Abstract: This research aims to determine the most important organizational factors that can direct behaviors, attitudes and interactions of nurses in order to promote Organizational Citizenship Behavior (OCB). This study was conducted at Baqiat-Allah Hospital (one of the most important hospitals in Tehran) from 2009/03 to 2009/09. This is an research (based on its purpose) and descriptive research (based on the data collection method). The structural equation model was used to analyze data. Also a confirmatory factor analysis was used to assess the validity of the variables. The mediating role of commitment and job satisfaction in the relationship between organizational justice and OCB was confirmed. As a result, organizational justice has an indirect, positive and meaningful effect on OCB. Organizational trust was not an intermediary variable in the relationship between justice and OCB. Also the organizational justice effect on OCB did not have a significantly direct effect (p<0.05). Regarding the distinct role of OCB of service quality of hospitals and health service centers, attitude and behavioral factors such as job satisfaction, commitment and especially organizational justice and trust should be considered as shown in this research.
INTRODUCTION
The service sector has produced approximately two-thirds of the world’s Gross National Product (GNP) for the twenty first century. In the service sector, the quality of service is a key strategic value (Roberts and Liegold, 2008). Hospitals and health service centers are very important due to the quality of their healthcare services provided (Gallagher and Rowell, 2003). Despite this fact, the definition of OCB and its related factors has received little attention in nursing. In our country, according to patients’ points of view, there are so many problems in the quality of healthcare services provided to them by hospitals. Nurses activities concern patients (customers). These activities are a vital factor in developing nurse-patient relations. One of the most important factors which can be employed to better the behavior, attitudes and interactions of nurses in order to improve the quality of healthcare services is OCB (Hui et al., 2001). OCB is a kind of behavior which goes beyond the predefined official behaviors by this organization which is not rewarded directly or recognized by official structures, but they are very significant in the operational and functional success of the organization (Hui et al., 2001; Organ and Konovsky, 1989; Robbins, 2001). Regarding the definition, it can be predicted that this kind of behavior would effect nurses attitudes and behavior and direct their activities toward the hospital’s goals and ultimately affect the quality of services given to patients.
This research focuses on the factors that create OCB. Studying the literature of the subject shows although various variables affect on OCB, yet concerning this matter the variables of justice, trust and organizational commitment and job satisfaction have the most frequency. Accordingly, the present research is providing a model of causal relations between organizational justice, trust, commitment and job satisfaction due to clarify OCB variable in the best manner possible.
Job satisfaction is the employer reaction to the roles they play in their jobs (Madhavan, 2001). Specter believes that job satisfaction is a theory that shows how people feel about their jobs in general or its various scopes (Spector, 1997). In the theory of performance-satisfaction, satisfaction in work environment is considered as a derivative variable whose value is affected by comparison made from fair reward. Therefore, according to the variation of these two amplitudes (expected value and reward), the amplitude of satisfaction or non satisfaction would change. Undoubtedly, measuring employees job satisfaction and surveying status that affect increasing or decreasing level of employees satisfaction helps organizations to offer better services, to produce more suitable products and finally, to promote productivity (Lawler and Porter, 1967). What is meant by trust is that the supervisor will act in their interests (Podsakoff et al., 2000). Trust is the unfailing confidence in person’s truthfulness, ability and or their personality (Lypnack and Stamps, 1997).
Greenberg (1990) refers to organizational justice as the just and fair manner in which organizations treat their employees fairly (Greenberg, 1990). These are employers who determine and comprehend fairness of processes and interactions in the organization by surveying and comparing work load, work schedule, salary levels and bonuses (Fernandes and Awamleh, 2006). On this basis, the top manager of an organization may comprehend justice from decision making processes while employers comprehend injustice of the same processes. Organizational justice is generally considered to encompass three different elements: distributive justice, procedural justice and interactional justice (McDowall and Fletcher, 2004). Procedural justice is the fairness of procedures which are used to determine the outcome of decisions (Folger and Konovsky, 1989). These procedures should be consistent, bias free and take the concerns of all parties and be morally acceptable into account (Leventhal, 1980). Interactional justice relates to the fairness of interpersonal communication relating to organizational procedures (McDowall and Fletcher, 2004). It is concerned with how the information was communicated and whether the individuals affected by a decision were treated with respect and dignity (Bies and Moag, 1986). Distributive justice refers to the concerns expressed by employees with regards to the distribution of outcomes and resources (Greenberg, 1990; Cropanzano and Folger, 1989).
In fact, one of the factors which affect the function of labor force in a hospital is OCBs. In spite of this fact, the definition of OCB and its related elements have received lesser attention in health service centers. Hence, this research has attempted to use an experimental test to provide a causal surveying about the impacts of organizational justice on OCB and define the role of mediator variables.
MATERIALS AND METHODS
Whereas the aim of this research is in determining causal relations between variables including organizational justice, organizational commitment, organizational trust, job satisfaction and OCB, therefore this research is practical based on its purpose, descriptive based on its data collection mode and because of its correlation nature. This study distinctly uses the structural equation model to analyze data. The structural equation model (or multi variable analysis, by using latent variables) is a comprehensive statistical approach which is used to test hypotheses concerning the relations between observed and latent variables (Segares, 1997).
In the analytical model of research, organizational justice is an exogenous variable and trust, satisfaction and OCBs are endogenous variables. In another respect, we can consider organizational justice an independent variable, trust and organizational commitment and satisfaction as intermediary variables and OCBs can be considered a dependent variable. The main mean of data collecting is a questionnaire. Various numbers of questionnaires were used to evaluate research variables, including: Beugre's (1998) questionnaire for organizational justice, Potter et al. (1974) questionnaire for organizational commitment, Scott's (1981) questionnaire for organizational trust, Hackman and Oldham (1975) questionnaire for job satisfaction and finally Bateman and Organ (1983) questionnaire for the organizational citizenship behavior. All these questionnaires are based on Likert scaling method.
These tools, which are all standard, are used in management research in the many countries such as Iran and their reliability is confirmed; for instance, in many researches in Iran. Cronbach's alpha coefficient values ranged from 75 to 95% for these questionnaires, which showed an appropriate level of reliability.
In order to assess the reliability of research tools, a primary sample which included 30 numbers of questionnaires was pretested. Next, based on acquired data obtained from questionnaires, the confidence coefficient was calculated using Cronbach's alpha model. Cronbach's alpha coefficients of the research that are shown in Table 2 in parenthesis indicate that the questionnaires are reliable enough. Factor validity was used in assessing the validity of questions. Factor validity is a form of construct validity which is acquired from factor analysis (Hair et al., 1998). Factor analysis is a statistical method which is used quite often in Humanitaries. In fact, the use of factor analysis is essential in such majors that use questions and questionnaires and their variables are latent (Kline, 1994). In this research the value of KMO (Kaiser-Meyer-Olkin Measure) acquired from confirmatory factor analysis for organizational justice has been calculated as, or is equivalent to 0/961% and value of significant for Bartlett's Test of Sphericity is p<0.001. Explained variance for organizational justice is calculated as 73.76. The value of KMO of confirmatory factor analysis of endogenous variables, which are trust, satisfaction and OCBs, is 0/831 and the value of significant obtained for Bartlett's Test of Sphericity is p<0.001. The shares of per explained variance are as bellow: 19/09 related to commitment, 17/79 related to satisfaction, 13/91% for organizational trust and 6/65% for citizenship behaviors that define 57/41% of the total variance. Regarding KMO>0/8 and value of significant Bartlett's Test of Sphericity (p<0/05) for both endogenous and exogenous variables, it is concluded that questions have proper validity.
The statistical population for this research was official nurses at Baqiat-Allah (A.S.) Hospital Simple random sampling was used based on the nature of statistical population (the generality of behavioral variables for entire members of the universe). The number of statistical population of nurses is N = 504. The variance for a pretesting sample of thirty is calculated as 0.25. According to the sampling formula of a limited population, with an error rate (E) of 0.075 and α = 0.05, a sample with a size equaling 129 subjects was tested. By considering rate of return as 90% of questionnaires, 140 questionnaires were distributed. Calculating statistical sample of the research is shown in the below formula:
| (1) |
| (2) |
Respondent characteristics of the sample of nurses show that 51.2% of sample size are men, 2% of sample size have a M.Sc, 6% have an Associate degree and the others have a high school diploma or less, 18% of these nurses were supervisors, 43% of them less than 10 years, 13% more than 20 years and 34% averaged between 10 to 20 years have records of service, 7% of the sample age was under 25, 81% was averaged 25 to 45 and 12% was older than 45.
RESULTS
Results of surveying the variables of the research by statistical universe average test are shown in Table 1.
As can be seen, job satisfaction, organizational commitment and OCB variables are in a befitting state. On the other hand, the two variables of trust and organizational justice are in a medial state.
The results of correlation analysis indicate positive and significant correlation relations between exogenous and endogenous variables of the model. Correlation between variables is shown in Table 2. The values in parenthesis are Cronbach's alpha coefficient for each variable.
Also as Table 2 shows the Cronbach's alpha coefficient for all variables are at a recommended level that confirms the questionnaire’s validity.
| Table 1: | Assessment research variables through mean test of statistical universe (*H0: μ = 3) |
| *H0: μ = 3 | |
| Table 2: | Correlation between research |
| **Significant level = 0.01 | |
| Fig. 1: | Research model. Measurement model and research structural model and questions factor loads and the variables effects are shown in this diagram. Significant level is 0.05 (p<0.05). The effects that are not significant have been drawn with dotted line. Unlike organizational trust, job satisfaction and commitment variables have intermediary role between organizational justice and organizational citizenship behavior |
The measurement model and structural model of the research and the factor loads of questions and variables effects are calculated by LISREL 8.5 software and shown in Diagram 1. Factor loads of whole questions are significant in the level of p<0/05. The value of model fitness indices are as: χ2/df, CFI = 0.94, NNFI = 0.94 and RMSE = 0/08 which indicate proper fitness of the model.
As shown in Fig. 1, questionnaire items are illustrated in rectangular form and all variables are shown in oval shapes as they are latent variables. The values that are shown between items and variables are the item factor loading related to its variable. In this model, factor loads of entire questions were significant. Values between two variables in the first row indicate the effect of one variable on the other. In the second row, the value in parenthesis indicates the significance level of the above mentioned effect at a significance level of p<0/05. As shown in the figure, the all affections, except direct effect of organizational justice on citizenship behavior and the effect of organizational trust on OCB, are significant in mentioned level. Hence, between three illustrated directions of the effect of organizational trust on citizenship behavior, two directions (job satisfaction and organizational commitment) are complete and one direction (organizational trust) is discontinuous. Also, organizational justice cannot have direct significant effect on citizenship behavior. Provided that, it can be said that job satisfaction and organizational commitment variables are intermediates between organizational justice and citizenship behavior. Detailed values of these effects are illustrated in Table 3.
Significant results are acquired concerning the relations between parts of the model at significance level of p<0.05.
Organizational justice has a direct, positive and significant effect on organizational trust which is equal to 0.84. But organizational justice is not a positive, direct and significant effect on citizenship behavior; therefore, this intermediary role of organizational trust in the relation of organizational justice and citizenship behavior in the model does not confirm and organizational justice does not have any indirect effect on OCB through organizational trust.
| Table 3: | Direct and indirect effects: Details of the effects values according to research model are shown in this table(p<0.05) |
| **Effects of the rows on columns are shown | |
Organizational justice has a direct, positive and significant effect on job satisfaction which is 0/87. Also, job satisfaction has a positive, direct and significant effect on citizenship behavior which is 0.79; so, the mediating role of job satisfaction in the relation of organizational justice and citizenship behavior in the model is confirmed. By confirming the mediating role of organizational trust, organizational justice has an indirect, positive and significant effect on citizenship behavior which is 0.558.
Organizational justice has a direct, positive and significant effect on organizational commitment which is 0.46. Also, organizational commitment has a direct, positive and significant effect on citizenship behavior which is 0.47; thus, the mediating role of organizational commitment in the relation of organizational justice and citizenship behavior is confirmed in the model. By confirming the mediating role of organizational commitment, organizational justice has an indirect, positive and significant effect on citizenship behavior which is 0.177.
Hence, summation of the entire indirect effects of organizational justice on OCB through two confirmed directions; commitment and job satisfaction is 0.736. Whereas organizational justice has not had a positive, direct and significant effect on citizenship effect, a combination of the direct and indirect effects (total effect of organizational justice) on citizenship behaviors of nurses is 0.736.
DISCUSSION
Many researchers have separately studied the mediating role of organizational commitment, satisfaction and trust. But this is the first research that studies the mediating role of organizational commitment, satisfaction and trust as whole in a scientific model. Erturk, Wat and Aryee, in their own researches, have shown that trust in the relation between organizational justice and OCBs has a complete intermediary role (Erturk, 2007; Wat and Shaffer, 2005; Aryee et al., 2002). Bulnet in his own researches has introduced the trust of a supervisor as a predictor variable of OCBs which is in contradiction with result of above researches. This research does not confirm the results of the abovementioned researches. The average status of organizational trust is in accordance with the previous result, that is to say, organizational trust does not have any effect on citizenship behaviors. It appears that by improving organizational justice and trust, one can witness the effect of organizational trust on citizenship behaviors. In his research Lavelle has come to the conclusion that organizational commitment plays an intermediary role in the relationship between organizational trust and citizenship behaviors (Lavelle, 2008). Goris’s experimental test was an indicator of the intermediary role of the job satisfaction variable between the two variables citizenship and organizational justice (Goris, 2000). The research carried out by Laschinger and Finegan has revealed that fair actions of management have a positive effect on job satisfaction and organizational commitment (Laschinger et al., 2001). Mulder et al. (2006) has revealed that by exerting justice in organizational procedures not only organizational identity will be reinforced but the trust between manager and staffs will also increase. The present research supports the results of these researches.
Regarding the special role of service quality in hospitals and health centers and sensitivity of the interactions between nurses and management and particularly between nurses and patients (customers), specific attention to promoting items of behavioral and theoretical variables such as job satisfaction, trust, commitment and particularly OCB is essential. As former researches have revealed, implementation of organizational justice dimensions in different scopes of an organization has a profound effect on strengthen mentioned behavioral and theoretical variables. In this case study, the statuses of all of variable are good except that of organizational justice and trust. Due to the specific effects of organizational justice and trust on important organizational factors such as OCB, these two variables should be improved in the organization studied. In order to improve organizational trust status, some required efforts is proposed, including: increased employee participate in decision-making and institutional affairs, holding periodic meetings to create understanding between managers and employees and attending to the material and spiritual needs of people. Also in order to improve organizational justice, it is proposed that procedures be established for fair decision making and fair interaction. In addition, it is suggested that a performance-based service compensation system to compensate members of the organization, be designed.
ACKNOWLEDGMENT
The authors would like to thank the Faculty of Management of Imam Sadiq (A.S.) University and Baqiat-Allah (A.S.) Hospital for supporting this research activity.