Linking Commitment and Job Satisfaction of Health Care ...The Job Characteristic Model (JCM) affirms...

SIT Journal of Management

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Bhattacharya, Dey & Saha

Linking Commitment and Job Satisfaction of Health Care Management

Employees: Insights from the Job Characteristics Model

*Debasis Bhattacharya, **Shuvendu Dey and *** Dipak Saha Abstract:

Organizational identification, job stress, job variety, autonomy, and quality of supervision typically

comprise the work environment characteristics of health care management workers, especially the nurses,

which are theorized to affect their level of job satisfaction and commitment of employees in the service

sectors. An overabundance of studies have established that customers, in today‟s competitive environment,

have more information, demand prompt service and have greater expectations from the service providers In

view of these developments, many service providers‟ organizations have moved towards enhancing their

performance through the customer-oriented strategies. Customer orientation behavior may be defined as the

application of the marketing concept philosophy at the employee-customer level. The Job Characteristic

Model (JCM) affirms that the motivation to work is a function of a few crucial psychological states such as

experienced meaningfulness of the work, experienced responsibility for outcomes of the work, and the

knowledge of actual results of the work activities. This situation in due course will lead to positive

workplace outcomes such as higher work force motivation, organizational commitment and job satisfaction.

The contemporary professional world is moving towards high performance, efficient organizations and the

management approach that could offer high degree of job satisfaction to employees. Organizational

Citizenship Behavior (OCB) can play a vital role in achieving these goals.

Key words: JCM, OCB, Nurse, Hospital, Job Stress, Job Satisfaction, Customer Orientation,

Supervision

*Debasis Bhattacharya, Associate Professor, Department of Commerce, University of North Bengal, India, email : [email protected] ,M : +91(0)9434256212. **Shuvendu Dey, Assistant Professor, Department of Business Administration, Siliguri Institute of

Technology, India , email :[email protected], M : +91(0)9434019648.

***Dipak Saha, Assistant Professor, Department of Business Administration, Siliguri Institute of Technology, India, email : [email protected], M : +91(0)9434210759.


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Introduction:

In their endeavor to relate job satisfaction and commitment of different types of employees, researchers

empirically test the work environment job characteristics. So far, little research work has been carried out to

unfold the influence of job related factors on the commitment and job satisfaction behavior of health care

employees. The work environment characteristics of service workers generally include organizational

identification, job stress, job variety, autonomy, quality of supervision that are theorized to affect the level

of job satisfaction, and commitment of employees in the service sectors. A plethora of studies have

established that customers, in today‟s competitive setting, have more information, demand timely service

and have greater expectations from the service providers (Roman, Ruiz, and Manuera, 2002). In view of

these developments, many service provider companies have moved towards improving their performance

through the customer-oriented strategies. Customer orientation behavior may be defined as the purpose of

the marketing concept philosophy at the employee-customer level (O‟Hara, Boles, and Johnston, 1991). It

has been widely addressed in prior literature that the practice of customer orientation creates greater long-

term performance benefits for the employees as well as for the organization compared to sales orientation

(Brady and Cronin, 2001; Goff, Boles, Bellenger, Stojack, 1997). It is evident from the above discussion

that the subject customer orientation has considerably attracted interest in academic, marketing, and

organizational behavior research as well as practice. It is supported by a surfeit of research findings that the

organizations that are more customers oriented can enhance the performance outcomes of buyer-seller

relationships (Goff, Boles, Bellenger, Stojack, 1997; Brady and Cronin, 2001; Boles, Babin, Brashear, and

Brooks, 2001).

Customer often base their assessment of their satisfaction with a service provider organization largely on

the service received from the customer contact-employees (Parasuraman, Zeithaml, and Berry, 1988). As a

result, there is an growing interest in determining factors which can lead to and increase customer

orientation among employees in organizations such as experienced meaningfulness i.e., the feeling of

achievement from the job they perform (Thakor and Joshi, 2005), and organizational identification, which

may be defined as a state of psychological congruence between worker and organizational values (Mael and

Ashforth, 1992). Another job related issue which has been increasingly discussed as an important driver of

an employee‟s customer orientation is that of supervisory style (Stock and Hoyer, 2004). Theoretically, if a

supervisor‟s attitude towards workers is favorable, it is likely to have a strong impact on the behavior of

subordinates to practice customer-orientation.


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Literature Review:

Industrial and organizational psychologists, management scientists, and sociologists show keen interest in

job satisfaction and organizational commitment. After Locke (1976) prepared his studies twenty-six years

ago, more than three thousand studies had been done solely on job satisfaction. Analysts have also

deliberated extensively on identifying, often with an eye to manipulating, the antecedents of job satisfaction

and organizational commitment (Loher, Noe, Moeller, & Fitzgerald, 1985). In fact, most of the research

conducted regards both job satisfaction and organizational commitment as the ultimate dependent variable.

The present study focuses on job satisfaction and organizational commitment of nurses belonging to both

public and private healthcare sector predicting an outcome of theoretical and practical interest for

organizational analysts. Not all analysts, though, agree that either job satisfaction or organizational

commitments are useful for foreseeing organizationally relevant behavior, such as turnover. Hodson (1991),

for one, argues that the concept of job satisfaction is severely flawed because “it lacks behavioral referents,

its connection with productivity is based on a naive theory of human behavior, it is too summary a measure

of workers‟ complex cognitive structures, and it is too individualistic”. He claims that commitment is a step

in the right direction as it expresses behavioral intentions (the intention to remain with the organization

being primary), but it too suffers from the problems that beset job satisfaction, and advocates moving away

from research based on attitudes to more behavioral research. Roznowski and Hulin (1992) maintain that

well constructed, validated scales of job satisfaction are “the most informative data an organizational

psychologist or manager can have” for predicting organizationally relevant behavior in individuals. They

argue that low levels of job satisfaction create one (or a combination) of four types of disagreeable

behavior. First, dissatisfied individuals may attempt to increase job outcomes by stealing, using work time

to pursue personal tasks, or by simultaneously holding a second job. Secondly, they may pull out from the

job psychologically as manifested in such behavior as not attending meetings, drinking on the job, or

wandering about trying to look busy. Thirdly, disgruntled employees may practice behavioral withdrawal

from the job as in non-attendance, turnover, or early retirement. Finally, employees may undertake specific

change behaviors that attempt to vary the work situation. This may include remaining in a particular job and

trying to affect changes through union or other activity, or it may involve attempts to change the orientation

of the job through transfer or relegation.

Organizational commitment has been defined in various ways (Reichers, 1985). In the present study,

organizational commitment refers to congruence between the goals of the individual and the organization

whereby the individual identifies with and extends effort on behalf of the general goals of the organization.

Most earlier research has suggested that organizational commitment is more strongly associated to turnover

than is job satisfaction (Koch & Steers, 1978; Parasuraman, 1982). The Organizational Commitment


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Questionnaire developed by Porter, Steers, Mowday, and Boulian (1974) is the most familiar method of

assessing the type of organizational commitment. The present study uses different items although the intent

of the measures of organizational commitment used is to assess the identification of respondents with the

goals of the organization. Today professional world is moving towards high performance, effective

organizations and the management that could offer high degree of job satisfaction to employees.

Organizational Citizenship Behavior (OCB) can play a crucial role in achieving these goals. OCB includes

extra role behaviors such as co-operation with staff, coming at place of work earlier and leaving late,

helping others, using organizational resources with care, spreading positivity in organization (Turnipseed &

Rassuli, 2005).

Competitive advantage cannot be achieved by organizations just by offering products or delivering services

but human resource undoubtedly plays an important role. That is the reason today many organizations are

paying great attention on employee commitment by motivating them to achieve organizational goals

effectively. In recent time enormous attention is being given to extra-role behavior that is OCB, for the fact

that it leads to better organizational performance and employee retention (Podasakoff, & Mackenzie, 1994;

Walz & Niehoff, 2000). Another reason behind OCB‟s attractiveness is that organizations have realized the

importance of extra-role behavior and the fact that those organizations which totally depend on written roles

and behaviors are actually weak and cannot survive in today‟s dynamic time where innovation and being

spontaneous is the need of the hour (Wyss, 2006). Worker behavior can be broadly classified into two

categories: in-role behavior and extra-role behavior. In-role behavior of employee is task dependent

behavior which has to be performed in all situations as they are part of employee job description where as

an extra-role behavior is beyond normal standards which are not set in written rules of organization. These

are such behaviors for which one cannot be castigated or held accountable if not acted upon (Brief &

Motowidlo, 1986).

Job Characteristic Model (JCM) has been in considerable discussion in order to develop in depth insights

about employee behavior for past several years. Literature portrays a positive association between job

characteristic and employee behaviors (Farh, Podsakoff, & Organ, 1990; Samuel & Aubrey, 2006) but the

relation between job characteristic and OCB is still unttended. Very few studies can be found in this area

(Samuel & Aubrey, 2006; Su & Hsiao, 2005) which elaborate the relationship. Some good studies have

been done in western countries (Cappelli & Rogovsky, 1998; Drago & Garvey, 1998; Farh, Podsakoff, &

Organ, 1990; Pearce & Gregersen, 1991; Samuel & Aubrey, 2006) but only a few studies have been

conducted in non-western culture (Chien & Su, 2009; Su & Hsiao, 2005). One of the research objectives of


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this paper is to examine relation between OCB and JCM. Hackman & Oldham‟s (1975, 1980) proposed

JCM based on 5 major job characteristic which influence employee work related behavior and its outcome.

The five core dimensions are: Task Variety – The ability of an employee to use different skills while

performing work related task. Task Identity – The degree to which a task is completed by a single employee

or a piece of work to which an employee can identify with. Task significance denotes the degree to which a

performed task makes significant impact on organization and it should be measurable so that the employee

can perceive his contribution towards the achievement of organizational objectives. Task Autonomy means

the degree of freedom given to an employee to perform task the way he wanted to perform. Task Feedback

is a term used in the Organizational Behavior as the degree to which an employee gets feedback about

performance from his superiors.. The predicted outcomes of JCM are employee behaviors which are

extremely motivated, satisfied and work more effectively by varying core dimensions of JCM in the

presence of moderating variables such as knowledge, skills, abilities, need for growth and employee

satisfaction (Banks, 2006). Two theories which work on Job characteristic and OCB relationship are: Social

Exchange Theory (Konovsky & Pugh, 1994) and Psychological Control Theory (Robinson & Morrison,

1995). According to these theories there is a “reciprocity rule” that employees reciprocate OCB towards

those who are benefited in some manner and employees who reciprocates OCB are the ones who are

satisfied and motivated with their job. While examining a direct relationship between job characteristic and

OCB it was found that task variables directly impact OCB‟s two dimensions altruism and compliance (Farh,

Posdakoff, & Organ, 1990). When there is inherent motivation among employees to perform the job

nothing can work better than this in organizational interest. Moreover task characteristic also produces

significant impact on OCB‟s dimensions: altruism, conscientiousness, courtesy, and civic virtue (Podsakoff,

MacKenzie, & Boomer, 1996b). Routinization of work has been negatively associated with OCB. These

results are quite consistent with findings of Podsakoff & Mackenzie (1993) in the survey of organizational

citizenship behavior on appraisal of sales person performance. According to (Jinyue, 2007) job feedback

dimension of JCM could not produce significant impact on job identity, altruism or conscientiousness as

human nature does welcome positive and productive feedback but only to certain extent. According to

Krishnan, Omar, & Ismail (2010), three job characteristic (task autonomy, task variety, and task

significance) of JCM leads towards OCB. These findings are quite consistent with the findings of Farh,

Podsakoff, & Organ (1990), Cappelli & Rogovsky (1998), and Drago & Garvey (1998). Krishnan, Omar, &

Ismail (2010) emphasized that greater the job autonomy, job variety and its perceived significance in

employee‟s mind, greater the probability will be for an employee to exhibit OCB.

Kahn (1990), terms employee engagement as physical, emotional and cognitive attachment of employee

with his (her) work. Researchers use different measures of engagement like interest and passion while

performing the work ; they also relate it with many other variables such as employee turnover rate, degree


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of customer satisfaction, customer loyalty, and to some extent, financial criteria (Harter, Schmidt, & Hayes,

2002). Employee engagement is energy, involvement, and self efficacy in performing work which is

opposite to burnout dimensions that are exhaustion, cynicism, and inefficacy (Maslach, Schaufeli, Leiter,

2001). Employee engagement acts as direct predictor of organization‟s financial performance and

achievement (Harter, Schmidt, & Hayes, 2002). But the harsh reality today is that employee engagement is

towards decline as organizations and workers both have a tendency to be more materialistic (Bates, 2004).

In today‟s workplace huge engagement gap can be witnessed (Bates, 2004; Kowalski, 2003). The most

comprehensive study on this subject was done by (Perrin, 2003), and according to him only 14% employees

are actively engaged in their work. The OCB dimension correlates with employee engagement is “taking

initiatives individually” which means going an extra-mile (Dicke, 2010). According to Saks (2006), OCB

differs from employee engagement in the sense that OCB involves voluntarily behaviors that are not part of

someone‟s job requirement whereas employee engagement is a formal role an employee performs. Scholars

forward differing views on employee commitment but fail to agree on common ground (Buchanan, 1974;

Sheldon, 1971). Meyer (2002) brought up three component model of organizational commitment.

According to this model, OCB is positively related to affective or normative commitment and on the other

hand continuance commitment is either negatively related or unrelated to OCB.

Job dissatisfaction among nurses lead to costly labor disputes, turnover, and risk to patients. Investigating

survey data from 95, 499 nurses, Matthew, Ann, Jeannie, Douglas, and Linda (2011) found much higher job

dissatisfaction and burnout among nurses who directly care for patients in hospitals and nursing homes than

among nurses who are employed in other jobs or settings, such as the pharmaceutical industry. They found

that nurses‟ evaluation of the overall quality of their work environment, including issues such as managerial

support for nursing, sensitivity of management to correcting problems in care at the bedside identified by

nurses, and doctor-nurse relations, are significantly associated not only with burnout and job satisfaction,

but also with nurses‟ satisfaction with employee benefits, including salary. Remarkably, nurses are mainly

dissatisfied with their health benefits, which emphasize the need for a benefits appraisal to make nurses‟

benefits more comparable to those of other white-collar employees. Patient satisfaction levels are lower in

hospitals with more nurses who are dissatisfied or burned out. Improving nurses‟ working environment may

perk up both nurses‟ and patients‟ satisfaction as well as the quality of care. A decade has passed since the

publication of „To Err Is Human‟, the first Institute of Medicine (IOM report, 2003) on medical errors but

patients still remain worried about the quality of care in hospitals. More than one-third of patients report

that they would not suggest their hospital to family and friends, and the quality of nursing home care has


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been an apprehension to families for a long time. Nurses reported since long that their work conditions are

not favorable to providing patient centered care that is safe and of desired quality. The association between

nurses‟ working conditions and patient safety was acknowledged by the IOM report „Keeping Patients Safe:

Transforming the Work Environment of Nurses‟ (Wachter, 2010). Many researchers have established that

the work environment and staffing levels for nurses impinge on both nurse burnout and job satisfaction, and

are also connected to patients‟ satisfaction with care (Maslach, Schaufeli, Leiter, 2001; Aiken, Clarke,

Sloane, Lake, Cheney, 2008; Vahey, Aiken, Sloane, Clarke, Vargas, 2004). Paradoxically, the most

satisfied and least burned-out nurses were those who did not provide direct care for patients or were not in

nursing roles at all. Importantly, Matthew, Ann, Jeannie, Douglas, and Linda (2011) found that high levels

of burnout and job dissatisfaction among hospital nurses are connected to lower patient satisfaction, which

hints towards problems with quality of care. The disparity was particularly great between clinical care

nurses in hospitals and nursing homes and those with nonclinical jobs such as the pharmaceutical industry.

They used data from the 2006 General Social Survey, a standard survey of social and demographic trends in

the United States, to compare the job satisfaction of nurses in the pharmaceutical industry to job satisfaction

in the US workforce generally and in the female, college-educated workforce in particular; they found that

there are similarly low levels of dissatisfaction. Seven percent of nurses in nonnursing pharmaceutical

industry jobs reported dissatisfaction with health benefits, compared to 9.1 percent among the general US

workforce. Ten percent of working women with a college degree reported dissatisfaction with health

benefits (Davis, Smith, and Marsden, 2009). Given nurses‟ multiple opportunities to work in jobs with

better benefits outside the hospital or nursing home setting, turnover and retention challenges may be a

costly consequence for these institutions (Waldman, Kelly, Arora, and Smith, 2004).

Gruber and Kleiner (2010) studied the effects of nursing strikes on patient outcomes and showed that the

hospital mortality rate was 19.4 percent higher and rates of hospital readmission were 6.5 percent higher for

patients admitted for the period of a nursing strike than among patients in hospitals in close proximity not

affected by the strike. Nurses‟ reports about their job satisfaction and observations of working conditions

present an organizational barometer of how well patients are faring. Patient satisfaction is much lower in

institutions where many nurses feel burned out and dissatisfied with their work conditions than in other

institutions. It may be possible to improve patient satisfaction and evade other undesirable patient outcomes

while also improving nurse satisfaction and retention by improving working conditions for nurses. Job

satisfaction has been the topic of great attention and much interdisciplinary research since the initiation of

the human relations school of management in the 1930s (Galup, Klein, and Jiang, 2008). Of late, there has

been a fresh resurgence of interest in the examination of job satisfaction variables (Gazioglu and Tansel,

2006). Given job satisfaction can be regarded as a multidimensional construct (Poulin, 1995) and

researchers have strived to elaborate this construct differently. Bitsch and Hogberg (2004) for example


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defined job satisfaction as a common attitude toward an individual‟s current job and organization that

covers the feelings, beliefs, and thoughts about that job. Job satisfaction is a measure of the degree to which

the employee is satisfied and pleased with the job (Dawal, Taha, and Ismail, 2009). Basically, job

satisfaction is the degree to which people like their jobs (Spector, 1997). The level of job satisfaction is

directly proportional to the level of organizational and departmental growth (Mishra, Mehta, Sinha, Shukla,

Ahmed, Kawatra, 2011). A high level of present job dissatisfaction was ascertained by Pearson (P ≤ 0.001,

do = 6, χ2 = 21.7) in all study groups. They also observed strong association of stress with avoidable factors

such as lack of departmental involvement, job satisfaction, and opportunity for self-expressions which is a

sign of unhealthy work culture. Other significant factors were work load, lack of clarity in job, and

unpredictable nature of work. Their improved satisfaction with nursing care and work was believed to be

related to the support they received in cognitive and emotional coping, the possibility of reflective learning

and the change in management style associated with intervention (Hallberg, Hansson, Axelsson, 2012).

Psychiatric mental health nurses have to deal with the daily responsibilities of assessing, intervening and

evaluating client responses to stress and patient reactions (Sullivan, 1993). Communication is a vital

element of palliative care and as such, communication difficulties are recognized stress factors among

health care professionals especially nurses (Katz, 2007). Communication training include activities such as

building relationships with adults and patients using notions of warmth, respect, genuineness, empathy and

trust, practicing active listening, observation and responding, improving communication and professional

presentation skills and practicing communication strategies with people who have explicit communication

needs due to mental health problems (Dublin, 2010).Proper communication makes it possible for nurses to

investigate in detail the concept of interpersonal communication and to aid nurses in identifying, practicing

and applying an assortment of communication skills that will allow them to develop helpful, caring

relationships with patients. Nurses have substantial job stress because they have long working hours, large

variety of tasks and complicated relationships with patients, their families, doctors and other medical

coworkers. Many studies have shown that the occurrence of burnout is higher among nurses who work in

especially stressful settings, such as oncology, mental health, emergency medicine, and critical care. As

premised by Tao and Kubo (1996), burnout consists of three dimensions such as emotional exhaustion,

depersonalization, and reduced personal accomplishment. Exhaustion occurs when one is emotionally

overwhelmed by the job demands and depleted of emotional resources. Depersonalization refers to the

growth of negative feelings and cold attitudes toward, or extremely detached response to, one's clients.

Many studies have investigated the burnout of nurses. Reduced personal accomplishment refers to the sense

of failure in matters of career advancement. Abraham‟s (2012) study on stress among nurses in a multi-

specialty hospital in India reveals that the stressors are bureaucratic role conflict, role strain and tension

from multiple expectations, management communication pattern, and leadership style of nursing


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administration, staffing and workload problems, negative patient outcome, communication with doctors,

lack of involvement in policy and practice decision, ample knowledge and skills for role functions. The

study attempts to understand the relationship between perceived self-efficacy and stress among nurses of a

big super-specialty hospital. The sample was made up of 55% of female and 45% male respondents. Most

of the respondents were young in the age group of 20 – 25 years and had work experience in the range of 1

– 5 years. It was found that respondents were more in the moderate, severe and dangerous levels of stress.

The main factors identified were both job-related and related to working environment. Rathore, Shukla,

Singh, Tiwari (2012) find lack of sleep and problems related to consequent fatigue are common among

professionals working in healthcare settings. Overly long duty hours, reduced chances for sleep with

minimal recovery time and shift work all contribute significantly to impairments in physical, cognitive, and

emotional functioning. Harmful effects include those on personal health and well-being, patient health and

safety, performance of job-related tasks, and professionalism. Several impediments exist in implementing

effective personal and system wide strategies to manage the impact of sleep loss.

Research Methodology

The data for the study have been drawn from a cross section of nurses having professional qualification

from Government nursing training colleges as well as from various institutes imparting diploma in nursing

training which are of short term duration. Depending on the nature of the study we have collected data from

both private and public sector health care organization from different districts of the eastern part of West

Bengal popularly termed as North Bengal where a large number of private nursing homes are established in

the recent past. The data for the government sector health employees the required data have been gathered

from the North Bengal Medical College and other sub divisional hospitals and primary health centers spread

all over North Bengal. In all three hundred questionnaires were distributed among the respondents

clarifying the purpose of the study. The respondents actively participated in the study which is evident from

their response. We need to administer the questionnaire personally since the questionnaire contained

multiple response scales with which the respondents are not fully accustomed. In order to generate reliable

response we have developed three questionnaires in three languages viz. English, Nepali and Bengali.

Adequate care has been taken to translate the English questionnaire into two other languages with the help

of expert‟s opinion. After two follow up sessions two fifty nine questionnaires have been obtained from the

respondents and after careful scrutiny two forty three questionnaire are found to be usable in all respect

Responses from sixteen nurses cannot be included in our study due to improper response provided by them.

Adequate care has been taken to keep the representative property of the population by selecting the

respondents belonging to different culture, linguistic and demographic background. The data for the study

are collected using a five point Likert scale for all the constructs considered in our study. The job


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satisfaction and supervision have been measured using a four items Likert scale and for all other variables

viz. commitment, pay satisfaction and job stress are captured using a three items Likert scale. The numbers

of items included in our study have been kept at a minimum level to reduce the length of the questionnaire

to get a better response. The scales used in our study have been adopted from various prior studies

conducted in this field. In addition to the descriptive measures the study employs multivariate data analysis

using factor analysis to identify the construct validity of the scale and multiple regression analysis to predict

job satisfaction of female health care personnel employed in private as well as in the government sector to

discern their attitudes on various job related variables.

Table - I

Descriptive Statistics

Variables Type of Organization Sample Size Mean Std. Deviation

Job Sat 1.00 125 13.8560 3.00726

.00 118 12.2034 2.33355

Commit 1.00 125 10.2880 2.20635

.00 118 11.2627 2.28869

Pay Sat 1.00 125 9.0880 2.45283

.00 118 8.2881 1.88608

Sup vision 1.00 125 13.4640 2.50337

.00 118 14.3983 2.75848

Stress 1.00 125 9.1520 2.13668

.00 118 7.4576 2.87828

*Note: 1.00 denotes Public Sector and .00 denotes Private Sector.

The descriptive statistics presented in table I is self explanatory but a few comments are required

to understand the behavior of health care employees drawn from two different sectors. The job

satisfaction of public sector employees is found to be marginally higher than the employees who

are working in the private sector. However it is evident that commitment of nurses of private

sector nursing homes is higher than the nurses working in the government sector. Similarly,

quality of supervision is quite better in private nursing homes and the stress perceived by these

employees is substantially lower than that of the nurses employed in the government sector. So

far as pay satisfaction is concerned, the health care employees working in the private sector

consider that they are ill paid.


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The Independent sample‘t’ test amply demonstrates that there exists significant difference

between all the variables considered in our study. The absolute values of ‘t’ are quite high and the

differences are significant beyond p<.000

Table - III

Independent Samples‘t’- Test

Variables t Sig. (2-tailed) Mean Difference

Job Satisfaction 4.801 .000 1.65261

Commitment -3.376 .001 -.97471

Pay satisfaction 2.859 .005 .79986

Supervision -2.760 .006 -.93431

Job Stress 5.186 .000 1.69437

Before we present the findings of the multivariate data analyses, it is imperative to establish the

scale reliability and validity. For measuring reliability, the most common measure reported in

literature is Cronbach's Alpha. The Cronbach's Alpha values presented below are quite satisfactory

despite smaller number of items administered to the respondents for measuring different job

related variables.

Reliability Statistics :Table II

Category N of Items Cronbach's Alpha

Job Satisfaction 4 0.78

Commitment 3 0.65

Pay Satisfaction 3 0.69

Stress 3 0.74

Supervision 4 0.82


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Government health care employees

Factor Analysis : Table IV : Factor Matrix

Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization, a Rotation converged in 7 iterations.

The results of the factor analysis presented above demonstrate that the extraction of five factors

more or less appeared distinct though there are some split loadings and mis-loadings. On the

whole, the dimensionality of the variables considered in our study is established using a varimax

rotation procedure. The percentage of variance explained is more than 83 percent which is quite

good by any standard. The chi-square value is significant beyond p<.000 for the Burlett’s test of

sphearicity which measures the sampling adequacy.

Total Variance Explained

Table V

Component Extraction Sums of Squared Loadings Rotation Sums of Squared Loadings

Total % of

Variance Cumulative

% Total % of

Variance Cumulative

%

1 7.761 45.651 45.651 3.759 22.109 22.109

2 2.397 14.103 59.754 3.447 20.276 42.385

3 1.952 11.485 71.238 2.839 16.700 59.085

4 1.382 8.132 79.370 2.488 14.633 73.718

5 0.71 4.149 83.519 1.666 9.801 83.519

Extraction Method: Principal Component Analysis with varimax rotation.

Component

Factor 1 Factor 2 Factor 3 Factor 4 Factor 5

JS 1 .425 .725

JS 2 .351 .445

JS 3 .523 .589

JS 4 .518

CM 1 .879

CM 2 .807 .341

CM 3 .767

PS 1 .850

PS 2 .856

PS 3 .835

ST 1 .821

ST 2 .782

ST 3 .891

SV 1 .781

SV 2 .894 .340

SV 3 .808

SV 4 .896 .349


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In an attempt to established the construct validity we have employed Factor Analysis using

Principal Component method and following a Varimax rotation procedure. The Factor Analysis

results reveal that five factor solutions explains 83.519% of the variability in the original data

using a confirmatory Factor Analysis restricting the Eigen value factor. Except some mis-loading

and split loading, the result of Factor Analysis is quite satisfactory.

After establishing the scale reliability and validity a multiple regression analysis have been employed to

predict the job satisfaction of nurses employed in the government sector employing OLS method. We have

run two separate regression analysis using the same set of explanatory variables with two different

independent variables viz. job satisfaction and commitment to avoid the problem of multi-collinearity. As

expected pay satisfaction and encouraging supervision are found to be positively influencing the job

satisfaction behavior of health care employees employed in the government sector. On the other hand, the

stress is negatively associated with the job satisfaction which is theoretically established by the researchers

working in the field of organizational behavior.

REGRESSION ANALYSIS: Coefficients

Table VI

Independent Variables


Unstandardized Coefficients

Standardized Coefficients t Sig.

B Std. Error Beta

Pay Satisfaction .266 .096 .217 2.776 .006

Stress -.538 .109 -.382 -4.941 .000

Supervision .235 .088 .212 2.683 .008

Dependent Variable: Job Satisfaction; R Square = .354, F= 22.081, P<.000

Coefficients

Table VII




B Std. Error Beta

Pay satisfaction .047 .071 .051 .670 .504

stress -.386 .081 -.364 -4.794 .000

Supervision .316 .065 .378 4.871 .000


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Dependent Variable: Commitment; R Square = .378, F= 24.529, P<.000

Similar analyses have been conducted for the health care employees engaged in the private sector

nursing homes. The Cronbach‟s Alpha values for the private sector health care employees are also

found to be satisfactory and the rotated factor matrix solution for the same group of employees

establishes further the construct validity of the scale.

Table VIII

Private health care employee

Factor Analysis Factor Matrix :Table IX

Component

1 2 3 4 5

JS 1 .459 .648

JS 2 .387 .393 . .719

JS 3 .577 .631 .601

JS 4 .513 .373 .360 .621

CM 1 .922

CM 2 .707 .304

CM 3 .390 .719 .389

PS 1 .862

PS 2 .825 .317

PS 3 .565 .661 .498

ST 1 .881 .319

ST 2 .863 .052

ST 3 .936

SV 1 .747 .341

SV 2 .863

SV 3 .305 .650 .498

SV 4 .651 .324

Reliability Statistics

Category N of Items Cronbach's Alpha

Job Satisfaction 4 0.75

Commitment 3 0.68

Pay Satisfaction 3 0.71

Stress 3 0.73

Supervision 4 0.71


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Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. a Rotation converged in 7 iterations.

Table X

In an attempt to established the construct validity we have employed Factor Analysis using Principal

Component method and following a Varimax rotation procedure. The Factor Analysis results reveal that

five factor solutions explains 82.371% of the variability in the original data using a confirmatory Factor

Analysis restricting the Eigen value factor. Except some mis-loading and split loading, the result of Factor

Analysis is quite satisfactory.

REGRESSION ANALYSIS

Table XI

Coefficients




B Std. Error Beta

paysat .210 .098 .190 2.140 .034

stress -.053 .076 -.065 -.698 .486

sup .337 .091 .360 3.689 .000

Dependent Variable: Job Satisfaction; R Square = 0.49, F= 8.988, P<.000

Total Variance Explained

Component Extraction Sums of Squared

Loadings Rotation Sums of Squared Loadings

Total % of

Variance Cumulative

% Total % of

Variance Cumulative

%

1 7.195 42.326 42.326 3.421 20.126 20.126

2 3.249 19.114 61.440 3.175 18.677 38.804

3 1.405 8.267 69.707 2.735 16.088 54.892

4 1.286 7.564 77.272 2.356 13.861 68.753

5 .867 5.099 82.371 2.315 13.618 82.371


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Coefficients: Table XII

Independent variables



B Std. Error Beta

Pay Sat .348 .075 .336 4.654 .000

Stress -.032 .058 -.042 -.551 .583

Sup .452 .070 .514 6.482 .000

Dependent Variable: Commitment; R Square = .468, F= 33.372, P<.000

After establishing the scale reliability and validity, we have employed multiple regression analysis

with two separate regression model using the same set of regressors with two different dependent

variables viz. job satisfaction and commitment to avoid the problem of multi-collinearity. As

expected pay satisfaction and encouraging supervision are found to be positively influencing the

job satisfaction behavior of health care employees employed in the government sector. On the

other hand, the stress is negatively associated with the job satisfaction which is theoretically

established by the researchers working in the field of organizational behavior.

Conclusion and Managerial Implications

A private hospital is one which is owned and governed by a person or many people who are managing the

whole finances on their own. Public hospitals, on the other hand, are completely and entirely run on the

governments funding and money. Differences in employee ratings of the importance and actual presence of

various job characteristics also give us some idea about the difference of employment environments in the

private and public sectors. Public sector and private sector contexts are different, both in terms of the

importance workers place on various job characteristics, as well as the actual presence of these factors. In

general, self-reported job conditions were better overall in the private sector than in the public sector. The

biggest advantages, private sector workers reported over public sector workers related to the presence of:

challenging work, good physical conditions, and tools to use skills on the job. It is interesting to note that

the private sector health care employees suffer from lesser amount of stress though their job security is less,


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One probable reason is that once an employee joins the organization she develops an intimate relationship

with the other team members which is not the situation in the government sector due to poor standard of

organizational culture prevailing in such organizations..Moreover, the private sector employees are in the

lower However, public sector workers perceived significantly better employment benefits. One strategy

may be to find ways to learn from the private sector, and perhaps replicate some of the relevant conditions

found in the market. For example, increasing training opportunities, improving the physical working

conditions and environment through improved physical structures, equipment, and materials, may help

improve these important working conditions. Some highly discordant factors include opportunity to

advance, good employment benefits, time for family life, good income, the absence of which affect the

motivation of the workers belonging to both the sectors, but more pronounced in case of private

health care sector. These are issues where policymakers and managers can intervene to close the gap

between importance and presence. Training and motivation of supervisory personnel to promptly recognize

good work, and foster an environment that encourages autonomy will improve health worker satisfaction

and motivation. Here again the need appears greater for the public sector institutions. Public sector health

workers longed for supervisors who would recognize their work.

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Sample Demographics Appendix

Private Health Care Employees

Age Below 20 21 -30 31 - 40 40 & above

30% 46% 21% 3%

Income 6000 - 8000 8001 - 10000 10001 - 12000 12000+

35% 42% 16% 7%

Tenure of service

Below 2 Yrs 2 – 4 Yrs 4 – 6 Yrs Above 6 Yrs

41% 18% 16% 25%

Qualification

Nursing

Diploma

Nursing Degree ----- ------

86% 14% ----- ------

Public Health Care Employees

Age Below 20 21 -30 31 - 40 40 & above

Nil 39% 45% 16%

Income Nursing

Diploma

Nursing Degree 25000 - 30000 30000& Above

86% 14%

Tenure of service

Nursing

Diploma

Nursing Degree 10 Yrs 10 & above

86% 14% 51% 25%

Qualification

Nursing

Diploma

Nursing Degree ----- ------

Nil 100% ------ ------

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