Nurse Practitioners’ Work Values and Their Conflict Management Approaches in a Stressful Workplace: A Taiwan Study

Globalization has created an urgent need to understand management practices in different cultures. This study examines Confucianism-based work values of nurse practitioners in Taiwan and explores their impact on conflict management approaches in order to help health practitioners maintain sustainable work relationships and improve organizational effectiveness in an increasingly stressful workplace. Based on the data from 259 nurse practitioners in Taiwan, this study shows that nurse practitioners in Taiwan consider holistic rewards, self-fulfillment and personal growth, challenge and responsibility, autonomy, and meaningfulness as important work values. Hierarchical regression results further indicate that nurse practitioners with strong group-centered needs, such as needs for holistic rewards, preferred collaborative methods to manage conflicts in the workplace, and individuals with strong self-centered needs, such as needs for personal growth and self-fulfillment and needs for autonomy, preferred competitive methods to manage conflicts. Interestingly, this study also finds that self-centered needs such as needs for self-fulfillment and personal growth, and needs for challenge and responsibility are also related to collaborative approaches. Managerial implications are then discussed for conflict management training for nurse practitioners under stressful work conditions.


Introduction
The twenty-first century has seen an increasingly globalized world economy, and greater emphasis has been given to cultural diversity in the workforces and the workforce diversity's impact on conflict management practices in the global context [1][2][3][4][5]. The highly competitive and often stressful workplace has posed an unsustainable and public health problem for health care professionals [4,6], which consequently makes it crucial to look for more effective conflict management in the workplace. Considering that a lot of conflict management theories have been developed in the West, and thus do not always consider the differences in culture and values in different contexts [7], a better knowledge of conflict management practices in a stressful work context in a different cultural context is greatly needed in order to maintain competitiveness in the world market [3,4,6].
This study explores contemporary work values of nurse practitioners in Taiwan and the relationship between these work values and conflict management approaches used by nurse practitioners in work-related conflicts. Hofstede [7] emphasized that Chinese culture in Taiwan is heavily affected by the Confucianism, and it is among one of the highly collectivistic cultures which place more emphasis on group interests than on individual benefits, and consequently provides a good context for examining employee behaviors in a different culture [1,3,5,8,9]. In addition, as a newly industrialized region, Taiwan also has a close relationship with other developed countries, including the USA and Japan, due to its politically strategic location in Asia-Pacific region, and thus its work values reflect the co-existence of strong Western influences and traditional Chinese collectivistic values. Even though Taiwan companies are often encouraged to adopt more management practices from the West, they are still distinguished by a highly centralized decision process, a more directive leadership style, and a relatively low level of delegation-the values typical of a collectivistic culture [1,3,7]. Research on nurse practitioners' work values in Taiwan and their impact on conflict management styles in stressful workplaces can thus help global managers and international HRM practitioners understand employee behaviors in cross-cultural contexts, and thus improve global effectiveness for multinational corporations [9]. Furthermore, as an important group of health professionals, nurse practitioners play a crucial role in helping establish closer relationships with patients in health care organizations, and thus are always the focus of attention in the health care research. Nurse practitioners have been reported to experience excessive conflicts due to several factors including lack of a clear definition of their responsibilities and authority, excessive workload, and role confusion [2,10]. When not effectively resolved, conflicts between nurse practitioners may impair both professional and interpersonal relationships among peers and adversely affect the functioning of health organizations [6]. It is thus equally important to explore how nurse practitioners manage their conflict in a stressful workplace in order to help build more supportive and harmonious organizational environments to promote employees' well-being and positive relationships among colleagues, which is of major importance for fostering healthy and more sustainable organizations, wherein people can live in harmony with effective conflict management.
Taiwan is also an important place to test the universality aspiration of various conflict management theories often developed in the West, in particular the test of their applicability in understanding the mechanism through which workplace conflict is resolved in an Eastern context, because Chinese culture is highly collectivistic and Taiwanese people are often very cautious of confrontations in the public in order to maintain group harmony and interpersonal relationships [3][4][5]7]. However, it is still not very clear what is the impact of contemporary work values on conflict management approaches in the workplace in Taiwan. The current study aims to explore the structure of nurse practitioners' work values in Taiwan, and then examine their impact on different conflict management methods nurse practitioners prefer to use for conflict management in the workplace. This exploratory research will thus be able to extend our understanding on cross-cultural work values and shed light on how to improve conflict management effectiveness in the increasingly diversified workplace and further enrich our understanding of nurse practitioners and their conflict management approaches in order to promote employee well-beings and foster healthy and sustainable organizations in an Eastern context.

Conceptual Framework
With more national markets opened to and integrated with the world economy in the era of globalization, people with different cultural backgrounds have often come together to work as heterogeneous groups in multinational corporations. Seen as a perceived incompatibility of interests, conflict is often caused by misalignment of objectives, motivations, and interests between two or more parties that can be real or perceived to be real [5], and consequently, the potential for interpersonal conflict in their daily interactions is tremendous, often leading to a very stressful workplace [6].
Diversified workforces have made conflict a common issue in the workplace, and research on conflict and conflict management has received wide attention [5]. With more scholars and practitioners seeking to manage conflicts in a most effective manner in the workplace, conflict management has evolved into a major research field in organizational behavior. The growing complexity of work relationships and the increased diversity in workplaces also places unprecedented pressure on business practitioners, forcing them to learn how to manage conflict more effectively in order to best utilize their human resources to compete in the global market. Scholars and management practitioners have painstakingly explored different approaches to improve conflict management skills.
Considered as one of the most complex organizations, hospitals are very stressful workplaces, and the management of hospital employees is extremely difficult because complex ambiguities arise more often than in other types of organizations and modern technologies are most widely used [11], which creates multiple unpredictable complicated processes. Thus conflicts, work-related and non-work related, frequently occur in such an environment. Nurse practitioners are an important group in this environment, and they play a crucial role in helping establish close relationships with the patients. Nurse practitioners have been reported to experience excessive conflicts due to several factors such as lack of a clear definition of their authority and responsibilities and role confusion and/or excessive workload [2,10]. It is therefore very important to examine how nurse practitioners manage their conflict in the stressful workplace such as hospitals.
It is believed that individuals' values determine and are also shaped by their behaviors [4,7]. In order to explore nurse practitioners' conflict management approaches, it is necessary to examine their values. And among different factors that strongly affect the way nurse practitioners approach conflicts in the workplace are their work values embedded in their cultural backgrounds [4,5,12]. In this research, the effects of contemporary work values of nurse practitioners in Taiwan on conflict management preferences in the workplace is explored within an Eastern context.

Conflict Management Approaches
Scholars have explored different ways to address work-related conflicts in organizations, and the research has generated impressive knowledge on conflict management and conflict management styles [5,[13][14][15]. Based on the research work on managerial grid [16], scholars in conflict management research contend that people choose different approaches or styles to manage conflict with the focus on two primary concerns-the concern for one's own interests, and the concern for the other's interests.
Based on these two dimensions, five different conflict management approaches can be generated which reflect how much an individual tries to satisfy his/her own interests or the other's interests [17]. These conflict management approaches include: Collaborating (high concern for one's own and the other's interests), competing (high concern for self-interests, but low concern for the other's interests), compromising (moderate concern for one's own and the other's interests), accommodating (low concern for one's own interests, but high concern for the other's interests), and avoiding (low concern both for self and for the other). These five approaches assess individuals' behavioral intentions for conflict resolution [12,13,18], and subsequent research on conflict management has showed that these five styles are consistent with the concepts in the conflict management research literature [12,19,20], which provides a solid foundation for relevant research on conflict management strategies [13,21].
The five conflict management styles can be categorized into two groups based on their motivational differences in the process of conflict management: The win-lose or distributive group, and the win-win or integrative group. The win-lose group attempts to reach distributive solutions to satisfy one party's interest, while the win-win group attempts to obtain integrative solutions to satisfy both parties' interests [3]. The win-lose group (competing, compromising, avoiding, and accommodating) pertains to either excessive taking from the other party when using competing, excessive yielding to the other party when using accommodating, finding a quick but not optimal middle ground whereby neither parties are completely satisfied when compromising, or ignoring the interests of involved parties and leaving conflict unresolved when avoiding. The win-lose group is based on such a notion: If one party wins during a conflict, then the other party must lose, a distributive or fixed-sum mentality. The other group (win-win group) pertains to satisfying both parties' interests by working together or collaborating to find solutions beneficial to both parties, an integrative or collaborating approach. This group answers the question how both parties' interests are built into the final solutions. The collaborating approach represents an assertive, but also cooperative, attempt to identify common interests and to create solutions that are beneficial to both parties. Within this group, collaborating style attempts to enlarge the common interests by searching for an alternative to allow both parties to completely satisfy their interests, an integrative style [4,22].

Work Values and the Choice of Conflict Management Styles in Taiwan
Work values refer to work-related norms individuals comply with in performing jobs, working with colleagues, and interacting with other stakeholders in the workplace [23,24]. Work values reveal an individual's evaluative tendency toward work and reflect his/her attitudes toward all job-related rewards, level of participation and engagement, and career ambition [23,24]. Studies on work values and organizational issues such as workplace commitment, overall job satisfaction, and employee job performance have attracted extensive attention in the past decades [24][25][26][27][28][29][30], mainly because these work-related values can drive employees to involve themselves in their work [31] and further facilitate employee job performance [24].
Current studies on work values in the West have largely focused on the Protestant work ethic, the one advanced by Weber [32]. Weber contended that the Protestant work ethic reflected the spirit of capitalism, and the fast development and success of capitalism in the past centuries was largely attributed to the Protestant work ethic, wherein people considered work and financial success as important means to achieve personal and religious goals. Consequently, the study on work values has become one of the most important research fields in organizational behavior and human resource management in the West [4]. However, limited research is available in Taiwan on the importance of work values, the nature of these work values, and their impacts on various organizational phenomena. The current research is to explore the key elements of nurse practitioners' work values in Taiwan and further examine their possible effects on nurse practitioners' choice of conflict management approaches.
Nurse practitioners' work values in Taiwan have their roots in the Confucianism, the philosophical thoughts about individual life and interpersonal relationships embedded in many East Asian societies [23]. The Confucianism-based work values often include hard working, thrifty, persistence, and fairness, which expects fair and equitable distribution of wealth among all societal members. Hard work is considered a virtue in these societies, and people who work hard are more likely to climb up in the society. Moreover, the Confucianism-based work values often place emphasis on education and training to acquire new skills and technology for long-term development, and these work values also discourage behaviors such as engaging in unproductive activities or living like a parasite on others' work [4]. The Confucianism-based work values also encourage cooperation and teamwork at the workplace and consider one's job as an important means to achieve personal growth, self-respect, esteem, self-fulfillment, and happiness, with many elements similar to those in other Eastern cultures [24,33].
While the past decades have seen a large number of studies on work values and conflict management approaches, research on these two organizational phenomena has largely remained scarcely studied, and it is not very clear what the impact of work values on the choice of conflict management approaches is, and even less so when nurse practitioners are concerned. Therefore, it is still not very clear what the impact of work values on conflict management approaches for nurse practitioners is, especially in an Eastern context. Given that work values guide employees' behaviors in performing their duties and interacting with peer workers in the workplace, it is expected that employees' attitudes toward their work will influence their approaches to addressing work-related conflicts, which will further affect their performance and productivity. It is thus contended in this study that in a highly stressful organizational setting, individual-oriented work values are more likely to drive nurse practitioners to use self-centered conflict management approaches, the win-lose ones that seek for the satisfaction of personal needs and individual achievement, like competing, accommodating, compromising, and avoiding. Similarly, work values that emphasize group interests also affect employees' approaches to organizational environment and often lead to more use of group-oriented conflict management styles in face of work-related conflicts, such as collaborating style [4,7,9]. It is thus hypothesized in this study that: Hypothesis 1. Group-oriented work values will be more likely to relate to integrative or win-win conflict management styles, such as collaborating.

Hypothesis 2.
Individual-oriented work values will be more likely to relate to distributive or win-lose conflict management styles, such as competing, accommodating, compromising, or avoiding.

Research Participants
This study collected the data at one vocational school in Taipei, Taiwan. The participants were nurse practitioners from various hospitals, and were attending vocational schools for retraining and for acquiring new skills required for their jobs. Questionnaires on conflict management styles and on work values were given to the participants. The participants completed the questionnaires as part of course requirements, with no identification information collected, and thus confidentiality ensured. Ethical concerns were addressed in the debriefing period, and there is minimum possible harm to the respondents. In the end, 259 questionnaires were returned, and all were used in the analysis. The participants had an average age of 23.6 (S.D. = 5.0) and 40.6% of them were male. Their averaged work experience is 4.34 years (S.D. = 3.86), with a minimum work experience of one year.

Conflict Management Approaches
The Rahim Organizational Conflict Inventory [12] was used to measure conflict management approaches. In the questionnaire, participants were asked to indicate the degree to which they agree with each of the 28 statements on a five-point Likert scale about their approaches to work related conflict with their coworkers, wherein 1 = strongly disagree, and 5 = strongly agree. The example scale items include "I try to investigate the issue with the other person to find a solution acceptable to both sides" and "I use my authority to make a decision in my favor".
We conducted an exploratory factor analysis on all the scale items and the result identified five conflict management factors, consistent with previous studies [4,12], and these five factors accounted for about 53.5% of the variances in this study. These five different conflict management styles include competing, a distributive style that seeks to maximize one's own interests; accommodating, a style that seeks to maximize the other's interest in order to please the other; compromising, a style to find a quick middle ground; avoiding, a style to step away from the conflict while leaving the conflict unresolved; and collaborating, an integrative style to seek for solutions to satisfy both parties. In order to establish a common frame of reference for participants to consider their conflict management methods, all participants were asked to consider the approaches they used to handle most recent work-related conflicts with their coworkers in the workplace. Given that the participants all had worked for a number of years in different hospitals (average work experience = 4.34 years, with the minimum at 1 year), they could relate their experiences in the workplace to different strategies they use to manage conflict. The reliability alphas for each of the conflict management approaches assessed in this study were 0.86 for collaborating, 0.73 for accommodating, 0.63 for competing, 0.75 for avoiding, and 0.60 for compromising, respectively, which is also consistent with previous studies [3,4,9]. This result also provides further support for the scale's validity used in this study. The example items representing collaborating, competing, compromising, avoiding, and accommodating, respectively, are as follows: (1) I try to investigate the issue with the other person to find a solution acceptable to both sides; (2) I use my authority to make a decision in my favor; (3) I usually propose a middle ground for breaking deadlocks; (4) I try to stay away from disagreement with the other person; and (5) I usually accommodate the wishes of the other person.

Nurse Practitioner's Work Values
To explore the nature of nurse practitioners' work values in Taiwan, a scale used in a previous study [34] on contemporary work values was adopted to measure the work-related values in a collectivistic culture. While work value and its relationship with different organizational variables have received tremendous attention in the West, it is not well studied in other cultures, in particular in a collectivistic culture. The questionnaire on contemporary work values versus Protestant work ethics used by Wayne in his study [34] was adopted. Wayne's study proved contemporary work ethics as a unique set of work values are different from Protestant work ethics. This scale consists of 35 statements regarding people's belief on various aspects of their work. Participants were asked to answer on a five-point Likert scale to indicate to what extent they agree with each of the 35 statements about their work attitudes with 1 = strongly disagree and 5 = strongly agree. The example scale items include "Work provides individuals with an opportunity to grow and realize their full potential", "I want more say over what will be assigned to me and how it is to be completed", and "Work is worth doing only when it makes a meaningful contribution to society".
This study conducted exploratory factor analyses (EFA) with the principal component method and varimax rotation to investigate the structure of contemporary work values of nurse practitioners in Taiwan. The data generated five different factors that accounted for 59.83% of the variance in this study. We assigned descriptive names to each of the identified factors based on the main component items (please refer to Table 1): (1) Holistic rewards, which assesses how people seek comprehensive rewards from what they are doing for their work (9 items, eigenvalue = 4.59, reliability alpha = 0.90), with scale items including "Work provides individuals with an opportunity to grow and realize their full potential", "I seek various emotional and psychological rewards from working in addition to my paycheck", and "I seek work experiences that help me expand and use my potential to the fullest extent possible"; (2) Self-fulfillment and personal growth, which assesses the extent to which individuals seek opportunity for self-fulfillment and personal growth in their work (7 items, eigenvalue = 4.42, reliability alpha = 0.88), with scale items including "I desire work that provides opportunities for personal growth and allows me to feel good inside" and "I expect work to be a meaningful and fulfilling part of my life"; (3) Challenge and responsibility, which assesses the extent to which individuals seek for opportunities for challenging work and responsibility taking in their work (3 items, eigenvalue = 2.18, reliability alpha = 0.64), with scale items including "I enjoy work assignments that are challenging and require extensive use of thought process" and "I accept total responsibility for the successful completion of my work"; (4) Autonomy, which assesses the extent to which individuals seek for freedom in their work related decisions (3 items, eigenvalue = 1.92, reliability alpha = 0.68), with scale items including "I want more say over what will be assigned to me and how it is to be completed" and "I must be given a high degree of freedom to accomplish work in the best way possible"; and (5) Meaningfulness, which assesses the degree of how people expect their work to be interesting and meaningful (3 items, eigenvalue = 1.85, reliability alpha = 0.62), with scale items including "Work is worth doing only when it makes a meaningful contribution to society" and "Work has to be meaningful for me to do it well". The results also showed that discriminant validity existed in these dimensions, with multicollinearity not a serious concern (no VIF is higher than 5, the commonly accepted criterion) and thus supported a five-dimension structure of contemporary work values for nurse practitioners in Taiwan (please refer to Table 1), and the result is also consistent with similar studies in the field [4,35]. The five dimensions of work values identified in this study reflect nurse practitioners' attitudes toward various aspects of work and relevant commitment and involvement in their work-related activities in the workplace in Taiwan. In particular, the desire for holistic rewards from their work shows that employees attach great importance to their work and attempt to obtain everything including economical, psychological, and emotional rewards from what they do in their organizations, a group-oriented motivation, which is consistent with the values in collectivistic cultures such as in Taiwan and Japan, where work is often the most important part of people's lives and companies are usually expected to look after employees from cradle to grave [4,29]. The need for self-fulfillment and personal growth, the need for challenge and responsibility, the desires to seek autonomy and meaningfulness in their work show more self-centered needs in people's view of their work: On the one hand, employees seek self-fulfillment and personal growth by performing challenging tasks and taking responsibility in completing required assignments; on the other hand, they also look for opportunities to have a say in decision making process, a certain level of autonomy, and to have meaningful work to do. Such a finding is consistent with the job characteristic theory developed and well researched in the West [35][36][37]. The five-dimensional structure of work values thus revealed the combined influence from Western industrialized cultures and Eastern collectivistic cultures on nurse practitioners' work values in Taiwan.

Procedures
This study used self-administered questionnaires to collect data in order to examine nurse practitioners' work values and its impact on conflict management methods in Taiwan. The scales and materials were originally developed in English. We followed translation and back-translation procedures to ensure the equivalence of these materials to be used in Taiwan [38].

Analysis of Data
We conducted hierarchical regression analysis in this study to examine the impact of different aspects of nurse practitioners' work values on their preferred conflict management approaches with age, gender, and work experience as control variables [4], and different conflict management styles as criterion variables. In this process, we first entered the control variables (age, gender, and work experiences) in the hierarchical regression, and then entered work value variables to explore the impact of work values on nurse practitioners' conflict management approaches to work-related conflicts with coworkers in their workplace in Taiwan.

Results
The means and correlations of all variables are reported in Table 2, and in general, the correlations reveal expected relationships and provide confidence that the measures functioned properly for the effects tested in this study (please refer to Table 2). The regression results are reported in Table 3 and Figure 1 (please refer to Table 3 and Figure 1). As shown in Table 3 and Figure 1, the results clearly indicate that the group-oriented work values, such as the needs for holistic rewards, are significantly related to win-win or integrative approaches (β = 0.26, p < 0.001), while the self-oriented work values, such as the need for self-fulfillment and personal growth, the need for challenge and responsibility, and the need for autonomy, are significantly related to win-lose or distributive approaches: Both the need for self-fulfillment and personal growth and the need for challenge and responsibility have a significant impact on accommodating (β = 0.19, p < 0.01; β = 0.24, p < 0.001, respectively), on avoiding (β = 0.20, p < 0.01; β = 0.20, p < 0.01, respectively), on compromising (β = 0.22, p < 0.01; β = 0.19, p < 0.01, respectively), and both the need for self-fulfillment and personal growth and the need for autonomy have significant impact on competing approach (β = 0.15, p < 0.05; β = 0.19, p < 0.01, respectively), in support of H1 and H2. While meaningfulness was not found related to any conflict management style, it is worthwhile to point out that the results also showed the need for self-fulfillment and personal growth, the need for challenge and responsibility, and the need for autonomy are also significantly related to collaborating style in resolving work-related conflicts with coworkers (β = 0.30, p < 0.001; β = 0.31, p < 0.001; β = 0.19, p < 0.01, respectively).

Discussions
The purpose of this research is to explore nurse practitioners' work values in Taiwan and their preferred conflict management approaches in order to help better understand cross-cultural differences in employee behaviors, and further, to promote employee well-being for a more sustainable work environment. This study began by contending that globalization made it essential to understand different management practices and employee behaviors across the global, and further, that increased workforce diversity had created a stronger need for more effective conflict management in stressful workplaces. The need becomes even stronger for nurse practitioners who are working in a constantly change environment with increased complexities and work-related conflicts. In order to better understand this phenomenon to promote employee well-being and create a healthy and more sustainable workplace, it was essential to study nurse practitioners' work values in a non-Western cultural context. The results provide strong support for H1 and H2, which predict that work values with a group-orientation are more likely to drive people to use integrative conflict management approaches (e.g., collaborating), and work values with a self-orientation are more likely to drive people to use distributive conflict management approaches (e.g., competing, accommodating, compromising). In addition, while the unexpected relationships between self-centered needs such as the need for self-fulfillment and personal growth and the collaborative methods are different from our prediction, it is consistent with notions of collectivistic culture in Taiwan where group interests are more important than individual interests; people must help achieve group objectives first before achieving individual goals, and collaborative work among group members is the stepping stone for satisfying individual interests such as personal growth and self-fulfillment [4,9]. It could also be because nurse practitioners use the collaborating style to build trust, which may free them to work independently in the long run. Future research should explore further to help better understand the underlying mechanism in this direction. The findings of this study add value to the literature of work values and the literature of conflict management by exploring the structure of nurse practitioners' work values in Taiwan and further relate them to the choice of conflict management approaches. The empirical results revealed a dimensional structure of work values and provided solid evidence for the significant effects of different dimensions of work values on nurse practitioners' choice of conflict management approaches. This study is different from previous studies, which often treat work values and conflict management studies as unrelated domains and argue that nurse practitioners' work values exert strong influence on their choice of conflict management approaches [39], and then explore these relationships with empirical data collected from an Eastern context.
The results of this study show that nurse practitioners' work values in Taiwan have five dimensions concerning employees' attitudes toward their work: Holistic rewards, self-fulfillment and personal growth, challenge and responsibility, meaningfulness, and autonomy. The need for holistic rewards reflects nurse practitioners' group-oriented attitude toward their work in Taiwan where Taiwanese nurses consider work as an integral part of their lives: They treat the workplace as their families, and also expect to obtain everything, including economic and non-economic returns, from the organization, which is consistent with the dominant values of the collectivistic culture in Taiwan. The need for challenge and responsibility, and the need for self-fulfillment and personal growth, as well as the need for meaningfulness and autonomy are more of a self-oriented attitude: Employees seek the gratification of different individual desires. This structural work values somehow indicates a joint influence of Western industrialized cultures and Eastern collectivistic culture on current work values in Taiwan, with the dimension of holistic rewards reflecting the notion of groups (or companies) being everything in collectivistic cultures, and thus it is reasonable to expect the company to take care of everything for their employees, while the other dimensions reflect the influence from the West, where personal growth, challenge and responsibility, autonomy, and meaningfulness as key job characteristics have been the foci of contemporary work studies for decades.
This study also shows that work values exert strong influence on nurse practitioners' conflict management approaches in Taiwan. More specifically, the need of holistic rewards is significantly related to the use of collaborating style in nurse practitioners' conflict management process, which is actually socially desirable in a collectivistic society such as Taiwan. Driven by a group-oriented work attitude to seek for holistic returns, employees prefer to employ collaborating approaches to manage work-related conflicts with coworkers so as to first maximize group interests before individual interests, often accomplished by either competing or accommodating, are satisfied, The needs for personal growth and self-fulfilling, for autonomy, and for challenge and responsibility, are found significantly related to both distributive (win-lose) methods and integrative (win-win) methods in nurse practitioners' conflict management. This probably reflects the joint influence of Chinese cultures and Western cultures on nurse practitioners' work values in Taiwan. Driven by self-oriented work values, employees are more likely to use competing, accommodating, or even compromising approaches to manage work-related conflict, however, given that the societal culture in Taiwan is a highly collectivistic culture, employees' individual needs often depend on the gratification of group interests. As a result, working together with co-workers to resolve conflicts collaboratively seems to be the best alternative in work-related conflicts, because collaborating style works for everyone's interest. This may also suggest why the need for self-fulfillment and personal growth, the need for challenge and responsibility, and the need for autonomy are also significantly related to the use of collaborating approaches, even though these work values are more self-oriented. The relatively stronger relationship between these work values and collaborating style, compared with the relationships between these work values and competing and accommodating styles, once again supports the notion that groups seems to be more important than individuals, deeply rooted in collectivistic cultures.

Theoretical Contributions
This study helps better understand contemporary research on work values and conflict management in two aspects. Firstly, this study shows that nurse practitioners' work values in Taiwan consist of five different dimensions, whereby some dimensions such as holistic rewards are group-oriented, and some such as personal growth and autonomy are self-centered. The multi-dimensional structure of nurse practitioner's work values may reflect the joint influences of Western industrialized cultures and Chinese collectivistic cultures on contemporary work values in Taiwan, a crossvergence of work values along with the increasingly globalized world economy [29]. The findings of this study thus provide more evidence for work value crossvergence in the field of human resource management in the Eastern context. The multi-dimensional structure of contemporary work values in Taiwan also provides a new perspective on the needs and motivation of the diversified workforce in nurse practitioners in Taiwan. In addition, this study shows that even though there is a different value origin, many work values are similar between the Protestant Work Ethic and Confucianism, consistent with the job characteristic theory developed and well researched in the West [36]. The five-dimensional structure of work values thus revealed the combined influence from Western industrialized cultures and Eastern collectivistic cultures on nurse practitioners' work values in Taiwan. It may also reflect the ideological fiction of career success in both value systems, where the caress success is created, sustained, and legitimated in a similar way in each system to support their respective political-economic system [40]. Therefore, the finding of this study sheds insightful light on how to create and implement employee intervention programs to promote effective conflict management in the workplace in Taiwan for a more supportive and sustainable organization.
Secondly, this study also makes contributions to the literature by relating work values to the choice of conflict management approaches in the workplace for nurse practitioners in Taiwan, and consequently breaks new ground for studying work values, work-related conflict, and conflict management. Even though there is plenty of research on conflict management and work values [4,9,13,41], our knowledge about the impact of work values on conflict management approaches in work-related conflicts is not sufficient, and thus these two lines of research remains largely isolated from each other, which is a surprise given that it is commonly accepted that individuals' values determine social behaviors such as conflict management approaches. This study helps to bridge the studies of conflict management and the studies of work values, and thus is able to improve our understanding on conflict management and provides a new view on how to improve work-related conflict management effectiveness. This also enriches our knowledge of employee behaviors in a non-Western culture in order to foster a healthy and more sustainable working environment.

Managerial Implications
The findings of this study also have important practical implications for management practitioners and health care managers in Taiwan and for those organizations that have Chinese employees with a Taiwanese origin working in the hospitals. Based on the findings of this study, management practitioners can design training programs and workshops to improve employee's organizational commitment by reshaping employees' work values and conflict management skills. First, considering the dimensional structure of nurse practitioners' work values in Taiwan, it is necessary for hospital administrators or other health care organizations to have a better understanding of their employees' preferences, attitudes, and relevant notions about their work. While nurse practitioners with a strong need for holistic rewards may place organizational interests at a very important position, employees with strong needs for personal growth or autonomy might pursue their individual interests at the expense of their companies. Based on the findings of this study, health care organizations could create well-designed training programs for employee behavior intervention, and administrators can thus help foster the development of group-oriented work values and design effective and inspiring jobs in order to satisfy nurse practitioners' needs for personal growth and self-fulfillment, challenge, and responsibility, as well as other self-centered work ethics, which will facilitate crafting an innovative workforce and further improve organizational commitment and job satisfaction in the workplace.
Second, the findings on the relationship between work values and the choice of conflict management approaches in Taiwan also shed light on how to promote employee well-being in stressful workplaces such as hospitals and other health care related organizations through more effective conflict management. As the workforce in organizations including hospitals has become more diversified, today's management practitioners are under pressure on how to approach workplace conflicts in an effective manner. This study shows that nurse practitioners with strong group-oriented work values are more inclined to adopt collaborative conflict management approaches to resolve work-related conflicts. Based on this result, hospital administrators and management practitioners could design relevant training programs to reshape nurse practitioners' work attitudes and preferences, and to encourage the adoption of more collaborating conflict management approaches to work-related conflicts, which will help improve job performance and employee relationships within a collaborative organization setting. That being said, it is also important to point out that there is no one best conflict management approach [13,40]. While collaborating style is helpful in improving trust and cooperation among individual employees, it is even more important to raise nurse practitioners' awareness and adaptability to adjust conflict management styles and use them appropriately and effectively, contingent upon situations.
In addition, considering the strong influence of Confucianism on the culture values in the Greater China region as revealed in this study and in other studies [4,41,42], it is reasonable to argue that the collaborative or integrative conflict management approach is consistent with the concepts of harmony and cooperation embedded in the societal culture in Taiwan, the essential elements of Confucianism. As a result, the promotion of group-based work values to facilitate effective conflict management approaches in the workplace can help nurse practitioners resolve work-related conflicts in a more collaborative manner, which will help reduce conflict-related stress, and consequently, a more supportive work environment can be fostered and more sustainable organizations can be created, an important contribution to sustainability in the workplace.
This study has limitations, and caution should be exercised in applying the findings of this study. First, this study is an exploratory study, and the five-dimensional structure of nurse practitioners' work values in Taiwan should not be considered as final, and more replications should be done to test the validity of the findings. Replication studies with different samples and in different fields are encouraged. Second, we collected the data (both independent variables and dependent variables) from the same participant, and thus a common method error is possible, which could affect this study's internal validity. Third, this study uses a convenience sample, which may not fully represent the whole population of all the nurse practitioners in Taiwan, and thus also limit how the findings of this study could be generalized to other contexts. It is also possible that nurse practitioners will use different approaches for conflict management rather than the one predicted by their work values when facing a specific context, which deserves further analysis using case studies. Last but not the least, effective conflict management at the workplace is just one approach to help nurse practitioners reduce stress for a more sustainable work environment. Many other factors could also affect nurse practitioners' physical and psychological well-being [43][44][45][46][47]. Future research is called upon to explore these important factors for a better understanding of how nurse practitioners could manage stress at the workplace. That being said, given that the participants are working in an increasingly stressful workplace in an Eastern context, the relationship between their work values and their preferred conflict management approaches are very valuable for a better understanding and more effective conflict management in Taiwan, and for promoting employee well-being and fostering healthy and sustainable organizations for nurse practitioners in stressful workplaces.