The effects of ownership, staffing level and organisational justice on nurse commitment, involvement, and satisfaction: A questionnaire study

Investigating the link between organisational justice, positive organisational behaviour and productivity in emergency nurses

BACKGROUND

Human resource management and employees' performance are fundamental to the success of healthcare organisations. Therefore, it is important to consider the factors that may affect employees' performance.

AIM

To determine the relationship between perceived organisational justice, positive organisational behaviour (POB) and the productivity of emergency nurses.

METHOD

This was a descriptive-analytical study that involved distributing questionnaires to emergency nurses working in hospitals affiliated with Mazandaran University of Medical Sciences in Iran. The researchers used proportionate stratified sampling to calculate the sample size. Three questionnaires were used to collect data on organisational justice, POB and productivity. The data were analysed using the Pearson correlation coefficient and multiple regression tests.

RESULTS

The questionnaires were distributed to 284 emergency nurses and completed by 234 of them. The results demonstrated a significant relationship between the productivity of the emergency nurses and the variables of perceived organisational justice and POB.

CONCLUSION

Higher levels of perceived organisational justice and POB in the ED setting are likely to lead to increased productivity among emergency nurses, and as a result the quality of patient care is likely to improve. Therefore, healthcare organisations should pay particular attention to the application of organisational justice, with the aim of promoting POB among nurses and increasing their productivity.

Psychosocial Work Environment and Well-Being of Direct-Care Staff Under Different Nursing Home Ownership Types: A Systematic Review

This systematic review investigated the psychosocial work environment and well-being of direct-care staff under different nursing home ownership types. Databases searched: Scopus, Web of Science, Cinahl, and PubMed, 1990-2020. Inclusion criteria: quantitative or mixed-method studies; population: direct-care staff in nursing homes; exposure: for-profit and non-profit ownership; and outcomes: psychosocial work environment and well-being. In total, 3896 articles were screened and 17(n = 12,843 participants) were assessed using the Joanna Briggs Institute Critical Appraisal tools and included in the narrative synthesis. The results were inconsistent, but findings favored non-profit over for-profit settings, for example, regarding leaving intentions, organizational commitment, and stress-related outcomes. There were no clear differences concerning job satisfaction. Job demands were higher in non-profit nursing homes but alleviated by better job resources in one study. The result highlights work environment issues, with regulations concerning for-profit incentives being discussed in terms of staff benefits.

Individual and organizational factors of nurses' job satisfaction in long-term care: A systematic review

BACKGROUND

In long-term care facilities, nurses' job satisfaction predicts staff turnover, which adversely affects resident outcomes. Thus, it is important to develop a comprehensive understanding of factors affecting nurses' job satisfaction in long-term care facilities.

OBJECTIVES

To analyze factors associated with job satisfaction among nurses in nursing homes from individual and organizational perspectives utilizing a deductive approach.

DESIGN

Systematic literature review SETTING: Nursing homes.

PARTICIPANTS

Registered nurses and licensed practical nurses in nursing homes.

METHODS

A systematic literature review of seven online databases (EMBASE, CINAHL, PsychINFO, MEDLINE, PubMed, Scopus, and Web of Science) to July 23, 2020 was conducted. Studies were included if they examined factors associated job satisfaction in the target population and setting. Decision rules on how to determine factors important to nurse job satisfaction were developed a priori. Two team members independently screened the publications for inclusion, extracted data, and assessed included publications for methodological quality; conflicts were resolved through a consensus process and consultation of the third senior team member when needed.

RESULTS

Twenty-eight studies were included. Of these, 20 studies were quantitative, 6 were qualitative, and 2 were mixed methods. Factors associated with job satisfaction were grouped into two categories: individual and organizational. Individual factors significantly associated with job satisfaction were age, health status, self-determination/autonomy, psychological empowerment, job involvement, work exhaustion, and work stress. Individual factors identified as not important or equivocal were gender and experience as a nurse/in aged care. No organizational factors were identified as important for nurses' job satisfaction. Facility ownership, supervisor/manager support, resources, staffing level, and social relationships were identified as equivocal or not important. Findings from qualitative studies identified relationship with residents as an important factor for job satisfaction.

CONCLUSIONS/IMPLICATIONS

Factors identified as important to nurses' job satisfaction differ from those reported among care aides in nursing homes and nurses employed in acute care settings, suggesting that there is a need for unique approaches to enhance nurses' job satisfaction in nursing homes.

Experienced time pressure and stress: electronic health records usability and information technology competence play a role

BACKGROUND

Electronic health records (EHRs) are an elementary part of the work of registered nurses (RNs) in healthcare. RNs are the largest group of healthcare workers, and their experiences with EHRs and their informatics competence play a crucial role in a fluent workflow. The present study examined EHR usability factors and nurses' informatics competence factors related to self-reported time pressure and psychological distress.

METHODS

A nationwide survey was conducted for working-age registered nurses in 2017. The study sample included 3607 nurses (5% men) in Finland. The association of age, sex, employment sector, EHR usability factors, and nurses' informatics competence factors with time pressure and psychological distress were examined with analyses of covariance.

RESULTS

The EHR usability factors that were associated with high time pressure were low EHR reliability and poor user-friendliness. Regarding the nurses' informatics competence factors, only low e-Care competence was associated with time pressure. Of the EHR usability factors, low EHR reliability and low support for cooperation were associated with high psychological distress. Of the nurses' informatics competence factors, low e-Care competence was associated with high psychological distress.

CONCLUSIONS

Unreliability and poor user-friendliness of EHRs seem to be prominent sources of time pressure and psychological distress among registered nurses. User-friendly EHR systems and digital tools in healthcare are needed. Nurses' competence to use eHealth tools to tailor patient care should be strengthened through organizational and regional actions. For example, house rules about how to use eHealth tools and instructions on common practices in cooperation with other organizations could be useful.

Factors Associated With Nurses' Job Satisfaction In Residential Long-term Care: The Importance of Organizational Context

OBJECTIVES

We examined demographic, individual, and organizational context factors associated with nurses' job satisfaction in residential long-term care (LTC) settings. Job satisfaction has implications for staff turnover, staff health, and quality of care.

DESIGN

A cross-sectional analysis of survey data collected in the Translating Research in Elder Care program.

SETTING AND PARTICIPANTS

N = 756 nurses (registered nurses: n = 308; licensed practical nurses: n = 448) from 89 residential LTC settings in 3 Western Canadian provinces.

METHODS

We used a generalized estimating equation model to assess demographic, individual, and organizational context factors associated with job satisfaction. Job satisfaction was measured using the Michigan Organizational Assessment Questionnaire Job Satisfaction Scale.

RESULTS

Demographic, individual, and organizational context factors were associated with job satisfaction among nurses in residential LTC settings. At the demographic level, hours worked in 2 weeks (B = 0.002, P = .043) was associated with job satisfaction. At the individual level, emotional exhaustion-burnout (B = -0.063, P = .02) was associated with lower job satisfaction, while higher scores on empowerment (meaning) (B = 0.140, P = .015), work engagement (vigor) (B = 0.096, P = .01), and work engagement (dedication) (B = 0.129, P = .001) were associated with higher job satisfaction. With respect to organizational context, culture (B = 0.175, P < .001), organizational slack-space (eg, perceived availability and use of adequate space; B = 0.043, P = .040), and adequate orientation (B = 0.092, P < .001) were associated with higher job satisfaction.

CONCLUSIONS AND IMPLICATIONS

We identified previously unexamined modifiable organizational features (organizational slack-space and adequate orientation) as factors associated with LTC nurses' job satisfaction in the Canadian context. Our findings support future efforts to improve job satisfaction through improvements in organizational space and provision of adequate workplace orientation.

Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

Background

Flexible, integrated models of service delivery are being developed to meet the changing demands of an ageing population. To underpin the spread of innovative models of care across the NHS, summaries of the current research evidence are needed. This report focuses exclusively on care homes and reviews work in four specific areas, identified as key enablers for the NHS England vanguard programme.

Aim

To conduct a rapid synthesis of evidence relating to enhancing health in care homes across four key areas: technology, communication and engagement, workforce and evaluation.

Objectives

(1) To map the published literature on the uses, benefits and challenges of technology in care homes; flexible and innovative uses of the nursing and support workforce to benefit resident care; communication and engagement between care homes, communities and health-related organisations; and approaches to the evaluation of new models of care in care homes. (2) To conduct rapid, systematic syntheses of evidence to answer the following questions. Which technologies have a positive impact on resident health and well-being? How should care homes and the NHS communicate to enhance resident, family and staff outcomes and experiences? Which measurement tools have been validated for use in UK care homes? What is the evidence that staffing levels (i.e. ratio of registered nurses and support staff to residents or different levels of support staff) influence resident outcomes?

Data sources

Searches of MEDLINE, CINAHL, Science Citation Index, Cochrane Database of Systematic Reviews, DARE (Database of Abstracts of Reviews of Effects) and Index to Theses. Grey literature was sought via Google™ (Mountain View, CA, USA) and websites relevant to each individual search.

Design

Mapping review and rapid, systematic evidence syntheses.

Setting

Care homes with and without nursing in high-income countries.

Review methods

Published literature was mapped to a bespoke framework, and four linked rapid critical reviews of the available evidence were undertaken using systematic methods. Data were not suitable for meta-analysis, and are presented in narrative syntheses.

Results

Seven hundred and sixty-one studies were mapped across the four topic areas, and 65 studies were included in systematic rapid reviews. This work identified a paucity of large, high-quality research studies, particularly from the UK. The key findings include the following. (1) Technology: some of the most promising interventions appear to be games that promote physical activity and enhance mental health and well-being. (2) Communication and engagement: structured communication tools have been shown to enhance communication with health services and resident outcomes in US studies. No robust evidence was identified on care home engagement with communities. (3) Evaluation: 6 of the 65 measurement tools identified had been validated for use in UK care homes, two of which provide general assessments of care. The methodological quality of all six tools was assessed as poor. (4) Workforce: joint working within and beyond the care home and initiatives that focus on staff taking on new but specific care tasks appear to be associated with enhanced outcomes. Evidence for staff taking on traditional nursing tasks without qualification is limited, but promising.

Limitations

This review was restricted to English-language publications after the year 2000. The rapid methodology has facilitated a broad review in a short time period, but the possibility of omissions and errors cannot be excluded.

Conclusions

This review provides limited evidential support for some of the innovations in the NHS vanguard programme, and identifies key issues and gaps for future research and evaluation.

Future work

Future work should provide high-quality evidence, in particular experimental studies, economic evaluations and research sensitive to the UK context.

Study registration

This study is registered as PROSPERO CRD42016052933, CRD42016052933, CRD42016052937 and CRD42016052938.

Funding

The National Institute for Health Research Health Services and Delivery Research programme.

Exploring fair decision-making rules in nursing: A qualitative study

BACKGROUND

The decision-making process should be done according to a set of rules and principles so as to be fairly understood.

OBJECTIVES

The aim of this study was to identify the basic principles and rules used by nurses to understand justice in nurse managers' decision-making processes based on a procedural justice model. Research design and participants: This research was a qualitative study based on directed content analysis, which was performed on a group of 15 nurses working in different hospitals in Tehran, Iran. An in-depth semi-structured interview was used as the method of data collection for this study. Ethical consideration: This research has been approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences. The respondents were informed about the aim of the study, about voluntary participation, anonymity and confidentiality.

FINDINGS

The results of this study showed that in order to understand procedural justice, nurses use several rules, including: duties organization, managerial support, consistency, bias-suppression, accuracy, correctability, representativeness, and ethicality.

CONCLUSION

Nursing leaders must consider the importance of justice rules as one of many strategies to ensure the nurses' perception of fairness in decision-making processes.

Financial performance, employee well-being, and client well-being in for-profit and not-for-profit nursing homes: A systematic review

BACKGROUND

Expanding the opportunities for for-profit nursing home care is a central theme in the debate on the sustainable organization of the growing nursing home sector in Western countries.

PURPOSES

We conducted a systematic review of the literature over the last 10 years in order to determine the broad impact of nursing home ownership in the United States. Our review has two main goals: (a) to find out which topics have been studied with regard to financial performance, employee well-being, and client well-being in relation to nursing home ownership and (b) to assess the conclusions related to these topics. The review results in two propositions on the interactions between financial performance, employee well-being, and client well-being as they relate to nursing home ownership.

METHODOLOGY/APPROACH

Five search strategies plus inclusion and quality assessment criteria were applied to identify and select eligible studies. As a result, 50 studies were included in the review. Relevant findings were categorized as related to financial performance (profit margins, efficiency), employee well-being (staffing levels, turnover rates, job satisfaction, job benefits), or client well-being (care quality, hospitalization rates, lawsuits/complaints) and then analyzed based on common characteristics.

FINDINGS

For-profit nursing homes tend to have better financial performance, but worse results with regard to employee well-being and client well-being, compared to not-for-profit sector homes. We argue that the better financial performance of for-profit nursing homes seems to be associated with worse employee and client well-being.

PRACTICAL IMPLICATIONS

For policy makers considering the expansion of the for-profit sector in the nursing home industry, our findings suggest the need for a broad perspective, simultaneously weighing the potential benefits and drawbacks for the organization, its employees, and its clients.

Investigating cyberloafing, organisational justice, work engagement and organisational trust of South African retail and manufacturing employees

Orientation: Understanding cyberloafing, organisational justice, work engagement and organisational trust will lead organisations to develop strategies to counter the consequences of cyberloafing.Research purpose: This research explored the relationships between cyberloafing, organisational justice, work engagement and organisational trust among South African office workers in the retail and manufacturing industry.Motivation for the study: Cyberloafing, a prevalent way for office employees to engage in non-work-related activities during work time, is considered harmful to organisations. Limited research exists about the relationship between cyberloafing and organisational justice, organisational trust and work engagement within South Africa.Research design, approach and method: A quantitative research design was followed. Questionnaires were administered in the South African retail and manufacturing industry; a convenient sample of N = 224 was obtained. Descriptive statistics, Cronbach’s alpha coefficients, structural equation modelling and bootstrapping were used for data analysis.Main findings: Organisational justice was positively related to organisational trust while organisational trust was positively related to work engagement; work engagement related negatively to cyberloafing. Organisational trust mediated the relationship between organisational justice and work engagement while work engagement mediated the relationship between organisational trust and cyberloafing.Practical and managerial implications: Strategies can be developed to enhance and warrant perceptions of organisational justice and fairness that will increase trust levels, leading to higher work engagement and decreased cyberloafing behaviour and resulting in higher productivity.Contribution or value-add: The research revealed that when employees perceive their organisations as being fair, organisational trust will increase, leading to heightened work engagement levels and ultimately reducing cyberloafing behaviour.

The effects of work factors on nurses' job satisfaction, quality of care and turnover intentions in oncology

AIMS

We examined the effects of perceived supervisor support, value congruence and hospital nurse staffing on nurses' job satisfaction through the satisfaction of the three psychological needs for autonomy, competence and relatedness. Then, we examined the links between job satisfaction and quality of care as well as turnover intentions from the workplace.

BACKGROUND

There is growing interest in the relationships between work factors and nurses' job satisfaction. However, minimal research has investigated the effects of perceived supervisor support, value congruence and staffing on nurses' job satisfaction and the psychological mechanisms by which these factors lead to positive outcomes.

DESIGN

A cross-sectional questionnaire was distributed in 11 oncology units between September 2015 - February 2016.

METHOD

Data were collected from a sample of 144 French nurses who completed measures of perceived supervisor support, value congruence, staffing adequacy, psychological need satisfaction, job satisfaction, quality of care and turnover intentions.

RESULTS

The hypothesized model was tested with path analyses. Results revealed that psychological need satisfaction partially mediated the effects of perceived supervisor support, value congruence and hospital nurse staffing on job satisfaction. Moreover, job satisfaction was positively associated with quality of care and negatively linked to turnover intentions.

CONCLUSION

Overall, these findings provide insight into the influence of perceived supervisor support, value congruence and staffing on nurses' attitudes and behaviours.

Relationship between perceived organizational justice and moral distress in intensive care unit nurses

BACKGROUND:

The nature of the nursing profession pays more attention to ethics of healthcare than its therapeutic dimension. One of the prevalent moral issues in this profession is moral distress. Moral distress appears more in intensive care units due to the widespread need for moral decision-making regarding treatment and care in emergency situations. In this connection, organizational justice is of high importance and, as a significant motivational tool, leaves important impacts upon attitude and behavior of personnel.

AIM/OBJECTIVE:

This study aimed at investigation of the relationship between perceived organizational justice and moral distress in intensive care unit nurses.

RESEARCH DESIGN:

This is a descriptive-correlational research which examined the relationship between perceived organizational justice and moral distress in intensive care unit nurses.

PARTICIPANTS AND RESEARCH CONTEXT:

A total of 284 intensive care unit nurses were selected via census sampling. The data were collected through questionnaires and then were analyzed via SPSS-20 using Pearson and Spearman correlation tests.

ETHICAL CONSIDERATIONS:

This study was approved by the Committee of Ethics in Medical Research. Completion of informed consent form, guarantee of the confidentiality of information, explanation on purposes of the research, and voluntary participation in the study were moral considerations observed in this study.

FINDINGS:

There was a statistically significant negative correlation between the total perceived organizational justice and the total moral distress (p = 0.024, r = -0.137) and also between "procedural and interactional justice and errors" and "not respecting the ethics principles." Meanwhile, no relationship was found by the findings between distributive justice and dimensions of moral distress.

CONCLUSION:

According to the results of the study, there was a reverse significant relationship between moral distress and perceived organizational justice; therefore, the head nurses are expected to contribute to reduce moral distress and to increase perceived organizational justice in nurses.

Conceptualizing the dynamics of workplace stress: a systems-based study of nursing aides

Background

Workplace stress is a complex phenomenon that may often be dynamic and evolving over time. Traditional linear modeling does not allow representation of recursive feedback loops among the implicated factors. The objective of this study was to develop a multidimensional system dynamics model (SDM) of workplace stress among nursing aides and conduct simulations to illustrate how changes in psychosocial perceptions and workplace factors might influence workplace stress over time.

Methods

Eight key informants with prior experience in a large study of US nursing home workers participated in model building. Participants brainstormed the range of components related to workplace stress. Components were grouped together based on common themes and translated into feedback loops. The SDM was parameterized through key informant insight on the shape and magnitude of the relationship between model components. Model construction was also supported utilizing survey data collected as part of the larger study. All data was entered into the software program, Vensim. Simulations were conducted to examine how adaptations to model components would influence workplace stress.

Results

The SDM included perceptions of organizational conditions (e.g., job demands and job control), workplace social support (i.e., managerial and coworker social support), workplace safety, and demands outside of work (i.e. work-family conflict). Each component was part of a reinforcing feedback loop. Simulations exhibited that scenarios with increasing job control and decreasing job demands led to a decline in workplace stress. Within the context of the system, the effects of workplace social support, workplace safety, and work-family conflict were relatively minor.

Conclusion

SDM methodology offers a unique perspective for researchers and practitioners to view workplace stress as a dynamic process. The portrayal of multiple recursive feedback loops can guide the development of policies and programs within complex organizational contexts with attention both to interactions among causes and avoidance of adverse unintended consequences. While additional research is needed to further test the modeling approach, findings might underscore the need to direct workplace interventions towards changing organizational conditions for nursing aides.

The relationship between organizational justice and job satisfaction

Purpose

Focusing on the corporations in China and aiming to figure out the significant connection between organizational justice perception and job satisfaction from Chinese setting, this study aimed to examine the effects of organizational justice upon job satisfaction of the full-time and part-time employees in the state owned enterprise (SOEs) and primate Chinese companies.

Design/methodology/approach

The study adopted the questionnaire to investigate more than 300 employees, and the empirical data of this paper is based on statistical analysis, such as confirmatory factor analysis, correlational and regression analysis.

Findings

The paper arrives at the conclusion that in SOEs, the employees’ perception about procedural justice was higher than distributive justice. While in private enterprises, the procedural justice and interactive justice were tested to have similar coefficients. The relationship between organizational justice and job satisfaction differed between full-time employees and part-time employees.

Practical implications

This study opens a new window for understanding how organizational justice influences employees’ job satisfaction in Chinese context, taking a further step to explore the different impacts of organizational justice on job satisfaction among different types of employees.

Originality/value

This paper collected data from both SOE and private companies in China, increasing the external validity of the findings. Meanwhile, the authors observed consistent findings with the studies in Western Society, which increase the generalization of our findings as well. The findings highlight the value of integrating literatures on organizational justice and job satisfaction.

Does Organizational Justice Modify the Association Between Job Involvement and Retirement Intentions of Nurses in Finland?

Given the growing aging population in Finland, retaining health staff to care for them is important. In an exploration of predictors of quitting before the typical retirement age, which ranges from 63 to 68 years in Finland, we examined whether organizational justice moderated the association between job involvement and retirement intentions among nurses 50 years and over. The sample was 446 nurses (70% practical nurses) working in 134 assisted living facilities providing 24-hour care for older residents in Finland. Job involvement was measured with the Job Involvement Questionnaire, and organizational justice with a scale that tapped its three dimensions: distributive justice, procedural justice, and interactional justice. In covariance analyses, low organizational justice and low job involvement were associated with a higher likelihood of retirement intention. Both interactional justice and procedural justice moderated the association of job involvement with retirement intentions. Among nurses with low job involvement, those who experienced unjust treatment, that is, low interactional justice, and evaluated organizational procedures as unjust had significantly stronger retirement intentions than nurses with high levels of interactional and procedural justice. Distributive justice was associated with retirement intentions in both high and low job-involved respondents. Organizational justice may act as a buffer against retirement intention as one consequence of nurses' low job involvement. © 2016 Wiley Periodicals, Inc.

Hospital employees’ perceptions of fairness and job satisfaction at a time of transformational change

Objective This study examines the relationships between job satisfaction and organisational justice during a time of transformational change. Methods Data collection occurred immediately before a major regional hospital’s move to a greenfield site. Existing measures of job satisfaction and organisational justice were used. Data were analysed (n = 316) using descriptive, correlation and regression methods together with interactions between predictor variables. Results Correlation coefficients for satisfaction and organisational justice variables were high and significant at the P < 0.001 level. Results of a robust regression model (adjusted R2 = 0.568) showed all three components of organisational justice contributed significantly to employee job satisfaction. Interactions between the predictor variables showed that job satisfaction increased as the interactions between the predictor variables increased. Conclusions The finding that even at a time of transformational change staff perceptions of fair treatment will in the main result in high job satisfaction extends the literature in this area. In addition, it was found that increasing rewards for staff who perceive low levels of organisational justice does not increase satisfaction as much as for staff who perceive high levels of fairness. If people feel negative about their role, but feel they are well paid, they probably still have negative feelings overall. What is known about the topic? Despite much research highlighting the importance of job satisfaction and organisational justice in healthcare, no research has examined the influence of transformational change, such as a healthcare organisational relocation, on these factors. What does this paper add? The research adds to academic literature relating to job satisfaction and organisational justice. It highlights the importance of organisational justice in influencing the job satisfaction of staff. What are the implications for practitioners? Financial rewards do not necessarily motivate staff but low rewards do demotivate. Shortages of health professionals are often linked to a lack of job satisfaction, and recruitment and retention strategies are often based on salary.

Is working in culturally diverse working environment associated with physicians' work-related well-being? A cross-sectional survey study among Finnish physicians

International mobility of health care professionals is increasing, though little is known about how working in a culturally diverse team affects the native physicians' psychosocial work environment. We examined Finnish physicians' perceptions of work-related wellbeing according to whether they had foreign-born colleagues (FBCs) in their work unit. We also examined whether work-related resources moderate the potential association between work-related wellbeing and working alongside FBCs. A cross-sectional survey was conducted for a random sample of physicians in Finland in 2010 (3826 respondents, response rate 55%). Analyses were restricted to native Finnish physicians working in public health care. The results were analyzed by ANCOVA. In unadjusted analyses, having FBCs was related to poor team climate (p<0.001) and poor job satisfaction (p=0.001). Those physicians who reported high procedural justice and high job control perceived also higher job satisfaction even if they had many FBCs in the work unit (p=0.007 for interaction between FBCs and procedural justice and p<0.001 for interaction between FBCs and job control). These associations were robust to adjustments for age, sex, health care sector, specialization, on-call duty, employment contract, full-time employment and leadership position. The results indicate that culturally diverse work units face challenges related to team climate and job satisfaction. The results also show that leadership plays an important role in culturally diverse work units. The potential challenges of culturally diverse teams for native physicians may be reduced by fair decision-making and by increasing physicians' job control.

Perceptions of Organizational Justice Among Nurses Working in University Hospitals of Shiraz: A Comparison Between General and Specialty Settings

Background:

Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems.

Objectives:

The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals.

Materials and Methods:

In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards.

Results:

Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards.

Conclusions:

Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions.

Privatizing health care in times of new public management: Investigating the role of psychological empowerment using cluster analysis

Although privatization within health care is usually justified using arguments based on efficiency and productivity, the empirical investigations underpinning such arguments are few and ambiguous in their results. Presenting a new theoretical and analytical approach to this research field, we argue that psychological empowerment, reflecting individuals' intrinsic change motivation state, is a crucial prerequisite for the transformation of a nonprofit health care organization to a for-profit one. The general aims of this study were to explore empowerment cognitions during a privatization, to relate these to a selection of key work-related outcome variables, and to identify the effects of privatization in terms of individual level changes in empowerment after privatization. A sample of health care workers (n = 210) provided survey longitudinal data that were analyzed using cluster analysis. Eight clusters were identified at both pre- and postprivatization with each cluster mirroring specific empowerment patterns: Empowered, In Control, Quasi-Empowered, Competent/Normed, Reference, Underused, Misfit, and Powerless. The clusters discriminated on positive work attitudes, mental health complaints, and turnover intentions. The analysis also revealed the complexity of privatization in that a homogenization as well as a differentiation tendency was observed, thereby implicating both socio-structural equality and inequality effects. The results highlighted the relevance of allocating importance to health care workers' psychological empowerment during the privatization process, and of viewing such organizational transformations not as simple shifts in the state of affairs, but as nonlinear processes involving dynamic changes in individual perceptions over time.

Do transactive memory and participative teamwork improve nurses' quality of work life?

Improvement in nurses' quality of work life (QWL) has become a major issue in health care organizations. We hypothesized that the level of transactive memory (defined as the way groups collectively encode, store, and retrieve knowledge) and participative teamwork (an organizational model of care based on vocational training, a specific service's care project, and regular interdisciplinary staffing) positively affect nurses' QWL. This cross-sectional study enrolled 84 ward-based psychiatric nurses. We assessed transactive memory, participative teamwork, perceived organizational justice, perceived organizational support, and QWL using psychometrically reliable and valid scales. Participative teamwork and transactive memory were positively associated with nurses' QWL. Perceived organizational support and organizational justice fully mediated the relationship between participative teamwork and QWL, but not between transactive memory and QWL. Improved transactive memory could directly improve nurses' QWL. Improved participative teamwork could improve nurses' QWL through better perceived organizational support and perceived organizational justice.

The importance of the supervisor for the mental health and work attitudes of Australian aged care nurses

BACKGROUND

The work attitudes and psychological well-being of aged care nurses are important factors impacting on the current and future capacity of the aged care workforce. Expanding our understanding of the ways in which the psychosocial work environment influences these outcomes is important in order to enable organizations to improve the management of human resources in this sector.

METHODS

Using survey data from a sample of 222 Australian aged care nurses, regression analyses were employed to test the relative impact of a range of psychosocial work environment variables derived from the demand-control-support (DCS) model and organizational justice variables on satisfaction, commitment, well-being, and depression.

RESULTS

The expanded model predicted the work attitudes and well-being of aged care nurses, particularly the DCS components. Specifically, demand was related to depression, well-being, and job satisfaction, job control was related to depression, commitment, and job satisfaction, and supervisor support and interpersonal fairness were related to well-being. The contributions of informational and interpersonal justice, along with the main and interaction effects of supervisor support, highlight the centrality of the supervisor in addressing the impact of job demands on aged care nurses.

CONCLUSION

Psychosocial variables have utility beyond predicting stress outcomes to the work attitudes of nurses in an aged care setting and thus present further avenues of research for the retention of nurses and improved patient care.

Violence against radiologists. II: Psychosocial factors

PURPOSE

Violence against radiologists is a growing problem. This study evaluated the psychosocial factors associated with this phenomenon.

MATERIALS AND METHODS

A questionnaire was administered to 992 Italian radiologists.

RESULTS

Physical violence experienced in the previous 12-month period was associated with the radiologist's poor mental health [odds ratio (OR) 1.11] and overcommitment to work (OR 1.06), whereas radiologists in good physical health (OR 0.64), with job satisfaction (OR 0.96) and with overall happiness (OR 0.67) were less exposed. Nonphysical abuse was equally associated with the radiologist's poor mental health (OR 1.10) and overcommitment (OR 1.14) and negatively associated with physical health (OR 0.54), job satisfaction (OR 0.96), happiness (OR 0.81), organisational justice (OR 0.94) and social support (OR 0.80).

CONCLUSIONS

Preventive intervention against violence in the workplace should improve workplace organisation and relationships between workers.