Journal of Nursing Management, 2015
Perceived organisational support, organisational commitment and self-competence among nurses: a study in two Italian hospitals ADALGISA BATTISTELLI CARLO ODOARDI M S c 4
PhD
1
, MAURA GALLETTA
PhD
2
, CHRISTIAN VANDENBERGHE
PhD
3
and
1
Professor, Bordeaux University, Bordeaux, France, 2Research Fellow, University of Cagliari, Cagliari, Italy, Professor, HEC Montreal, Montreal, Quebec, Canada and 4Professor, University of Florence, Florence, Italy
3
Correspondence Maura Galletta Department of Public Health University of Cagliari SS554 bivio per Sestu 09042 Monserrato Cagliari Italy E-mail: [email protected]
BATTISTELLI A., GALLETTA M., VANDENBERGHE C. & ODOARDI C.
(2015) Journal of Nursing
Management Perceived organisational support, organisational commitment and selfcompetence among nurses: a study in two Italian hospitals Aim This study examined the contributions of perceived organisational support (POS) and organisational commitment (i.e. affective, continuance and normative) to self-competence among nurses. Background In high-POS environments, workers benefit from socio-emotional resources to improve their skills, while positive forms of commitment (e.g. affective commitment) create a fertile context for developing one’s competencies. Methods A cross-sectional study was conducted among the nursing staff of two Italian urban hospitals (hospital A, n = 160; hospital B, n = 192). A structured questionnaire was administered individually to the nurses. Data analysis was conducted through multi-group analysis and supplemented by a bootstrapping approach. Results The results showed that POS was positively related to self-competence through affective commitment. In contrast, continuance and normative commitment did not mediate this relationship. Conclusions This study shows that supporting employees through caring about their well-being as well as fostering positive forms of organisational commitment increases nurses’ self-competence. Implications for nursing management Nurse managers may increase support perceptions and commitment among their staff by rewarding their contributions and caring about their well-being, as well as concentrating on training strategies that improve work-related skills. Keywords: affective, continuance, normative commitment, perceived organisational support, self-competence Accepted for publication: 13 December 2014
Background Nurses’ competencies represent an important human feature that contributes to performance and the quality of nursing care (Istomina et al. 2011). In this sense, continuing education to increase and improve DOI: 10.1111/jonm.12287 ª 2015 John Wiley & Sons Ltd
competence is becoming increasingly important (e.g. Vernon et al. 2013). Indeed, given the complexity of health-care delivery in today’s hospitals, nurses’ sense of competence can make the public confident that the provision of health services meets the expected levels of quality (Vernon et al. 2011). Self-competence is 1
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also critical for nurses themselves as it allows them to build their confidence in completing work duties efficiently (Kajander-Unkuri et al. 2014). In this study, we look at the role of perceived organisational support (POS) and organisational commitment as drivers of nurse self-competence. The POS reflects the aggregate perception by employees that their employer takes actions that support them (Eisenberger et al. 1986). This perception is a well-established precursor of organisational commitment (Rhoades & Eisenberger 2002). Thus, POS indirectly contributes to increase the retention of workers in the organisation. Given the positive features associated with POS and commitment, we thus investigate the possibility that they can also contribute to instil a sense of competence among nurses. Indeed, organisations that adopt supportive management practices tend to offer employees opportunities to grow and to increase their competencies (Kraimer et al. 2011). We thus explore this possibility in a nursing context.
Overview of the literature and the core concepts of the study Self-competence Perceived competence has been described in various ways. In the pioneering literature, Conger and Kanungo (1988) defined it as empowerment and asserted it is a motivational construct that has a status similar to self-efficacy. Thomas and Velthouse (1990) have argued that empowerment is multifaceted and should be considered as an intrinsic task motivation manifested in a set of four cognitions reflecting an individual’s orientation to his or her work role: meaning, competence (which is synonymous to Conger and Kanungo’s self-efficacy), self-determination and impact. Among these four cognitions, competence reflects an individual’s belief that he or she is capable of performing tasks with skill. Following the classic definition of Bandura (1977), competence is analogous to agency, beliefs, personal mastery and/or effort-performance expectancy. This dimension has been labelled competence rather than general self-efficacy by Spreitzer (1995) because her definition focuses on efficacy specific to a work role. In the pioneering literature, self-competence has been defined as an individual’s subjective evaluation of his/her task-related ability, a sense of confidence stemming from the perceived ability to act efficiently in a specific situation (Ford 1985). It is the psychological component of the construct, called ‘competence’. Self-competence also 2
involves performance expectations: self-competent people are supposed to perform at higher levels. Thus, the concept ‘self-competence’ (‘I can do it’) subsumes also attributes of the concept ‘self-efficacy’ (‘I am effective’) (Bandura 1977). Self-competence is specific to particular situations or specific tasks, and it can be influenced by the joint effect of situational and dispositional factors (Williams & Lillibridge 1992). A few more recent studies on perceived self-competence have reported positive relationships with performance (Parker & Collins 2010), psychological well-being (Dogan et al. 2013), task interest (Judge et al. 2007) and attitudes toward the organisation (Yakin & Erdil 2012). Similarly, POS can enhance perceived competence through increasing employees’ interest in their work. In their meta-analysis, Mathieu and Zajac (1990) have reported a positive correlation between perceived competence and affective organisational commitment. It is thus possible to assume that self-competence may emerge as a result of organisations providing growth opportunities (i.e. high POS), which can lead to increased organisational commitment (which in turn may foster selfcompetence). These assumptions make sense in regard to prior work. For example, Battistelli et al. (2006) found that employees who experienced high levels of self-competence perceived that they were supported by their organisation and were more involved in their work.
Perceived organisational support Perceived organisational support reflects an employee’s perception regarding the extent to which the organisation values his or her contribution and cares about his or her well-being (Eisenberger et al. 1986). It emerges through exposure to actions taken by the organisation or its representatives that benefit employees. The POS is an important element of a social exchange process whereby employees trust that the organisation will provide rewards and value their accomplishments and the organisation trusts that employees will perform highly at work (Shore & Wayne 1993). Research has reported POS to be negatively related to absenteeism (Eisenberger et al. 1986, Adebayo & Nwabuoku 2008) and turnover intention (Tumwesigye 2010) and positively related to effort–reward expectancies, inrole performance and prosocial behaviour (Uymaz 2014), and proactive and citizenship behaviours (e.g. Shore & Wayne 1993, Chu & Lee 2006, Young 2012). Similarly, POS has been found to be related to, yet distinct from, affective organisational commitment ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
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(Shore & Tetrick 1991, Shore & Wayne 1993, El Akremi et al. 2014), continuance commitment (Shore & Tetrick 1991) and normative commitment (Battistelli et al. 2006). Rhoades et al. (2001) have shown that POS led to a change in affective organisational commitment, and not the reverse. Moreover, highPOS environments fulfil employees’ needs for affiliation, esteem and autonomy (Ryan & Deci 2000) and hence promote a high sense of competence and mastery in managing work activities.
or decisions that make the retention of valued assets (e.g. company benefits, status in the community) more salient. Normative commitment is influenced by familial/cultural or organisational socialisation experiences that emphasise the appropriateness of continued service, or by the receipt of benefits from the organisation (e.g. investment in education or training) that create a sense of obligation to reciprocate (Meyer & Herscovitch 2001, Gellatly et al. 2014).
Study assumptions and hypotheses Organisational commitment It is widely accepted today that employee commitment can take different forms (Meyer & Allen 1991, Stanley et al. 2013, Gellatly et al. 2014). In their threecomponent model of commitment, Meyer and Allen (1991) (see also Meyer & Herscovitch 2001) conceptualised commitment as a psychological force that binds the individual to the organisation and increases the likelihood that the employee will maintain membership in the organisation. They used the labels affective commitment (which reflects a desire to stay and an emotional attachment to the organisation), continuance commitment (which refers to the perceived cost of leaving) and normative commitment (which represents a perceived obligation to stay) to differentiate among different mindsets of commitment and argued that employees can experience various combinations of all three mindsets simultaneously. Affective commitment (AC) refers to an employee’s emotional attachment to, identification with, and involvement in the organisation. Employees with strong AC maintain employment with their organisation because they want to do so (Meyer & Allen 1991). Continuance commitment (CC) refers to an awareness of the costs associated with leaving the organisation. Employees with high CC stay with their organisation because they need to (Meyer & Allen 1991). Finally, normative commitment (NC) reflects a feeling of obligation to continue employment. Employees with high NC feel that they ought to remain with their organisation (Meyer & Allen 1991). Among the three components, affective commitment has been found to be most strongly related to turnover and job performance (Meyer et al. 2002, Qaisar et al. 2012). Affective commitment is strengthened by work experiences that contribute to employees’ sense of comfort in the organisation (e.g. good interpersonal relations; role clarity) as well as their sense of ‘competence’ and self-worth (e.g. participation, feedback, challenge). Continuance commitment increases based on actions ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
The pioneering and current literature seem to suggest that employees’ sense of self-competence is influenced by perceived organisational support and organisational commitment. More specifically, a person’s self-competence develops to the extent that the organisation provides opportunities that meet the basic needs of employees, among whom the need for competence is central (Ryan & Deci 2000). It is likely that POS, as an indication of the organisation’s willingness to recognise employees’ contributions and care about their well-being, will ultimately lead to enhanced self-competence. Indeed, a supportive organisation facilitates competence development due to its emphasis on rewards throughout the learning process, thereby leading to feelings of self-competence. However, empirical studies have shown that AC at least partially mediates the effect of POS on work outcomes (e.g. Rhoades et al. 2001). Indeed, through a social exchange process, POS or the employer’s commitment to employees instils a sense of commitment in return. Continuance commitment and normative commitment may also act as mediators in this process. In effect, POS can be interpreted as a sign that organisational membership is a valuable asset for the employee, resulting in increased CC. In turn CC can lead to self-competence to the extent that CC is associated with organisation-specific skills (Meyer & Allen 1991). Moreover, normative commitment, which has been reported to be positively associated with POS (Rhoades & Eisenberger 2002), may be strengthened owing to POS reflecting the organisation’s effort at investing into developing employees’ skills. In turn, normative commitment can lead to self-competence as high-NC employees may feel they ought to develop their competencies in order to reciprocate the positive treatment received from the organisation. The above assumptions lead to the following hypotheses. Hypothesis 1. Perceived organisational support is positively related to self-competence. 3
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Hypothesis 2. Affective commitment (hypothesis 2a), continuance commitment (hypothesis 2b) and normative commitment (hypothesis 2c) are positively related to self-competence. Hypothesis 3. The relationship between perceived organisational support and self-competence will be positively mediated by affective commitment (hypothesis 3a), continuance commitment (hypothesis 3b) and normative commitment (hypothesis 3c). The purpose of the present study was to examine the above-mentioned hypotheses among the nursing staff of two Italian hospitals. The use of two hospitals allowed us to test the hypotheses on two separate samples of nurses, and therefore increase the generalisability of the model.
Methods Design and samples A paper-and-pencil questionnaire including measures of POS, AC, CC, NC, self-competence and demographic questions was administered to nursing staff of two Italian urban hospitals. Data were collected between September 2012 and January 2013. Participation to the study was voluntary and questionnaires were completed during working hours. Data collection lasted 3 weeks, with informal reminders being given by nursing units’ heads. These reminders also indicated that participation remained anonymous. In each hospital, completed questionnaires were collected in sealed boxes. The recruited samples in the study were 210 nurses from hospital A, a hospital located in central Italy and 230 nurses from hospital B, situated in northern Italy. Response rates were 76.2% (n = 160) and 83.5% (n = 192), respectively. As the data were collected from two hospitals with different characteristics (i.e. differences in size and location, different types of wards and different structures, with hospital A being a university hospital and hospital B a general hospital), we conducted separate analyses on the two samples and ran multi-group analyses to examine whether the results were invariant across the two hospitals.
Measures All measures were translated from English into Italian using a standard translation back-translation procedure. Items were rated using a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). 4
Perceived organisational support The 8-item version of the POS scale (Eisenberger et al. 1986) was used. An example question is: ‘My unit values my contribution to its well-being’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.87 and from hospital B: a = 0.84. Organisational commitment Meyer et al. (1993) 18-item scale (six items per subscale) was used to measure AC. An example question is: ‘I feel part of my unit’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.76 and from hospital B: a = 0.81. An example question for CC is: ‘I feel that I have too few options to consider leaving this unit’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.79 and from hospital B: a = 0.70. Finally, an example question for normative commitment is ‘This unit deserves my loyalty’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.73 and from hospital B: a = 0.79. Self-competence The 6-item scale of the Italian version (Battistelli et al. 2006) of the self-competence scale developed by Steel et al. (1989) was used. An example question is: ‘I have got all the skills needed to do this job well’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.90 and from hospital B: a = 0.85. The demographic data section comprised questions about age, gender, educational background, employment contract and organisational tenure.
Data analysis Statistical analyses were carried out using PREDICTIVE ANALYTICS SOFTWARE (PASW Inc., Chicago, IL, USA) 18.0 for Windows and Analysis of Moment Structures (AMOS Development Corporation, Crawfordville, FL, USA) 18.0 for Windows software packages. A confirmatory factor analysis (CFA) with the maximum likelihood method of estimation was used for examining the structure of the measures. Moreover, as perceptual data were used for measuring both independent and dependent variables, we examined whether common method variance (CMV) was an issue by following the recommendations of Podsakoff et al. (2003). Specifically, we used the unmeasured latent method construct (ULMC) approach to determine the prevalence of CMV. The ULMC procedure separates response variance into three components: trait, method and ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
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random error (Richardson et al. 2009). If the trait/ method models combination fits better than the trait model, there is evidence that trait-based and method variance is present in the data. If the fit of a trait/ method–R model is significantly worse than the fit of the trait/method model, there is evidence of CMV bias. Finally, our hypotheses were tested using structural equations modelling. The robustness of our theoretical path model was examined in the two samples using a multigroup analysis. Model fit was gauged using the comparative fit index (CFI), the incremental fit index (IFI), the root-mean-square error of approximation (RMSEA) (Hu & Bentler 1998), the RMSEA 90% confidence interval, and the ratio of chi-squared relative to the degrees of freedom (v2/df), which, to be acceptable, should be less than three (Kline 1998). We also examined the differences in CFI values (DCFI) across multigroup models with different restrictions in order to determine the degree of equivalence of the results in the two samples. Differences in CFI of 0.01 and larger indicate meaningful differences in model fit (Cheung & Rensvold 2002). To estimate the significance of the mediation effects of commitment variables in the POS-self-competence relationship, 95% bias-corrected bootstrap confidence intervals (CI) were constructed (MacKinnon et al. 2004) around the estimated indirect effects of POS through AC, CC and NC. To do so, 5000 random resamples of the data with replacement were used. This approach represents the most appropriate way to test for mediation effects given the known asymmetry of the theoretical distribution of indirect effects.
Results The respondents’ ages ranged from 24 to 56 years with an average of 34.68 years (SD = 7.00) in the central Italy hospital (hospital A) while it ranged from to 23 to 57 years with an average of 39.50 years (SD = 7.49) in the northern Italy hospital (hospital B). Organisational tenure averaged 11.24 years (range = 1–36; SD = 7.86) in the first hospital and 17.96 years (range = 1–38; SD = 8.44) in the second hospital. Most respondents were women (83 and 84%, respectively). Nurses who participated in the study were affiliated with various types of units such as surgery, paediatrics, internal medicine, intensive care, operating rooms and other services (see Table 1). The number of nurses differed significantly across units (P < 0.001). The CFA of the five-factor model yielded a good fit for both samples, v2 (130) = 199.50, P < 0.001, ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
Table 1 Hospital unit characteristics Northern Italy hospital
Central Italy hospital
Clinical department
N
%
N
%
Intensive care Internal medicine Operating rooms Other services Paediatrics Surgery
38 49 10 62 9 24
19.8 25.5 5.2 32.3 4.7 12.5
36 25 27 25 13 34
22.5 15.6 16.9 15.6 8.1 21.3
N (central Italy hospital) = 160; N (northern Italy hospital) = 192. P < 0.001.
v2/df = 1.53, CFI = 0.95, IFI = 0.95, RMSEA = 0.06 (90% CI = 0.04, 0.07) (central Italy hospital) and v2 (130) = 244.80, P < 0.001, v2/df = 1.88, CFI = 0.92, IFI = 0.92, RMSEA = 0.07 (90% CI = 0.06, 0.08) (northern Italy hospital), with all items loading significantly (P < 0.001; range = 0.50–0.88 in both samples) on their factor. The five-factor model also improved significantly (P < 0.001) over any more parsimonious model (see Table 2). Thus, the five-factor model is supported. The CMV analyses revealed that model fit was poorer for the method-only model than the trait-only model for both the central and northern Italy hospitals (Dv2 [13] = 446.8, P < 0.001, and Dv2 [13] = 403.5, P < 0.001, respectively). Moreover, the fit for the Trait/Method–R model was not worse than for the Trait/Method model (Dv2 [5] = 2.8, ns and Dv2 [5] = 5.9, ns, respectively). This suggests common method variance was not a serious issue in this study. The descriptive statistics and correlations for the study variables are reported in Table 3. Among commitment variables, only AC correlated significantly, but weakly with self-competence in both samples (r = 0.34, P < 0.01 and r = 0.24, P < 0.01, respectively). Perceived organisational support was positively and weakly related to self-competence in the northern Italy hospital (r = 0.17, P < 0.05) but not in the central Italy hospital (r = 0.12, ns). Hypothesis 1 was thus partly supported. Hypotheses 2a–c and 3a–c were examined using structural equations modelling. The theoretical model specifying full mediation of the POS-self-competence relationship through AC, CC and NC yielded a good fit, v2 (128) = 218.70, P < 0.001, v2/df = 1.71, CFI = 0.93, IFI = 0.93, RMSEA = 0.07 (90% CI = 0.05, 0.08) (central Italy hospital), and v2 (128) = 277.00, P < 0.001, v2/df = 2.16, CFI = 0.90, IFI = 0.90, RMSEA = 0.08 (90% CI = 0.07, 0.09) (northern Italy hospital). Moreover, freeing the path 5
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Table 2 Fit indices for confirmatory factor analyses v2
df
v2/df
Dv2
AC CC NC self-competence
199.50*** 472.50*** 355.40*** 288.60*** 656.10*** 869.20***
130 134 134 134 134 135
1.53 3.53 2.65 2.15 4.90 6.44
AC CC NC self-competence
244.80*** 493.00*** 423.10*** 405.10*** 640.60*** 862.10***
130 134 134 134 134 135
1.88 3.68 3.16 3.02 4.78 6.39
Model Central Italy hospital Five-factor model Combining POS and Combining POS and Combining POS and Combining POS and One-factor model Northern Italy hospital Five-factor model Combining POS and Combining POS and Combining POS and Combining POS and One-factor model
Ddf
CFI
IFI
RMSEA
– 273.00*** 155.90*** 89.10*** 456.60*** 669.70***
– 4 4 4 4 5
0.95 0.75 0.84 0.89 0.62 0.46
0.95 0.75 0.84 0.89 0.62 0.46
0.06 0.13 0.10 0.09 0.16 0.18
– 248.20*** 178.30*** 160.30*** 395.80*** 617.30***
– 4 4 4 4 5
0.92 0.74 0.79 0.80 0.63 0.48
0.92 0.74 0.79 0.80 0.64 0.47
0.07 0.12 0.11 0.10 0.14 0.17
n (central Italy hospital) = 160; n (northern Italy hospital) = 192. POS, perceived organisational support; AC, affective commitment; CC, continuance commitment; NC, normative commitment. ***P < 0.001.
from POS to Self-competence did not improve the model fit, Dv2 (1) = 0.70, ns and Dv2 (1) = 0.10, ns, respectively. Therefore, the fully mediated model was retained as the best fitting model. The standardised path coefficients associated with this model are reported in Figure 1. Perceived organisational support was positively related to affective commitment (c = 0.45, P < 0.001 and c = 0.45, P < 0.001, respectively) and normative commitment (c = 0.29, P < 0.001 and c = 0.40, P < 0.001, respectively) and negatively related to continuance commitment (c = 0.15, P < 0.05 and c = 0.15, P < 0.05, respectively) (Figure 1). Affective commitment was positively related to self-competence (c = 0.34, P < 0.001 and c = 0.18, P < 0.05, respectively) but continuance commitment (c = 0.04, ns, and c = 0.05, ns, respectively) and normative commitment (c = 0.11, ns, and c = 0.03, ns, respectively) were not. Hence, hypothesis 2a was supported and hypotheses 2b and 2b were rejected. To examine whether commitment variables acted as mediators between perceived organisational support and self-competence (hypotheses 3a–c), a bootstrapping approach was used. Bootstrapped confidence intervals (CIs) for the indirect effects of perceived organisational support on self-competence through commitment variables were computed. The indirect effect of POS on self-competence through affective commitment was significant (0.15 [99% CI = 0.08, 0.25], and 0.08 [95% CI = 0.01, 0.15], respectively) but its indirect effects through continuance commitment (0.01 [95% CI = 0.02, 0.05], and 0.01 [95% CI = 0.01, 0.03], respectively) and normative commitment ( 0.03 [95% CI = 0.10, 0.03], and 0.01 6
[95% CI = 0.07, 0.06], respectively) were not. Hypothesis 3a was supported and hypotheses 3b and 3c were rejected. Finally, we conducted multigroup analyses to determine whether the parameters of our theoretical model were invariant across the two samples. The unconstrained multigroup structural model (e.g. relaxing all invariance constraints except the structure of the model – i.e. configural invariance) yielded a good fit to the data, v2 (256) = 495.70, P < 0.001, v2/ df = 1.94, CFI = 0.91, IFI = 0.91, RMSEA = 0.05, 90% CI 0.04, 0.06. Adding the constraint of invariant factor loadings (i.e. metric invariance; Vandenberg & Lance 2000) resulted in a nonsignificant change in model fit, Dv2 (13) = 9.10, ns, DCFI = 0.002, DIFI = 0.001. Finally, additionally constraining the structural path coefficients to be invariant across samples yielded a nonsignificant change in model fit, Dv2 (20) = 10.80, ns, DCFI = 0.002, DIFI = 0.001. This provides strong support for the invariance of the structural model across the two hospitals.
Discussion Drawing from organisational support theory (Eisenberger et al. 1986) and commitment theory (Meyer & Allen 1991), this study tested the hypothesised relationships among POS, organisational commitment and selfcompetence in the nursing staff of two Italian hospitals. The findings were similar across the two samples such that AC acted as a positive mediator of the relationship between POS and nurse self-competence. In contrast, CC and NC did not mediate this relationship. It is likely that a supportive organisation encourages the ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
7.49 1 7.28 8.44 0.73 0.69 0.68 0.78 0.55 2 33.70 3. 4. 5. 6. 7. 8.
Tenure POS AC CC NC Self-competence
39.50 1 34.73 17.96 2.66 3.22 2.63 2.57 3.29 1. Age 2. Gender
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n (central Italy hospital) = 160; n (northern Italy hospital) = 192. M, SD, and a columns on the right and correlations above the diagonal refer to the central Italy hospital, while M, SD, and a columns on the left and correlations below the diagonal refer to the northern Italy hospital. Gender: 1, female; 2, male. *P < 0.05, **P < 0.01.
– 0.87 0.76 0.79 0.73 0.90 0.22** 0.12 0.34** 0.05 00.08 – 0.03 0.45** 0.44** 0.36** – 0.13 0.05 – 0.47** 0.17* 0.38** 0.17* – 0.09 0.05 0.05 0.09 0.27** –0.04 0.11 0.07 0.00 0.10 0.01 0.92** 0.08 0.04 0.06 0.07 0.27** – 0.84 0.81 0.70 0.79 0.85
2 6.88
– –
–0.03 0.49** – 0.20** 0.58** 0.24**
0.18* 0.19* 0.12 – 0.34** 0.10
0.20* 0.02 0.05 0.16* 0.20* 0.17* – –0.06
0.05 –
0.78** 0.05
0.02 0.18*
–0.03 0.16
7 a SD M Variable
Table 3 Descriptive statistics and correlations for the study variables
1
2
3
4
5
6
8
34.68 1 39.40 11.24 2.61 3.30 2.55 2.56 3.34
M
2 40.66
7.00 1 7.57 7.86 0.83 0.76 0.66 0.53 0.66
SD
2 6.76
– –
a
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emergence of an emotional bond with the organisation as well as a sense of identification that increases the development of new skills. On the contrary, CC and NC are based on a sense of duty and a calculative orientation, respectively, which may be insufficient drivers of competence development. In effect, scholars have suggested that POS increases affective commitment by satisfying the needs for esteem and approval, leading to an integration of organisational membership and social identity (Rhoades et al. 2001, Tumwesigye 2010). This could explain the positive relationship between affective commitment and self-competence, as well as POS’s relationship to self-competence through affective commitment. In sum, nurses’ self-competence may be more reactive to the affective ties that nurses develop with their organisation than to the calculative and normative aspects of individual commitment.
Implications for nursing management This study’s findings suggest that nurse managers can foster self-competence and learning among ward nurses by acting either on support perceptions or affective commitment. For example, nurse managers can use empowerment strategies and make sure ward nurses benefit from decision latitude in their jobs and participate in decision making, receive valuable feedback about their performance, or enjoy diversity in their tasks. Empirical evidence from a recent research indeed indicates that by designing work in ways that allow individuals to use their full potential and capabilities, individuals increase intellectual flexibility and are able to deal with more complex problems, and strengthen their occupational identities (Parker 2014). Moreover, previous work suggests that such supportive, job-based actions are likely to provide nurses with job resources that foster job engagement and ultimately facilitate the learning process (Shacklock et al. 2014). Other signs of support can be transmitted to ward nurses when nurse managers make sure that fair decisions are taken and the employer’s promises are kept and fulfilled over time. For example, in a study of registered nurses and midwives conducted in Australia, Rodwell and Gulyas (2013) found that both the employer’s fulfilment of promises (e.g. regarding career and developmental opportunities) and fair treatment at work (e.g. fair allocation of resources across members of the nursing team) contributed to more job satisfaction and organisational commitment. Although nurse managers do not always have control over the extent to which organisational promises are 7
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0.45***(0.45***)
Perceived organisational support
–0.15* (–0.15*)
0.29***(0.40***)
Affective commitment 0.34***(0.18*)
Continuance commitment
Normative commitment
0.04 (0.05)
Selfcompetence
–0.11 (0.03)
Figure 1 Standardised path coefficients for the structural model. Results for the northern Italy hospital are in parentheses while those for the central Italy hospital are not. *P < 0.05; **P < 0.01; ***P < 0.001.
kept and just decisions are implemented, they can nonetheless use their negotiation power to make sure these issues are properly addressed in their teams. An alternative way through which nurse managers can foster self-competence is through protecting ward nurses from being exposed to excessive workload, conflicting demands, role ambiguity or emotionally draining events (Adriaenssens et al. 2012). In effect, nurse managers can enhance support perceptions when they exert a protective function for ward nurses. For example, they can warn the nursing director when job demands exceed nurses’ resources and potentially affect the quality of care to patients. In so doing, they act as supportive and protective leaders for their team. Finally, nurse managers can also create the conditions for self-competence and learning by creating linkages between the nursing team and the hospital’s upper management. As hospitals are decentralised organisations, nursing heads can facilitate the development of affective commitment among ward nurses by defending their actions to upper management (e.g. nursing director). Nurse managers can also do so by aligning the values in use in their team with those promoted by the hospital. Such person–organisation fit has indeed been shown to predict organisational commitment among nursing faculty (Gutierrez et al. 2012).
Limitations This study has a few limitations. Firstly, all the data were collected at the same time using self-reported measures. It would be worth including more objective measures in the future such as supervisor-rated job performance, as this would allow examination of whether self-competence results in stronger work performance. Secondly, as the present study was cross-sectional, we cannot draw conclusions regarding causal connections among variables. For example, it may be that self-competence leads to support 8
perceptions and commitment rather than the reverse. Future research should consider using longitudinal designs to investigate the long-term effects of organisational strategies promoting self-competence and involvement in the work unit. Thirdly, it would have been interesting to study if self-competence levels in nursing teams are related to nursing staffing rates (i.e. proportion of planned nursing hours which are actually covered). However, such data were not available in this study. One may speculate that self-competence increases the likelihood that nurses complete their tasks more efficiently, hence affects staffing rates. Fourthly, future research could supplement the quantitative approach used in this study by a qualitative approach incorporating interviews and/or focus groups to gain a better understanding of the dynamics of individuals’ psychological experience of self-competence. Fifthly, stratified instead of convenience sampling should be used in future investigations. This procedure reduces sampling errors and enhances the external validity of studies. A future purpose of this study is thus to continue the data collection in order to obtain data from other similar samples and look at the generalisability of our model. Moreover, further efforts should be put into unveiling the role of work motivation in the relationships among perceived organisational support, commitment and selfcompetence. The work context (i.e. POS) may indeed significantly influence perceived self-competence and work motivation (Wright 2004, Battistelli et al. 2013). In fact, being successful in controlling one’s own work or new situations arouses positive emotions capable of generating skill transfer toward handling similar tasks and more autonomous motivation. It is likely that as employees perceive that the organisation satisfies their need for growth through fostering self-competence perceptions they will be enthusiastic about what they are doing. Similarly, future research may investigate the role of self-competence in other outcomes such as ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
Support, commitment and self-competence
psychological well-being, job engagement and employee performance. Finally, an international research comparison would help to accumulate knowledge regarding the cross-cultural applicability of the role of perceived organisational support and commitment in the emergence of self-competence.
Conclusion This study showed that supporting employees by caring about their well-being as well as fostering positive forms of organisational commitment creates a fertile context for the development of nurses’ selfcompetence. Across two Italian hospitals, perceived organisational support was found positively to relate to self-competence through affective commitment, whereas continuance and normative commitment did not mediate this relationship.
Source of funding This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.
Ethical approval Ethical approval was obtained from the appropriate ethics committee of the Italian Public Health Department. Formal permission to survey ward nurses was obtained from the Health Directors of the hospitals where the study was conducted. Both verbal and written information about the nature and purpose of the study was given to nurses to ensure ethical clarity. Informed consent to participate was assumed on receipt of the completed questionnaires.
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ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
Perceived organisational support, organisational commitment and self-competence among nurses: a study in two Italian hospitals ADALGISA BATTISTELLI CARLO ODOARDI M S c 4
PhD
1
, MAURA GALLETTA
PhD
2
, CHRISTIAN VANDENBERGHE
PhD
3
and
1
Professor, Bordeaux University, Bordeaux, France, 2Research Fellow, University of Cagliari, Cagliari, Italy, Professor, HEC Montreal, Montreal, Quebec, Canada and 4Professor, University of Florence, Florence, Italy
3
Correspondence Maura Galletta Department of Public Health University of Cagliari SS554 bivio per Sestu 09042 Monserrato Cagliari Italy E-mail: [email protected]
BATTISTELLI A., GALLETTA M., VANDENBERGHE C. & ODOARDI C.
(2015) Journal of Nursing
Management Perceived organisational support, organisational commitment and selfcompetence among nurses: a study in two Italian hospitals Aim This study examined the contributions of perceived organisational support (POS) and organisational commitment (i.e. affective, continuance and normative) to self-competence among nurses. Background In high-POS environments, workers benefit from socio-emotional resources to improve their skills, while positive forms of commitment (e.g. affective commitment) create a fertile context for developing one’s competencies. Methods A cross-sectional study was conducted among the nursing staff of two Italian urban hospitals (hospital A, n = 160; hospital B, n = 192). A structured questionnaire was administered individually to the nurses. Data analysis was conducted through multi-group analysis and supplemented by a bootstrapping approach. Results The results showed that POS was positively related to self-competence through affective commitment. In contrast, continuance and normative commitment did not mediate this relationship. Conclusions This study shows that supporting employees through caring about their well-being as well as fostering positive forms of organisational commitment increases nurses’ self-competence. Implications for nursing management Nurse managers may increase support perceptions and commitment among their staff by rewarding their contributions and caring about their well-being, as well as concentrating on training strategies that improve work-related skills. Keywords: affective, continuance, normative commitment, perceived organisational support, self-competence Accepted for publication: 13 December 2014
Background Nurses’ competencies represent an important human feature that contributes to performance and the quality of nursing care (Istomina et al. 2011). In this sense, continuing education to increase and improve DOI: 10.1111/jonm.12287 ª 2015 John Wiley & Sons Ltd
competence is becoming increasingly important (e.g. Vernon et al. 2013). Indeed, given the complexity of health-care delivery in today’s hospitals, nurses’ sense of competence can make the public confident that the provision of health services meets the expected levels of quality (Vernon et al. 2011). Self-competence is 1
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also critical for nurses themselves as it allows them to build their confidence in completing work duties efficiently (Kajander-Unkuri et al. 2014). In this study, we look at the role of perceived organisational support (POS) and organisational commitment as drivers of nurse self-competence. The POS reflects the aggregate perception by employees that their employer takes actions that support them (Eisenberger et al. 1986). This perception is a well-established precursor of organisational commitment (Rhoades & Eisenberger 2002). Thus, POS indirectly contributes to increase the retention of workers in the organisation. Given the positive features associated with POS and commitment, we thus investigate the possibility that they can also contribute to instil a sense of competence among nurses. Indeed, organisations that adopt supportive management practices tend to offer employees opportunities to grow and to increase their competencies (Kraimer et al. 2011). We thus explore this possibility in a nursing context.
Overview of the literature and the core concepts of the study Self-competence Perceived competence has been described in various ways. In the pioneering literature, Conger and Kanungo (1988) defined it as empowerment and asserted it is a motivational construct that has a status similar to self-efficacy. Thomas and Velthouse (1990) have argued that empowerment is multifaceted and should be considered as an intrinsic task motivation manifested in a set of four cognitions reflecting an individual’s orientation to his or her work role: meaning, competence (which is synonymous to Conger and Kanungo’s self-efficacy), self-determination and impact. Among these four cognitions, competence reflects an individual’s belief that he or she is capable of performing tasks with skill. Following the classic definition of Bandura (1977), competence is analogous to agency, beliefs, personal mastery and/or effort-performance expectancy. This dimension has been labelled competence rather than general self-efficacy by Spreitzer (1995) because her definition focuses on efficacy specific to a work role. In the pioneering literature, self-competence has been defined as an individual’s subjective evaluation of his/her task-related ability, a sense of confidence stemming from the perceived ability to act efficiently in a specific situation (Ford 1985). It is the psychological component of the construct, called ‘competence’. Self-competence also 2
involves performance expectations: self-competent people are supposed to perform at higher levels. Thus, the concept ‘self-competence’ (‘I can do it’) subsumes also attributes of the concept ‘self-efficacy’ (‘I am effective’) (Bandura 1977). Self-competence is specific to particular situations or specific tasks, and it can be influenced by the joint effect of situational and dispositional factors (Williams & Lillibridge 1992). A few more recent studies on perceived self-competence have reported positive relationships with performance (Parker & Collins 2010), psychological well-being (Dogan et al. 2013), task interest (Judge et al. 2007) and attitudes toward the organisation (Yakin & Erdil 2012). Similarly, POS can enhance perceived competence through increasing employees’ interest in their work. In their meta-analysis, Mathieu and Zajac (1990) have reported a positive correlation between perceived competence and affective organisational commitment. It is thus possible to assume that self-competence may emerge as a result of organisations providing growth opportunities (i.e. high POS), which can lead to increased organisational commitment (which in turn may foster selfcompetence). These assumptions make sense in regard to prior work. For example, Battistelli et al. (2006) found that employees who experienced high levels of self-competence perceived that they were supported by their organisation and were more involved in their work.
Perceived organisational support Perceived organisational support reflects an employee’s perception regarding the extent to which the organisation values his or her contribution and cares about his or her well-being (Eisenberger et al. 1986). It emerges through exposure to actions taken by the organisation or its representatives that benefit employees. The POS is an important element of a social exchange process whereby employees trust that the organisation will provide rewards and value their accomplishments and the organisation trusts that employees will perform highly at work (Shore & Wayne 1993). Research has reported POS to be negatively related to absenteeism (Eisenberger et al. 1986, Adebayo & Nwabuoku 2008) and turnover intention (Tumwesigye 2010) and positively related to effort–reward expectancies, inrole performance and prosocial behaviour (Uymaz 2014), and proactive and citizenship behaviours (e.g. Shore & Wayne 1993, Chu & Lee 2006, Young 2012). Similarly, POS has been found to be related to, yet distinct from, affective organisational commitment ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
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(Shore & Tetrick 1991, Shore & Wayne 1993, El Akremi et al. 2014), continuance commitment (Shore & Tetrick 1991) and normative commitment (Battistelli et al. 2006). Rhoades et al. (2001) have shown that POS led to a change in affective organisational commitment, and not the reverse. Moreover, highPOS environments fulfil employees’ needs for affiliation, esteem and autonomy (Ryan & Deci 2000) and hence promote a high sense of competence and mastery in managing work activities.
or decisions that make the retention of valued assets (e.g. company benefits, status in the community) more salient. Normative commitment is influenced by familial/cultural or organisational socialisation experiences that emphasise the appropriateness of continued service, or by the receipt of benefits from the organisation (e.g. investment in education or training) that create a sense of obligation to reciprocate (Meyer & Herscovitch 2001, Gellatly et al. 2014).
Study assumptions and hypotheses Organisational commitment It is widely accepted today that employee commitment can take different forms (Meyer & Allen 1991, Stanley et al. 2013, Gellatly et al. 2014). In their threecomponent model of commitment, Meyer and Allen (1991) (see also Meyer & Herscovitch 2001) conceptualised commitment as a psychological force that binds the individual to the organisation and increases the likelihood that the employee will maintain membership in the organisation. They used the labels affective commitment (which reflects a desire to stay and an emotional attachment to the organisation), continuance commitment (which refers to the perceived cost of leaving) and normative commitment (which represents a perceived obligation to stay) to differentiate among different mindsets of commitment and argued that employees can experience various combinations of all three mindsets simultaneously. Affective commitment (AC) refers to an employee’s emotional attachment to, identification with, and involvement in the organisation. Employees with strong AC maintain employment with their organisation because they want to do so (Meyer & Allen 1991). Continuance commitment (CC) refers to an awareness of the costs associated with leaving the organisation. Employees with high CC stay with their organisation because they need to (Meyer & Allen 1991). Finally, normative commitment (NC) reflects a feeling of obligation to continue employment. Employees with high NC feel that they ought to remain with their organisation (Meyer & Allen 1991). Among the three components, affective commitment has been found to be most strongly related to turnover and job performance (Meyer et al. 2002, Qaisar et al. 2012). Affective commitment is strengthened by work experiences that contribute to employees’ sense of comfort in the organisation (e.g. good interpersonal relations; role clarity) as well as their sense of ‘competence’ and self-worth (e.g. participation, feedback, challenge). Continuance commitment increases based on actions ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
The pioneering and current literature seem to suggest that employees’ sense of self-competence is influenced by perceived organisational support and organisational commitment. More specifically, a person’s self-competence develops to the extent that the organisation provides opportunities that meet the basic needs of employees, among whom the need for competence is central (Ryan & Deci 2000). It is likely that POS, as an indication of the organisation’s willingness to recognise employees’ contributions and care about their well-being, will ultimately lead to enhanced self-competence. Indeed, a supportive organisation facilitates competence development due to its emphasis on rewards throughout the learning process, thereby leading to feelings of self-competence. However, empirical studies have shown that AC at least partially mediates the effect of POS on work outcomes (e.g. Rhoades et al. 2001). Indeed, through a social exchange process, POS or the employer’s commitment to employees instils a sense of commitment in return. Continuance commitment and normative commitment may also act as mediators in this process. In effect, POS can be interpreted as a sign that organisational membership is a valuable asset for the employee, resulting in increased CC. In turn CC can lead to self-competence to the extent that CC is associated with organisation-specific skills (Meyer & Allen 1991). Moreover, normative commitment, which has been reported to be positively associated with POS (Rhoades & Eisenberger 2002), may be strengthened owing to POS reflecting the organisation’s effort at investing into developing employees’ skills. In turn, normative commitment can lead to self-competence as high-NC employees may feel they ought to develop their competencies in order to reciprocate the positive treatment received from the organisation. The above assumptions lead to the following hypotheses. Hypothesis 1. Perceived organisational support is positively related to self-competence. 3
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Hypothesis 2. Affective commitment (hypothesis 2a), continuance commitment (hypothesis 2b) and normative commitment (hypothesis 2c) are positively related to self-competence. Hypothesis 3. The relationship between perceived organisational support and self-competence will be positively mediated by affective commitment (hypothesis 3a), continuance commitment (hypothesis 3b) and normative commitment (hypothesis 3c). The purpose of the present study was to examine the above-mentioned hypotheses among the nursing staff of two Italian hospitals. The use of two hospitals allowed us to test the hypotheses on two separate samples of nurses, and therefore increase the generalisability of the model.
Methods Design and samples A paper-and-pencil questionnaire including measures of POS, AC, CC, NC, self-competence and demographic questions was administered to nursing staff of two Italian urban hospitals. Data were collected between September 2012 and January 2013. Participation to the study was voluntary and questionnaires were completed during working hours. Data collection lasted 3 weeks, with informal reminders being given by nursing units’ heads. These reminders also indicated that participation remained anonymous. In each hospital, completed questionnaires were collected in sealed boxes. The recruited samples in the study were 210 nurses from hospital A, a hospital located in central Italy and 230 nurses from hospital B, situated in northern Italy. Response rates were 76.2% (n = 160) and 83.5% (n = 192), respectively. As the data were collected from two hospitals with different characteristics (i.e. differences in size and location, different types of wards and different structures, with hospital A being a university hospital and hospital B a general hospital), we conducted separate analyses on the two samples and ran multi-group analyses to examine whether the results were invariant across the two hospitals.
Measures All measures were translated from English into Italian using a standard translation back-translation procedure. Items were rated using a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). 4
Perceived organisational support The 8-item version of the POS scale (Eisenberger et al. 1986) was used. An example question is: ‘My unit values my contribution to its well-being’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.87 and from hospital B: a = 0.84. Organisational commitment Meyer et al. (1993) 18-item scale (six items per subscale) was used to measure AC. An example question is: ‘I feel part of my unit’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.76 and from hospital B: a = 0.81. An example question for CC is: ‘I feel that I have too few options to consider leaving this unit’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.79 and from hospital B: a = 0.70. Finally, an example question for normative commitment is ‘This unit deserves my loyalty’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.73 and from hospital B: a = 0.79. Self-competence The 6-item scale of the Italian version (Battistelli et al. 2006) of the self-competence scale developed by Steel et al. (1989) was used. An example question is: ‘I have got all the skills needed to do this job well’. The Cronbach’s alphas of the scale were from the responses from hospital A: a = 0.90 and from hospital B: a = 0.85. The demographic data section comprised questions about age, gender, educational background, employment contract and organisational tenure.
Data analysis Statistical analyses were carried out using PREDICTIVE ANALYTICS SOFTWARE (PASW Inc., Chicago, IL, USA) 18.0 for Windows and Analysis of Moment Structures (AMOS Development Corporation, Crawfordville, FL, USA) 18.0 for Windows software packages. A confirmatory factor analysis (CFA) with the maximum likelihood method of estimation was used for examining the structure of the measures. Moreover, as perceptual data were used for measuring both independent and dependent variables, we examined whether common method variance (CMV) was an issue by following the recommendations of Podsakoff et al. (2003). Specifically, we used the unmeasured latent method construct (ULMC) approach to determine the prevalence of CMV. The ULMC procedure separates response variance into three components: trait, method and ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
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random error (Richardson et al. 2009). If the trait/ method models combination fits better than the trait model, there is evidence that trait-based and method variance is present in the data. If the fit of a trait/ method–R model is significantly worse than the fit of the trait/method model, there is evidence of CMV bias. Finally, our hypotheses were tested using structural equations modelling. The robustness of our theoretical path model was examined in the two samples using a multigroup analysis. Model fit was gauged using the comparative fit index (CFI), the incremental fit index (IFI), the root-mean-square error of approximation (RMSEA) (Hu & Bentler 1998), the RMSEA 90% confidence interval, and the ratio of chi-squared relative to the degrees of freedom (v2/df), which, to be acceptable, should be less than three (Kline 1998). We also examined the differences in CFI values (DCFI) across multigroup models with different restrictions in order to determine the degree of equivalence of the results in the two samples. Differences in CFI of 0.01 and larger indicate meaningful differences in model fit (Cheung & Rensvold 2002). To estimate the significance of the mediation effects of commitment variables in the POS-self-competence relationship, 95% bias-corrected bootstrap confidence intervals (CI) were constructed (MacKinnon et al. 2004) around the estimated indirect effects of POS through AC, CC and NC. To do so, 5000 random resamples of the data with replacement were used. This approach represents the most appropriate way to test for mediation effects given the known asymmetry of the theoretical distribution of indirect effects.
Results The respondents’ ages ranged from 24 to 56 years with an average of 34.68 years (SD = 7.00) in the central Italy hospital (hospital A) while it ranged from to 23 to 57 years with an average of 39.50 years (SD = 7.49) in the northern Italy hospital (hospital B). Organisational tenure averaged 11.24 years (range = 1–36; SD = 7.86) in the first hospital and 17.96 years (range = 1–38; SD = 8.44) in the second hospital. Most respondents were women (83 and 84%, respectively). Nurses who participated in the study were affiliated with various types of units such as surgery, paediatrics, internal medicine, intensive care, operating rooms and other services (see Table 1). The number of nurses differed significantly across units (P < 0.001). The CFA of the five-factor model yielded a good fit for both samples, v2 (130) = 199.50, P < 0.001, ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
Table 1 Hospital unit characteristics Northern Italy hospital
Central Italy hospital
Clinical department
N
%
N
%
Intensive care Internal medicine Operating rooms Other services Paediatrics Surgery
38 49 10 62 9 24
19.8 25.5 5.2 32.3 4.7 12.5
36 25 27 25 13 34
22.5 15.6 16.9 15.6 8.1 21.3
N (central Italy hospital) = 160; N (northern Italy hospital) = 192. P < 0.001.
v2/df = 1.53, CFI = 0.95, IFI = 0.95, RMSEA = 0.06 (90% CI = 0.04, 0.07) (central Italy hospital) and v2 (130) = 244.80, P < 0.001, v2/df = 1.88, CFI = 0.92, IFI = 0.92, RMSEA = 0.07 (90% CI = 0.06, 0.08) (northern Italy hospital), with all items loading significantly (P < 0.001; range = 0.50–0.88 in both samples) on their factor. The five-factor model also improved significantly (P < 0.001) over any more parsimonious model (see Table 2). Thus, the five-factor model is supported. The CMV analyses revealed that model fit was poorer for the method-only model than the trait-only model for both the central and northern Italy hospitals (Dv2 [13] = 446.8, P < 0.001, and Dv2 [13] = 403.5, P < 0.001, respectively). Moreover, the fit for the Trait/Method–R model was not worse than for the Trait/Method model (Dv2 [5] = 2.8, ns and Dv2 [5] = 5.9, ns, respectively). This suggests common method variance was not a serious issue in this study. The descriptive statistics and correlations for the study variables are reported in Table 3. Among commitment variables, only AC correlated significantly, but weakly with self-competence in both samples (r = 0.34, P < 0.01 and r = 0.24, P < 0.01, respectively). Perceived organisational support was positively and weakly related to self-competence in the northern Italy hospital (r = 0.17, P < 0.05) but not in the central Italy hospital (r = 0.12, ns). Hypothesis 1 was thus partly supported. Hypotheses 2a–c and 3a–c were examined using structural equations modelling. The theoretical model specifying full mediation of the POS-self-competence relationship through AC, CC and NC yielded a good fit, v2 (128) = 218.70, P < 0.001, v2/df = 1.71, CFI = 0.93, IFI = 0.93, RMSEA = 0.07 (90% CI = 0.05, 0.08) (central Italy hospital), and v2 (128) = 277.00, P < 0.001, v2/df = 2.16, CFI = 0.90, IFI = 0.90, RMSEA = 0.08 (90% CI = 0.07, 0.09) (northern Italy hospital). Moreover, freeing the path 5
A. Battistelli et al.
Table 2 Fit indices for confirmatory factor analyses v2
df
v2/df
Dv2
AC CC NC self-competence
199.50*** 472.50*** 355.40*** 288.60*** 656.10*** 869.20***
130 134 134 134 134 135
1.53 3.53 2.65 2.15 4.90 6.44
AC CC NC self-competence
244.80*** 493.00*** 423.10*** 405.10*** 640.60*** 862.10***
130 134 134 134 134 135
1.88 3.68 3.16 3.02 4.78 6.39
Model Central Italy hospital Five-factor model Combining POS and Combining POS and Combining POS and Combining POS and One-factor model Northern Italy hospital Five-factor model Combining POS and Combining POS and Combining POS and Combining POS and One-factor model
Ddf
CFI
IFI
RMSEA
– 273.00*** 155.90*** 89.10*** 456.60*** 669.70***
– 4 4 4 4 5
0.95 0.75 0.84 0.89 0.62 0.46
0.95 0.75 0.84 0.89 0.62 0.46
0.06 0.13 0.10 0.09 0.16 0.18
– 248.20*** 178.30*** 160.30*** 395.80*** 617.30***
– 4 4 4 4 5
0.92 0.74 0.79 0.80 0.63 0.48
0.92 0.74 0.79 0.80 0.64 0.47
0.07 0.12 0.11 0.10 0.14 0.17
n (central Italy hospital) = 160; n (northern Italy hospital) = 192. POS, perceived organisational support; AC, affective commitment; CC, continuance commitment; NC, normative commitment. ***P < 0.001.
from POS to Self-competence did not improve the model fit, Dv2 (1) = 0.70, ns and Dv2 (1) = 0.10, ns, respectively. Therefore, the fully mediated model was retained as the best fitting model. The standardised path coefficients associated with this model are reported in Figure 1. Perceived organisational support was positively related to affective commitment (c = 0.45, P < 0.001 and c = 0.45, P < 0.001, respectively) and normative commitment (c = 0.29, P < 0.001 and c = 0.40, P < 0.001, respectively) and negatively related to continuance commitment (c = 0.15, P < 0.05 and c = 0.15, P < 0.05, respectively) (Figure 1). Affective commitment was positively related to self-competence (c = 0.34, P < 0.001 and c = 0.18, P < 0.05, respectively) but continuance commitment (c = 0.04, ns, and c = 0.05, ns, respectively) and normative commitment (c = 0.11, ns, and c = 0.03, ns, respectively) were not. Hence, hypothesis 2a was supported and hypotheses 2b and 2b were rejected. To examine whether commitment variables acted as mediators between perceived organisational support and self-competence (hypotheses 3a–c), a bootstrapping approach was used. Bootstrapped confidence intervals (CIs) for the indirect effects of perceived organisational support on self-competence through commitment variables were computed. The indirect effect of POS on self-competence through affective commitment was significant (0.15 [99% CI = 0.08, 0.25], and 0.08 [95% CI = 0.01, 0.15], respectively) but its indirect effects through continuance commitment (0.01 [95% CI = 0.02, 0.05], and 0.01 [95% CI = 0.01, 0.03], respectively) and normative commitment ( 0.03 [95% CI = 0.10, 0.03], and 0.01 6
[95% CI = 0.07, 0.06], respectively) were not. Hypothesis 3a was supported and hypotheses 3b and 3c were rejected. Finally, we conducted multigroup analyses to determine whether the parameters of our theoretical model were invariant across the two samples. The unconstrained multigroup structural model (e.g. relaxing all invariance constraints except the structure of the model – i.e. configural invariance) yielded a good fit to the data, v2 (256) = 495.70, P < 0.001, v2/ df = 1.94, CFI = 0.91, IFI = 0.91, RMSEA = 0.05, 90% CI 0.04, 0.06. Adding the constraint of invariant factor loadings (i.e. metric invariance; Vandenberg & Lance 2000) resulted in a nonsignificant change in model fit, Dv2 (13) = 9.10, ns, DCFI = 0.002, DIFI = 0.001. Finally, additionally constraining the structural path coefficients to be invariant across samples yielded a nonsignificant change in model fit, Dv2 (20) = 10.80, ns, DCFI = 0.002, DIFI = 0.001. This provides strong support for the invariance of the structural model across the two hospitals.
Discussion Drawing from organisational support theory (Eisenberger et al. 1986) and commitment theory (Meyer & Allen 1991), this study tested the hypothesised relationships among POS, organisational commitment and selfcompetence in the nursing staff of two Italian hospitals. The findings were similar across the two samples such that AC acted as a positive mediator of the relationship between POS and nurse self-competence. In contrast, CC and NC did not mediate this relationship. It is likely that a supportive organisation encourages the ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
7.49 1 7.28 8.44 0.73 0.69 0.68 0.78 0.55 2 33.70 3. 4. 5. 6. 7. 8.
Tenure POS AC CC NC Self-competence
39.50 1 34.73 17.96 2.66 3.22 2.63 2.57 3.29 1. Age 2. Gender
ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
n (central Italy hospital) = 160; n (northern Italy hospital) = 192. M, SD, and a columns on the right and correlations above the diagonal refer to the central Italy hospital, while M, SD, and a columns on the left and correlations below the diagonal refer to the northern Italy hospital. Gender: 1, female; 2, male. *P < 0.05, **P < 0.01.
– 0.87 0.76 0.79 0.73 0.90 0.22** 0.12 0.34** 0.05 00.08 – 0.03 0.45** 0.44** 0.36** – 0.13 0.05 – 0.47** 0.17* 0.38** 0.17* – 0.09 0.05 0.05 0.09 0.27** –0.04 0.11 0.07 0.00 0.10 0.01 0.92** 0.08 0.04 0.06 0.07 0.27** – 0.84 0.81 0.70 0.79 0.85
2 6.88
– –
–0.03 0.49** – 0.20** 0.58** 0.24**
0.18* 0.19* 0.12 – 0.34** 0.10
0.20* 0.02 0.05 0.16* 0.20* 0.17* – –0.06
0.05 –
0.78** 0.05
0.02 0.18*
–0.03 0.16
7 a SD M Variable
Table 3 Descriptive statistics and correlations for the study variables
1
2
3
4
5
6
8
34.68 1 39.40 11.24 2.61 3.30 2.55 2.56 3.34
M
2 40.66
7.00 1 7.57 7.86 0.83 0.76 0.66 0.53 0.66
SD
2 6.76
– –
a
Support, commitment and self-competence
emergence of an emotional bond with the organisation as well as a sense of identification that increases the development of new skills. On the contrary, CC and NC are based on a sense of duty and a calculative orientation, respectively, which may be insufficient drivers of competence development. In effect, scholars have suggested that POS increases affective commitment by satisfying the needs for esteem and approval, leading to an integration of organisational membership and social identity (Rhoades et al. 2001, Tumwesigye 2010). This could explain the positive relationship between affective commitment and self-competence, as well as POS’s relationship to self-competence through affective commitment. In sum, nurses’ self-competence may be more reactive to the affective ties that nurses develop with their organisation than to the calculative and normative aspects of individual commitment.
Implications for nursing management This study’s findings suggest that nurse managers can foster self-competence and learning among ward nurses by acting either on support perceptions or affective commitment. For example, nurse managers can use empowerment strategies and make sure ward nurses benefit from decision latitude in their jobs and participate in decision making, receive valuable feedback about their performance, or enjoy diversity in their tasks. Empirical evidence from a recent research indeed indicates that by designing work in ways that allow individuals to use their full potential and capabilities, individuals increase intellectual flexibility and are able to deal with more complex problems, and strengthen their occupational identities (Parker 2014). Moreover, previous work suggests that such supportive, job-based actions are likely to provide nurses with job resources that foster job engagement and ultimately facilitate the learning process (Shacklock et al. 2014). Other signs of support can be transmitted to ward nurses when nurse managers make sure that fair decisions are taken and the employer’s promises are kept and fulfilled over time. For example, in a study of registered nurses and midwives conducted in Australia, Rodwell and Gulyas (2013) found that both the employer’s fulfilment of promises (e.g. regarding career and developmental opportunities) and fair treatment at work (e.g. fair allocation of resources across members of the nursing team) contributed to more job satisfaction and organisational commitment. Although nurse managers do not always have control over the extent to which organisational promises are 7
A. Battistelli et al.
0.45***(0.45***)
Perceived organisational support
–0.15* (–0.15*)
0.29***(0.40***)
Affective commitment 0.34***(0.18*)
Continuance commitment
Normative commitment
0.04 (0.05)
Selfcompetence
–0.11 (0.03)
Figure 1 Standardised path coefficients for the structural model. Results for the northern Italy hospital are in parentheses while those for the central Italy hospital are not. *P < 0.05; **P < 0.01; ***P < 0.001.
kept and just decisions are implemented, they can nonetheless use their negotiation power to make sure these issues are properly addressed in their teams. An alternative way through which nurse managers can foster self-competence is through protecting ward nurses from being exposed to excessive workload, conflicting demands, role ambiguity or emotionally draining events (Adriaenssens et al. 2012). In effect, nurse managers can enhance support perceptions when they exert a protective function for ward nurses. For example, they can warn the nursing director when job demands exceed nurses’ resources and potentially affect the quality of care to patients. In so doing, they act as supportive and protective leaders for their team. Finally, nurse managers can also create the conditions for self-competence and learning by creating linkages between the nursing team and the hospital’s upper management. As hospitals are decentralised organisations, nursing heads can facilitate the development of affective commitment among ward nurses by defending their actions to upper management (e.g. nursing director). Nurse managers can also do so by aligning the values in use in their team with those promoted by the hospital. Such person–organisation fit has indeed been shown to predict organisational commitment among nursing faculty (Gutierrez et al. 2012).
Limitations This study has a few limitations. Firstly, all the data were collected at the same time using self-reported measures. It would be worth including more objective measures in the future such as supervisor-rated job performance, as this would allow examination of whether self-competence results in stronger work performance. Secondly, as the present study was cross-sectional, we cannot draw conclusions regarding causal connections among variables. For example, it may be that self-competence leads to support 8
perceptions and commitment rather than the reverse. Future research should consider using longitudinal designs to investigate the long-term effects of organisational strategies promoting self-competence and involvement in the work unit. Thirdly, it would have been interesting to study if self-competence levels in nursing teams are related to nursing staffing rates (i.e. proportion of planned nursing hours which are actually covered). However, such data were not available in this study. One may speculate that self-competence increases the likelihood that nurses complete their tasks more efficiently, hence affects staffing rates. Fourthly, future research could supplement the quantitative approach used in this study by a qualitative approach incorporating interviews and/or focus groups to gain a better understanding of the dynamics of individuals’ psychological experience of self-competence. Fifthly, stratified instead of convenience sampling should be used in future investigations. This procedure reduces sampling errors and enhances the external validity of studies. A future purpose of this study is thus to continue the data collection in order to obtain data from other similar samples and look at the generalisability of our model. Moreover, further efforts should be put into unveiling the role of work motivation in the relationships among perceived organisational support, commitment and selfcompetence. The work context (i.e. POS) may indeed significantly influence perceived self-competence and work motivation (Wright 2004, Battistelli et al. 2013). In fact, being successful in controlling one’s own work or new situations arouses positive emotions capable of generating skill transfer toward handling similar tasks and more autonomous motivation. It is likely that as employees perceive that the organisation satisfies their need for growth through fostering self-competence perceptions they will be enthusiastic about what they are doing. Similarly, future research may investigate the role of self-competence in other outcomes such as ª 2015 John Wiley & Sons Ltd Journal of Nursing Management
Support, commitment and self-competence
psychological well-being, job engagement and employee performance. Finally, an international research comparison would help to accumulate knowledge regarding the cross-cultural applicability of the role of perceived organisational support and commitment in the emergence of self-competence.
Conclusion This study showed that supporting employees by caring about their well-being as well as fostering positive forms of organisational commitment creates a fertile context for the development of nurses’ selfcompetence. Across two Italian hospitals, perceived organisational support was found positively to relate to self-competence through affective commitment, whereas continuance and normative commitment did not mediate this relationship.
Source of funding This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.
Ethical approval Ethical approval was obtained from the appropriate ethics committee of the Italian Public Health Department. Formal permission to survey ward nurses was obtained from the Health Directors of the hospitals where the study was conducted. Both verbal and written information about the nature and purpose of the study was given to nurses to ensure ethical clarity. Informed consent to participate was assumed on receipt of the completed questionnaires.
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