Conflict management style, supportive work environments and the experience of work stress in emergency nurses
Open accessAbstract
Aims To examine the conflict management style that emergency department (ED) nurses use to resolve conflict and to determine whether their style of managing conflict and a supportive work environment affects their experience of work stress. Background Conflict is a common stressor that is encountered as nurses strive to achieve patient satisfaction goals while delivering quality care. How a nurse perceives support may impact work stress levels and how they deal with conflict. Methods A correlational design examined the relationship between supportive work environment, and conflict management style and work stress in a sample of 222 ED nurses using the expanded nurse work stress scale; the survey of perceived organisational support; and the Rahim organisational conflict inventory-II. Results Twenty seven percent of nurses reported elevated levels of work stress. A supportive work environment and avoidant conflict management style were significant predictors of work stress. Conclusions Findings suggest that ED nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress. Implications for nursing management Providing opportunities for ED nurses in skills training in constructive conflict resolution may help to reduce work stress and to improve the quality of patient care.
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0 of 13 cited sources checked · 0 supported · 0 flagged
- Findingown data
Avoidant conflict management style was a significant independent predictor of work stress in ED nurses (b = 0.209, P = 0.018).
“both supportive work environment and avoidant conflict management style were significant independent predictors of work stress (b = À0.262,P = 0.003, b = 0. 209, P = 0.018, respectively).”
- Also stated in: § Supportive work environment, conflict management style and work stress · plain
“avoidant conflict management style had an independent effect on work stress while controlling for the effects of a supportive work environment”
Quote in the paperSubstantial claim - Also stated in: § Supportive work environment, conflict management style and work stress · plain
- Findingown data
Integrating, dominating, and obliging conflict management styles were not significantly related to work stress in ED nurses.
“No significant relationships were found between integrating, dominating and obliging dimensions of conflict management styles and work stress.”
- Also stated in: § Discussion · plain
“No direct relationship was found between an integrating conflict management style and dominating conflict management style and work stress”
- Also stated in: § Discussion · plain
“There was no significant relationship between an obliging conflict management style and work stress”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
In the study sample, 66% of ED nurses perceived low levels of organisational support.
“Sixty-six percent (n = 147) of the sample perceived low levels of organisational support (Table 2).”
- Also stated in: § Implications for nursing management · plain
“This study also found that 66% of ED nurses perceived their work environment was not supportive”
Quote in the paperSubstantial claim - Also stated in: § Implications for nursing management · plain
- Findingown data
In the study sample, 73% of ED nurses reported low levels of work stress (occasional stress).
“a large majority, 73% of nurses experienced stress occasionally and reported low levels of work stress (n = 161)”
- Also stated in: § Discussion · plain
“73% of nurses experienced low levels.”
- Also stated in: § Implications for nursing management · plain
“In this study 73% of emergency nurses reported occasional experiences of work stress.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
A supportive work environment did not significantly moderate the relationship between conflict management style and work stress in ED nurses.
“Hierarchical regression analyses revealed that there were no significant relationships between conflict management style and a supportive work environment, on the level of work stress in staff nurses who worked in hospital-based emergency departments.”
Quote in the paperSubstantial claim
- Findingown data
In the study sample, 28% of ED nurses reported using an avoidant conflict management style.
“A little more than one in four nurses (28%) reporting used an avoidant conflict management style”
- Also stated in: § Discussion · plain
“In this study more than 25% of emergency nurses used an avoidant approach to manage conflict”
Quote in the paperNot a substantial claim - Also stated in: § Discussion · plain
- Findingown data
Supportive work environment was a significant independent predictor of work stress in ED nurses (b = -0.262, P = 0.003).
“both supportive work environment and avoidant conflict management style were significant independent predictors of work stress (b = À0.262,P = 0.003, b = 0. 209, P = 0.018, respectively).”
- Also stated in: § Supportive work environment, conflict management style and work stress · plain
“a supportive work environment had an independent effect on work stress while controlling for the effects of avoidant conflict management style”
Quote in the paperSubstantial claim - Also stated in: § Supportive work environment, conflict management style and work stress · plain
- Findingown data
Avoidant conflict management style was positively correlated with work stress among ED nurses (r = 0.300, P = 0.000).
“There was a moderate positive, relationship between avoidant conflict management style and work stress (r = 0.300, P = 0.000)”
- Also stated in: § Discussion · plain
“A significant moderate relationship was found between an avoidant conflict management style and work stress”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
In the study sample of 222 ED nurses, 27% reported moderate to high levels of work stress.
“Twenty seven percent of nurses reported elevated levels of work stress.”
- Also stated in: § Work stress · plain
“the remaining 27% (n = 54) experienced stress frequently with moderate to high levels.”
- Also stated in: § Discussion · plain
“In this study, 27% reported moderate to high levels of work stress and 73% of nurses experienced low levels.”
Quote in the paperNot a substantial claim - Also stated in: § Work stress · plain
- Interpretationown data
ED nurses who use an avoidant conflict management style are likely to experience work stress.
“suggesting that emergency department nurses who use this conflict management approach are likely to experience work stress”
- Also stated in: § Discussion · boosted
“This study demonstrated that there is a relationship between an avoidant conflict management style and work stress.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · boosted
- Interpretationown data
ED nurses experience less work stress in a supportive work environment.
“This suggests that ED nurses experienced less work stress in a supportive work environment”
- Also stated in: § Discussion · hedged
“indicating that nurses who work in emergency room settings with greater levels of perceived support from their organisation experience less work stress”
Quote in the paperSubstantial claim - Also stated in: § Discussion · hedged
- Interpretationown data
A supportive work environment may be an important antecedent to preventing work stress for ED nurses.
“findings from this study indicate that a supportive work environment may be an important antecedent to preventing work stress for nurses who work in emergency department environments as well.”
Quote in the paperSubstantial claim - Premisecitation
Conflict is a common work stressor in the emergency department.
“Due to the nature of the emergency department, conflict is an inevitable characteristic of the work environment and a common work stressor that emergency nurses encounter in the unpredictable workplace where nursing responsibilities are driven by patient needs that are often complex and dynamic (Laschinger et al. 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Laschinger et al. 2008 source
Not checked in the free run.
- Study design and conductreasoning
Self-report measures in this study run the risk of common method variance that could inflate or deflate the reported correlational relationships.
“Self-reporting measures run the risk of potential common method variance which could inflate or deflate the reported correlational relationships.”
Quote in the paperNot a substantial claim - Interpretationown data
ED nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress.
“Findings suggest that ED nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress.”
- Also stated in: § Conclusions · hedged
“suggesting that emergency nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress.”
Quote in the paperSubstantial claim - Also stated in: § Conclusions · hedged
- Premisecitation
Perceived organisational support may impact work stress levels in emergency department nurses.
“The perception of one's work environment, that is, the perceived organisational support may likely impact work stress levels in emergency department nurses (Rhoades & Eisenberger 2002).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Rhoades & Eisenberger 2002
Not checked in the free run.
- Interpretationreasoning
The 66% of ED nurses who perceived their work environment as not supportive are experiencing some degree of work stress.
“This study also found that 66% of ED nurses perceived their work environment was not supportive suggesting that they are experiencing some degree of work stress.”
Quote in the paperSubstantial claim - Premisecitation
Conflict management style may directly affect the level of work stress.
“Thus, the conflict management style rendered in response to conflict may directly affect the level of work stress and may be an important determinant of work stress in emergency department nurses (Friedman et al. 2000, Montoro-Rodriguez & Small 2006, Vivar 2006, Sportsman & Hamilton 2007).”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Nurses in acute care settings such as the ED with greater levels of perceived support from their supervisors experience less work stress.
“Research suggests that nurses in acute care settings such as the ED with greater levels of perceived support from their supervisors experience less work stress (Hall 2007, Verhaeghe et al. 2008).”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationown data
ED nurses who used an obliging conflict management style may not experience high levels of work stress.
“There was no significant relationship between an obliging conflict management style and work stress, suggesting that emergency nurses who used an obliging conflict management approach may not experience high levels of work stress.”
Quote in the paperSubstantial claim - Interpretationreasoning
ED nurses who used integrating or dominating conflict management styles may have experienced less work stress.
“No direct relationship was found between an integrating conflict management style and dominating conflict management style and work stress, indicating that emergency nurses who used these behavioural approaches to managing conflict may have experienced less work stress.”
Quote in the paperSubstantial claim
- The quote only partly states this claim. 1
- Classified as probably not a substantial claim. 7
- May combine two claims. 5
The quote only partly states this claim.
Findingown dataSupportive work environment was inversely correlated with work stress among ED nurses (r = -0.292, P = 0.000).
“A significant weak relationship was found between a supportive work environment and work stress”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationA supportive work environment may lessen the negative effects of conflict management style on overall work stress.
“Although findings in the literature indicate that supportive work environments and conflict management styles are directly related to work stress, it is thought that the individual's perception of their work environment may lessen the negative effects of conflict management style on overall work stress (Friedman et al. 2000, Rhodes Rhoades & Eisenberger 2002).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Friedman et al. 2000 source
Not checked in the free run.
- cites Rhoades & Eisenberger 2002
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataThe final sample consisted of 222 staff nurses after excluding 78 respondents who were educators, nurse practitioners, or managers.
“Three hundred surveys were returned for a 40% response rate.Seventy-eight of these surveys were excluded because responders identified their current position as educators, nurse practitioners or nurse managers.The final sample size for this study was 222 staff nurses who worked in hospital-based emergency departments.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductcitationThe abbreviated survey of perceived organisational support (SPOS) has reported Cronbach's alpha of 0.90 and subscale reliability of 0.97.
“Cronbach's alpha coefficient of 0.90 has been reported for the SPOS.The reliability for the SPOS subscales was 0.97 (Eisenberger et al. 1986).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Eisenberger et al. 1986 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Study design and conductnone givenMore objective organisational variables such as hospital type, trauma level, hospital size, staffing levels, and shift work could affect the relationships.
“In addition, more objective organisational variables such as hospital type (urban, rural and suburban), trauma level and hospital size, staffing levels and shift work could affect relationships.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoningSelection bias may have occurred because the study used only registered nurses who were current members of the ENA, decreasing generalisability.
“Selection bias may have occurred during the data collection process as this study used only registered nurses who were current members of the ENA.This also decreases the generalisability of these study findings.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe Rahim organisational conflict inventory-II (ROCI-II) subscale reliability ranged from 0.72 to 0.74.
“Reliability for all ROCI-II subscales ranged from 0.72 to 0.74 (Weider-Hatfield 1988).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Weider-Hatfield 1988
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIndividuals with high concern for themselves tend to use dominating or integrating conflict management styles and experience lower work stress, while those with low concern use avoidant or obliging styles and experience higher work stress.
“Individuals who have a high concern for themselves have personal internal resources and are more skilled in ensuring that their interests are represented when urgent needs arise and as a result, these individuals experience lower levels of work stress.These individuals tend to use a dominating or integrating (problem-solving) conflict management style.Conversely, individuals who have a low concern”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Friedman et al. 2000 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe data for this study were collected approximately four years before the time of writing.
“Lastly, it should be noted that the data for this study were collected approximately four years ago.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenUnmeasured variables such as task and relationship conflict could affect the results.
“There may also be unmeasured variables in the analysis such as task and relationship conflict which could affect the results.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataMore than 25% of emergency nurses used an avoidant approach to manage conflict, suggesting that more emergency nurses may experience some level of work stress.
“In this study more than 25% of emergency nurses used an avoidant approach to manage conflict, suggesting that more emergency nurses may experience some level of work stress.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductcitationA sample size of 84 was needed for correlational analysis to obtain power 0.80 at a 0.05 significance level, and 135 for regression with 14 predictors.
“For correlational analysis, using a moderate effect size (r = 0.30) based on the literature (Rhoades & Eisenberger 2002, Tabak & Koprak 2007), a sample size of 84 was needed to obtain a power of 0.80 at a 0.05 significance level.”
- Also stated in: § Sample · plain
“Using a moderate effect size (f2 = 0.30), based on a review of the literature (Hall 2007, Tabak & Koprak 2007, Verhaeghe et al. 2008) and 14 predictor variables (the total number of subscales in the instruments), a minimum sample size of 135 was needed to obtain a power of 0.80 at a significance level of 0.05 (Cohen 1992) for regression analysis.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Cohen 1992 source
Not checked in the free run.
- Also stated in: § Sample · plain
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Moderate-to-high work-stress percentage is inconsistent with the count
MajorThe reported 54 nurses are 24.3% of the stated sample of 222, not 27%. This changes the reported prevalence of the study's central outcome.
Reported 27 · recomputed 24.324324
“the remaining 27% (n = 54) experienced stress frequently with moderate to high levels.”
Higher-support percentage does not match its count
MinorOf the stated sample of 222, 68 nurses represent 30.6%, not the 34% shown in Table 2.
Reported 34 · recomputed 30.630631
“| Perceived organisational support | | | | Low | 147 | 66 | | Moderate to high | 68 | 34 |”
Avoidant conflict is described as both reducing and increasing stress
MinorThe results interpret avoidance as associated with less work stress, whereas the discussion presents the study's finding as consistent with higher stress among avoidant nurses. The reported positive correlation also conflicts with the lower-stress interpretation.
“There was a moderate positive, relationship between avoidant conflict management style and work stress (r = 0.300, P = 0.000) indicating that ED nurses who avoided conflict experienced less work stress (Table 3).”
“These findings are congruent with previous studies, which demonstrated that nurses using an avoidant approach to managing conflict have higher levels of stress (Friedman et al. 2000, Tabak & Koprak 2007).”
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- Authors
- Johansen, M. L., & Cadmus, E.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Johansen, Mary L.
- Venue
- Journal of Nursing Management
- Publisher
- Hindawi Limited
- Published
- 2015-04-06
- Volume
- 24
- Issue
- 2
- Pages
- 211-218
- ISSN
- 0966-0429 (ISSN-L)
- OpenAlex
- W2168143749
- Cited by
- 83
- References
- 32
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 7 · 2023: 10 · 2022: 10 · 2021: 12 · 2020: 11 · 2019: 6 · 2018: 6 · 2017: 3 · 2016: 2
- FWCI
- 12.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nursing Management (publishedVersion)
- PubMed (publishedVersion)
- Rutgers University Community Repository (Rutgers University) (submittedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Conflict Management and Negotiation
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- conflict management styles, supportive work environment, occupational stress, emergency department nurses, emergency nursing, organizational support, organizational conflict, nurse stress
- MeSH terms
- Nurse Specialists, Adolescent, Adult, Conflict, Psychological, Female, Humans, Job Satisfaction, Male, Middle Aged, Nursing Staff, Hospital, Social Support, Stress, Psychological, United States, Organizational Culture, Linear Models, Emergency Nursing, Negotiating, Young Adult, Self Report
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