Background of the Study
The work environment is a multifactorial aspect of people’s life that affects health both positively and negatively. In traditional epidemiology, the study of work and health is mainly focused on detrimental working conditions, i.e. problems and impediments related to different health outcomes. An important component of work environment is the psychosocial working conditions which are linked to psychological strain (Stoetzer,2010). Interpersonal relationships at work play critical role in the development and maintenance of trust and positive feelings in an organization. Although the quality of the relationships alone is not enough to produce worker productivity, it can significantly contribute to it (Gregorio, 2014).
In today’s corporate world, there is a need for work to be done as quickly and as well as possible and for this purpose, working professionals need to have good interpersonal relationships among themselves. If there are healthy interpersonal relationships in the team members, they tend to work collectively towards the prescribed goals. Team work also contributes a lot to a healthy work environment. Employees feel good to work if there is a favourable environment at the work place. If employees have a mutual understanding of each other, there are less chances of work place conflicts (Rampur, 2010).
Healthy interprofessional relations can be maintained by effective workplace communication and team work. Interpersonal relationships gradually develop with good team participation and communication with other members. On the other hand, these relationships may deteriorate.
When health professionals do not possess the necessary communication skills. In order to create and maintain these relationships, one needs to consider some simple, yet significant aspects (Rampur, 2010).
Interpersonal relationships are important components of a psychosocial working condition but inadequately studied. At work, interpersonal relationship can be considered to be mainly governed by personality traits. Alternatively they are potentially affected by other psychosocial working conditions rooted in the organizations, thus prompting the need to study the relation to organizational factors. In epidemiology interpersonal relationships at work are defined as detrimental factors e.g. conflicts (Stoetzer, 2010). Examples of organizational factors that could be related to interpersonal relationship at work are strategies and procedures to involve the employees in a teamwork in the organisation. Other psychosocial working conditions may also affect relationship. Research has shown that friendships at work can improve individual employee attitudes such as job satisfaction, job commitment, engagement and perceived organisational support (Morrison,2009, Song & Olshfski; 2008, Zagnezyk, Scott, Gibney, Murrell, & Thatcher,2010)..
Interpersonal relationships at work constitute the day to day interactions between co-workers, or managers and employees. These relations are natural parts of the work environment, and are usually pleasant and creative, but sometimes the source of tension and frustration. It can be described from an individualistic viewpoint, or an organizational viewpoint. An alternative perspective would be how relationships are dealt with on an organizational level i.e. strategies and procedures affecting many employees simultaneously. In order to capture the nature of an organization, one has to rely on the individuals’ experiences. An important aspect when studying organizational factors at the company level is management or leadership that deals with strategies and procedures that directly affect the employees. Leadership is a process, a system, that has a very broad range and depth,(Avolio, 2011). Positively deviant leadership is associated with the promotion of outcomes such as interpersonal flourishing ,meaningful work, virtuous behaviours, positive emotions, and energizing networks, (Cameron, 2012). For interpersonal relationships, this means how managerial decisions can directly or indirectly influence the relationships among the employees. Direct influences include decisions resulting in more or fewer contacts, such as opportunities for team meetings, indirect influences include working conditions that may affect individuals’ way of interacting, for example high work load that hinders spontaneous interactions. Managerial decisions may affect interpersonal relationships not only quantitatively but qualitatively.
In health care, there are key elements in the workplace that strengthen and support the workforce and in turn have positive impact on patients’ outcomes and organizational cost effectiveness. These are factors like effective communication skills, common venue for interaction, conflict resolution strategies, formal interpersonal practice, good and supportive work environment, compatibility and respect. These factors when in place and supported by appropriate resources (both financial and human), go a long way in ensuring the establishment and maintenance of an effective healthcare professional workforce, and ultimately the overall quality of the system (ICN, PC/OF, 2008). This study, therefore explores strategies for fostering healthy interpersonal relationship among health professionals.
Statement of the problem
Conditions such as work overload, poor interpersonal relations and unsupportive climates are common workplace factors contributing to staff burnout, low morale and voluntary turnover. It has become even more common to observe problems of labour dissatisfaction among hospital staff. This is partly due to labour organization in the hospital and how such problems are managed. The dissatisfaction is also due to relationship problems and the absence of adequate communication among the healthcare professionals,(Raquet, Ronix, Juan, Marcos &Solen, 2013). Cost of turnover is escalating in part because of high rates of departure by health professionals, especially nurses and administrators .Surprisingly, the fact that turnover costs due to working conditions are largely avoidable has not been given the attention it deserves from health system executives, policy makers and managers. Positive relationships are regarded as stimulators of positive attitude to work, employee wellbeing and a restraint of employee overloading. They provide employees with a higher sense of meaningfulness, safety and availability This has a resultant effect of creativity, job satisfaction, commitment, and decrease in absence and employee turnover, (Halbesleben, 2012).
There have been reported cases of workplace incivility, harassment and abuses among different organisations and in health care sector worldwide. In the hospital context, most researches on work life quality focus on how nurses and physicians perceive and react to work conditions.. Valued work relationships can influence organisational outcomes by increasing institutional participation, establishing supportive and innovative climates, increasing organizational productivity and indirectly reducing the intent to turnover (Song & Olshfski, 2008). Unfortunately, this is not the case for health workers in some health institutions.
Anecdotal reports show that there have been series of unrest in the workplace due to poor interpersonal relationships. One professional group fights for the interest of her members excluding all other groups in the sector. This has resulted in many industrial actions in ESUTTH which the researcher, a staff of the hospital has witnessed.
In 2009, the hospital experienced a partial shut down for three months as a result of a move by a group for improved welfare. Earlier in the same year the house officers went on strike for improved pay. A similar incidence occurred in December 2010 to June 2011 when the resident doctors embarked on another long strike for nonpayment of CONMESS-consolidated medical salary scale excluding the nurses and other health workers. Between 2009 and 2013,there had been migration of nurses across the institution, nine to National Orthopaedic Hospital Enugu, fifteen to UNTH Ituku Ozalla, and eight to Ebonyi State,etc. Also, up to twelve resident doctors with some consultants left for UNTH, FMC Umuahia, and Abakaliki. Many periodic recruitment of health professionals have been done within three to four years in succession but still there is shortage of workers mainly due to migration of Nurses as well as laboratory technologists without the other groups(Personnel Department, 2013). In practice, there have been incidences of disagreement and unfriendly exchange of words even in front of the patients among the doctors and nurses over prescriptions of drugs and procedures. Some even resort to bullying their colleagues openly for issues which should be resolved amicably. “Can two walk together except they agree?”. Given that friendship at work provides valuable individual and organisational outcomes, one may ask, how can the health professionals working in ESUTH generate positive interpersonal relationships in the work place? Reviewed literature revealed some strategies that foster healthy interpersonal relationships which include effective workplace communication, institutional culture like team building, meetings and social events. Other perceived strategies are expanding resources for conflict resolution and increasing opportunities for the formation of healthy workplace relationships. This study is an attempt to determine strategies that foster healthy relationships among the health professionals.
Purpose of the Study
The purpose of this study is to determine perceived strategies for fostering healthy interpersonal relationship among health professionals in Enugu state University Teaching Hospital (ESUTTH).
Objectives of the study
The specific objectives of the study are to;
- Identify the communication structure strategies that foster healthy interpersonal relationships as perceived by health professionals in ESUTTH.
- Determine the institutional culture strategies that foster positive interpersonal relationship development as perceived by health professionals in ESUTTH.
- Identify opportunities for inter departmental dialogue that enhance positive relationships as perceived by different health professionals in ESUTTH.
- Identify conflict resolution strategies that foster healthy interpersonal relationships as perceived by health professionals in ESUTTH.
The questions being raised in this study are;
- What forms of communication structure strategies foster healthy interpersonal relationships among health professionals in ESUTTH?
- What are the institutional culture strategies that may foster healthy interpersonal relationships among health professionals in ESUTTH?
- What are the opportunities for interdepartmental dialogue that may enhance the development of healthy relationships among the health professionals in ESUTTH?
- What are the conflict resolution strategies that may foster healthy interpersonal relationships among health professionals in ESUTTH?
Significance of the study
Findings from this study will identify the strategies for improving interpersonal relationship through effective communication. The findings on perceived institutional culture from this study will help to determine the institutional culture that fosters healthy relationships among health professionals. The findings from the study will provide information on creating opportunities for inter professional relationships for better workplace interactions and exchange of ideas. It will also assist healthcare managers with information on better conflict resolution strategies and establish positive practice environment across the health sector. The information from the findings will improve the existing knowledge on peaceful coexistence and healthy workplace environment. The findings will also enhance the knowledge base on healthy inter professional cohabitation and efficient team work.
Scope of the study
The study is focused on identifying the perceived strategies for fostering healthy interpersonal relationship among health professionals in ESUT Teaching Hospital Parklane. Enugu. It is also confined to variables such as communication structure, institutional culture, opportunities for inter professional interactions, and conflict management strategies that help in fostering healthy interpersonal relationships among health professionals. The study is delimited to all the healthcare professionals such as the doctors, nurses, medical laboratory scientists/technologists and pharmacists at ESUTTH Parklane.
Operational definition of terms
Perceived Strategies for healthy interpersonal relationship; Refer to measures for maintaining effective day to day interaction among health professionals. These include; communication structure, institutional culture, opportunities for inter departmental dialogue and conflict resolution strategies.
Healthy Interpersonal Relationship A recognized relationship between health care professionals of different/the same department in a hospital, geared towards achieving excellent health outcomes in a way which is more effective, efficient or sustainable.
Perceived Strategies; This means ways or means by which healthy interpersonal relationships can be built and maintained among the health professionals as envisaged by the health professionals themselves.
Communication structure; This is a form of open and active communication and listening which make mutual knowledge possible among team professionals and allow improvement on processes for sharing clinical information. This includes the use of memos, bill board, internet, meetings and face to face interactions among healthcare professionals in the workplace.
Institutional culture; These are activities developed by the management to improve harmonious relationship and enhance opportunities for friendship formation like; team building, regular departmental meetings, inter departmental conferences, encouraging communication between immediate superiors and subordinates, and reinforcing positive performance by reward or praises.
Increasing opportunities for social engagements for development of interpersonal relationships; This involves encouraging social events, interdepartmental positive competitions, end of the year party for all professionals together, institutional health week, road walk, picnics and sports activities.
Conflict resolution strategies; refers to the use of dialogue, meetings, prompt address to issues, panel or disciplinary committee, team work and effective communication to prevent and resolve conflicts.
Health Professionals refers to all professionally trained health personnel employed or contracted to provide health services. They include nurses, doctors, pharmacists, lab technologists/scientists, physiotherapists, radiologists/radiographers.
Interdepartmental dialogue ;Discussions or interactions among various departments to ensure good working relationships and for conflict resolution.