Nursing Work Stress: The Impacts of SocialNetwork Structure and Organizational

Citizenship Behavior

Seng-Su Tsang1 & Tzu-Yin Chen2 & Shih-Fong Wang3 & Hsin-Ling Tai4*

1PhD, Assistant Professor, National Taiwan University of Science and Technology & 2RN, BSN, Departmentof Nursing, Taipei Veterans General Hospital & 3MS, Doctoral Student, Department of Business

Administration, National Taiwan University of Science and Technology & 4RN, MSN,Department of Nursing, Taipei Veterans General Hospital.

IntroductionIn the postindustrial era, work stress is a risk issue in var-ious occupations. Stress has been frequently referred to asphysiological, emotional, and behavioral changes that oc-cur when dealing with stressful situations (Augusto Landa,Lopez-Zafra, Berrios Martos, & Aguilar-Luzon, 2008). Re-cent research has shown that work stress may diminishemployee task performance (LePine, Podsakoff, & LePine,2005). Stressors are oftentimes attributed to the surround-ing environment, events, economic recession, and other sim-ilar causes (Katerndahl & Parchman, 2002). Nursing is anoccupation typified by continual work stress and relativelyhigh burnout rates (Piko, 2006; Wu, Zhu, Wang, Wang, &Lan, 2007). The National Union of Nurses’ Associations,ROC (2011) calculated that Taiwan had 228,718 registerednurses in October 2011, wherein 134,528 were currentlyemployed as such. The nearly 40% of accredited nurses notworking as nurses is a root cause of Taiwan’s current nurs-ing work force shortage. The decision to not participate isattributable to the inherent nature of professional nursing,which requires constant adoption of new medical technol-ogy, dealing with hiring restrictions due to cost contain-ment programs, facing growing chronic patient numbers,and dealing with new diseases such as AIDS and repetitivestrain injuries (Peeters & Le Blanc, 2001). Furthermore,this occupation can be depressing, as one is regularly in con-tact with patients experiencing depression, pain, and ter-minal illness; works irregular shifts that interrupt normalfamily life; and is forced to balance between a demandingprofessional life and the role of wife and mother. These are

ABSTRACTBackground: The nursing workplace imposes significantlymore stress on its employees than other workplace settings.Organizational resources, both physical and psychological, havebeen recognized in prior studies as important alleviators of nurs-ing workplace stress. Whereas physical resources are less dif-ficult to manipulate because of their tangibility, psychologicalresources, particularly psychological support from colleagues,are typically not deployed to greatest effect.

Purpose: This article investigated the alleviation of nursing workstress using resources already extant in coworker social networks.

Methods: Researchers conducted a survey in a dialysis de-partment at a medical center located in Taipei City, Taiwan. Thissurveymeasured nursework stress, satisfaction, organizationalcitizenship behavior (OCB) and social network structures. Re-searchers employed UCINET to analyze the network structuredata, which were in dyadic matrix format to estimate nursenetwork centralities and used partial least squares analysis toestimate research construct path coefficients and test extrapo-lated hypotheses.

Result: The level of OCB induced by nurse social ties was sat-isfactory and did not only directly increased work satisfactionbut also alleviated work stress, which indirectly boosted worksatisfaction.

Conclusions: Findings suggest that managers may be able touse social network analysis to identify persons appropriate toconduct the distribution of organizational resources. Choosingthose with multiple social connections can help distribute re-sources effectively and induce higher OCB levels within theorganization. In addition, staff with strong friendship networkconnections may provide appropriate psychological resources(support) to coworkers. If those with high friendship networkcentrality receive proper counseling training, they should be in agood position to provide assistance when needed.

KEY WORDS:work stress, resources, social support, organizationalcitizenship behavior, social network.

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Accepted for publication: December 15, 2011*Address correspondence to: Hsin-Ling Tai, No. 201, Shih-Pai Rd.Sec. 2, Taipei, Taiwan 11217, ROC.Tel: +886 (2) 2875-7028; Fax: +886 (2) 2875-7841;E-mail: hltai@vghtpe.gov.tw

doi:10.1097/JNR.0b013e318247bf11

problems faced in Taiwan and worldwide (Ihan, Durukan,Taner, Maral, & Bumin, 2008; Wang, Huang, Lu, & Ho,2007). In Taiwan, nurses are further particularly vulnerableto management pressures (Lin, Chuang, Liu, Chen, & Chen,2011), job values, and organizational commitment, whichare significant organizational factors that affect nurse reten-tion (Wang, Chou, & Huang, 2010). Sadly, nursing workersrepresent a high-risk group that is subject to occupationalchronic disorder syndrome (McGowan, 2001).

Among various nursing categories, dialysis nursing placesmuch heavier demands on nurses than other departments.Most patients enrolled in dialysis treatment can expect tocontinue such for the rest of their lives. Dialysis patients areoften dismayed by the treatment regimen and become mel-ancholy or may attempt suicide as the treatment becomesincreasingly less effective (Chou, 2009). Dialysis departmentnurses often encounter melancholy dialysis patients, henceexperience particularly high mental loadings. Patient condi-tions inevitably affect nurse life quality (Demerouti, Bakker,Nachreiner, & Schaufeli, 2000). Social support has beenshown to be an effective managerial tool for reducing workstress (Tsai & Huang, 2008), and coworkers providing so-cial support has been shown to effectively relieve nursingstress (Tourangeau, Cummings, Cranley, Ferron, & Harvey,2010). Although the effect of social supports is supposedlytransferred through certain media, such as the social tiesthat connect coworkers (i.e., social networks), prior studieshave rarely addressed the attributions of embedded socialnetworks in workplace to social supports. Therefore, thefirst objective of this study was to investigate the associa-tion between social networks and work stress in the nursingworkplace.

Although social supports have been shown to effectivelyrelieve stress, there remain concerns regarding the efficacyof specific measures (Haber, Cohen, Lucas, & Baltes, 2007).Prior studies tend to use self-reported surveys to assess socialsupport received from coworkers. This direct measure, how-ever, has a problem in circumstances typified by a significantgap between perceived and received supports. Although re-medial measures have been proposed (Gottlieb & Bergen,2010), perceived versus received measurement arguments re-main. Although there may not be an objective justificationof the two measures (i.e., perceived and received), this en-tangling problem is unexpectedly resolved as long as themeasure gap exists. The second objective of this study was,thus, to propose an alternative to the self-reported social sup-port measure. We proposed to measure social support byintegrating social network measures among nurses and theorganizational citizenship behavior (OCB) of nurses in thedialysis department.

Theoretical BackgroundSocial support is fostered by personal interactions. Via in-teractions support accrues in the physical and emotionalresources transferred among individuals. Because of the

unsettled nature of the aforementioned self-reported mea-sure, we proposed an alternative to the direct measure asfollows: Prerequisites to developing support within an or-ganization include the one transferring support must havethe needed resources and the giver must be confident of thereceiver’s payback in future. Although there may be no pay-back expectation, reciprocity is the norm in the organization.Thus, to operate the above concepts, the first requisite per-tains to an indicator that depicts resource endowment, andthe second pertains to an indicator showing likelihood ofworker payback for coworker goodwill received. In the fol-lowing, social network notions are aligned with the first re-source endowment indicator, and the confidence indicatoris associated with OCB levels.

Social Network and TiesResource scarcity is obviously an important factor that re-strains social support. The scarcity may encourage the re-source holder to optimize by selecting the receiver amongcoworkers. Naturally, resource giving and receiving is shapedby interpersonal ties among coworkers, that is, the embed-dings of individuals in social network (Granovetter, 1985). Inan investigation of ties, social network analysis provides aquantitative method that endeavors to draw on the struc-tural properties of social ties to explain organizational is-sues such as job performance (Sparrowe, Liden, Wayne, &Kraimer, 2001), power (Brass, 1984), and so on.

The structures of social networks may be analyzed graph-ically by drawing the links among networkedmembers.How-ever, further statistical inferences are difficult. Centrality,which shows the connections between one and others in thenetwork, is a widely adopted network property for socialnetwork analysis. Centrality is shown to be indicative of or-ganization resource availability (Krackhardt,1992). Greatercentrality may hint at greater resource availability. Three es-timators for this measure were proposed as follows: degreecentrality, closeness centrality, and betweenness centrality(Degenne & Forse, 1999). Of the three, degree centralitywas the earliest proposed estimator. It simply counts thenumber of ties to other actors in the network. Betweennesscentrality was proposed to show the extent to which a nodelies between other nodes in a network. It takes into accountthe connectivity of the node’s neighbors by measuring thenumber of actors connecting indirectly through their directlinks. Finally, the closeness centrality was proposed to esti-mate the proximity of an individual to all other individualsin a network. It reveals access through network actors. Of-tentimes, closeness is the inverse of the sum of the shortestdistances between actors and others in the network(Wasserman & Faust, 1994). Therefore, for a small networkstudy, closeness centrality is oftentimes similar to degreecentrality.

In addition to centrality measures, social networks canalso be measured in terms of network characteristics at-tributable to the organization. For instance, strong versus

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weak ties are an issue widely discussed in network studies(Krackhardt & Hanson, 1993). Organizational hierarchyand job assignment (e.g., work network) often creates strongties, whereas weak ties often arise in informal networks(e.g., advice and friendship networks). For strong ties inwork networks, centrality is an indicator, with those withgreater centrality more likely to hold higher job titles, so-cial status (Kenis & Knoke, 2002), and knowledge capital(Jamal, 1990) because of greater control over social sup-port (Adler & Kwon, 2002). For weak ties in the friendshipnetwork, as ties are woven on the basis of close communi-cation and interactions, derived social support are prone tobe sentimental (Krackhardt & Hanson, 1993). Thus, socialnetwork can effectively reduce nurse job stress (Anderson,1991) and enhance their life quality (Achat et al., 1998).

The literature has rarely addressed the direct link betweennetwork ties and OCB. One rare case is the adoption of so-cial exchange theory (Lin, Hung, & Chiu, 2008). The keyfor this theory is reciprocity. We introduce OCB first sothat the link is clearly explained for this case.

Organizational Citizenship BehaviorInterpersonal relationship is an organizational factor funda-mental to collaboration. The altruism that springs from suchrelationships is often key to organizational success. Altruisticbehavior in the workplace has been widely documented asOCB. Endeavors to streamline the OCB, while recognizedas discretionary and not directly or explicitly recognized bythe formal reward system (Organ, 1990), can promote or-ganization efficiency and effectiveness.

In the light of altruistic behavior, reciprocity is an im-portant organizational norm that can induce further inter-personal support (Einsemberger, Armeli, Rexwinkel, Lynch,& Rhoades, 2001). When one excises altruistic behaviortoward coworker, the reciprocity norm assures later pay-back, which is key to the social exchange theory (Cook &Rice, 2006). Accordingly, organizations with higher OCBattitudes may strengthen reciprocity confidence, as resource

owners intend to share resources with other coworkers. Asa result, the social network centrality and the OCB togethermay pertain to the persistence of resource sharing by hold-ing belief of receiving payback from favor recipients in thefuture. In other words, the existence of OCB may give high-centrality individuals (i.e., those with greater resources) con-fidence to support other coworkers.

Direct linkage between organizational network connec-tions and OCB is nevertheless rarely addressed in the lit-erature. Lin et al. (2008) is somewhat relevant because oftheir use of self-reported social network measures ratherthan centrality, a practice widely adopted in social networkanalysis. It is our belief that the formally quantified dyadicmeasure of connections unleashes the embedded relation-ship more precisely. This quantitative social network anal-ysis approach may make the notion of social supports moreoperable in managerial settings.

HypothesesAccordingly, hypotheses were drawn as follows:

H1a & H1b: Work network centrality and friend-ship network centrality both positively affect OCB.

H2: OCB positively affects job satisfaction.H3: OCB negatively affects work stress.H4: Work stress negatively affects work satisfaction.These hypotheses are summarized in Figure 1 as the

research construct of this study.

Methods

Subjects and Questionnaire DesignThe survey was conducted on April 16th, 2010, at thedialysis department of a medical center in Taipei City,Taiwan. This project was authorized by the medical cen-ter’s institutional review board (No. 980238A). Participantsreceived a briefing about the study and were asked to signinformed consent to participate. We did not use random

Figure 1. Hypothesis-based research framework. Plus and minus in the parentheses represent positive and negativeimpacts on factors, respectively. OCB = organizational citizenship behavior.

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sampling because of the study’s social network analysis ap-proach, which collected responses from all 60 nurses in thetarget department. The following measures were used:

Social network centralities measure the embedded rela-tionships either attributed to formal work relations or in-formal friendships (Lincoln & Miller, 1979). BWith whomdo you usually share with the work-related information,knowledge, and experience?[was the question used to framethe work network. BWith whom can you share personalissues confidently?[ was the question used to frame thefriendship network. Degree centralities with respect to workand friendship networks were estimated using UCINET6software (Analytic Technologies, Inc., Lexington, KY, USA).

Instrumental measures for OCB had gone through sev-eral revisions. The five-trait measure that uses altruism, con-scientiousness, sportsmanship, courtesy, and civil virtue hasbeen applied widely among Western societies. A revised mea-sure designed for Eastern societies by Farh, Earley, and Lin(1997) included 20 items (measured using Likert scale, 1Y5)attributed to the following five traits: identification with thecompany, altruism toward colleagues, conscientiousness, in-terpersonal harmony, and protecting company resources.

To measure nursing stress, the Nursing Stress Scalewas adapted into four traits in this study (Gray-Toft &Anderson, 1981), including death, conflict with doctors,lack of support, and work loadings. The measure incor-porated 33 itemized questions (measured with Likert scale,1Y5). Nursing Stress Scale has been widely adopted in nurs-ing stress studies (Augusto Landa et al., 2008; French,Lenton, Walters, & Eyles, 2000).

The Minnesota Satisfaction Questionnaire (Weiss, Dawis,England, & Lofquist, 1967) was adopted for job satisfactionmeasurement and includes items addressing the nursing oc-cupation. This questionnaire is a well-regarded measure ofjob satisfaction (Arvey, Bouchard, Segal, & Abraham, 1989).It was developed in two formats: a long form with 100 itemsand a short form with 20 items (measured using a Likertscale, 1Y5). The short form was adopted to induce higherresponse rates. The scale was intended to measure intrinsicand extrinsic worker satisfaction toward their job.

Structural equation modeling path analysis and smartPLS(Ringle, Wende, & Will, 2007) were employed to test re-search construct (Figure 1) and extrapolate hypotheses. Al-though path analysis is also available in traditional structuralequation modeling such as AMOS and LISREL, the limitedcase size in regular organizational departments (less than ahundred normally, or n = 60 in this study) forbids the useof these two approaches. Thus, partial least squares anal-ysis was used in this study, as it allows small to mediumsample sizes (Henseler & Chin, 2010).

Validity and Reliability Check of PretestThe questionnaire was pretested before the formal survey.Ten copies were collected for validity and reliability checks.For the validity check, the KaiserYMeyerYOlkin analysis was

conducted, with generated values of .5, .5, .85, .73, and .65for work network, friendship network, work satisfaction,OCB, and work stress, respectively. All met the .5 validitycriterion (Dziuban & Shirkey, 1974; Kaiser & Rice, 1974).Validity was further confirmed using the Bartlett test. Chi-square values were 79.97, 13.17, 629.08, 756.07, and293.83 for work network, friendship network, work sat-isfaction, OCB, and work stress, respectively. Significanceswere all significant at the 1% level.

Reliability was checked using Cronbach’s alpha. Valuesof .70, .41, .92, .88, and .77 for work network, friendshipnetwork, work satisfaction, OCB, and work stress, re-spectively, all met the .7 criterion (Robinson, Shaver, &Wrightsman, 1991). Pretest results therefore supported theuse of the questionnaire in a formal survey. All nurses (70individuals) in the dialysis department received a copy ofthe questionnaire and were asked to fill it out for collection2 weeks afterward.

ResultsResearchers distributed 70 copies of the questionnaire andcollected 63 responses for a response rate of 90%. A furtherthree were disqualified for missing entries. Analysis workwas performed on 60 participants. Table 1 shows partici-pant profiles. Reliability and validity check results are shownin Table 2. The mean for centrality was 4.61 (SD = 5.84),with means for the subcategories of work network andfriendship network of 5.17 (SD = 6.45) and 4.04 (SD =5.10), respectively. The mean of job satisfaction was 3.55

TABLE 1.

Subject Descriptive Statistics (N =60)

Variable n %

Seniority (years)5Y10 3 5.011Y15 19 31.716Y20 27 45.0Above 20 11 18.3

Job rankN1 0 0.0N2 43 71.7N3 12 20.0N4 5 8.3

Job titleNurse 22 36.7Professional nurse 35 58.3Associate head nurse 2 3.3Head nurse 1 1.7

StatusTenured 56 93.3Contracted 4 6.7

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(SD = 0.79). OCB mean was 3.94 (SD = 1.01). Work stressmean was 2.29 (SD = 1.05).

Social Network AnalysisFigures 2 and 3 are graphical presentations of workand friendship network structures (using the UCINET6NetDraw function). The work network in Figure 2 closelyreflects the presence of two subdepartments within thedialysis department. Some of the disconnected persons(coded 4, 13, 24, 25, 57, and 58) include telephoneoperators, janitors, and so on. The friendship network inFigure 3 is very different from the work network (Figure 2).

Seven smaller groups are identified (noted from G1 to G7).Work seniority plays less significance in the structure, forinstance, Numbers 1 and 2, top managers of the depart-ment, are not in the major groups.

Path AnalysisFigure 4 shows partial least squares path analysis results.According to path analysis, nurse centrality in both net-works (work and friendship) positively induced OCB withmarginal statistical significance (t = 1.60; p = .06 and t =1.44; p = .08) with respect to work network and friendshipnetwork. Next, OCB significantly induced work satisfac-tion (t = 2.90; p = .003). Besides, OCB was found to signif-icantly alleviate work stress (t = j5.19; p = .000). Finally,work stress was identified as a significant factor in de-creasing work satisfaction (t = j2.62; p = .006). In otherwords, work stress was a significant factor that negativelymediated OCB and work satisfaction.

Social Network Structure and OCBThe path analysis showed that the centralities of bothwork and friendship networks positively affected the riseof OCB in the organization. For work networks, central-ity indicated the availability of tangible resources. In thepresent case, high centrality occurred with department heads,such as the high connection density in Figure 2. In general,those with high work network centrality were those expe-rienced nurses who not only controlled physical resourcesbut were also in command of decision-making powers. This

TABLE 2.

Variable Measurement Validity andReliability

Variable Cronbach’s ! KMOBartlett #2

value

Work network centrality .70 0.50 79.97*

Friendship networkcentrality

.41 0.50 13.17*

Job satisfaction .93 0.85 629.08*

OCB .88 0.73 756.07*

Work stress .77 0.65 293.83*

Note. KMO = KaiserYMayerYOlkin (measure of sampling adequacy); OCB =organizational citizenship behavior.*Significant at the 1% level.

Figure 2. Work network. The work network illustrates work-related connections between department members. The twodistinct networks reflect the existence of two subdepartments (hemodialysis and peritoneal dialysis). Numbers disconnectedfrom the main network (coded 4, 13, 24, 25, 57, and 58) represent staff workers such as telephone operators and janitors.

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was also true in the friendship network, although centralityarose among different participants. In the friendship net-work, those with high centrality were not necessarily ofhigher rank in the organization. Those with high centralityshown in Figure 3 differ significantly from those shown inFigure 2. There are several smaller networks in Figure 3, andthose with high centrality tend to have more connections inthem. Instead of controlling physical resources, those high-centrality nurses in the friendship network tended to bethose able and willing to provide psychological support tocoworkers. Analogous to the work network, both centrali-ties indicate a capacity to support their coworkers, whichinduced OCB within the organization.

Centrality and OCB as Indicator of Social

SupportWhether or not centrality and OCB are valid measures ofsocial support is the next key question. Because the robust-ness of direct measurement scales (either perceived or re-ceived) remains uncertain, comparison between the resultsof centrality and OCB with the scales in prior studies can-not answer the question satisfactorily. Nevertheless, we canat least check the impacts following directions given by priorstudies. According to path analysis results shown in Figure 4,OCB significantly impacted work satisfaction and workstress. OCB not only induced work satisfaction at a sig-nificant level (t = 2.90; p = .003) but also reduced work

Figure 3. Friendship network. The friendship network shows the connections resulting from individual relationships. Severalsmaller groups are identified (noted from G1 to G7). Work seniority played less significant roles, as senior staffs werenot members of the major groups (codes 1 and 2).

Figure 4. Partial least squares path analysis results. * depicts t *G t (60, ! = .10) = 1.30; ** depicts t *G t (60, ! = .01) = 2.39,one-tailed test. The circle in Figure 1 for centrality was replaced with rectangles to show that the two variables are not latentvariables. One question was asked of each network. OCB = organizational citizenship behavior.

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stress at a significant level (t = j5.19; p = .000). In ad-dition, work stress affected work satisfaction at a signifi-cant level (t = j2.62; p = .006). In summary, OCB candirectly and indirectly affect work satisfaction through themedium of work stress.

DiscussionGiven path analysis results, empirical data supported all ofour hypotheses. This lends support to our proposition thatthe social support in conventional studies may be mitigatedor even substituted by the join concepts of the centrality ofnetworks and OCB. Centrality measures one’s position inthe social network, which is equivalent to resources neededby other network members, and OCB reflects one’s confi-dence in reciprocity through future payback. Jointly, the twoindicate the support one expects to receive from a coworker.By addressing social supports with divided concepts makesthe concept more insightful by underscoring that support isnot solely an ad hoc idea. Presumably, it is preferable thatsocial supports are available as needed at the right time.Yet, in practice, the truth is that awareness of needs comesvia certain Bchannels.[ For humans, the social network isan important awareness channel, with support distributedaccordingly. Therefore, the social network depicts not onlythe possession of resources but also the channels of know-ing resource needs and distributing resources.

Moreover, the OCB that depicts the attitudes of altru-ism toward others is interpreted with new significance thatshows the likelihood of reciprocity within an organization.The greater the OCB, the higher is the expected likelihoodof reciprocity. According to social exchange theory, reciproc-ity indicates the resource exchange within an organizationand suggests the willingness of intraorganization resourcesharing. By integrating these factors and paths, we havederived an instrumental construct of work stress and con-tributed to the literature and managerial implications asdescribed in the following section.

Theoretical ContributionsThe adoption of centrality and OCB to show the mechanismat work between social support and work stress providethree insights. First, the availability of resources and wil-lingness to share resources are both important factors be-hind fostering social support within organizations. Thosewith high centrality may own and control resource distribu-tion. However, they may not be willing to share resources.In situations exhibiting high OCB and thus a higher prob-ability of receiving payback in the future, this study showsthat resource controllers were more willing to share re-sources. This insight is new and not presented in prior stud-ies. Second, although OCB is recognized as a consequenceof job performance and satisfaction, organizational dynam-ics may transform this consequence into an antecedent offuture performance and satisfaction (Chu & Hsu, 2011).

This study echoes this dynamic perspective, and OCB isperceived as an antecedent of job stress and satisfaction.Finally, although aforementioned studies (Lin et al., 2008)had linked social ties and OCB, they did not examine thelink to centrality but rather used a self-reported survey tomeasure social ties. This study confirms the previously as-sumed link with centrality.

Managerial ImplicationsPresent study findings suggest that managers may leveragesocial network analysis to identify individuals appropri-ate to distributing organizational resources. Choosing thosemost highly connected may facilitate the most effective dis-tribution of resources and induce greater overall OCB withinthe organization. In addition, those with high friendshipnetwork connections may provide required psychologicalresources (support) for coworkers. Providing proper coun-seling training to those with high friendship network cen-trality may be in a position to provide significant assistancewhen needed. OCB can also be considered a robust media-tor for work stress reduction (Chu & Hsu, 2011). Althoughobjective-oriented, organizations, particularly private organi-zations, tend to conduct intensive performance assessments.Building the organization using altruism can effectively reducestress and achieve high levels of work satisfaction. Organiza-tion performance will be induced as well (AbuAlRub, 2004).

ConclusionsNursing work stress is an undesirable consequence thathinders the maintenance of the nursing workforce. Tomitigate work stress, managers in medical institutes resortnot only to monetary incentives but also to social psycho-logical factors. Social support is also widely applied. Thisstudy shows that social support can be more instrumentalin terms of social networks rather than individual factors.Putting the nursing workers in an appropriate network po-sition (in either a work or friendship network) could ef-fectively mitigate work stress. This may imply that workstress counseling is not solely applicable to individuals. Groupcounseling that helps individuals to take favorable positionsin a network may be better off in the future.

Limitations and Future StudiesThis study was conducted in one dialysis department at onehospital. Nurses in other department may behave differently.A cross-departmental study of nurses will improve findingsgeneralizability. Also, we adopted only one dyadic matrixto measure centrality and derive degree and betweennesscentralities. Using multiple dyadic measures to estimate cen-trality is advised.

The authors recommend a cross-departmental study to testthe proposed model and validate findings using a greatersample size. Althoughwe also recommend a cross-occupationstudy, stress measures may require adjustment to better

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approximate the conditions in each occupation considered.Prior studies (e.g., Van Den Tooren & De Jonge, 2008) haveset out to explore the types of support (resources) that aremost effective in achieving stress alleviation in the work-place. Measuring centrality with respect to network typemay reflect these support types and discern their respectiveimpacts on OCB.

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Journal of Nursing Research VOL. 20, NO. 1, M 2012

社會網絡結構與組織公民行為對護理工作壓力之影響

曾盛恕1　陳姿吟2　王詩鳳3　戴辛翎4*

1國立台灣科技大學企業管理系助理教授　2台北榮民總醫院護理部護理師3國立台灣科技大學企業管理系博士生　4台北榮民總醫院護理部護理師

背　景 職場裡工作壓力往往無法避免，護理工作壓力相對其他職場尤為顯著，先前的研究顯

示，組織內資源無論是有形或心理層面都可有效的降低工作壓力，但有形資源容易掌

控，而心理層面的資源例如：同事的支持，卻難琢磨與藉管理手段發揮其作用。

目　的 探討護理人員的社會網絡所可以提供的資源，對工作壓力的減輕效果。

方　法 透過問卷量測台灣台北市某醫學中心血液透析部門之護理人員的工作壓力、滿意度、

組織公民行為與社會網絡結構，其次因社會網絡結構的資料為二維矩陣資料，須藉由

UCINET軟體將資料轉為護理人員在網絡中的中心性指標，再藉由Partial least squares

(PLS)分析研究架構的路徑關係與假說檢定。

結　果 路徑分析結果顯示，護理人員的社會網絡可有效衍生組織公民行為，此利他行為直接

促成滿意度；另一方面亦藉工作壓力的減輕，間接提升工作滿意度。

結　論 管理者可藉由人員的社會網絡確認；將合適的人來進行組織資源的有效分配，使組織

公民行為在組織裡有效的發生以減輕壓力。此外由於友誼網絡可以提供有效的心理支

持，如可以讓高中心性的人員接受適當的諮商訓練，應可以在必要時發揮社會支持作

用。

關鍵詞：工作壓力、資源、社會支持、組織公民行為、社會網絡。

接受刊載：100年12月15日*通訊作者地址：戴辛翎　　11217台北市北投區石牌路二段201號電話：（02）28757028　　E-mail: hltai@vghtpe.gov.tw

社會網絡與護理工作壓力

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