Team Cohesion in Intensive Care Nursing: At the Interface of Nurse Self-concept and Unit Structure

Team cohesion is a critical factor in the provision of high-quality care, yet its antecedents remain understudied, particularly in the context of some healthcare professional groups where structural and individual constraints coexist, and demand for high quality performance is prevailing. In this study, we focus on the nursing group in intensive care units (ICU). Not researched, yet important for employee attitudes towards their workplaces and workgroups, is the interface between the characteristics of individual care providers and those of the teams and organizations in which they are employed. This study examines the effects of three levels of self-concept– individual, relational, and collective–and ICU structural characteristics such as size (number of nurses), nurse training profile, and number of beds. These factors are investigated as they jointly shape the degree to which nurses perceive their teams as cohesive. A multi-source and multi-level study of approximately 140 nurses employed in 20 ICUs across Denmark demonstrates the critical role of self-concept in easing and enhancing the constraints workplaces impose on team cohesion. Furthermore, the study confirms the positive relationship between overall team member-rated cohesion and manager-rated quality of care. Hence, understanding the interplay among self-concept, ICU structural characteristics, and team cohesion is highly relevant to enhancing quality of care.