The effect of
occupational health and safety on organizational commitment in the clinical
wards of public hospitals affiliated to Guilan
University of Medical Sciences in Rasht
Arman Assar 1 *, Mahnaz Hemmati No’doust Gilani 2
1 Payame Noor
University, Rasht, Iran
1 Department of Public Administration, Faculty of Management, Payame Noor University, Tehran, Iran
*Corresponding
Author: Arman Assar
* Email: arman.assar@yahoo.com
Abstract
Introduction: The success of an organization depends on the commitment and
participation of its employees. Improving occupational health and safety of
employees has led to greater productivity and is a matter of interest to
developed countries. Some of the factors that reduce productivity in this
regard increase costs, including the unfavorable work structure, improper
design of the human-machine relationship, and improper management programs. By
determining the relationship between occupational safety and health status and
organizational commitment, this study proposes solutions to eliminate or modify
the risk factors due to poor occupational safety and health and reduce
financial and human costs due to employee commitment. The main question of this
study is whether there is a significant relationship between organizational
commitment and compliance with the components of occupational health and safety
of clinical staff of public hospitals affiliated with Guilan
University of Medical Sciences in Rasht.
Materials
and Methods: This research is an applied research-descriptive and correlational
study. The statistical and sample population in this study is 60 wards of
public hospitals of Guilan University of Medical
Sciences. Sampling was done by census method and in each section, the
respondents answered the questions as evaluators.
Results: One of the indicators of superiority of one organization over another
is having capable and committed human resources and focusing on organizational
commitment of employees is known as a strategy to increase the performance of
organizations. Increasing organizational commitment increases the incidence of
organizational citizenship behaviors.
Conclusion: The analysis of the data of this study shows that there is a
relationship between the components "Existence of safety instructions and
risk management", "Existence of occupational health and safety
laws" and "Organization safety supports" with organizational
commitment (emotional commitment and normative commitment). And there is no
relationship between the components of "first aid and training" and
"prevention of occupational hazards" with organizational commitment
(emotional commitment and normative commitment).
Keywords: Occupational Health, Safety, Organizational Commitment, Government
Hospital
Introduction
Today,
human resource management plays a wide and sensitive role in advancing the
activities of the organization. This strategic role in practice is related to
the functioning of human resource management subsystems, ie
recruitment and selection, training and development, effective use and
retention of human resources (1).
The success of an organization depends on the
commitment and participation of its employees. McGregor believed that the
biggest challenge for management is to integrate the needs of the organization
with the individual needs of its members. In the United States, the need for
nurses is increasing but the number of nurses is decreasing, one reason for
this may be attention to organizational commitment and the need for nurses (2).
However,
the shortage of medical staff is a real concern for hospitals, and given the globalization
of the economy and the beginning of the migration of educated medical staff to
earn better salaries, benefits and opportunities, not paying attention to this
issue can also cause concern. It imposes a lot on today's hospitals. The most
important cost is the loss of skills and experience in providing patient care,
which is gained by spending scarce resources (3). Inspired by recent studies by
Kaynak et al. in 2016 (4) on the impact of occupational
health and safety as an independent variable on organizational commitment as a
dependent variable in the clinical wards of public hospitals affiliated to Guilan University of Medical Sciences in Rasht to review
and analyze It deals with relationships and provides effective solutions to
improve the performance of the organization. This article examines the impact
of occupational health and safety on organizational commitment in the clinical
wards of hospitals under Guilan University of Medical
Sciences and Rasht, including Razi, Poursina, Amir Al-Momenin,
Dr. Heshmat, Shafa, Al-Zahra, Velayat, and among
medical staff. Nurses, physicians and midwives) was conducted in a period of 5
months from September to December 2017. The statistical population of this
study includes physicians-nurses and midwives and 60 medical wards in public
hospitals of Guilan University of Medical Sciences.
In each section, the respondents answered the questions as an evaluator (total:
243 people) and their answers were averaged to obtain the average score of each
representative for that section. For the organizational commitment variable,
use the Allen and Meyer Organizational Commitment Questionnaire. (1991) with
the dimensions of "normative commitment" and "emotional
commitment" and for the occupational health and safety variable, Kaynak et
al. (2016) with the dimensions of "prevention of occupational
hazards", "first aid and training", "existence of
organizational safety support" "Existence of safety and risk
management guidelines" and "Existence of occupational health and
safety regulations" have been used. PLS 2 and SPSS 24 software were used
for data analysis. After analyzing the collected data, acceptance and rejection
of the following five hypotheses are examined:
Hypothesis
1: The existence of safety and risk management guidelines has a significant
effect on the organizational commitment of the staff of clinical wards of
public hospitals affiliated with Guilan University of
Medical Sciences in Rasht.
Hypothesis
2: The existence of occupational health and safety laws has a significant
effect on the organizational commitment of the staff of clinical wards of
public hospitals affiliated to Guilan University of
Medical Sciences in Rasht.
Hypothesis
3: The existence of first aid and training has a significant effect on the
organizational commitment of the staff of clinical wards of public hospitals
affiliated with Guilan University of Medical Sciences
in Rasht.
Hypothesis
4: Prevention of occupational hazards has a significant effect on the
organizational commitment of the staff of clinical wards of public hospitals
affiliated with Guilan University of Medical Sciences
in Rasht.
Hypothesis
5: Organizational safety support has a significant effect on the organizational
commitment of the staff of clinical wards of public hospitals affiliated with Guilan University of Medical Sciences in Rasht.
Results
1.
Conceptual framework of research
Considering
the review of previous studies and considering that the study of the impact of
occupational health on organizational commitment has not been done in the
country so far, the conceptual model of this research has been taken from the
studies of Kaynak, Toklu, Elci, et al. 2016 after
some changes (Figure 1).
Figure 1. Conceptual model of research based
on conceptual model (Kaynak, Toklu, Elci, et al. 2016).
2. Research data
In this research, a questionnaire which is one of the most common tools
for collecting field data has been used. In the first part, the questionnaire
of demographic characteristics of employees includes gender, education, age,
occupation, type of employment and title of ward and hospital. In the second
part, questions related to the dimensions of occupational health and safety and
in the third part, dimensions of organizational commitment. It was composed of
a range of strongly disagree, disagree, have no opinion, agree and strongly
agree. The specifications of this research questionnaire are as follows in
table 1.
Table 1. Specifications of the research
questionnaire.
|
Variable
|
Number of items
|
Ref
|
|
Occupational
health and safety
|
28
|
(4)
|
|
Organizational
commitment (emotional commitment and normative commitment)
|
16
|
(5)
|
30
questionnaires were distributed among the staff of clinical wards of public
hospitals affiliated with Guilan University of
Medical Sciences in Rasht and using the data obtained from it, the confidence
coefficient was calculated by Cronbach's alpha method (Table 2).
Table 2. Reliability coefficients of the
initial questionnaire.
|
Variable
|
Alpha coefficient
|
|
safety and
risk management instructions
|
0.942
|
|
occupational
health and safety act
|
0.917
|
|
first aid and
training
|
0.873
|
|
Avoid
occupational hazards
|
0.951
|
|
Organizational
safety support
|
0.854
|
|
Emotional
commitment
|
0.955
|
|
Normative
commitment
|
0.958
|
Out
of 60 medical wards of Guilan University of Medical
Sciences, 21 wards belong to Razi Hospital, 3 wards to Poursina Hospital, 6
wards to Amir Al-Momenin Hospital, 6 wards to Dr.
Heshmat Hospital, 10 wards to Shafa Hospital, 10
wards to Al-Zahra Hospital and 4 wards belonging to the hospital Are provinces.
Women
make up 84.8% and men 15.2% of the respondents. Undergraduate, postgraduate and
doctoral study groups are 82.3, 2.9 and 14.8% of the respondents, respectively.
Age groups 20 to 30 Years, 21 to 40 years, 41 to 50 years and 51 to 60 years
have made up 20.2, 40.3, 32.5 and 7% of the respondents, respectively.
Occupational groups: nurse, midwife, medical doctor and faculty members 82.3,
6.2, 1.2 and 10.3% of the respondents, respectively. Definitive,
formal-probationary, contract and contract formal employment groups,
respectively, 53.9, 6.2, 9.9 and They make up 30% of the respondents.
In
this study, the information obtained from the questionnaire after the study, was
classified, to analyze the data and information, according to the objectives
presented, first the amount or value of each variable was determined based on
the data and scores obtained from the questionnaire. Then, describing the
information obtained in the form of descriptive tables and graphs gives an
overview of how they are distributed, which can help in how to use different
statistical models. In the next step, the research hypotheses were tested using
the structural equation method. All these analyzes were performed by Smart PLS
2 and SPSS 24 software.
3.
Description of research variables
Among
the dimensions of occupational health and safety, the presence of first aid and
education with 3.62 and among the dimensions of commitment, emotional
commitment with 3.12 has the highest average.
4.
Inferential statistics
In
this section, to answer the research questions and test the hypotheses, the
partial least squares method was used using Smart PLS 2 software.
5.
Structural model test
In
this section, the research model is reviewed. In the proposed model, the sign
of the variables is as follows:
-
Existence of safety and risk management instructions: SPRM
-
Existence of occupational health and safety laws: SAHR
-
Existence of first aid and training: FAST
-
Occupational hazard prevention: OHP
-
Organization Security Support: OSS
-
Emotional Commitment: Aff-Com
- Normative
Commitment: No-Com
Figure 2. Research model test.
7. Criteria for evaluating the fit of the structural part
7.1. Significant numbers t (t-values)
The most basic criterion for the relationship between structures in
the model (structural part) is the significant number t. If the value of these
numbers exceeds 1.96, it indicates the correctness of the relationship between
the structures and thus confirms the research hypotheses at a 95% confidence
level.
7.2. Standard squares or R2
R2 is a criterion used to connect the measurement part and the
structural part of structural equation modeling and shows the effect that an
exogenous variable has on an endogenous variable as shown in Table 3, given
that the value of R2 for organizational commitment is 0.42, this result means
that about 0.42 of the variance of organizational
commitment is explained by independent variables.
Table 3. Coefficient of determination.
|
|
Determination coefficient
|
|
Organizational
commitment
|
0.428
|
7.3. General Seed Fit Evaluation Criteria
GOF criterion: With this criterion, the researcher can control the
overall section fit after examining the fit of the measurement part and the
structural part of his general research model. Wetzels
et al. (2009) introduced three values of 0.1, 0.25 and 0.36 as weak, medium and
strong values. GOF is calculated as follows:
: The average of the common values of each
structure
: The average values of the
endogenous structures of the model
The amount of this statistic for the present research model is:
Considering that three values of 0.1, 0.25 and 0.36 have been
introduced as weak, medium and strong values (Wetzels
et al., 2009), obtaining the value of 0.555 indicates a good fit for the model.
Discussion
Organizational commitment is an important concept in management
that refers to the nature of the relationship between the individual and the
organization. Researchers have studied this structure extensively, especially
in the field of organizational psychology and organizational behavior (6).
Organizational commitment
and attention to the health and well-being of employees in the workplace is one
of the important effects of strategies on employees' work tendencies.
Organizational commitment requires the establishment of an active relationship between
the employee and the organization, so that the employee with an esoteric
desire, beyond predetermined behaviors, wants to help achieve the goals of the
organization by playing a more active role (7). Studies on organizational
commitment show the importance of the fact that this variable affects other
variables such as performance, citizenship behavior, leaving work (8, 9), job satisfaction and
organizational behavior (10). It is expected that increasing
organizational commitment will increase the incidence of organizational
citizenship behaviors. Experimental findings also confirm this Health care
workers are at risk for nosocomial infections and musculoskeletal injuries from
lifting and transporting patients or putting stress on them. According to the
National Institute for Occupational Safety and Health (NIOSH), the most common injuries in
the healthcare sector are injuries from needle injuries, musculoskeletal
disorders and back injuries. There are five groups of biological, chemical,
physical, ergonomic and psychological factors as well as problems caused by
poor occupational safety (11).
Occupational health and safety focus on health, safety and
well-being, and protects emotional and physical health to guide employees (12).
Improving occupational
health and safety of employees has led to greater productivity and is a matter
of interest to developed countries. Some of the factors that reduce
productivity in this area that increase costs are Improper workplace design,
inappropriate work structure, job-employee mismatch, unfavorable environments,
inappropriate human-machine relationship design, and inappropriate management
plans. The five components of occupational health and safety are
"Occupational Hazard Prevention (OHP)", " Safety procedures and
risk management (SPRM)", "Organizational Safety Supports (OSS)",
"First-aid supports and training (FAST)" and "Safety and health
rules (SAHR)" (4). Organizations of all kinds are
increasingly interested in achieving and proving the proper functioning of
occupational safety and health by controlling occupational safety and health
risks consistent with their overall goals and policies. These organizations
implement their strategies in the form of laws, development of economic
policies and other measures for good safety activities, occupational health and
increasing attention to stakeholders to increase organizational commitment (13). Considering that in recent years
less attention has been paid to the role of occupational health and safety on
organizational commitment among the clinical staff of public hospitals of Guilan University of Medical Sciences in Rasht and due to
the increasing importance of occupational health and safety in ranking and
accreditation of hospitals and attention Failure to pay attention to the job
and safety needs of staff can lead to problems and reduce the motivation and
commitment of clinical staff in hospitals. Therefore, this study seeks to
investigate the components affecting occupational health and safety and its
relationship with organizational commitment (normative commitment and emotional
commitment). Therefore, this study investigates whether the observance of
occupational health and safety principles has an effect on the organizational
commitment of clinical staff of public hospitals of Guilan
University of Medical Sciences in Rasht?
Despite the fact that several studies have been conducted in the
country to assess the satisfaction of various occupations, especially the
nursing profession, but despite the importance of the impact of occupational
health and safety factors on organizational commitment, no study has been
conducted in this field. Also, so far, no applied research on the impact of
occupational health and safety on the organizational commitment of clinical
staff of Guilan University of Medical Sciences in
Rasht and the country's medical universities has not been conducted.
Conclusion
1. Descriptive findings of demographic variables
Based on the description and analysis of the collected data:
Out of 60 medical wards of Guilan
University of Medical Sciences, 21 wards belong to Razi Hospital, 3 wards to
Poursina Hospital, 6 wards to Amir Al-Momenin
Hospital, 6 wards to Dr. Heshmat Hospital, 10 wards to Shafa
Hospital, 10 wards to Al-Zahra Hospital and 4 wards belonging to the hospital
Are provinces. Gender: 84.8% of the respondents were female and 15.2% of the
respondents were male. The education rate is 82.3% for bachelor's respondents,
14.8% of doctoral students and 2.9% of masters. Most respondents (40.3%) are in
the age group of 31 to 40 years. Most of the participants (82.3%) were nurses.
Most respondents (53.9%) had formal-definite employment status.
2. Descriptive findings of the main variables
2.1. Organizational commitment variable:
It can be seen that from the dimensions of organizational
commitment, normative commitment has the lowest average and emotional
commitment has the highest average.
2.2. Components of occupational health:
It can be seen that among the components of occupational health and
safety, the lowest average is related to the dimension of safety support of the
organization and the highest average is related to the dimension of first aid
and training.
3. Results of inferential statistics (results
obtained from research hypotheses)
Hypothesis 1: Existence of safety and risk management guidelines
has a significant effect on the organizational commitment of the staff of
clinical wards of public hospitals affiliated with Guilan
University of Medical Sciences in Rasht.
The general results obtained from the value of the accepted
standard coefficient belong to the variables of the existence of safety
instructions and risk management and organizational commitment and the study of
the research model indicates that this hypothesis is accepted.
According to the research model in a significant way, it was
observed that the value of the t-statistic between these two variables is equal
to 2.45 and since this value is more than the limit value of 1.96, the result
can be at least 95% Trust acknowledged that the existence of safety and risk
management guidelines has a significant impact on employees' organizational
commitment. As it was observed, the existence of safety and risk management
guidelines with a standardized coefficient of 0.167 has a significant positive
effect on the organizational commitment variable.
Hypothesis 2: The existence of occupational health and safety laws
has a significant effect on the organizational commitment of the staff of
clinical wards of public hospitals affiliated with Guilan
University of Medical Sciences in Rasht.
The general results obtained from the value of the accepted
standard coefficient belonging to the variables of the existence of
occupational health and safety laws and organizational commitment and the study
of the research model indicate the acceptance of this hypothesis.
According to the research model in a significant way, it was
observed that the value of t-statistic between the two variables of
occupational health and safety laws and organizational commitment is equal to
3.71 and since this value is more than the limit value of 1.96 As a result, it
can be accepted with at least 95% confidence that the existence of occupational
health and safety laws has a significant effect on organizational commitment.
As it was observed, the existence of occupational health and safety laws with a
standardized coefficient of 0.255 has a significant positive effect on the
organizational commitment variable.
Hypothesis 3: The existence of first aid and training has a
significant effect on the organizational commitment of the staff of clinical
wards of public hospitals affiliated to Guilan
University of Medical Sciences in Rasht.
The general results obtained from the value of the accepted
standard coefficient belonging to the variables of the presence of first aid
and training and organizational commitment and review of the research model
indicate the non-acceptance of this hypothesis.
According to the research model in a significant way, it was
observed that the standardized coefficient between the two variables of the
presence of first aid and training and organizational commitment is equal to
0.05. Also, the value of the t-statistic between these two variables is equal
to 0.9. This value is less than the limit value of 1.96. Therefore, this effect
is meaningless and the existence of first aid and education has no significant
effect on the organizational commitment of the staff of the clinical wards of
public hospitals affiliated with Guilan University of
Medical Sciences in Rasht.
Hypothesis 4: Prevention of occupational hazards has a significant
effect on the organizational commitment of the staff of clinical wards of
public hospitals affiliated with Guilan University of
Medical Sciences in Rasht.
The general results obtained from the value of the accepted
standard coefficient belonging to the variables of professional risk prevention
and organizational commitment and the study of the research model indicate that
this hypothesis is not accepted.
According to the research model in a significant way, it was
observed that the standardized coefficient between the two variables of
professional risk prevention and organizational commitment is -0.148. Also, the
value of t-statistic between these two variables is equal to 1.83. This value
is less than the limit value of 1.96. Therefore, this effect is meaningless and
the prevention of occupational hazards has no significant effect on the
organizational commitment of the staff of the clinical wards of public hospitals
affiliated with Guilan University of Medical Sciences
in Rasht.
Hypothesis 5: Organizational safety support has a significant
effect on the organizational commitment of the staff of clinical wards of
public hospitals affiliated with Guilan University of
Medical Sciences in Rasht.
The general results obtained from the value of the accepted
standard coefficient belonging to the variables of organizational safety
support and organizational commitment and a review of the research model
indicate that this hypothesis is accepted.
According to the research model in a significant way, it was
observed that the value of t-statistic between the two variables of
organizational safety support and organizational commitment is equal to 7.68
and since this value is more than the limit value of 1.96, a result It can be
accepted with at least 95% confidence that organizational safety support has a
significant effect on organizational commitment. And as it was observed, the
safety support of the organization with a standardized coefficient of 0.473 has
a significant positive effect on the variable of organizational commitment.
The results showed that among the components of occupational
health; the Existence of safety and risk management instructions, existence of
occupational health and safety laws, and safety support of the organization
will increase the organizational commitment of the staff of the clinical wards
of public hospitals affiliated to Guilan University
of Medical Sciences in Rasht. According to the results of this study, in order
to increase the organizational commitment of employees, especially employees of
clinical wards of public hospitals affiliated to Guilan
University of Medical Sciences in Rasht, the following practical suggestions
are presented:
1. In order to increase the organizational commitment of employees
and also to reduce absenteeism and leaving work, efforts should be made to
define potential risks and their consequences in the relevant organization, and
the method of doing work following the criteria should be provided to employees
related to that job.
2. The organization pays attention to maintaining the health of its
employees and medical examinations should be performed both at the beginning of
employment and during employment to maintain their health.
3. Try to eliminate dangerous and threatening conditions for
employees' health. And safety laws are enforced under all circumstances.
4. Efforts should be made to provide appropriate medical support to
staff, compensation should be paid in the event of injury, and staff should be
given sufficient time to recover.
5. Design a questionnaire based on indigenous needs.
6. Use other models and organizational commitment questionnaires
such as Balfour and Kessler (1996), Porter’s Organizational Commitment
Questionnaire (POCQ) et al. (1974), which have fewer items.
7. The subject of the research should be done with a comparative
approach in paraclinical and non-clinical wards of hospitals.
8. In future research, accounting commitment should be considered
as one of the dimensions of organizational commitment.
Author contributions
AA and MHNG Contributed to the design and implementation of
the research, analysis of the results and to the writing of the manuscript
Conflict of interest
The authors declare that they have no conflicts of interest.
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