Raising nurses' job satisfaction through patient-oriented perception and organizational citizenship behaviors

Proactive behaviors and health care workers: A systematic review

BACKGROUND

Proactive behaviors at work refer to discretionary actions among workers that are self-starting, change oriented, and future focused. Proactive behaviors reflect the idiosyncratic actions by individual workers that shape the delivery and experience of professional services, highlight a bottom-up perspective on workers' agency and motivation that can influence organizational practices, and are associated with a variety of employee and organizational outcomes.

PURPOSE

This systematic review aims to understand the various forms of proactive behaviors in health care workers that have been studied, and how these proactive behaviors are associated with employee-level outcomes and quality of care.

METHODS

Systematic review of articles published to date on proactive behaviors in health care workers.

RESULTS

Based on the identification of 40 articles, we find that job crafting, active problem solving, voice, extra-role behaviors, and idiosyncratic deals have been investigated as proactive behaviors among health care workers. Among these, job crafting is the most commonly studied (35% of articles), and it has been conceptualized and measured in the most consistent way, including as individual- and group-level phenomena, and as organizational interventions. Studies on active problem solving, which refers to workers accepting responsibility, exercising control, and taking action around anticipated or experienced problems at work, have not been consistently investigated as a form of proactive behavior but represent 25% of the articles identified in this review. Overall, this review finds that proactive behaviors in health care is a burgeoning area of research, with the majority of studies being cross-sectional in design and published after 2010, and focused on workers' job satisfaction as the outcome.

PRACTICE IMPLICATIONS

Health care workers and managers should consider the distinct influences and contributions of proactive behaviors as ways to improve employee-level outcomes and quality of care.

Explaining Organizational Citizenship Behavior Among Chinese Nurses Combating COVID-19

Background

Little is known about the associated factors with organizational citizenship behavior among Chinese nurses combating COVID-19. The aim of the present study was to investigate the relationships between autonomy, optimism, role conflict, work engagement, and organizational citizenship behavior based on moderated mediation models among Chinese nurses combating COVID-19.

Methods

This cross-sectional study was performed on a sample of 368 nurses supporting the COVID-19 epidemic in Wuhan Leishenshan Hospital, China. According to the Job Demands-Resources model, two moderated mediation models were tested, in which autonomy/optimism was associated with organizational citizenship behavior through work engagement, when role conflict served as a moderator.

Results

This current study found the mediating effect of work engagement and the moderating effect of role conflict on the relationship between autonomy/optimism and organizational citizenship behavior among nurses. Of note, nurses working in the COVID-19 epidemic viewed role conflict as challenge job demands rather than hindrance job demands.

Conclusion

Based on the findings, organizational citizenship behavior can be affected by work engagement and role conflict. Nursing management is suggested to put emphasis on work engagement and role conflict among nurses supporting the COVID-19 epidemic.

Boosting Perceived Customer Orientation as a Driver of Patient Satisfaction

OBJECTIVE

Several hospitals have embraced customer orientation as a strategy to better meet patients' needs, desires, and wishes. This study therefore investigates how hospitals can boost the extent to which patients feel treated in a customer-oriented way by staff (hereafter, "perceived customer orientation") and its implications for their satisfaction with the hospital.

DESIGN

A cross-sectional study of hospital staff's interpersonal skills (interpersonal quality) and the atmosphere and physical features of the hospital (environmental quality) as drivers of perceived customer orientation and its satisfaction implications.

PARTICIPANTS AND SETTING

Two hundred eighty-nine patients in seven surgery wards and two day-surgery departments of a Belgian hospital.

MAIN OUTCOME MEASURES

Perceived customer orientation and patient satisfaction.

RESULTS

Our results show that interpersonal and environmental qualities have a positive impact on perceived customer orientation, with the interpersonal skills of nursing staff having a greater effect than those of physicians. Perceived customer orientation, however, matters most for patient satisfaction when the nature of the service involves high-contact frequency.

CONCLUSIONS

Interpersonal and environmental qualities may help to ensure that patients feel treated in a customer-oriented way, which improves patient satisfaction with the hospital.

The Impact of Transformational Leadership on Nurses' Organizational Commitment: A Multiple Mediation Model

This study proposed that the transformational style of nursing staff supervisors inculcate commitment amongst nurses. Moreover, psychological empowerment and psychological well-being were posited as multiple meditators in the above-mentioned association, based on the tenant of conservation of resource (COR) theory. The authors have collected the survey data from the sample of (n = 299) hospital nurses working in Sargodha district of Pakistan. The bootstrap results have supported the direct, as well as indirect relationships. These findings imply that when the nursing staff perceives their leader as transformational, their psychological empowerment is enhanced, and they have higher well-being, which in turn increases their commitment to their hospitals. This study offers a better understanding of psychological states that mediate transformational leadership and organizational commitment linkage.

Effect of organizational citizenship behavior on family-centered care: Mediating role of multiple commitment

Family-centered care is one the most important indicators of high-quality care. The organizational citizenship behavior and commitment can enhance the quality of healthcare. This study aimed to investigate the effect of the organizational citizenship behavior on family-centered care considering the mediating role of multiple commitment. This descriptive study was conducted on 237 nurses working in pediatric and infant units of hospitals in Tehran city, Iran. The subjects were selected using the convenience sampling method. Data collection was performed using the Organizational Citizenship Behavior Scale, Perceived Family-Centered Care Staff Questionnaire, Affective Commitment Scale, and Commitment to the Supervisor Scale. The SPSS v.22 and SEM-PLS v.2 software were used for data analysis. Results were extracted in the form of a standard model and fitted for indices pertaining to the measurement and structural models. Accordingly, the organizational citizenship behavior had a direct effect on family-centered care (β = 0.19, t = 2.39). Moreover, multiple commitment including commitment to the leader and commitment to the organization had indirect weak and moderate effects on the relationship between the organizational citizenship behavior and family-centered care, respectively. An inverse association was reported between commitment to the leader and family-centered care. Furthermore, the organizational citizenship behavior predicted family-centered care by 70% considering the mediating role of multiple commitment. Therefore, family-centered care as an indicator of high-quality care can be improved through enhancing the organizational citizenship behavior and organizational commitment among Iranian nurses working in pediatric wards.

Job Satisfaction of Nurses and Its Moderating Effects on the Relationship Between Organizational Commitment and Organizational Citizenship Behaviors

Because nurses deliver care to patients on behalf of hospitals, hospitals should enhance the spontaneous organizational citizenship behaviors of front-line nurses to increase patient satisfaction and, hence, to increase the competitiveness of the hospital. However, a major gap in the literature is the lack of evidence-based studies of the correlations among job satisfaction, organizational commitment, and organizational citizenship behaviors in nursing personnel. Therefore, this study performed a cross-sectional survey of nurses in 1 large hospital in Taiwan; out of 400 questionnaires distributed, 386 valid questionnaires were collected, which was a valid response rate of 96.50%. The survey results revealed that organizational commitment has a significant positive effect on organizational citizenship behaviors (γ11 = 0.57, p < .01) and that job satisfaction has a significant positive moderating effect on the relationship between organizational commitment and organizational citizenship behaviors (Δχ2 = 26.397, p < .01). Therefore, hospitals can improve the job satisfaction of their nursing staff by improving perceived working satisfaction, interpersonal satisfaction, and remunerative satisfaction, which would then improve organizational commitment and organizational citizenship behaviors.

Organizational justice, trust, and identification and their effects on organizational commitment in hospital nursing staff

BACKGROUND

It is of importance and urgency for hospitals to retain excellent nursing staff in order to improve patient satisfaction and hospital performance. However, it was found that simply increasing the salary is not the best method to resolve the problem of lacking nursing staff; it is necessary to focus on the impact of non-monetary factors. The delicate relationship between organizational justice, organizational trust, organizational identification, and organizational commitment requires investigation and clarification from more studies if application in nursing practice is to be expected. Therefore, this study was to investigate how the organizational justice perception could affect nurses' organizational trust and organizational identification, and whether the organizational trust and organizational identification could encourage nurses to willingly remain in their jobs and commit themselves to the hospitals.

METHODS

A cross-sectional design was used. Questionnaires were distributed in 2013 to a convenience sample of 400 registered nurses in one teaching hospital in Taiwan: 392 were retrieved. Of these, 386 questionnaires were valid, which was a 96.5% response rate. The SPSS 17.0 and Amos 17.0 (structural equation modeling) statistical software packages were used for data analysis.

RESULTS

The organizational justice perceived by nurses significantly and positively affects their organizational trust (γ₁₁ = 0.49) and organizational identification (γ₂₁ = 0.58). Organizational trust (β₃₁ = 0.62) and organizational identification (β₃₂ = 0.53) significantly and positively affect organizational commitment.

CONCLUSIONS

Hospital managers can enhance the service concepts and attitudes of frontline nursing personnel by maximizing organizational justice, organizational trust and organizational identification. Nursing personnel would then be motivated to provide feedback to the attention and care provided by hospital management by demonstrating substantial improvements in their extra-role performance. Improved service concepts and attitudes would also facilitate teamwork among colleagues, boost the morale of the nursing faculty and reduce resignations and career changes.

Linking nurses' attitudes and behaviors to organizational values: Implications for human resource management

The researchers use established measures of job satisfaction (JS) and organizational citizenship behavior (OCB) to analyze data obtained from nurses in an Australian hospital (N = 573), and to discuss implications for human resource management. In this study the researchers seek to understand the links between nurses' JS, OCB and their perceptions of the values espoused by the organization. Changes in JS and OCB as length of service increases are also examined. Findings suggest that JS and OCB are both significant predictors of nurses' perceptions of organizational values. The findings also suggest that nurses more readily internalize organizational values when levels of JS and OCB are high. A further finding is that the tendency to engage in OCB declines significantly as length of service increases.

Moderating Effects of Nurses’ Organizational Support on the Relationship Between Job Satisfaction and Organizational Commitment

The aim was to investigate whether job satisfaction enhances organizational commitment among nursing personnel while exploring whether organizational support perception has a moderating effect on the relationship between their job satisfaction and organizational commitment. A cross-sectional survey was sent to 400 nurses; 386 valid questionnaires were collected, with a valid response rate of 96.5%. According to the research findings, nurses’ job satisfaction has a positive and significant influence on organizational commitment. Results also indicated that the moderating effect of nurses’ organizational support perception on the relationship between their job satisfaction and organizational commitment was stronger for high organizational support perception than it was for low organizational support perception. This study suggests that organizational support perception will develop a sense of belonging, and this will help improve nurses’ job satisfaction and organizational commitment. This kind of relationship is rarely discussed in the research literature, and it can be applied for human resources management of nursing staff.

Validation of the Brazilian Version of the Newcastle Satisfaction With Nursing Scales: A Partial Least Squares Path Modeling Approach

Background and Purpose: Assessing patient satisfaction requires reliable and valid instruments. This study evaluated the reliability and validity of the Brazilian version of the Newcastle Satisfaction with Nursing Scales (B-NSNS). Methods: This cross-sectional study enrolled 351 adult inpatients. Partial least squares path modeling (PLS-PM) approach was used to evaluate the reliability and validity of this instrument. Results: After the adjustments of model, both constructs exhibited adequate convergent and discriminant validity, showing that experiences with nursing care have a significant effect on patient satisfaction (r = .70) and account for 49.1% of the variance in patient satisfaction with the nursing care (R2 = 0.49). Conclusions: The B-NSNS result in a valid and reliable measure for use in managing nursing care.

Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa

Background

Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies.

Objective

The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.

Methods

We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave.

Results

There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ²=140.3, p<0.001). 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (χ²=83.5, p<0.001). The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave.

Conclusions

We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less standardised and more targeted HRH strategies than has been practised to date.

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

Background

Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study.

Methods

We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses.

Results

Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction.

Conclusions

According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers’ demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions.

Motivating medical information system performance by system quality, service quality, and job satisfaction for evidence-based practice

Background

No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study.

Methods

The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing.

Results

The findings are as follows: System quality has a positive influence on service quality (γ₁₁= 0.55), job satisfaction (γ₂₁= 0.32), and system performance (γ₃₁= 0.47). Service quality (β₃₁= 0.38) and job satisfaction (β₃₂= 0.46) will positively influence system performance.

Conclusions

It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems.

Linking nurses' attitudes and behaviors to organizational values: Implications for human resource management

The researchers use established measures of job satisfaction (JS) and organizational citizenship behavior (OCB) to analyze data obtained from nurses in an Australian hospital (N = 573), and to discuss implications for human resource management. In this study the researchers seek to understand the links between nurses' JS, OCB and their perceptions of the values espoused by the organization. Changes in JS and OCB as length of service increases are also examined. Findings suggest that JS and OCB are both significant predictors of nurses' perceptions of organizational values. The findings also suggest that nurses more readily internalize organizational values when levels of JS and OCB are high. A further finding is that the tendency to engage in OCB declines significantly as length of service increases.

Job satisfaction among hospital nurses revisited: a systematic review

BACKGROUND

The current nursing shortage and high turnover is of great concern in many countries because of its impact upon the efficiency and effectiveness of any healthcare delivery system. Recruitment and retention of nurses are persistent problems associated with job satisfaction.

OBJECTIVE

To update review paper published in 2005.

DESIGN

This paper analyses 100 papers relating to job satisfaction among hospital nurses derived from systematic searches of seven databases covering English and Chinese language publications 1966-2011 (updating the original paper with 46 additional studies published 2004-2011).

FINDINGS

Despite varying levels of job satisfaction across studies, sources and effects of job satisfaction were similar. Hospital nurse job satisfaction is closely related to working conditions and the organizational environment, job stress, role conflict and ambiguity, role perception and role content, organizational and professional commitment.

CONCLUSIONS

More research is required to understand the relative importance of the many identified factors relating to job satisfaction of hospital nurses. It is argued that the absence of a robust causal model reflecting moderators or moderator is undermining the development of interventions to improve nurse retention.