Antecedents and Consequences of Job Satisfaction: Evidence from Hospitals of Khyber Pakhtunkhwa (KPK)

Abstract

Job satisfaction has grasped the attention of many researchers, authors and practitioners. Job satisfaction as a subject realized the significance of organizational commitment. The current study explored the antecedents of job satisfaction and its effects on Organization commitment. A sample of 135 of doctors serving in hospitals of Khyber Pukhtoon Khawah (KPK) participated in the current study. Results indicated that doctors face certain problems like work conflict, and role stress which reduces their level of job satisfaction. Moreover, factors like autonomy and relationship with supervisor have positive impact on job satisfaction. Besides, job satisfaction resulted in organizational commitment. So, management of hospitals and policy makers need to take effective measures to solve above mentioned factors which hinder the job satisfaction and commitment of the doctors in hospitals of KPK Pakistan.

Headnote

Abstract

Job satisfaction has grasped the attention of many researchers, authors and practitioners. Job satisfaction as a subject realized the significance of organizational commitment. The current study explored the antecedents of job satisfaction and its effects on Organization commitment. A sample of 135 of doctors serving in hospitals of Khyber Pukhtoon Khawah (KPK) participated in the current study. Results indicated that doctors face certain problems like work conflict, and role stress which reduces their level of job satisfaction. Moreover, factors like autonomy and relationship with supervisor have positive impact on job satisfaction. Besides, job satisfaction resulted in organizational commitment. So, management of hospitals and policy makers need to take effective measures to solve above mentioned factors which hinder the job satisfaction and commitment of the doctors in hospitals of KPK Pakistan.

Keywords: Work Conflict, Role Stress, Autonomy, Relationship with Supervisor, Job Satisfaction, Organizational Commitment, KPK Hospitals

Introduction

The phenomenon of job satisfaction is one's emotional state towards his or her job and is vital for organization success. According to Locke and Lathan (1976), "Job satisfaction is a pleasurable or positive emotional state resulting from the appraisal of one's job and job experiences" (p.1300).Employee's positive attitude towards his or her job assignments is the reflection of his or her commitment with the organization which in turn proves to be fruitful for success of the organization. Job satisfaction is a priceless asset and previous research predominantly signified its significance for the organizations establishing the fact that more satisfied the employees are better will be their performance (Hafizh & Imam, 2012; Hunter & Tietyen, 1997; Keller, 1975; Linz, 2002; Nelson, 2006; Malik 2010).

The previous literature predominantly signified the positive effects of organization commitment e.g. improved retention, regularity, increased participation in organization^ affairs and decrease in employee turnover (Mathien & Zajac, 1990; Meyer, Herscovitech & Topolnysky, 2002).This consequently facilitates in providing better products and services in an effective and efficient manner (Coope-Hakim &Visewasavaran,2005).

Many notable studies were previously conducted in health sector of Pakistan. Doctor's role in the health sector is very crucial and recent research highlighted negative consequences of doctor's dissatisfaction with their job related matters which consequently has negative effect on the overall system of Public hospital and the health care quality,(Alamdar&Aleem,2014 ; Ghazali, Shah, Zaidi, & Tahir, 2007;Hafeez et al.,2010;Kazmi,2011;Khawaja et al.,2004). Ali and Wajidi (2013) in their seminal work established that certain factors like career development opportunities, promotion and work load structure were found highly associated with satisfaction of employees. Alamdar and Aleem (2014) concluded that working conditions, nature of work, pay and promotion factor significantly improves satisfaction level in Autonomous Medical Health Institutions. A study by Jaiswal et al. (2015) among employees working in hospitals of India suggested that hospital administration should focus on satisfaction of employees on priority as it will not only be fruitful for financial health of the organization but will also enhance psychological and social well-being of the employees. Some other studies among doctors in Pakistan have concluded that factors which create dissatisfaction include prevailing working environment, time pressure/work load, low salaries/ reward system, work life conflicts and less training and development opportunities. These studies further suggested that the appropriate strategies for creating conducive environment, incentive based remuneration system needs to move rigorously in a positive direction (Abida, Rizwana, Maqsood& Arshad 2009; Kumar et al., 2013; Zohaib,Kamran, Atif& Samar., 2014). A number of studies have been conducted by different practitioners for finding factors that influence job satisfaction and they found salary, promotion, recognition, autonomy, and relationship with supervisor and relationship with co-worker, working condition, role conflicts, role stress, and many more to be responsible for it (Aziz, Goldman & Olsen, 2007; Jen, 2010; Locke, 1976; Purani & Sahadev, 2007). In addition to it, previous studies on job satisfaction in hospitals examined factors in term of role stress, role conflict and work load (Rubin, 2009). The present study aims to identify the antecedents e.g. work family conflict (i.e. family to work and work to family), role stress (i.e. role ambiguity, role conflict), autonomy, relationship with supervisor and consequences of job satisfaction i.e. organization commitment by choosing the sample from KPK Hospitals. Census record of 2010-11 says that Khyber Pukhtoon Khawah (KPK) has an approximate population of 22676855 .The statistics of hospitals of KPK are 17% of the total Pakistani hospital approximately. War on terrorism and law and order situation in KPK particularly after the incident of 9/11 has affected health sector employees.

Literature is replete with research on a very important aspect of work-family conflict. According to Greenhaus and Beutell (1985) work-family conflict is "a form of inter-role conflict in which the role pressures from the work and family domains are mutually incompatible in some respect" (p. 77).It may be work to family conflict and family to workconflict. Previous research has demonstrated that larger family size and family duties put pressure on employees who consequently have detrimental effects on employee's health and hence he is unable to give full attention towards his job assignments. Such conflicts in turn contribute to dissatisfaction with the job (Olorunfemi, 2009).The gender wise analysis previously revealed that among females the negative relationship between work family conflicts to job satisfaction is more than men (Bruck, Allen & Spector 2002; Kossek&Ozeki, 1998). Earlier research predominantly concluded that as Work family conflict (i.e. Family to Work and Work to family) increases there will be significant decrease in job satisfaction (Chen & Kao, 2011; Kahn et al., 1964; Netemeyer, Boles, & McMurrian, 1996).

Role stress refers to role ambiguity and role conflict (Chan, 2011; Grandey and Cropanzano, 1999).Putting in another way, role stress is due to organizational role which creates possible unpleasant and adverse consequences for the employee (Ahsan et al., 2009; Kahn & Quin, 1970). Rizzo, House, and Lirtzman (1970) define role conflict as "the incompatibility of requirements and expectations from the role, where compatibility is being judged on a set of conditions that impact performance". It has two dimensions such as role conflict and role ambiguity (Chen & Kao, 2011; Rizzo, House, 1972). According to Kahn et al., (1964) employees face complex and constantly changing tasks in the organization which vary their expectations along with the organizational roles. This ultimately results in role ambiguity and conflict which leads to lower satisfaction. The managers make different rules compatible to the situation. This creates a gap between the actual and desired outcome for the employees which arises role conflict (Kopelman, Greenhaus, & Connolly, 1983). House and Rizzo (1972) found that role ambiguity is more strongly correlated to job satisfaction than that of role conflict. Previous research has concluded that role conflict and role ambiguity negatively affect the level of job satisfaction (Cervoni & DeLucia-Waack, 2011; David, Syed, Zaini & Nilufar, 2009; Mansoor et al., 2011; Moura, Orgambídez-Ramos & Gonçalves, 2014; Rizzo, House & Lirtzman, 1970).A study conducted by Ling, Bahron and Boroh (2014) tested the relationship between role stress and job satisfaction in banking sector. Findings of the study reconfirmed the relationship between role stress and job satisfaction i.e. high level of role stress significantly related with low levels of job satisfaction. The study also highlighted the negative consequences of this relationship which may lead to poor performance and propensity to leave.

When employees are given the freedom to self-governance or to act what they know is called Autonomy (Aiken, Sloane, & Lake, 1997; Guest, 2004, 2005). Frankfurt (1989) identifies two types of freedom which is linked with autonomy. The first one is freedom of action and the second one freedom of will. Previous research has shown positive association between the level of autonomy and job satisfaction (Benson & Lawler, 2005; George& Karen, 2007; Jen-Te Yang, 2010; Ross& Reskin, 1992).

The evaluation of relation between the employee and their supervisor is considered a relationship with supervisor (Minsky, 2002). Jung and Avolio (2002) scrutinize the relationship between the supervisors and subordinate and concluded that it lead to job satisfaction. Friedlander and Margulies (1969) stated that pleasant relationship with co-worker influences job satisfaction in a positive way. Herzberg (1966) considered relationship with supervisor as one of the highest rated factor that produces job satisfaction.

According to Meyer and Allen (1991) organizational commitment "is a psychological state that characterizes the employee's relationship with the organization, and has implications for the decision to continue membership in the organization" (p. 67).He further conceptualized the concept into effective, normative and continuance commitment. Previous research highlighted the positive role of job satisfaction with the organization commitment (Kotze & Roodt 2005; Mathieu & Zajac, 1990).

The current study aimed at evaluating the antecedents of job satisfaction among the doctors in the hospitals of KPK. The study also aimed at assessing the dominant factors among these. It further investigated the effect of job satisfaction on organization commitment. Thus, the researcher devised the following research hypotheses of the study:

1. Work-family conflict i.e. works to family and family to work is negatively associated with job satisfaction.

2. Role stress i.e. role ambiguity and role conflict is negatively associated with job satisfaction.

3. There would be positive relationship between autonomy the employee has and job satisfaction.

4. There would be positive relationship between relation with supervisor and job satisfaction.

5. There would be positive relationship between job satisfaction and organization commitment.

Methodology

Sample

The present study was cross-sectional and quantitative in nature. Moreover, the population of the study was doctors of the hospitals of KPK. Convenience sampling technique was used for data collection. For that purpose, 200 questionnaires were distributed in public hospitals of KPK (i.e. Lady Reading Hospital, Peshawar Medical Complex, Mardan Medical complex, SherPao Hospital Peshawar) and 155 were responded out of which 1 35 were complete and useable. Respondents constituted 99(72%) males and 36(26.5%) females. Age statistics were 25 or below (16.9%), 25-30(44.1%), 30-35(24.3%), 35-40(11%), 40 or above (2.9%).Marital status of the respondents was 67(49.3%) Single, 66(48.5%) married, 2(1.5%) divorced. The statistics representing the job levels of the respondents were 72(52.9%) training medical officers, 27(19.9%) medical officers, 8(5.9%) assistant registrars, 5(3.7%) ward-in charges and others 21(15%).The statistics regarding frequency of emergency calls were 13(9.6%) once a week ,81(59.6%) twice in a week 81(59.9) and 40(29.4%) daily. The shift wise analysis demonstrated that 29(21.3%) were in morning shift, 11(8%) were in evening shift and 95(69.9%) were in both. The statistics regarding the specialization of doctors participating in the study were 63(46.3%) surgeons, 15(11%) ENTs, 11(8.1%) Cardiologists, 16(11.8%) General Physicians and others 29(21.3%).

Instruments

Previous validated instruments with five-point Likert scale were used in the current study. The instrument of Grandley (2005) was adapted to measure work conflict (8 items).Among 8 items, four items comprised of family to work conflict and four items were of work to family conflict. To measure role stress, a previously validated instrument of Netemeyer et al., (2005) was adapted which was measured through role ambiguity (7 items) and role conflict (7 items). For measuring autonomy, 5 items scale was adapted from Breaugh (1989). For measuring relationship with supervisor, 6 items scale was adapted from Beinart (2004). For measuring job satisfaction, 5 items scale was adapted from Autry and Daugherty (2003). For measuring organization commitment, 8 items scale was adapted from Meyer and Allen (1984).To ensure face validity twenty doctors of SherPao Hospital were contacted and according to their consultation the inconsistencies in the items were removed. As instrument for all the constructs was adapted from previous studies, thus, content validity was assured. Moreover, the internal consistency of each variable was measured through Cronbach's Alpha (a). For example Alpha values for Worktofamilyconflict(0.69),familytoworkconflic(0.80),roleambiguity(0.78),roleconflict(0.87),autonomy(0.81 ^relationship with supervisor(0.72) and job satisfaction (0.75).All the values showed satisfactory results and all values were above 0.60 (Kerlinger and Lee, 2000). The normality was confirmed through skewness and kurtosis values which were found within the acceptable range. SPSS 17 software was used for data analysis.

Results

Descriptive analysis, reliability, correlation analysis and regression analysis were used to evaluate the study objects as highlighted previously.

Table 1 presented the means and standard deviations. All the variables were found significantly correlated as hypothesized.

Correlation result indicated that both Family to work conflict (r=-0.42) and work to family conflict (r=0.43) were found inversely related with satisfaction level of doctors respectively. The overall relation of construct Work conflict was found (-0.488) which was negatively related with job satisfaction. Role ambiguity(r=-0.421) and role conflict (r=-0.167) was also negatively related with job satisfaction respectively. The overall relation of Role stress (which was measured through role ambiguity and role conflict) was also significantly related with job satisfaction (-0.313).Similarly the factors autonomy (r= 0.217) and Relationship with supervisor (r=0.205) was positively related with job satisfaction. Job satisfaction was significantly related with organization commitment (r=0.289).

Linear regression results for all the independent constructs namely Work conflict (WC), Role stress (RS), Autonomy (AT), Relationship with supervisor (RWS) with Job satisfaction was examined individually. Significant relationships were found for all the constructs with job satisfaction (Table II).Similarly job satisfaction was also significantly related with organization commitment (TableII).

Multiple regression results revealed that overall all the four antecedents i.e. work conflict, role stress, autonomy and relationship with supervisor explained 28% (i.e. R2=.297) in dependent variable i.e. job satisfaction.

A stepwise multiple regressions were also conducted to evaluate the dominant factor contributing job satisfaction. Results revealed (Table III) that out of four, two factors work conflict (beta = -0.481) followed by autonomy factor (beta = 0.202) were found dominantly contributing towards job satisfaction. R2 for the factor work conflict contributes 23.8% in job satisfaction and when the factor autonomy was added in the model, R2 increases to 0.279 with increase of 4 % approximately.

Discussion

The present study focused on antecedents i.e. work conflict, role stress. Autonomy and relationship with supervisor of job satisfaction and its consequence i.e. organization commitment. Regression results revealed that all the hypothesised relationships were found significantly related with job satisfaction. Results of the study revealed that work family conflict was the dominant factor affecting the job satisfaction of the doctors i.e more the work family conflict, less will be the satisfaction level with the job. It may be noted that work to family and family to work conflict both significantly negatively related with the job satisfaction of the sample of the doctor under study. The results of the current study corroborate with the previous findings (Kahn et al., 1964; Netemeyer, Boles, & McMurrian, 1996).

Moreover, Gozukara and Colakoglu (2016) stated that employees become dissatisfied with their jobs when they are unable to balance their work and family duties.The descriptive results further demonstrated that mean value of work to family conflict and family to work conflict were on agreement side which indicated that sample of the doctors had problems in maintaining the balance between work and family. Majority of the doctors felt that their job effects their family life and vice versa. The reasons may be the daily emergency calls due to war against terrorism situation prevailing in the province of KPK, shortage of medical staff and duties timings i.e. working in both shifts etc. Role stress is significantly negatively related with level of job satisfaction. The results also revealed that both role ambiguity and role conflict are negatively related with the criterion i.e. job satisfaction. This signifies that more is the role ambiguity and role conflict the employees will have less satisfaction level. The results of the current study corroborate with the previous findings (Cervoni & DeLucia-Waack, 2011; David,Syed, Zaini & Nilufar ,2009; Jen-Te Yang,2010; Mansoor et al., 2011; Ling,Bahron& Boroh,2014 ; Moura et al., 2014; Rizzo,House& Lirtzman, 1970;Samartha et al. ,2011).

The factor autonomy is found to be significantly positively related with level of job satisfaction. The results of the study have established that more autonomy the employee has in his/her job the more will be the job satisfaction. Belias, Koustelios, Sdrolias, & Aspridis (2015) found significant relationship between job autonomy and job satisfaction.Moreover, the results of the current study corroborate with the previous findings (Benson & Lawler, 2005; George & Karen, 2007; Jen-Te Yang, 2010; Kuo, 2010; Lee, 1998; Ross & Reskin, 1992).Better relationship with supervisor was also found to enhance job satisfaction. This factor has significant positive relationship with job satisfaction. Job satisfaction was found significantly related with organizational commitment. Dhurup, Surujlal, & Kabongo (2016) probed the significant effect of job satisfaction on organizational commitment.The result reiterated the fact that more the job satisfaction the more will be the organizational commitment and thus is aligned with previous research (Kotze&Roodt 2005; Mathieu &Zajac, 1990).

Limitations

The study has certain potential limitations. The sample size of the study is limited to the responses of doctors of one province only i.e. KPK. Thus results may not be generalized to wider population. Therefore, in future larger sample may be considered which cater responses from all four provinces of Pakistan so that results may be generalized. The longitudinal study is also suggested .The risk of common method biased is also there as in any survey study therefore the limitation of response bias cannot be ignored.

Conclusions

It can be concluded that the factors like work-family conflict (i.e. Family to Work and Work to family) and Role stress (i.e. role ambiguity and role conflict) are negatively related with job satisfaction .Similarly, the factor autonomy and relationship with supervisor are positively related with job satisfaction. Job satisfaction in turn is positively related with organizational commitment.

This study offered some useful managerial implications. Management of hospitals should assess the work load of the doctors to facilitate the balance between work and family life. Furthermore, the management of the hospitals should also review the role stress as it affects the job satisfaction of the employees. The study provided useful evidence that satisfaction of hospital staff can be strengthened through minimizing the role stress, work-family conflicts and enhancing the supervisor support and work place autonomy which, of course, facilitate in maintaining the better customer service. The management should ensure the confidence building measures like interactive sessions to obtain the in-depth causes of these variables that may affect the doctors 'satisfaction level as well as their commitment to the hospitals.

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