Resilience And Hope As Predictors Of Organizational Commitment Among Private Hospitals’ Nurses

Abstract

In view of the nursing shortage and the complementary role of the private healthcare sector to Malaysia’s overall healthcare system, organizational commitment is regarded as an essential work attitude among nursing professionals. Nurses who are committed to the organization are known to always give their best at their work because they possess the willingness and sense of responsibility to perform their job tasks efficiently and effectively. In nursing, resilience and hope are deemed as two desirable personal traits that could enhance commitment. Therefore, the aim of this study is to examine the role of resilience and hope in predicting organizational commitment. Self-administered questionnaires were used to collect the survey data on 639 staff nurses working in large private hospitals in Malaysia. Data was subsequently analysed using Partial Least Squares (PLS) method. Our results revealed that hope alone has a direct and positive effect on organizational commitment. The present findings suggest the importance of possessing positive mindsets in enhancing nurses' commitment. Positive expectations regarding work goals will lead to greater levels of motivation and dedication among nurses. Lastly, useful insights are provided to hospital administrators on recruitment and training strategies to help ensure nurses continue to deliver superior quality care to patients on behalf of the employing healthcare organization.

Keywords: Organizational commitmentresiliencehopeprivate hospitalsMalaysia

Introduction

The Malaysian healthcare system is composed of a mixture of the public and private healthcare providers that are under the responsibility of the Ministry of Health Malaysia (Hassali et al., 2014). The country provides healthcare services to all its population through a tax-based public healthcare system, which promises delivery of care to all Malaysians with minimal charges (Loganathan et al., 2019). On the other hand, private healthcare providers are profit-oriented that charge their patients based on services offered (Chee & Barraclough, 2007). According to the Department of Statistics Malaysia (2017), the private healthcare sector has become an essential contributor to the Malaysian economy due to its rapid growth throughout the country. For instance, under the Economic Transformation Programme (ETP), the private healthcare sector is expected to generate a revenue of RM 6.59 billion by 2020 besides creating 26,966 jobs (PEMANDU, 2013).

According to Alipour and Kamaee (2015), organizational commitment is a very desirable employee attitude in healthcare organizations. This is because committed employees will have greater retention, lower absences, and better performance. All these benefits will translate into higher-quality care to patients. Organizational commitment of nurses is highly prized given that the healthcare industry not only have to reduce its operational costs but at the same time need to improve its quality of services within an environment of constantly changing technology. Nurses have been described as the most essential human resources in a hospital and the effectiveness of a hospital in delivering quality healthcare services depends on its nurses’ commitment to the organization (Khan & Jan, 2015). Organizational commitment represents an employee’s attitude towards the organization which affects employees’ identification with the goals and values of the organization, their willingness to contribute a substantial amount of effort for the organization as well as the desire to stay working for that particular organization (Mowday et al., 1979).

Nurses represent the largest share of the healthcare workforce (Buchan & Aiken, 2008). They are responsible in providing care to patients while ensuring effective patient health outcomes (Buchan & Aiken, 2008). Nurses are always involved in physically and emotionally demanding situations which often expose them to occupational and health risks as well as work overload, increased patient numbers, incidences of bullying, and even harassment at the workplace (Bogossian et al., 2014). Due to such taxing environments, nurses require a high level of psychological capital in order to perform their job effectively (Luthans & Youssef, 2004). Luthans and Youssef (2004) stated that psychological capital denotes a positive state of mind which is displayed during the growth and development of an individual. There are four key components of psychological capital which includes self-efficacy, optimism, resilience and hope (Luthans & Youssef, 2004). However, given the challenges and stressful situations that nurses encounter in their daily work, two dimensions of psychological capital in the form of resilience and hope are deemed as more appropriate. Hence, the present study will focus on these two variables.

Resilience denotes an individual’s capability to bounce back from a tough situation to attain victory and is typically found in people who perceive life as meaningful and needs improvisation and adaptation (Luthans & Youssef, 2004). Meanwhile, hope signifies a cognitive set of positive expectations for goal achievement based on one’s goal-directed determination and one’s plans of meeting those goals (Snyder et al., 1991a). In other words, individuals with hope possess the ability to focus on their goals and fulfil those goals (Snyder et al., 1991b). Individuals with hope will remain hopeful that there is always an alternative way in every circumstances (Snyder, 1994). These individuals will therefore perform creatively and explore all possible avenues towards reaching their goal due to their strong determination (Larson & Luthans, 2006). According to Peng et al. (2013), hope and resilience have positive and significant relationships with organizational commitment. Furthermore, Lifeng (2007) demonstrated that both hope and resilience are important determinants of employees’ organizational commitment. This notion was further supported by Toor and Ofori (2009) who stated that hope and resilience lead to increased organizational commitment. Therefore, this study sought to inspect the effects of two dimensions of psychological capital (resilience and hope) on organizational commitment of nurses from Malaysian private hospitals.

Problem Statement

Since nurses who represent the largest group of professionals in a hospital are responsible in carrying out the hospital’s work activities, their role is essential in determining the quality of the hospital’s services (Khan & Jan, 2015). According to Huang et al. (2006), nurses were more pleased with their work if they were dedicated to their principles, values and practices in the organization (Huang et al. 2006). Moreover, nurses with low organizational commitment, may not be able to perform work effectively, which may ultimately, lead to decreased patient care quality (Ford et al., 2006). Joo (2010) stated that one important strength for employees working in any organization is their commitment because employees who are committed will remain loyal to their employing organization and willing to extend efforts on its behalf. As such, they would be more likely to engage in extra role behaviour in order to achieve their organization’s goals (Luthans, 2002).

Nowadays, healthcare organizations throughout the world are faced with high turnover rate among healthcare personnel which can negatively affect a hospital’s capacity to meet patients’ needs (Laschinger et al., 2006). Malaysia is also confronted with problems related to nursing shortage where the turnover rate of Malaysian nurses are on the rise year by year (Barnett et al., 2010). Haider et al. (2015) asserted that high turnover rate can cause monetary and non-monetary problems to healthcare organizations. As a result, healthcare organizations have experienced economic losses because they have to continuously recruit new nurses (Buerhaus et al., 2007). To address this concern there is a need for healthcare personnel to exhibit high organizational commitment. According to Dixit and Bhati (2012), committed employees are unlikely to leave their organization and are acknowledged to always perform at their best, which ultimately, in the aggregate, lead to enhanced organizational performance. In light of this, an improved understanding of the effects of hope and resilience on nurses’ organizational commitment is essential. Therefore, this study aims to contribute to the literature by examining the role of resilience and hope as predictors of organizational commitment among Malaysian private hospitals’ nurses.

Research Questions

The following are the research questions for this study.

• Does resilience has a direct and positive effect on organizational commitment of nurses attached to Malaysian private hospitals?

• Does hope has a direct and positive effect on organizational commitment of nurses attached to Malaysian private hospitals?

Purpose of the Study

The purpose of this study was to investigate the effects of two dimensions of psychological capital (resilience and hope) on organizational commitment among nurses working in private hospitals in Peninsular Malaysia. This research used a cross sectional approach where all variables and data were collected over a set period of time. All variables for this study were measured at the individual level using self-administered questionnaires.

Research Methods

Findings

Measurement Model Results

Factor loadings, composite reliability (CR), and average variance extracted (AVE) were computed to measure convergence validity. As shown in Table 1 , all indicators ranged from 0.676 to 0.860, which exceeded Hair et al.’s (2010) minimum cut-off value of 0.5. Similarly, all latent constructs demonstrated adequate convergent validity with AVE values ranging from 0.596 to 0.707. Meanwhile, the CR values for the latent variables ranged from 0.879 to 0.898 and were above Hair et al.’s (2010) threshold value of 0.7, suggesting the existence of significant homogeneity. Thus, the measurement model is considered reliable and displayed sufficient convergent validity.

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Discriminant validity was assessed by the Heterotrait-Monotrait (HTMT) ratio of correlations between the study variables. As shown in Table 2 , all HTMT values (ranging from 0.389 to 0.791) did not surpass Gold et al.’s (2001) threshold value of 0.90, which corroborated the existence of discriminant validity.

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Figure 1 shows that the R2 values for organizational commitment is 0.181 which suggests that 18.1% of the variance in organizational commitment can be explained by resilience and hope.

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Conclusion

Given the importance of the healthcare industry to the health and wellbeing of society in a country, this study sought to examine the direct and positive relationships between two dimensions of psychological capital (resilience and hope) and organizational commitment. Our sample comprised nurses from private hospitals in Malaysia. Our statistical results indicated that hope alone has a positive and direct effect on organizational commitment. Given that nurses represent the largest component of healthcare professionals, their commitment to the organization is essential in ensuring superior healthcare quality provided to patients. Therefore, hospital administrators may want to focus on recruiting candidates that have positive outlooks. In addition, training programs may be continuously conducted to boost nurses’ inner strength in the form of hope so that they are able to persevere toward goals, and in times of difficulty, redirect their goal’s route to another pathway in order to win. Hence, nurses become bonded to their employer, resulting in greater organizational commitment.

Acknowledgments

The authors would like to thank Universiti Sains Malaysia for funding this research with a grant (1001/PMGT/816252).

References

• Alipour, F., & Kamaee M., M. (2015). Examining the relationship between job stress and organizational commitment among nurses of hospitals. Journal of Patient Safety & Quality Improvement, 3(4), 277-280.
• APHM (2016). http://www.hospitals-malaysia.org/portal/index.asp?menuid=42
• Bardoel, E. A., Pettit, T. M., De Cieri, H., & McMillan, L. (2014). Employee resilience: an emerging challenge for HRM. Asia Pacific Journal of Human Resources, 52(3), 279-297.
• Barnett, T., Namasivayam, P., & Narudin, D. A. A. (2010). A critical review of the nursing shortage in Malaysia. International Nursing Review, 57(1), 32-39.
• Bogossian, F., Winters‐Chang, P., & Tuckett, A. (2014). “The Pure Hard Slog That Nursing Is..”.: A Qualitative Analysis of Nursing Work. Journal of Nursing Scholarship, 46(5), 377-388.
• Buchan, J., & Aiken, L. (2008). Solving nursing shortages: A common priority. Journal of Clinical Nursing, 17(24), 3262-3268.
• Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., DesRoches, C., & Dittus, R. (2007). Impact of the nurse shortage on hospital patient care: comparative perspectives. Health Affairs, 26(3), 853-862.
• Chee, H. L., & Barraclough, S. (Eds.). (2007). Health Care in Malaysia: The Dynamics of Provision, Financing and Access. Routledge.
• Department of Statistics Malaysia (2017). Time series table of mid-year population estimate by state and sex, Malaysia, 1970–2017. Department of Statistics Malaysia.
• Dixit, V., & Bhati, M. (2012). A study about employee commitment and its impact on sustained productivity in Indian auto-component industry. European Journal of Business and Social Sciences, 1(6), 34-51.
• Ford, R., Sivo, S., Fottler, M., Dickson, D., Bradley, K., & Johnson, L. (2006). Aligning internal organizational factors with a service excellence mission: An exploratory investigation in healthcare. Health Care Management Review, 31(4), 259–269.
• Gold, A. H., Malhotra, A., & Segars, A. H. (2001). Knowledge management: An organizational capabilities perspective. Journal of Management Information Systems, 18(1), 185-214.
• Haider, M., Rasli, A., Akhtar, S., Yusoff, R. B. M., Malik, O. M., Aamir, A., Arif, A., Naveed, S., & Tariq, F. (2015). The Impact of Human Resource Practices on Employee Retention in the Telecom Sector. International Journal of Economics and Financial Issues, 5(1), 63-69.
• Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate Data Analysis: A Global Perspective (7th Ed.). Pearson Prentice Hall.
• Hassali, M. A., Alrasheedy, A. A., Ab Razak, B. A., AL-Tamimi, S. K., Saleem, F., Ul Haq, N., & Aljadhey, H. (2014). Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia. Australian Medical Journal, 7(1), 35-44.
• Huang, L., Chen, L., Tsai, H. C., & Lin, C. J. (2006). Development of an Instrument for Assessing Factors Related to Nurses. Mid-Taiwan Journal of Medicine, 11(1), 9-19.
• Joo, B. K. B. (2010). Organizational commitment for knowledge workers: The roles of perceived organizational learning culture, leader–member exchange quality, and turnover intention. Human Resource Development Quarterly, 21(1), 69-85.
• Khan, A. S., & Jan, F. (2015). The study of organization commitment and job satisfaction among hospital nurses. Global Journal of Management and Business Research, 15(1), 1-16.
• Larson, M., & Luthans, F. (2006). Potential added value of psychological capital in predicting work attitudes. Journal of Leadership & Organizational Studies, 13(1), 45-62.
• Laschinger, H. K. S., Purdy, N., Cho, J., & Almost, J. (2006). Antecedents and consequences of nurse managers' perceptions of organizational support. Nursing Economics, 24(1), 20-30.
• Lifeng, Z. (2007). Effects of Psychological Capital on Employees' Job Performance, Organizational Commitment, and Organizational Citizenship Behavior. Acta Psychologica Sinica, 2(1), 18-28.
• Loganathan, T., Rui, D., Ng, C. W., & Pocock, N. S. (2019). Breaking down the barriers: Understanding migrant workers’ access to healthcare in Malaysia. PloS one, 14(7), 1-24.
• Luthans, F. (2002). The need for and meaning of positive organizational behavior. Journal of Organizational Behavior, 23(6), 695–706.
• Luthans, F., & Youssef, C. M. (2004). Human, social, and now positive psychological capital management: Investing in people for competitive advantage. Organizational Dynamics, 33(2), 143-160.
• Mowday, R. T., Steers, R. M., & Porter, L. W. (1979). The measurement of organizational commitment. Journal of Vocational Behavior, 14(2), 224-247.
• PEMANDU (2013). EPP 10: Setting up wellness resorts. Performance Management Delivery Unit.
• Peng, J., Jiang, X., Zhang, J., Xiao, R., Song, Y., Feng, X., ... & Miao, D. (2013). The impact of psychological capital on job burnout of Chinese nurses: The mediator role of organizational commitment. PloS one, 8(12), 1-7.
• Shin, J., Taylor, M. S., & Seo, M. G. (2012). Resources for change: The relationships of organizational inducements and psychological resilience to employees’ attitudes and behaviors toward organizational change. Academy of Management Journal, 55(3), 727–748.
• Snyder, C. R. (1994). The Psychology of Hope: You Can Get There From Here. Simon and Schuster.
• Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., & Harney, P. (1991b). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570-585.
• Snyder, C. R., Hoza, B., Pelham, W. E., Rapoff, M., Ware, L., Danovsky, M., ... & Stahl, K. J. (1996). The development and validation of the Children’s Hope Scale. Journal of Pediatric Psychology, 22(3), 399-421.
• Snyder, C.R., Irving, L., & Anderson, J.R. (1991a). Hope and health: Measuring the will and the ways. In C. R. Snyder & D. R. Forsyth (Eds.), Handbook of Social and Clinical Psychology: The Health Perspective (pp. 285-305). Pergamon Press.
• Toor, S. U. R., & Ofori, G. (2009). Positive psychological capital as a source of sustainable competitive advantage for organizations. Journal of Construction Engineering and Management, 136(3), 341-352.
• Wagnild, G., & Young, H. (1993). Development and psychometric. Journal of Nursing Measurement, 1(2), 165-178.