Journal of Nursing Management, 2014, 22, 499–505
Organisational values and organisational commitment: do nurses’ ethno-cultural differences matter? TOVA HENDEL
RN PhD
1
and ILYA KAGAN
RN PhD
2
1
Senior Teacher and Head, Baccalaureate Program, Nursing Department, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, and 2Senior Coordinator, Quality and Patient Safety in Nursing, Rabin Medical Center, Clalit Health Services and Lecturer, Nursing Department, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Correspondence Ilya Kagan Nursing Department Steyer School of Health Professions Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel E-mail:
[email protected]
(2014) Journal of Nursing Management 22, 499–505. Organisational values and organisational commitment: do nurses’ ethnocultural differences matter?
HENDEL T. & KAGAN I.
Aim To examine the association between perceived organisational values and organisational commitment among Israeli nurses in relation to their ethnocultural background. Background Differences and the discrepancy between individuals’ organisational values and those of their organisational culture are a potential source of adjustment difficulties. Organisational values are considered to be the bond of the individual to their organisation. In multicultural societies, such as Israel, the differences in perception of organisational values and organisational commitment may be reflected within workgroups. Method Data were collected using a questionnaire among 106 hospital nurses. About 59.8% of the sample were Israeli-born. Results A positive correlation was found between organisational values and organisational commitment. Significant differences were found in organisational values and organisational commitment between Israeli-born-, USSR-born- and Ethiopian-born nurses. The socio-demographic profile modified the effect of organisational values on organisational commitment: when the nurse was male, Muslim, religiously orthodox and without academic education, the effect of organisational values on organisational commitment was higher. Conclusion Findings confirm the role of culture and ethnicity in the perception of organisational values and the level of organisational commitment among nurses. Implications for nursing management Assessing ethno-cultural differences in organisational values and organisational commitment provides a fuller understanding of nurses’ ability to adjust to their work environment and helps nurse managers devise means to increase nurses’ commitment. Keywords: culture, ethnicity, nurses, organisational commitment, organisational values Accepted for publication: 2 August 2012
Introduction Values are products of a culture or social system (Meglino & Ravlin 1998) and are shaped by the indiDOI: 10.1111/jonm.12010 ª 2012 John Wiley & Sons Ltd
vidual’s socialization throughout their life cycle. The importance that an individual places on values may differ with age, life cycle phase, life experience and culture (Parkes et al. 2001, McNeese-Smith & Crook 499
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2003). A person’s total value set shapes his or her perceptions, attitudes and beliefs and influences how they approach and perform their roles and responsibilities. A nurse’s individual values guide their actions, attitudes and judgments within their employing organisation. Organisational values (OV) – the main concept explored in this study – are the key factors in shaping organisational climate and influence the way the organisation is managed. However, they can conflict with the personal values of individual employees (Marquis & Huston 2006). Value differences and the discrepancy between individual values and those represented in an organisational culture are a potential source of adjustment difficulties. The term, person–organisation (P–O) fit, has been used to describe the congruence between individual and organisational goals, and between individual preferences or needs and organisational systems or structures. The P–O fit can predict outcomes such as adjustment, job satisfaction, organisational commitment, intention to stay and tenure, as well as affecting communication by reducing ambiguity and conflict (Meglino & Ravlin 1998, Parkes et al. 2001, Rosete 2006). Meglino and Ravlin (1998) suggest that people who hold similar values and goals view the world in similar ways, enabling them to communicate more clearly, anticipate each other’s behaviour and coordinate activities more efficiently – all of which result in reduced role conflict and ambiguity and higher satisfaction with interpersonal relationships. Although not all members of a workgroup may hold the same values, typically a majority of group members are aware of and support those values. A central value system is said to exist when key values concerning behaviours and the way the organisation manages its praxis are shared across all units and levels. The second concept examined by this study is organisational commitment (OC). Over the years, OC has been defined and measured in different ways (Meyer & Allen 1991) and has been the object of a great deal of empirical study, both as consequence and antecedent of other work-related variables. As a consequence, OC has been linked to several personal variables and role states, as well as to aspects of the work environment, ranging from job characteristics to the dimensions of organisational structure. As an antecedent, OC has been used to predict employee absenteeism, performance, turnover intentions, job involvement, job satisfaction and other behaviours (Ingersoll et al. 2000, Shachar 2003, Way et al. 2007). Organisational commitment is defined as the extent of an employee’s identification with, and involvement in, the goals and 500
values of their employer organisation (McNeese-Smith 1986, McNeese-Smith (1996), McNeese-Smith & Crook 2003). Allen and Meyer (1990) and Mathieu and Zajac (1990), emphasizing its intrapersonal aspects, have defined it as a psychological state that binds and links the individual to the organisation (and so makes turnover less likely). Scholl (1981) and Brown (1996) have noted that the concept of commitment is not the same as motivation or general attitudes. They suggest that commitment influences behavior independently of other motives and attitudes and might lead to an employee persisting in a course of action even in the face of conflicting motives or attitudes. Commitment, for example, can lead individuals to behave in ways that, to a neutral observer, might seem contrary to their own self-interest. It is now well recognized that employees develop multiple work-related commitments and that organisational commitment is a multidimensional construct that can take various forms and, arguably, has the potential to influence organisational effectiveness and employee wellbeing (Meyer & Herscovitch 2001). The lack of consensus in the definition of commitment has contributed greatly to its treatment as a multidimensional construct (Meyer & Allen 1991). In general, however, all definitions make reference to the fact that commitment is a stabilizing or obligating force that gives direction to behavior (by, for example, restricting freedom and binding the individual employee to a certain course of action) (Meyer & Herscovitch 2001). Although OC can be defined in terms of commitment-related behaviours, the authors of the present paper approach it in terms of attitudes. Attitudinal commitment represents a state in which an individual identifies with a particular organisation and its goals, and wants to maintain membership of the organisation in order to realize these goals. For the purposes of the present study we have adopted the definition of commitment as the relative strength of an individual’s identification with and involvement in a particular organisation (Porter & Smith 1970; McNeese-Smith & Crook 2003). This identification can be characterized by at least three related factors: (1) a strong belief in and acceptance of the organisation’s goals and values; (2) a willingness to exert considerable effort on behalf of the organisation; and (3) a strong desire to maintain membership in the organisation. When defined in this fashion, commitment represents something beyond mere passive loyalty. It involves an active relationship with the organisation, a willingness to give something of oneself in order to ª 2012 John Wiley & Sons Ltd Journal of Nursing Management, 2014, 22, 499–505
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contribute to the organisation’s wellbeing (Mowday et al. 1979). A number of studies exploring the association between OV and OC were found. Rosete (2006) examined the association between organisational values, human resource management and OC among 325 employees of an Australian public service organisation, finding that individuals who work in environments where a fit exists between OV and performance management systems have a greater level of commitment than other individuals. A relationship between OV and OC was also found in studies among 387 transportation executives (Boxx et al. 1991), among 121 workers of a large petrochemical company (Finegan 2000) and among 386 Chinese managers and 145 workers employed in various private and public service sectors (Siu 2003). In another study, which investigated nurses’ work values, OC and their turnover and intention to leave, a strong mediating effect of OC on the relationship between the work values and intention to leave was reported (Takase et al. 2008). Elizur and Koslovski (2000) studied the relationship between OV and OC among 204 business studies students at two universities in Israel who were also in employed work. They found a positive correlation between values and commitment and that the gender variable, as a moderator, significantly contributed to this correlation. We have found no studies on the association between OV and OC among nurses in Israel.
Multiculturalism in Israel, organisational values and commitment In multicultural societies such as Israel individual cultural values may vary substantially and this disparity may show up within an organisation’s workforce (Bochner & Hesketh 1994). Given that multiculturalism is increasing within organisations, the interaction between the values of individual employees and of the organisation may affect the fit between them. Diverse nursing workforces in Israel reflect the diverse demographics of the Israeli population, which is segmented into a number of socially significant groupings. Jews represent about 80% of the overall population. Almost all non-Jews are Arabs, who differ from Jews in language, cultural norms, traditions, religion and way of life. Further, the Jewish population itself is culturally diverse. The Jewish cultural groupings represented in this research are immigrants from Eastern Europe (the former USSR) and Ethiopia and citizens born in Israel. ª 2012 John Wiley & Sons Ltd Journal of Nursing Management, 2014, 22, 499–505
Ethno-cultural differences among health-care workers have been demonstrated to have a variety of negative effects on communication, role clarity, and job satisfaction. Assessing differences in culturally derived values will provide a more complete understanding of nurses’ ability to adjust and work effectively with coworkers and managers (Allensworth-Davies et al. 2007). A literature review reveals that, with the changing demographics of developed countries with globalization, the shortage of nurses and the growing need for a diversely-recruited nursing workforce at all levels, the interest in cultural diversity is extensive and growing. As a result, the effect of diversity and cultural competence on caring for a diverse population has become a central issue in nurse education, research and health policy (Allensworth-Davies et al. 2007, de Leon Siantz 2008, Scott 2008). While there has been extensive research into the acculturation of new immigrants to a new culture, the association between ethno-cultural values and organisational values has been little explored among nurses in Israel. The effect of ethno-cultural origin on differences in nurses’ organisational values and organisational commitment has received very little empirical attention in the acutecare nursing literature. The present study examined differences in nurses’ organisational commitment and their perception of organisational values in an acute-care general hospital in order to assess how these differences related to the nurses’ ethno-cultural background. The following questions were addressed: What organisational values do nurse-respondents perceive to be the most important? Is there an association between the respondents’ perceived organisational values and their organisational commitment? Is there an association between the respondents’ demographics, their perception of the importance of organisational values and their organisational commitment?
Methods Sample A sample of 140 registered nurses, working in eight units/departments in a large medical centre in central Israel participated in the study. A total of 106 responses (75.7%) were obtained. The nurses were employed in three regular medical care departments (42.5% of the sample), two surgical departments (19.8%) and three intensive care units (37.7%); most (74%) were women. Their average age was 38.8 years 501
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(SD 10.2); 72.8% of the sample were Jews and 25.2% were Muslims. Of the sample (Jews and Arabs) 59.8% were Israeli-born, 21.6% had migrated from the former USSR and 7.8% had migrated from Africa (mainly Ethiopia). The average length of stay in Israel of the immigrants was 21.14 years (SD 11.3). In our sample 22.3% had a registered nurse diploma, 57.3% had a BA degree and 20.4% had an MA degree. Staff nurses comprised 88.5% of the sample and 10.5% were nurse managers and deputy nurse managers. Of the sample 70.5% worked full-time and had an average of 12.1 years’ (SD = 9.6) experience in nursing.
Procedure This cross-sectional study was carried out at the end of 2009. Eight departments were selected to represent the 21 medical–surgical and intensive care nursing departments in the medical centre selected. The questionnaires were distributed together with a letter explaining the aim of the study and guaranteeing respondent anonymity and data confidentiality. The return of a completed questionnaire was taken to convey consent to participate.
Data analysis The instrument A structured three-part, self-administered questionnaire was used. Part 1 – organisational values This section used an instrument tested in several earlier studies (Hendel & Steinman 2002, Hendel & Gefen-Liban 2003, Hendel et al. 2006). It presented respondents with a list of 20 organisational values, such as leadership, risk-taking, competition, vision, power, collaboration, achievements and effectiveness. Respondents were asked to rank their perceived importance of each value on a Likert scale from 1 (the least important) to 7 (the most important). The responses in the present study demonstrated an internal consistency (Cronbach’s alpha) of 0.91.
Descriptive statistics were used to characterize all socio-demographic data. Pearson correlation coefficients were used to evaluate the linear relationships between variables. t-Tests for independent samples were used to examine the differences between the distributions of two groups. Multiple regression analyses were used to examine the unique contribution of independent variables to the dependent ones. In addition, we stratified the sample into subgroups according to background profiles based on gender, nationality, degree of religiosity and professional education and then examined the relations between OV and OC. The level of statistical significance was set at P = 0.05.
Results Part 2 – organisational commitment This section employed the Porter Organisational Commitment Questionnaire (OCQ) (Mowday et al. 1979), which comprises 15 items representing three aspects of the concept. The response format was a seven-point Likert scale ranging from strongly agree to moderately agree, slightly agree, neither agree nor disagree, slightly disagree and moderately disagree to strongly disagree. The higher the overall score the stronger the respondent’s commitment to the organisation. Results were totalled and divided by 15 to arrive at an indicator of the respondent’s organisational commitment. Six items were negative and reverse scored. The OC scale demonstrated, in this study, an internal consistency (Cronbach’s alpha) of 0.78. Part 3 This section gathered socio-demographic data on age, gender, country of origin, religion, professional education, position, professional experience, clinical field of work and part/full-time occupational status. 502
Perception of organisational values’ importance The mean score for perceived organisational values’ importance was 5.96 (SD 0.86), on a scale from 1 to 7. The mean scores for each item are given in Table 1, which shows that the values accorded most importance were quality, cooperation, effectiveness, efficiency and commitment. The perceived five least important values were competition, marketing, power, risk-taking and achievement. There was a significant difference between these two groups of values: the mean score of the five top values was 6.44 compared with 5.41 for the five least-valued values (t = 9.66, P < 0.001).
Organisational commitment The mean score for nurses’ organisational commitment was 4.9 (SD 0.73), on a scale from 1 to 7. Three items scored highest: ‘My decision to work in the organisation was right’ (mean = 5.84, SD 1.43), ‘I am ª 2012 John Wiley & Sons Ltd Journal of Nursing Management, 2014, 22, 499–505
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Table 1 Perceived importance of organisational values (n = 106) Value
Mean
SD
Quality Cooperation Effectiveness Efficiency Commitment Success Authority Innovativeness Technology Culture Initiative Creativity Assertiveness Vision Leadership Achievement Risk-taking Power Marketing Competition
6.59 6.51 6.39 6.33 6.33 6.30 6.12 6.10 6.02 6.01 5.98 5.95 5.88 5.87 5.84 5.81 5.60 5.44 5.36 4.93
0.85 1.06 0.99 1.16 1.14 1.16 1.16 1.31 1.27 1.34 1.10 1.33 1.27 1.21 1.36 1.30 1.72 1.64 1.51 1.81
Scores ranged from 1 (the least important) to 7 (the most important).
willing to exert considerable effort on behalf of the organisation to achieve its goals’ (mean = 5.76, SD 1.34) and ‘The future of the organisation is important to me’ (mean = 5.63, SD 1.25). The lowest score was given to the item that referred to the respondent having the option to leave the hospital for a similar job in another organisation (mean = 2.75, SD 1.56).
Organisational values and commitment: the association with demographic/occupational background Of all the respondents’ socio-demographic and occupational characteristics only two contributed to the differences between the respondents on organisational values and commitment: place of birth and level of academic education. Significant differences were found in the mean scores on perceived importance of organisational values between Israeli-born nurses (mean = 6.00) and Ethiopian-born nurses (mean = 6.59) (t = 2.15; P < 0.0.5). Significant differences were also found between the mean scores of USSR-born nurses (mean = 6.01) and Ethiopian-born nurses (mean = 6.59) on both the importance of organisational values (t = 2.22, P < 0.05) and organisational commitment (mean = 4.81 and mean = 5.38, respectively) (t = 0.61, P < 0.05). Nurses with an MA had higher scores than those with a BA on both organisational values’ importance (mean = 5.92 and mean = 6.32, respectively, t = 1.88, P = 0.06) and organisational commitment (mean = 5.15 and mean = 4.82, respectively, t = 1.76, P = 0.08). The results of the analysis of the association between perceived importance of values and organisational commitment and demographic characteristics are shown in Table 2. As can be seen, the socio-demographic profile Table 2 The association between perceived importance of organisational values and organisational commitment by demographic background (n = 106) Demographics
The relationship between organisational values and commitment A significant positive correlation was found between organisational values and organisational commitment (r = 0.25, P < 0.01). Six of 20 OV items correlated significantly to the mean commitment score: vision (r = 0.33, P < 0.001), commitment as a value (r = 0.28, P < 0.001), achievement (r = 0.26, P < 0.001), leadership (r = 0.25, P < 0.01), power (r = 0.23, P < 0.05) and marketing (r = 0.23, P < 0.05). To identify which elements of OC were influenced most by organisational values the relationship between all OV items and all OC items was tested by multiple regressions. Three commitment items – ‘I am willing to exert considerable effort on behalf of the organisation to achieve its goals’, ‘I talk about the organisation as an excellent place to work’ and ‘The future of the organisation is important to me’ – were found to be the items most influenced by organisational values. ª 2012 John Wiley & Sons Ltd Journal of Nursing Management, 2014, 22, 499–505
Gender Male Female Not known Country of origin Israel Africa (mainly Ethiopia) Former USSR Other Religion Jews Arabs (Muslims) Not known Religious Observance Secular Conservative Orthodox Not known Professional education RN Diploma RN + BA degree RN + MA degree Not known
n
R2
P
27 77 2
0.19 0.04
0.00 NS
61 8 22 15
0.09 .00 0.01
NS NS NS
75 28 3
0.03 0.24
NS 0.01
53 30 20 3
0.04 0.03 0.22
NS NS 0.03
23 59 21 3
0.27 0.04 0.02
0.01 NS NS
NS, non-significant.
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of respondents modifies the effect of OV on OC; when the nurse is male, Muslim, religiously orthodox and without academic education, the effect of OV on OC is higher.
Discussion It is largely since the 1990s that the notion of health care as an economic activity has impinged on nursing paradigms. Since then, nurses have struggled to devise a nursing praxis consistent with the profession’s values while at the same time adjusting to newly-prioritized factors in the health-care environment, such as costs and other economic considerations. This has entailed ethical conflicts (Olson 1998, David 1999). Financial accountability and the need to compete with other health-care institutions for potential consumers are still relatively new considerations for Israeli nurses. Corporate business values, such as productivity, competition, cost-efficiency, achievement and risk taking, derive from models of competitive economics that now undergird the service delivery models of many health-care institutions. In the competitive model, health care is viewed as an interactive market with multiple suppliers competing for customers. Organisational values have a broad impact on all decisions made in and for the organisation and if these values can be shared by all groups within the workforce, the organisation’s effectiveness and achievements should improve. However, the present study shows that nurse respondents scored competition, marketing, power, risk-taking and achievement lowest of all the organisational values presented to them, while a large majority of respondents agreed on the importance of values such as quality, cooperation, effectiveness, efficiency and commitment. This study also addressed the association between organisational values and organisational commitment from an ethno-cultural perspective and considered the possibility of ethno-cultural variance in OV and OC within a single organisation. The results provide some evidence for such a variance. Culture and ethnicity have become increasingly important factors in explaining attitudes and behaviours in the workplace. Researchers have argued that differences between ethno-cultural groups within a single country may be stronger than between countries and that the priorities people assign to different values will affect how they interpret situations and react and behave in given circumstances (Cohen 2007a,b). Although ethno-cultural differences are frequently examined by comparing cross-national data we cannot ignore the cultural or 504
ethnic disparities within a given country, especially in multicultural societies such as Israel. Research findings confirm the role of culture and ethnicity in the perception of organisational values and the level of organisational commitment (Cohen 1999, 2007a,b), and cultural differences among health-care workers have been demonstrated to exert a variety of negative effects on communication, role clarity and job satisfaction. In Israel, the ethno-cultural diversity of its nursing workforce reflects the demographics of the population the nurses serve. The nurses who participated in this study were found to be moderately committed to their employing organisation. Measurement and evaluation of this commitment can help administrators and nurse managers devise means to increase it and bridge gaps in communication. For nurses, the same measurement and evaluation might make them more aware of the quality of their commitment to the organisation and enable them to articulate their reasons for remaining in their job. Values are a critical element of what motivates and rewards nurses. Assessing how differences of culture and ethnicity affect the perception of organisational values provides a fuller understanding of nurses’ ability to adjust to and work effectively with co-workers and managers. Organisational commitment may be essential to the effectiveness and stability of health-care organisations (Shwu-Ru 2008). Despite the contributions this study makes, the results need to be interpreted with caution owing to some methodological limitations. It was conducted in only one medical centre, the sample subgroups were relatively small, particularly the Ethiopian-born group, and only nurses were asked to participate. The small numbers in the subgroups limited our ability to make generalization about the present study’s findings. Despite its limitations, the research findings contribute to a better understanding of the role played by culture and ethnicity in the variation in Israeli nurses’ OV and OC.
Sources of funding No funding has been received for this study.
Ethical approval Ethical approval was obtained from the Management of the hospital where the study was held.
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