Document Type : Original articles
Authors
1 Nursing Administration
2 Professor of Nursing Administration, Faculty of Nursing – Minia University
3 Assistant. Professor of Nursing Administration, Faculty of Nursing – Minia University
4 Lecturer of Nursing Administration, Faculty of Nursing – Minia University
Abstract
Keywords
Introduction
The health sector is one of the important sectors due to the vital role it plays at the present time. This requires conducting more research to improve the level of service it provides to a wide range of people Society (Rosen et al., 2018). The nursing job is one of the jobs in which there are many sources of pressure, which make workers are dissatisfied with their profession or their organizations, and their low level of quality of work life, which results in negative and cynical expressions that reflect on their job performance (Saleem, 2017).
Capital had been a bottleneck for many years, but this view is no longer correct. Working and keeping human resource in good shape is the bottleneck (Fatima, 2017). Therefore, after the organizations realize that the main way towards achieving their goals is through the human element. Which has become the subject of interest in many administrative and behavioral researches, which have tested many Various organizational characteristics, such as organizational cynicism, Quality of work life (QWL) and employee effectiveness for the purpose of knowing what surrounds workers in the workplace and how the characteristics of their organizations to perform their work (Al-Kurdi et al., 2020).
Cynicism is among the salient concepts that have emerged in the field of organizational behavior in recent years. Although its synonyms include “skepticism,” “incredulity,” “insecurity,” “disbelief,” “pessimism” and “negation,” in the modern sense, a cynic is “one who finds faults, the one who likes things with difficulty, and the one who criticizes” (Kökalan, 2019). Organizational cynicism can be defined as general or specific attitudes of disappointment, insecurity, hopelessness, anger, mistrust of institutions or persons, group, ideology, and social skills (Peter & Chima, 2018). In other words, organizational cynicism is the negative attitude that is developed by individuals against the organization in which they work (Jiang et al., 2019).
Organizational cynicism is a pessimistic approach that involves three dimensions; the first dimension of organizational cynicism is cognitive (belief)dimension. It is the belief in the organization's lack of honesty. It consists of the belief that the organization's practices are deficient in justice, honesty, and sincerity. Second dimension of organizational cynicism is affective (emotional) dimension that consists of strong emotional reactions towards the organization. The last dimension is behavioral dimensionthat refers to negative tendencies and mainly humiliating attitudes. It consists of negative and frequently critical attitudes. Therefore, Organizational cynicism is a learned response that is affected by workplace experiences
(Mousa, 2018).
Employees who are cynical can influence the entire organization and can hinder the organization from reaching its goals. If majority of employees are cynical, there are chances of having more negative outcomes in the organizations. Thus, these employees will show less commitment to organizations. The chances of employee's turnover are quiet high with more cynicism since more stress and burnout are associated with organizational cynicism. In addition, the organizational cynicism brings negative results to the organization in terms of quality of employee work life and satisfaction (Brown et al., 2019).
Quality of work life (QWL) has become a prime importance in today’s corporate world. Every organization wants to improve the quality of work life of their employees, as the organizations have started believing that good quality of work life can help achieving the desired outcomes. And so, it is important to understand the concept of quality of work life (Gupta et al., 2019).
Quality of Employee Work Life can be defined as the extent to which employees feel a sense of team work within groups and the extent to which the organization provides them with a good work environment and job satisfaction (Kocman & Weber, 2018), QWL is intended to increase an employee’s trust, involvement and problem solving to increase job satisfaction and organizational and employee effectiveness, as work performed by people is an important source of satisfaction (Pio & Tampi, 2018).
Employee effectiveness is a capability of employees to produce a specific, desired effect with minimized costs and in strict compliance with initial requirements. It is a qualitative characteristic that indicates the extent to which targeted problems are addressed and the degree to which preset goals and objectives are achieved by employees (Yusuf et al., 2020). Organizational cynicism has a negative influence on employee effectiveness. However, researchers argue that cynical employees can be a positive force for change by challenging ineffective policies and routines and, consequently, influencing work effectiveness in a positive way, while some studies found that society developed negative attitudes towards those firms and their management (Arslan & Roudaki, 2019).
Significance of the research:
Organizational cynicism studies in Egypt are novel and in its rudimentary stages (Rayan et al., 2018). Also, many of the organizational cynicism studies have been conducted in the developed countries, while there is very limited discussion on this issue in other developing countries. This means that more research is needed to understand organizational cynicism and its consequences in the Egyptian context. Most of the prior literature in organizational cynicism has been devoted towards understanding of its impact on organizational change efforts. It is very important for both academician and practitioners to investigate the impact of organizational cynicism on employees’ attitudes and behaviors (Durrah et al., 2019).
Nurses are the largest employee group in hospitals. Therefore, it is not surprising that hundreds of studies have been conducted on the concepts that are related to nurses’ QWL (Holland, 2019). Previous research suggests that the recruitment and retention of nurses are affected by their QWL (Raeissi et al., 2019). Consequently, it appears that identifying the factors that contribute to QWL can provide critical information for nurse directors in order to design managerial programs that will make the nursing profession more attractive. It is evident that, before nurse directors can explore properly which the most effective strategies are for promoting nurses’ QWL (Querstret et al., 2020).
Also, when the researcher went to Minia University Hospitals during clinical training of students the researcher recognized that there were lack of appreciation and recognition from superiors toward nurses and pessimism view of nurses toward hospital's expectation. also because of nurses comprise a great part of healthcare professionals that provide direct service for those who apply to organizations for healthcare service, must be assessed in terms of organizational cynicism, quality of work life and employee effectiveness, and, all of which that directly influence the efficiency of organization; therefore, the researcher carry out this study.
The aim of the research:
The aim of the current study was to assess the effect of organizational cynicism on quality of work life and employee effectiveness among nursing staff.
Research questions:
1- What are the levels of organizational cynicism, quality of work life and employee effectiveness among nursing staff at Minia University Hospitals?
2- What are the relations between organizational cynicism, quality of work life and employee effectiveness among nursing staff at Minia University Hospitals?
Subjects and Methods
Research Design:
A descriptive research design was utilized in the present research.
Setting:
The study was conducted at (Minia University Hospital for Obstetric and Pediatric, Minia University Liver Hospital, as well as Minia University Kidney and Urology Hospital), Minia, Egypt. Affiliated to Minia University Hospitals.
Subjects:
Convenience sample included all nurses who work at the three selected hospitals during the period of data collection (no.=314), classified as follows: Minia University Hospital for Obstetric and Pediatric (no.= 137), Minia University Liver Hospital (no.= 124), as well as Minia University Kidney and Urology Hospital (no.= 53).
Scales of Data collection:
Data collected through using three scales namely: Organizational Cynicism Scale, Quality of Work Life Scale and Employee Effectiveness Scale.
Scale (I): Organizational Cynicism
This scale was divided into two parts:
Part Ι: personal data sheet: It was used to collect data about nurses encompass item such as age, marital status, educational qualification, salary, years of experience in the nursing field, sex, residence and department.
Part ΙΙ:Organizational Cynicism Scale
Organizational cynicism scale was developed by (Goudarzi et al., 2011). This scale was aimed to measure level organizational cynicism among nursing staff. It consists of 12 statements. It contained three dimensions cognitive cynicism, affective cynicism and behavioral cynicism wherein every dimension had four items. Each item was measured by a five-point Likert scale ranked from 1 (strongly disagree) to 5 (strongly agree).
Scoring system:
organizational cynicism |
Low |
Moderate |
High |
Total |
(12 to 28) |
(29 to 44) |
(45 to 60) |
(12 to 60) |
Scale ΙΙ: Quality of Work Life
Quality of work life scalewas developed by (Bhopatkar, 2013). This scale was aimed to measure level QWL among nursing staff, it contained (40) items. Each item was measured by a five-point Likert scale ranged from 1 (strongly disagree) to 5 (strongly agree).
Scoring system:
Quality of Work Life Scale |
Low |
Moderate |
High |
Total |
(40 to 93) |
(94 to 146) |
(147 to 200) |
40 to 200 |
Scale (III): Employee Effectiveness
Employee effectivenessscale was developed by (Bhopatkar, 2013). This scale aimed to measure effectivenessamong nursing staff. It contained (35) items. It contained five dimensions as following training and development (11 items), team spirit and favorable working environment (5 items), role clarity and performance planning (9 items), effective leadership and reward system (5 items) and performance and potential feedback (5 items). Each item was measured by a five-point Likert scale ranged from 1 (strongly disagree) to 5 (strongly agree).
Scoring system:
Employee Effectiveness |
Low |
Moderate |
High |
Total |
(35 to 81) |
(82 to 128) |
(129 to 175) |
35 to 175 |
Validity of the research scales:
The scales were tested for the content validity by a jury of 5 experts in the field of nursing administration and education, the jury composed of two Professor and one Assistant Professor from Faculty of Nursing, Minia University, one Assistant Professor from Faculty of Nursing, Beni Sweif one Assistant Professor from Faculty of Nursing, Cairo Universities. Each of the expert panel was asked to examine the instruments for content coverage, clarity, wording, length, format and overall appearance. And necessary modification was done from jury panel.
Reliability of the research scales:
Reliability of the scales were performed to confirm consistency of scales. The internal consistency measured to identify the extent to which the items of the scales measured what it was intended to measure. Also, the scales were tested for its reliability by using Cronbach alpha test which revealed good internal reliability for the scales; and distributed as follows:
Scale |
α |
|
.932 |
|
.976 |
|
.976 |
Pilot Study:
A pilot study was conducted on 10% of participants (31 nurses) classified as following: Minia University Hospital for Obstetric and Pediatric (14), Minia University Kidney and Urology Hospital (12) and Minia University Liver Hospital (5). The main purposes of the pilot study were to ascertain the clarity, comprehensiveness and applicability of the scales as well as to estimate the appropriate time required to fill the scales. Based on pilot study there was no modification done, and it was added to final results.
Data Collection Procedures:
Administrative design:
Ethical Considerations:
Statistical analysis:
The collected data was tabulated, computerized, analyzed and summarized by using descriptive statistical tests to test research questions by using SPSS version (25). Qualitative data were expressed as frequency and percentage. Probability (P-value) is the degree of significance, less than 0.05 was considered significant. The smaller the P-value obtained, the more significant is the result (*) and less than 0.001 was considered highly significant (**).
Results
Table (1): Distribution of the nursing staff’s personal data at the three selected Hospitals (no.=314).
Hospitals |
Hospital’s total (314) |
|
|
no. |
% |
Age |
||
|
244 |
77.7 |
|
44 |
14.0 |
|
20 |
6.4 |
|
6 |
1.9 |
Mean ± SD |
28.25+7.246 |
|
Marital status |
||
|
149 |
47.5 |
|
159 |
50.6 |
|
5 |
1.6 |
|
1 |
0.3 |
Educational Qualifications |
||
|
46 |
14.6 |
|
218 |
69.4 |
|
47 |
15 |
|
3 |
1 |
Salary: |
||
|
14 |
4.5 |
|
206 |
65.6 |
|
94 |
29.9 |
Mean ± SD |
1.54+.767 |
|
Experience: |
||
|
198 |
63 |
|
63 |
20.1 |
|
53 |
16.9 |
Mean ± SD |
2.25+.529 |
Table (1) illustrates the personal characteristic of the nursing staff, it is observed that (77.7%) of nursing staff age at the three selected Hospitals are ranged between 19-30 year, with Mean ± SD (28.25+7.246). Regarding marital status it is observed that (50.6%) of them are married. About the education qualifications, (69.4%) of them have technical institute of nursing. Concerning to salary, (65.6%) of them are ranged between 2000-3000 LE, with Mean ± SD (1.54+.767). In relation to Experience, (63%) them have less than 5 years of experience, with Mean ± SD (2.25+.529).
Figure (1): Distribution of the nursing staff regarding their sex (no.=314).
Figure (1) shows that (58.5%) of nursing staff at Minia University Liver Hospital is male, while the highest percent of them at Minia University Kidney and Urology Hospital and Minia University Hospital for Obstetric and Pediatric (62.9%, 78.8% respectively) are female. moreover, it is observed that (60.2%) of them at the three selected Hospitals are female.
Figure (2): Distribution of the nursing staff regarding their residence (no. =314).
Figure (2) shows that the majority of nursing staff at Minia University Liver Hospital, Minia University Kidney and Urology Hospital and Minia University Hospital for Obstetric and Pediatric (67.9%, 78.2%, 80.3% respectively) living in rural residence. Moreover, it is observed that (77.4%) of them at the three selected Hospitals living in rural residence.
Figure (3): Levels of organizational cynicism among nursing staff at the three selected Hospitals (no.=314).
As evident in the figure (3), it is found that (43.4%) of nursing staff at Minia University Liver Hospital has low level of organizational cynicism, while (50%) of them at Minia University Kidney and Urology Hospital has moderate level of organizational cynicism, also (54.7%) of them at Minia University Hospital for Obstetric and Pediatric has moderate level of organizational cynicism. Moreover, it is observed that (50.6%) of them at the three selected Hospitals have moderate level of organizational cynicism.
Figure (4): Levels of quality of work life among nursing staff at the three selected Hospitals (no.=314).
Figure (4) shows that (43.4%) of nursing staff at Minia University Liver Hospital has low quality of work life, while (47.6%) of them at Minia University Kidney and Urology Hospital has moderate level of quality of work life, also (62.8%) of them at Minia University Hospital for Obstetric and Pediatric has moderate level of quality of work life. Moreover, it is observed that (52.5%) of them at the three selected Hospitals have moderate level of quality of work life.
Figure (5): Levels of employee effectiveness among nursing staff at the three selected Hospitals (no. =314).
Figure (5) shows the levels of employee effectiveness among nursing staff at the three selected Hospitals, it is noted that (43.4%) of them at Minia University Liver Hospital has moderate level of employee effectiveness, while (56.5%) of them at Minia University Kidney and Urology Hospital has moderate level of employee effectiveness, also (59.1%) of them at Minia University Hospital for Obstetric and Pediatric has moderate level of employee effectiveness. Moreover, it is observed that (55.4%) of them at the three selected Hospitals have moderate level of employee effectiveness.
Table (2): Correlation between studied variables among nursing staff at the three selected Hospitals (no.= 314).
Employee Effectiveness
|
Quality of Work Life |
Organizational Cynicism
|
Variable
|
|
-.383-** .001 |
-.344-** .001 |
1 |
R P |
Organizational Cynicism |
.885** .001 |
1 |
-.344-** .001 |
R P |
Quality of Work Life |
1 |
.885** .001 |
-.383-** .001 |
R P |
Employee Effectiveness |
**Correlation is significant at the 0.01 level (2-tailed) * p≤0.01 (significant) **p≤0.05 (highly significant)
PCC: P – value based on Pearson correlation coefficient
In table (2), it is noted that there is a statistically high significant negative poor correlation between organizational cynicism, quality of work life and employee effectiveness with P- value (.001, .001). While there is positive strong correlation between quality of work life and employee effectiveness with P- value (.001).
Discussion
Nursing is an indispensable profession for the health and well-being of all nations and is the backbone of the healthcare system (Al‐Hamdan & Bani Issa, 2021). Nurses constitute the largest part of the healthcare workforce, and their professional ability plays an important role in the effective operation of healthcare systems (Said & Chiang, 2020). It is important in healthcare institutions to minimize or reduce negative situations such as organizational cynicism so that nurses can provide more efficient and qualified service within the healthcare system (Sungur et al., 2019).
Regarding the personal data, the majority of nursing staff age at the three selected Hospitals were ranged between 19-30 year, in relation to marital status more than half of them were married. About the education qualifications, more than two thirds of them had technical institute of nursing.
Concerning to salary, less than two thirds of nursing staff salary at the three selected Hospitals were ranged between 2000-3000 LE, in relation to Experience, the majority of them had less than 5 years of experience; also, the majority of them were female. Regarding to their residence, there were more than three quarters of them living in rural residence.
Regardingorganizational cynicism, the current study revealed that more than two fifths of the nursing staff at Minia University Liver Hospital had low level of organizational cynicism. Also, half of them at Minia University Kidney and Urology Hospital, more than half of them at Minia University Hospital for Obstetric and Pediatric and more than half of them at the three selected hospitals had moderate level of organizational cynicism.
During data collection at Minia University Liver Hospital, the nursing staff reported that despite the workload in their work, they see that their working condition much better than nursing staff working in other university hospital as regard to increased patient overload, lack of resources and lack of apperception. In addition, their directors included them in decision making, consider the problems they face in their work and try to solve them. This study in same line with Sungur et al., (2019) who indicated that, nurses’ perceptions of organizational cynicism were low. This study also incompatible with Kahar, (2019) who illustrated that perception of organizational cynicism is relatively higher among senior Staff employees.
As regard to Minia University Kidney and Urology Hospital and Minia University Hospital for Obstetric and Pediatric the obvious reason for this finding was related to that the studied nurses are suffering from inadequate supervision and guidance by head nurses, scarce human and material resources, intense workload, rotating shifts, long hours and lack of arrangement of the work schedules including weekends and vacations, stressful working environment, lack of orientation programs offered in the hospital for new nurses, verbal abuse by physicians and patients’ relatives, and non-constructive feedback system on their performance.
This finding symmetrical with El-liethiey and Atalla, (2021), who concluded that the more than half of studied nurses perceived moderate organizational cynicism. While the present study incongruent with Mahdy and Elsayed-ElAraby, (2021), who illustrated that slightly more than half of studied nurses reported high level of organizational cynicism. The present study is also in inconsistent with the study in USA, in 2014, which shows that the level of organizational cynicism was highly reported among USA health care providers (Volpe et al., 2014).
Regards to quality of work life, the finding of this study reported that more than two fifths of nursing staff at Minia University Liver Hospital had low level of quality of work life, less than half of nursing staff at Minia University Kidney and Urology Hospital, less than two thirds of them at Minia University Hospital for Obstetric and Pediatric and more than half of them at the three selected Hospital had moderate level of quality of work life.
From the researcher explanation, during collecting data at Minia University Liver Hospital, the nursing staff reported that because the shortage of nursing staff they are heavily overloaded, spent much time in work shifts in hospital, they have less vacation, this affects their health condition and interfere with family relations. The nurses reported that they were incapable of balancing between the work-home lives and were dissatisfied in their job. Moreover, the majority of nursing staff living in rural areas, they have problem in transportation because most of them live far away from hospital. Travelling long and sometimes difficult distances before and after nursing shifts hampered the quality of their lives and working abilities, and relationships with significant others, including work colleagues. And made them come late to hospital.
This study supported by Javanmardnejad et al., (2021) who showed that the nurses did not have an optimum level of quality of working life. In agreement with the present study Akter et al., (2019) whostated that, some nurses perceived a lack of accommodation facilities as a barrier to QWL, and also reported that most participants perceived that their heavy workload hampered their QWL, this study conducted among registered nurses in Bangladesh. This study also in contrast with Gurdogan and Uslusoy, (2019) who showed that the general quality of work life of nurses is on an average level.
From the researcher explanation, during collecting data at Minia University Kidney and Urology Hospital and Minia University Hospital for Obstetric and Pediatric, the nursing staff reported that the lack of opportunities for educational advancement and hospital sponsored training and inability to influence decisions which are issues that affect the QWL, they also reported that they do not have an autonomy to make client or patient care decisions in their facilities.
In agreement with the present study Alharbi et al., (2019) stated that, the overall level of quality of nursing working life among nurses was moderate. This finding also supported by Akter, (2018) who indicated that the quality of work life as perceived by less than half of nurses in Bangladesh was at moderate level. This finding parallel with Anvari et al., (2016) who revealed that he majority of participants had moderate quality of life.
Concerning to employee effectiveness, the finding revealed that more than two fifths of nursing staff at Minia University Liver Hospital, more than half of them at Minia University Kidney and Urology Hospital, more than half of them at Minia University Hospital for Obstetric and Pediatric and more than half of them at the three selected hospitals had moderate level of employee effectiveness. The obvious explanation for this finding may be due to goals aren’t clearly communicated to employee, training and development program aren’t enough to improve nursing staff knowledge, skills and competence also, this may be due to lack of employee’s satisfaction about reward system moreover, they don’t receive appropriate feedback at regular interval.
Regarding the correlation between organizational cynicism and quality of work life among nurses, the present study highlighted that there is a statistically high significant negative Poor correlation between organizational cynicism and quality of work life among nurses. this may be due to organizational cynicism brings negative results to the organization as poor working environment anxiety and aggression toward their directors which affect quality of employee work life and satisfaction negatively. This finding supported by Yasin and Khalid, (2015) who indicated that there was a negative relationship between organizational cynicism and work-related quality of life.
The present study also highlighted that there is a statistically high significant negative Poor correlation between organizational cynicism and employee effectiveness. From the researcher point of view this may be due to the fact that workers who are more cynical toward organization, expressed less enthusiasm to put forth efforts, anticipated less individual success, and recognized fewer and less important intrinsic and extrinsic rewards and had low quality of working life moreover organizational cynicism has several negative consequences such as dissatisfaction with job, low commitment to their organization, high burnout, and as results of their personality lead to decrease their effectiveness. This study supported by Ozdem and Sezer, (2019) who showed that employee perceive low levels of organizational cynicism, but high level of organizational commitment and job satisfaction.
The present study also highlighted that there is a statistically high significant positive strong correlation between quality of work life and employee effectiveness. This may be due to QWL emphasizes the circumstances and procedures relating to promotional policies, supervision and safe working conditions, while subjectively related to supervision, communication and leadership which in turn affect employee performance and effectiveness. This expectation supported by Suyantiningsih et al., (2018) who indicated that there was a significant and positive relationship between QWL and job performance.
Conclusion
This study contributes to the current academic literature by concluding that studied nurses at the three selected hospitals perceived moderate level of organizational cynicism, moderate level of quality of work life and moderate level of employee effectiveness. Moreover, the results demonstrated that organizational cynicism was significantly and poor negatively correlated to quality of work life and employee effectiveness, while quality of work life was significantly and strong positively correlated to employee effectiveness.
Recommendations
Some recommendations are highlighted in the light of the results of this study as following:
For future Research: