Structurational divergence theory as explanation for troublesome outcomes in nursing communication.

Structurational divergence (SD) theory captures negative communication cycles resulting from interpenetration of incompatible meaning structures. It is estimated that 12-15% of practicing nurses suffer from a problematic level of SD. With a sample of 713 nurses (57 departments) in a large hospital, this study tests a model positing SD as a root explanation of nursing job satisfaction and turnover. A number of variables long presumed to be explanations for job satisfaction and turnover were hypothesized as mediators between SD and those outcomes. Path analysis showed support for burnout, role conflict, bullying, and organizational identification as useful mediators, explaining 68% of the variance in job satisfaction, and 45% in intentions to leave. The study also explores relationships between SD and hospital quality indicators. SD is a concern because it powerfully explains a number of poor outcomes and provides an underlying explanation for a number of factors that predict job satisfaction and turnover.