INTRODUCTION

Labor conflicts are defined in the Health Sciences Descriptors ⁽¹, as opposed or competitive actions, between incompatible parts. It also refers to the antagonistic state or action (of ideas, interests or people). In labor relations, interactions are created among workers and between them and their employers which are influenced by government interventions, work, or emerge outside the labor situation, which obviously can lead to a conflict. According to the International Labor Organization (ILO) document published in 2013 ², conflicts are accepted as an ineviTable element within the organization and a market economy, which is possible to avoid finding a solution to them, for which it is essential that conflict management or management systems encourage conflicts and their employees to avoid the arising of conflicts.

For the effective labor disputes management, initiatives based on consensus that provide conciliation / mediation and arbitration services should be promoted to ensure that differences do not become conflicts that require the intervention of third parts. When there is a conflictive working environment, relationships at work and their management become stress generators that affect the psychosocial environment of the worker and therefore the organization productivity ³.

There are different types of labor disputes, individual or collective of a legal nature, as well as the interest or object of the conflict, it can be either one worker conflict or several or even all the workers of a company or an organization ⁴. In health institutions, the so-called work suffering generates an internal conflict among employees, due to everyday experiences ⁵, to which other conflicts are added due to workplace harassment and the lack of ethics of some employees of the institutions. In the particular case of Peru, in health institutions such as Ministry of Health as well as Es Salud, conflicts occur because the members compete for scarce resources, prestige and positions of power. Although all organizations have internal disagreements, in these institutions often occur incorrect information, misunderstandings and disagreements ⁶.

On the other hand, there are frequent situations of conflict within hospitals, mainly due to the unionization of personnel and the resulting negotiation methods ⁷. The introduction of new control methods, such as the organization for the forecasting of professional standards as well as the disagreement over authority and power among professional staff, requests for guidance of resources often at the expense of existing departments, creates the perfect climate for the generation of conflicts that negatively affect the work environment of health institutions. According to a research made ⁸, the health workers demand in the hospital sector in Peru was mostly linked to management issues, in 41%; the highest demand of the workers of the Ministry of Health (MINSA) was by designations (job positions conflict), in 67%; the highest demand for Es Salud workers was due to an increase in salaries, by 33%

This research aims to associate the labor conflict types and conflict management in nursing staff in Honorio Delgado Regional Hospital in the city of Arequipa, Peru, under the premise that there may be a relationship between the type of conflict that is generated and the methodology or management method applicable to its resolution, from the point of view of nursing professionals working in the health institute.

METHODOLOGY

population and field of study

A total population of 375 nursing professionals was taken, from which a probabilistic sample was taken by simple random sampling of 190 study subjects, representing a sample size of 51% of the population, with an estimation error of 7.1%, calculated with the following equation ⁹⁾⁽¹⁰:

Where: e is the sampling error, Z is the confidence level (1.96 for 95%), p.q is the population variance (0.25) and n is the sample size.

RESULTS

Of the 190 study subjects, according to what is observed in Table 1, 34.7% are between 50 and 59 years old, the predominant sex in professional nursing practice continues to be female with 94.7%; 65.8% are married, 94.2% work in hospitalization, 43.7% have worked for 10 years or more, 51.6% have practiced for at least 16 years or longer, 58.9% are appointed and 58.9% of nursing staff have a specialty.

Table 1. Sociodemographic and labor factors 

Source: Own elaboration based on the data collected from the questionnaire made.

The normality test data results, according to the Kolmogorov-Smirnov and Shapiro-Wilk tests, are shown in Table 2. Where the following hypotheses were raised:

Ho: the data is not distributed according to a normal probability model (p<0.05)

Ha: the data is distributed according to a normal probability model (p>0.05)

Table 2. Data normality test results 

Source: Results of the statistical tests with the data collected.

The data collected through the questionnaire applied does not fit a normal distribution, since in both tests it is observed that p <0.05. The results indicate that non-parametric tests should be applied.

The conflict types detected in the most frequent study sample (Table 3) were: staff communication conflicts with 44.8%, less frequently but no less worrisome, the staff type with 26.8% and communication of nursing staff 15.8%. It is noted that communication conflicts among staff are considered the most common and staff conflicts associated to professional skills and jobs stand out.

Table 3. Population according to type of conflict in the HRHD - 2015 

Source: Own elaboration based on the data collected.

Table 4 shows that the most frequent conflict management is the cooperative 48.4%, followed by assertive management with 18.4% and elusive with 17.4%. These conflict management categories were proposed by Robert Blake and Tane Mouton in 1960. It is observed that according to the research subjects opinion, in most cases the conflicts are resolved, or are managed in a cooperative group way, that is to say that peaceful methodologies are applied through communication and collaboration.

Table 4. Population according to conflict management in the HRHD - 2015 

Source: Own elaboration based on the data collected.

According to the Chi-square test (χ2 = 13.53) it shows that the type of conflict and conflict management do not have a significant statistical relationship (p> 0.05). Likewise, nurses who report conflict of the staff communication type whose conflict management style is Cooperative (22.1%) are more frequently observed, while 6.8% of nurses present personal conflict type and management of assertive conflict.

Table 5. Association between type and conflict management HRHD - 2015 

Source: Own elaboration based on the data collected.

DISCUSION

The literature review shows that many investigations have been made where labor disputes are analyzed in different organizations. Some researches deepen into the root causes of conflicts ¹³. Other types of staff conflicts are analyzed in other investigations ¹⁴ and in other investigations the management of labor conflicts is studied and analyzed ^15)(16)(17. In the specific case of investigations about conflicts in nursing practice, some research can be found ^18)(19)(20) however; the relationship between the types of conflicts and their management or management by nursing professionals has not been studied.

The sample taken for the research presented sociodemographic characteristics similar to those observed in other investigations ²⁰⁾⁽²¹, in which the tendency towards nursing professionals was mostly women. In the research carried out, it was also observed that the majority are married people with work experience over 16 years what it is consistent with the highest age range found that was over 50 years old, which coincides with other researches. ²¹.

Regarding the types of conflicts, it is clear that the majority of the people surveyed declare that there are conflicts of a communicational-staff nature, which indicates a tendency to conflictive relationships related to poor communication in the health institution where the research was conducted. The lack of communication among health professionals, as well as between them and patients is a problem that can seriously affect the safety of attention ²² and obviously it also affects the work environment in which they work, which is clearly seen in the perception of respondents. Another factor that affects interpersonal relationships in nursing professionals and therefore effective communication are excessive workloads and concerns about the development of new techniques in the practice ¹⁶.

The most used conflict management according to the opinion of the respondents was the cooperative, which indicates that they prefer to resolve the conflicts in a group way. This conflict resolution methodology is used to respond to a conflict in a cooperative or collaborative manner, avoiding as far as possible inappropriate solutions ²³. The cooperative conflict solution is developed in several stages where each individual contributes his vision to the possible solution. Cooperative conflict management in the nursing practice also highlights in other research ²⁴, where it is concluded that this is the most appropriate option for conflict resolution, however, it is also stated that the choice of management strategy depends on many variables, such as the situation itself, the time to make the decision, the power and status of those involved, the importance of the problem and the maturity of the people involved in the conflict and their experience.

The above is reflected in the analysis of the relationship between the conflicts types and their management or negotiation, where it was determined that no significant statistical relationship is evidenced. The perception of respondents coincides with the complexity of conflict management ²⁴, since it is observed that the conflict handling does not depend on its type but on the disposition of those involved and the leaders of the organization in its resolution. However, in resolving group conflicts, negative results can be obtained when all members do not agree with the measures to be taken.⁽²⁷⁾

CONCLUSION

A general characteristic of the research sample shows that professionals who practice nursing are mostly female, it is also concluded that the average age of nursing professionals working in the health institution taken as a reference is 45 years old, and people with married status predominate. In labors, the population is characterized by a professional performance period over 16 years; permanence in hospitalization services over 10 years, appointed and specialists in the working area.

Among the types of conflict were those of communication that, according to respondents, are due to the fact that unclear and poor reports and messages are generated. Interpersonal conflicts were also identified due to the style of work, the type of work and group status, especially among the bosses with the nursing technical staff in charge.

In research sample's opinion, conflict management is mostly cooperative or concerned for others in the health institution, followed by the assertive or self-conscious and evasive or doing nothing to their own satisfaction or others.

From the normality analysis data results, it was shown that the sample is not distributed normally so a non-parametric test was applied (χ2) to establish the degree of association between the type of conflict and its bunch. It was concluded that there was no statistically significant relationship between the variables studied. (p =0,139).