Organizational commitment is most strongly related to

1Department of Midwifery, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

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Mojgan Javedani Masrour

2Research and Clinical Center of Gynecology and Fertility, Shahid Akbar-Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran

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Maryam Sefidi

3International Student Midwifery, Master's Degree in Management of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

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Ezzat Jafar Jalal

4Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

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1Department of Midwifery, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

2Research and Clinical Center of Gynecology and Fertility, Shahid Akbar-Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran

3International Student Midwifery, Master's Degree in Management of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

4Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

Address for correspondence: Maryam Sefidi, Iran University of Medical Sciences, Tehran, Iran. E-mail: moc.oohay@28idifes_m

Copyright : © 2018 Journal of Family Medicine and Primary Care

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Abstract

Introduction and Aim:

Human resources with the quality of desirable performance are the most important assets of the organization and increase the probability of success, survival, and progress of the organization. Midwives have a critical role in promoting the health of mothers and infants and survey the relationship between job motivation and organizational commitment can help health system managers and planners to improve the quality of the services provided.

Methods:

This is a cross-sectional and correlational study; samples of midwives in Arak University of Medical Sciences were selected by stratified sampling with proportional allocation method. The instrument of gathering was demographic information questionnaire, Herzberg's job motivation, and organizational commitment of Allen and Meyer. Data were analyzed by SPSS 16 software and (P < 0.05) were considered significant.

Results:

There was a significant relationship between job motivation and organizational commitment and their dimensions (r = 0.68, P < 0.001). The highest correlation between job motivation and emotional commitment (r = 0.77), normative commitment (r = 0.62), and continuous commitment (r = 0.55). The most related emotional commitment by way of communication (r = 0.74), continuous commitment to salary and wages (r = 0.54), and normative commitment with the nature of midwifery was r = 0.61.

Conclusion:

The results show the importance of communication dimensions, salaries, and wages and the nature of job in the commitment of midwives in Markazi Province. More attention from health system administrators to these dimensions can be useful in increasing the motivation and organizational commitment of midwives in this province.

Keywords: Job motivation, midwife, organizational commitment

Introduction

Job motivation is the motive for need satisfaction and orientation and the factor that drives interests, perseverance, and willingness to achieve organizational goals. Creating job motivation is one of the most important responsibilities of managers, which also indicates the importance of leadership in the organization.[] Job motivation is the main instrument for regulating the staff behavior,[] and attempts to motivate the staff to better perform their organizational responsibilities can include encouraging and rewarding them in order to boost their spirits and enhance their efficiency, which can be effective in increasing their motivation.[] Having committed staff is associated with efficiency, better performance, and more success. Furthermore, strong commitment enhances job satisfaction, motivation, performance, and creativity and decreases absences from work and quitting service among the staff.[] Committed staff direct the organization toward competitive advantages through creating processes.[] Since there is a close relationship between commitment and job satisfaction,[] job satisfaction and organizational commitment affect efficiency and performance and reduce absences and replacements.[]

Midwives have the responsibility to provide pregnancy and delivery care, pregnancy health, and decreased mortality and morbidity among mothers and children.[] Given the vital nature of the kind of service they provide, the diversity of their employment location, the centrality of Markazi Province in the country, easier access to the target population and environment, their workload, job stress in educational, medical, and health-care settings which can affect midwives’ commitment and motivation employed in these centers, the researcher set out to investigate the relationship between job motivation and organizational commitment among midwives employed by Arak University of Medical Sciences, so that policy-makers and health-care planners and managers in the province can benefit from the results.

Materials and Methods

This is a cross-sectional correlational study. The target setting is all the educational and health-care centers affiliated with Arak University of Medical Sciences. The study population is the midwives employed by Arak University of Medical Sciences.

The researcher conducted the sampling in the health-care centers affiliated with Arak University of Medical Sciences using a stratified sampling procedure with proportional allocation after gaining approval from the Ethics Committee with the reference number IR.IUMS.REC.1395.9313593002, obtaining permission for conducting the study from Iran University of Medical Sciences, and obtaining the introduction letter and the required licenses from Arak University of Medical Sciences. The sample size was determined at the confidence interval of 95% and a study power effect of 80%, assuming that the correlation coefficient between job motivation, cognitive ability, and organizational commitment in the employed midwives needs to be R = 0/2 in order for the relationship between these variables to be considered statistically significant. Sample size was estimated by assigning the values in the following formula. It should be mentioned that based on a confidence interval of 95%,

After determining the sample size in each stratum, the midwives who met the criteria for entering the study were informed about the research objectives and were assured about the confidentiality of the data. The criteria for entering the study included were as follows: midwives employed on a long-term, short-term, or internship basis with at least 6-month experience of working in the unit, not suffering from special diseases (e.g., MS, lupus, etc.), not having experienced an unfortunate event in the past 6 months, and not taking drugs affecting their psyche. The eligible midwives completed an informed consent form and the questionnaires. The data-gathering instruments included a demographic information questionnaire, Herzberg's career motivation questionnaire, and the Allen Meyer organizational commitment questionnaire. The demographic information included age, marital status, level of education, work experience, position, employment location, employment type, and the economic status of the family. Herzberg's career motivation included 40 questions relating to the 11 factors in Herzberg's theory scaled on a Likert scale from very important, important, not very important, not important at all, and does not apply. The number of statements in each group of internal (mental) and health (external) factors were 5 statements on appreciation and appreciation factor, 4 statements on job progress and development, 3 statements on the nature of job factor, 3 statements on independence and responsibility factor, 2 statements on job success and promotion, 3 statements on salary and wages, 3 statements on the policy in the workplace, 5 statements on communication with others factor, 4 statements on job security, 3 statements on workplace conditions, and 5 statements on the authorities’ supervision and monitoring factor, respectively. Questions 1–3 investigate the salary and wage dimension, 4–6 the policy in the workplace dimension, 7–11 the communication dimension, 12–15 job security dimension, 16–18 workplace condition dimension, 19–23 the supervision and monitoring dimension, 24–28 appreciation and appreciation dimension, 29–32 job progress and development dimension, 33–35 the nature of job dimension, 36–38 job responsibilities, and 39–40 the job status dimension. Given the abundance of choices for degree of importance, the “very important” and “important” choices were put in one category titled “being important,” and the choices “not very important” and “not important at all” were put in one category titled “not being important” for each of the five mental or internal factors and the six health or external factors, and the responses were score accordingly. The score 4 was given to the “very important” response, and “not important at all” response received the score 1. The validity of the questionnaire was confirmed using a content validity approach, and its reliability was estimated to r = 0.92 by Jabbari et al. using a retest measure.[] Allen Meyer's organizational commitment questionnaire includes 24 questions with three components of affective commitment, continuance commitment, and normative commitment. Each component contains 8 questions scale on a 7-point Likert scale from “strongly agree” to “strongly disagree” and scored from 1 to 7, respectively. Questions 1–8 are related to affective commitment, questions 9–16 to continuance commitments, and questions 17–24 investigate normative commitment. To get obtain the total score for the questionnaire, the scores for each of the individual items are added up and considered as the total score. Higher scores indicate stronger commitment and vice versa. The scores range is between 24 and 168. It should be noted that question numbers 4, 5, 6, 8, 9, 10, 15, 16, 17, 18, 19, 21, and 24 have a reverse scoring method. The validity of the questionnaire was confirmed using a face validity approach, and its reliability coefficient was estimated to be 0.77 for the affective component, 0.79 for the continuance component, and 0.61 for the normative component, using Cronbach's alpha.[]

The data gathered through the questionnaires were analyzed using descriptive and inferential statistical procedures in Statistical Package for the Social Sciences (SPSS) version 22.0 Student Version for windows (IBM SPSS Statistics, United States).

Results

The mean age for the midwives was 32.5 ± 7 with the majority of them (49.2%) being under 29 and with an age range of 22–47. 65.5% were married and 77.2% had a bachelor's degree. They had a mean work experience of 7.43 ± 6.29 years and a mean work experience of working in the delivery room of 4.86 ± 5.52 years.

The mean and standard deviation for the motivation of the staff was 73.27 ± 33.96. The lowest motivation score was 42 and the highest 138 out of 200. The most important motivating factors were the nature of the job, supervision and monitoring method, job progress and development, appreciation and acknowledgment, workplace conditions, job security, salary and wages, communication and policy in the workplace, job position, and responsibilities, respectively. Nearly 70.4% of the midwives reported the nature of the midwifery job as the most important factor in internal motivation, and 69.8% reported supervision and monitoring method as the most important factor in external motivation.

The mean and standard deviation was 46.96 ± 26.60 for external motivation and 27.16 ± 8.37 for internal motivation. External motivation factors are more effective than internal motivation factors.

The total score and standard deviation for organizational commitment was 87.89 ± 27.62. The score and standard deviation for the affective, continuance, and normative components was 28.55 ± 8.91, 28.56 ± 8.91, and 29.07 ± 11.19, respectively.

Based on the questionnaire responses, the lowest and the highest score was 24–168 for organizational commitment and 8–56 for its three components (affective, continuance, and normative commitment).

The Pearson correlation test showed a significant relationship between job motivation and organizational commitment and its components (P < 0.001, r = 0.68). The highest relationship with job motivation was found for supervision and monitoring dimension (r = 0.67) and the lowest for job responsibilities (r = 0.55).

The relationship between affective commitment and job motivation was (r = 0.77), then with normative commitment (r = 0.62), and continuance commitment (r = 0.55). The strongest correlations were found between affective commitment and supervision and monitoring method (r = 0.74), continuance commitment and salary and wages (r = 0.54), and normative commitment and the nature of the job (r = 0.61).

The Table 1 shows that 68.6% of the participants consider the above factors to be effective in motivation, and the mean and standard deviation for motivation was 73.27 ± 33.96. The most important motivating factors were the nature of job, supervision and monitoring method, job progress and development, appreciation and acknowledgment, workplace conditions, job security, salary and wages, communication and policy in the workplace, and job responsibilities and position. Table 2 shows the numerical indices for organizational commitment and its components.

Table 1

Mean and standard deviation for job motivation and its components score for midwives employed by Arak University of Medical Sciences

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Table 2

The numerical indices for organizational commitment and its components (affective, continuance, and normative commitment) in midwives employed by Arak University of Medical Sciences in 2017

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According to the Table 2, the mean and standard deviation for organizational commitment was 87.89 ± 27.62. The mean and standard deviation for the affective, continuance, and normative components was 28.55 ± 8.91, 28.56 ± 8.91, and 29.07 ± 11.19, respectively. The lowest and highest score was 24–168 for organizational commitment and 8–56 for its components (affective, continuance, and normative commitment), with higher scores indicating stronger total and componential organizational commitment. Table 3 shows the relationship between motivation and its components with organizational commitment and its components in midwives employed by Arak University of Medical Sciences in 2017.

Table 3

The relationship between motivation and its components and organizational commitment and its components in midwives

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According to the results of the Pearson correlation test [Table 3], there is a significant relationship between job motivation and organizational commitment and its components (P < 0.001, r = 0.68). The highest correlation was found between the components of job motivation related to supervision and monitoring dimension (r = 0.67) and the lowest was for job responsibilities (r = 0.55). The strongest correlation was found between job motivation and affective commitment (r = 0.77), normative commitment (r = 0.62), and continuance commitment (r = 0.55). The strongest relationships were found between affective commitment and communication method (r = 0.74), continuance commitment and salary and wages (r = 0.54), and normative commitment and the nature of job (r = 0.61).

Discussion

Herzberg's two-factor theory is one of the most comprehensive theories of job motivation which classifies effective factors into the two groups of motivational and health factors. Health factors eliminate dissatisfaction in people, and motivational factors increase their work motivation.[] It is necessary to know effective factors in the creation of job motivation in order to enhance efficiency, job satisfaction, and organizational commitment. A study by Hoseyni et al. (2014) titled “investigating effective factors in job motivation of faculty members of Yazd University of Medical Sciences” showed that external motivating factors are more important than internal motivating factors, and that job security, salary and wages, workplace conditions, job position and promotion, job progress, and development are the most important factors, respectively,[] which is in line with the results of the present study and shows that it is necessary to pay more attention to external motivation factors. Manzoor et al. investigated job motivation factors in faculty members of Rafsanjan University of Medical Sciences based on Herzberg's two-factor theory and showed that, in order of importance, the external factors, i.e., salary and wages, job security, workplace conditions, communication method with others, supervision and monitoring, and the policy in the workplace are the most important once, and that, in order of importance, the internal factors, i.e., the nature of job, appreciation and acknowledgment, and job progress and success are the most effective factors in the creation of job motivation and job security,[] which is in line with our emphasis on external factors over internal ones.

In a study by Baradaran-Kazemzadeh (2009) titled “investigating job motivation factors in an organization” which was done based on Herzberg's theory, the results showed that, in most organizations, health or external factors have lower means compared to internal motivation factors and argued that people had job dissatisfaction. Of the health factors, justice and fairness, policy and regulations in the organization, supervision and monitoring, management, and salary are of greatest importance, respectively.[] In the resent study as well, external factors were more important, and the obtained mean score for the external factors was higher than the mean score for the internal factors. Therefore, it can be concluded that paying more attention to these factors can be effective in enhancing the midwives’ motivation.

The results of a study by Ansar-Foumany (2015) titled “the relationship between job motivation, job attachment, and organizational commitment in teachers with the managers’ efficiency in the Education Department of Zanjan Province,” it was shown that there is a relationship between job motivation, job attachment, and organizational commitment. A significant positive relationship was found between teachers’ motivation and the managers’ efficiency (P < 0.001) and between job motivation, job attachment, and organizational commitment in teachers and efficiency (P < 0.001),[] which is in line with the results of the present study. A study by Saatchi (2008) titled “investigating the relationship between job motivation in managers and job satisfaction and organizational commitment in teachers in secondary schools in the city of Marvdasht,” no significant relationship was found between the three variables of teachers’ job motivation, job satisfaction, and organizational commitment, and that the managers’ motivation does not cause commitment in the staff,[] and that more attention needs to be paid to the important role of human force in organizations.

Conclusion

The most important motivating factors in Arak midwives were found to be the nature of job, supervision and monitoring method, job progress and development, appreciation and acknowledgment, workplace conditions, job security, salary and wages, communication and policy in the workplace, job position, and responsibilities in the workplace, respectively. The most important internal motivating factor in the midwives was the nature of job, which was very effective in the creation of motivation. Supervision and monitoring method had the strongest relationship as an external factor with the midwives’ motivation. External motivation factors were more effective than internal motivation factors in the midwives employed by Arak University of Medical Sciences in the creation of motivation. The highest commitment score was for the normative component, followed by the continuance and affective components. The mean commitment score for midwives employed by Arak University of Sciences is lower compared to similar studies done in the same filed in the country, a fact pointing to the necessity of investigating effective factors on organizational commitment in the midwives employed by Arak University of Medical Sciences.

There was a significant relationship between job motivation and organizational commitment and its components. The highest correlation was with the supervision and monitoring dimension and the lowest with job responsibilities. Job motivation was most strongly related to affective commitment, normative commitment, and continuance commitment, respectively. Affective commitment was most strongly related to communication method, and continuance commitment was most strongly related to salary and wages, and normative commitment was most strongly related to the nature of job in the midwives of Arak University of Medical Sciences.

Given the lower score for organizational commitment in midwives of Arak University of Medical Sciences compared to midwives in other similar studies, it seems necessary that managers in the health-care system of Arak University of Medical Sciences investigate the issue and take the required measures in order to promote organizational commitment in the midwives of the province.

Autonomy, merit, job efficiency, and job meaningfulness are related to normative commitment, and autonomy and merit are related to continuance commitment. Therefore, the authorities and the managers can take effective measure toward enhancing the midwives’ organizational commitment by giving them more autonomy and discretion.

Financial support and sponsorship

Research Vice-Chancellor for International Affairs of Iran University of Medical Sciences is a financial sponsor of the research. All stages of the research were monitored by the University of Medical Sciences.

Conflicts of interest

There are no conflicts of interest between the authors of the article.

Acknowledgment

The authors wish to express their deep gratitude to the graduate studies office, the dean of the research department, the dean of the international relations of Iran University of Medical Sciences, the dean of research and health department of Arak University of Medical Sciences, and each and every one of the midwives who sincerely and cooperatively took part in this study.

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