Academic journal article Review of European Studies

The Congruence of Nurses in a Czech Hospital with Organizational Work Setting as Related to Organizational Engagement and Perceived Chances to Fulfill One's Own Professional Aspirations

Academic journal article Review of European Studies

The Congruence of Nurses in a Czech Hospital with Organizational Work Setting as Related to Organizational Engagement and Perceived Chances to Fulfill One's Own Professional Aspirations

Article excerpt

Abstract

The aim of this study was to study how organizational engagement (OE) of nurses is related to the congruence with the work settings as described by the Worklife Model (Leiter & Maslach 2004) and how the perceived lack of support in the relational aspect of the nurses' professional role (PRF) is related to the value-fit with the organization. Our concept of OE is concerned more with the employees' involvement in organizational goals than with their psychological state of mind. A non-experimental survey design was used to test the hypothetical relationships. From the population of 836 nurses at a Czech district hospital, 411 nurses were chosen by stratified selection. A response rate 83% was achieved with respect to the administered questionnaires.

There is a strong relationship between OE and total AWS score (0.373, p < 0.01), which supports our hypothesis. The level of autonomy of nurses, expressed by feeling of control over their job activities, has a very strong relationship with OE (0.418, p < 0.01). The regression model proved the strong predictive power of value-fit and autonomy in the worklife for OE of nurses. The perceived lack of support in the relational aspect of the nurses' professional role has the highest correlation with workload, followed by value-fit and fairness. The model did not prove that PRF is significantly contributing to the value-fit between nurse and the organization. Furthermore, there is no association between PRF and OE. The implications for the management of quality process are discussed.

Keywords: engagement, person-centered care, value-fit, work-life model, professional role of nurse, quality management

1. Introduction

The Czech health care system has been undergoing many changes since 1990 when the communist regime ended (Kinkorová & Topol?an, 2012). As in other Western countries, there are growing productivity pressures and financial concerns combined with low wages and lack of clinical supervision in Czech hospitals; taken together, these factors result in a considerably stressful environment for Czech nurses. As a result, there is growing dissatisfaction among Czech nurses. In an extensive research study on Czech nurses working in hospitals, Vévoda et al. (2010) identified several factors contributing to their work satisfaction, including proper salary, nature of care for patients, safety of job position and recognition of their results. Krupková and Havrdová (2013) assessed the satisfaction of nurses in a large Czech hospital based on the possibility to fulfill their professional role. Their result supports the view that Czech nurses view direct care for patients which involves a holistic approach to patients' needs as the most important (but significantly less supported) aspect of their professional role (as related to the other attributes of professionalism, i.e., work based on standards and on the nursing plan, etc.). This can mirror the fact that the quality issues in hospitals are seen to be related much more to a standardized and evidence-based approach to patients and less to the nurturing relationship which is often expected by patients. Similar to other countries, Czech nurses are forced to adopt the rather impersonal technocratic nature of care in their professional role; at the same time, however, responsivity to patients' needs is required (Epstein et al., 2005). For example, recognition of the importance of approaching the patient as a whole person, as expressed in the concept of person-centered care (e.g., Epstein et al., 2005), has become part of the ethical standards for Czech nurses (?eská asociace sester, 2008). As in other countries, this concept has been identified in the education of nurses as an important competency necessary for healthcare professionals. This situation can create confusion between the ideal concept of the nurse's professional role and the reality in which the role must be fulfilled.

In the present study we will look at how the lack of support in the relational aspect of nurses' professional role is related to the engagement for quality and change in the organization and, furthermore, how the lack of support is related to the congruence of nurses with the work settings as described by the Worklife Model (Leiter & Maslach, 2004). …

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