行政院國家科學委員會專題研究計畫 成果報告
台美醫院員工離職意願之影響因素關聯比較分析
計畫類別： 個別型計畫 計畫編號： NSC92-2416-H-009-023- 執行期間： 92 年 08 月 01 日至 93 年 07 月 31 日 執行單位： 國立交通大學經營管理研究所 計畫主持人： 丁承 共同主持人： 林介鵬 報告類型： 精簡報告 處理方式： 本計畫可公開查詢中 華 民 國 93 年 11 月 4 日
行 政 院 國 家 科 學 委 員 會 專 題 研 究 計 畫 成 果 報 告
台美醫院員工離職意願之影響因素關聯比較分析
Comparing the Effects of Determinants of Turnover Intentions
Between Taiwanese and U.S. Hospital Employees
計畫編號：NSC 92-2416-H009-023
執行期限：92 年 8 月 1 日至 93 年 7 月 31 日
主持人：丁 承 國立交通大學經營管理研究所
共同主持人：林介鵬 萬能科技大學企管系
一、 中文摘要 本研究比較台美醫院員工在工作滿意 度與生涯滿意度對離職意圖的直接影響效 果以及透過組織承諾的間接影響效果上， 如何呈現差異。利用 179 筆台灣醫院員工 及 144 筆美國醫院員工的資料，我們發現 台灣醫院員工之工作滿意度對離職意圖有 顯著的負向直接效果，但美國醫院員工則 無；台灣醫院員工之工作滿意度透過組織 承諾對離職意圖的間接影響效果較美國醫 院員工強；美國醫院員工之生涯滿意度對 離職意圖的負向直接效果以及透過組織承 諾的間接效果皆較台灣醫院員工強。其於 實證研究發現，我們提供了若干管理上的 意涵與建議。 關鍵詞：工作滿意度、生涯滿意度、離職 意圖、組織承諾、中介變項、調節變項 AbstractThis study investigated how the direct effects of job satisfaction and career satisfaction on turnover intentions and the indirect effects through organizational commitment differed between Taiwanese and U.S. hospital employees. Using the data collected from 179 Taiwanese and 144 U.S. hospital employees, we found that the direct effect of job satisfaction on turnover intentions was negative and significant for Taiwanese hospital employees, but not for U.S. hospital employees; the indirect effect of job satisfaction on turnover intentions through organizational commitment was
stronger for Taiwanese hospital employees than for U.S. hospital employees; the negative direct effect of career satisfaction on turnover intentions and the indirect effect through organizational commitment were stronger for U.S. hospital employees than for Taiwanese hospital employees. Managerial implications and suggestions based on the empirical results have been provided.
Keywords: Job Satisfaction, Career Satis-
faction, Turnover Intentions, Organizational Commitment, Mediator, Moderator
二、緣由與目的
Employee job satisfaction, career satisfaction, and turnover intentions have been receiving much more attention in the Western world than other societies and countries. More research is needed to elucidate the relationships in non-Western societies. Since the non-western culture is sharply different from Western culture, the research results regarding turnover intentions may provide quite different implications for managers.
Individual turnover intentions can be described as a psychological response to specific organizational conditions, and fall along a continuum of organizational withdrawal behaviors ranging from day-dreaming to actual quitting. The focus of the research is on the formation of turnover intentions, dealing with how turnover intentions are influential by their antecedents. Some previous research on predicting
turnover intentions using individual difference variables has focused on such demographic characteristics as gender, age, organizational tenure, educational level and family size (e.g., Chen & Francesco, 2000). The results generally display a consistent negative relationship between age and turnover intentions, and also between tenure and turnover intentions (e.g., Martin, 1979).
Job satisfaction, career satisfaction, and organizational commitment are believed to influence turnover intentions. Turnover intentions are negatively related to job satisfaction and career satisfaction (e.g., Abraham, 1999). Specifically, comparisons of stayers and leavers in various occupations revealed higher job satisfaction for stayers. Increasing worker satisfaction can significantly reduce turnover intentions. Meanwhile, employees who are satisfied with their careers should perceive greater benefits in retaining membership in their organizations than employees whose careers have been less gratifying (Igbaria & Greenhaus, 1992).
Satisfaction and organizational commitment are distinct attitudes, with satisfaction being an affective response to specific aspects of the job or career, and commitment an affective response to the organization as a whole (Williams & Hazar, 1986), but have been suggested to be positively related (Igbaria & Greenhaus, 1992). Higher level of job or career satisfaction would enhance organizational commitment. Moreover, organizational commitment negatively influences turnover intentions. Employees who are highly committed to their organization are less likely to leave than employees who are relatively uncommitted. Williams & Hazer (1986) reviewed several turnover models, and concluded with empirical analysis that both job satisfaction and organizational commitment are important antecedents of turnover intentions, and organizational commitment plays a mediating role between job satisfaction and turnover intentions.
Most studies regarding turnover intentions were conducted only on U.S. organizations
and samples, e.g., employees in military organizations (Bluedorn, 1979) and mental health centers (Michaels & Spector, 1982), accountants (Arnold & Feldman, 1982), and high-tech personnel (Igbaria and Siegel, 1992). The Chinese society, including three major ‘mini dragons’, namely Taiwan, Hong Kong, and Singapore, constitutes the largest foreign direct investment absorption territory in the world. Therefore, from the management viewpoint, it is of interest to see, in the society, if and how the formation process of turnover intentions differs. Although some preliminary work has been done (e.g., Yousef, 1998), the role of nation as a moderator still needs to be clarified. On the other hand, since the employees in hospitals are mostly doctors and nurses, whose training costs are high, understanding how turnover intentions are influenced by their determinants is important for hospital supervisors. However, different nations with different cultures may possess different causal relationships and therefore there may exist different management focus. Since Taiwan and U.S. can well represent two important but different cultures, they are used as the target nations in this study.
The purpose of this study is to examine the role of nation (Taiwan versus U.S.) as a moderator on the formation process of turnover intentions in hospitals. Specially, we wish to investigate the moderating effects of nation on the influences of job satisfaction, career satisfaction, and organizational commitment on turnover intentions and the influences of job satisfaction and career satisfaction on organizational commitment. Based on cross-national empirical results, managerial implications will be discussed. 三、結果與討論
3.1 Methods 3.1.1 Participants
Cross-sectional data were obtained from employees of a large hospital in Taiwan and those of another large hospital in U.S.A.
Using a sample within a single organization can reduce the influence of subcultures in other organizations on the hypothesized relationships to be tested (Herndon et al., 2001). The employees in hospitals will be limited to doctors and nurses only. The hospital selected from Taiwan is a large general hospital in Taipei. The hospital selected from U.S.A. is also a large one in Nashville, Tennessee. The hospitals selected must have willingness to cooperate with this research. Two hundred questionnaires were distributed to each of the hospitals, and the number of usable ones are 179 (for Taiwan) and 144 (for U.S.A.).
3.1.2 Measures
Three steps will be employed to determine the items for measuring the constructs. First, the items will be taken from the literature and appropriately adapted. Second, the items will be pretested through face-to-face interviews with 10 hospital employees. Finally, back-translation recommended by Reynolds et al. (1993) was utilized to form a Chinese version of questionnaire. The above process can achieve the content validity of the questionnaire.
The following measures are all 5-point Likert type scales with anchors of “strongly disagree” (1) to “strongly agree” (5).
1. Turnover Intentions: Based on Landau & Hammer (1986), three items such as “I am actively looking for a job outside the hospital” and “As soon as I can find a better job, I’ll leave this hospital” were used.
2. Organizational Commitment (OC): A nine-item measure developed by Porter et al. (1974) was adopted to measure affective OC. Six items were actually used according to the principal components analysis by Wayne et al. (1997). Example items included “I am willing to put in a general deal of effort beyond that normally expected in order to help my hospital be successful” and “I really care about the fate of my hospital”.
3. Career Satisfaction: A scale with five items developed by Greenhaus et al. (1990) was used. Example items included “I am
satisfied with the success I have achieved in my career” and “I am satisfied with the progress I have made toward meeting my overall career goal”.
4. Job Satisfaction: Four items drawn from Churchill et al. (1974) were used. Example items included “My work is satisfying” and “My job is often dull and monotonous”.
3.1.3 Data Analysis
Following data collection, SEM (Structural Equation Modeling) was applied to conduct data analysis based on the two-step procedure proposed by Anderson & Gerbing (1988). The first step involves developing an effective measurement model with confirmatory factor analysis (CFA), while the second step dealing with the structural model. To reduce experimental errors, gender and tenure were used as control variables. Both SAS and AMOS were adopted as the tools for analyzing the data for reconfirmation.
3.2 Results
3.2.1 Tests for the Measurement Models
Repeated filtering by CFA was conducted to make the construct indicators identical for the Taiwanese and U.S. groups. Every construct in the final measurement models is measured by at least two indicator variables. The overall goodness-of-fit indices (chi-square/d.f. smaller than 2.0, CFI, GFI, NFI, and NNFI all greater than 0.9 except AGFI slightly smaller than 0.9) indicated that the fits of the models were satisfactory.
Reliabilities for constructs all exceeded 0.70 for both Taiwanese and U.S. groups, satisfying the general requirement of reliability for research instruments.
Convergent validity can be assessed by examining the t tests for the factor loadings in CFA (Hatcher, 1994). It appears that, for both Taiwanese and U.S. groups, the factor loadings for indicators measuring the same construct were all statistically significant, showing that all indicators effectively
measured their corresponding construct and hence supporting convergent validity.
Discriminant validity can be assessed by using the chi-square difference test, which involves the difference of the chi-square statistics for the constrained and unconstrained measurement models (Hatcher, 1994). The constrained model is identical to the unconstrained model, in which all constructs are allowed to covary, except that the correlation between the two constructs of interest is fixed at 1. Discriminant validity is demonstrated if the chi-square difference (with 1 df) is significant. Since discriminant validity needs to be assessed for every pair of five constructs, the experimentwise error rate (the overall significance level) should be controlled. By using the Bonferroni method, the critical value of the chi-square test under the overall 0.01 level is χ2(1, 0.01/10) = 10.83. Since the chi-square difference tests were significant for all pairs of constructs for both of the Taiwanese and U.S. groups, discriminant validity is achieved.
3.2.2 Tests for the Moderating Effects
The analytical strategy by Singh (1995) was applied to examine the existence of the moderating effect of nation on the structural relationships. First, an “unconstrained” model is estimated, in which path coefficients are allowed to vary for different groups. Next, a “fully constrained” model is estimated by requiring that all path coefficients be equal for different groups. Comparing the goodness-of-fit statistics for the “unconstrained” and “fully constrained” models and using a χ2 difference test yields evidence for examining our hypotheses. The
χ2
statistics for the unconstrained and constrained models were 171.83 (df = 124) and 211.81 (df = 129), respectively. The difference 39.98, with 5 degrees of freedom, was significant at the 1% level, indicating the existence of the moderating effects. The
χ2
difference test is used again to test for the moderating effects for individual paths, in which the χ2 statistics for the “unconstrained” and “partially constrained”
models are compared. “Partially constrained” means that only the target path coefficients are set to be equal for different groups.
The test results indicated that four out of the five paths were significantly moderated by nation. The direct effect of job satisfaction on turnover intentions was negative and significant for Taiwanese hospital employees, but not for U.S. hospital employees; the indirect effect of job satisfaction on turnover intentions through organizational commitment was stronger for Taiwanese hospital employees than for U.S. hospital employees; the negative direct effect of career satisfaction on turnover intentions and the indirect effect through organizational commitment were stronger for U.S. hospital employees than for Taiwanese hospital employees.
3.3 Discussions and Managerial Implications
The supervisors who approach tasks with the attitude of “whatever works in hospitals in the U.S. society will surely work in the hospitals in the Chinese society” may be very much mistaken. No matter what efforts supervisors make to reduce turnover intentions, the factor of nation should be taken into account.
The stronger influence of job satisfaction on organizational commitment and turnover intentions for Taiwanese professionals than for U.S. ones indicates that increasing job satisfaction of hospital employees is more effective to strengthen their organizational commitment and reduce their turnover intentions in Taiwan than in U.S.A. Guanxi is considered as one of the critical interpersonal relationship values in the Chinese society (Kao, 1993; Osland, 1989). Research done on guanxi has confirmed the importance of guanxi in the employment setting (e.g., Buttery & Leung, 1998; Chen & Francesco, 2000). It follows that guanxi is a catalyst for job satisfaction and organizational commitment. Better guanxi in working environment can tackle job
difficulties more effectively and brings more pleasure, and thus reduce the psychological intentions to quit. We suggest that supervisors should plan out more tasks on the teamwork basis for Taiwanese hospital employees. Given that the feature of guanxi is often named as social capital (Luo, 1997), working by team not only reduces the risk of mistakes caused by individual ignorance but also enhances the individual social capital through the interdependency and interaction among team members. Mechanism should be devised to encourage employees to form working groups so as to establish good guanxi with coworkers, and to strengthen job satisfaction. In this way, organizational commitment can be enhanced and turnover intentions will drop dramatically.
The stronger influence of career satisfaction on organizational commitment and turnover intentions for U.S. professionals than for Taiwanese ones indicates that U.S. professionals are more sensitive on individual achievement and advancement. As soon as staffs are found to perceive limited career advancement, supervisors should provide internal job-rotation or promotion opportunities. A dual career track (a management track together with a technical track) system may be built, especially for U.S. hospital employees. For those who wish to enter a managerial area, the system can provide assistance for them to successfully switch into managerial area. On the other hand, for those who are interested in staying in a technical area, the system can offer advanced medical training opportunities to attract staffs to stay with their hospital. Career track counseling by professional counselors should be included in the system to help ascertain and satisfy staffs’ needs of career development. Western culture fosters an independent conception of self that encourages employees to perceive feedback in job environment (Bailey et al., 1997). Therefore, opportunities should be provided to allow employees to set individual job standards so as to boost the sense of personal achievement, and to receive regular feedback
from organizations explaining how their employers can help them attain their career goals. In this way, their organizational commitment will increase and turnover intentions will decrease dramatically.
四、計畫成果自評
The contribution of the study is to reveal how the effects of the determinants of turnover intentions differ between Taiwanese and U.S. hospital employees. Managerial implications and suggestions based on the empirical results have been provided.
A paper derived from the research results has been submitted to Asian Pacific Management Review, and is currently under review.
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