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Title: Statistical analysis of conflict management styles of health service executives in greater China
Other Titles: Da Zhonghua qu yi wu xing zheng ren yuan zhi chong tu guan li fang fa
Authors: Lo, Wai Leung Colin ( 羅偉樑)
Department: Department of Systems Engineering and Engineering Management
Degree: Engineering Doctorate
Issue Date: 2011
Publisher: City University of Hong Kong
Subjects: Conflict management -- China.
Health services administrators -- China.
Notes: CityU Call Number: HD42 .L6 2011
xii, 207 leaves : ill. 30 cm.
Thesis (Eng.D.)--City University of Hong Kong, 2011.
Includes bibliographical references (leaves 183-203)
Type: thesis
Abstract: Conflict has historically been viewed as undesirable and something to be avoided. However, conflict is inevitable and a natural part of interacting with others. It frequently occurs in workplace when people have different opinions about procedures, expectations or values. Especially, in the life-threatening, highly stressful and rapidly changing healthcare environment, poorly managed conflict can damage relationship, demoralize staff, increase turnover, and alienate patients. It is a common belief that because of a culture and value that has been greatly influenced by Confucianism, Chinese generally show a passive way of handling conflict. Previous studies on conflict management in Chinese society revealed that Chinese culture promoted an indirect, avoiding style of handling conflict (Bond & Wang, 1983; Tang & Kirkbride, 1986; Ting-Toomey, 1994; Jehn & Weldon, 1997). During the last decade, conflict management has received more attention in China due to a shift in attitudes toward conflict (Yu, 2002; Chen, Tjosvold, & Fang, 2005). Chinese managers are said to be more open to facing and dealing with conflicts and making use of them as part of the powerful management repertoire. The diversity of staff perspectives and experiences create challenges in healthcare facilities. Researchers claimed that conflict management is especially difficult for health service executives to embrace, because many of them are highly adverse to confrontation, limited emotional expressiveness, and significant communication deficits (Sotie & Sotie, 1999; Andrew, 1999). They often make critical decisions with incomplete or ambiguous information under severe time constraints. Competitive rather than cooperative behaviours tend to be reinforced, causing severe stress and emotional distancing from their co-workers and patients. On the other hand, healthcare professionals are noted to be commonly using avoidance as a technique to deal with conflicts (Andrew, 1999; Aschenbrener & Siders, 1999; Pinosky, 2003). In the literature of conflict management, very few attempts have been made to study its importance and tendency in Greater China, especially in healthcare section. The project aims to determine which conflict management styles health service executives in the region preferred to use. Besides, it aims to provide some practical recommendation and training for technical staff, in order to optimize their conflict management skill. They should thus understand, be aware of and able to reduce or resolve conflict more easily in workplace. Five conflict management styles of this study were measured by items adopted from the Rahim's Organizational Conflict Inventory-II. A newly designed questionnaire with thirty five questions was prepared with respect to some possible conflictive situations happened in healthcare facilities. Participants were requested to answer accordingly to how they would usually act when dealing with particular type of conflicts against certain parties. Hence, the variables chosen for this purpose were the authority position of corresponding parties and sources of conflict. The former refers to respondent's peer, subordinate, or service provider. Sources of conflict are refined as totally seven items, namely, quality, performance, operation, technology, communication, management and safety. The study recruited a hundred and fifty executives from thirty healthcare institutions located in Shanghai, Taipei and Hong Kong respectively. Random samples of five executives were chosen at each institute which was equipped with our medical equipment. Totally ten institutes were selected at each city by means of convenience sampling. Based on these one hundred and fifty sets of the questionnaire collected, the results indicated that Chinese have different perspectives on diverse conflict sources and various corresponding parties. Statistical analysis was employed by using the Statistical Package for Social Sciences (SPSS 15.0 for Windows). Validity was checked by Exploratory Factor Analysis and the results showed that the validity of all factors were acceptable. To check the internal consistency reliability, Cronbach's alpha (α) coefficient for reliability was computed. The alphas for all items were higher than .70, which indicated that the reliability coefficients were acceptable with good internal consistency. Based on the scores obtained from the questionnaires, assertiveness index and cooperativeness index were calculated. The data analysis demonstrated that Hong Kong health service executives had the highest assertiveness index and lowest cooperativeness index, which was opposed to the results of Shanghai participants. There is also significantly difference between these indices among Shanghai participants and Hong Kong participants, but no significantly difference among Taipei participants. Preferred conflict management styles, regarding corresponding parties and sources of conflict, were analyzed by One-way ANOVA and Tukey honestly significant difference (HSD) test if the F-ratio of ANOVA was significant. The comparative analysis in the study indicated that health service executives commonly prefer having collaboration style for managing conflict, but not avoidance or compromising. The results also showed that participants tend to use the same style when dealing with different conflicting parties. On the other hand, some sources of conflict had considerable influence and correlated with specified conflict management styles. For instance, technology had significant and positive relationships with avoidance, accommodation and compromising styles. In Taipei and Hong Kong, health service executives with collaboration style or forcing style were more assertive to handle issues related to safety, quality, and technology. Therefore, the project successfully identified the major conflict sources which may affect the relations between healthcare professionals and their service providers. The results were valuable for developing a conflict management training programme. During the one-day training, some practical recommendations and application tools were introduced, as well as open discussions, case studies and role-playing. Thus, frontline technical staff should be rewarded for understanding of how customers are likely to approach conflicts, and for preparing themselves well. To evaluate the training effectiveness, a follow-up exercise was performed by interviewing totally six participants individually about six months later. Certain participants believed that they had behaviour changed upon completion of the training, or felt more comfortable when facing workforce conflicts.
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