Correlation between Organizational Culture, Quality of Work Life and Burnout (Case Study: Golestan Province State Hospitals)

Transcription

1 International Research Journal of Management Sciences. Vol., 1 (2), 27-32, 2013 Available online at ISSN x 2013 Correlation between Organizational Culture, Quality of Work Life and Burnout (Case Study: Golestan Province State Hospitals) Naser Zanganeh 1 *, Aliakbar Aghaei 2 1 Department of Management, Aliabad Katoul Branch, Islamic Azad University, Aliabad Katoul, Iran 2 Golestan University, Gorgan, Iran ABSTRACT: The main aim of this study is to survey the correlation between organizational culture, quality of work life and burnout in the Golestan province state hospitals. Based on the type of aim, this research is an applied research, and it is a descriptive-correlative research which has been conducted in Field methods are used for collecting the data and the tools for gathering the information are questionnaires. The current research population includes Golestan state hospitals, and the sample size includes 206 individuals. The SPSS 16 software and tests of Kolmogorov-Smirnov, and Spearman's correlation coefficient were used for analyzing the information. This research consists of three main hypotheses and 16 sub-hypotheses. Research results of the main hypotheses showed that a positive and significant correlation exists between the organizational culture, quality of work life, and burnout in the Golestan state hospitals. Also, Research results of the sub-hypotheses tests showed that a significant correlation exists between the components of organizational culture (work involvement, compatibility, adaptability, and mission), components of quality of work life (fair and adequate payment, safe and healthy workplace, providing growth opportunities and continued security, legalism in the organization, social ties in working life, overall living environment, unity and social cohesion in the organization and development of human capabilities), and burnout. At the end, a few applicable and research proposals are provided. Keywords: Organizational culture, Quality of work life, Burnout. INTRODUCTION Studying the culture of an organization acts as a tool for collecting information, and it enables the managers to firstly compare the working groups or sections with each other through this. Secondly, it helps them to prioritize the issues. Thirdly, it detects the staffs perceptions and expectations in order to improve the gap between the current situation and the desired situation (Tsui et al., 2006). Studying the organizational culture of healthcare organizations has a particular sensitivity, because such kinds of organizations which hospitals are on top of them, and due to provision of public health they are considered as the most basic human rights, have encountered difficult challenges, and the most important part of these challenges are related to the organizational culture of such institutions. Thus, having a capable and dominant management over organizational culture is one of the important factors in the hospitals management systems. Hospital management has a crucial role in development and maintenance of organizational culture, and management features of each manager could result in formation of organizational culture in that hospital. Hospital managers (directors) should know that their role and their responsibility in creating a positive environment in the organization result in the satisfaction of staff and patients (Kane, 2009). Denison s organizational culture model is used in this research, which is based on the scientific theories and findings and in addition to the conducted researches in USA, other researches in China, Russia, and Taiwan also support and confirm it. This model has four dimensions of compatibility, work involvement, adaptability and mission. In the recent years, quality of work life programs had a crucial and important role in increasing the labor productivity, thus increasing the efficiency and effectiveness of organizations and large companies. Strategic plans of promoting the work life of the human resources in the organizations is a comprehensive and long-term approach, which means that efficient manpower plays a central role in the transformation of organization (Khadivi, 2007). Quality of work life is a comprehensive program which is designed * Corresponding author. address: n.manag@gmail.com 72

2 to attract the attention and satisfaction of the staff and help them to manage the changes and retain the staff in the organization. Dissatisfaction with the quality of work life is a fundamental problem which affects all of the staff regardless of post or position. Surveying, controlling and detecting all of the influential aspects on the quality of work life is a complicated work (Walton, 1973). In a general definition it could be said that, quality of work life is a mental perception and understanding of staff of an organization from the physical and mental desirability of the workplace and its working conditions (Salmani, 2005). One of the most important factors related to the jobs, especially the difficult jobs, is the burnout. Burnout is a psychological sign and it is more observed in the jobs which involve humans in longer hours. Burnout is a psychological syndrome consisting of three main axes of emotional exhaustion, depersonalization, and feeling of personal inadequacy and it has symptoms such as: chronic fatigue, sleep disturbances, different physical signs, negative and pessimistic tendencies towards colleagues and clients, feeling of guilt, loss of job performance and etc. Burnout is a common phenomenon in the healthcare field, especially among the hospitals personnel. Therapists who experience the burnout are usually physically, emotionally and mentally tired, and this has a wide impact on the quality of caring for the patient, in a way that therapists gradually feel that they can no longer face with the patient. Burnout is a psychological syndrome consisting of emotional fatigue (chronic fatigue, sleep disturbances, different physical signs), depersonalization (negative and pessimistic tendencies towards colleagues and clients, feeling of guilt, isolation, and reduction in daily work), and reduction of feeling of personal adequacy (Dissatisfaction with work, feelings based on failure and inability, loss of ability to recognize and understand, permanent feeling of extortion and exploitation and loss of job performance). This syndrome is more common among the jobs which involve helping people than other jobs. Personnel working in the healthcare section include general practitioners (GP), specialists, nurses and assistants that due to encountering with stressors such as pressures of emotional stress, physical, management and interpersonal pressures they experience more burnout comparing to other jobs (Maslach, 2001). Adler (1996) stated that prioritizing the organizational culture and human resources results in the efficiency and improvement of organizational performance. Studies of Cheung et al (2010) determined that existence of a strong culture in an organization results in the creation of a better feeling for the staff and ultimately results in better performance, increase of the staffs commitment and their alignment with organizational goals. Bent s research showed that a significant inverse correlation exists between the entrepreneurial and collaborative organizational culture and burnout. Also, the research results show that the organizational culture could have a positive effect on the indicators of organization effectiveness such as performance, commitment, self-confidence, and ethical behaviors of staff and workers. Yilmaz (2008) studied the effect of dimensions of Denison s organizational culture model on the performance of organizations. Through this research it was detected that the highest score was for adaptability dimension and the lowest score was for compatibility dimension. Also, the research results indicate that the mission dimension had the highest effect on the increase of manufacturing companies performance. Also, the ability of company in producing new products is severely under the influence of adaptability and compatibility dimensions. The research of Talaei et al (7002) was conducted for surveying the different dimensions of burnout in the employees of health centers in Mashhad. The research results showed that 24.5% of staff had severe emotional exhaustion, 0.7% of them had severe depersonalization and 6.7% of them had low personal adequacy. A significant correlation exits between the three dimensions of burnout, amount of emotional exhaustion and depersonalization, and also the amount of personal adequacy showed a significant correlation with emotional exhaustion. The amount of emotional exhaustion and depersonalization had a significant inverse correlation with the age of staff, but the personal adequacy did not have a significant correlation with the age of staff. It was only in the depersonalization dimension that a significant difference was observed between females and males (with superiority of men). In comparison with other surveys, the high emotional exhaustion is a considerable concern, but in other amounts of burnout in the healthcare centers, the condition was good, and in some statistics, there were huge differences between the other amounts of medical units of Iran and world. Regarding the theoretical relationship of three components of organizational culture, quality of work life and burnout in the management books and also the relationship retrieved from the internal and external investigations conducted in this field, according to the conceptual framework of research (Figure 1) the researcher is looking for existence of a correlation between the organizational culture, quality of work life and burnout in the Golestan province state hospitals, in order to provide a context for promoting the quality of work life and organizational culture of the staff through conducting this research and reduce their burnout in the Golestan state hospitals accordingly. Thus, the main aim of the current study is to answer this main question that does any correlation exist between the organizational culture, quality of work life and burnout in the Golestan province state hospitals or not? 72

3 Figure 1. Research conceptual framework. METHODOLIGY According to the research subject that is studying the correlation between organizational culture, quality of work life and burnout, the descriptive-correlative research method was used, because the aim of descriptive research is to describe the features of a situation or a subject, subjectively, for real and regularly, which means that everything is presented without any intervention or mental inference of the researcher. Correlativity is also the correlation between two or more set of variables, and the degree of these correlations is evaluated and described by the correlation coefficient. Thus methodology of this research is descriptive-correlative survey. From the aim perspective, this research is an applied research. Applied researches are the ones that use the theories, laws, principles and techniques that are edited in the basic researches for solving the implementation and real issues. In this research both library and field methods are used for collecting the data. The current research population consists of the Golestan province state hospitals. For calculating the sample size in this research, the Krejcie and Morgan table is used, and based on this matter that the number of mentioned staff were 412 individuals, the sample size of 196 individuals were extracted from the mentioned table. But, according to this fact that in each research there was the possibility of no return of the questionnaires, 5% was added to the selected sample, and based on this, 206 questionnaires were distributed among the population. Also, for sampling in this research, the simple random sampling was used. The main advantage of this type of sampling is low bias and high capability of generalization of the data. Data collecting tools used were three questionnaires of Denison s organization culture (2004), Walton s quality of work life (1973) and Maslach burnout (1981). Although reliability and validity of all three questionnaires were studied and confirmed in several internal and external researches, the current research was overviewed and all of the reliability coefficients were at the acceptable level. In addition to descriptive statistics, inferential methods of Kolmogorov-Smirnov test and Spearman s correlation coefficient by the use of SPSS 16 software were used for analyzing the data. RESULTS Surveying the demographic information of the research examinees showed that from the whole 206 participating individuals, 175 individuals (equal to 85%) were male, 179 individuals were married, more than 51% of the participants had a bachelor degree and approximately 81% of the research participants were at the age range of 30 to 50, and nearly 60% of these individuals had from 10 to 20 years of work experience. Also the research results of the Kolmogorov- Smirnov test showed that none of the main variables and the research subscales had normal distribution, thus, the 72

4 Spearman s correlation coefficient test was used for surveying the significance of correlation between the research variables. Table 1 and 2 show that the main and sub-hypotheses of the research are tested and the results are observable. Table 1. Results of testing the research main hypotheses. Variable Names R Sig. Conclusion Organizational culture and Rejection of the null quality of work life hypothesis Organizational culture and Rejection of the null burnout hypothesis Quality of work life and Rejection of the null burnout hypothesis *Error rate (P) is 0.01 As you can see in the table1, all three main hypotheses are confirmed. In other words, a significant correlation exits between the organizational culture and quality of work life, and burnout, two by two. But we should consider that only the correlation between organizational culture and quality of work life is positive, which means that by promoting the level of organizational culture, the quality of work life also promotes, and the correlation of burnout with these two variables is negative. Table 2. Results of testing the research sub-hypotheses. Name of correlation Name of subscales R Sig. Compatibility Correlation between quality of Involvement In work work life and subscales of Adaptability organizational culture Mission Compatibility Correlation between burnout Involvement In work and subscales of organizational Adaptability culture Mission Fair payment Secure workplace Providing growth opportunity Correlation between burnout Legalism and subscales of quality of work Social ties life Overall living environment Social unity and cohesion Development of human capabilities *Error rate (P) is As you can see in table 2, all the research sub-hypotheses were confirmed. In other words, all the correlations between the quality of work life, and all the subscales of organizational culture, the correlation between burnout and all the subscales of organizational culture, and correlation between burnout and subscales of quality of work life were reported to be significant. The strongest correlation among them was reported to be the correlation between burnout and fair payment (-0.611), and the weakest one was reported to be the correlation between the quality of work life and compatibility (0. 322). DISCUSSION AND CONCLUSION The main aim of this research was to answer this question that whether a significant correlation exists between the organizational culture, quality of work life and burnout in the Golestan province state hospitals or not. In line with this and based on the three main research hypotheses, 16 sub-hypotheses were discussed and surveyed. Regarding the acceptance of these 16 sub-hypotheses and three following main research hypotheses, it could be stated that a positive and significant correlation exists between the organizational culture, quality of work life and burnout in the Golestan province state hospitals, which means that based on the acceptance of the first main research hypothesis, the more the organizational culture and its components including (involvement in work, compatibility, adaptability, mission) promote, the more the quality of work life promotes. Based on the acceptance of the second main research hypothesis, the more the organizational culture and its components including (involvement in work, compatibility, adaptability, mission) promote, the less the burnout become, and based on the acceptance of the third main research hypothesis, the 00

5 more the quality of work life and its components including (fair and adequate payment, secure healthy workplace, providing growth opportunity and permanent security, legalism in organization, social ties in working life, overall living environment, social unity and cohesion in organization and development of human capabilities) promote, the less the burnout become. Analyzing the results of research questionnaires by the use of Spearman s correlation test which was conducted in a significant level showed that a significant correlation exists between the qualities of work life of the hospital staff with their amount of burnout. And due to the correlation coefficient, it was negative, and this is an inverse correlation. Meaning that by increasing the quality of work life of the staff, their burnout decreases. Thus, for reducing the amount of burnout of the hospital staff, special attention should be put on the seven other components of quality of work life (fair salary payment, social relevance, overall living environment, development of individuals capabilities, providing continuous growth opportunity, legalism in organization, and secure healthy workplace). The current research result was similar to Zomorodi s research (2003) that confirms the existence of an inverse correlation between the variables of quality of work life and burnout with the correlation coefficient of Also the current research result is inexplicitly similar to the Mohammadi (2008) and Fardipour s research (2000). Results of analyzing the questionnaire of quality of work life show that based on the amount of correlation coefficient (-0.611) and the acquired significance level (0.000) an inverse significant level exists between the component of fair payment and burnout. Which means that the fairer the hospital staff get paid for the work they do, the less their burnout. In fact, if the staff get their payment from the organization on-time, and if their salaries are in compatible with their expectations and their work loads and also if the amount of salary is equal in the same situation in other organizations the amount of their burnout will decrease. The results of mean analysis of this component indicate that the hospital staffs are somewhat satisfied with their amount of fair payment. The correlation coefficient is (-0.487) and significance level is (0.000) and an inverse significant correlation exists between the continuous growth opportunity and the burnout, which means that the more the hospital staff have the continuous growth opportunities, the less their burnout will be. Based on the obtained results, if the staff have job security, or in other words if they are recruited formally in the organization, and also if they have the ability to take into action what they have learned at the university, and ultimately if the workplace for growing the capacity and potential ability is provided, definitely by the results of this research their burnout will decrease. Organization managers providing the healthcare should inexplicitly have perceptions and understandings about the beliefs and values dominated in the organization which somehow form the staffs behaviors and stimulate them. If we consider the high death rate and medical errors in the hospitals, we will understand that most of these cases are due to the weakness of the organizational culture in the hospitals. This statement indicating that management is only summarized in the organizational culture and structure is a correct statement (Cheung et al., 2010). A healthy organizational culture provides an open, friendly, trustworthy, creative, collaborative, empirical, scientific, rational, logical, insignificant atmosphere for releasing the individuals abilities and potentialities in the organization. Peter and Waterman researches indicate that supreme superior organizations have a strong positive culture, because this type of culture increases the staffs involvement and agreement on the strategic points and increase their commitment for increasing the efficiency and effectiveness. It seems that the current organizational culture existing in the hospitals can have a positive impact on the quality of work life of staff. In other words, the increase of organizational commitment, work involvement, empowerment and job satisfaction has high correlation with cultural values of human relationships in the hospitals (Gifford, 2002). Due to the importance and influence of dimensions of organizational culture on the quality of work life, it is recommended that the managers pay more attention to the organizational culture and implementing its dimensions on the organization more than before, and provide the context for promoting the level of quality of work life. Regarding the achieved findings of this research, it is suggested that with introducing an appropriate context of culture, the staff tendencies toward non-material and spiritual rewards increase and it provides a context for getting material and spiritual rewards, also the management attention toward coordination between different units of organization, attention toward the risk factors for unity and cohesion from the staff perspective, proposing the necessity and importance of the subject in meetings and emphasis of the higher level management should be taken to account as well. It is recommended to the future researchers who want to study in this field that based on the importance of each and every one of the components of the quality of work life and the need to understand each of them separately, it is suggested to survey the correlation and impact of each of these components with other concepts and organizational categories such as productivity, efficiency, effectiveness, etc. in the research works. In addition to that, based on the Denison s inventory, 4 dimensions of organizational culture are realized in this research, and it is suggested to evaluate the other dimensions of this variable as well. REFERENCES Adler NJ, International Dimensions of Organizational Behavior, 3rd edn. New York: Wadsworth Publishing Company. Bent M, Effect of cognitive-behavioral treatments to PTSD an anger. In social issue :Pottraumatic Stress.17(3): Cheung S, On W, Peter S, Wu P, Ada WY, Towards an organizational culture framework in construction. International journal Project Management. 12(1):

6 Denison, D, Haaland S, Goelzer P, Corporate Culture and Organizational Effectivenss: Is Asia Different From the Rest of the World? Organizational Dynamics. 33(1): Fardipour H, Surveying the quality of work life of accounting units of education offices of nineteen districts of Tehran. MS Thesis, University of Tehran. Gifford BD, Zammuto RF, Goodman EA, The Relationship between Hospital unit culture and nurses Quality of Work life. Journal of Healthcare Management. 47(1): Kane V, Management Role in Shaping Organizational Culture. Journal of Nurs Manage. 14(3): Khadivi A, Introduction to organizational behavior in organizations of third millennium. Tabriz, Shayesteh publication. Maslach D, Jackson SE, The measurement of experienced burnout. Journal of Occupational Behavior. 2: Maslach C, Job Burnout. Annual Review of Psychology. 52: Mohammadi B, Surveying the correlation of quality of work life and the organizational health in secondary schools of Kordestan province. MS Thesis, University of Shahid Rajaei, Tehran. Salmani D, 2005, Quality of work life and the improvement of organizational behavior. Tehran: Management faculty publication. Talaei A, Mokhber N, Mohammadnezhad M, Samari AA, Burnout and factors depended to it in the staff of university hospitals of Mashhad, Koomesh. Research-Scientific journal of Semnan medical sciences university, Semnan. 3: Tsui AS, Zhang Z, Wang H, Xin KR, Wu JB, Unpacking the relationship between CEO leadership behavior and organizational culture. The Leadership Quarterly. 17: Walton RF, Quality of Work life: what is it?. Sloan Management Review. 15(1): Yilmaz CE, Organizational culture and firm effectiveness: An examination of relative effects of culture traits and the balanced culture hypothesis in an emerging economy. Journal of World Business. 43: Zomorodi H, Correlation between the quality of work life and burnout of the principles of Mashhad schools in year. MS Thesis, University Allameh Tabatabaei, Tehran. 07