Assessing the effect of demographic factors on conflict situations in Ghana government hospitals

Year 2014, Volume: 1 Issue: 3, 305 - 317, 01.09.2014

Gabriel Dwomoh Kofi Kwarteng Evelyn Frempong Regina Anima Frempong

Abstract

The   study   seeks   to   examine   the   influence   of   demographic   factors   on   conflict   in  Ghana  government  hospitals.    It  adopted  the  quantitative  approach  which  involves  the  use  of  questionnaires  and  interviews  coupled  with  statistical  analysis  to  assess  the   effect   of   demographic   factors   (age,   educational   level,   gender   and   number   of  years  on  the  job  of  employees)  and  conflict  occurrences  at  the  workplace.    The  use  of  purposive  and  convenience  sampling  techniques  were  adopted  to  get  a  sample  of   123   employees   and   10   heads   or   deputy   heads   of   human   resource   of   the   ten  regional  hospitals  in  Ghana.  The  study  found  out  that  there  is  association  between  these   demographic   factors   and   conflict   occurrences   at   these   hospitals   with   95%  confidence  level.      It  therefore  recommends  to  management  of  these  hospitals  and  other   policy   makers   to   pay   much   attention   to   these   factors   when   formulating  policies  so  that  they  meet  the  expectation  of  different  categories  of  employees  at  the  workplace.     1.  INTRODUCTION  Workplace   conflict   is   a   universal   organizational   phenomenon   because   it   is   inevitable  aspect   of   modern   life.   For   any   organization   to   perform   well   to   achieve   its   objectives,  different  teams  and  individuals  of  different  age,  sex,  gender  and  marital  status  must  work  together   and   create   relationships   across   organizational   lines   and   groups.   In   the   flow   of  work   and   information,   individuals,   groups   and   departments   depend   on   each   other   for  information   sharing,   assistance   or   coordinated   action.   For   example,   in   the   hospital  environment,   doctors   will   depend   on   nurses,   lab   technicians,   x-­‐ray   attendants   and  pharmacists  to  collate  the  needed  and  relevant  information  to  assist  their  patients  in  the  recovery  process.  Without  the  help  of  the  personnel  mentioned  above,  the  work  of  the  medical  doctor  will  be  very  difficult  especially  if  there  are  disagreements  among  them.      In   the   same   way,   the   pharmacist   will   depend   on   the   medical   doctor   in   the   area   of  prescriptions.   Such   interdependence   may   either   foster   cooperation   or   conflict.     The  hospital   environment   is   a   mixture   of   different   categories   of   people   with   different  background   in   terms   of   age,   gender,   education,   religion,   beliefs   and   tribe   and   as  mentioned   by   Collier   (2006)   such   differences   are   potential   causes   of   conflict   in  organizations.   Again,   the   hospital   is   the   only   working   environment   where   its   customers  patronized   its   service   when   they   have   health   related   problems   and   it   can   range   from   a  simple   disease   to   a   complicated   health   condition   hence   makes   the   hospital   a   conflict  prone  workplace.    As   people   with   different   backgrounds,   age,   gender,   sex,   values,   needs   and   personalities  interact  with  each  other,  conflicts  are  bound  to  develop.  Moreover  where  one  party  does  not  have  a  sound  mind  then  the  probability  that  the  person  will  not  reason  up  with  the  other  party  is  high  and  hence  disagreement  is  likely  to  occur.    Taking  the  second  largest  government  hospital  (Komfo  Anokye  Teaching  Hospital)  as  an  example,  according  to  the  first  half  year  report  of  the  Ministry  of  Health  for  2012,  a  total  of  150,430  patients  visited  the   Outpatient   Department   (OPD)   whilst   199,176   also   visited   the   OPD   of   the   teaching  hospital  in  2011.  These  patients  come  to  the  OPD  with  varying  degrees  of  health  related  disease  and  complications.  Added  to  this,  the  government  hospitals  is  one  of  the  public  institutions   that   absorbs   a   large   number   of   employees   in   the   public   sector   and   these  employees  apart  from  the  fact  that  they  are  different  in  terms  of  their  values  and  needs    are  also  demographically  different  in  terms  of  sex,  educational  level,  income  level,  marital  status,  occupation    and  religion.    As   already   indicated,   it   appears   these   differences   in   demographic   factors   together   with  the   fact   that   the   hospital   is   the   only   institution   whose   services   are   patronized   when  people   have   health   related   problems   makes   the   hospital   environment   a   place   where  conflict   can   easily   occur.       In   support   of   this,   the   literature   from   American   College   of  Physician   Executives’   (2009)   indicated   that   98%   of   those   surveyed   had   witnessed   an  incident  of  disruptive  behavior  between  nurses  and  physicians.  In   another   study   by   Anderson   and   D’Antonio   (2005),   about   50%   of   physician’s   time   is  spent   on   conflict.   This   according   to   the   writers   stem   from   the   fact   that   the   hospital   is  among  the  few  organizations  that  normally  does  not  segment  or  target  specific  customers.    Demographically,  all  people  of  different  age,  sex,  marital  status,  religion  and  occupation  are  expected  to  patronize  in  the  services  of  these  hospitals.  Now  the  question  one  may  ask  is  that,  looking  at  the  fact  that  these  demographic  factors  are  not  homogenous  and  as  such   there   are   differences   in   age,   gender,   religion   and   marital   status,   is   it   prudent   for  health  professionals  to  spend  most  of  their  time  taking  into  consideration  differences  in  these  factors  when  dealing  with  patients  and  their  fellow  colleagues  since  their  thinking,  reasoning,  perception,  values  and  needs  are  not  the  same?  In  answering  such  a  question,  Studdert   et   al   (2010)   are   of   the   view   that   the   uniqueness   of   the   hospital   environment  demands   that   health   professionals   are   tolerant   in   all   situations   and   in   the   worse   case  when  conflict  occurs  as  a  result  of  differences  in  reasoning,  perception  and  thinking,  they  needed  to  be  dealt  with  in  a  swift  manner  in  order  to  avoid  loss  of  human  lives.  Whilst  we  may   agree   with   the   writers,   it   is   also   true   that   one   need   to   really   examine   what   brings  these   differences   in   reasoning,   perception   and   thinking   and   its   effect   on   conflict  occurrences.      In   light   of   this,   the   researchers   decided   to   go   into   this   research   to   look   at   the   effect   of  these  demographic  factors  on  conflict  occurrences  in  government  hospitals  in  Ghana  since  though   many   research   had   been   done   on   conflict   and   its   occurrences,   there   is   little   on  isolating   these   demographic   factors   and   their   consequences   on   conflict   occurrence.    Second  in  terms  of  Ghanaian  context,  literature  available  to  the  researchers  indicates  that  proper   attention   has   not   been   given   in   terms   of   research   on   conflict   situations   in  government  hospitals.        It  is  the  believe  of  the  researchers  that  going  into  this  research  by  focusing   on   this   area   will   help   bridge   the   gap   in   terms   of   knowing   the   effect   of  demographic  factors  on  conflict  and  its  occurrence  in  Ghana  government  hospitals.  2.  LITERATURE  SURVEY  Over  the  years  the  term  conflict  has  been  branded  to  many  people  as  an  awful  conduct  of  parties   who   engaged   in   an   argument   which   is   normally   generated   from   differences   in  ideas,  beliefs  and  values.  It  was  tagged  as  a  disturbing  force  (Walton,  1969),  hence  most  scholars   advocated   for   its   eradication.   By   the   year   1980,   researchers   such   as   Tjosvold  (1991),   began   to   rethink   about   the   constructive   and   solidarity   consequence   of   conflict.  Thus,   though   conflict   act   as   a   negative   force   operating   against   successful   completion   of  group  common  goals,  it  may  also  lead  to  positive  effects  depending  on  the  nature  of  the  conflict  (Obasan,  2011).    From  the  literature  of  Henry  (2009),  organizational  conflict  is  regarded  as  the  friction  that  occurs   when   the   goals,   interests   or   values   of   different   individuals   or   groups   are  incompatible  with  those  of  other  individuals  or  groups  in  an  organization  and  where  they  may  block  or  frustrate  each  other  in  an  attempt  to  achieve  their  objectives.  Other  writers  such  as  Meek,  Heit  and  Page  (2005),  Hart  (2000)  and  Reece  and  Brandt  (1996)  adding  their  voices   to   what   is   meant   by   conflict   share   a   similar   view   that   it   is   a   state   of   opposition,  disagreement  or  incompatibility  between  two  or  more  people  or  groups  of  people  which  is  sometimes  characterized  by  physical  violence  or  assault.    Their  views  on  conflict  actually  points  to  the  fact  that  it  is  not  always  that  parties  tend  to  be  physical  or  violent  towards  each  other  that  one  can  actually  says  there  is  conflict.    In  some  instances  as  can  be  found  in   the   comments   by   Lambert   and   Myers   (1999)   and   Hocker   and   Wilmot   (1995),   conflict  can  be  latent  and  the  other  party  may  not  even  be  aware  that  there  is  a  conflict.    In  the  case  of  health  care  environment,  a  patient  may  be  in  conflict  with  a  physician  without  the  physician   been   aware   that   the   patient   is   in   conflict   with   him   since   it   is   believed   that  conflict  is  cognitive  rather  than  behavioral  state.        Conflict  is  inevitable  hence  needs  a  strategic  approach  in  terms  of  its  resolution  so  that  the  end  result  can  be  functional  rather  than  dysfunctional.      Whilst  it  tends  to  be  inevitable,  from   the   literature   of   Rahim   (2001),   departments,   units   and   sections   competing   with  limited  resources  is  one  of  the  most  common  sources  of  conflict  in  organizations.  Looking  at   the   literature   given   by   the   writer,   the   researchers   of   this   study   based   on   their   own  observation  see  it  as  one  of  the  major  causes  of  conflict  in  Ghana  government  hospitals  where  patient  frustrations  due  to  congestions  and  pressure  on  health  equipment  generate  frequent  quarrels  and  disagreements  among  them  and  staff  based  on  the  time  taken  for  health  care  professionals  to  deliver  a  service.  To  Tseveendorj  (2008),  the  causes  of  conflict  are  not  only  limited  to  scarce  resources  but  people’s  perception  and  culture  also  breeds  conflict.    Culture  and  perception  is  very  instrumental  human  make  up  that  is  very  hard  to  transform.  Instances  where  team  mates  working  on  the  same  task  have  diverse  cultures  and  values,  their  perception  on  how  to  achieve  the  task  vary  because  each  one’s  decision  will   be   influenced   by   his   values   or   beliefs.   From   the   literature   of   Henkin   and   Cistone  (2000),  demographic  factors  such  as  religion,  educational  level,  gender  and  age  have  high  influence   on   perception   and   as   such   makes   people   think   differently.     Looking   at   the