Other Titles
What Matters Most? Novel Findings From an Innovative Measure of Coworker Relations on Nursing Units [Title Slide]
Abstract
Background: Coworker support improves trust1 and decreases or prevents nurses’ stress,2 anxiety, or burnout.3,4 Lack of teamwork and cohesion among coworkers can lead to nurses’ stress, burnout, disengagement, and turnover.5 The Practice Environment Scale of the Nursing Work Index, a widely used measure, does not capture coworker interrelations. Team virtuousness, a work environment in which virtues and character strengths (routes to displaying virtues) are practiced, supported, and encouraged5 improves coworker interrelations. People on virtuous teams feel safe, grateful, positive, and supported by one another;6,7 view work as more meaningful; are more engaged; and are more committed to their team and to improving team performance.6,8 The literature lacks a comprehensive measure of team virtuousness built from a theoretical foundation that captures the underlying structure.
Purpose: Develop a comprehensive measure of team virtuousness built from a theoretical foundation that captures the underlying structure.
Methods: Four experts in Aquinas’ Virtue Ethics Theory generated 114 items relevant to work teams that were initially administered to Master of Business Administration students. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were run on randomly split halves of the data. The emergent instrument plus five items added back to potentially strengthen reliability of one of the scales were administered to nursing unit staff at three US hospitals. EFA and CFA were run on randomly split halves. The new emergent instrument was administered at six additional US hospitals.
Findings: CFA item loadings on data from 1,402 hospital unit staff replicated EFA and revealed a 28-item instrument with two scales (wisdom, α = .97; excellence, α = .94).9 Team virtuousness differed significantly among nursing units (p < .0001) and correlated significantly with staff engagement (r = 0.42, p < .05).9 The wisdom scale captures integrity lived out in a beneficent, prudent, and practical way and comprises four themes: relational and inner harmony; reconciliation; kindness; and team orientation.9 Three of the four strongest items on the wisdom scale pertain to reconciliation.9 The excellence scale captures optimally executing one’s competencies and abilities to produce the best possible outcomes and comprises three themes: helpfulness; competence; and high self-standards.9
Discussion: Forgiveness and Relational and Inner Harmony emerged as elements of team virtuousness not found in the literature, broadening understanding of the construct.9 Reconciliation entails proactively rebuilding broken trust; being forgiving; giving others second chances; letting go of negative emotions; taking responsibility for one’s role in a relationship; making needed changes; and trusting again.9 Relational and Inner Harmony captures underlying peace and tranquility (e.g., experiencing situations as they unfold without negative emotions).9 It entails taking care of one’s mental, physical, and emotional needs; expressing thoughts and feelings in an appropriate manner; and giving due consideration to others’ thoughts, ideas, values, or attitudes before determining whether one shares them.9
Conclusion: The instrument is a comprehensive measure of team virtuousness built from a theoretical foundation that captures the underlying structure and demonstrates strong reliability. Coworker reconciliation is a novel finding that matters most. The innovative team virtuousness instrument can help nurse leaders strengthen coworker interrelations.
Notes
Published work from same author on this topic:
Varagona, L., Ballard, N., McCartt, P., McEwan, K. K., & Knotts, K. (2023). Another Piece of the Practice Environment Puzzle: Development and Validation of a Team Virtuousness Instrument. Nursing Administration Quarterly, 47(2), 150–160. https://doi-org.proxy.ulib.uits.iu.edu/10.1097/NAQ.0000000000000571
References:
1 Sheng, C., Tian, Y., & Chen, M. (2010). Relationships among teamwork behavior, trust, perceived team support, and team commitment. Social Behavior and Personality, 38(10), 1297-1306. https://doi.org/10.2224/sbp.2010.38.10.1297
2 Wyder, M., Ehrlich, C., Crompton, D., McArthur, L., Delaforce, C., Dziopa, F., Ramon, S., & Powell, E. (2017). Nurses experiences of delivering care in acute inpatient mental health settings: A narrative synthesis of the literature. International Journal of Mental Health Nursing, 26(6),527-540. https://doi.org/10.1111/inm.12315
3 Labrague, L. J., & Santos, J. A. A. (2020). COVID-19 anxiety among front-line nurses: Predictive role of organizational support, personal resilience and social support. Journal of Nursing Management, 28(7), 1653-1661. https://doi.org/10.1111/jonm.13121
4 Lowe, M. A., Prapanjaroensin, A., Bakitas, M. A., Hites, L., Loan, L. A., Raju, D., & Patrician, P. A. (2020). An exploratory study of the influence of perceived organizational support, coworker social support, the nursing practice environment, and nurse demographics on burnout in palliative care nurses. Journal of Hospice and Palliative Nursing, 22(6):465-472. https://doi.org/10.1097/NJH.0000000000000686
5 O’hara, M. A., Burke, D., Diitomassi, M., & Lopez, R.P. (2019). Assessment of millennial nurses’ job satisfaction and professional practice environment. The Journal of Nursing Administration, 49(9):411-417. https://doi.org/10.1097/NNA.0000000000000777
6 Rego, A., Vitoria, A., Magalhaes, A., Ribeir, N., & Pina e Cunha, M. (2013). Are authentic leaders associated with more virtuous, committed and potent teams? The Leadership Quarterly, 24,61-79. https://doi.org/10.1016/j.leaqua.2012.08.002
7 Lilius, J. M., Worline, M. C., Maitlis, S., Kanov, J., Dutton, J. E., & Frost, P. (2008). The contours and consequences of compassion at work. Journal of Organizational Behavior, 29(2):193-218. https://doi.org/10.1002/job.508
8 Cameron, K., Mora, C., Leutscher, T., & Calarco, M. (2011). Effects of positive practices on organizational effectiveness. The Journal of Applied Behavioral Science, 47(3), 266-308. https://doi.org/10.1177/0021886310395514
9 Varagona, L., Ballard, N., McCartt, P., McEwan, K. K., & Knotts, K. (2023). Another piece of the practice environment puzzle: Development and validation of a team virtuousness instrument. Nursing Administration Quarterly, 47(2), 150-160. https://doi.org/10.1097/NAQ.0000000000000571
Sigma Membership
Mu Phi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Interpersonal Relations, Well-being, Psychological Well-Being, Work Environment, Teamwork, Nursing Practice, Instrument Construction, Hospital Nursing Staff
Recommended Citation
Varagona, Lynn and Ballard, Nancy, "What Matters Most? Novel Findings From an Innovative Measure of Coworker Interrelations on Nursing Units" (2026). Creating Healthy Work Environments (CHWE). 72.
https://www.sigmarepository.org/chwe/2024/presentations_2024/72
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2024
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-02-20
What Matters Most? Novel Findings From an Innovative Measure of Coworker Interrelations on Nursing Units
Washington, DC, USA
Background: Coworker support improves trust1 and decreases or prevents nurses’ stress,2 anxiety, or burnout.3,4 Lack of teamwork and cohesion among coworkers can lead to nurses’ stress, burnout, disengagement, and turnover.5 The Practice Environment Scale of the Nursing Work Index, a widely used measure, does not capture coworker interrelations. Team virtuousness, a work environment in which virtues and character strengths (routes to displaying virtues) are practiced, supported, and encouraged5 improves coworker interrelations. People on virtuous teams feel safe, grateful, positive, and supported by one another;6,7 view work as more meaningful; are more engaged; and are more committed to their team and to improving team performance.6,8 The literature lacks a comprehensive measure of team virtuousness built from a theoretical foundation that captures the underlying structure.
Purpose: Develop a comprehensive measure of team virtuousness built from a theoretical foundation that captures the underlying structure.
Methods: Four experts in Aquinas’ Virtue Ethics Theory generated 114 items relevant to work teams that were initially administered to Master of Business Administration students. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were run on randomly split halves of the data. The emergent instrument plus five items added back to potentially strengthen reliability of one of the scales were administered to nursing unit staff at three US hospitals. EFA and CFA were run on randomly split halves. The new emergent instrument was administered at six additional US hospitals.
Findings: CFA item loadings on data from 1,402 hospital unit staff replicated EFA and revealed a 28-item instrument with two scales (wisdom, α = .97; excellence, α = .94).9 Team virtuousness differed significantly among nursing units (p < .0001) and correlated significantly with staff engagement (r = 0.42, p < .05).9 The wisdom scale captures integrity lived out in a beneficent, prudent, and practical way and comprises four themes: relational and inner harmony; reconciliation; kindness; and team orientation.9 Three of the four strongest items on the wisdom scale pertain to reconciliation.9 The excellence scale captures optimally executing one’s competencies and abilities to produce the best possible outcomes and comprises three themes: helpfulness; competence; and high self-standards.9
Discussion: Forgiveness and Relational and Inner Harmony emerged as elements of team virtuousness not found in the literature, broadening understanding of the construct.9 Reconciliation entails proactively rebuilding broken trust; being forgiving; giving others second chances; letting go of negative emotions; taking responsibility for one’s role in a relationship; making needed changes; and trusting again.9 Relational and Inner Harmony captures underlying peace and tranquility (e.g., experiencing situations as they unfold without negative emotions).9 It entails taking care of one’s mental, physical, and emotional needs; expressing thoughts and feelings in an appropriate manner; and giving due consideration to others’ thoughts, ideas, values, or attitudes before determining whether one shares them.9
Conclusion: The instrument is a comprehensive measure of team virtuousness built from a theoretical foundation that captures the underlying structure and demonstrates strong reliability. Coworker reconciliation is a novel finding that matters most. The innovative team virtuousness instrument can help nurse leaders strengthen coworker interrelations.
Description
Widely used practice environment instruments don’t measure coworker interrelations vital to nurses’ well-being and engagement and safe patient care. Learn about an innovative measure of coworker relations on nursing units and what is most important for creating healthy work environments.