of subgroups, each with its informal leader, which may in turn engage
in conflict with each other (Rahim & Bonoma, 1979).
In summary, the study by Cox (1997) was the only study found that examined the
relationship between nursing unit size and intragroup conflict. Other research examining team
size and conflict has found that larger teams have more potential for dissimilarity. As the team
size increases, the ability to resolve conflict diminishes, therefore conflict is likely to occur more
frequently in larger teams, and subsequently larger units.
Interpersonal Characteristics
Managerial Support. Managerial support plays an important role in the daily work of
nurses. Professional nursing organizations identify nurse manager support of staff nurses as an
essential component of a productive, healthy work environment. Nurses value work
environments that support their ability to provide high quality patient care. Magnet hospital
research has consistently demonstrated that nurses who work in supportive work environments
have lower levels of burnout, greater job satisfaction, and lower turnover intent (Aiken, Sloane,
& Lake, 1997; Aiken, Sloane, Lake, Sochalski & Weber, 1999; Aiken, Smith, & Lake, 1994;
Chu, Hsu, Price, & Lee, 2003; Schmalenberg & Kramer, 2008; Seo, Ko, & Price, 2004).
The nurse manager’s support of nurses has been identified as one of the key factors in a
positive work environment (Choi, Bakken, Larson, Du, & Stone, 2004; Lake, 2002), however,
nurses frequently mention a lack of manager support in their work environment (Boey, 1999;
Hillhouse & Adler, 1997; Ivancevich & Matteson, 1980). Nurses look to their managers for
support and when they fail to receive this support it is seen as a betrayal (Bishop, 2004).
24
Examples include the lack of support during confrontations with physicians, being understaffed
for safe patient care, and having no input into unit decisions. In a study with 177 mental health
workers (including nurses), Leiter (1991) found that lack of managerial support resulted in
higher levels of intragroup conflict, and subsequently, emotional exhaustion. In a study by
Kramer, Maguire, Schmalenberg, Brewer, Burke, Chmielewski, et al. (2007) supportive role
behaviours were identified by 2382 staff nurses from 101 clinical units in 8 Magnet hospitals in
which staff nurses had previously confirmed excellent nurse manager support. The participants
identified the following supportive role behaviours by managers: is approachable and safe,
cares, “walks the talk,” motivates development of self-confidence, gives genuine feedback,
provides adequate and competent staffing, “watches our back,” promotes group cohesion and
teamwork, and resolves conflicts constructively.
In interviews with 20 nurses working in Australian hospitals, Lawrence and Callan
(2006) examined the different sources used by nurses when dealing with conflict, such as
managers or colleagues. Due to their perceived status, power and responsibility for resource
planning and policy implementations, managers were perceived to be a source of formal
information, such as policies and procedures as well as advice when nurses were attempting to
resolve workplace issues such as conflict. In a study with 118 nurses (25% managers),
Lawrence, Pisarski, and Callan (2005) examined the role of perceived available support in
buffering the negative effects of intragroup conflict. Perceived available support was defined as
the amount of support that individuals feel is available when a need arises (Schwarzer & Leppin,
1991). Nurses who felt a high amount of support from their managers were able to cope more
effectively with conflict in their workplace. Interestingly, individuals who felt they had a high
amount of support from their colleagues were more satisfied with their job and less stressed,
however the support from their colleagues had no effect on their coping with conflict. These
findings emphasize the importance of managers’ support when dealing with conflict.
In summary, managerial support of nurses is a key factor in a positive work
environment. When this support is not available, nurses feel betrayed and their work
environments are affected. Nurses rely on their managers to be a source of formal information
and advice that helps them cope more effectively when attempting to resolve conflict. However,
due to extensive restructuring and greatly expanded areas of responsibility and spans of control,
the role of the nurse manager has changed resulting in diminished visibility (Doran,
25
McCutcheon, Evans, MacMillan, McGillis Hall, Pringle, et al., 2004; Laschinger, Wong,
Ritchie, D’Amour, Vincent, Wilk, et al., 2008). This diminished visibility and perceived lack of
support impacts the amount of conflict among nurses within their work environment. Nurses
look to their managers for support and when they fail to receive this support, the underlying
causes of the conflict are not resolved, and subsequently, the level of conflict increases.
Interactional Justice. The study of interactional justice can be found in research on
organizational justice. This area of research has demonstrated the effects of fair treatment on
employee attitudes, such as satisfaction and commitment, and individual behaviours, such as
absenteeism (Colquitt, Conlon, Wesson, Porter, & Ng, 2001). Three categories of
organizational justice (distributive, procedural, interactional) are commonly described in the
literature, however, interactional justice is the most relevant when discussing respect. As part
of the Canadian Nursing Advisory Committee (CNAC), six focus groups were held across
Canada in 2001/2002 (Devine & Turnbull, 2002). In these focus groups, the majority of nurses
reported a lack of managerial respect in their workplaces. In addition, this lack of respect was
reflected in overwhelming workloads, lack of input into decisions impacting their units, lack of
representation on key hospital committees, lack of professional development opportunities, and
reporting to managers with no nursing background. Other studies have found similar results. In
two qualitative studies, nurses felt that their expertise, knowledge, loyalty, and hard work were
neither acknowledged nor valued by their employer (Rolleman, 2001; Warner, 2001). In a study
with 273 staff nurses from Ontario, Laschinger and Finegan (2005) reported that the majority of
nurses did not feel respected by their managers. Higher levels of structural empowerment and
interactional justice resulted in nurses feeling more respected. However, nurses who reported
lower levels of managerial respect were less likely to trust their managers, and ultimately, had
lower levels of job satisfaction and organizational commitment. VanYperen, Hagedoorn,
Zweers, and Postma (2000) found that nurses who felt they were not treated with dignity or
respect (interactional justice) by their managers were more likely to exhibit aggressive
behaviour, such as starting fights.
Bies (2001) defined interactional justice as the quality of interpersonal treatment
received by employees in their everyday encounters with managers at work. The definition
proposes four interactional justice dimensions: derogatory judgments, deception, invasion of
privacy, and disrespect. Derogatory judgments refer to the truthfulness and accuracy of
26
statements and judgments made by a manager about an employee. Examples include a manager
blaming the team for a performance failure that is really due to a bad decision by the manager or
a manager ‘bad-mouthing’ another person to create an unfavourable image of that person can
violate one’s sense of interactional justice (Bies & Tripp, 1996). Deception refers to the
correspondence between one’s words and actions. For example, when people feel ‘lied’ to, it
makes them angry and resentful (Bies, 2001). Invasion of privacy refers to the legitimacy of
disclosure of personal information about one person to another. For example, the disclosure of
confidences and secrets by one’s manager to another person is a common occurrence.
Disrespect refers to the signs and symbols conveying respect for the intrinsic value or worth of
the individual.
In summary, interactional justice refers to the way individuals are treated in their
everyday encounters at work, including the degree of respect from managers. If individuals are
treated with dignity and respect by their managers they are more likely to trust management, and
have positive reactions to workplace issues. A positive relationship with managers that is free
from derogatory judgments, deception, invasion of privacy, and disrespect enhances perceptions
of fairness (Bies, 2001; Laschinger & Finegan, 2005) and, in turn, reduces conflict-inducing
responses (Bies & Shapiro, 1987).
Unit Morale and Interpersonal Relations. Unit morale is defined as the degree to which
individuals exhibit a positive or motivated psychological state (Gemmill & Oakley, 1992;
Schwartz, 1990). High morale can result in increased productivity, whereas low morale can lead
to an increase in stress, absenteeism, professional negligence, poor professional behaviour and
poor performance (Andersson & Bateman, 1997; Castledine, 1997; Denney, 2003; Gilmore,
Ferris, Dulebohn, & Harrell-Cook, 1996). Cox (1997) found that intragroup conflict was higher
on units where nurses reported lower perceptions of unit morale and interpersonal relations.
Interpersonal relationships that form among nurses are crucial to team cohesiveness, and
the stability of this cohesion depends upon morale. Negative interpersonal relationships and
poor unit morale may result in conflict, which often leads to distrust, suspicion, and hostility
among team members that further undermines team cohesiveness and decreases satisfaction.
Conflict can also impede the exchange of information and decrease the level of commitment
between team members (Amason & Sapienza, 1997). As individuals experience increased
conflict with each other, they may find it difficult to like their co-workers and, as a result, may
27
be less willing to remain on the team (Jehn, 1995). Once employees experience frustration,
strain, and uneasiness due to perceptions of dislike of others, they typically withdraw physically
and psychologically from the situation (Jehn, 1995). If individuals are unhappy, they can
become dissatisfied with their team, which in turn can lead to lower morale.
In summary, there is little research examining the impact of unit morale on conflict.
Workplace relationships among nurses can have an impact on morale, which in turn can have an
impact on team cohesiveness. Individuals who are not motivated and have a negative view of
their work and possibly their team are less likely to work effectively as a team member, which
in turn may lead to conflict.
Group Cohesion. Group cohesion describes the measure of attractiveness of the group to
its members. If members feel accepted and liked by others, and have similar qualities, attitudes
and values, attraction is increased (Stanhope & Lancaster, 1988). In addition, how a workgroup
functions depends on the ability of the members to communicate, share responsibility in getting
the work done, and feel as if they belong to the group (Wells, Roberts, & Cagle Medlin, 2002).
Skills needed in effective teams generally fall into knowledge and technical skills and
interpersonal skills. Effective communication skills, active listening and conflict resolution
skills are important. Groups that fail to become teams may lack focus, have poor leadership, and
lack effort or commitment (Kattzenback & Smith, 1993).
In the only study found that examined group cohesion and conflict, Cram (2002)
examined the relationship among the type of Operating Room (OR) assignment (consistent
teams versus nurses who rotated among teams) and 393 OR nurses’ perceptions of job stress,
group cohesion, interpersonal conflict, job satisfaction, and anticipated turnover. OR nurses
working on teams reported greater group cohesion and less conflict than rotating nurses. Other
studies have identified group cohesion as a situational support mechanism that assists in
problem solving and enhances personal and professional integrity (Brooks, Wilkinson, &
Popkess-Vawter, 1994). Collegial relationships with other nurses to address broader situations
effecting nurses, nursing issues, and patient care has been identified by Magnet hospital staff
nurses as a key component of control over practice. Rafferty, Ball and Aiken (2001) found that
nurses with higher teamwork scores exhibited higher levels of autonomy and were more
involved in decision making. Benefits to nurses occur in environments characterized by mutual
respect, collegiality, and an exchange of knowledge and information (Hughes, Ward, Grindel,
28
Coleman, Berry, Hinds, et al., 2001). In a study examining nursing care delivery teams,
Dreachslin, Hunt and Sprainer (1999) found that cohesive teams were better performers, team
autonomy enhanced performance, and teams that collaborated and resolved conflicts were more
satisfied. Hinshaw, Smeltzer and Atwood (1987) developed a five-stage theoretical model to
specify the organizational and personal factors that predict job satisfaction and turnover of
nurses. In a study to test the model, 1597 nurses in 15 hospitals were surveyed. Nurses who
were more integrated as members of the nursing staff (high group cohesion) had higher job
satisfaction (both professional and organizational) and had lower anticipated turnover.
In summary, group cohesion refers to members of a team feeling accepted and liked by
others on the team, as well as having similar qualities, attitudes and values. How well a team
functions depends on their ability to communicate, resolve conflict, share responsibility in
getting the work done, and feel as if they belong to the group. Nurses who work on cohesive
teams are more likely to have a sense of belonging, a sense of commitment to the team, and
mutual trust and respect for each other. Shared values such as trust and respect enhance risk
taking and problem solving, such as conflict resolution.
Intragroup Conflict
While there are numerous definitions of conflict, there are three underlying themes or
properties: disagreement, negative emotion, and interference (Barki & Hartwick, 2004). In this
study, conflict is defined as a phenomenon occurring between interdependent parties as they
experience negative emotional reactions to perceived disagreements and interference with the
attainment of their goals (Barki & Hartwick, 2001). Barki and Hartwick’s (2004) two-
dimensional framework of conflict is used to represent the main construct of the theoretical
model, specifically intragroup conflict. The first dimension of their framework identifies
disagreement, interference, and negative emotion as the three properties generally associated
with conflict situation. The second dimension of the framework identifies relationship conflict
and the task content or task process as two targets of conflict encountered in organizational
settings. In addition to Barki and Hartwick’s framework, conflict management style is also
included in the theoretical model in this study. Conflict scholars have made a strong case for
separating the occurrence of conflict from the way individuals manage conflict (De Dreu,
Harinck & Van Vianen, 1999; Pondy, 1992; Pruitt, 1998; Thomas, 1992; Tjosvold, 1998).
29
Therefore, in this study the occurrence of intragroup conflict is conceptualized to impact the
style of conflict management chosen by nurses to resolve the conflict.
Barki and Hartwick’s Framework
Based on a comprehensive review of studies that assessed the level or amount of
conflict, Barki and Hartwick (2004) found that conflict was conceptualized by combining these
three themes in different ways: (a) disagreement; (b) negative emotion; (c) disagreement and
negative emotion; (d) interference; (e) interference and disagreement; (f) interference and
negative emotion; and (g) disagreement, interference, and negative emotion.
As discussed in chapter two, the results of Barki and Hartwick’s (2001) study of
Information Systems Development (ISD) teams provided empirical support for the three
dimensions of interpersonal conflict. The results supported the hypothesized model with 95% of
the variance in individuals’ perceptions of conflict (as measured through assessment of conflict
frequency and intensity) were explained by perceptions of disagreement, negative emotion, and
interference. The authors concluded that it is an individual’s perception of the simultaneous
presence of all three properties that invariably leads to their interpretation of a situation as one
of conflict.
The second dimension examines the types of conflict. Relationship conflicts, an
awareness of interpersonal incompatibilities, include affective components such as feeling
tension and friction. Relationship conflict involves personal issues such as dislike among
individuals and feelings such as annoyance, frustration, and irritation (Jehn, et al., 2000). In
contrast, task conflicts are disagreements among individuals about the content of the task being
performed, including differences in viewpoints, ideas, and opinions. Task conflicts may
coincide with animated discussions and personal excitement but, by definition, are void of the
intense interpersonal negative emotions that are more commonly associated with relationship
conflict. The most frequently reported task conflicts concern distribution of resources,
procedures or guidelines, and interpretation of facts (Jehn, 1995, 1997). Task process conflicts
occur when determining how task accomplishment should proceed, who’s responsible for what,
and how things should be delegated (Jehn & Mannix, 2001). While task conflict focuses on the
content and the goals of the work, process conflict focuses on how tasks would be accomplished
(Jehn, 1997). For example, when group members disagree about whose responsibility it is to
30
complete a specific duty, they are experiencing process conflict. The more diverse a group’s
values, the more likely they are to experience process conflict (Jehn, 1992).
Research has shown that the three types of conflict have different consequences or
outcomes. Relationship conflict produces negative emotional reactions in individuals such as
anxiety, mistrust, or resentment (Jehn, 1995), frustration, tension, and fear of being rejected by
other team members (Murnigham & Conlon, 1991). High relationship conflict also creates
dysfunction in teamwork, diminishes commitment to team decisions, decreases organizational
commitment (Jehn, et al., 1999), raises communication problems within team members (Baron,
1991), diminishes work satisfaction (Jehn, 1995; Jehn, et al., 1997), and increases stress levels
(Friedman, et al., 2000).
In contrast, task conflict has been associated with several beneficial effects, such as
improving the quality of ideas and innovation (Amason, 1996; West & Anderson, 1996),
increasing constructive debate (Jehn, et al., 1999), facilitating a more effective use of resources,
and leading to better service provision (Tjosvold, et al., 1992). However, other studies have
shown that task conflict may also have harmful effects by decreasing individuals' perceptions of
teamwork and job satisfaction (Kabanoff, 1991; Jehn, et al., 1997), increasing anxiety (Jehn,
1997) and increasing the propensity to leave (Jehn, 1995). Jehn (1992) found that process
conflict was associated with a lower level of group morale as well as with decreased
productivity.
In an attempt to reduce or resolve the conflict, individuals adopt general strategies or
styles of conflict management. The style of conflict management chosen by individuals depends
in part on their perception of disagreement, interference, negative emotions, as well as the type
of conflict. Research has shown that task conflict has a positive and negative influence on
outcome variables, but relationship conflict has a predominantly negative influence (De Dreu &
Weingart, 2003). Members of teams who become mired in relationship conflict typically
exhibit declines in satisfaction, liking of other team members, and intentions to stay (Amason,
1996; Jehn, 1995, 1997; Jehn & Mannix, 2001) because it produces tension and antagonism (De
Dreu & Weingart, 2003). When attempting to manage relationship conflict defensive behaviours
are initiated that restrict open discussion of ideas. The anger, stress and other negative emotions
associated with relationship conflict quickly generates less-than-affable perceptions of the other
individual. These perceptions include misunderstandings, perceiving the opponent's behaviour
31
as harmful, the inability to see the opponent's perspective (Blake & Mouton, 1984), and
questioning their intentions. During and after conflict, attitudes towards the opponent generally
become more negative (Bergman & Volkema, 1989). Therefore individuals may be more likely
to use ‘negative’ or less agreeable styles of conflict management, such as avoidance or
domination. The level of conflict also affects an individual’s selection of conflict management
style. Barki and Hartwick (2001) found that individuals working in teams with high levels of
conflict were more likely to manage conflict through domination or avoidance (components of a
disagreeable style) rather than collaboration (component of an agreeable style). They argued
that due to high levels of conflict, individuals are hesitant to become involved in an open
discussion to resolve the situation. Instead, individuals are more likely to avoid discussing the
situation due to fear or anxiety, or choose to dominate as a way of controlling the situation.
Conflict Management Style
A review of the nursing literature found that several studies have examined the conflict
styles of women at various levels of management and gender differences in managing conflict.
The results of these studies have shown that staff nurses predominantly use avoidance when
managing conflict (Cavanagh, 1991; Eason & Brown, 1999; Hightower, 1986; Marriner, 1982).
In the study by Valentine (1995) staff nurses indicated that they use avoiding as their main style
for handling conflict as a way of preventing open confrontation and preserving relationships.
Hightower (1986) found that nurses increase their use of avoidance when in a subordinate role
while Woodtli (1987) found that nurses in supervisory positions used compromise as their most
frequent style. Barton (1991) also suggested that the style of conflict management varied
depending on the level of position held, with the most frequently used mode being
compromising, followed by collaborating. In contrast, Eason and Brown (1999) found that
both managers and staff nurses used avoidance more than the other styles, followed by
accommodation.
The study of conflict also seems to suggest that women respond differently to conflict
than men (Valentine, 1995). Marriner (1982) and Barton (1991) found female nurses use more
avoidance and less collaboration than their male counterparts in business settings. However,
Rahim (1983) found that female managers in business and industry were more integrating,
avoiding and compromising and less obliging than their male counterparts. Finally, Valentine
(1995) found that women were more likely to consider the interests of others, utilizing more
32
compromising and tactful strategies, whereas men preferred competitive and aggressive
strategies.
Recently, Morrison (2008a) examined the relationship between emotional intelligence
and preferred conflict-handling styles of 94 nurses. Higher levels of emotional intelligence (EI)
was positively related with a collaborating style but negatively related with an accommodating
style. Interestingly, there was no relationship between EI and an avoiding conflict-handling
style. In another study examining the relationship between different personality factors of 97
female nurses and their method of dealing with conflict, Whitworth (2008) found no relationship
between conflict management and the personality factors of extraversion/ introversion,
sensing/intuition, thinking/feeling and judging/perceiving. The author suggested that the work
environment has more of an influence on conflict management style than personality factors.
In general, conflict management has been studied extensively with much of this work
being built on Blake and Mouton’s (1964) typology of management styles, which suggests five
specific styles of managing conflict: collaborating, accommodating, compromising, avoiding
and dominating (Rahim, 1983; Pruitt & Rubin, 1986; Thomas, 1992). Alternative
classifications have been suggested by other researchers (Sternberg & Dobson, 1987; Thomas,
1976), resulting in confusion over the appropriate dimensions underlying conflict management.
Sternberg and Dobson (1987) examined the nature of the structure that underlies conflict
resolution. Students rated their own styles as well as the styles of others when dealing with
conflict in a variety of situations. Based on a factor analyses by Sternberg and Dobson (1987),
agreeableness and activeness were conceptualized as orthogonal dimensions that captured
behaviour during conflict resolution. Next, Van de Vliert and Euwema (1994) constructed a
metataxonomy with these two higher order categories, agreeableness and activeness, which
incorporated the dimensional model of Sternberg and Dobson (1987) and the five styles of
conflict management developed by Blake and Mouton (1964). Van de Vliert and Euwema
(1994) argued that agreeableness and activeness were appropriate factors for describing and
comparing modes of conflict management, even when the modes were from different
taxonomies. They further suggested that this two-dimensional structure allows researchers to
examine conflict behaviour along a continuum as opposed to restricting investigation of conflict
management behaviour to five distinct (and presumably independent) styles. Research has
shown this continuum to be related to job satisfaction and job performance (DeChurch & Marks,
33
2001), and that each of the five distinct styles could be identified along each continuum (Van de
Vliert & Euwema, 1994). More detail is provided below.
Activeness and Agreeableness
According to Van de Vliert and Euwema (1994), activeness describes the extent to
which there is discussion or confrontation resulting in a responsive and direct form of conflict
management. Individuals who use an active style openly discuss differences of opinion, voice
their concerns, exchange information to solve problems together, however they may also
dominate the conflict episode by firmly pursuing their own sides of disagreements.
Agreeableness is the extent to which there is acceptance, understanding and concurrence
resulting in a pleasant and relaxed atmosphere. Individuals using agreeable conflict
management are more likely to integrate one another’s ideas and try to satisfy the expectations
of everyone, which makes their work environment less conflict-laden over time. Disagreeable
is the extent to which help is withheld, with outright rejection resulting in an unpleasant and
strained atmosphere (Van de Vliert & Euwema, 1994). Individuals who use a disagreeable style
focus on having their own ideas or needs met, or they choose to avoid the conflict altogether.
In the study by Van de Vliert and Euwema (1994), trained observers watched videotaped
conflict episodes and evaluated the conflict behaviours used along the two dimensions of
agreeableness and activeness, as well as, Blake and Mouton's (1964) five styles. Their results
provided support for the two dimensions. Correlations between observer ratings of Blake and
Mouton's five styles of conflict management and the dimensions of activeness and agreeableness
showed the five styles could be described in order of increasing activeness: avoiding,
accommodating, dominating, compromising, and collaborating and in order of increasing
agreeableness: competing, compromising, avoiding, accommodating, and collaborating.
In a field survey with 96 business school project groups, DeChurch and Marks (2001)
examined the influence of group conflict management on group effectiveness, as well as the
moderating role of group conflict management on task conflict and two outcomes, group
performance and group satisfaction. Using an agreeable style of conflict management in
response to task conflict resulted in greater group satisfaction. When task conflict was managed
with an active style, the relationship between task conflict and group performance was positive
but this same relationship was negative when the task conflict was managed passively.
34
Similarly, the relationship between task conflict and group satisfaction was positive when
managed with an agreeable style of conflict management but negative when a neutral or
disagreeable style was used
Prior research has found that actively managing conflict positively influences work
performance, especially when dealing with task conflict (DeChurch & Marks, 2001). Team
members are focused on the content of a task and work goals, therefore actively discussing
differences in viewpoints, ideas, and opinions, or firmly pursuing one’s own side of the
disagreement improves the quality of the team decisions without impacting the relationships on
the team. However, research has shown that an agreeable style of conflict management is more
effective in resolving relationship conflict and maximizing the quality of the relationship
between individuals (Van de Vliert, Euwema, & Huismans, 1995). When the conflict is about
interpersonal incompatibility, accepting and understanding one another’s needs and expectations
improves the quality of the relationships while still resolving the conflict. Because the focus of
this study is on intragroup conflict, which is similar to relationship conflict, only the agreeable
style of conflict management is included.
Mediator or Moderator
According to Baron and Kenny (1986), a mediator is a variable that changes in relation
to the independent and dependent variables, while a moderator does not necessarily change in
relation to the independent variable. Conflict management styles are chosen by individuals to
match situations and vary depending upon an individual’s perceptions of disagreement,
interference, negative emotions, as well as the type of conflict. Therefore, it is logical to
hypothesize that an individual’s style of conflict management is a mediator variable. Mediation
implies a causal sequence among three variables. A mediation model identifies and clarifies the
mechanism that underlies an observed relationship between an independent variable and a
dependent variable via the inclusion of a third explanatory variable, known as a mediator
variable. Specifically, the theoretical model in this study hypothesizes that the style of conflict
management is the mechanism that underlies the relationship between nurses’ perceptions of
intragroup conflict and job stress and job satisfaction.
In comparison to the current study, DeChurch and Marks (2001) examined task conflict,
in a field survey of 96 business school project groups, modeling conflict management as a
35
moderator of the relationship between conflict and group satisfaction and group performance.
In contrast to relationship conflict, findings concerning task conflict are not as conclusive with
research finding both positive and negative outcomes. According to Baron and Kenny (1986),
moderator variables are typically introduced when there is an inconsistent relationship between
a predictor and a criterion variable. Mediation is used in the case of a strong relationship
between the predictor and criterion variable, or where there is a theoretical rationale for these
effects. This has been consistently shown in the research examining relationship conflict and
negative outcomes. In this current study, conflict management style will be examined as a
mediator between intragroup conflict and the selected outcomes, job stress and job satisfaction.
In summary, the development of several typologies and models of conflict management
have resulted in confusion in the underlying dimensions (DeChurch & Marks, 2001). In an
attempt to integrate and extend previous models, Van de Vliert and Euwema (1994) constructed
a metataxonomy with two higher order categories, agreeableness and activeness, however
agreeableness has been shown to be more effective when managing relationship conflict, the
focus of this study. The conflict literature has shown that it is the style of conflict management
that determines whether conflict has positive or negative effects. Essentially, this states that
nurses who use an agreeable style of conflict management will have lower levels of job stress
and higher levels of job satisfaction than those who use a disagreeable style.
Outcomes
Conflict has been found to affect nurses in many ways. In several studies, conflict has
been identified as a source of stress within nursing work environments (Bishop, 2004; Dijkstra,
Van Dierendonck, & Evers, 2005; Gardner, 1992; Rolleman, 2001). In addition, Cox (2003)
found that high levels of intragroup conflict resulted in job dissatisfaction. No studies were
found that examined the agreeableness style of conflict management in nurses. Studies that
have examined the relationship between conflict, conflict management style, and outcomes are
described below.
Job Stress
Stress is defined as a non-specific body response to any demand, either due to or because
of unpleasant conditions (Selye, 1976). When compared to conflict with patients or doctors,
36
nurses report that conflict with other nurses is the most stressful (Lawrence & Callan, 2006),
and leads to increased anxiety, emotional strain and physical strain (Gray-Toft & Anderson,
1981; Hillhouse & Adler, 1997). Nurses who are highly stressed also report lower levels of job
satisfaction, organizational commitment, and higher intent to leave their job (Irvine & Evans,
1995; McNeese-Smith, 1997; Parsons, 1998). In a longitudinal study with 5582 non-nurses
examining the relationship between conflict at work and self-reported health outcomes and
occupational mobility, De Raeve, Jansen, van den Brandt, Vasse and Kant (2009) found that co-
worker conflict was a significant predictor of poor general health and turnover from the
organization.
Van de Vliert, Euwema, and Huismans (1995) found that agreeableness was positively
related to relational outcomes such as mutual trust and the quality of the personal relationship,
while disagreeable behaviours were negatively related to these same outcomes. Individuals who
use an agreeable style of conflict management are more likely to integrate one another’s ideas
and try to satisfy the expectations of everyone, leading to more positive relationships, and less
tension. In contrast, individuals who use a disagreeable style use influence to get their own
ideas or needs met, or they may choose to avoid the conflict altogether. As a result,
relationships with colleagues are more likely to be strained, resulting in higher levels of job
stress.
In summary, conflict with other nurses is a significant stressor for nurses, resulting in
emotional and physical strain. Research has shown that being in conflict with co-workers brings
about strong feelings of unpleasantness and, ultimately stress. Nurses who use an agreeable
style of conflict management are more likely to have less stress in their work environment due
to their ability to integrate one another’s ideas and to satisfy the expectations of others.
Job Satisfaction
Satisfaction in the workplace occurs when employees experience happiness with the job
(Hackman & Oldham, 1975). Research suggests that job dissatisfaction is a significant cause of
the current nursing shortage (Andrews & Dziegielewski, 2005; Crow, Smith, & Hartman, 2005).
In the United States, Aiken, Clarke, Sloane, Sochalski, Busse, et al. (2001) found job
dissatisfaction for hospital nurses to be four times greater than for the average occupation. In
addition, one in five nurses planned on leaving their job within one year. Other research has
37
low levels of job satisfaction results in higher absenteeism (Cowin, 2002), attrition (Westendorf,
2007) and turnover (Andrews & Dziegielewski, 2005; Cowin, 2002; Westendorf, 2007).
Kleinman (2004) identified a significant relationship between effective leadership
characteristics, staff nurse satisfaction, and retention.
Studies have also found that high levels of conflict are significantly related to job
dissatisfaction with pay (Cox, 2003) and job dissatisfaction in general (Gardner, 1992). Several
studies have also found a significant relationship between workplace relationships and job
satisfaction (Cox & Kerfoot, 1990; Sofield & Salmond, 2003; Tovey & Adams, 1999). Adams
and Bond (2000) found that job autonomy and good interpersonal relationships with the
manager and colleagues predicted higher levels of job satisfaction. Recent studies have found
that nurses experiencing conflict with other nurses have considered leaving their profession
(Bishop, 2004; McKenna, et al., 2003), their current position (Bishop, 2004; Lambert, et al.,
2004), and reducing their hours of work (Warner, 2001). New nursing graduates in New
Zealand reported high levels of conflict one year after graduation, resulting in lower self-esteem
and increased absenteeism (McKenna, et al., 2003).
A more agreeable approach to conflict management has been found to result in improved
interpersonal relations (Rubin, Pruitt, & Kim, 1994), and higher levels of job satisfaction (Pruitt
& Rubin, 1986; Tjosvold, 1997). In a field survey of 96 business school project groups,
DeChurch and Marks (2001) found that agreeable conflict management was associated with
greater group satisfaction, while disagreeable conflict management resulted in dissatisfaction.
In addition, stress levels have also been shown to be directly related to job satisfaction. In two
separate meta-analyses, Irvine and Evans (1992) and Blegen (1993) identified several factors
contributing to nursing job satisfaction. Significant factors in both studies were job stress, the
relationship with their manager, communication with manager, age and years of experience.
In summary, there is empirical evidence to suggest that individuals who use an agreeable
style of conflict management are more likely to be satisfied with their jobs while those who use
a disagreeable style are more likely to be dissatisfied. There is also evidence from two meta-
analyses supporting a negative relationship between job stress and job satisfaction.
38
Overview of Theoretical Framework
The purpose of this study is to test a theoretical model (Figure 3) linking selected
dispositional, contextual and interpersonal characteristics to intragroup conflict, which results in
conflict management (mediator variable), and, ultimately, selected outcome variables. The
dispositional characteristic is core self-evaluation (self-esteem, self-efficacy, locus of control,
emotional stability). The contextual characteristics are complexity of nursing care and unit size
(number of beds). The interpersonal characteristics are perceptions of managerial support,
interactional justice, unit morale and interpersonal relations, and group cohesion. Intragroup
conflict includes the nurse’s perception of disagreement, interference, negative emotions, as
well as the type of conflict. The selected outcomes are job stress and job satisfaction. Finally,
the relationship between perceived conflict and the selected outcomes is mediated by an
individual’s agreeable style of conflict management.
Hypotheses
Individuals’ responses to the everyday encounters in their work life are influenced by
their level of confidence, belief in themselves, control in their life, and negative cognition. Core
self-evaluation may influence an individual’s decision to engage in behaviours related to
conflict, how much effort they choose to expend on the conflict, and whether to persist in the
face of setback or failure of conflict resolution. Individuals who are positive, self-confident, and
perceive themselves as efficacious, will be happier in their jobs, and less likely to experience
conflict with others. Therefore, it is hypothesized that:
Hypothesis 1: Nurses’ perceptions of core self-evaluation are negatively related to
intragroup conflict within nursing units.
Fluctuations due to unpredictable changes, different knowledge for different patient
populations, and complex work may limit the amount of time and energy that nurses have to
resolve conflict. The complexity of nursing care may also prevent the resolution of the
underlying causes of conflict (Fisher & Brown, 1998), and as a result, higher levels of conflict
will exist. Therefore, it is hypothesized that:
Hypothesis 2: Nurses’ perceptions of the complexity of nursing care are positively
related to intragroup conflict within nursing units.
39
Figure 3: Theoretical Model: Antecedents and Consequences of Conflict
Antecedents Consequences
Contextual Characteristics Complexity of Nursing Care
Unit Size
Interpersonal Characteristics Managerial Support Interactional Justice
Unit Morale/Interpersonal Relations
Group Cohesion
Intragroup
Conflict
Job Stress
Core Process
Dispositional Characteristics
Core Self-evaluation
Job Satisfaction
Agreeable Style of Conflict
Management
40
Team size (number of nurses) and unit size (number of beds/patients) in acute care
settings are related concepts as units with a larger number of beds require a larger number of
nurses working per shift, and, subsequently a larger team overall, to provide nursing care to the
patients. Unit size has been found to affect conflict. Larger teams have more potential for
dissimilarity and, because the ability to resolve conflict diminishes as numbers rise, conflict is
likely to occur more frequently. If a group is too large, communication may become difficult to
maintain, resulting in more conflict. Therefore it is hypothesized that:
Hypothesis 3: The size of nursing units is positively related to intragroup conflict within
nursing units.
Managerial support has been identified as one of the key factors in a positive work
environment (Choi, et al., 2004; Lake, 2002). Lack of managerial support can result in higher
levels of intragroup conflict (Leiter, 1991). Nurses rely on their managers to be a source of
formal information and advice that helps them cope more effectively when attempting to resolve
workplace issues, including conflict (Lawrence & Callan, 2006; Lawrence et al., 2005). When
managers do not provide this support, the underlying causes of the conflict are not resolved, and
subsequently, the level of conflict increases. Therefore it is hypothesized that:
Hypothesis 4: Nurses’ perceptions of managerial support are negatively related to
intragroup conflict within nursing units.
Nurses care deeply about how they are treated in their everyday encounters at work. If
nurses are treated with dignity and respect by managers they are more likely to trust
management, and have positive reactions to workplace issues. Trusting nurses’ judgments,
respecting their choices and decisions, and communicating with them truthfully and honestly
enhances perceptions of fairness (Bies, 2001) and, in turn, reduces conflict (Bies & Shapiro,
1987). Therefore, it is hypothesized that:
Hypothesis 5: Nurses’ perceptions of interactional justice are negatively related to
intragroup conflict within nursing units.
Workplace relationships among nurses can have an impact on morale, which in turn can
have an impact on team cohesiveness. Individuals, who are motivated with a positive view of
41
their work and possibly their team, are more likely to work effectively as a team member, which
in turn may lead to less conflict. Therefore, it is hypothesized that:
Hypothesis 6: Nurses’ perceptions of unit morale and interpersonal relations are
negatively related to intragroup conflict within nursing units.
Nurses who work on cohesive teams are more likely to feel accepted and liked by others
on the team, as well as having similar qualities, attitudes and values. As a result they are more
likely to experience a sense of belonging, a sense of commitment to the team, and mutual trust
and respect for each other. Team members who trust and respect each other are more likely to
take risks and resolve problems, which in turn leads to the resolution of conflict. Therefore, it is
hypothesized that:
Hypothesis 7: Nurses’ perceptions of group cohesion are negatively related to
intragroup conflict within nursing units.
Intragroup conflict includes the individual nurse’s perception of disagreement,
interference and negative emotions, as well as the type of conflict. As the individual becomes
emotionally involved in the conflict the affective states or feelings that may be experienced
during conflict are mistrust, threat, hostility, fear (Filley, 1975), anxiety, tenseness, frustration or
hostility (Robbins, 1979). The conflict is then enacted through behaviours which take the form
of disagreement and interference. The style of conflict management chosen by individuals
depends in part on the level of conflict as well as their perception of the disagreement and
interference by another and the generation of negative emotions. When attempting to manage
relationship conflict defensive behaviours are initiated that restrict open discussion of ideas.
The anger, stress and other negative emotions associated with relationship conflict quickly
generates less-than-affable perceptions of the other individual. These perceptions include
misunderstandings, perceiving the opponent's behaviour as harmful, the inability to see the
opponent's perspective (Blake & Mouton, 1984), and questioning their intentions. Therefore
individuals are more likely to use ‘negative’ or less agreeable styles of conflict management,
such as avoidance or domination. In addition, in situations with high levels of conflict,
individuals are hesitant to become involved in an open discussion to resolve the situation.
Instead, individuals are more likely to avoid discussing the situation due to fear or anxiety, or
choose to dominate as a way of controlling the situation.
42
Hypothesis 8: Nurses’ perceptions of intragroup conflict are negatively related to the
agreeable style of conflict management.
The conflict literature has shown that it is the style of conflict management that
determines whether conflict has positive or negative effects. Research has shown that being in
conflict with co-workers brings about strong feelings of unpleasantness. Nurses who use an
agreeable style of conflict management are more likely to have less stress and higher job
satisfaction due to their ability to integrate one another’s ideas and to satisfy the expectations of
others. Therefore it is hypothesized that:
Hypothesis 9: Conflict management style will mediate the relationship between
intragroup conflict and the selected outcomes, job stress and job satisfaction.
Specifically, an agreeable style of conflict management will cause lower levels of job
stress and higher levels of job satisfaction.
Job stress has also been found to be a significant predictor of job satisfaction (Irvine &
Evans, 1992; Blegen, 1993). When individuals are upset with one another, they experience
negative emotions, which, in turn, lead to personal frustration (Thomas, 1976) and job
dissatisfaction (Filley, 1978; Robbins, 1978). Therefore it is hypothesized that:
Hypothesis 10: Nurses’ perceptions of job stress are negatively related to their
perceptions of job satisfaction.
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Chapter 4: Methods
A predictive non-experimental survey design was used to test the proposed theoretical
model linking dispositional (core self-evaluation), contextual (complexity of nursing care and
unit size), interpersonal characteristics (managerial support, interactional justice, unit morale
and interpersonal relations, and group cohesion), intragroup conflict, style of conflict
management (mediator), and the selected outcomes (job stress and job satisfaction). This
chapter describes the setting, methods and procedures that were used to implement the study.
The sample, instruments, data collection methods, data analysis process, ethical considerations
and risks and benefits are also discussed.
Setting and Sample
Criteria for Sample Selection
The inclusion criteria were registered nurses (RN) working as full-time or part-time staff
nurses on inpatient units across all specialties in acute care hospitals in Ontario. The exclusion
criteria were RNs who did not work as staff nurses or work in non-inpatient units (including
outpatient departments, ambulatory care) or non-acute care hospitals.
To test the theoretical model for the first time, a sample of only registered nurses (RNs)
working on inpatient units was used to reduce the likelihood of extraneous variables having an
impact on the research results, for instance different roles and working relationships between
RNs and Registered Practical Nurses and other health care professionals. Inpatient units and
acute care hospitals were chosen because the majority of RNs work on inpatient units in acute
care settings and RNs are the largest group of health care providers within these organizations.
In 2008, there were 120,265 nurses registered with the provincial registry and employed in
nursing in Ontario. Seventy-six percent (n=91,965) were registered nurses with 66% working as
staff nurses, 65% working in hospitals, and 58% working in acute care hospitals (College of
Nurses of Ontario, 2008).
Sample and Sample Size
The College of Nurses of Ontario database was used to obtain a random sample of RNs
who met the criteria. Six-hundred participants were randomly selected by a staff member at the
44
College of Nurses of Ontario (CNO) from an annual registration list of full-time and part-time
registered nurses, working on all specialty inpatient units within acute care hospitals in Ontario,
who gave prior consent to be approached for research studies. The names and home mailing
addresses of each participant were then forwarded to the investigator who distributed a
recruitment package to all names on the list (more details below). While all practising nurses
within Ontario must be registered with the College of Nurses, only the names of those nurses
who agree to participate in research studies were are included in the list of eligible participants
for this study. This use of self-selected nurses may have introduced sample selection bias into
the study results. This will be discussed further in the limitations section in Chapter 6.
The sample size calculation was based on the assumption that the proposed model would
be tested using path analysis techniques with maximum likelihood estimation within a structural
equation modeling technique. For such testing, it is recommended that the sample size
calculation be based on a minimum of 15 cases per measured variable or indicator (Bentler &
Chou, 1987; Stevens, 1996). Sample sizes of 200 are recommended to maintain the accuracy of
the estimates in determining the degree of fit between the data and the proposed model (Hoyle,
1995). However, it is also recommended that a larger sample be collected beyond the minimum
sample size in case there are missing data. As there were 18 indicators in the model, a minimum
of 270 cases were required. To compensate for a 40 to 50% response rate commonly found in
survey research (Polit & Hungler, 1995), a total of 600 participants were sent surveys, to ensure
that data from a sufficient number of respondents were available for the analysis.
The sample size calculation in this study was based on the assumption that all of the
variables, except intragroup conflict, would be modelled as manifest variables and measured by
a single indicator. With the exception of intragroup conflict, all of the variables were measured
using well-established scales that have undergone prior psychometric testing. A single indicator
may be acceptable if the researcher is confident in the measure's validity and reliability (Garson,
2009). More details are provided in the instrument section. Intragroup conflict was modelled as
a latent variable with eight indicators. The measure of intragroup conflict was recently
developed by Cox (2008) and, at the time of this study, had only been tested in one study using
an exploratory factor analysis. Therefore, with intragroup conflict being the main focus of this
study, it was decided to conduct a more thorough investigation of the underlying constructs of
the intragroup conflict scale using confirmatory factor analysis.
45
Data Collection Procedure
Each participant was mailed via Canada Post a survey package containing a letter of
information, the questionnaire and a researcher-addressed, stamped envelope to be returned to
the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto. The letter of
information (Appendix A) explaining the study purpose, participant’s confidentiality and
anonymity, and researcher contact information were included. As a token of appreciation, a
voucher from a popular coffee shop was included. As suggested by Dillman (2000), a follow-up
reminder letter was sent to non-respondents two weeks after the initial mailing, followed by a
final mailing three weeks later with a follow-up letter, replacement questionnaire, and return
envelope. Each questionnaire was coded to enable follow-up with non-respondents.
Participants were assured that their responses were confidential and code numbers were used
only for follow-up purposes.
Data Collection Instruments
The survey consisted of the following: dispositional characteristics (core self-evaluation),
unit characteristics (complexity of nursing care and unit size), interpersonal characteristics
(managerial support, interactional justice, unit morale/interpersonal relations and group
cohesion), intragroup conflict, conflict management style, outcomes (job stress and job
satisfaction) and demographic items. With the exception of the Intragroup Conflict Scale, all of
the instruments used in this study are in the public domain and can be obtained from the
citations listed in the references. Enquiries regarding the Intragroup Conflict Scale should be
directed to Dr. Kathleen Cox (2008).
Core Self-Evaluation
Core self-evaluation was measured using the 12-item Core Self-Evaluation Scale (CSES)
(Judge, Bono, Erez, & Thoresen, 2003). The scale consists of four dimensions with three items
in each subscale. Self-esteem describes the overall value a person places on oneself (Harter,
1990). Generalized self-efficacy refers to an individual’s belief about their ability to cope,
perform, and achieve success (Locke, et al., 1996). Locus of control describes an individual’s
belief they have control over events in their lives, rather than the events being controlled by the
environment or fate (Rotter, 1966). Neuroticism refers to how much an individual focuses on
46
their negative aspects, or has a negativistic cognitive/explanatory style (Watson, 2000).
Participants rate their level of agreement or disagreement with each item on a five-point Likert
scale with 1 representing ‘strongly disagree’ and 5 representing ‘strongly agree’.
In a literature review involving the measurement of individual core traits, Judge, et al.
(2003) generated a list of 65 items covering the range of core self-evaluation described by these
four well established traits. Scale items were chosen based on four criteria: 1) the items
adequately described the content domain covered by the four traits; 2) the scale was reliable, and
the items were significantly correlated to each other; 3) items were significantly correlated with
job satisfaction, life satisfaction, and job performance, and; 4) the scale was short enough to be
useful. In all, 12 items matched these four criteria.
In this study, the Cronbach alpha for the entire scale was .81. In a series of independent
studies with employees, managers and students, Judge, et al. (2003) found the CSES to be a
reliable scale with Cronbach alphas ranging from .81 to .87 for the subscales. The results from
these studies also supported the validity of the measure. The CSES correlated with each of the
four core traits, demonstrating convergent validity. In addition, the CSES was significantly
correlated in independent studies with three of the focal criteria in industrial-organizational
psychology: job satisfaction, job performance and life satisfaction. The results from these
studies also indicated that the 12-item CSES displayed a unitary factor structure. The difference
in chi-square tests showed the four-factor model was not significantly different from the single-
factor model in any of the samples. Therefore, the 12-items load on a single dimensional
construct with the 12-items being summed and averaged. A high score indicates a high level of
core self-evaluation.
Complexity of Nursing Care
Nurses’ perceptions of the complexity of nursing care was measured by a 21-item Unit
Technology questionnaire developed by Leatt and Schneck (1981), which incorporates the
dimensions of uncertainty (10-items), instability (8-items), and variability (3-items).
Uncertainty describes the degree of difficulty and complexity of work, which is reflected in the
patients’ illnesses and treatments, the social-psychological nature of nursing care and the
changes in tasks due to changes in the patient’s conditions. Instability describes the fluctuation
in nurses’ practice due to the unpredictable changes arising from patients’ conditions. This is
47
reflected in frequent nursing observations, multiple tests, technical equipment, time pressures,
and frequent emergencies. Variability refers to the unpredictability from variations among
patients and their nursing care needs, reflected by the variety of patient’s problems, nursing
care, and nurses’ decisions.
Overton, Schneck and Hazlett (1977) developed the original 34-item questionnaire to
measure nursing subunit technology. A factor analysis resulted in a three-factor orthogonal
solution explaining 61 percent of the variance in observed scores. The three factors were
interpreted as uncertainty, instability, and variability. Thirteen items were removed because
they did not contribute to identifying the technology dimensions. Leatt and Schneck (1981)
repeated this study using the revised 21-item questionnaire. The results were similar to the
original study, with a three-factor solution explaining 66.5 percent of the variance in subunit
responses. The reliability (Cronbach alphas ranging from .82 to .90) and validity of this
instrument have been tested in acute care, psychiatric and community health settings (Alexander
& Bauerschmidt, 1987; Alexander, 1996; Cumbey & Alexander, 1998).
In this study, the 21-item questionnaire developed by Leatt and Schneck (1981) was used
to measure individual nurses’ perceptions of complexity of nursing care. The original
instrument used a 5-point Likert scale with respondents indicating the percentage of time each
item was present with 0 representing 5%, 6 representing 25%, 26 representing 50%, 51
representing 75% and 76 representing 100%. Factor scores were transformed to have means of
25 and standardized deviations of 5. Leatt and Schneck calculated composite scores by
summing each of the responses for each subscale. Further analysis showed that the composite
scores and the associated factor scores were highly correlated. Therefore, the authors
concluded, a reliable and valid measure of the complexity of nursing care could be obtained
more simply by totalling subunit’s responses rather than obtaining factor scores. Alexander and
Randolph (1985) further revised the 5-point Likert scale with 1 representing 5% and 5
representing 100%. The items are summed and averaged. This format was used in this study
with a high score representing units with high levels of instability, variability, and uncertainty.
In this study, the Cronbach alpha for the entire scale was .82.
48
Unit Size
Unit size was measured by number of beds staffed on the unit. This is the same measure
used in the study by Cox (1997).
Managerial Support
Managerial support was measured using the 8-item measure of Supportive Supervision
developed by Oldham and Cummings (1996) to describe employee perceptions of the extent to
which they receive supervisory support. When managers are supportive, they show concern for
an employee’s feelings and needs; encourage them to voice their concerns; provide positive
feedback; and facilitate skill development (Deci, Connell & Ryan, 1989). An exploratory factor
analysis confirmed the unitary factor structure (Oldham & Cummings, 1996). The coefficient
alpha was .86. Supportive supervision was correlated positively with job complexity and
employee performance ratings, and also correlated negatively with intentions to quit.
Participants rate their level of agreement with each statement on a seven-point Likert scale with
1 representing ‘strongly disagree’ and 7 representing ‘strongly agree’. The items are summed
and averaged with a high score indicating a high level of support. In this study, the Cronbach
alpha for the entire scale was .92.
Interactional justice
Interactional justice was measured using the 17-item measure of interactional justice
developed by Roch and Shanock (2006). Participants rate their level of agreement with each
statement on a five-point Likert scale with 1 representing ‘strongly disagree’ and 5 representing
‘strongly agree’. The items are summed and averaged with a high score indicating a high level
of interactional justice.
As discussed in chapter 3, Bies (2001) recently provided an updated conceptualization of
interactional justice with a wider variety of interpersonal treatment experienced by employees in
their everyday work encounters. Four content areas were identified: derogatory judgments,
deception, invasion of privacy, and disrespect. Based on this revised definition, Roch and
Shanock (2006) developed a new measure of interactional justice. To ensure content validity,
the authors followed a procedure based on Hinkin’s (1995) recommendations. To assess each of
the content areas, multiple items were written independently by each author, and then reviewed
49
together. Items that were the most representative of each content area were retained. The final
scale consisted of 17 items with four items in each content area and 1 general item, “My
supervisor treats me fairly.” A principal axis factor analysis indicated a single factor accounting
for 48.8% of the variance in observed scores. Using Nunnally’s (1978) recommended cut-off of
.45 for factor loadings, all items met the criteria for retention. The lowest factor loading was .48.
The internal consistency reliability of the measure was .96. In this study, the Cronbach alpha
for the entire scale was .90.
Unit Morale and Interpersonal Relations
Unit morale and interpersonal relations were measured using 2 items from the measure
of team performance effectiveness developed by Weisman, Gordon, Cassard, Bergner, and
Wong (1993). The entire scale was developed following a review of the theoretical literature
and specific information collected from five focus groups (one consisting of managers only) that
were conducted to determine the characteristics and the impact of a professional practice model
on their nursing unit. Using item analysis and factor analysis, Weisman, et al. developed a four
factor multi-item scale tapping into the dimensions of unit-work process (participation in
decision-making, control of work schedule, coordination of care, and team performance).
The team performance effectiveness scale was the only subscale used in the study by
Cox (1997); however, the measurement model resulted in the elimination of two indicators
(quality of patient care provided by nurses and spirit of teamwork on unit). The reliability for
the 4-item measure was .85. Only two of these four questions examined unit morale and
interpersonal relations while the other two examined the efficiency of nurses’ work and nurses’
willingness to help if unit is understaffed. As the focus of this study was on unit morale and the
interpersonal relationships among nurses, only the two items measuring unit morale and
interpersonal relations were used. The Cronbach alpha for the two item scale was .76. Nurses
were asked to rate their unit’s morale and interpersonal relations, using a five-point Likert scale
with 1 representing ‘very much below average’ and 5 representing ‘very much above average’.
The items were summed and averaged with a high score indicating a high level of unit morale
and interpersonal relations.
50
Group Cohesion
Group cohesion was measured using the 8-item Work-Group Cohesiveness Scale
(Riordan & Weatherly, 1999). This scale assesses the degree to which individuals believe that
the members of their work groups are attracted to each other, willing to work together, and
committed to the completion of the tasks and goals of the work group (Bass, 1960; Stogdill,
1972). Riordan and Weatherly (1999) originally conducted a study to develop a conceptually
and methodologically sound measure of employee identification with the work group, which
included a measure of group cohesiveness, identification and communication. Only the group
cohesiveness scale will be discussed here.
A three-phase analysis approach was used to develop the measure of employee
identification. First, a content analysis was conducted with subject matter experts (SMEs) in the
field of organizational behaviour and psychology who were asked to verify that the items in the
scale actually reflect the construct definition. The items were presented in random order, and the
SMEs were asked to match items with definitions. All items were correctly categorized into
their respective theoretical constructs at least 80% of the time by the SMEs. Second, an
exploratory factor analysis of the factor structure was conducted using a sample of employees
from a credit union (n=140). Principal components analysis with orthogonal (varimax) rotation
was used to examine the factor structure of the 17 items measuring work identification. Three
factors emerged with eigenvalues greater than 1, which together accounted for 69.2% of the
variance in the data. The 8 items from the work cohesiveness scale loaded on one factor and
accounted for 48.2% of the variance. Finally, confirmatory analyses using LISREL 8 were
conducted with a sample of employees derived from four insurance organizations (n=309). The
analysis showed the three-factor model generally represented a good fit to the data (CFI = .93,
TLI = .92, PNFI = .76, RMSEA = .072) with all of the factor loadings >.57 for the group
cohesiveness scale. The scale scores showed acceptable levels of internal consistency in both
samples (r = .94; r = .92, respectively). In this study, the Cronbach alpha for the entire scale
was .96.
Intragroup conflict
Intragroup conflict was measured using the revised 48-item Intragroup Conflict Scale
(Cox, 2008). Participants rated their level of agreement with each statement on a five-point
51
Likert scale with 1 representing ‘strongly agree’ and 5 representing ‘strongly disagree’. The
items are summed and averaged with higher scores indicating higher perceptions of intragroup
conflict within the immediate work group.
In her dissertation, Cox (1997) developed the original 26-item Intragroup Conflict Scale
(ICS) based on the framework developed by Wall and Callister (1995) and described in chapter
two. The ICS was recently revised by Cox (2008) by incorporating Barki and Hartwick’s
(2004) dimensions into the core process of Wall and Callister’s framework. Barki and Hartwick
(2004) define conflict as a dynamic process that occurs between interdependent parties as they
experience negative emotional reactions to perceived disagreements and interference with the
attainment of their goals. They further argued that the conflict process consists of 1) three
dimensions: the amount or level of conflict, the extent to which the respondent perceives
disagreement and interference, and has negative feelings; and 2) three possible types: task
content, task process, and/or relationship. In the original ICS, factor 1, opposition processes and
negative emotion, was similar to the dimensions of interference and negative emotion proposed
by Barki and Hartwick (2004). Therefore the items from this original subscale were kept and
revised slightly for the new scale. In addition, forty-one items were generated and a 2-member
panel with expertise in scale construction and organizational theory evaluated the items and the
new subscales. Both experts were in 100% agreement that the items were content valid. The
eight new subscales consisted of 1) disagreement related to work itself (7-items); 2)
disagreement related to work process (9-items); 3) disagreement related to interpersonal
incompatibilities (5-items); 4) interference related to work itself (9-items); 5) interference
related to interpersonal incompatibilities (2-items); 6) negative emotions related to work itself
(9-items); 7) negative emotions related to interpersonal incompatibilities (4-items); and 8)
frequency and intensity of conflict (3-items).
The scale was pilot tested with a sample of 430 nurses working in a large acute care
hospital to evaluate the psychometric properties of the scale. An exploratory factor analysis was
completed using principal components analysis (PCA) with varimax rotation. The initial
analysis of the 48-item scale suggested an eight factor solution explaining 69.4% of the variance
in observed scores. Fourteen items were eliminated due to cross loadings. A second analysis
suggested a 6-factor solution that explained 68.4% in observed scores. In this analysis, two
factors, frequency and intensity and interference related to interpersonal incompatibilities did
52
not meet the criteria and 3 items were eliminated due to cross-loadings. A third and final
analysis suggested a 6-factor solution that explained 71.9% of the variance in observed scores.
The final 6-factor scale consisted of 31-items with Cronbach’s alpha of .95 for Factor
1(Interference related to work, 7 items), .89 for Factor 2 (disagreement related to work process,
6 items), .95 for factor 3 (negative emotions related to work, 5 items), .90 for factor 4 (negative
emotions related to interpersonal incompatibilities, 5 items), .79 for factor 5 (disagreement
related to the work itself, 5 items), and .82 for factor 6 (disagreement related to interpersonal
incompatibilities, 3 items).
Additional study was recommended by Cox (2008) to test these items further, and to
evaluate the psychometric properties. Therefore, in this study the 48-item scale was used, and a
confirmatory factor analysis (CFA) was conducted. The CFA results are described in chapter 5.
The Cronbach alpha for each of the subscales in the current study ranged from .70 to .93 and .97
for the entire scale.
Conflict management style
Conflict management style was measured using the Rahim Organizational Conflict
Inventory-II (ROCI-II) (Rahim, 1983), which consists of 28 items measured on a 5-point Likert
scale that ranges from 1 ‘strongly agree’ to 5 ‘strongly disagree’. The dual-concern model
(Blake & Mouton, 1964; Pruitt & Rubin, 1986; Rahim & Bonoma, 1979) distinguishes the
styles of handling conflict along two dimensions, concern for self (high/low) and concern for
others (high/low). Combining the two dimensions results in five styles of conflict management:
collaborating (7-items), avoiding (6-items), competing (5-items), accommodating, (6-items),
and compromising (4-items). Scores are summed and averaged with participants receiving an
individual score for each style, and higher scores representing greater use of a conflict style.
The original items in the ROCI-II were constructed from a study with MBA and
undergraduate students and managers. After completing a questionnaire consisting of 105
items, participants took part in focus groups to evaluate each item for difficulty, ambiguity and
inconsistency. Next, several factor analyses were conducted with items being discarded or
rephrased if loading below .40 or loading on an uninterpretable factor. The final scale contained
35 items with seven items to measure each of the five styles. Using the 35-item measure, a
study was completed with 1219 executives. A factor analysis extracted eight factors, with the
53
first five factors being consistent with a priori expectations regarding the five styles. Other
factors were deleted due to loadings below .40 or loading on an uninterpretable factor.
Subsequent tests of the stability of these five factors in different subsamples, found similar
results. Therefore, the final instrument contained 28 items with factor loadings > .40. The test-
retest reliabilities of the subscales ranged from .60 and .83 and the internal consistency
reliability coefficient for each subscale ranged from .72 and .76. Other studies have shown
acceptable internal consistency reliabilities for the subscales ranging from .68 to .90 (Friedman,
et al., 2000; Rahim, Antonioni, & Psenicka, 2001; Tidd & Friedman, 2002). A number of
studies have supported the criterion validity of the instrument (Lee, 1990; Pilkington,
Richardson, & Utley, 1988).
Chanin and Schneer (1984) provide a method for representing the agreeable dimension
of conflict behaviour. In their calculation, individual items for the collaborating, dominating,
avoiding, and accommodating subscales are summed and averaged to form four separate scales.
The collaborating and accommodating scales are summed together, and the competing and
avoiding scales are summed together. The agreeableness index is formed by subtracting the
second sum from the first (Collaborating + Accommodating) - (Competing + Avoiding). The
index ranges from –8 to + 8 with higher scores representing higher levels of agreeableness.
Individuals using agreeable conflict management integrate each other’s ideas by collaborating
and trying to satisfy everyone’s expectations. In this study, the Cronbach alpha for each of the
subscales ranged from .73 to .88.
Job Stress
Job stress was measured using a modified version of the Perceived Stress Scale (PSS)
(Cohen, Kamarck, & Mermelstein, 1983), which consists of six items measured on a 5-point
Likert scale that ranges from 1 ‘never’ to 5 ‘very often’. The PSS is a global measure of
perceived stress that measures individuals’ general experience of stress. The original scale
consisted of 14 items designed to measure individuals’ feelings and thoughts related to stress
over the past month. In a study with two independent samples of college students, Cohen, et al.
(1983) found that the PSS was significantly correlated with life-events scores, physical and
depressive symptomology, health services utilization, social anxiety (difficulty making friends
and social contacts), and smoking cessation, providing evidence of convergent validity. Test-
retest correlation was .85 and the Cronbach alpha was .84 to .86.
54
Using a modified version of the measure, Friedman, et al. (2000) reduced the scale to six
items with a focus only on stress experienced at work. The reference to ‘in the last month’ was
also removed from the original version. Reported Cronbach alphas for the six-item scale have
ranged from .83 (Tidd & Friedman, 2002) to .90 (Friedman, et al., 2000). Items are summed and
averaged with a high score representing high levels of stress. In this study, the Cronbach alpha
was .82.
Job Satisfaction
Job satisfaction was measured using a global measure of work satisfaction (Laschinger
& Havens, 1996), which measures an employee’s overall satisfaction with their jobs. Adapted
from Hackman and Oldham’s (1975) Job Diagnostic Survey (JDS), the scale consists of four
items measured on a Likert scale that ranges from 1 ‘strongly disagree’ to 5 ‘strongly agree’.
The Job Diagnostic Survey was developed by Hackman and Oldham (1975) to assess
five job characteristics across organizations and is based on their theory examining the impact of
job characteristics on employee motivation. According to Hackman and Oldham’s theory of job
characteristics, individuals who find meaning in their work, feel accountable for their work, and
know how effectively they perform their job are more likely to have positive outcomes,
specifically internal work motivation, growth satisfaction, general satisfaction, and work
effectiveness (Hackman & Oldham, 1980). The 5-item general satisfaction scale describes the
degree to which employees are satisfied and happy with their job.
Using a modified version of the general satisfaction scale in a study with staff nurses,
Laschinger and Havens (1996) reduced the scale to 4-items and modified the items to a health
care setting. A confirmatory factor analysis revealed a good fit of the hypothesized factor with
standardized factor loadings of .68 to .81 (Laschinger, Finegan, Shamian & Wilk, 2001). The
modified scale has been used in several nursing populations and has been found to have good
internal consistency with Cronbach alpha’s ranging from .82 to .84 (Laschinger, Almost, &
Tuer-Hodes, 2003; Laschinger, Finegan & Shamian, 2001; Laschinger, et al., 2001, Laschinger
& Havens, 1996). In this study, the Cronbach alpha was .85.
55
Demographics
A short demographic survey was used to collect information about participants’ age,
highest level of nursing education, years in nursing, years employed on current unit, work status
(full-time/part-time), and type of current unit (medical/surgical, ICU, etc). Participants were
also asked to indicate who they experienced the most conflict with: nursing coworkers,
managers/ administration, patients, patient’s family, doctors, other health care professionals and
an ‘other’ category. This question provides the opportunity to compare the results of this study
with recent qualitative studies that found nurses identify their managers and nursing colleagues
as the most common sources of conflict (Bishop, 2004; Warner, 2001).
Data Analysis
The data were entered into a SPSS data file and double checked by two individuals for
data entry errors. Several data analysis techniques were used to address the research question.
First, descriptive statistics (e.g., means, standard deviations, and percentages) were calculated to
provide basic information about the scales used in this study and to provide a description of the
sample. Second, to analyze the relationships among factors, product-moment correlation
coefficients (also known as a Pearson r) were utilized. Pearson’s correlation is used to test the
strength of linear relationships between variables (Gall, Gall & Borg, 2003). Product-moment
correlation was selected because the variables being tested were considered to be continuous.
The significance levels were set at .05. Next, to analyze the strength of the relationships
between each of the dimensions presented in the proposed conceptual model, structural equation
modeling (SEM) analysis techniques were used. The Analysis of Moment Structures, or AMOS,
computer program was used to test the hypothesized model (Arbuckle, 2005). To meet the
several assumptions required by structural equation modeling, the data were first checked for
missing data, outliers, univariate and multivariate normal distributions, multicollinearity and
reliability.
Missing Data
Missing data can decrease power and bias standard errors and loading coefficients
(Allison, 2003; Patrician, 2002). If extensive data are missing for certain variables, the data
should be examined to determine if the data are missing at random or if there is a pattern to the
56
missing data based on some other factor. For this study, established criteria were used to
identify missing data: missing values (≥5%) and the Little’s Missing Completely at Random
Test (MCAR) (Tabachnick & Fidell, 2001). Cohen and Cohen (1983) suggest that 5% or even
10% of missing data are not particularly large but percentages greater than this should be
studied further. In this study, all missing data was at the individual item level. The only
variable with missing data at the variable level was unit size with 11 missing cases (4.3%). In
addition, the findings from the missing values analysis identified only one variable with missing
values exceeding the 5% criterion with 6.5% of the participants not reporting their specialty
area. Missing values for the remaining variables ranged from 0 to 4.3%. The higher percentage
of missing data for specialty area was not a concern as this variable was used only for
descriptive purposes and not included in the structural equation model.
The pattern of missing data is also very important. For Little’s MCAR Test, the null
hypothesis is that the missing data are random. If the MCAR test findings are significant
(MCAR = χ² value, p < .05) then the missing data are not random and should be examined
further (Allison, 2003; Patrician, 2002). In this study, findings from Little’s MCAR Test was
non-significant (χ²[df1978] = 2075.14, p = 0.63) indicating that the missing values were missing
at random and no further examination is required. This implies that participants with missing
observations differ only by chance from those who have scores on that variable and that the
results based on data from participants with non-missing observations can be generalized to
those with missing data (Kline, 2005). no imputation of missing data was therefore pursued.
Outliers
Univariate outliers are defined as cases with an ‘extreme’ value on a single variable.
There is no absolute definition of ‘extreme’, however, a common rule of thumb is that scores
more than three standard deviations away from the mean are considered to be ‘extreme’ outliers
(Kline, 2005). The SEM analysis is sensitive to the effects of extreme outliers as covariance
matrices are negatively influenced (Bollen, 1989; Kline, 2005). SPSS Box Plots were used to
identify extreme outliers for each of the individual items. No extreme cases were found on any
of the individual items.
Multivariate outliers are defined as cases with extreme values on multiple variables
(Kline, 2005; Tabachnick & Fidell, 2001). Mahalanobis Distance (D²) was used to identify
57
multivariate outliers (Muthen, 1994; Tabachnick & Fidell, 2001) in the measurement models
and structural equation model. This analysis measures the distance of a case from the centroid
(multidimensional mean) of a distribution, given the covariance (multidimensional variance) of
the distribution (Kline, 2005). Within large samples, the squared Mahalanobis Distance is
interpretable as χ² statistics with degrees of freedom equal to the number of variables included in
the calculation. By comparing the squared Mahalanobis Distance of a particular case against the
appropriate critical value of χ², one can determine whether the case differs significantly from the
rest. The level of significance (p = .001) is a conservative criteria, but recommended by
Tabachnick & Fidell (2001). The squared Mahalanobis Distance was assessed in each of the
confirmatory factor analyses and the structural equation analyses. Cases with a calculated χ²
value that exceeded the critical chi-square were deleted and are discussed in more detail in the
results section.
Distribution normality
Skewness and kurtosis are two ways that a distribution can be non-normal. Well
established skewness and kurtosis statistics were used to identify univariate distribution
normality. Typically, skewness statistics ≤ 3 and kurtosis statistics ≤ 8 reflect normality (Kline,
2005; Tabachnick & Fidell, 2001). In this study, the values for skewness for the items ranged
from 0.06 to 1.27, while values for kurtosis ranged from -0.01 to 1.62. Therefore the data were
normally distributed.
Multicollinearity
Multicollinearity is defined as bivariate correlations between variables that are extremely
high (r>.85) (Bollen, 1989; Tabachnick & Fidell, 2001). This results in increased standard
errors and unstable loading coefficients among the multicollinear variables (Bollen, 1989;
Tabachnick & Fidell, 2001). Utilizing indicators which are highly correlated breaks an
underlying assumption of SEM that indicators used for measurement are independent. Assessing
for highly correlated indicators is critical in SEM given the use of latent variables formed
through combining multiple indicators to measure a single concept (Kline 2005; Garson 2009).
The findings indicated that no bivariate correlations among the major study variables were
greater than or equal to .85 therefore there was no multicollinearity. However, the analysis did
show high correlations among two sets of predictors: interactional justice and managerial
58
support (r = .76) as well as unit morale/interpersonal relations and group cohesion (r = .66).
This is examined further in the analysis of the structural equation model. Specific results are
provided in the results section for each of the analyses.
Reliability
Scale reliability is defined as the proportion of variance in participants’ scores on an
instrument due to true differences in their scores (Polit & Beck, 2004). Reliability reflects the
consistency of items over time, tests, and groups (Kline, 2005; Nunnally & Bernstein, 1994).
For this study, internal consistency coefficients (Cronbach’s alphas) were calculated for each of
the major study variables. Generally, Cronbach’s alphas ≥.70 are considered acceptable (Kline,
2005; Polit & Beck, 2004). In this study, the Cronbach alphas ranged from .70 to .97 indicating
that the instruments’ items and subscales were reliable.
Structural Equation Modeling Analysis
To analyze the strength of the relationships between each of the variables presented in
the proposed conceptual model, structural equation modeling (SEM) analysis techniques were
used. SEM was selected for numerous reasons. First, SEM is a multivariate technique, used in
the building and testing of theoretical models, that simultaneously estimates relationships
between independent variables and dependent variables (Ullman, 1996). Second, unlike other
traditional multivariate techniques, SEM has the ability to model constructs as latent variables,
allowing measurement error to be captured in the model and controlled for in the analysis
(Baron & Kenny, 1986; Hoyle & Smith, 1994). SEM can accommodate the bias in the estimates
due to the measurement error associated with imperfect measures by using multiple indicators
for all latent variables. As a result, SEM can provide more precise parameter estimates and
increased statistical power. Third, SEM estimates indirect effects as well as direct effects
among latent variables that allow for the estimation of the total effect. The path diagram in the
SEM helps to clearly present the direction of each effect and the covariances among all
variables in one complete picture (Hair, et al., 1998; Kline, 1998). The two-step approach to
SEM was employed in this study, which involves first evaluating the measurement model and
then evaluating the structural model (Anderson & Gerbing, 1998).
59
Measurement Model
The measurement model first specifies the relationships among latent variables
(unobserved variables or constructs) and their indicators (observed variables or manifest
variables), e. g., how the latent variables are measured in terms of the observed variables,
including description of the measurement properties (validity and reliability) of the observed
variables (Kline, 1998). A single indicator may be acceptable if the researcher is confident in
the measure's validity and reliability (Garson, 2009). If the researcher is not confident then a
factor analysis is used to evaluate the nature and validity of the major constructs by determining
the underlying dimensionality of a large number of items (Polit & Hungler, 1999). In this study,
only the measure of intragroup conflict underwent factor analysis. As mentioned earlier in this
chapter, all of the variables in this study were measured using well established scales with prior
factor analyses completed, except for the measure of intragroup conflict. The measure of
intragroup conflict was recently developed by Cox (2008) and, at the time of this study, had
only been tested in one study using an exploratory factor analysis. Therefore, since intragroup
conflict is the main focus of this study, it was decided to conduct a more thorough investigation
of the underlying constructs, specifically using confirmatory factor analysis. In this study, a
confirmatory factor analysis (CFA) was first used to test the conceptual framework based on a
priori theoretical considerations. These analyses are discussed in more detail in the results
section.
Confirmatory Factor Analysis
Confirmatory factor analysis (CFA) is used when the researcher has specific
expectations regarding the factors, and when there is well-developed theory supporting loading
patterns. With CFA, one is able to first predict the model, evaluate the fit of this model through
goodness of fit indices, and explore possible modifications to the model. Similar to structural
equation modelling, there are a number of fit indices that can be used to evaluate the overall
model fit. These are described in more detail in the next section.
Structural Equation Model
The structural equation model specifies the relationships among the latent variables, and
describes the causal effects and amount of unexplained variance. The latent variables could be
60
either endogenous or exogenous, and each has its own measurement equation. While exogenous
latent variables act only as predictors or causes for other latent variables in the structural model,
endogenous latent variables are the dependent or outcome variables in at least one causal
relationship. The structural equation model uses the covariance and variances of the factors to
estimate a causal system of relationships among them. As mentioned previously, each
construct, except for intragroup conflict, was modelled as a manifest variable and measured by a
single indicator. Intragroup conflict was modelled based on the results of the confirmatory
factor analysis which will be described in more detail in the next chapter. In addition, based on
previous research, it was expected that there would be significant relationships between several
of the exogenous variables (antecedents); therefore covariances were included among the
exogenous variables (Garson, 2009).
The structural equation modeling procedure generally consists of four steps. Step 1 is
the specification of the theoretical model either as a set of equations or as a diagram (Figure 4).
Error terms are assigned to each endogenous variable. The line from the error term to the
endogenous variable represents the combined effects of all the causes of that variable that are
not being studied. In structural equation modeling with AMOS, it is necessary to initially assign
an arbitrary value to a regression weight associated with the error term. This allows the
measurement scale to be set. By setting the paths from each error term to 1 initially, the model
can be identified and the variance coefficients of the error terms can be determined (Arbuckle &
Wothke, 1999; Garson, 2009).
Step 2 is the identification of the model to ensure that the model can be estimated with
observed data. A model is said to be identified if it is theoretically possible to calculate a unique
estimate of every one of its parameters (Kline, 1998). There must be at least as many
observations as model parameters are a basic requirement for identification. An overidentified
model is optimal with the number of ‘knowns’ (observed variable variances and covariances)
being greater than the number of ‘unknowns’ (parameters to be estimated). For an
overidentified model, the difference between observations and estimated parameters should
result in degrees of freedom greater than zero (Kline, 2005; Pedhazur & Schmelkin, 1991).
Thus, in SEM software output, the listing for degrees of freedom (df) for model chi square is a
measure of the degree of overidentification of the model. In this study, the model is
overidentified with 113 degrees of freedom (df) in the structural equation model.
61
Figure 4. Structural Equation Model
Intragroup Conflict
Frequency and
Intensity
Core Self-Evaluation
Complexity of Nursing Care
Unit Size
Managerial Support
Interactional Justice
Unit Morale &
Interpersonal Relations
Job Stress
e1
e11
e2
e4
Job Satisfaction
e10
Agreeable Style of Conflict
Management
e9
Group Cohesion
Disagreement Work Process
Disagreement Work Itself
Disagreement Work Related
Interference Interpersonal
Negative Emotions
Work Related
Negative Emotions
Interpersonal
Disagreement Interpersonal
e3
e5
e6
e7
e8
62
Step 3 is the estimation of the model's parameters using AMOS. Estimation of model fit
yields values which indicate how well the model fits the data overall (fit statistics) as well as
parameter estimates which indicate the strength of the hypothesized relationships between
variables. Using the parameters of the estimated model, the correlations or covariances between
measured variables are predicted, and compared to the observed correlations or covariances
(Kenny, 1998). Maximum likelihood estimation (MLE or ML) makes estimates based on
maximizing the probability (likelihood) that the observed covariances are drawn from a
population assumed to be the same as that reflected in the coefficient estimates. That is, MLE
picks estimates which have the greatest chance of reproducing the observed data.
Step 4 is the evaluation of overall model fit. AMOS generates goodness of fit measures
for three versions of the structural model. The saturated model which is the fully explanatory
model with as many parameter estimates as degrees of freedom. Most goodness of fit measures
will be 1.0 for a saturated model, but since saturated models are the most un-parsimonious
models possible, parsimony-based goodness of fit measures will be 0. Some measures, like
RMSEA, cannot be computed for the saturated model at all. The independence model is one
which assumes all relationships among measured variables are 0, including correlations among
the latent variables and all paths in the structural model. Where the saturated model will have a
parsimony ratio of 0, the independence model has a parsimony ratio of 1. Most fit indexes will
be 0, whether of the parsimony-adjusted variety or not, but some will have non-zero values (ex.,
RMSEA, GFI) depending on the data. The default model is the theoretical or structural model
which is always more parsimonious than the saturated model and almost always fitting better
than the independence model with which it is compared using goodness of fit measures. That is,
the default model will have a goodness of fit between the perfect explanation of the trivial
saturated model and terrible explanatory power of the independence model, which assumes no
relationships (Kline, 1998). The goal is to find the most parsimonious model which is not
significantly different from the saturated model and fully explains the data (Garson, 2009).
There are a number of fit indices that can be used to evaluate the overall model fit. Kline
(1998) recommends at least four tests be used, such as chi-square (χ²) (Jöreskog & Sörbom,
1989), Comparative Fit Index (CFI) (Bentler, 1988), Incremental Fit Index (IFI) (Bollen, 1989),
Goodness of Fit Index (GFI) (Jöreskog & Sörbom, 1993) and Root Mean Square Error of
Approximation (RMSEA). Chi-square (χ²) is used as a goodness of fit measure to test the
63
proposed model's covariance structure against the observed covariance matrix. Unlike the more
familiar uses of the chi-square statistic where one is looking for a large statistically significant
value to support a theoretically posited relationship, one is looking for a small, nonsignificant
chi-square (Kline, 1998). The small chi-square provides evidence that the specified model and
the investigator's data are congruent rather than different (Hoyle, 1995). There are three
problems with the chi-square test as a fit index: 1) it is extremely sensitive to sample size. The
larger the sample size, the more likely the rejection of the model and the more likely a Type II
error (Kline, 2005); 2) model size also has an increasing effect on chi-square values. Models
with more variables tend to have larger chi-squares; and, 3) its values are not interpretable in a
standardized way as its lower bound is always zero but theoretically it has no upper bound.
Because of these reasons, many researchers who use SEM believe that with a reasonable sample
size (> 200) and good approximate fit as indicated by other fit tests from a cross section of
categories (discussed below), the significance of the chi-square test may be discounted and that
a significant chi-square is not a reason by itself to modify or reject the model (Byrne, 1998;
Kline, 2005; Pedhazur & Schmelkin, 1991). These categories of fit indices include absolute fit
indices, incremental fit indices and residual fit indices.
In addition to chi-square, other absolute fit indices include the Goodness of Fit Index
(GFI) and the likelihood ratio (χ²/df). The GFI is a measure of the relative amount of the
observed variances and covariances explained by the model, and vary from zero to 1. The
Likelihood ratio is a non-central parameter that takes sample size into account. Wheaton,
Muthen, Alwin and Summers (1977) suggested a higher upper limit which is greater than or
equal to 5, but most literature suggests a more stringent criterion of 3 (Bollen, 1989).
Incremental fit indices compare the existing model with a null or independence model,
which assumes the latent variables in the model are uncorrelated. The covariance matrix
predicted by the model is compared to the observed covariance matrix, and the null model
(covariance matrix of 0's) is compared with the observed covariance matrix, to gauge the lack of
fit between the null model and the default model. The Bentler Comparative Fit Index (CFI)
varies from 0 to 1 with values close to 1 indicating a very good fit. According to Kline (1998), a
value greater than or equal to .90 is indicative of a good fit. CFI and RMSEA are among the
measures least affected by sample size (Fan, Thompson, & Wang, 1999). The Tucker-Lewis
Index (TLI) is another well-known measure that adjusts for model complexity and is less
64
affected by sample size. However, unlike the CFI, the TLI is moderately corrected for
parsimony: its value estimates the relative improvement [in fit] per degree of freedom over a
baseline model (Hoyle & Panter, 1995). A TLI close to 1 indicates a good fit. Rarely, some
authors have used a cut-off as low as .80 since TLI tends to run lower than GFI. However, more
recently, Hu and Bentler (1999) have suggested TLI ≥ .95 as the cut-off for a good model fit and
this is widely accepted (Schumacker & Lomax, 2004) as the cut-off.
Residual fit indices include the RMSEA which is a popular measure of fit that is less
affected by sample size (Fan, Thompson, & Wang, 1999). Taking into account the error of
approximation in the population, the RMSEA assesses the extent to which a model, with
unknown but optimally chosen parameter values, fits the population covariance matrix (Browne
& Cudeck, 1993). A range of findings reflects model fit (RMSEA ≤ .05 = excellent fit; RMSEA
≤ .08 = acceptable fit; and RMSEA ≥ = .10 = poor fit) (Kline, 2005).
Modification indices (MI) are often used to alter models to achieve better fit, but model
adjustments must be done carefully and be based on sound theoretical rationales. MIs are
calculated for every parameter in the model that is fixed to zero. The greater the value, the
greater the decrease in the model’s overall chi-square, and, ultimately, the better the overall
model fit (Kline, 1998). A common strategy is to add the parameter with the largest MI, then
see the effect as measured by the chi-square fit index. However, even very small discrepancies
may trigger an MI flag, so the researcher should also take into account the effect size of the
arrow to be added as indicated by the parameter change, not just the fact that it is significant by
MI. That is, blind use of MI runs the risk of capitalization of chance and model adjustments
which make no substantive sense (Silvia & MacCallum, 1988).
Direct, indirect, and total effects of the independent variables on the dependent variables
were examined. Hoyle (1995) describes the direct effect as the directional relation between two
variables. An indirect effect is the effect of the independent variable on a dependent variable
through a mediating variable. The total effect is the sum of the direct and indirect effect of an
independent variable on the dependent variable. Effect size for standardized path coefficients
with absolute values of less than .30 are considered a small effect, .30 to .50 a medium effect,
and greater than .50 as a large effect (Kline, 1998).
65
To test the mediation effects of agreeableness using structural equation modelling, the
steps outlined by Iacobucci, Saldanha, and Deng (2007) were followed. In step one, the SEM
analysis is completed to allow the direct and indirect paths to be fit simultaneously. If the
coefficients from the independent variable (IV) to the mediator variable and from the mediator
variable to the dependent variable (DV) are significant then ‘some’ mediation is occurring and
the researcher should go to step two. If either coefficient is not significant than there is no
mediation and no further analysis is done. In step two, a test is conducted to examine the
relative sizes of the indirect (mediated) versus direct paths. As recommended by Baron and
Kenny (1986), Sobel’s test is performed using the interactive calculation tool for mediation tests
(Preacher & Leonardelli, 2003). The Sobel test determines the significance of the indirect effect
of the mediator by testing the hypothesis of no difference between the total effect and the direct
effect. If the Sobel test is significant and the direct path between the independent and dependent
variable is not significant, then the mediation is complete. If both the Sobel test and the direct
path between the independent variable and dependent variable are significant, then the
mediation is ‘partial’.
Ethical Considerations
Prior to implementation of the study, ethical approval was obtained from the University
of Toronto Research Ethics Board. The College of Nurses of Ontario requires ethical approval
from the academic institution to access information from their database. No participating
individuals are identified by name in any report or presentations of the study results. Results of
the study are presented for the total sample in a way that does not identify any participant.
Participants were identified with code numbers and a master code list was kept in safekeeping at
the University of Toronto in a locked file cabinet separate from the raw data.
66
Chapter 5: Results
In this chapter, the study findings are presented. First, characteristics of the sample are
described. Then descriptive statistics of the study variables are discussed and the measurement
model presented. Finally, the analysis of the structural equation model is presented.
Characteristics of the Sample
Of the 600 surveys mailed, 311 were returned. Thirty-four surveys were not included in
the analysis: six surveys were returned with address unknown, one survey was returned as
participant was deceased, one participant had retired, 10 participants did not meet the study
criteria with one working casual and nine working in non-acute or outpatient settings, and 16
surveys were returned blank indicating the participants did not want to participate. The final
sample was 277, for a response rate of 47.6%.
Ontario Region Distribution
Nurses from across the province participated in the study. There were 38.6% (n=107)
working in Central Ontario (e.g., Barrie, Collingwood, Tobermory), 21.7% (n=60) in
Southwestern Ontario (e.g., Hamilton, Windsor, St. Catherines), 19.1% (n=53) in Eastern
Ontario (e.g., Ottawa, Cornwall, Kingston), 11.9% (n=33) in the greater Toronto area, and 8.7%
(n=24) in Northern Ontario (e.g., Sault Ste. Marie, Sudbury, Thunder Bay and Timmins).
Demographics
The majority of participants were female (98.2%), primarily educated at the diploma
level (71.5%) and worked full-time (68.7%). The participants ranged in age from 23 to 65 years
with an average age of 42 years (SD=10.54). Overall, nurse participants in this study averaged
17.8 years of nursing experience with 9 years on their current unit. The years of nursing
experience ranged from 9 months to 45 years and years on current unit ranged from 3 months to
38 years. The majority of nurses worked on medical/surgical units (39.8%), followed by critical
care units (32.8%), emergency departments (13.9%), maternal child units (8.9%) and psychiatry
(4.6%). Nurses identified managers/ administration (25.3%) and nursing coworkers (24.9%) as
the group with whom they experience the most conflict, followed closely by patients’ families
(24.5%). More details about all of the demographics are provided in Appendix B.
67
The demographics are similar to The College of Nurses of Ontario’s (2008) profile with
the exception of age. In the current survey, respondents were slightly younger. Of the RNs
reporting employment in nursing in Ontario in 2008, 95.4% were female (95.4%), 64.7%
worked full-time and the average age was 46.1 years. The demographic results are consistent
with other profiles of registered nurses who have participated in research in Ontario. In a study
conducted with 3,156 nurses from 217 hospital units in 21 hospitals across Ontario, Laschinger,
Finegan and Wilk (2009) reported a similar profile: 95.3% were female, 40.9% worked in
medical/surgical units and 34.6% worked in critical care units, 72.8% were diploma prepared.
In addition, the average age was 42 years with 17 years in nursing and 11 years on their current
unit.
Descriptive Statistics
The mean and standard deviation for each of the major study variables are presented in
Table 3. First, the antecedents in the theoretical model will be discussed. Nurses in this study
reported a moderately high level of core self-evaluation. The level of group cohesion and
interactional justice were moderately high, while managerial support was slightly above
undecided and unit morale and relationships was reported as being average on their units. The
average unit size was close to 26 beds that were open and staffed on their unit, with a wide
range of 4 to 60, and one unit with 88 beds. Overall, the level of complexity of nursing care was
above 50%, indicating a moderate level of variability, instability and uncertainty on the units.
An examination of the original eight conflict subscales developed by Cox (2008) showed
that, overall, nurse participants in this study reported a low level of intragroup conflict with low
frequency and intensity. In examining the various subscales on disagreement, interference and
negative emotions, the results showed that the most disagreement occurred due to interpersonal
incompatibilities and the work process, followed by the work itself. The highest levels of
interference occurred due to interpersonal incompatibilities, followed by work-related issues.
Finally, nurses reported slightly higher negative emotions due to conflict over the work itself
rather than conflict due to interpersonal incompatibilities. When examining the intragroup
relationship conflict scale used in the final model (discussed later in this chapter), nurse
participants also reported a low level of intragroup relationship conflict.
68
The majority of nurses reported using a collaborating and accommodating style of
conflict management with the avoiding and competing style being used the least. However, on
average, the nurse participants used a low level of agreeableness as their style of conflict
management. Finally, the nurse participants in this study reported moderate levels of job stress
and job satisfaction.
Table 3. Means and Standard Deviations for Major Study Variables
Correlations
Correlations among the model variables were investigated and the results are shown in
Table 4. Coefficient values around .10 or below are considered small or weak, those around .30
considered moderate, and those around .50 high or large (Cohen, 1988). High correlations may
Measure Scale Mean SD
Antecedents Core self-evaluation 1-5 3.83 0.52 Unit Size 4-88 25.84 11.65 Complexity of Nursing Care 10-100 53.50 12.12 Group Cohesion 1-7 5.04 1.29 Unit Morale & Relationships 1-5 3.12 0.92 Interactional Justice 1-5 3.87 0.82 Managerial Support 1-7 4.23 1.45 Intragroup Conflict (Original scale developed by Cox (2008)) Disagreement over work process 1-5 2.78 0.53 Disagreement over work itself 1-5 2.24 0.57 Disagreement over interpersonal incompatibilities 1-5 2.78 0.51 Interference over work related issues 1-5 2.09 0.73 Interference over interpersonal incompatibilities 1-5 2.42 0.77 Negative emotions work related 1-5 2.60 0.69 Negative emotions due to interpersonal incompatibilities 1-5 2.06 0.68 Frequency and intensity of conflict 1-5 2.31 0.67 Overall conflict 1-5 2.48 0.51 Intragroup Relationship Conflict (Scale used in final model) 1-5 2.39 0.60 Conflict Management Style Collaborating 1-5 4.00 0.55 Accommodating 1-5 3.45 0.55 Avoiding 1-5 3.37 0.77 Competing 1-5 2.61 0.66 Agreeableness -8 - +8 1.45 1.16 Outcomes Stress 1-5 2.81 0.67 Job satisfaction 1-5 3.11 0.94
69
be a possible cause for concern as highly correlated scales might measure overlapping or similar
phenomena (McMillan, 2000).
First, correlations among the exogenous variables were examined. Core self-evaluation,
group cohesion, unit morale and interpersonal relations, interactional justice and managerial
support were all significantly and positively correlated with each other. Unit size and
complexity of nursing care were not significantly correlated to any of the other variables but
were significantly and negatively correlated to each other. Two correlations among the
exogenous variables were high or strong: interactional justice and managerial support (r = .76)
as well as unit morale and group cohesion (r = .67). The values are less than 0.85 indicating that
multicollinearity is not a concern, however, because each of the variables are modeled as
predictors, this is examined more closely in the structural equation model.
Table 4. Correlations Among Major Study Variables
**p<.01
Mea
sure
Uni
t Siz
e
Com
plex
ity o
f N
ursi
ng C
are
Gro
up
Coh
esio
n
Uni
t Mor
ale
&
Rel
atio
nshi
ps
Inte
ract
iona
l Ju
stic
e
Man
ager
ial
Supp
ort
Intra
grou
p R
elat
ions
hip
Con
flict
Agr
eeab
lene
ss
Job
Stre
ss
Job
Satis
fact
ion
Core self-evaluation
.03 .00 .33** .17** .26** .24** -.31** .23** -.48** .43**
Unit Size - -.30** -.07 -.09 .06 .01 .09 -.01 .05 -.03 Complexity of Nursing Care
- .10 .09 -.06 .06 .06 -.06 -.00 .06
Group Cohesion
- .66** .36** .45** -.68** .31** -.37** .50**
Unit Morale & Relationships
- .38** .51** -.58** .26** -.46** .57**
Interactional Justice
- .76** -.43** .17** -.36** .44**
Managerial Support
- -.43** .26** -.41** .58**
Intragroup Relationship Conflict
- -.29** .44** -.50**
Agreeableness - -.25** .33** Job Stress - -.68**
70
Next, correlations between the exogenous and endogenous variables were examined.
With the exception of unit size and complexity of care, all of the exogenous variables were
significantly and negatively related to intragroup relationship conflict. In addition, the same
exogenous variables were significantly and positively related to agreeableness and job
satisfaction, with a significant and negative relationship to job stress. Of the exogenous
variables, group cohesion had the strongest correlation with intragroup relationship conflict
followed by unit morale and interpersonal relations, interactional justice, managerial support
and core self-evaluation. Again, complexity of nursing care and unit size were not significantly
correlated with any of the other variables. Finally, correlations among endogenous variables
were examined and all correlations were significant. Intragroup relationship conflict was
negatively related to agreeable conflict management style and job satisfaction, and positively
related to job satisfaction. Agreeable conflict management style was negatively related to job
stress and positively related to job satisfaction. Job stress and job satisfaction were negatively
related to each other. Of the endogenous variables, intragroup relationship conflict had the
strongest relationship with job satisfaction, followed by job stress and agreeableness.
Measurement Model
Prior to the analysis of the structural equation model, a measurement model was
conducted to validate the questionnaire items for the Intragroup Conflict Scale (ICS). A
confirmatory factor analysis was conducted with the 48-item ICS which is provided in more
detail in Appendix C. Using the theoretical framework adopted in this study, intragroup conflict
consists of three dimensions (disagreement, interference, and negative emotions), two types
(relationship, task/process) and the frequency/intensity of conflict. This framework was
measured with the 48-item, eight-factor ICS. Each item was hypothesized to load on one
specified factor, with zero loading on the other factors; error terms for the items were
uncorrelated; and factors were correlated (Soeken, 2004). The initial model was rejected due to:
1) poor fit between the data collected in this study and the a priori factor structures (χ2 =
2699.92; p = .00; df = 1052; χ2 /df = 2.57, GFI = .66, TLI = .81, CFI = .82, and RMSEA = .08);
2) correlation estimates between subscales were high (r ≥ .60) with several values greater than
.85 suggesting multicollinearity; and 3) modification indices suggested additional pathways
between items hypothesized to load on separate factors and among several error terms.
Theoretically, the addition of these pathways was not logical. Therefore, it was concluded that
71
this confirmatory factor analysis was unable to acceptably replicate the eight-factor solution
hypothesized by Cox (2008) and the measurement model was rejected. Since the primary focus
of this research study was the examination of relationship conflict, the focus turned to the 11-
item ICS subscale which examines relationship conflict. Still using the theoretical framework
adopted in this study, a confirmatory factor analysis of the measurement model with the three
dimensions (disagreement (5-items), interference (2-items), and negative emotions (4-items))
was conducted. More detail is provided in Appendix D.
The three-factor and two-factor models were rejected due to: 1) poor fit between the data
collected in this study and the a priori factor structures (χ2 = 186.33; p = .00; df = 41; χ2/df =
4.55, GFI = .88, TLI = .88, CFI = .91, and RMSEA = .12); and 2) high correlation estimates (r >
.90) between subscales. The model was rerun using a two-dimension and one-dimension model,
however, the results showed an even poorer fit than the initial model (χ2 = 309.50; p = .00; df =
44; χ2/df = 7.03, GFI = .82, TLI = .80, CFI = .91, and RMSEA = .15). The modification indices
suggested several pathways between items in different subscales and between individual items
and subscales. Therefore this measurement model was also rejected and an alternative model
was explored.
Alternative Relationship Subscale of the Intragroup Conflict Scale
Still in accordance with Barki and Hartwick’s (2004) theory with the three dimensions
(disagreement, interference, and negative emotions), 3-items were selected for each dimension
based on understanding of the theory. Kline (2005) suggests that three indicators per latent
variable are sufficient to capture the underlying construct. Such modifications provide more
concise measures of the constructs and are more amenable for use in a SEM analysis than scales
with many items.
Eight of the nine items were part of the original 11-item measure developed by Cox
(2008). Because the original subscale for interference related to interpersonal incompatibilities
only consisted of two items, a third item was selected from the ‘interference related to work’
subscale which reflected the construct of undermining. The initial model, which is presented in
Figure 5, had a significant Chi-square (χ2 = 53.73; p = .00; df = 24; χ2/df = 2.24), high GFI
(.957), high TLI (.962), high CFI (.975), and low RMSEA (.067). Correlations between two
72
Figure 5. CFA of Alternative Relationship Subscale: 3 Factors, 9-items
subscales were high (emotion and interference subscale, r = .97; disagreement and interference
subscale, r = .88) which again suggested multicollinearity and a one-factor scale.
The one-factor model, which is presented in Figure 6, had a good fit with a significant
Chi-square (χ2 = 74.84; p = .00; df = 27; χ2/df = 2.77), high GFI (.944), high TLI (.946), high
CFI (.959), and acceptable RMSEA (.08). The one factor structure was retained and used in the
SEM analyses as it revealed an overall good fit with strong factor loadings. However, these
results are inconsistent with the theoretical framework which, as described in chapter two,
suggests that intragroup relationship conflict consists of three subscales: disagreement,
interference, and negative emotions. Therefore the individual items were examined further and
compared to the definitions of each of these areas as discussed in chapter 2 (table 5). Item 1
discusses a general incompatibility among individuals while item 2 describes a disagreement
and item 3 describes the opposite of disagreement, with a sharing of values and view. Items 4
to 6 describe various behaviours associated with interfering or opposing individuals’
conf17 e17
conf19 e19
conf29 e29
Rconf21e21
disagreement
e31
conf32 e32
conf42 e42
conf44 e44
conf45 e45
conf31 interference
negativeemotions
.80.77
.69
.76
.82 .84
.97
.88
.76
.69
.56
.76
73
Figure 6. CFA of Alternative Relationship Subscale: 1 Factor, 9-items
achievements of their goals. Items 7 and 8 describe specific negative emotions that arise from
the conflict while item 9 describes negative emotion overall. As a result item 9 may overlap
with items 7 and 8. So, overall two items (1, 9) provide a general statement about the different
properties of conflict, while the other seven items describe specific cognitions, behaviours or
emotions associated with conflict. As a one-factor scale, the scale represents negative
interpersonal relationships with incompatibilities, negative behaviours and negative emotions
due to the incompatibilities. Therefore, based on the results of the confirmatory factor analysis,
it would appear that in this context the nature of the conflict being observed is more consistent
with the definition of relationship conflict proposed by Jehn (1995). She defined relationship
conflict as interpersonal incompatibilities among group members, including personality clashes,
tension, and annoyance, which subsequently produces negative emotions.
Table 5. Barki and Hartwick’s (2004) Typology for Conceptualizing Relationship Conflict Properties Definition Items in Scale in this Study Cognition/ Disagreement
Disagreement about personal values, views, preferences, etc
1. There are interpersonal incompatibilities between parties.
2. There is disagreement between parties about personal values and views that are unrelated to work.
3. Parties share similar personal values and views.
conf17e17
conf19e19
Rconf21e21
e31
conf32e32
conf42 e42
conf44e44
conf45e45
conf31 Relationship
Conflict.75.81
conf29 e29 .75
.68
.79.75
.62.51
.68
74
Behaviour/ Interference
When the behaviour of one individual interferes or opposed another’s achievement of goals.
4. One party undermines another over work-related issues.
5. Parties oppose one another over personal values and views unrelated to work.
6. There is backbiting related to interpersonal incompatibilities.
Affect/ Negative Emotion
Anger and frustration directed to the other as a person
7. Parties become enraged over issues unrelated to work. 8. Parties become annoyed with one another over
personal values and views. 9. There are negative emotions related to interpersonal
incompatibilities.
Structural Equation Model
Based on the factor analysis, the original structural equation model (Figure 4) was
revised to include the new intragroup relationship conflict measure (Figure 7). Structural
equation modelling was conducted using AMOS 16.0 to determine the fit between the
theoretical structure fit and the data. The initial model had a significant Chi-square (χ2 =
425.66; p = .00; df = 130; χ2/df = 3.27), low TLI (.818), low CFI (.876), and high RMSEA
(.091). As previously discussed models with an acceptable fit have a CFI and TLI > .90 and a
RMSEA less than .08 (Jaccard & Wan, 1996; Kline, 1998). Before examining the modification
indices, the individual parameters were analyzed, the results showed that the variable unit size
was not a significant predictor of intragroup relationship conflict (unstandardized regression
weight = .002, Critical ratio (CR) = .809, standardized regression weight = .041). Although
labelled CR, this statistic is also referred to as both the t-statistic and Wald-statistic. Values
below 2 indicate that the value of the estimate is not significantly different from zero and is a
parameter that should not be included in the model (Stevens, 1996). In addition, the covariance
estimates showed that unit size was only significantly related to the complexity of nursing care.
These findings are consistent with the correlation findings previously discussed. Therefore, the
variable unit size was removed from the model and further analysis.
The structural equation model was re-run without the unit size variable. Findings from
the squared Mahalanobis Distance test were used to identify multivariate outliers. A point can
be a multivariate outlier even if it is not a univariate outlier on any variable. If a point has a
greater Mahalanobis distance from the rest of the sample population of points is said to have
75
Figure 7. Revised Structural Equation Model
higher leverage since it has a greater influence on the slope or coefficients of the regression
equation (Kline, 1998). In this analysis the squared Mahalanobis Distance provided a calculated
χ² value that was compared to a critical χ² (df 18) = 42.31, p = .001). Degrees of freedom were
based on the number of variables in the analysis. The results indicated that two cases were
outliers and these cases were deleted. On closer examination, one participant worked in a
critical care area for six months and reported a high mean for complexity of care (93.9) as well
as scores that were above average for core self-evaluation, group cohesion, interactional justice,
managerial support, and job satisfaction. The other individual worked on a medical unit and
reported average scores that were lower than the average for the whole group.
The modified model had a similar fit to the initial model with a significant Chi-square
(χ2 = 416.24; p = .00; df = 119; χ2/df = 3.50), χ2 difference=9.42 (ns), low GFI (.875), low TLI
(.839), low CFI (.875), and high RMSEA (.095). Examination of the modification indices
indicated additional paths that would result in a better fitting model. In the modified model,
three direct paths were added. The first direct path was between core self-evaluation and job
Intragroup Relationship
Conflict
e11
e12
e13
Core Self-evaluation
Agreeableness
Job Stress
Interactional Justice
Managerial Support
Group Cohesion
Unit Morale
1
1
Job Satisfaction
1
Complexity of Nursing Care
conf17 conf19 Rconf21 conf31 conf32 conf42 conf44 conf45
e1 e2 e3 e5 e6 e7 e8 e91 1 1 1 1
e10
1
Unit Size
1
conf29
e41
1
1 1
76
stress. In a meta-analysis, Kammeyer-Mueller, Judge & Scott (2009) found that core self-
evaluation was negatively related to job stress. The second direct path was added from unit
morale to job stress. Other studies have shown that low morale can lead to an increase in stress
(Andersson & Bateman, 1997; Castledine, 1997). The last direct path was added between
managerial support and job satisfaction. Magnet hospital research has consistently demonstrated
that nurses who work with supportive managers report greater job satisfaction (Chu, Hsu, Price,
& Lee, 2003; Schmalenberg & Kramer, 2008; Seo, Ko, & Price, 2004).
With the new paths added (Figure 8), the model fit indices showed a better fitting model
with lower Chi-square (χ2 = 252.49; p = .00; df = 116; χ2/df = 2.18), χ2 difference=163.75 (p <
.001), high GFI (.906), high TLI (.924), high CFI (.943), and low RMSEA (.066). Examination
of the maximum likelihood estimates showed that all paths except managerial support and core
self-evaluation to conflict as well as agreeableness to job stress had a critical ratio of greater
than 1.96. The remaining modification indices suggested additional direct paths between group
cohesion and job satisfaction as well as unit morale and job satisfaction however the PAR
changes showed only minimal changes to the chi-square. In addition, while all of these
additional pathways resulted in a better fitting model, the main focus of this dissertation was the
examination of the antecedents and consequences of conflict. The additional pathways have
supported previously shown relationships between each of the hypothesized predictors and
outcomes, but have not provided a clear picture of the causes of conflict and subsequently the
outcomes of conflict. When model fit is less than ideal it is appropriate to test a theoretically
sound alternative structural model in an attempt to achieve a model which better fits the
empirical data (Kline, 2005). Because results of the hypothesized model are adequate but not
ideal, an alternative model was tested.
Alternative Model
As mentioned previously, high correlations were found between two sets of predictors: 1) unit
morale and group cohesion; and 2) interactional justice and managerial support. High
correlations may be a possible cause for concern as highly correlated scales might measure
overlapping or similar phenomena. These four variables were examined more closely to
determine if all four concepts were appropriate for the model. First, managerial support
77
Figure 8. Revised Structural Equation Model with Modification Indices
Intragroup Relationship
Conflict
Core Self-evaluation
Agreeableness Job Stress
Interactional Justice
Managerial Support
Group Cohesion
Unit Morale
-.23
-.26
.15
-.31
Job Satisfaction
.12
-.07
-.53
Complexity of Nursing Care
.13
-.04
conf17 conf19 Rconf21 conf31 conf32 conf42 conf44 conf45
-.45 .67
.36
.45
.11
.33
.38
.52
.11
.18
.76
-.08
.25
.03
.23
-.02
.81 .76
conf29
.71.60 .55 .76 .70
.77.76
-.40
.34
-.37
---- indicates non-significant paths. All other paths significant at p<.05
78
was not found to be a significant predictor of intragroup relationship conflict with a CR < 1.96,
therefore it was removed from the model. Second, even though group cohesion was a stronger
predictor of intragroup relationship conflict, unit morale was included in the study by Cox
(1997). Since this current study is an extension of the research by Cox, the decision was made
to include unit morale to allow for a direct comparison of the two studies. Therefore group
cohesion was removed from the model.
The alternative model (Figure 9) had a poor fit with a significant Chi-square (χ2 =
344.79; p = .00; df = 97; χ2/df = 3.56), low GFI (.885), low TLI (.832), low CFI (.864), and high
RMSEA (.097). Examination of the Modification Indices indicated additional paths that would
result in a better fitting model. In the modified model, two direct paths were added. The first
direct path was between core self-evaluations and job stress. The second direct path was added
from intragroup relationship conflict to job stress. These relationships have been supported in
the literature. In a meta-analysis, Kammeyer-Mueller, Judge & Scott (2009) found that core self-
evaluation was negatively related to job stress. Other studies have found that relationship
conflict produces frustration, tension, (Murnigham & Conlon, 1991), and job stress (Friedman,
Tidd, Currall, & Tsai, 2000; Kivïmaki, Elovainio, & Vahtera, 2000).
With the new paths added, the model fit indices showed a better fitting model with a
lower Chi-square (χ2 = 255.20; p = .00; df = 95; χ2/df = 2.69), χ2 difference=89.59 (p < .001),
high GFI (.905), low TLI (.889), high CFI (.912), and high but acceptable RMSEA (.078).
Again, the modification indices were reviewed and suggested additional direct paths from unit
morale to job stress and job satisfaction. However, another modification indices suggestion was
a direct path from intragroup relationship conflict to job satisfaction. The last suggested MI,
though smaller than the MI for unit morale, was supported in the literature and consistent with
the purpose of this study. Other studies have shown that relationship conflict decreases
employees' satisfaction (Jehn, 1995; Jehn & Mannix, 2001). Therefore, this path was added and
final model (Figure 10) had a good fit with the data: (χ2 = 239.10; p = .00; df = 94; χ2/df =
2.54), χ2 difference=16.10 (p < .001), high GFI (.907), low TLI (.898), high CFI (.920), and
high but acceptable RMSEA (.075).
79
Figure 9. Alternative SEM Model
Intragroup Relationship
Conflict
Core Self-evaluation
AgreeablenessJob
Stress
Interactional Justice
Unit Morale
-.45
-.20
-.31
Job Satisfaction
.17
-.26
-.64
Complexity of Nursing Care .11
-.13
conf17 conf19 Rconf21 conf31 conf32 conf42 conf44 conf45
.38
.11
.18 -.08
.25
-.02
.82
.76
conf29
.70 .59 .53 .76 .70
.78
.76
All paths significant at p<.05
80
The standardized total effects (with direct and indirect effects in parentheses) are
included in Table 6. Hoyle (1995) describes the direct effect as the immediate relation between
two variables. An indirect effect reflects the effect of the independent variable on dependent
variables though a mediating variable. The total effect is the sum of the direct and indirect
effects of an independent variable on the dependent variable. Effect size for standardized path
coefficients with absolute values of less than .30 are considered small, .30 to .50 medium and
greater than .50 as a large effect (Kline, 1998). The majority of the values are less than .30
indicating small effect sizes. Five of the values were between .30 to .50, specifically
relationships between intragroup relationship conflict and unit morale/interpersonal relations,
agreeableness, job stress, and job satisfaction as well as the relationship between core self-
evaluation and job stress. In addition, the relationship between job stress and satisfaction was
above .55, indicating a large effect size.
Table 6. Model Variables Standardized Total Effects Variable Conflict
(Direct/Indirect) Agreeableness
(Direct/Indirect) Job Stress
(Direct/Indirect) Job Satisfaction (Direct/Indirect)
Core self-evaluation
-.13 (-.13/-)
.04 (-/.04)
-.43 (-.39/-.04)
.27 (-/.27)
Complexity of Nursing Care
.11 (.11/-)
-.03 (-/-.03)
.04 (-/.04)
-.05 (-/-.05)
Interactional Justice
-.21 (-.21/-)
.07 (-/.07)
-.07 (-/-.07)
.09 (-/.09)
Unit Morale & Relationships
-.47 (-.47/-)
.15 (-/.15)
-.15 (-/-.15)
.20 (-/.20)
Relationship Conflict
- -.31 (-.31/-)
.33 (.31/.02)
-.43 (-.20/-.23)
Agreeableness - - -.08 (-.08/-)
.18 (.13/.05)
Job Stress - - - -.56 (-.56/-)
81
Figure 10. Final Model
Intragroup Relationship
Conflict
Core Self-evaluation
Agreeableness
Job Stress
Interactional Justice
Unit Morale -.47
-.21
-.31
Job Satisfaction
.13
-.56
Complexity of Nursing Care
.11
conf17 conf19 Rconf21 conf31 conf32 conf42 conf44 conf45
.38
.11
.18 -.08
.25
-.02
.71 .59 .54 .81.78
.76.76 .71
-.13
-.08
.31
-.38
-.21
conf29
.75
---- Non-significant paths. All other paths significant at p<.05
82
Test of the Mediator
To test the mediation effects of agreeableness using structural equation modelling, the
steps outlined by Iacobucci, Saldanha, and Deng (2007) were followed. In this study, it was
hypothesized that the variable agreeableness would mediate two relationships: 1) intragroup
relationship conflict to job stress, and 2) intragroup relationship conflict to job satisfaction. In
step one, the SEM analysis was conducted as outlined above to allow the direct and indirect
paths to be fit simultaneously. If the coefficients from the independent variable (IV) to the
mediator and from the mediator variable to the dependent variable (DV) are significant then
‘some’ mediation is occurring and the researcher should go to step two. If either coefficient is
not significant than there is no mediation and no further analysis is done. In the SEM analysis
of the final model (Figure 10), the coefficient for the path from conflict (IV) to agreeableness
(mediator) was significant. The path from agreeableness (mediator) to job stress (DV) was not
significant, indicating that no mediation was occurring and no further testing was required.
However, the path from agreeableness (mediator) to job satisfaction (DV) was significant,
indicating that ‘some’ mediation was occurring and further mediation testing should be done.
In step two of the test for mediation, a test is conducted to examine the relative sizes of
the indirect (mediated) versus direct paths. As recommended by Baron and Kenny (1986),
Sobel’s test was performed using the interactive calculation tool for mediation tests (Preacher &
Leonardelli, 2003). The Sobel test determines the significance of the indirect effect of the
mediator by testing the hypothesis of no difference between the total effect and the direct effect.
If the Sobel test is significant and the direct path between the independent and dependent
variable is not significant, then the mediation is complete. If both the Sobel test and the direct
path between the independent variable and dependent variable are significant, then the
mediation is ‘partial’. In this study, Sobel’s test was significant (Table 7) and the direct path
from conflict to job satisfaction was also significant (Figure 10), indicating that agreeableness
partially mediates the relationship between conflict and job satisfaction.
Table 7. Significance Testing of Mediator Model
Mediator Model Unstandardized Estimate
Standard Error
Sobel’s Test Value
p
Conflict Agreeableness Agreeableness Job Satisfaction
-.550 .106
.109
.036 -2.543 .01
83
Hypothesis Testing
On the basis of the final model (Figure 10), the hypotheses were tested by examining the
path coefficients and the critical ratio (> ± 1.96). As shown in Table 8, hypotheses 1, 2, 5, 6, 8
and 10 were supported. Hypotheses 9 was partially supported as conflict management style
partially mediated the relationship between intragroup relationship conflict and job satisfaction
but not the relationship between intragroup relationship conflict and job stress. Hypotheses 3, 4,
and 7 were not supported. The parameter estimates for the additional pathways in the final
model are also show in Table 8. These results will be discussed in more detail in the next
chapter.
Summary
This chapter presented the results of several statistical analyses conducted to address the
research hypotheses. Descriptive statistics were presented in order to describe the sample. In
addition to descriptive statistics, correlations between the major study variables were also
presented. Correlations within each of the constructs were consistent with correlations reported
in previous studies. The SEM analysis revealed that the hypothesized model was a good fit to
the data, however the tested alternative model was a better fit and represented a more complete
understanding of the antecedents of intragroup conflict, which was the purpose of this study.
Finally, seven of the ten hypotheses were supported. In summary, lower levels of core self-
evaluation, interactional justice and unit morale/interpersonal relations and higher levels of
complexity of nursing care, resulted in higher levels of intragroup relationship conflict on
nursing units which in turn resulted in lower levels of agreeable conflict management style and
subsequently lower levels of job satisfaction. In addition, lower levels of core self-evaluation
directly resulted in higher levels of job stress. And finally, higher levels of intragroup
relationship conflict lead to higher levels of job stress and lower levels of job satisfaction.
84
Table 8. Parameter Estimates of Final Model and Hypotheses Hypothesis Estimate Standard
Error Critical Ratio Value
Standardized Regression Weights
Hypothesis Supported?
1. Nurses’ perceptions of core self-evaluation are negatively related to conflict.
-.16 .07 -2.44 -.13 Yes
2. Nurses’ perceptions of the complexity of nursing care are positively related to conflict.
.01 .00 2.09 .11 Yes
3. Size of nursing units is positively related to conflict (Figure 7). .00 .00 1.02 .05 No 4. Nurses’ perceptions of managerial support are negatively
related to conflict (Figure 8). .07 .04 1.82 .15 No
5. Nurses’ perceptions of interactional justice are negatively related to conflict.
-.17 .05 -3.67 -.21 Yes
6. Nurses’ perceptions of unit morale and interpersonal relations are negatively related to conflict.
-.33 .04 -7.96 -.47 Yes
7. Nurses’ perceptions of group cohesion are negatively related to intragroup conflict within nursing units (Figure 8).
-.23 .04 -6.46 -.45 No
8. Nurses’ perceptions of conflict are negatively related to the agreeable style of conflict management.
-.55 .11 -5.06 -.31 Yes
9 a. Conflict management style will mediate the relationship between conflict and job stress. Non-significant path between agreeableness and job stress, therefore no further mediation testing done.
-.05
.03
-1.47
-.08
No
9 b. Conflict management style will mediate the relationship between conflict and job satisfaction. Significant path between agreeableness and job satisfaction. Significant Sobel’s test (Table 9).
.11
.04
2.96
-.13
Partially
10. Nurses’ perceptions of job stress are negatively related to their perceptions of job satisfaction.
-.78 .07 -11.94 -.56 Yes
Additional Pathways in Final Model Core self-evaluation to job stress. -.49 .07 -7.41 -.38 N/A Intragroup relationship conflict to job stress. .31 .06 5.21 .31 N/A Intragroup relationship conflict to job satisfaction. -.29 .07 -3.99 -.21 N/A
85
Chapter 6: Discussion of the Findings
The purpose of this study was to test a theoretical model of intragroup conflict. The
theoretical model consisted of four components: antecedents, core process, conflict
management, and outcomes. Antecedents, which originated from a variety of possible sources,
refer to the conditions that create opportunities for conflict to arise. The core process refers to
the conflict situation between interdependent parties as they experience negative emotional
reactions to perceived disagreement and interference with goal attainment. In an attempt to
reduce or resolve the conflict, individuals adopt general strategies or styles of conflict
management, which subsequently results in the outcomes. Overall, the majority of hypotheses
were supported. However, unit size was eliminated because of weak causal effects while group
cohesion and managerial support were eliminated because of conceptual overlap with other
antecedent variables. In the final model, lower core self-evaluation, higher complexity of care,
lower interactional justice, and poor unit morale resulted in higher conflict, and ultimately a less
‘agreeable’ conflict management style, higher stress and job dissatisfaction. Conflict
management style partially mediated the relationship between conflict and job satisfaction. Job
stress also had direct effect on job satisfaction and core self-evaluation had direct effect on job
stress.
In this chapter, an overview of the findings specific to intragroup relationship conflict
will be discussed. Next an overview of the theoretical model will be provided followed by a
more detailed discussion of each individual hypothesis. In addition, implications for practice,
nursing administrators, nursing education, and nursing research are discussed, followed by
limitations and the final summary.
Overview of Intragroup Relationship Conflict
In this study, conflict was defined as the phenomenon occurring between interdependent
parties as they experience negative emotional reactions to perceived disagreements and
interference with the attainment of their goals (Barki & Hartwick, 2001). Barki and Hartwick’s
(2004) two-dimensional framework of conflict was used to represent the main construct of the
theoretical model. The measurement model of Cox’s (2008) Intragroup Conflict Scale did not
confirm the two-dimensional model which consisted of the three properties of conflict
(disagreement, interference, negative emotion) and the three types of conflict (task, process,
86
relationship). These results differed from the work by Cox (2008) and Barki and Hartwick
(2001). In the study by Barki and Hartwick (2001), conflict was measured using a different
questionnaire that had been developed specifically for Information System Development teams.
Therefore it is not possible to directly compare the results. Cox (2008) used a much larger
sample of nurses from one acute care hospital, compared to the smaller sample used in this
present study. Cox also did not use confirmatory factor analysis but relied on exploratory factor
analysis for instrument development. Confirmatory factor analysis (CFA) is a means of testing
and confirming the factors proposed by the exploratory factor analysis and it is important to
subject an instrument to CFA as a further test of construct validity. In addition, a revised version
of the relationship subscale was developed from Cox’s (2008) instrument. A confirmatory
factor analysis revealed a one factor structure, rather than a three factor model described by Cox
(2008) and Barki and Hartwick (2004). As a one-factor scale, the measure represents negative
interpersonal relationships with incompatibilities, negative behaviours and negative emotions
due to these incompatibilities. Therefore, based on the results of the confirmatory factor
analysis, it would appear that in this context the nature of the conflict being observed is more
consistent with the definition of relationship conflict proposed by Jehn (1995). She defined
relationship conflict as interpersonal incompatibilities among group members, including
personality clashes, tension, and annoyance, which subsequently produce negative emotions.
The overall results, which showed a low level of conflict, are inconsistent with other
studies and reports. Several key reports during the past decade have identified conflict among
nurses as a significant issue in nursing work environments (Baumann, et al., 2001; Canadian
Nursing Advisory Committee, 2002). In addition, recent qualitative studies have shown that
according to nurses the frequency of conflict among nurses is on the rise (Bishop, 2004; Hesketh
et al., 2003; Rolleman, 2001; Warner, 2001). These inconsistent findings suggests that the
instruments used to measure conflict may not be sensitive enough to capture the concept of
conflict or the instruments may not be capturing what nurses are referring to as ‘conflict’. In
addition, nurses themselves may not be sure what the term ‘conflict’ means to them or their
perception of conflict is exaggerated. When asked to define conflict, nurses often list a
multiplicity of issues, situations, and behaviours. In the study by Rolleman (2001), when asked
to define or describe conflict, very few nurses provided an answer while others simply described
how conflicts were handled or the consequences of conflict. In the study by Warner (2001),
87
nurses described conflict characteristics but they also listed several causes of the conflict, factors
that hindered them dealing with conflict, and outcomes of the conflict.
The level of conflict in this study was consistent with the results found recently by Cox
(2008) but lower than the levels of conflict reported in several other studies. When the scores
from the original subscales were compared to the original subscales used in the most recent
study by Cox (2008), the results were similar with means ranging from 1.66 to 2.89 on a 5-point
Likert Scale. The one exception is that nurses in this present study reported higher levels of
relationship conflict with higher levels of disagreement, interference and negative emotions due
to interpersonal incompatibilities. Another study reported a lower level of conflict than the
current study. In a study with 678 RNs working in community hospitals in Ontario, Siu et al.,
(2008) reported a mean of 2.40 on a 5-point Likert scale. Three other studies reported higher
levels of conflict among nurses in acute care settings. In a study examining nurse managers’
perceptions of conflict among nurses on their units, Almost and Laschinger (2008) reported a
mean of 3.06 on a 5-point Likert scale. However, in this study it was the managers’ perceptions
of conflict rather than the perceptions of the nurses themselves which may have accounted for
the higher levels. In a study with operating room nursing teams, Cram (2002) reported means
ranging from 3.06 to 3.50 on a 6-point Likert scale. In her earlier study with nurses working on
13 inpatient units, Cox (2003) reported a mean of 3.48 on a 6-point Likert scale. Both of these
studies examined conflict on teams or units within one setting. Therefore the higher levels of
conflict may be due to the contexts within those settings. The random sample used in this study
was selected from a variety of different hospitals across Ontario. This sampling may have
resulted in a lower level of conflict due to a wider variability in conflict among the different
settings with the level of high conflict versus low conflict being more evenly distributed across
the sample. In addition, the nurses in Cox’s sample included advanced practice nurses and
administrators and had worked fewer years on their units. This may have accounted for the
higher levels of conflict as well. Interestingly, the level of conflict had decreased from Cox’s
original study in 1997 to her recent study in 2008, suggesting that the amount of conflict may, in
fact, be decreasing rather than increasing. However, it should be noted that a different
measurement tool was used which may have accounted for some of the change.
Lastly, the findings in this study showed that nurses identified managers/administration
and nursing coworkers as the group with whom they experience the most conflict. This is
88
consistent with other studies that also reported managers and nursing colleagues as the most
common source of conflict (Bishop, 2004; Lawrence & Callan, 2006; Warner, 2001).
Overview of Theoretical Framework
The overall model demonstrates that intragroup relationship conflict and its associated
outcomes is a complex process, affected by individual, contextual and interpersonal factors. The
hypothesized model was partially supported, demonstrating that some outcomes of relationship
conflict, such as job satisfaction, are partially mediated by how individuals manage conflict.
However the factors that influence conflict outcomes were more complex than originally
hypothesized, with both significant direct and indirect effects. The specific findings are
discussed below.
The results of the AMOS analysis of the original proposed model indicated a poor fit
between the model and data. Unit size was eliminated because of weak causal effects.
Managerial support was eliminated because of the conceptual overlap with interactional justice.
Group cohesion was eliminated because of the conceptual overlap with unit morale and
interpersonal relations. In the alternate revised model, the remaining antecedents were core
self-evaluation, complexity of nursing care, interactional justice and unit morale/interpersonal
relations. The results of the second AMOS analysis indicated a good fit between the model and
the data. Consistent with theoretical propositions, higher perceptions of core self-evaluation,
lower complexity of nursing care, higher interactional justice and higher unit morale and
interpersonal relations resulted in lower perceptions of intragroup relationship conflict, which in
turn resulted in higher use of an agreeable style of conflict management. Unit morale and
interpersonal relations was the strongest predictor of intragroup relationship conflict followed
by interactional justice, core self-evaluation and complexity of care. Next, nurse participants’
agreeable style of conflict management resulted in higher perceptions of job satisfaction but the
relationship to job stress was non-significant. An agreeable style of conflict management
partially mediated the relationship between intragroup relationship conflict and job satisfaction.
Finally, higher levels of job stress resulted in lower levels of job satisfaction. Additional
pathways not originally hypothesized, but theoretically sound, included 1) higher perceptions of
intragroup relationship conflict directly resulting in higher levels of job stress and lower levels
of job satisfaction, and 2) higher perceptions of core self-evaluation directly resulting in lower
levels of job stress.
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An individual nurse’s personal disposition, the context in which he/she works and
his/her working relationships with others all contribute to the level of conflict. How nurses
respond to the everyday encounters in their work lives is influenced by their level of confidence,
belief in themselves, control in their life and negative cognition, and ultimately, influences the
amount of conflict and job stress that they experience. The complexity of patient care delivery
within units creates many barriers that prevent effective conflict resolution. Fluctuations due to
unpredictable changes, knowledge required for different patient populations, and complex work
ultimately increases the level of conflict. A collegial work environment built on interactional
justice from management as well as positive unit morale and interpersonal relationships with
nursing colleagues fosters an environment of respect, collaboration and support. Nurses care
deeply about how they are treated in their everyday encounters at work. If they feel they are
treated with respect and fairness by managers, and if they work on a unit with positive
relationships and morale, they experience a positive work environment with less conflict. The
results of this study also shows that an agreeable style of conflict management is not enough to
completely prevent the negative effects of relationship conflict on job stress and job satisfaction.
Intragroup relationship conflict directly influences the level of job stress and job satisfaction.
And while the way in which nurses manage relationship conflict with their nursing colleagues
can make their job more satisfying, it does not change their level of stress due to the conflict.
This study showed that an individual’s core self-evaluation may be more effective in reducing
an individual’s stress level than their ability to manage relationship conflict. Job stress also
directly influences the level of job satisfaction. In the next section, an overview of the results
specific to intragroup relationship conflict will be discussed.
Discussion of the Tests of the Hypothesis
Antecedents of Intragroup Relationship Conflict
Dispositional Characteristic
Core self-evaluation. Core self-evaluation is a broad personality construct that is based
on four well-established personality traits: self-esteem, self-efficacy, locus of control, and
neuroticism. Nurses’ perceptions of core self-evaluation were negatively related to intragroup
relationship conflict within nursing units. Nurses who were positive, self-confident, and
efficacious with a strong belief in themselves were less likely to experience conflict with others.
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Nurses in this study reported a moderately high level of core self-evaluation with high levels of
self-esteem and self-efficacy, slightly lower locus of control and low negativity. Core self-
evaluation was significantly and positively correlated with unit morale and relationships, and
interactional justice. Higher perceptions of core self-evaluation also directly resulted in lower
levels of job stress. The findings imply that nurses’ level of confidence, belief in themselves,
control over situations, and negative cognition influences their responses to the everyday
encounters in their worklife, and subsequently affects the level of conflict and job stress within
their work environment (Judge, Locke & Durham, 1997).
Self-esteem refers to the overall value a person places on oneself (Harter, 1990).
Generalized self-efficacy refers to an individual’s ability to cope, perform, and achieve success
(Locke, McClear, & Knight, 1996). Locus of control refers to an individual’s belief that they
have control over events in their lives, rather than the events being controlled by the
environment or fate (Rotter, 1966). Neuroticism refers to how much an individual focuses on
their negative aspects, or has a negativistic cognitive/explanatory style (Watson, 2000). Judge,
Bono, Erez, and Locke (2005) have suggested that core self-evaluation enables individuals to
cope with external constraints through self-regulatory functioning and, subsequently, experience
beneficial emotions and attitudes. Individuals with lower levels of core self-evaluation believe
that their actions are futile and that little can be done to change their circumstances (Judge,
Locke, Durham, & Kluger, 1998). Individuals who consider themselves worthy and able to
cope with life’s experiences bring a ‘positive frame’ to the situations they encounter, whereas
people who do not see themselves as worthy and able bring a negative frame to the same
situations (Judge, Erez, & Bono, 1998).
The findings in this study are consistent with other research in which core self-
evaluation was found to positively predict job satisfaction (Erez & Judge, 2001; Judge, Bono &
Locke, 2000; Best, Stapleton & Downey, 2005). Prior research has also shown that negative
affectivity relates to a variety of job stressors (Brief, Burke, George, Robinson & Webster,
1988; Chen & Spector, 1991; Heinisch & Jex, 1997; Spector & Jex, 1998). In a study that
combined a meta-analyses with the collection of data through daily diary logs, Kammeyer-
Mueller, Judge & Scott (2009) found that core self-evaluation was negatively related to job
stress. In addition, their results showed that individuals with higher levels of core self-
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evaluation and emotional stability were especially likely to perceive their work environments
positively.
In summary, an individual’s response to the everyday encounters in their worklife is
influenced by their level of confidence, belief in themselves, control in their life, and negative
cognition. Core self-evaluation may influence an individual’s belief that their actions can
change a situation related to conflict Individuals who are well adjusted, positive, self-
confident, and efficacious with a strong belief in themselves will bring a ‘positive frame’ to
situations and, subsequently, will experience less conflict with others, less job stress and
ultimately more job satisfaction.
Contextual Characteristics
Complexity of nursing care. Complexity of nursing care consists of instability,
variability, and uncertainty (Leatt & Schneck, 1981; Overton, et al., 1977). In this study,
nurses’ perceptions of complexity of nursing care were positively related to intragroup conflict
within nursing units. The level of complexity was above 50%, suggesting a moderate level of
variability, instability and uncertainty on the units. Complexity of nursing care was not
significantly correlated to any of the other exogenous variables when examined in the structural
equation model. This suggests that the complexity of care is not significantly related to
interactional justice or unit morale and relationships.
Instability describes the fluctuation of nurses’ practice due to unpredictable changes on
the unit. Variability refers to nurses’ engagement in different tasks resulting from patient
differences. Uncertainty describes the difficulty and complexity of the work. Nursing care is
said to be complex when there are high levels of instability, variability, and uncertainty. Nurses
working on units with high complexity engage more in different tasks resulting from patient
differences and experience more fluctuation in their practice due to unpredictable changes, as
well as more difficult and complex work.
The results of this study are consistent with previous studies that report situational
causes such as time pressure and high workloads as sources of conflict (Bishop, 2004; Warner,
2001). Cox (1997) also found that specialty units with higher patient acuity reported higher
levels of conflict. The complexity of delivering care makes conflict management difficult and
prevents resolving the underlying causes (Fisher & Brown, 1998). Problems are often a tangled
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web of related issues which make it difficult to develop solutions that can be implemented
throughout the unit or organization. This cascade of complex problems results in poor working
relationships and creates a cycle of unresolved conflicts that resurface repeatedly (Beaudoin &
Edgar, 2003). The continued exposure to systemic conflict taxes the emotional resources of staff
and contributes to the development of low unit morale and poor interpersonal relations (Cloke &
Goldsmith, 2002). Over time, nurses stop investing their energy in trying to resolve conflicts
that appear to have no solution. They become disengaged which leads to further frustration, loss
of trust and a tendency to have a negative attitude towards colleagues (Cloke & Goldsmith,
2002; Valentine, 1995). Fostering collaborative relationships is the key to ensuring success for
professionals working within complex environments and serves as a foundation for dealing with
differences when they arise (Anderson & McDaniel, 2000; Marcus, Dorn, Kriteck, Miller, &
Wyatt, 1995).
In summary, fluctuations due to unpredictable changes, knowledge required for different
patient populations, and complex work limits the amount of time and energy that nurses have to
resolve conflict. The complexity also prevents the resolution of the underlying causes of
conflict (Fisher & Brown, 1988), and as a result, a higher level of conflict exists.
Unit Size. Hypothesis 3 regarding unit size and conflict was not supported. Unit size
was eliminated because of weak causal effects in the original proposed model. This is
inconsistent with the study by Cox (1997), which found that units with a smaller number of beds
reported higher levels of intragroup conflict. However, Cox concluded that the unit size alone
did not account for higher levels of conflict as the smaller units were specialty units with higher
complexity of care and higher levels of stress, as well as lower unit morale and interpersonal
relations. Cox’s conclusions are consistent with the results from the current study which found
that complexity of nursing care, rather than unit size, resulted in higher levels of conflict. In the
study by Cox (1997), complexity of nursing care was removed from the structural equation
model due to low factor loadings therefore a direct comparison of the results is not possible.
In the current study, unit size (number of beds/patients) was used as a measure of team
size (number of nurses). It was assumed that units with a larger number of beds require a larger
number of nurses working per shift, and, subsequently a larger team overall, to provide nursing
care to the patients. However, this assumption may be incorrect and it may be beneficial for
future studies to include the size of the nursing team or number of nurses working on each shift.
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Interpersonal Characteristics
Managerial Support. Hypothesis 4 was not supported. Managerial support was also
eliminated from the final model because of the conceptual overlap with interactional justice.
Previous research found that a lack of managerial support resulted in higher levels of conflict,
and subsequently emotional exhaustion (Leiter, 1991). Lawrence, Pisarski, and Callan (2005)
also found that nurses who felt supported by their managers were able to cope more effectively
with conflict in their workplace.
However, in this present study, managerial support was significantly related to higher
perceptions of interactional justice, unit morale and interpersonal relations, group cohesion and
job satisfaction, and lower levels of job stress. Nurses look to their managers for support and
when they receive this support, they feel more respected by managers, the morale and
interpersonal relations on the unit are higher and the work group is cohesive which in turn could
result in lower levels of conflict. Subsequently, if nurses fail to receive this support, the
underlying causes of the conflict are not resolved (lack of respect, poor unit morale and
relationships, and poor group cohesion), and the level of conflict rises.
Interactional Justice. Interpersonal justice refers to the quality of personal treatment,
respect and sensitivity (Greenberg, 1990). In this study, nurses’ perceptions of interactional
justice were negatively related to intragroup conflict among nurses. Nurses reported a
moderately high level of interactional justice. Nurses who felt their relationship with their
manager was free from derogatory judgments, deception, invasion of privacy, and disrespect
reported less conflict among the nurses on their units. In addition, interactional justice was
significantly and positively correlated with unit morale and relationships, and core self-
evaluation.
Honesty, respect and politeness generally increase perceptions of interpersonal justice
(Colquitt, et al., 2001). According to Bies (2001), the concerns regarding interpersonal treatment
include everyday encounters, not just those in formal decision-making contexts. Thus, a wide
number of treatments, such as deception, invasion of privacy, derogatory judgments and
disrespect, fall into the scope of interpersonal justice (Roch & Shanock 2006). Derogatory
judgments refer to the truthfulness and accuracy of statements and judgments made by a
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manager about an employee. Examples of violations of one’s sense of interaction justice include
a manager blaming the team for a performance failure that is really due to a bad decision by the
manager or a manager ‘bad-mouthing’ another person to create an unfavourable image of that
person (Bies & Tripp, 1996). Deception refers to the correspondence between one’s words and
actions. For example, when people feel ‘lied’ to, it makes them angry and resentful (Bies,
2001). Invasion of privacy refers to the disclosure of confidences and secrets by one’s manager
to another person. Disrespect refers to the signs and symbols conveying respect for the intrinsic
value or worth of the individual.
These results are consistent with the study by VanYperen, et al. (2000) who reported that
nurses who felt they were not treated with dignity or respect (interactional justice) by their
managers were more likely to exhibit aggressive behaviour, such as starting fights. Nurses
frequently report a lack of managerial respect in their workplaces (Devine & Turnbull, 2002;
Laschinger & Finegan, 2005). This lack of respect is often reflected in overwhelming
workloads, lack of input into decisions impacting their units, and lack of acknowledgement
(Rolleman, 2001; Warner, 2001). A positive relationship with managers, which includes
respect, enhances perceptions of fairness (Bies, 2001; Laschinger & Finegan, 2005) and, in turn,
reduces conflict-inducing responses (Bies & Shapiro, 1987). If individuals are treated with
dignity and respect by their managers they are more likely to trust management, and ultimately,
have higher levels of job satisfaction and organizational commitment (Laschinger & Finegan,
2005).
A collegial work environment is based on relationships between colleagues that are
collaborative and supportive, where there is a commitment to open communication and the
fostering of an environment of mutual respect (Beyer & Marshall, 1981; Hansen, 1995).
DeLellis and Sauer (2004) proposed that respectful communication has many faces: respect as
active listening; respect as assertive speech; respect as avoidance of passive-aggressive
communication; and respect during conflict. Nurses care deeply about how they are treated in
their everyday encounters at work. Trusting nurses’ judgments, respecting their choices and
decisions, and communicating with them truthfully and honestly enhances perceptions of
fairness (Bies, 2001) and, in turn, reduces conflict (Bies & Shapiro, 1987).
Unit Morale and Interpersonal Relations. In this study, nurses’ perceptions of unit
morale and interpersonal relations were negatively related to intragroup conflict among nurses.
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Nurses reported a moderate level of unit morale and interpersonal relations. Unit morale and
interpersonal relations were also significantly and positively correlated with interactional justice
and core self-evaluation. These results are consistent with the study by Cox (1997) which found
that intragroup conflict was higher on units where nurses reported lower perceptions of unit
morale and interpersonal relations.
Interpersonal relationships that form among nurses are crucial to team cohesiveness, and
the stability of this cohesion depends upon morale. The relational environment of the workplace
is adversely affected by relationships involving jealousy, unresolved or inappropriately resolved
conflict, competitiveness, poor communication, gossip and mistrust among colleagues (Farrell,
1997; McMahon, 1990; Quine, 1999). Numerous studies have found that relationships among
nurses are often dysfunctional resulting in job dissatisfaction and turnover (Cox, 2001; Farrell,
1999; Hoel & Cooper, 2001; Kivïmaki, et al., 2000; O'Connell, Young, Brooks, Hutchings &
Lofthouse, 2000; Taylor, 2001). In addition, negative interpersonal relationships and poor unit
morale often lead to distrust, suspicion, and hostility among team members that further
undermines team cohesiveness and decreases satisfaction (Amason & Sapienza, 1997).
Conflict can impede the exchange of information and decrease the level of commitment
among team members (Amason & Sapienza, 1997). As individuals experience increased
conflict with each other, they may find it difficult to like their co-workers and, as a result, may
be less willing to remain on the team (Jehn, 1995). Once employees experience frustration,
strain, and uneasiness due to perceptions of dislike of others, they typically withdraw physically
and psychologically from the situation (Jehn, 1995). If individuals are unhappy, they can
become dissatisfied with their team, which in turn can lead to lower morale. Individuals who
are not motivated and have a negative view of their work and possibly their team are less likely
to work effectively as a team member. This in turn leads to conflict.
Group Cohesion. Hypothesis 7 was not supported. Group cohesion was eliminated
from the final model because of the conceptual overlap with unit morale and interpersonal
relations. Previous research found that operating room nurses working on the same team each
shift reported higher levels of group cohesion than nurses who rotated among different shifts
(Cram, 2002). Other studies have found that cohesive teams were better performers, team
autonomy enhanced performance, and teams that collaborated and resolved conflicts were more
satisfied (Dreachslin, Hunt & Sprainer, 1999). Hinshaw, Smeltzer and Atwood (1987) also
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reported that nurses who felt more integrated as members of the nursing staff (high group
cohesion) had higher job satisfaction (both professional and organizational) and had lower
anticipated turnover.
However, in this present study, group cohesion was significantly related to higher
perceptions of interactional justice, unit morale and interpersonal relations, managerial support
and job satisfaction, and lower levels of conflict and job stress. Team members who feel
accepted and liked by others with similar qualities, attitudes and values report less conflict, less
job stress and higher job satisfaction. How well a team functions depends on their ability to
communicate, resolve conflict, share responsibility in getting the work done, and feel as if they
belong to the group. Nurses who work on cohesive teams are more likely to have a sense of
belonging, a sense of commitment to the team, and mutual trust and respect for each other.
Shared values such as trust and respect enhance risk taking and problem solving, such as
conflict resolution (Kattzenback & Smith, 1993).
Conflict Management Style
Agreeableness is the extent to which individuals accept, understand and concur with one
another when managing conflict. In this study, intragroup relationship conflict was negatively
related to an agreeable style of conflict management. In general, nurses in this study reported
using more of an agreeable conflict management style than a disagreeable style, however the
mean was low. Nurses who reported higher levels of relationship conflict were less likely to use
an agreeable style of conflict management.
This style of conflict management often results in a pleasant and relaxed atmosphere.
Individuals using an agreeable style of conflict management are more likely to collaborate,
integrate one another’s ideas and satisfy the expectations of everyone, which makes their work
environment less conflict-laden over time. A disagreeable style is the extent to which help is
withheld, with outright rejection resulting in an unpleasant and strained atmosphere (Van de
Vliert & Euwema, 1994). Individuals who use a disagreeable style focus on having their own
ideas or needs met, or they choose to avoid the conflict altogether.
The style of conflict management chosen by individuals depends in part on the level of
conflict. Barki and Hartwick (2001) found that individuals working in teams with high levels of
conflict were more likely to manage conflict through domination or avoidance (components of a
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disagreeable style) rather than collaboration (component of an agreeable style). They argued
that due to high levels of conflict, individuals are hesitant to become involved in an open
discussion to resolve the situation. When attempting to manage relationship conflict defensive
behaviours are initiated that restrict open discussion of ideas. The anger, stress and other
negative emotions associated with relationship conflict quickly generates less-than-affable
perceptions of the other individual (Amason, 1996; Jehn, 1995, 1997; Jehn & Mannix, 2001).
These perceptions include misunderstandings, the inability to see the opponent's perspective
(Blake & Mouton, 1984), and questioning the opponent’s intentions. Therefore individuals are
more likely to use ‘negative’ or less agreeable styles of conflict management, such as avoidance
or domination.
Outcomes
Job Stress
In this study, it was hypothesized that individuals who used an agreeable style of conflict
management would report lower levels of job stress. As discussed in the previous chapter, an
agreeable style of conflict management did not mediate this relationship. These results suggest
that intragroup relationship conflict is stressful, no matter how it is managed. Relationship
conflict produces negative emotional reactions in individuals such as anxiety, mistrust, or
resentment (Jehn, 1995), frustration, tension, and fear of being rejected by other team members
(Murnigham & Conlon, 1991). As a result, relationship conflict is hard to manage, leaving
people with increased pressures and less ability to manage them. In this study, core self-
evaluation had a negative direct effect on job stress, suggesting that an individual’s core self-
evaluation may be more effective in reducing an individual’s stress level than their ability to
manage relationship conflict. Individuals who are well adjusted, positive, self-confident, and
efficacious with a strong belief in themselves are able to use effective coping mechanisms when
managing stressors such as conflict, and subsequently are able to reduce their level of stress.
In this study, intragroup relationship conflict was directly and positively related to job
stress. Nurses who reported high levels of intragroup relationship conflict were more stressed in
their job, which included being upset by something happening unexpectedly, feeling nervous
and stressed, feeling overwhelmed by difficulties at work and not feeling on top of things at
work. These results are consistent with numerous other studies which have found that conflict
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has been identified as a source of stress within nursing work environments (Bishop, 2004;
Dijkstra, et al., 2005; Gardner, 1992; Rolleman, 2001). Several studies have also found that
relationship conflict produces frustration, tension, (Murnigham & Conlon, 1991), and job stress
(Friedman, et al., 2000; Kivïmaki, et al., 2000). When compared to conflict with patients or
doctors, nurses report that conflict with other nurses is the most stressful (Lawrence & Callan,
2006), and leads to increased anxiety, emotional strain and physical strain (Gray-Toft &
Anderson, 1981; Hillhouse & Adler, 1997). Similarly research has revealed that aggression
directed at nurses from other nurses is the most distressing form of aggression in the workplace,
negatively impacting the work environment (Farrell, 1997; 1999) while positive interactions
among nurses have been identified as the most satisfying aspect of the work experience (Evans,
2005).
In addition, nurses in this study who reported higher levels of job stress were more
dissatisfied with their jobs. This is consistent with the results from two seminal meta-analyses
which found that job stress was a significant predictor of job satisfaction (Irvine & Evans, 1992;
Blegen, 1993). Nurses who are highly stressed are more likely to report lower levels of job
satisfaction, organizational commitment, and higher intent to leave their job (Irvine & Evans,
1995; McNeese-Smith, 1997; Parsons, 1998). When individuals are upset with one another,
they experience negative emotions, which, in turn, lead to personal frustration (Thomas, 1976)
and job dissatisfaction (Filley, 1978; Robbins, 1978).
Job Satisfaction
In this study, it was hypothesized that individuals who used an agreeable style of conflict
management would report higher levels of job satisfaction. As discussed in the previous
chapter, agreeableness partially mediated the relationship between intragroup relationship
conflict and job satisfaction. In addition, intragroup relationship conflict had a direct negative
effect on job satisfaction. These results may suggest that this hypothesis was not supported;
however, full mediation is rare and may not be realistic to expect (MacKinnon, Fairchild, &
Fritz, 2007). Therefore, it was concluded that this hypothesis was partially supported. Nurses
who reported high levels of intragroup relationship conflict were more dissatisfied with their
jobs, however nurses who used an agreeable style of conflict management were more satisfied.
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While some level of conflict at work is inevitable in all organisations, how it is handled
in the workplace may influence the outcomes. Individuals who use an agreeable style of conflict
management are more likely to integrate one another’s ideas and try to satisfy the expectations
of everyone, leading to more positive relationships, and less tension. When the conflict is about
interpersonal incompatibility, accepting and understanding one another’s needs and expectations
improves the quality of the relationships while still resolving the conflict. These results are
consistent with other studies. A more agreeable approach to conflict management has been
found to result in improved interpersonal relations (Rubin, et al., 1994), and higher levels of job
satisfaction (Pruitt & Rubin, 1986; Tjosvold, 1997). In a field survey of 96 business school
project groups, DeChurch and Marks (2001) found that agreeable conflict management was
associated with greater group satisfaction, while disagreeable conflict management resulted in
dissatisfaction.
However, even an agreeable style of conflict management is not enough to prevent the
negative effect of relationship conflict on job satisfaction. Relationship conflict decreases
employees' satisfaction and psychological well-being (Jehn, 1995; Jehn & Mannix, 2001;
Medina, Munduate, Dorado, Martinez, & Guerra, 2005). Research has shown that being in
conflict with co-workers brings about strong feelings of unpleasantness. Several studies have
found that teams who become mired in relationship conflict typically exhibit declines in
satisfaction and intentions to stay (Amason, 1996; Peterson & Behfar, 2003). Other studies have
found that high levels of conflict were significantly related to job dissatisfaction with pay (Cox,
2003) and job dissatisfaction in general (Gardner, 1992). Nurses experiencing conflict with
other nurses have considered leaving their profession (Bishop, 2004; McKenna, et al., 2003),
their current position (Bishop, 2004; Lambert, et al., 2004), and reducing their hours of work
(Warner, 2001). With the current demand for nurses and heavy workloads, turnover and
absenteeism is a concern.
Implications for Nursing Practice
While conflict cannot be eliminated from the workplace, learning appropriate conflict-
handling skills is important (Deutsch, 1993). This study found that the complexity of nursing
care was a significant determinant of intragroup relationship conflict. The complex care
environment within hospitals creates many barriers that prevent effective conflict resolution,
including time constraints, poor communication structures, practice variations, emotionally
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charged situations, and fatigue (Ang, 2002; Hawryluck, Espin, Garwood, Evans, & Lingard,
2002). The goal for conflict management is to overcome these barriers and stay engaged in
resolving the issues (Gerardi, Thornby, & Pettrey, 2004).
Nurses who have higher levels of core self-evaluation and are positive, self-confident,
and efficacious with a strong belief in themselves can manage the stress from conflict situations
more effectively and ultimately reduce the amount of conflict with others. Nurses are better
able to cope with the stress from conflict if they strengthen their confidence, efficacy, and
ability to monitor their feelings and emotions while making appropriate decisions to guide
thinking and actions. In many cases, a misperception or a false assumption triggers conflict and
often consists of an act, pattern of treatment, or negative behaviour toward another person
(Dellasega, 2009). Nurses can learn to discuss perceptions and assumptions with their
colleagues rather than acting on them (College of Nurses of Ontario, 2009).
The development and maintenance of respectful and collaborative professional
relationships is the responsibility of each individual nurse and stated in The Standards of
Practice for the College of Nurses of Ontario (College of Nurses of Ontario, 2009). This
includes being self-aware, reflective of one’s own behaviour and aware of the impact of this
behaviour on others. In order to achieve self-awareness and reflective practice, learning to
understand and reflect on one’s own personal attitudes, motivators, values and beliefs that affect
relationships with colleagues. Identifying areas or behaviours that need improvement then
striving to alter that behaviour in situations that have previously ended in conflict. Nurses can
learn to collaborate with colleagues to identify the underlying causes of conflict which includes
focusing on the behaviours that lead to the conflict rather than blaming the other person
(College of Nurses of Ontario, 2009). In order to become emotionally competent leaders, nurses
need to continuously apply reflective strategies to their clinical practice with the identification
of behaviour patterns, interpreting the meaning of the behaviour pattern then growing from this
understanding. Leaders also help others learn to be reflective and to be leaders through active
listening, being available for dialogue, sharing thinking, questioning and reframing situations
(Horton-Deutsch & Sherwood, 2008).
Positive unit morale and interpersonal relations reduce the amount of conflict among
nurses. Negative, non-supportive, and uncooperative colleagues are barriers to positive unit
morale and interpersonal relations. Many individuals are not aware of the impact of their
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negative attitudes or behaviours on those around them. Through direct actions, silence or
inactivity, nurses may contribute to or exacerbate problems in a group. For example, nurses can
discourage gossip by refusing to participate or walking away. If nurses find ways to support one
another socially and care enough about each other to be direct and confront negative behaviour,
relationships among nurses and unit morale will improve and respect will be heightened. An
offer to back a colleague up or a friendly word of encouragement during a difficult time can be
invaluable. A cohesive and supportive team can be created through the recognition that each
person is important, valued, and necessary to the team, and subsequently reduce the amount of
conflict on that team (Dellasega, 2009).
Interactional justice, or the quality of interpersonal treatment during everyday
encounters, is also a significant determinant of intragroup relationship conflict. Effective
relationships are based upon communication that is free from derogatory judgments, deception,
invasion of privacy and disrespect. One way to develop effective relationships is to
communicate with respect in interpersonal relationships and work-related situations where
nurses care enough about themselves and their goals to confront in a caring, self-asserting,
responsible manner (Kupperschmidt, 1994). Relationships are only as good as the
communication between individuals, therefore silent withdrawal to disrespectful comments or
behaviours is self-defeating. Individuals must be able to negotiate their differences in clear,
respectful, truthful ways. Becoming skilled in developing effective and respectful relationships
may assist individual nurses to skilfully address and resolve conflicts (Kupperschmidt, 1994).
In addition, as suggested in this study, becoming skilled in handling conflict through
collaboration and compromise with an acceptance and understanding of one another’s ideas will
improve one’s overall job satisfaction.
Implications for Nursing Administration
This study found that the complexity of nursing care was a significant determinant of
intragroup relationship conflict. Assessing the complexity of the clinical environment can help
to focus the way in which conflict is managed. The complexity of delivering care makes conflict
management difficult and prevents resolving the underlying causes (Fisher & Brown, 1998).
Fostering collaborative relationships serves as a foundation for dealing with differences when
they arise (Anderson & McDaniel, 2000; Marcus, et al., 1995).
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Nurses who have higher levels of core self-evaluation and are positive, self-confident,
and efficacious with a strong belief in themselves can manage and cope with conflict situations
more effectively. The study by Siu, et al. (2008) also found that nurses with higher core self-
evaluation were better able to engage in effective conflict management when they felt their work
environment supported their professional practice. Managers should learn to recognize and
appreciate how individual nurses might be supported and provide the best possible environment
for nurses to engage in effective conflict management. From a motivation standpoint, managers
could find ways to help build nurses’ self-efficacy and expectancy beliefs, which in turn will
help to ensure that nurses feel confident and competent to effectively deal with conflict (Eden,
2003; Gist & Mitchell, 1992). The self-efficacy component of core self-evaluation is a concept
from social cognitive theory (Bandura, 1986) and self-efficacy theories (Bandura, 1977). There
have been numerous studies in organizational settings demonstrating that self-efficacy can be
enhanced (modified) through cognitive behavioural interventions (Bandura, Caprar,
Barbaranelli, Pastorelli, & Regalia, 2001; Brunero, Cowan & Fairbrother, 2008; Mathisen &
Bronnick, 2009; Richman-Hirsch & Mercer, 2001; Schwoerer, May, Hollensbe, & Mencl,
2005). Future research needs to build on this theoretical base and empirical evidence to develop
and evaluate cognitive behavioural interventions that nurse managers could employ in the work
setting. In addition, efforts to reduce conflict should consider more than just the situational or
contextual perspective. Individuals’ core belief systems play an important role in nurses’
responses to situations and to interventions. Therefore efforts to reduce conflict and improve
conflict management may enhance positive outcomes for some individuals but not for others
(Best, Stapleton & Downey, 2005).
This study also found that unit morale and interpersonal relations were significant
determinants of intragroup relationship conflict. When an environment supports and promotes
teamwork, teams have effective communication strategies, co-ordination, and mechanisms to
resolve conflict when it arises (Oandasan, Baker, Barker, Bosco, D’Amour, Jones, et al., 2006),
as well as individual accountability, commitment, enthusiasm and motivation (Pearson, Porritt,
Doran, Vincent, Craig, Tucker, et al., 2006). Successful teams recognize the benefits of
working together with the professional and personal contributions of all members and the
encouragement of personal growth and development of all individuals (Oandasan, et al., 2006).
By creating a clear organizational philosophy on the importance of teamwork, teams are
encouraged to find new ways of working together; the development of common goals;
103
mechanisms to overcome resistance to change and the elimination of turf wars among teams
(Oandasan, et al., 2006).
In this study interactional justice was a significant determinant of intragroup relationship
conflict. Nurses expect to be treated with respect by their managers with positive interactions
that are free from derogatory judgments, deception, and invasion of privacy. Due to the daily
stressors and pressures of work, treating employees or each other fairly is often overlooked.
The findings in this study suggest that one way to reduce conflict is for managers to learn and
understand respectful communication. As mentioned previously, this includes being self-aware,
reflective of their own behaviour and aware of the impact of the behaviour of others. Managers
need to learn and understand nurses’ perceptions of fairness can be enhanced by giving them a
voice with serious consideration of their ideas and the belief that they can affect the situation
(Greenberg, 2004). Managers nad/or administration who seek nurses’ input but then ignore it
are highly disrespectful, sending the message that nurses input is not worthwhile. Taking the
time to explain what was done and why can help nurses understand the meaning and
consequences of those decisions. But this should also be communicated with sincerity and
empathy. An explanation communicated in a calloused and indifferent manner will diminish all
of the perceptions of fairness and respect (Greenberg, 2004). In response to an “apparent
culture of disrespect among healthcare providers”, the Institute for Safe Medication Practices
outlined steps organizations can take to change that culture. This includes establishing a
committee to study the issue further; developing a code of conduct and requiring all staff to sign
it annually; establishing a standard, assertive communication process; and creating a conflict
resolution process (Institute for Safe Medication Practices, 2004).
Implications for Nursing Education
As the results of this study have suggested, positive interpersonal relationships and
respectful communication can reduce the amount of intragroup conflict among nurses. Learning
more about interactional justice practices and behaviours, effective communication strategies
and skills, and effective conflict management can reduce conflict. Strategies to manage and
reduce conflict can be learned (Boyle & Kochinda, 2004; Gerardi, et al., 2004). Effective
education programs for all staff should include interpersonal and communication skills,
contributing factors, appropriate communication techniques emphasizing conflict resolution and
management, and recognizing negative outcomes (Beech & Leather, 2005; MacIntosh, 2005).
104
Education programs should also be developed to educate managers in management principles,
specifically dealing with staff interactions, interactional justice, and positive interpersonal
relationship skills (Deans, 2004; Hansen, Hogh, Persson, Karlson, Garde, & Orbaek, 2006). All
nurses should be encouraged to take an active role in seeking out and participating in training
opportunities and all education programs should be evaluated for their effectiveness.
This study suggested that intragroup relationship conflict was a significant determinant
of job stress. In addition, core self-evaluation reduced the level of job stress. An individual’s
core self beliefs contributes to their ability to cope more effectively with stressors and demands
(Judge, Erez, & Bono, 1998). As mentioned previously, the self-efficacy component of core
self-evaluation is a concept that can be enhanced (modified) through cognitive behavioural
interventions (Bandura, Caprar, Barbaranelli, Pastorelli, & Regalia, 2001; Brunero, Cowan &
Fairbrother, 2008; Mathisen & Bronnick, 2009; Richman-Hirsch & Mercer, 2001; Schwoerer,
May, Hollensbe, & Mencl, 2005). Education programs that contribute to an individual’s ability
to feel more confident and positive about managing conflict may also help them cope more
effectively with the stress due to the conflict. Brunero, Cowan and Fairbrother (2008) found
that nurse–nurse conflict was reduced at six weeks following a one-day stress management
program. Nurse participants attended an eight hour face-to-face interactive workshop based on
cognitive behavioural therapy and were given follow-up reading, self-directed learning material
and exercises to use at the close of the workshop. Nurses can also be taught useful coping
strategies such as engaging in positive self-talk, maintaining their own integrity, trying different
kinds of stress releasing activities, and accessing both formal and informal sources of support
(MacIntosh, 2005).
In academic settings, strategies to identify and reduce relationship conflict should also be
included in the nursing curricula, starting in the first year of the program. This could include
conflict resolution, interpersonal communication, being respectful to others, and dealing with
anger, controversy, and differences between individuals. In a study with senior nursing
students, Spickerman and Brown (1991) found that the students primarily used compromise and
avoidance as their main conflict management styles. Following a variety of teaching/learning
strategies on the topic, the students' predominant styles changed to compromise and
collaboration. In a study with Turkish nursing students, Seren and Ustun (2008) found that the
conflict resolution skills (empathy, listening skills, requirement-based approach, social
105
adaptation and anger management) of nursing students enrolled in a problem-based learning
(PBL) program were significantly higher than those enrolled in a conventional curriculum.
These findings support the need for nurse educators to focus on the development of personal
insight, communication skills, self-awareness and conflict resolution which are key features of a
PBL curriculum. Seren and Ustun (2008) recommended that: 1) work environment issues be
discussed more thoroughly with new graduates before graduation so that they are better
prepared for adverse professional interactions and have some of the skills necessary to address
them; 2) nursing programmes include nursing socialisation issues so that students are prepared
with skills to reject, interrupt and replace oppressive practices; 3) new graduate programs be
introduced in academic and practice settings to assist with positive integration and belonging;
and 4) experienced nurses and unit managers to be aware of their influence on new graduates
and the need for new graduates to be nurtured. McKenna, et al. (2003) also suggested that
transition programs be developed for new graduates, with the development of preceptors and
mentors who are sensitive to new graduate issues and can teach strategies to identify the
potential for conflict and interventions related to prevention (McKenna, et al., 2003).
Implications for Nursing Research
Based on the findings in this study, future research recommendations have been
generated for the following areas: type of conflict, conflict management style, manager/nurse
conflict, and further testing of the theoretical model.
The main focus of this current study was relationship conflict among nurses; however, as
previously discussed there are different types of conflict. Further development of a
measurement model for task and process conflict will be conducted using the data from this
study. Structural equation modeling will then be completed using task/process conflict instead
of relationship conflict and the results compared to determine if the two types of conflict have
similar relationships with each of the variables. In this investigation, the new Intragroup
Conflict Scale exhibited strong psychometric properties, though the results of the factor analyses
were inconsistent with the results found by Cox (2008). Therefore, further testing of the
psychometric properties of this scale should be done with a larger sample and different
populations of nurses.
106
In the metataxonomy of conflict management styles developed by Van de Vliert and
Euwema (1994) there were two higher order categories, agreeableness and activeness. Only the
agreeable style of conflict management was included in this study as a mediator between
intragroup conflict and the two outcomes. Activeness describes the extent to which there is
discussion or confrontation resulting in a responsive and direct form of conflict management
(Van de Vliert & Euwema, 1994). Previous research has shown that it is effective when
managing task conflict, however, little research has examined its effectiveness when managing
relationship conflict. Further work will be conducted with the current data set to calculate a
score for the activeness style of conflict management. Structural equation modeling will then be
completed using activeness style instead of the agreeable style and the results compared.
Overall, the level of conflict in this study was relatively low however, some nurses
reported high levels of conflict. These individuals also report very low levels of unit morale and
interpersonal relations as well as poor group cohesion. This may suggest that nursing units exist
where there are very high levels of conflict within the whole team and unit. Future research
could focus on units such as these to determine if there may be different causes of these high
levels of conflict on a whole unit. A unit-level analysis could determine if the relationships
found in this study also exist on these units. In addition, this would enable the inclusion of other
possible antecedents, such as staff mix, intergenerational conflict, team size (as opposed to unit
size), team collaboration, professional practice environments, and other organizational variables,
such as manager’s span of control, policies/procedures on conflict, transitioning programs for
new graduates. Other possible outcomes were identified in the could also include nurse safety
outcomes such as absenteeism, workplace injuries, actual turnover, productivity, and nurse
performance, as well as patient outcomes such as quality of patient care, patient satisfaction,
length of stay, and adverse events. Recent qualitative studies completed in Canada with nurses
did identify all of these variables as possible causes or outcomes of intragroup conflict (Bishop,
2004; Rolleman, 2001; Warner, 2001). Future research efforts could also be directed towards an
intervention study on units with higher levels of conflict to examine the effectiveness of the
different strategies outlined in the implications for nursing practice, nurse administrators and
nursing education. In addition, while the relationships in the theoretical model in this study
were previously shown in other research, several relationships had never been examined
previously in nursing work environments. Therefore, future research should be done to further
validate these findings using different samples.
107
Lastly, nurses identified managers as a significant source of conflict in this study. The
manager/nurses relationship is a key factor in a positive work environment. The theoretical
model used in this study could be revised to include other possible causes or predictors of
conflict between managers and nurses such as the managers’ span of control, manager’s
leadership style, and leader-member exchange.
Limitations
There were several limitations in this study. The first limitation is related to the
selection of the sample and possible selection bias. While participants were randomly selected
from the provincial database, the names were drawn from the list of nurses who had given their
consent to participate in research. Therefore every registered nurse working in Ontario did not
have an equal chance of inclusion in the sample. It is not known whether nurses in this study
were inherently different from nurses who do not agree to participate in research studies. This
may have introduced sample selection bias into the study results and limited the generalizability
of the results.
Secondly, a low response rates can create the potential for selection bias and decrease
the generalizability of the study findings (LoBiondo-Wood & Haber, 2005). In order to ensure
that the obtained sample is representative of the total population, a response rate of 70% and
above is recommended (Patel, Doku, & Tennakoon, 2003). The higher the response rate, the
more likely the sample represents the population of interest (Woods, Ziedonis, Semyak, et al,
2000; Hulley, Cimmings, Browner, et al, 2001). Individuals who choose not to participate once
they have been contacted may be different from the individuals who do participate. Survey non-
responses can occur for many reasons, including personality traits, attitude toward the survey
topic, job dissatisfaction, and negative beliefs (Rogelberg, Luong, Sederburg, & Cristol, 2000).
In this study, the response rate was low at 46% despite using methods suggested by Dillman
(2000). It is not known if the characteristics of those nurses who responded to the survey were
different from the non-respondents and the sample obtained in this study may not be
representative of nurses in Ontario. Replication of the results in future studies would provide
confirmation of the nature of conflict observed in this study in other samples as well as the
relationships under investigation. In spite of these issues, comparison of the sample in this study
to the membership statistics from the College of Nurses of Ontario (2008) provided some
evidence that it is representative of the population of registered nurses across Ontario. The
108
sample demographics are also similar to other samples of nurses in Ontario who participated in
research (Laschinger et al., 2009)
A second limitation in this study was the use of self-report surveys which creates the
potential for common method variance or measurement bias. Common method variance is
associated with the method of measuring variables that can inflate the relationship between
variables (Podsakoff, MacKenzie, Lee & Podsakoff, 2003; Spector, 1987) and is a concern
when self-reports are used to measure both the independent and dependent variable. However,
self-reports are necessary for the study of concepts such as perceptions of the environment
(Podsakoff & Organ, 1986; Spector, 1994). Common method variance can occur for several
reasons: respondents may try to maintain consistency in their responses; answer in accordance
to pre-existing theories about what the relationships between the variables under study should
be; try to present themselves favorably; and answer in accordance with the format of the items,
rather than the content (Podsakoff et al., 2003).
In this study, precautions were taken to decrease the impact of common method
variance. Spector (2006) argues that common method variance and measurement bias can be
minimized if: 1) a study is well designed, with a careful analysis of the purpose and the
necessary measurement methods. Using a monomethod approach with self-reports asking for
the participant’s perception was appropriate for the purpose of this study, and provided the
necessary data to test the theoretical model. 2) Self-reports are assessed for accuracy, biases,
and reasonable conclusions. Method biases can be reduced through the careful construction of
the items themselves. The measures used in this study have undergone previous exploratory or
confirmatory factor analysis with the elimination of ambiguous items, and all demonstrated
strong validity and reliability during their development and in subsequent studies. Different
scale endpoints and formats were used for the predictor and criterion measures. This reduces
method biases caused by commonalities in scale endpoints and anchoring effects. Ensuring
confidentiality and reporting group data (rather than individual data) reduced the likelihood that
respondents would edit their responses to be more socially desirable, lenient, or consistent with
how they think the researcher wants them to answer (Podsakoff et al., 2003). Participants were
assured that there was no right or wrong answers and they should answer questions as honestly
as possible. Despite these precautions, common method variance cannot be ruled out in the
current study.
109
A third limitation of the study is the cross-sectional nature of the data. The direction of
the relationships between the variables cannot be determined through this study because the data
were collected at one point in time suggesting the need for repetition of the study longitudinally.
In addition, bias may have been introduced through the omission of relevant variables. While
the variables chosen for this proposal were perceived to be the most relevant to the current work
environment of nurses, there are multiple other causes and outcomes of conflict that could have
been included, such as those identified in the previous section (implications for nursing
research). Future research could be conducted to examine the impact of these other variables.
Conflict also occurs outside of the nurse-to-nurse relationship. For instance previous studies
have shown that conflict occurs with patients, physicians and other groups. However, due to
nurses reporting a rising frequency of conflict with their colleagues and the lack of research in
this area, this proposal focused specifically on the conflict between nurses. Utilizing well-
developed theory to guide the study, relying on valid and reliable data, and a method that is
consistent with the purpose of the study are the best defenses against measurement error and
omitted variable bias (Mark, 2006). This current study was guided by a well-developed,
previously tested theory, the data were valid and reliable and the predictive non-experimental
design was consistent with the purpose and analysis of the study.
A final limitation in this study was the alteration of the Intragroup Conflict Scale. While
the individual items were not changed, the relationship subscale of the initial measure was
shortened with an item added from another subscale. The alpha coefficients for the scales were
greater than 0.70 confirming reliability of the scales and the confirmatory factor analysis
revealed a good fit between the hypothesized model and the data, however the validity may have
been altered in ways that cannot be estimated.
Summary
This study contributes to the sparse body of knowledge on the nature of conflict within
acute care nursing settings by testing a theoretical model derived from the literature that
provides insight into: 1) previously unexamined causes and effects of intragroup conflict among
nurses in current acute care settings; and 2) the mediating effect of conflict management style on
the relationship between intragroup conflict and the selected outcomes, a relationship that had
not been examined previously in nursing research. The purpose of this study was to test a
theoretical model of intragroup conflict by linking selected antecedent variables (core self-
110
evaluation, unit size, complexity of nursing care, interactional justice, managerial support, group
cohesion and unit morale), intragroup conflict, agreeable style of conflict management, job
stress and, job satisfaction. Consistent with theoretical propositions, higher perceptions of core
self-evaluation, lower complexity of nursing care, higher interactional justice and higher unit
morale and interpersonal relations resulted in lower perceptions of intragroup conflict, which in
turn resulted in higher use of an agreeable style of conflict management. Unit morale and
interpersonal relations was the strongest predictor of intragroup conflict followed by
interactional justice, core self-evaluation and complexity of nursing care. Next, an agreeable
style of conflict management resulted in higher perceptions of job satisfaction but the
relationship to job stress was non-significant. Finally, higher levels of job stress resulted in
lower levels of job satisfaction. Additional pathways not originally hypothesized, but
theoretically sound, included 1) higher perceptions of intragroup conflict directly resulting in
higher levels of job stress and job satisfaction, and 2) lower perceptions of core self-evaluation
resulting in higher perceptions of job stress. The findings have implications for nursing practice
and nursing education and also practical implications for nursing administrators to create an
environment to promote and support collaboration and a team-oriented culture. The study also
provides direction for future research which will contribute to the development of knowledge
about intragroup conflict.
111
References
Adams, A., & Bond, S., (2000). Hospital nurses’ job satisfaction, individual and organizational
characteristics. Journal of Advanced Nursing, 32 (3), 536–543.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J.A., Busse, R., Clarke, H., Giovannetti, P.,
Hunt, J., Rafferty, A.M., & Shamian, J. (2001). Nurses’ reports on hospital care in five
countries. Health Affairs, 20, 43-53.
Aiken, L. H., Sloane, D. M., & Lake, E. T. (1997). Satisfaction with inpatient acquired
immunodeficiency syndrome care: A national comparison of dedicated and scattered-bed
units. Medical Care, 35, 948-962.
Aiken, L. H., Sloane, D. M., Lake, E. T., Sochalski, J., & Weber, A. L. (1999). Organization and
outcomes of inpatient AIDS care. Medical Care, 37, 760-772.
Aiken, L. H., Smith, H. L., & Lake, E. T. (1994). Lower Medicare mortality among a set of
hospitals known for good nursing care. Medical Care, 32, 771-787.
Alexander, J. W. (1996). Organizational development strategies on nursing units. Nursing
Connections 9, 43-52.
Alexander, J. W., & Bauerschmidt, A. D. (1987). Implications for nursing administration of the
relationship of technology and structure to quality of care. Nursing Administration
Quarterly, 11, 1-10.
Alexander, J. W. & Kroposki, M. (2001). Using a management perspective to define and
measure changes in nursing technology. Journal of Advanced Nursing, 35(5), 776-783.
112
Alexander, J. W., & Randolph, W. A. (1985). The fit between technology and structure as a
predictor of performance on nursing units. Academy of Management Journal, 28, 844–
859.
Allison, P. (2003). Missing data techniques for structural equation modeling. Journal of
Abnormal Psychology, 112(4), 545-557.
Almost, J. (2006). Conflict within nursing work environments: Concept analysis. Journal of
Advanced Nursing, 53(4), 444-454.
Almost, J., & Laschinger, H. (2008). The impact of unit conflict on managers' physical
well-being. Paper presented at the Canadian Nurses Biennial Conference, Ottawa, ON
Amason, A. C. (1996). Distinguishing the effects of functional and dysfunctional conflict on
strategic decision-making: Resolving a paradox for top management groups. Academy
of Management Journal, 39, 123-148.
Amason, A.C. & Sapienza, H. (1997). The effects of top management team size and
interaction norms on cognitive and affective conflict. Journal of Management, 23, 496
516.
Amason, A.C. & Schweiger, D.M. (1994). Resolving the paradox of conflict, strategic decision
making, and organizational performance. International Journal of Conflict Management,
5, 239-253.
Anderson, R., & McDaniel Jr, R. (2000). Managing health care organizations: Where
professionalism meets complexity science. Health Care Management Review, 25(1), 83-
92.
113
Andersson, L. & Bateman, T. S. (1997). Cynicism in the workplace: Some causes and effects.
Journal of Organizational Behavior, 18, 449-469.
Anderson, J.C., & Gerbing, G.W. (1998). Structural equation modeling in practice: a review and
recommended two-step approach. Psychological Bulletin, 103(3), 411-423.
Andrews, D. & Dziegielewski, S. (2005). The nurse manager: Job satisfaction and the nursing
shortage and retention issues. Journal of Nursing Management, 13, 286-295.
Ang, M. (2002). Advanced communication skills: Conflict management and persuasion.
Academic Medicine, 77, 1166.
Arbuckle, J. L. & Wothke, W. (1999). Amos 4.0 User’s Guide. Chicago, IL: SPSS, Inc.
Arbuckle, J.L. (2005). Amos 6.0 User's Guide. Chicago, IL: SPSS Inc.
Augsburger, D. (1973). Caring enough to confront. Glendale, CA: Regal Books.
Ayoko, O. & Härtel, C. (2002). The role of emotion and emotion management in destructive and
productive conflict in culturally heterogeneous workgroups. In N. Ashkanasy, W. Zerbe
& C. Härtel (Eds.), Managing emotions in the workplace (pp. 77-97). New York:
Sharpe Publishing.
Bandura A. (1977). Social learning theory. Englewood Cliffs: NJ: Prentice Hall.
Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs: NJ:
Prentice Hall.
Bandura, A., Caprara, G.V, Barbaranelli, C., Pastorelli, C., & Regalia, C. (2001). .
Sociocognitive Self-Regulatory Mechanisms Governing Transgressive Behavior.
Journal of Personality and Social Psychology, 1(80), 125-135.
114
Bantel, K. A. & Jackson, S. E. (1989). Top management and innovations in banking: Does the
composition of the top team make a difference? Strategic Management Journal, 10, 107-
124.
Barki, H. & Hartwick, J. (2001). Interpersonal conflict and its management in information
systems development. MIS Quarterly, 25, 217-250.
Barki, H. & Hartwick, J. (2004). Conceptualizing the construct of interpersonal conflict.
International Journal of Conflict Management, 15(3), 216-244.
Baron, R. A. (1991). Positive effects of conflict: A cognitive perspective. Employee
Responsibilities and Rights Journal, 2, 25-36.
Baron, R. A. & Kenny, D. A. (1986). The moderator-mediator variable distinction in social
psychological research: Conceptual, strategic, and statistical considerations. Journal of
Personality and Social Psychology, 51, 1173-1182.
Barton, A. (1991). Conflict resolution by nurse managers. Nursing Management, 22(5), 83-86.
Bass, B. M. (1960). Leadership, psychology, and organizational behavior. New York, NY:
Harper.
Baumann, A., O'Brien-Pallas, L., Armstrong-Stassen, M., Blythe, J., Bourbonnais, R., Cameron,
S., Irvine Doran, D., Kerr, M., McGillis Hall, L., Zina, M., Butt, M., & Ryan, L. (2001).
Commitment and care: The benefits of a healthy workplace for nurses, their patients and
the system. Ottawa, ON: Canadian Health Services Research Foundation.
Beaudoin, L. E., & Edgar, L. (2003). Hassles: Their Importance to Nurses' Quality of Work
Life. Nursing Economics, 21(3), 106-13.
115
Beech, B. & Leather, P. (2005). Workplace violence in the health care sector: a review of staff
training and integration of training evaluation models. Aggression and Violent Behavior,
11, 27–43.
Bentler, P. M., (1988). Comparative fit indices in structural models. Psychological Bulletin, 107,
238–246.
Bentler, P. M, & Chou, C. P. (1987). Practical issues in structural modeling. Sociological
Methods and Research, 16, 78–117.
Bergman, T.J. & Volkema, R.J. (1989). Understanding and managing interpersonal conflict at
work: Its issues, interactive processes and consequences. In M.A. Rahim (Ed.),
Managing conflict: An interdisciplinary approach (pp. 7-19). New York: Praeger.
Best, R. G., Stapleton, L. M., & Downey, R. G. (2005). Core self-evaluations and job burnout:
The test of alternative models. Journal of Occupational Health Psychology, 10, 441–51.
Beyer, J., & Marshall, J. (1981). The interpersonal dimension of collegiality. Nursing Outlook,
29, 662–665.
Best, R. G., Stapleton, L. M., & Downey, R. G. (2005). Core Self-Evaluations and Job Burnout:
The Test of Alternative Models. Journal of Occupational Health Psychology, 10(4),
441-451.
Bies, R.J. (2001). Interactional (in)justice: The sacred and the profane. In J. Greenberg & R.
Cropanzano (Eds.), Advances in organizational behavior (pp. 89-118). Palo Alto, CA:
Stanford University Press.
116
Bies, R.J., & Shapiro, D.L. (1987), Interactional fairness judgments: the influence of causal
accounts. Social Justice Research, 1(2), 199-218.
Bies, R. J., & Tripp, T. M. (1996). Beyond distrust: "Getting even" and the need for revenge. In
R.M. Kramer & T. Tyler (Eds.), Trust and organizations (pp. 246-260). Thousand Oaks,
CA: Sage.
Bishop, S. R. (2004). Nurses and conflict: Workplace experiences. M.N. dissertation,
University of Victoria (Canada), Canada. Retrieved from Dissertations & Theses: Full
Text. (Publication No. AAT MR02074).
Blake, R. R., & Mouton, J. S. (1964). The managerial grid. Houston, TX: Gulf.
Blake, R. R., & Mouton, J. S. (1984). Solving costly organizational conflicts. San Francisco:
Jossey-Bass.
Blegen, M. A. (1993). Nurses’ job satisfaction: A meta-analysis of related variables. Nursing
Research, 42(1), 36-41.
Boey, K.W. (1999). Distressed and stress resistant nurses. Issues in Mental Health Nursing, 20,
33-54.
Bollen, K.A. (1989). Structural equations with latent variables. New York: Wiley.
Bowie, V., Fisher, B. S., & Cooper, C. L. (2005). Introduction: New issues, trends and
strategies in workplace violence. In V. Bowie, B. S. Fisher, & C. L. Cooper (Eds.),
Workplace violence (pp. 1-12). London: Willan Publishing.
Boychuck-Duchscher, J. & Cowin, L. (2004). The experience of marginalization of new nursing
graduates. Nursing Outlook, 52(6), 289-296.
117
Boyle, D. & Kochinda, C. (2004). Enhancing collaborative communication of nurse and
physician leadership in two intensive care units. Journal of Nursing Administration,
34(2), 60-70.
Brief, A.P., Burke, M. J., George, J. M., Robinson, B. S. & Webster, J. (1988). Should negative
affectivity remain an unmeasured variable in the study of job stress. Journal of Applied
Psychology, 73, 193-198.
Brooks, E., Wilkinson, J. & Popkess-Vawter, S. (1994). Promoting situational support for nurses
in practice. Image: Journal of International Scholarship, 26(4), 305-307.
Browne, M. W. & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen,
& J. S. Long (Eds.), Testing Structural Equation Models (pp. 136–162). Beverly Hills,
CA: Sage.
Brunero, S., Cowan, D., & Fairbrother, G. (2008). Reducing emotional distress in nurses
using cognitive behavioral therapy: A preliminary program evaluation. Journal of
Nursing Science, 5(2), 109-115.
Byrne, B. M. (1998). Structural equation modeling with LISREL, PRELIS and SIMPLIS: Basic
concepts, applications and programming. New Jersey: Lawrence Erlbaum Associates.
Canadian Nursing Advisory Committee. (2002). Our health, our future: Creating quality
workplaces for Canadian nurses. Ottawa, ON: Advisory Committee on Health Human
Resources.
Castledine, G. (1997). What has happened to morale in nursing? British Journal of Nursing 6,
10-23.
118
Cavanaugh, S. J. (1988). The conflict management style of intensive care nurses. Intensive
Care Nursing, 4, 118-123.
Cavanaugh, S. J. (1991). Conflict management style of staff nurses and nurse managers.
Journal of Advance Nursing, 16, 1254-1260.
Chanin, M. N., & Schneer, J. A. (1984). A study of the relationship between Jungian personality
dimensions and conflict-handling behavior. Human Relations, 37, 863-879.
Chen, P. Y., & Spector, P. E. (1991). Negative affectivity as the underlying cause of correlations
between stressors and strains. Journal of Applied Psychology, 76, 398-407.
Choi, J., Bakken, S., Larson, E., Du, Y., & Stone, P. W. (2004). Perceived nursing work
environment of critical care nurses. Nursing Research, 53(6), 370-8.
Chu, C.I., Hsu, H.M., Price, J.L., & Lee, J.Y., (2003). Job satisfaction of hospital nurses: an
empirical test of a causal model in Taiwan. International Nursing Review, 50, 176–182.
Cloke, K. & Goldsmith J. (2002). The end of management and the rise of organizational
democracy. San Francisco: Jossey-Bass.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ:
Lawrence Earlbaum Associates.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress.
Journal of Health and Social Behavior, 24, 385-396.
College of Nurses of Ontario. (2008). College of Nurses of Ontario Membership Statistics
Report 2008. Toronto, ON: CNO.
119
College of Nurses of Ontario. (2009). Compendium of standards for practice of nurses in
Ontario: Conflict Prevention and Management (#47004 – June 2009). Toronto, ON:
CNO. http://www.cno.org/pubs/compendium.html
Colquitt, J, Conlon, D, Wesson, M, Porter, C, & Ng, K. (2001). Justice at the millennium: A
meta-analytic review of 25 years of organizational justice research. Journal of Applied
Psychology, 86, 425-445.
Conrad, C. (1990). Strategic organizational communication: An integrated perspective (2nd
ed.). Ft. Worth, TX: Holt, Rinehart, and Winston.
Cowin L. (2002) The effects of nurses’ job satisfaction on retention. Journal of Nursing
Administration, 32(5), 283–291.
Cox, K. B. (1997). Antecedents and effects of intragroup conflict in the nursing unit. Ph.D.
dissertation, Virginia Commonwealth University, United States -- Virginia. Retrieved
from Dissertations & Theses: Full Text. (Publication No. AAT 9824636).
Cox, K. B. (2001). The effects of unit morale and interpersonal relations on conflict in the
nursing unit. Journal of Advanced Nursing, 35(1), 17-25.
Cox, K. B. (2003). The effects of intrapersonal, intragroup, and intergroup conflict on team
performance effectiveness and work satisfaction. Nursing Administration Quarterly,
27(2), 153-63.
Cox, K. B. (2008). Intragroup conflict scale: Original and revised versions. Paper presented at
the American Organization of Nurse Executives (AONE) Conference, Seattle, WA
Cox, H. C. & Kerfoot, K. M. (1990). Changing verbal abuse into a syntonic interactive mode:
120
The nurse manager's challenge. Nursing Economics, 8(6), 416-417.
Cram, E. (2002). The effect of consistent operating room nursing teams on operating room
nurses' perceptions of job stress, group cohesion, conflict, job satisfaction and
anticipated turnover. Ph.D. dissertation, The University of Iowa, United States -- Iowa.
Retrieved from Dissertations & Theses: Full Text. (Publication No. AAT 3050787).
Crow, S.M., Smith, S.A. & Hartman, S.J. (2005). Attrition in nursing - Perspectives from
the national survey of college graduates. Healthcare Manager, 4, 336-346.
Cumbey, D. A. & Alexander, J. W. (1998). The relationship of job satisfaction with
organizational variables in public health nursing. Journal of Nursing Administration, 28,
39-46.
Deans, C. (2004). The effectiveness of a training program for emergency department nurses in
managing violent situations. Australian Journal of Advanced Nursing, 21(4), 17-22.
DeChurch, L., A. & Marks, M. A. (2001). Maximizing the benefits of task conflict: The role of
conflict management. International Journal of Conflict Management, 12(1), 5-22.
Deci, E. L., Connell, J. P., & Ryan, R. M. (1989). Self-determination in a work organization.
Journal of Applied Psychology, 74, 580-590.
De Dreu, C.K.W. (1997). Productive conflict: The importance of conflict issue and conflict
management. In C.K.W. De Dreu & E. Van de Vliert (Eds.), Using conflict in
organizations (pp 9 - 22). London: Sage.
De Dreu, C.K.W. & Gelfand, M.J. (2008). Conflict in the workplace: Sources, dynamics, and
functions across multiple levels of analysis. In C. K. W. De Dreu & M. J. Gelfand (Eds.),
121
The psychology of conflict and conflict management in organizations (pp. 3 – 54). New
York: Lawrence Erlbaum.
DeDreu, C., Harinck, F. & Van Vianen, A. (1999). Conflict and performance in groups and
organizations. In C.L. Cooper & I.T. Robertson (Eds.), International Review of
Industrial and Organizational Psychology (pp. 376-405). Chichester: Wiley.
De Dreu, C. K. W., & Weingart, L. R. (2003). Task versus relationship conflict and team
effectiveness: A meta-analysis. Journal of Applied Psychology, 88, 741-749.
DeLellis, A. J. & Sauer, R. L. (2004). Respect as ethical foundation for communication in
employee relations. Laboratory Medicine, 35(5), 262-266.
Dellasega, C. A. (2009). Bullying among nurses. American Journal of Nursing, 109(1), 52-58.
DeMarco, R. (1998). Caring to confront in the workplace: An ethical perspective for nurses.
Nursing Outlook, 46,130-135.
Denney, C. (2003). Safe, secure staff provides better care. Nursing Management, 34(3), 18.
De Raeve, L., Jansen, N. W., van den Brandt, P. A., Vasse, R., & Kant, I. J. (2009).
Interpersonal conflicts at work as a predictor of self-reported health outcomes and
occupational mobility. Occupational and Environmental Medicine, 66, 16-22.
Deutsch, M. (1990). Sixty years of conflict. International Journal of Conflict Management, 1,
237-263.
Deutsch, M. (1993). Educating for a peaceful world. American Psychologist, 48, 510-517.
Devine, G. & Turnbull, L. (2002). Nurses’ definitions of respect and autonomy in the
workplace: Summary of focus groups with Canadian nurses. Report commissioned for
122
the Canadian Nursing Advisory Committee (2002), Our Health, Our Future, Creating
Quality Workplaces for Canadian Nurses. Ottawa, Ontario.
Dijkstra, M. T. M., Van Dierendonck, D., & Evers, A. (2005). Responding to conflict at work
and individual well-being: The mediating role of flight behavior and feelings of
helplessness. European Journal of Work and Organizational Psychology, 14, 119-135.
Dillman D. (2000). Mail and Internet Surveys: The Tailored Design Method (2nd ed.). New
York: John Wiley & Sons.
Dirks, K. T. & Parks, J. M. (2003). Conflicting stories: The state of the science of conflict. In J.
Greenberg (Ed.), Organizational Behavior: The State of the Science (pp. 283-324).
Hillsdale, NJ: Lawrence Earlbaum Associates.
Doran, D., McCutcheon, A. S., Evans, M. G., MacMillan, K., McGillis Hall, L., Pringle, D.,
Smith, S., & Valente, A. (2004). Impact of the manager’s span of control on leadership
and performance. Ottawa, ON: Canadian Health Services Research Foundation.
www.chsrf.ca/final_research/ogc/pdf/doran2_e.pdf
Dreachslin, J., Hunt, P., & Sprainer, E. (1999). Communication Patterns and Group
Composition: Implications for Patient-Centered Care Team Effectiveness. Journal of
Healthcare Management, 44(4),253-267.
Eason, F. & Brown, S. (1999). Conflict Management: Assessing Educational Needs. Journal for
Nurses in Staff Development, 15(3), 92-96.
Eden D. (2003). Self-fulfilling prophecies in organizations. In: Greenberg J, (ed).
Organizational Behavior: The State of the Science. Lawrence Erlbaum Publishers;
123
Mahwah, New Jersey.
Erez, A. & Judge, T. A. (2001). Relationship of core self-evaluations to goal setting,
motivation, and performance. Journal of Applied Psychology, 86, 1270–9.
Evans, M. (2005). On the job: nurses reveal most, least enjoyable aspects of work. Modern
Healthcare, 35, 14–16.
Fan, X., Thompson, B & Wang, L. (1999). The Effects of sample size, estimation methods, and
model specification on SEM fit indices. Structural Equation Modeling: A
Multidisciplinary Journal, 6, 56-83.
Farkas, S. & Johnson, J. (2002). Aggravating circumstances: A status report on rudeness in
America. New York: Public Agenda.
http://www.publicagenda.org/files/pdf/aggravating_circumstances.pdf
Farrell, G. (1997). Aggression in clinical settings: nurses' views. Journal of Advanced Nursing,
25(3), 501-508.
Farrell, G. (1999). Aggression in clinical settings: a follow-up study. Journal of Advanced
Nursing, 29, 532–541.
Farrell, G. (2001). From tall poppies to squashed weeds: Why don’t nurses pull together more?
Journal of Advanced Nursing, 35, 26–33.
Filley, A. C. (1975). Interpersonal conflict resolution. Glenview, ILL: Scott, Foresman and
Company.
Findorff, M., McGovern, P., & Sinclair, S. (2005). Work-related violence policy: A process
evaluation. AAOHN Journal, 53, 360–369.
124
Fisher, R., & Brown, S. (1988). Getting together: Building relationships as we negotiate. New
York: Penguin Books.
Forte, P.S. (1997). The high cost of conflict. Nursing Economics, 15, 119–123.
Friedman, R. A., Tidd, S. T., Currall, S. C., & Tsai, J. C. (2000). What goes around comes
around: The impact of personal conflict style on work conflict and stress. International
Journal of Conflict Management, 11, 32-55.
Furr, R. M., & Funder, D. C. (1998). A multi-modal analysis of personal negativity. Journal of
Personality and Social Psychology, 74, 1580-1591.
Gall, M., Gall, J., & Borg, W. (2003). Educational research: An introduction (7th ed.). Upper
Saddle River, New Jersey: Pearson Education, Inc
Gardner, D. L. (1992). Conflict and retention of new graduate nurses. Western Journal of
Nursing Research, 14, 76-85.
Garson, C. D. (2009). Structural equation modeling. Statsnotes: Topics in multivariate
analysis. Retrieved 04/28/2009 from
http://faculty.chass.ncsu.edu/garson/pa765/statnote.htm.
Gemmill, G. & Oakley, J. (1992). Leadership: an alienating social myth. Human Relations,
45(2), 113-129.
Gerardi, D., Thornby, D. C., & Pettrey, L. J. (2004). Using mediation techniques to manage
conflict and create health work environments. AACN Advanced Critical Care, 15(2),
182-195.
125
Gilmore, D.C., Ferris, G.R., Dulebohn, J.H., & Harrell-Cook, G. (1996). Organizational politics
and employee attendance. Group and Organization Management, 21(4), 481-94.
Gist, M. & Mitchell, T. (1992). Self-Efficacy: A Theoretical Analysis of Its
Determinants and Malleability. Academy of Management Review, 17(2),183-211.
Gray-Toft, P. & Anderson, J.G. (1981). Stress among hospital nursing staff: its causes and
effects. Social Sciences and Medicine, 15(5), 639–647.
Greenberg, J. (1990). Organizational justice: Yesterday, today, and tomorrow. Journal of
Management, 16(2), 399-432.
Greenberg, J. (2004). Stress fairness to fare not stress: Managing workplace stress by promoting
organizational justice. Organizational Dynamics, 33, 352-365.
Hackman, J. R., & Oldham, G. R (1975). Development of the Job Diagnostic Survey. Journal
of Applied Psychology, 60, 159-70.
Hackman, J. R., & Oldham, G. R (1980). Work redesign. Reading, MA: Addison-Wesley.
Hair, J.F., Anderson, R.E., Thatham, R.L. & Black, W.C. (1998). Multivariate Data Analysis
(5th ed.). New Jersey: Prentice-Hall.
Hansen, H. (1995). A model of collegiality among staff nurses in acute care. Journal of Nursing
Administration, 25, 11–20.
Hansen, A. M., Hogh, A., Persson, R., Karlson, B., Garde, A. H., & Orbaek, P. (2006).
Bullying at work, health outcomes and physiological stress. Journal of Psychosomatic
Research, 60(1), 63-72.
126
Harter, S. (1990). Causes, correlates, and the functional role of global self-worth. A life span
perspective. In R. J. Sternberg & J. Kolligan Jr (Eds.), Competence considered (pp. 67-
97). New Haven: Yale University Press.
Hawryluck, L., Espin, S., Garwood, K., Evans, C., & Lingard, L. (2002). Pulling together and
pushing apart: Tides of tension in the ICU ream. Academic Medicine, 77(10), S73–S76.
Heinisch, D. A., & Jex, S. M. (1997). Negative affectivity and gender as moderators of the
relationship between work-related stressors and depressed mood at work. Work & Stress,
11, 46-57.
Hershcovis, M. S., Turner, N., Barling, J., Arnold, K. A., Dupré, K. E., Inness, M., LeBlanc, M.
M., & Sivanathan, N. (2007). Predicting workplace aggression: A meta‐analysis.
Journal of Applied Psychology, 92, 228‐38.
Hesketh, K. L., Duncan, S. M., Estabrooks, C. A., Reimer, M. A., Giovannetti, P., Hyndman, K.
& Acorn, S. (2003). Workplace violence in Alberta and British Columbia hospitals.
Health Policy, 63, 311-321.
Hightower, T. (1986). Subordinate choice of conflict-handling modes. Nursing Administration
Quarterly, 11, 29-34.
Hillhouse, J.J. & Adler, C.M. (1997). Investigating stress effect patterns in hospital staff nurses:
result of cluster analysis. Social Science and Medicine, 45, 1781–1788.
Hinkin, T.R. (1995). A review of scale development practices in the study of organizations.
Journal of Management, 21(5), 967-988.
127
Hinshaw, A., Smeltzer, C., & Atwood, J. (1987). Innovative retention strategies for nursing
staff. Journal of Nursing Administration, 17, 8-16.
Hipwell A.E., Tyler P.A. & Wilson C.M. (1989). Sources of stress and dissatisfaction among
nurses in four hospital environments. British Journal of Medical Psychology, 62, 71–79.
Hoel, H. & Cooper, C. (2001). Destructive conflict and bullying at work. Counselling at Work,
32, 3–6.
Horton-Deutsch, S. & Sherwood, G. (2008). Reflection: An educational strategy to develop
emotionally-competent nurse leaders. Journal of Nursing Management, 16(8), 946-954.
Hoyle, R. H. (Ed). (1995). Structural Equation Modeling: Concepts, issues, and applications.
Thousand Oaks, CA: Sage Publications.
Hoyle, R. H., & Panter, A. T. (1995). Writing about structural equation models. In R. H. Hoyle
(Ed.), Structural equation modeling (pp. 158-176). Thousand Oaks, CA: Sage
Publications.
Hoyle, R. H. & Smith, G. T. (1994). Formulating clinical research hypotheses as structural
equation models: A conceptual overview. Journal of Consulting and Clinical
Psychology, 62, 429-440.
Hu, L.T. & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis:
conventional criteria versus new alternatives. Structural Equation Modeling 6, 1–55.
Hughes, L.C., Ward, S., Grindel, C.G., Coleman, E.A., Berry, D.L., Hinds, P.S., Oleske, D.M.,
Murphy, C.M., & Frank-Stromberg, M. (2001). Relationships between certification and
job perceptions of oncology nurses. Oncology Nursing Forum, 28, 99-106.
128
Hulley, S. B., Cimmings, S. R., Browner, W. S., et al (2001). Designing Clinical Research. An
Epidemiologic Approach (2nd ed). London: Lippincott Williams and Wilkins.
Hutton, S. A. (2006). Workplace incivility: state of the science. Journal of Nursing
Administration, 36, 22-28.
Iacobucci, D., Saldanha, N.,& Deng, S., (2007). A Meditation on Mediation: Evidence that
Structural Equations Models Perform Better than Regressions. Journal of Consumer
Psychology, 17(2), 139-53.
Institute of Medicine. (2004). Keeping Patients Safe: Transforming the Work Environment of
Nurses. Washington, DC: National Academy Press.
Institute for Safe Medication Practices (ISMP). (2004). Intimidation: Practitioners speak up
about this unresolved problem. ISMP Medication Safety Alert, March 11.
Ironside, M & Seifert, R. (2003). Tackling Bullying in the Workplace. In S. Enarsen, H. Hoel,
D. Zapf & C. L. Cooper (Eds.), Bullying and Emotional Abuse in the Workplace:
International Perspectives in Research and Practice, London/New York: Taylor and
Francis.
Ivancevich, J. M., & Matteson, M. T. (1980). Stress and work: A managerial perspective. In J.
C. Quick, R. S. Bhagat, J. E. Dalton, & J. D. Quick (Eds.), Work stress: Health care
systems in the workplace (pp. 27-49). New York: Praeger.
Irvine, D. M., & Evans, M. G. (1995). Job satisfaction and turnover among nurses: Integrating
research findings across studies. Nursing Research, 44(4), 246-253.
129
Jaccard, J. & Wan, C. K. (1996). LISREL approaches to interaction effects in multiple
regression. Thousand Oaks, CA: Sage Publications.
Jehn, K. A. (1995). A multimethod examination of the benefits and detriments of intragroup
conflict. Administrative Science Quarterly, 40, 256-282.
Jehn, K. A. (1997). A qualitative analysis of conflict types and dimensions in organizational
groups. Administrative Science Quarterly, 42, 530-557.
Jehn, K. A., Chadwick, C., & Thatcher, S. M. (1997). To agree or not to agree: The effects of
value congruence, individual demographic dissimilarity, and conflict on workgroup
outcomes. The International Journal of Conflict Management, 8(4), 287-306.
Jehn, K. A., & Mannix, E. (2001). The dynamic nature of conflict: A longitudinal study of
intragroup conflict and performance. Academy of Management Journal, 44, 238-251.
Jehn, K. A., Northcraft, G. B., & Neale, M. A. (1999). Why some differences make a
difference: A field study of diversity, conflict, and performance in workgroups.
Administrative Science Quarterly, 44, 741-763.
Jöreskog, K. G., & Sörbom, D. (1989). LISREL 7: User's reference guide. Mooresville, IN:
Scientific Software, Inc.
Joreskog, K. G., & Sorbom, D. (1993). LISREL 8: Users' reference guide. Chicago: Scientific
Software International.
Judge, T. A., Bono, J. E., Erez, A., & Locke, E. A. (2005). Core self-evaluations and job and life
satisfaction: The role of self-concordance and goal attainment. Journal of Applied
Psychology, 90, 257–268.
130
Judge, T., Bono, J., Erez, A., & Thoresen, C. (2003). The core self-evaluations scale:
Development of a measure. Personnel Psychology, 56(2), 303-331.
Judge, T. A., Bono, J. E., & Locke, E. A. (2000). Personality and job satisfaction: The
mediating role of job characteristics’, Journal of Applied Psychology, 85, 237–49.
Judge, T.A., Erez, A., & Bono J.E. (1998). The power of being positive: The relationship
between positive self-concept and job performance. Human Performance, 11, 167-187.
Judge, T. A., Locke, E. A., & Durham, C. C. (1997). The dispositional causes of job
satisfaction: A core evaluations approach. Research in Organizational Behavior, 19,
151–188.
Judge, T. A., Locke, E. A., Durham, C. C., & Kluger, A. N. (1998). Dispositional effects on job
and life satisfaction: The role of core evaluations. Journal of Applied Psychology, 83,
17–34.
Kabanoff, B. (1991). Equity, equality, power and conflict. Academy of Management Review, 16
(2), 416-441.
Kattzenback, J. & Smith, D. (1993). The Wisdom of Teams. Harper Business: New York, NY.
Kammeyer-Mueller, J.D., Judge, T.A., & Scott, B.A. (2009). The role of core self-evaluations in
the coping process: Testing an integrative model. Journal of Applied Psychology, 94,
177-195.
Kelly, J. & Ahern, K. (2009). Preparing nurses for practice: a phenomenological study of the
new graduate in Australia. Journal of Clinical Nursing, 18(6), 910-918.
Kenny, D. (1998). Structural Models with Latent Variables. http://davidakenny.net/cm/sem.htm
131
Kivïmaki, M., Elovainio, M., & Vahtera, J. (2000). Workplace bullying and sickness absence in
hospital staff. Occupational and Environmental Medicine, 57, 656–660.
Kleinman, C.S. (2004). Leadership and retention: Research needed. Journal of Nursing
Administration, 34(3), 111-114.
Kline, R. B. (1998). Principles and practices of structural equation modeling. New York:
Guilford Press.
Kline, R. B. (2005). Principles and practices of structural equation modeling (2nd ed.). New
York: Guilford Press.
Kramer, M., Maguire, P., Schmalenberg, C., Brewer, B., Burke, R., Chmielewski, L., Cox, K.,
Kishner, J., Krugman, M., Meeks-Sjostrom, D., & Waldo, M. (2007). Nurse manager
support: What is it? Structures and practices that promote it. Nursing Administration
Quarterly, 31(4), 325-40.
Kupperschmidt, B. (1994). Carefronting: caring enough to confront. The Oklahoma Nurse, 7-10.
Kushell, E, & Ruh, S. (1996). Dealing with conflict: The Margaret Chapman case. Journal of
Nursing Administration, 26, 34-40.
Lake, E. T. (2002). Development of the Practice Environment Scale of the Nursing Worklife
Index. Research in Nursing and Health, 25, 176-188.
Lambert, V., Lambert, C., & Ito, M. (2004). Workplace stressors, ways of coping and
demographic characteristics as predictors of physical and mental health of Japanese
hospital nurses. International Journal of Nursing Studies, 41, 85-97.
132
Laschinger, H. K. S. (2004). Hospital nurses’ perceptions of respect and organizational justice.
Journal of Nursing Administration, 34, 354-364.
Laschinger, H. K. S., Almost, J., & Tuer-Hodes, D. (2003). Workplace empowerment and
magnet hospital characteristics: Making the link. Journal of Nursing Administration, 33,
410-422.
Laschinger, H. K. S., & Finegan, J. (2005). Using empowerment to build trust and respect in
the workplace: A strategy for addressing the nursing shortage. Nursing Economics, 23,
6-13.
Laschinger, H. K. S., Finegan, J., & Shamian, J. (2001). The impact of workplace empowerment
and organizational trust on staff nurses’ work satisfaction and organizational
commitment. Health Care Management Review, 26(3), 7-23.
Laschinger, H., Finegan, J., &Wilk, P. (2009). Context matters: the impact of unit leadership
and empowerment on nurses' organizational commitment. Journal of Nursing
Administration, 39(5), 228-235.
Laschinger, H. K. S, Finegan, J., Shamian, J., & Wilk, P. (2001). Impact of structural and
psychological empowerment on job strain in nursing work settings: Expanding Kanter’s
model. Journal of Nursing Administration, 31, 260-72.
Laschinger, H. K. S., & Havens, D. S. (1996). Staff nurse empowerment and perceived control
over nursing practice. Journal of Nursing Administration, 26(9), 27-35.
Laschinger, H. K. S., Purdy, N., & Almost, J. (2007). The impact of leader-member exchange
quality, empowerment, and core self evaluation on nurse managers’ job satisfaction.
133
Journal of Nursing Administration, 37, 221-229.
Laschinger, H. K. S., Wong, C., Ritchie, J., D’Amour,D., Vincent,L., Wilk, P., Armstrong
Stassen, M., Matthews, S., Saxe-Braithwaite, M., Grinspun, D., Shamian, J.,
McCutcheon, A., Kerr, M., Macdonald-Rencz, M., Oke, B., Denney, D., & Almost, J.
(2008). A profile of the structure and impact of nursing management in Canadian
hospitals. Longwoods Review, 6(1), 85-94.
Lawrence, S. & Callan,V. J. (2006). Interpersonal conflict and support mobilization: Nurses’
experience in coping in the workplace. Paper presented to the Health Care Management
Division of the Academy of Management Meeting, Atlanta, GA.
Lawrence, S., Pisarski, A. & Callan, V.J. (2005). An integrative model of the role of perceived
available support in coping with interpersonal conflict. Paper presented to the
Organizational Behaviour Division of the British Academy of Management Meeting,
Oxford UK.
Leatt P, & Schneck R. (1981). Nursing subunit technology: a replication. Administrative
Science Quarterly, 26(2), 225–236.
Leatt, P. & Schneck, R. (1985). Sources and management of organizational stress in nursing
sub-units in Canada. Organization Studies, 6(1), 55-79.
Lee, C. (1990). Relative status of employees and styles of handling interpersonal conflict: An
experimental study with Korean managers. International Journal of Conflict
Management, 1, 327-340.
134
Leiter, M. P. (1991). Coping patterns as predictors of burnout: The functions of control
and escapist coping patterns. Journal of Organizational Behavior, 12, 123-144.
Lewicki, R. J., Weiss, S. E., & Lewin, D. (1992). Models of conflict, negotiation, and third
party intervention: A review and synthesis. Journal of Organizational Behavior, 13,
209-252.
LoBiondo-Wood, G. & Haber, J. (2005). Nursing Research in Canada. (C. Cameron & M. D.
Singh Canadian Eds.). Toronto, Canada: Elsevier Canada.
Locke, E. A., McClear, K., & Knight, D. (1996). Self-esteem and work. In C. Cooper, & I.
Robertson (Eds.), International review of industrial and organizational psychology.
Chichester, UK: Wiley.
MacIntosh, J. (2005). Experiences of workplace bullying in a rural area. Issues in Mental Health
Nursing, 26, 893–910.
MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of
Psychology, 58, 593-614.
Marcus, L., Dorn, B., Kriteck, P., Miller, V., & Wyatt, J. (1995). Renegotiating health care:
Resolving conflict to build collaboration. San Francisco, Ca: Jossey Bass.
Mark, B. (2006). Methodological issues in nurse staffing research. Western Journal of Nursing
Research, 28(6), 694-709.
Mark, B. & Hagenmueller, A. C. (1994). Technological and environmental characteristics of
intensive care units. Implications for Job Redesign. Journal of Nursing Administration,
24(4 Suppl), 65–71.
135
Marriner, A. (1982). Managing conflict. Nursing Management, 13(6), 29-31.
Mathisen, G. & Bronnick, K. (2009). Creative self-efficacy: An intervention study.
International Journal of Educational Research, 48(1), 21-29.
McCune, J. C. (2000). Civility Counts. Management Review, 89 (3), 6-8.
McKenna, B. G., Smith N. A., Pool, S. J., & Coverdale, J. H. (2003). Horizontal violence:
Experiences of registered nurses in their first year of practice. Journal of Advanced
Nursing, 42 (1), 90-96.
McMahon, R. (1990). Power and collegial relations among nurses on wards adopting primary
nursing and hierarchical ward management structures. Journal of Advanced Nursing, 15,
232–239.
McMillan, J.H. (2000). Educational Research: Fundamentals for the Consumer. New York,
NY: Addison Wesley Longman.
McNeese-Smith, D. K. (1997). The influence of manager behavior on nurses' job satisfaction,
productivity, and commitment. Journal of Nursing Administration, 47-55.
Medina, F.J., Munduate, L., Dorado, M.A., Martínez, I., & Guerra, J. M. (2005). Types of
intragroup conflict and affective reactions. Journal of Managerial Psychology, 20(3/4),
219-30.
Merriam-Webster Online Dictionary. (2006-2007). http://www.m-w.com/dictionary/conflict,
accessed July 20, 2007.
Meyer, S. (2004). Organizational response to conflict: future conflict and work outcomes. Social
Work Research, 28, 183–190.
136
Morrison, J. (2008a). The relationship between emotional intelligence competencies
and preferred conflict-handling styles. Journal of Nursing Management, 16, 974 – 983.
Morrison, R. L. (2008b). Negative relationships in the workplace: Associations with
organizational commitment, cohesion, job satisfaction, and intention to turnover.
Journal of Management and Organization, 14(4), 330-344.
Murnigham, J.K. & Conlon, D.E. (1991). The dynamics of intense work groups: A study of
British string quartets. Administrative Science Quarterly, 36, 165-186.
Muthen, B. (1994). Multilevel covariance structure analysis. Sociological Methods &
Research, 22(3), 376-269.
Nachreiner, N.M., Gerberich, S.G., McGovern, P.M., Church, T.R., Hansen, H.E., Geisser,
M.S., & Ryan, A.D. (2005). Impact of training on work-related assault, Research in
Nursing and Health, 28, 67–78.
Neuman, J. H., & Baron, R. A. (1998). Workplace violence and workplace aggression: Evidence
concerning specific forms, potential causes, and preferred targets. Journal of
Management, 24, 391-419.
Nunnally, J. C. (1978). Psychometric theory (2nd ed.). New York: McGraw-Hill.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd Ed.). New York: McGraw-
Hill.
Nye, R. D. (1973). Conflict among humans. New York: Springer.
Oandasan, I., Baker, G.R., Barker, K., Bosco, C., D’Amour, D., Jones, L., Kimpton, S.,
Lemieux-Charles, L., Nasmith, L., Rodriguez, L., Tepper, J., & Way, D. (2006).
137
Teamwork in healthcare: Promoting effective teamwork in healthcare in Canada.
Policy Synthesis and Recommendations. Ottawa, ON: Canadian Health Services
Research Foundation.
O’Connell, B., Young, J., Brooks, J., Hutchings, J., & Lofthouse, J. (2000). Nurses’ perceptions
of the nature and frequency of aggression in general ward settings and high dependency
areas. Journal of Clinical Nursing, 9, 602–610.
Oldham, G. R. & Cummings, A. (1996). Employee creativity: Personal and contextual factors
at work. Academy of Management Journal, 39, 607-634.
Overton, P., Schneck, R. & Hazlett, C. B. (1977). An empirical study of the technology of
nursing subunits. Administrative Science Quarterly, 22, 203-219.
Parsons, L.C. (1998). Delegation skills and nurse job satisfaction. Nursing Economics, 16, 18-
26.
Patel, M. X., Doku, V., & Tennakoon, L. (2003). Challenges in recruitment of research
participants. Advances in Psychiatric Treatment, 9, 229-238.
Patrician, P. (2002). Multiple imputation for missing data. Research in Nursing & Health,
25(1), 76-84.
Pearson, A., Porritt, K. A., Doran, D., Vincent, L. Craig, D., Tucker, D., & Long, L. E. (2006).
A comprehensive systematic review of evidence on the structure, process, characteristics
and composition of nursing team that fosters a healthy work environment. International
Journal of Evidence Based Healthcare, 4, 118-159.
138
Pedhazur, E. J. & Schmelkin, L. P. (1991). Measurement, design and analysis. Hillsdale, NJ:
Lawrence Erlbaum Associates.
Peters, L.H. & O’Connor, E.J. (1980). Situational constraints and work outcomes: The
influences of a frequently overlooked construct. Academy of Management Review, 5,
391-397.
Peterson, R. & Behfar, K. (2003). The dynamic relationship between performance feedback,
trust, and conflict in groups: A longitudinal study. Organizational Behavior and Human
Decision Processes, 92, 102-112.
Pilkington, C.J., Richardson, D.R., & Utley, M.E. (1988). Is conflict stimulating? Sensation
seekers' responses to interpersonal conflict. Personality and Social Psychology Bulletin,
14, 596-603.
Pinkley, R. L. (1990). Dimensions of conflict frame: Disputant interpretations of conflict.
Journal of Applied Psychology, 75, 117-126.
Podsakoff, P. M., MacKenzie, S. B., Lee, J.-Y. & Podsakoff, N. P. (2003). Common method
biases in behavioral research: a critical review of the literature and recommended
remedies. Journal of Applied Psychology, 88(5), 879-903.
Podsakoff, P. M. & Organ, D. W. (1986). Self-reports in organizational research: problems and
prospects. Journal of Management, 12(4), 531-543.
Polit, D.F., & Beck, C.T. (2004). Nursing research: Principles and methods (7th ed.).
Philadelphia: Lippincott Williams and Wilkins.
Polit, D., & Hungler, B. (1995). Nursing research: Principles and methods (5th ed.).
139
Philadelphia, PA: Lippincott.
Polit, D., & Hungler, B. (1999). Nursing research: Principles and methods (6th ed.).
Philadelphia, PA: Lippincott.
Pondy, L. R. (1967). Organizational conflict: Concepts and models. Administrative Science
Quarterly, 12, 296-320.
Pondy, L. R. (1992). Reflections on organizational conflict. Journal of Organizational
Behavior, 13, 257-261.
Preacher, K. J., & Leonardelli, G. L. (2003). Calculation for the Sobel test: An interactive
calculation tool for mediation tests. Retrieved August 13, 2009 from
http://people.ku.edu/~preacher/sobel/sobel.htm.
Pruitt, D. G. (1998). Social conflict. In D. Gilbert, S. T. Fiske, & G. Lindzey (Eds.), Handbook
of social psychology (4th ed., Vol. 2) (pp. 470-503). New York: McGraw-Hill.
Pruitt, D. G., & Rubin, J. (1986). Social conflict: Escalation, stalemate, and settlement. New
York, NY: Random House.
Quine, L. (1999). Workplace bullying in NHS community trust: staff questionnaire survey.
British Medical Journal, 318, 228–232.
Rafferty, A. M., Ball, J., & Aiken, L. H. (2001). Are teamwork and professional autonomy
compatible, and do they result in improved hospital care? Quality in Health Care,
10(Suppl 2), ii32-37.
Rahim, M. A. (1983). Measurement of organizational conflict. Journal of General Psychology,
109, 189-199.
140
Rahim, M. A. (1992). Managing conflict in organizations. Westport, CT: Praeger.
Rahim, M. A., Antonioni, D., & Psenicka, C. (2001). A structural equations model of leader
power, subordinates’ styles of handling conflict, and job performance. International
Journal of Conflict Management, 12(3), 191-211.
Rahim, A., & Bonoma, T. V. (1979). Managing organizational conflict: A model for diagnosis
and intervention. Psychological Reports, 44, 1323-1344.
Raver, J., & Barling, J. (2008). Workplace aggression and conflict: Constructs, commonalities,
and challenges for future inquiry. In C.K.W. De Dreu & M.J. Gelfand (Eds.), The
psychology of conflict and conflict management in organizations (pp. 211-244). New
Jersey: Lawrence Erlbaum Associates.
Richman-Hirsch, W. & Mercer, W. (2001). Post-training interventions to enhance transfer:
The moderating effects of work environments. Human Resource Development
Quarterly, 12(2), 105-120.
Riordan, C. M. & Weatherly, E. (1999). Defining and measuring employees' identification with
their work groups. Educational and Psychological Measurement, 59(2), 310-324.
Robbins, S. P. (1979). Organizational behaviour: Concepts and controversies. Englewood
Cliffs, NJ: Prentice-Hall, Inc.
Roch, S. G., & Shanock, L. R. (2006). Organizational justice in an exchange framework:
Clarifying organizational justice dimensions. Journal of Management, 32, 299-322.
Rodgers, B. L. (1989). Concepts, analysis, and the development of nursing knowledge: The
evolutionary approach. Journal of Advanced Nursing, 14, 330-335.
141
Rogelberg, S. G., Luong, A., Sederburg, M. E., & Cristol, D. S. (2000). Employee attitude
surveys: Examining the attitudes of noncompliant employees. Journal of Applied
Psychology, 85, 284-293.
Rolleman, R. (2001). The nature of interpersonal and informal conflicts in the West Kootenay
Region of the British Columbia Nurses' Union: A general inquiry. M.A. dissertation,
Royal Roads University (Canada), Canada. Retrieved from Dissertations & Theses: Full
Text. (Publication No. AAT MQ62036).
Rotter, J. B. (1966). Generalized expectancies for internal versus external control of
reinforcement. Psychological Monographs, 80. (Whole No. 609).
Royal College of Nursing. (2005). Working with Care: Improving Working Relationships in
Health Care. RCN: London.
http://www.rcn.org.uk/__data/assets/pdf_file/0005/78638/002487.pdf
Rubin, J. Z., Pruitt, D. G., & Kim, S. H. (1994). Social conflict: Escalation, stalemate, and
settlement. New York: McGraw-Hill.
Schmalenberg, C. & Kramer, M. (2008). Essentials of a productive nurse work environment.
Nursing Research, 57(1), 2-13.
Schumacker, R. E. & Lomax, R. G. (2004). A Beginner's Guide to Structural. Equation
Modeling (2nd ed.). Mahwah, NJ: Erlbaum and Associates.
Schwartz, R.H. (1990). Coping with unbalanced information about decision-making influence
for nurses. Hospital and Health Services Administration, 35(4), 547-59.
142
Schwarzer, R., & Leppin, A. (1991). Social support and health: A theoretical and empirical
overview. Journal of Social and Personal Relationships, 8, 99-127.
Schwoerer, C., May, D., Hollensbe, E., & Mencl, J. (2005). General and specific self-efficacy
in the context of a training intervention to enhance performance expectancy. Human
Resource Development Quarterly, 16(1), 111-129.
Selye, H. (1976). The Stress of Life. New York: McGraw-Hill.
Seo, Y., Ko., J. & Price, J. L. (2004). The determinants of job satisfaction among hospital
nurses: A model estimation in Korea. International Journal of Nursing Studies, 41(4),
437-446.
Seren, S., & Ustun, B. (2008). Conflict resolution skills of nursing students in problem-based
compared to conventional curricula. Nurse Education Today, 28(4), 393-400.
Silvia, E.S.M., & MacCallum, R.C. (1988). Some factors affecting the success of specification
searches in covariance structural modeling. Multivariate Behavioral Research. 23, 297-
326.
Siu, H., Laschinger, H. K. S., & Finegan, J. (2008). Nursing professional practice environments:
Setting the stage for constructive conflict resolution and work effectiveness. Journal of
Nursing Administration, 38, 250-257.
Slaikeu, K. A., & Hasson, R. H. (1998). Controlling the Costs of Conflict. San Francisco:
Jossey-Bass.
143
Smith, K.G., Smith, K.A., Olian, J.D., Sims, H.P., O'Bannon, D.P. & Scully, J.A. (1994). Top
management team demography and process: The role of social integration and
communication. Administrative Science Quarterly, 39, 412-438.
Soeken, K. (2004). Validity of measures. In C. F. Waltz, Strickland, O., & Lenz, E. R. (Eds.),
Measurement in nursing and health research (3rd ed.) (pp 154-190). New York:
Springer Publishing Company.
Sofield, L., & Salmond, S.W. (2003). Workplace violence: A focus on verbal abuse and intent to
leave the organization. Orthopedic Nursing, 22(4), 274-283.
Spector, P.E. (1982). Behavior in organizations as a function of employee’s locus of control,
Psychological Bulletin, 91, 482-497.
Spector, P. E. (1987). Method variance as an artifact in self-reported affect and perceptions at
work: myth or significant problem? Journal of Applied Psychology, 72, 438-443.
Spector, P. E. (1994). Using self-report questionnaires in OB research: a comment on the use of
a controversial method. Journal of Organizational Behavior, 15, 385-392.
Spector, P. E. (2006). Method variance in organizational research: Truth or urban legend?
Organizational Research Methods, 9(2), 221-232.
Spector, P. E., & Jex, S. M. (1998). Development of Four Self-Report Measures of Job Stressors
and Strain: Interpersonal Conflict at Work Scale, Organizational Constraints Scale,
Quantitative Workload Inventory, and Physical Symptoms Inventory. Journal of
Occupational Health Psychology, 3, 356-367.
Spickerman, S., & Brown, S. T. (1991). Student conflict management: Before and after
144
instruction. Nurse Educator, 16(6), 6-11.
Stanhope, M. & Lancaster, J. (1988). Community health nursing: Processes and practice for
promoting health (2nd ed.). Washington, DC: Mosby.
Sternberg, R.J. & Dobson, D.M. (1987). Resolving interpersonal conflicts: An analysis of
stylistic consistency. Journal of Personality and Social Psychology, 52, 794-812.
Stevens, J. (1996). Applied multivariate statistics for the social sciences. Hillsdale, NJ:
Laurence Erlbaum.
Stogdill, R. M. (1972). Group productivity, drive, and cohesiveness. Organizational Behavior
and Human Performance, 8, 26-43.
Tabachnick, B. G. & Fidell, L. S. (2001). Using Multivariate Statistics. (4th ed.). Needham
Heights, MA: Allyn & Bacon.
Taylor, B. (2001). Identifying and transforming dysfunctional nurse-nurse relationships through
reflective practice and action research. International Journal of Nursing Practice, 7(6),
406-413.
Terhune, K.W. (1970). The effects of personality in cooperation and. conflict. In P. Swingle,
(Ed.), The structure of conflict (pp. 193-234). New York: Academic Press.
Thomas, K.W. (1976). Conflict and conflict management. In M. D. Dunnette (Ed.), Handbook
of Industrial and Organizational Psychology (pp. 889-935). Palo Alto, CA; Consulting
Psychologists Press.
Thomas, K. W. (1992). Conflict and negotiation processes in organizations. In M. D. Dunnette
& L. M. Hough (Eds.), Handbook of Industrial and Organizational Psychology (2nd
145
ed.) (pp. 651-717). Palo Alto, CA: Consulting Psychologists Press.
Tidd, S. T. & Friedman, R. A. (2002). Conflict style and coping with role conflict: An
extension of the uncertainty model of work stress. International Journal of Conflict
Management, 13, 236-257.
Tjosvold, D. (1997). Conflict within interdependence: its value for productivity and
individuality. In C. K. De Dreu, & E. Van de Vliert (Eds.), Using Conflict in
Organizations (pp. 23-37). Thousand Oaks, CA: Sage.
Tjosvold, D. (1998). Cooperative and competitive goal approach to conflict: Accomplishments
and challenges. Applied Psychology: An International Review, 47, 285-342.
Tjosvold, D., Dann, V., & Wong, C. (1992). Managing conflict between departments to serve
customers. Human Relations, 45(10), 1035-1054.
Tovey, E, & Adams, A. (1999). 'The changing nature of nurses' job satisfaction: an exploration
of sources of satisfaction in the 1990s . Journal of Advanced Nursing, 30(1), 150 – 158.
Ullman. J.B. (1996). Structural equation modeling. In B.G. Tabachnick & L.S. Fidell, (Eds.),
Using multivariate statistics (3rd ed.) (pp. 709-819). New York, NY: Harper Collins
College Publishers.
Valentine, P. (1995). Management of conflict: Do nurses/women handle it differently? Journal
of Advanced Nursing, 22(1), 142–149.
Valentine, P. E.B. (2001). A gender perspective on conflict management strategies of nurses.
Journal of Nursing Scholarship, 33(1), 69-74.
146
Valentine, E.B., Richardson, S., Wood, M.J., & Godkin, D.M. (1998). Nurse educators’/
administrators’ ways of handling conflict. Journal of Professional Nursing, 14(5), 288-
297.
Van de Vliert, E. (1997). Complex interpersonal conflict behaviour: Theoretical frontiers.
London: Psychology Press.
Van de Vliert, E. & Euwema, M. (1994). Agreeableness and activeness as components of
conflict behaviors. Journal of Personality and Social Psychology, 66, 674-687.
Van de Vliert, E., Euwema, M., & Huismans, S. (1995). Managing conflict with a subordinate
or a supervisor: Effectiveness of conglomerated behavior. Journal of Applied
Psychology, 80, 271-281.
VanYperen, N, Hagedoorn, M, Zweers, M, & Postma, S. (2000). Injustice and employees’
destructive responses: The mediating role of state negative affect. Social Justice
Research, 13(3), 291-312.
Wall, J. & Callister, R. (1995). Conflict and its management. Journal of Management, 21, 515-
558.
Walton, R. E. (1966). Theory of conflict in lateral organizational relationships. In J. R.
Lawrence, (Ed.), Operational research and the social sciences (pp. 409-426). London:
Tavistock Publications.
Watson, D. (2000). Mood and temperament. New York: Guilford.
Warner, I. J. (2001). Nurses' perceptions of workplace conflict: Implications for retention and
recruitment. M.A. dissertation, Royal Roads University (Canada), Canada. Retrieved
147
from Dissertations & Theses: Full Text. (Publication No. AAT MQ62041).
Weisman, C. S., Gordon, D. L., Cassard, S. D., Bergner, M., & Wong, R. (1993). The effects
of unit self-management on hospital nurses' work process, work satisfaction, and
retention. Medical Care, 31(5), 381-93.
Wells, N., Roberts, L., & Cagle Medlin, L. (2002). Issues related to staff retention and turnover.
Seminars for Nurse Managers, 10(3), 171-179.
West, M. A. & Anderson, N. R. (1996). Innovation in top management teams. Journal of
Applied Psychology, 81(6), 680-693.
Westendorf JJ (2007). Magnet recognition program. Plastic Surgical Nursing, 27, 102‐104.
Wheaton, B., Muthen, B., Alwin, D., F., & Summers, G. (1977). Assessing Reliability and
Stability in Panel Models. Sociological Methodology, 8(1), 84-136.
Whitworth, B. S. (2008). Is there a relationship between personality type and preferred conflict-
handling styles? An exploratory study of registered nurses in Southern Mississippi.
Journal of Nursing Management, 16, 921 – 932.
Wiersema, M. F., & Bantel, K. A. (1992). Top management team demography and corporate
strategic change. Academy of Management Journal, 35, 91-121.
Woods, S. J., Ziedonis, D. M., Sernyak, M. K., et al (2000). Characteristics of participants and
non-participants in medication trials for treatment of schizophrenia. Psychiatric Services,
51, 79–84.
Woodtli, A. O. (1987). Deans of nursing: perceived sources of conflict and conflict-handling
modes. Journal of Nursing Education, 26(7), 272-277.
148
Appendix A: Letters of Information
149
Intragroup Conflict Among Nurses
Letter of Information
March 2008 Dear Nursing Colleague: We would like to invite you to participate in a doctoral research project we are conducting at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto. The purpose of this study is to examine the antecedents and consequences of conflict among nurses within acute care settings. Your name was randomly selected from the College of Nurses of Ontario registry list. If you are a registered nurse working on an inpatient unit within an acute care hospital for at least six months, please consider participating in this study. In order to examine this topic, we have developed a questionnaire that asks for your opinion about your job and your unit, as well as more general questions about yourself. Your participation in this research is entirely voluntary. We estimate that the questionnaire should take about 30 minutes to complete. You may refuse to participate, refuse to answer any questions or withdraw from the study at any time without negative consequences. Completion and return of the questionnaire indicates your consent to participate in the study. Your responses will be kept confidential and locked in a filing cabinet in a Research Office at the Lawrence S. Bloomberg Faculty of Nursing until the data have been analyzed. Questionnaires will be shredded at the completion of the study. Individual responses will only be seen by Joan Almost, doctoral student, who will enter responses into a computer file. Each questionnaire is identified by a code number to enable us to send out reminders letter to individuals who have not responded. The master code list will be kept in a filing cabinet separate from the questionnaires. Your name will never be identified in any report or presentation of the study results and only grouped information will be reported. While there are no known risks to this study, your participation will give you the opportunity to provide information useful for creating environments that promote supportive and collaborative relationships. If you have any questions regarding this study, please do not hesitate to contact us using the email or phone numbers listed below. If you have questions about your rights as a research participant, please contact Jill Parsons, Health Sciences Ethics Review Officer, Ethics Review Office, University of Toronto, at telephone 416-946-5806 or by email: [email protected]. As a small token of our appreciation for your contribution, we would like to provide you with a coupon redeemable at Tim Horton’s. This letter and the coupon are for you to keep, regardless of your decision to participate or not. If you chose to participate, please use the pre-addressed, stamped envelope enclosed to return the questionnaire. If you do not wish to participate, please return the blank questionnaire, after which you will not be contacted further. Thank you very much for considering our request. Sincerely, Joan Almost, RN, PhD(c) Diane Doran RN, PhD Doctoral Candidate Professor (416) 946-3914 (416) 978-2866 [email protected] [email protected]
150
Intragroup Conflict Among Nurses Reminder Letter
April 2008 Dear Nursing Colleague: A few weeks ago we mailed a questionnaire to you seeking your opinions about the antecedents and consequences of conflict among nurses on your unit. Your name was randomly selected from the College of Nurses of Ontario registry list. If you have already completed and returned the questionnaire to us, please accept our sincere thanks. If not, please consider taking part. Because it has been sent to only a small, but representative, sample of Ontario nurses it is extremely important that yours also be included in the study if the results are to accurately represent the opinions of all Ontario nurses. Should you have any questions about the research, or if by some chance you did not receive the questionnaire, or it has been misplaced, please contact us at the numbers below and we would be happy to send you another copy. If you have questions about your rights as a research participant, please contact Jill Parsons, Health Sciences Ethics Review Officer, Ethics Review Office, University of Toronto, at telephone 416-946-5806 or by email: [email protected]. Thank you very much for considering our request. Sincerely, Joan Almost, RN, PhD(c) Diane Doran RN, PhD Doctoral Candidate Professor (416) 946-3914 (416) 978-2866 [email protected] [email protected]
151
Intragroup Conflict Among Nurses
Final Letter of Information May 2008 Dear Nursing Colleague: A few weeks ago we invited you to participate in a doctoral research project we are conducting at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto. If you have already completed and returned the questionnaire to us, please accept our sincere thanks. If not, please consider taking part. We are writing to you again because of the significance each questionnaire has to the usefulness of this study. In order for the results of this study to be truly representative of the opinions of all Ontario nurses, it is essential that each person in the sample return the questionnaire. In the event that your questionnaire has been misplaced, a replacement is enclosed. Conflict among nurses has become a significant issue in health care settings. The purpose of this study is to examine the antecedents and consequences of conflict among nurses within acute care settings. Your responses will help us understand the factors that contribute to conflict, and the impact that conflict has on nurses. It is important that we gain a clear understanding of these factors because of their impact on your work environment. In order to examine this topic, we have developed a questionnaire that asks for your opinion about your job and your unit, as well as more general questions about yourself. Your participation in this research is entirely voluntary. We estimate that the questionnaire should take about 30 minutes to complete. You may refuse to participate, refuse to answer any questions or withdraw from the study at any time without negative consequences. Completion and return of the questionnaire indicates your consent to participate in the study. Your responses will be kept confidential and locked in a filing cabinet in a Research Office at the Lawrence S. Bloomberg Faculty of Nursing until the data have been analyzed. Questionnaires will be shredded at the completion of the study. Individual responses will only be seen by Joan Almost, doctoral student, who will enter responses into a computer file. Each questionnaire is identified by a code number to enable us to send out reminders letter to individuals who have not responded. The master code list will be kept in a filing cabinet separate from the questionnaires. Your name will never be identified in any report or presentation of the study results and only grouped information will be reported. While there are no known risks to this study, your participation will give you the opportunity to provide information useful for creating environments that promote supportive and collaborative relationships. If you have any questions regarding this study, please do not hesitate to contact us using the email or phone numbers listed below. If you have questions about your rights as a research participant, please contact Jill Parsons, Health Sciences Ethics Review Officer, Ethics Review Office, University of Toronto, at telephone 416-946-5806 or by email: [email protected]. If you chose to participate, please use the pre-addressed, stamped envelope enclosed to return the questionnaire. If you do not wish to participate, please return the blank questionnaire, after which you will not be contacted further. Thank you very much for considering our request. Sincerely, Joan Almost, RN, PhD(c) Diane Doran RN, PhD Doctoral Candidate Professor (416) 946-3914 (416) 978-2866 [email protected] [email protected]
152
Appendix B. Demographics of Study Participants
Demographic (n=277) Range Mean SD Age 23-65 42.09 10.54
Years on current unit 0.25-38 9.08 8.20 Years in nursing 0.75-45 17.84 10.78
Demographic n % Gender (n=277)
FemaleMale
272 5
98.2 1.8
Location (n=277) Central Ontario
Southwestern OntarioEastern OntarioMetro Toronto
Northern Ontario
107 60 53 33 24
38.6 21.7 19.1 11.9 8.7
Employment Status (n=276) Full-timePart-time
189 86
68.7 31.3
Nursing Education (n=277) Diploma
BachelorsMasters
198 76 3
71.5 27.4 1.1
Unit Specialty (n=259) Medical/surgical
Critical CareEmergency
Maternal ChildPsychiatry
103 85 36 23 12
39.8 32.8 13.9 8.9 4.6
153
Appendix C
Confirmatory Factor Analysis
48-item Intragroup Conflict Scale
154
Confirmatory Factor Analysis of 48-item Intragroup Conflict Scale
Using the theoretical framework adopted in this study, there are three dimensions
(disagreement, interference, negative emotions) that reflect intragroup conflict and these three
dimensions are measured with the eight-factor ICS; thus, dimensionality of the ICS was first
examined by means of a confirmatory factor analysis (figure 11). Findings from the squared
Mahalanobis Distance test were used to identify multivariate outliers. In this analysis the
squared Mahalanobis Distance provided a calculated χ² values that were compared to a critical
χ² (df 56) = 94.46, p=0.001). Degrees of freedom were based on the number of variables in the
analysis. The results indicated that thirteen cases were outliers and these cases were deleted.
The correlation matrix was examined to be sure that there were no high correlations (r>0.85)
between variables that would indicate multicollinearity. The correlation matrix for the 48-item
questionnaire contains correlations from 0.09 to 0.84 indicating no multicollinearity.
With confirmatory factor analysis, the first step is to review the overall goodness of fit
indices, followed by an examination of the indices that provide a more detailed assessment of
fit. After examining the fit statistics, modification indices are examined to determine if a better
model-to-data fit could be generated. A confirmatory factor analysis was conducted using
AMOS 16.0 to determine how the theoretical structure fit with the data. In accordance with
Barki and Hartwick’s (2004) theory, an overall construct for intragroup conflict was derived
from measures of the following components: disagreement related to work itself (7-items),
disagreement related to work process (9-items), disagreement related to interpersonal
incompatibilities (5-items), interference related to work itself (9-items), interference related to
interpersonal incompatibilities (2-items), negative emotions related to work itself (9-items),
negative emotions related to interpersonal incompatibilities (4-items), and frequency and
intensity of conflict (3-items). Each item was hypothesized to load on one specified factor, with
zero loading on the other factors; error terms for the items were uncorrelated; and factors were
correlated (Soeken, 2004).
The findings from the initial model suggested a poor fit between the data collected in
this study and the a priori factor structures: significant Chi-square (χ2 = 2699.92; p = .00;
df=1052; χ 2 /df=2.57), low GFI (.659), low TLI (.807), low CFI (.820), and high RMSEA
(.077). The CFA also revealed exceptionally high correlations between factors. The correlation
estimate between several subscales was greater than 0.85 suggesting multicollinearity
155
(interference related to interpersonal incompatibilities and negative emotions related to
interpersonal incompatibilities (.93);interference related to work-related issues and interference
related to interpersonal incompatibilities (.85); and disagreement related to the work process and
disagreement related to the work itself (.91)). The correlations among the remaining subscales
were all greater than 0.61. Therefore the overall model was rejected and modifications were
explored. The modification indices suggested 14 additional pathways between individual items
with MIs >20. Four of these pathways were between items hypothesized to load on separate
factors. In addition, the modification indices suggested 12 additional covariances among 12 of
the error terms. However, caution was used because data driven modifications capitalize on
chance (MacCallum et al., 1992). To minimize on chance capitalization, only modifications that
were theoretically plausible were allowed. Theoretically, it did not make sense to add pathways
between any of the individual items or covariances among their error terms. Therefore, it was
concluded that this confirmatory factor analysis was unable to acceptably replicate the eight-
factor solution hypothesized by Cox (2008), and an exploratory factor analysis was
implemented to explore instrument dimensionality.
156
Figure 11. Confirmatory factor analysis of Intragroup Conflict Scale
disagreement -work process
Rconf1e11 conf2e21 Rconf3e31 conf4e41 Rconf5e51 conf6e61 Rconf7e71 conf8e81 conf9e91
disagreement -work itself
Rconf10e10conf11e11
1 Rconf12e121 Rconf13e13
1 conf14e141 conf15e151 Rconf16e161
disagreement -interpersonal
conf17e171 Rconf18e181 conf19e191 Rconf20e201 Rconf21e211
interference -work
conf22e221 conf23e231 conf24e241 conf25e251 conf26e261 conf27e271 conf28e281 conf29e291 conf30e30
1interference -interpersonale31
conf32e321
negative emotions -work itself
conf33e331 conf34e341 conf35e351 conf36e361 conf37e371 Rconf38e381 conf39e391 conf40e401 conf41e411
negative emotions -interpersonal
conf42e421 conf43e431 conf44e441 conf45e451
frequency andintensityconf46e46
1 conf47e471 Rconf48e48
1
1
conf311
1
1
1
1
1
1
1
1
157
AMOS Output for Confirmatory Factor Analysis of Intragroup Conflict Scale
Variable counts (Group number 1)
Number of variables in your model: 104 Number of observed variables: 48 Number of unobserved variables: 56 Number of exogenous variables: 56 Number of endogenous variables: 48
Result (Default model)
Minimum was achieved Chi-square = 2699.921 Degrees of freedom = 1052 Probability level = .000
Group number 1 (Group number 1 - Default model)
Estimates (Group number 1 - Default model)
Scalar Estimates (Group number 1 - Default model)
Maximum Likelihood Estimates
Regression Weights: (Group number 1 - Default model)
Estimate S.E. C.R. P Label Rconf13 <--- disagreement -_work itself .833 .094 8.845 *** par_1 conf19 <--- disagreement -_interpersonal .989 .110 8.975 *** par_2 conf26 <--- interference -_work 1.273 .098 13.029 *** par_3 conf37 <--- negative emotions -_work itself 1.308 .085 15.396 *** par_4 conf31 <--- interference -_interpersonal .925 .071 12.980 *** par_5 conf2 <--- disagreement -_work process 1.112 .144 7.746 *** par_34Rconf3 <--- disagreement -_work process 1.123 .157 7.168 *** par_35Rconf1 <--- disagreement -_work process 1.000Rconf5 <--- disagreement -_work process 1.122 .158 7.105 *** par_36conf4 <--- disagreement -_work process 1.415 .173 8.178 *** par_37conf6 <--- disagreement -_work process 1.567 .178 8.787 *** par_38Rconf7 <--- disagreement -_work process 1.492 .173 8.640 *** par_39conf8 <--- disagreement -_work process 1.448 .177 8.200 *** par_40conf9 <--- disagreement -_work process 1.613 .182 8.847 *** par_41conf11 <--- disagreement -_work itself 1.340 .122 10.968 *** par_42Rconf10 <--- disagreement -_work itself 1.000Rconf12 <--- disagreement -_work itself .880 .100 8.786 *** par_43
158
Estimate S.E. C.R. P Label conf14 <--- disagreement -_work itself 1.594 .136 11.682 *** par_44conf15 <--- disagreement -_work itself 1.275 .118 10.776 *** par_45Rconf16 <--- disagreement -_work itself .913 .104 8.753 *** par_46Rconf18 <--- disagreement -_interpersonal .693 .091 7.607 *** par_47conf17 <--- disagreement -_interpersonal 1.000Rconf20 <--- disagreement -_interpersonal .905 .098 9.211 *** par_48Rconf21 <--- disagreement -_interpersonal .970 .096 10.062 *** par_49conf24 <--- interference -_work 1.237 .093 13.340 *** par_50conf25 <--- interference -_work 1.252 .093 13.521 *** par_51conf22 <--- interference -_work 1.000conf23 <--- interference -_work 1.064 .090 11.843 *** par_52conf27 <--- interference -_work 1.300 .114 11.456 *** par_53conf28 <--- interference -_work 1.240 .095 13.084 *** par_54conf29 <--- interference -_work 1.254 .097 12.894 *** par_55conf30 <--- interference -_work 1.168 .107 10.948 *** par_56conf32 <--- interference -_interpersonal 1.000conf36 <--- negative emotions -_work itself 1.236 .083 14.947 *** par_57conf33 <--- negative emotions -_work itself 1.000conf35 <--- negative emotions -_work itself 1.353 .088 15.302 *** par_58conf34 <--- negative emotions -_work itself 1.227 .083 14.870 *** par_59Rconf38 <--- negative emotions -_work itself .605 .075 8.112 *** par_60conf39 <--- negative emotions -_work itself 1.239 .099 12.463 *** par_61conf40 <--- negative emotions -_work itself 1.109 .106 10.457 *** par_62conf41 <--- negative emotions -_work itself 1.228 .106 11.587 *** par_63conf43 <--- negative emotions -_interpersonal 1.168 .084 13.879 *** par_64conf42 <--- negative emotions -_interpersonal 1.000conf44 <--- negative emotions -_interpersonal 1.105 .084 13.210 *** par_65conf45 <--- negative emotions -_interpersonal 1.108 .090 12.369 *** par_66conf47 <--- frequency and_intensity 1.161 .068 17.000 *** par_67Rconf48 <--- frequency and_intensity .321 .075 4.259 *** par_68conf46 <--- frequency and_intensity 1.000
Standardized Regression Weights: (Group number 1 - Default model)
Estimate Rconf13 <--- disagreement -_work itself .590conf19 <--- disagreement -_interpersonal .638conf26 <--- interference -_work .834conf37 <--- negative emotions -_work itself .895conf31 <--- interference -_interpersonal .794conf2 <--- disagreement -_work process .602Rconf3 <--- disagreement -_work process .540
159
Estimate Rconf1 <--- disagreement -_work process .561Rconf5 <--- disagreement -_work process .534conf4 <--- disagreement -_work process .653conf6 <--- disagreement -_work process .732Rconf7 <--- disagreement -_work process .712conf8 <--- disagreement -_work process .656conf9 <--- disagreement -_work process .740conf11 <--- disagreement -_work itself .747Rconf10 <--- disagreement -_work itself .676Rconf12 <--- disagreement -_work itself .585conf14 <--- disagreement -_work itself .803conf15 <--- disagreement -_work itself .732Rconf16 <--- disagreement -_work itself .583Rconf18 <--- disagreement -_interpersonal .530conf17 <--- disagreement -_interpersonal .679Rconf20 <--- disagreement -_interpersonal .657Rconf21 <--- disagreement -_interpersonal .731conf24 <--- interference -_work .854conf25 <--- interference -_work .866conf22 <--- interference -_work .702conf23 <--- interference -_work .756conf27 <--- interference -_work .731conf28 <--- interference -_work .837conf29 <--- interference -_work .825conf30 <--- interference -_work .698conf32 <--- interference -_interpersonal .742conf36 <--- negative emotions -_work itself .872conf33 <--- negative emotions -_work itself .745conf35 <--- negative emotions -_work itself .890conf34 <--- negative emotions -_work itself .869Rconf38 <--- negative emotions -_work itself .499conf39 <--- negative emotions -_work itself .744conf40 <--- negative emotions -_work itself .634conf41 <--- negative emotions -_work itself .696conf43 <--- negative emotions -_interpersonal .882conf42 <--- negative emotions -_interpersonal .720conf44 <--- negative emotions -_interpersonal .838conf45 <--- negative emotions -_interpersonal .785conf47 <--- frequency and_intensity .903Rconf48 <--- frequency and_intensity .271conf46 <--- frequency and_intensity .840
160
Covariances: (Group number 1 - Default model)
Estimate S.E. C.R. P Label negative emotions -interpersonal <--> frequency and intensity .280 .038 7.439 *** par_6
negative emotions -work itself <--> frequency and intensity .302 .037 8.053 *** par_7
interference -interpersonal <--> frequency and intensity .333 .045 7.410 *** par_8
interference -work <--> frequency and intensity .310 .040 7.804 *** par_9 disagreement -interpersonal <--> frequency and intensity .206 .032 6.515 *** par_10
disagreement -work itself <--> frequency and intensity .210 .030 7.054 *** par_11 negative emotions - work itself <--> negative emotions -
interpersonal .229 .031 7.302 *** par_12
interference -interpersonal <--> negative emotions -
interpersonal .358 .045 7.972 *** par_13
interference - work <--> negative emotions -interpersonal .268 .036 7.505 *** par_14
disagreement -interpersonal <--> negative emotions -
interpersonal .196 .029 6.720 *** par_15
disagreement - work itself <--> negative emotions -interpersonal .173 .026 6.710 *** par_16
negative emotions -interpersonal <--> disagreement - work
process .125 .021 5.867 *** par_17
negative emotions - work itself <--> interference -
interpersonal .304 .039 7.716 *** par_18
interference - work <--> negative emotions -work itself .249 .033 7.550 *** par_19
disagreement -interpersonal <--> negative emotions -
work itself .178 .027 6.644 *** par_20
disagreement -work itself <--> negative emotions -work itself .187 .026 7.222 *** par_21
negative emotions -work itself <--> disagreement - work
process .144 .022 6.421 *** par_22
disagreement -interpersonal <--> interference -
interpersonal .261 .037 7.062 *** par_23
disagreement -work itself <--> interference -interpersonal .223 .032 6.947 *** par_24
interference -_interpersonal <--> disagreement -work
process .160 .027 6.003 *** par_25
disagreement -_interpersonal <--> interference -work .195 .029 6.700 *** par_26
disagreement -work itself <--> interference -work .204 .028 7.209 *** par_27 interference -work <--> disagreement -work .143 .023 6.212 *** par_28
161
Estimate S.E. C.R. P Label process
disagreement -work itself <--> disagreement -_interpersonal .160 .024 6.670 *** par_29
disagreement -_interpersonal <--> disagreement -work
process .126 .021 6.041 *** par_30
disagreement -work itself <--> disagreement -work process .146 .022 6.618 *** par_31
interference -work <--> interference -_interpersonal .326 .043 7.640 *** par_32
frequency and intensity <--> disagreement -work process .154 .025 6.127 *** par_33
Correlations: (Group number 1 - Default model)
Estimate negative emotions -_interpersonal <--> frequency and_intensity .720negative emotions -_work itself <--> frequency and_intensity .800interference -_interpersonal <--> frequency and_intensity .730interference -_work <--> frequency and_intensity .796disagreement -_interpersonal <--> frequency and_intensity .627disagreement -_work itself <--> frequency and_intensity .691negative emotions -_work itself <--> negative emotions -_interpersonal .724interference -_interpersonal <--> negative emotions -_interpersonal .936interference -_work <--> negative emotions -_interpersonal .823disagreement -_interpersonal <--> negative emotions -_interpersonal .711disagreement -_work itself <--> negative emotions -_interpersonal .678negative emotions -_interpersonal <--> disagreement -_work process .607negative emotions -_work itself <--> interference -_interpersonal .820interference -_work <--> negative emotions -_work itself .786disagreement -_interpersonal <--> negative emotions -_work itself .662disagreement -_work itself <--> negative emotions -_work itself .757negative emotions -_work itself <--> disagreement -_work process .721disagreement -_interpersonal <--> interference -_interpersonal .805disagreement -_work itself <--> interference -_interpersonal .745interference -_interpersonal <--> disagreement -_work process .663disagreement -_interpersonal <--> interference -_work .703disagreement -_work itself <--> interference -_work .801interference -_work <--> disagreement -_work process .693disagreement -_work itself <--> disagreement -_interpersonal .742disagreement -_interpersonal <--> disagreement -_work process .719disagreement -_work itself <--> disagreement -_work process .909interference -_work <--> interference -_interpersonal .852frequency and_intensity <--> disagreement -_work process .626
162
Variances: (Group number 1 - Default model)
Estimate S.E. C.R. P Label disagreement -_work itself .199 .033 6.037 *** par_69 disagreement -_interpersonal .234 .040 5.817 *** par_70 interference -_work .326 .051 6.448 *** par_71 negative emotions -_work itself .307 .044 7.001 *** par_72 interference -_interpersonal .449 .067 6.677 *** par_73 negative emotions -_interpersonal .325 .049 6.575 *** par_74 frequency and_intensity .463 .057 8.076 *** par_75 disagreement -_work process .130 .028 4.744 *** par_76 e1 .285 .026 10.931 *** par_77 e2 .283 .026 10.800 *** par_78 e3 .399 .036 10.985 *** par_79 e4 .351 .033 10.595 *** par_80 e5 .412 .037 11.001 *** par_81 e6 .277 .027 10.103 *** par_82 e7 .282 .028 10.255 *** par_83 e8 .363 .034 10.582 *** par_84 e9 .280 .028 10.032 *** par_85 e11 .283 .028 10.169 *** par_86 e12 .296 .027 10.942 *** par_87 e13 .259 .024 10.930 *** par_88 e14 .279 .029 9.571 *** par_89 e15 .280 .027 10.282 *** par_90 e16 .322 .029 10.948 *** par_91 e17 .274 .028 9.686 *** par_92 e18 .287 .027 10.664 *** par_93 e19 .334 .033 10.048 *** par_94 e20 .253 .026 9.890 *** par_95 e21 .192 .021 9.064 *** par_96 e22 .335 .031 10.924 *** par_97 e23 .277 .026 10.723 *** par_98 e24 .185 .019 9.954 *** par_99 e25 .170 .017 9.781 *** par_100 e26 .232 .023 10.191 *** par_101 e27 .482 .045 10.828 *** par_102 e28 .214 .021 10.153 *** par_103 e29 .241 .023 10.276 *** par_104 e30 .470 .043 10.938 *** par_105 e32 .366 .039 9.428 *** par_106 e33 .246 .023 10.792 *** par_107 e34 .150 .015 9.793 *** par_108
163
Estimate S.E. C.R. P Label e35 .147 .016 9.381 *** par_109 e36 .147 .015 9.730 *** par_110 e37 .130 .014 9.270 *** par_111 e38 .339 .030 11.288 *** par_112 e39 .381 .035 10.798 *** par_113 e40 .562 .051 11.105 *** par_114 e41 .492 .045 10.959 *** par_115 e42 .302 .029 10.407 *** par_116 e43 .127 .016 7.916 *** par_117 e44 .168 .019 9.094 *** par_118 e45 .249 .025 9.872 *** par_119 e46 .193 .024 8.035 *** par_120 e47 .141 .026 5.398 *** par_121 e10 .236 .022 10.610 *** par_122 e48 .603 .053 11.368 *** par_123 e31 .225 .027 8.262 *** par_124
Squared Multiple Correlations: (Group number 1 - Default model)
Estimate conf31 .630 Rconf48 .074 Rconf10 .458 conf47 .816 conf46 .705 conf45 .616 conf44 .702 conf43 .778 conf42 .519 conf41 .485 conf40 .402 conf39 .553 Rconf38 .249 conf37 .801 conf36 .761 conf35 .793 conf34 .755 conf33 .555 conf32 .551 conf30 .487 conf29 .680 conf28 .701
164
Estimate conf27 .534 conf26 .695 conf25 .750 conf24 .729 conf23 .571 conf22 .493 Rconf21 .534 Rconf20 .432 conf19 .407 Rconf18 .281 conf17 .461 Rconf16 .340 conf15 .536 conf14 .645 Rconf13 .348 Rconf12 .343 conf11 .558 conf9 .548 conf8 .430 Rconf7 .507 conf6 .536 Rconf5 .285 conf4 .426 Rconf3 .292 conf2 .363 Rconf1 .314
Modification Indices (Group number 1 - Default model)
Covariances: (Group number 1 - Default model)
M.I. Par Change e45 <--> negative emotions -interpersonal 11.563 -.036e43 <--> e44 29.665 .061e42 <--> negative emotions -interpersonal 20.908 -.053e42 <--> e44 16.362 -.064e41 <--> e44 10.894 -.066e41 <--> e42 36.938 .154e40 <--> negative emotions -work itself 13.383 -.054e40 <--> e44 20.025 -.095e40 <--> e42 60.734 .210e40 <--> e41 90.939 .320e39 <--> frequency and_intensity 14.325 .067
165
M.I. Par Change e39 <--> negative emotions -work itself 16.381 -.049e39 <--> e47 12.110 .068e39 <--> e42 11.041 .075e39 <--> e41 41.774 .181e39 <--> e40 42.599 .194e38 <--> e39 10.988 .076e37 <--> e41 11.763 -.060e37 <--> e40 13.924 -.070e36 <--> e41 21.268 -.084e36 <--> e40 13.344 -.071e36 <--> e39 12.211 -.056e36 <--> e37 29.449 .054e35 <--> e39 11.673 -.056e35 <--> e36 12.366 .037e34 <--> e42 13.055 -.053e34 <--> e40 27.367 -.102e34 <--> e39 17.446 -.068e34 <--> e35 13.633 .039e33 <--> e42 13.354 -.066e33 <--> e34 15.617 .052e32 <--> e45 14.530 .080e30 <--> interference -_interpersonal 20.744 .088e30 <--> e31 15.561 .087e28 <--> e29 66.607 .127e27 <--> interference -_interpersonal 13.019 .071e27 <--> interference -work 16.774 -.053e27 <--> e45 19.089 .102e27 <--> e42 13.802 -.094e27 <--> e32 39.406 .176e27 <--> e29 13.238 .083e26 <--> interference -interpersonal 16.314 -.057e26 <--> e32 13.432 -.073e26 <--> e29 12.505 -.057e26 <--> e27 12.289 -.078e25 <--> e42 15.868 .063e25 <--> e29 10.295 -.045e25 <--> e27 25.175 -.098e25 <--> e26 57.176 .105e24 <--> e29 16.674 -.059e24 <--> e26 18.954 .062e24 <--> e25 38.563 .077e23 <--> interference -work 14.231 -.037
166
M.I. Par Change e23 <--> e45 12.067 .062e23 <--> e26 10.952 -.056e23 <--> e25 14.842 -.057e22 <--> e41 12.431 .092e21 <--> e26 11.660 .052e20 <--> disagreement -interpersonal 12.032 .041e20 <--> e21 54.342 .115e18 <--> e20 15.802 .072e17 <--> negative emotions -work itself 10.342 .035e17 <--> disagreement -_interpersonal 23.324 -.060e17 <--> e23 14.900 .073e17 <--> e20 12.710 -.065e17 <--> e18 15.963 -.076e16 <--> disagreement -work process 18.061 -.034e16 <--> disagreement -work itself 16.594 .036e16 <--> e10 13.405 .066e14 <--> e10 13.950 -.066e14 <--> e15 11.891 .067e13 <--> disagreement -work itself 11.150 .027e13 <--> e10 21.975 .076e13 <--> e38 14.355 .071e13 <--> e20 17.485 .072e13 <--> e17 17.756 -.076e13 <--> e16 26.000 .095e13 <--> e14 12.399 -.064e12 <--> e10 16.094 .069e12 <--> e16 14.504 .076e12 <--> e14 16.055 -.078e12 <--> e13 95.691 .174e11 <--> disagreement -work process 13.523 .028e11 <--> disagreement -work itself 10.210 -.027e9 <--> disagreement -work process 16.155 -.030e9 <--> disagreement -work itself 15.235 .034e9 <--> e42 11.168 .066e9 <--> e34 13.941 -.054e9 <--> e14 22.632 .094e6 <--> e11 10.286 .062e5 <--> e9 11.117 -.075e5 <--> e7 21.364 .104e3 <--> e5 15.567 .102e2 <--> e16 12.230 -.068e2 <--> e13 12.666 -.062
167
M.I. Par Change e2 <--> e11 10.581 .061
Variances: (Group number 1 - Default model)
M.I. Par Change
Regression Weights: (Group number 1 - Default model)
M.I. Par Change Rconf48 <--- Rconf20 13.968 .269Rconf48 <--- Rconf18 11.400 .257Rconf48 <--- Rconf13 12.526 .270Rconf10 <--- Rconf13 13.768 .183Rconf10 <--- Rconf12 10.171 .147conf45 <--- conf33 13.913 .165conf45 <--- conf27 12.661 .115conf44 <--- conf41 13.049 -.104conf44 <--- conf40 21.036 -.132conf42 <--- frequency and_intensity 10.020 .173conf42 <--- Rconf48 12.685 .156conf42 <--- conf47 13.388 .148conf42 <--- conf41 35.710 .217conf42 <--- conf40 56.096 .274conf42 <--- conf39 15.857 .153conf42 <--- conf26 11.772 .139conf42 <--- conf25 18.734 .186conf42 <--- conf22 14.912 .168conf42 <--- conf9 14.184 .169conf41 <--- conf42 18.393 .239conf41 <--- conf40 52.823 .331conf41 <--- conf39 17.675 .201conf41 <--- conf22 13.874 .202conf40 <--- conf42 32.552 .338conf40 <--- conf41 44.915 .322conf40 <--- conf39 18.010 .216conf40 <--- conf26 10.315 .173conf40 <--- conf25 10.312 .183conf40 <--- conf22 12.614 .205conf39 <--- conf47 11.713 .153conf39 <--- conf41 20.657 .182conf39 <--- conf40 24.755 .201Rconf38 <--- Rconf21 12.711 .201Rconf38 <--- Rconf13 18.339 .246
168
M.I. Par Change Rconf38 <--- Rconf1 11.049 .187conf36 <--- conf41 10.567 -.085conf34 <--- conf40 15.953 -.106conf32 <--- conf27 19.880 .172conf30 <--- conf31 13.509 .203conf29 <--- conf28 18.002 .160conf28 <--- conf29 19.473 .154conf27 <--- conf45 13.334 .200conf27 <--- conf37 10.206 .174conf27 <--- conf34 13.449 .206conf27 <--- conf32 29.545 .265conf26 <--- conf32 11.401 -.118conf26 <--- conf25 12.542 .135conf25 <--- conf27 11.218 -.090conf25 <--- conf26 15.910 .125conf23 <--- conf17 15.487 .185Rconf21 <--- Rconf20 28.085 .236Rconf20 <--- Rconf21 21.533 .238Rconf20 <--- Rconf18 10.775 .171Rconf18 <--- conf36 11.906 -.150conf17 <--- negative emotions -work itself 18.047 .271conf17 <--- interference -work 10.807 .204conf17 <--- conf45 10.699 .140conf17 <--- conf39 11.985 .130conf17 <--- conf37 19.326 .188conf17 <--- conf36 18.363 .189conf17 <--- conf35 15.119 .160conf17 <--- conf34 12.766 .158conf17 <--- conf33 14.867 .179conf17 <--- conf29 12.071 .138conf17 <--- conf27 17.469 .142conf17 <--- conf24 10.789 .137conf17 <--- conf23 23.764 .210conf17 <--- Rconf18 10.897 -.181Rconf16 <--- Rconf13 16.269 .229Rconf16 <--- conf2 11.165 -.179conf14 <--- Rconf12 10.189 -.168Rconf13 <--- Rconf10 11.155 .162Rconf13 <--- Rconf20 12.115 .168Rconf13 <--- Rconf16 16.487 .187Rconf13 <--- Rconf12 60.400 .372Rconf12 <--- Rconf13 59.879 .420
169
M.I. Par Change conf11 <--- conf2 10.064 .165conf9 <--- conf25 10.309 .135conf9 <--- conf14 15.089 .152Rconf7 <--- Rconf5 14.771 .174Rconf5 <--- Rconf3 10.619 .175Rconf3 <--- Rconf5 10.736 .172
Model Fit Summary
CMIN
Model NPAR CMIN DF P CMIN/DF Default model 124 2699.921 1052 .000 2.566 Saturated model 1176 .000 0 Independence model 48 10276.091 1128 .000 9.110
RMR, GFI
Model RMR GFI AGFI PGFI Default model .047 .659 .619 .590 Saturated model .000 1.000 Independence model .278 .103 .065 .099
Baseline Comparisons
Model NFI Delta1
RFIrho1
IFIDelta2
TLIrho2 CFI
Default model .737 .718 .821 .807 .820 Saturated model 1.000 1.000 1.000 Independence model .000 .000 .000 .000 .000
Parsimony-Adjusted Measures
Model PRATIO PNFI PCFI Default model .933 .688 .765 Saturated model .000 .000 .000 Independence model 1.000 .000 .000
NCP
Model NCP LO 90 HI 90 Default model 1647.921 1498.299 1805.158 Saturated model .000 .000 .000
170
Model NCP LO 90 HI 90 Independence model 9148.091 8827.161 9475.544
FMIN
Model FMIN F0 LO 90 HI 90 Default model 10.266 6.266 5.697 6.864 Saturated model .000 .000 .000 .000 Independence model 39.073 34.784 33.563 36.029
RMSEA
Model RMSEA LO 90 HI 90 PCLOSE Default model .077 .074 .081 .000 Independence model .176 .172 .179 .000
AIC
Model AIC BCC BIC CAIC Default model 2947.921 3004.706 3391.339 3515.339 Saturated model 2352.000 2890.542 6557.316 7733.316 Independence model 10372.091 10394.072 10543.736 10591.736
ECVI
Model ECVI LO 90 HI 90 MECVI Default model 11.209 10.640 11.807 11.425 Saturated model 8.943 8.943 8.943 10.991 Independence model 39.438 38.217 40.683 39.521
HOELTER
Model HOELTER.05
HOELTER.01
Default model 110 114 Independence model 31 32
171
Appendix D
Confirmatory Factor Analysis of 11-item Relationship Subscale
of the Intragroup Conflict Scale
172
A confirmatory factor analysis was conducted using AMOS 16.0 to determine how the
theoretical structure fits with the data. In accordance with Barki and Hartwick’s (2004) theory,
an overall construct for relationship conflict was derived from the items developed by Cox
(2005) to measure of the following components: disagreement (5-items), interference (2-items)
and negative emotions (4-items) related to interpersonal incompatibilities. Findings from the
squared Mahalanobis Distance test were used to identify multivariate outliers. In this analysis
the squared Mahalanobis Distance provided a calculated χ² values that were compared to a
critical χ² (df 14) = 36.12, p=0.001). Degrees of freedom were based on the number of variables
in the analysis. The results indicated that there were no outliers. The correlation matrix was
examined to be sure that there were no high correlations (r>0.85) between variables that would
indicate multicollinearity. The correlation matrix for the 11-item questionnaire contains
correlations from 0.22 to 0.68 indicating no multicollinearity. The initial model, which is
presented in Figure 12, had a significant Chi-square (χ2 = 186.33; p = .00; df=41; χ 2 /df=4.55),
low GFI (.875), low TLI (.880), high CFI (.911), and high RMSEA (.118). Correlations
between emotion and interference subscale was 0.90 suggesting multicollinearity and a two-
factor scale.
Figure 12. Confirmatory Factor Analysis of Three Factor, 11-item Relationship Subscale of ICS
.39conf17e17
.32Rconf18e18
.36conf19e19
.51Rconf20e20
.60Rconf21e21
disagreement
e31
.52conf32e32
.47conf42e42
.83conf43e43
.76conf44e44
.58conf45e45
.71conf31
negativeemotions
.77.71
.76.87
.69
.65
.60
.63
interference.72
.84
.90
.76
.91
.56
173
The items from these two scales were loaded onto one factor labelled interference and
negative emotions and the analysis was repeated. This model, which is presented in Figure 13,
had a poorer fit than the previous model with a significant Chi-square (χ2 = 210.23; p = .00;
df=43; χ 2 /df=4.89), low GFI (.863), low TLI (.868), low CFI (.897), and high RMSEA (.119).
The modification indices suggested several pathways between items in different subscales
(conf45 to conf17; conf32 to conf17) and between individual items and subscales.
Figure 13. Confirmatory Factor Analysis of Two Factor, 11-item Relationship Subscale of ICS
.37conf17 e17
.33Rconf18e18
.34conf19 e19
.53
Rconf20 e20
.62Rconf21 e21
disagreement
e31
.48conf32 e32
.49
conf42 e42
.79
conf43 e43
.74
conf44 e44
.60
conf45 e45
.62conf31
interference and negative emotions
.73
.57
.61
.79
.58
.70.69
.79
.89
.86.77
.68
174
Finally, the model was run using one factor labelled relationship conflict. This model,
which is presented in Figure 14, suggested an even poorer fit than the previous model with a
significant Chi-square (χ2 = 309.50; p = .00; df=44; χ 2 /df=7.03), low GFI (.816), low TLI
(.796), low CFI (.837), and high RMSEA (.148).
Figure 14. Confirmatory Factor Analysis of One Factor, 11-item Relationship Subscale of ICS
.40conf17 e17
.16
Rconf18e18
.35conf19 e19
.22
Rconf20e20
.28
Rconf21e21
e31
.51conf32 e32
.49conf42 e42
.74
conf43 e43
.69conf44 e44
.60conf45 e45
.65conf31
relationshipconflict
.70
.63
.81
.86
.71
.78.83
.40
.59.47
.53
175
AMOS Output for CFA of One Factor, 11-item Relationship Subscale of ICS
Variable counts (Group number 1) Number of variables in your model: 23 Number of observed variables: 11 Number of unobserved variables: 12 Number of exogenous variables: 12 Number of endogenous variables: 11 Result (Default model) Chi-square = 309.495 Degrees of freedom = 44 Probability level = .000 Regression Weights: (Group number 1 - Default model)
Estimate S.E. C.R. P Label conf42 <--- relationship_conflict 1.204 .121 9.994 ***conf17 <--- relationship_conflict 1.000conf31 <--- relationship_conflict 1.355 .121 11.160 ***conf43 <--- relationship_conflict 1.391 .119 11.683 ***conf32 <--- relationship_conflict 1.371 .135 10.135 ***conf45 <--- relationship_conflict 1.327 .122 10.847 ***conf44 <--- relationship_conflict 1.347 .118 11.411 ***Rconf18 <--- relationship_conflict .546 .090 6.091 ***conf19 <--- relationship_conflict .941 .108 8.744 ***Rconf20 <--- relationship_conflict .657 .092 7.141 ***Rconf21 <--- relationship_conflict .715 .090 7.966 *** Standardized Regression Weights: (Group number 1 - Default model)
Estimate conf42 <--- relationship_conflict .699conf17 <--- relationship_conflict .634conf31 <--- relationship_conflict .806conf43 <--- relationship_conflict .859conf32 <--- relationship_conflict .711conf45 <--- relationship_conflict .776conf44 <--- relationship_conflict .831Rconf18 <--- relationship_conflict .396conf19 <--- relationship_conflict .594Rconf20 <--- relationship_conflict .471Rconf21 <--- relationship_conflict .533
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Variances: (Group number 1 - Default model)
Estimate S.E. C.R. P Label relationship_conflict .228 .040 5.713 ***e17 .339 .030 11.111 ***e18 .366 .032 11.572 ***e19 .370 .033 11.233 ***e20 .345 .030 11.479 ***e21 .294 .026 11.373 ***e32 .418 .039 10.777 ***e42 .347 .032 10.844 ***e43 .156 .017 9.053 ***e44 .185 .019 9.613 ***e45 .265 .026 10.306 ***e31 .225 .023 9.976 *** Squared Multiple Correlations: (Group number 1 - Default model)
Estimate conf31 .650 conf45 .603 conf44 .691 conf43 .738 conf42 .488 conf32 .506 Rconf21 .284 Rconf20 .222 conf19 .353 Rconf18 .157 conf17 .403 Matrices (Group number 1 - Default model) Total Effects (Group number 1 - Default model)
relationship_conflict conf31 1.355 conf45 1.327 conf44 1.347 conf43 1.391 conf42 1.204 conf32 1.371 Rconf21 .715 Rconf20 .657 conf19 .941
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relationship_conflict Rconf18 .546 conf17 1.000 Standardized Total Effects (Group number 1 - Default model)
relationship_conflict conf31 .806 conf45 .776 conf44 .831 conf43 .859 conf42 .699 conf32 .711 Rconf21 .533 Rconf20 .471 conf19 .594 Rconf18 .396 conf17 .634 Direct Effects (Group number 1 - Default model)
relationship_conflict conf31 1.355 conf45 1.327 conf44 1.347 conf43 1.391 conf42 1.204 conf32 1.371 Rconf21 .715 Rconf20 .657 conf19 .941 Rconf18 .546 conf17 1.000 Standardized Direct Effects (Group number 1 - Default model)
relationship_conflict conf31 .806 conf45 .776 conf44 .831 conf43 .859 conf42 .699 conf32 .711 Rconf21 .533 Rconf20 .471 conf19 .594 Rconf18 .396
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relationship_conflict conf17 .634 Indirect Effects (Group number 1 - Default model)
relationship_conflict conf31 .000 conf45 .000 conf44 .000 conf43 .000 conf42 .000 conf32 .000 Rconf21 .000 Rconf20 .000 conf19 .000 Rconf18 .000 conf17 .000 Standardized Indirect Effects (Group number 1 - Default model)
relationship_conflict conf31 .000 conf45 .000 conf44 .000 conf43 .000 conf42 .000 conf32 .000 Rconf21 .000 Rconf20 .000 conf19 .000 Rconf18 .000 conf17 .000 Modification Indices (Group number 1 - Default model) Covariances: (Group number 1 - Default model)
M.I. Par Change e43 <--> e44 56.081 .092e32 <--> e45 14.589 .084e21 <--> e43 10.659 -.048e20 <--> e43 10.578 -.052e20 <--> e21 96.468 .193e18 <--> e45 11.209 -.067e18 <--> e21 31.224 .113e18 <--> e20 38.377 .135e17 <--> e43 13.072 -.057e17 <--> e32 8.105 .069
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M.I. Par Change e17 <--> e19 10.232 .071 Variances: (Group number 1 - Default model)
M.I. Par Change Regression Weights: (Group number 1 - Default model)
M.I. Par Change conf45 <--- Rconf18 9.338 -.152conf44 <--- conf43 12.210 .128conf43 <--- conf44 15.211 .135conf43 <--- Rconf20 8.100 -.114Rconf21 <--- Rconf20 73.498 .426Rconf21 <--- Rconf18 25.976 .256Rconf20 <--- Rconf21 67.051 .457Rconf20 <--- Rconf18 31.924 .307Rconf18 <--- Rconf21 21.697 .267Rconf18 <--- Rconf20 29.229 .298 Model Fit Summary CMIN Model NPAR CMIN DF P CMIN/DF Default model 22 309.495 44 .000 7.034 Saturated model 66 .000 0 Independence model 11 1681.119 55 .000 30.566 RMR, GFI Model RMR GFI AGFI PGFI Default model .041 .816 .724 .544 Saturated model .000 1.000 Independence model .263 .308 .170 .257 Baseline Comparisons
Model NFI Delta1
RFIrho1
IFIDelta2
TLIrho2 CFI
Default model .816 .770 .838 .796 .837 Saturated model 1.000 1.000 1.000 Independence model .000 .000 .000 .000 .000 Parsimony-Adjusted Measures Model PRATIO PNFI PCFI Default model .800 .653 .669 Saturated model .000 .000 .000 Independence model 1.000 .000 .000
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NCP Model NCP LO 90 HI 90 Default model 265.495 213.412 325.068 Saturated model .000 .000 .000 Independence model 1626.119 1495.986 1763.626 FMIN Model FMIN F0 LO 90 HI 90 Default model 1.121 .962 .773 1.178 Saturated model .000 .000 .000 .000 Independence model 6.091 5.892 5.420 6.390 RMSEA Model RMSEA LO 90 HI 90 PCLOSE Default model .148 .133 .164 .000 Independence model .327 .314 .341 .000 AIC Model AIC BCC BIC CAIC Default model 353.495 355.495 433.223 455.223 Saturated model 132.000 138.000 371.185 437.185 Independence model 1703.119 1704.119 1742.984 1753.984 ECVI Model ECVI LO 90 HI 90 MECVI Default model 1.281 1.092 1.497 1.288 Saturated model .478 .478 .478 .500 Independence model 6.171 5.699 6.669 6.174 HOELTER
Model HOELTER.05
HOELTER.01
Default model 54 62 Independence model 13 14
