THE MEDIATING EFFECT OF WORK MOTIVATION BETWEEN THE PSYCHOSOCIAL ENVIRONMENT AND NURSES’ JOB PERFORMANCE

Introduction:This study aimed to determine the level of motivation, psychosocial work environment support, and job performance. Further, it aimed to determine the relationship of motivation, psychosocial work environment, and job performance, and the mediating effect of motivation to psychosocial work environment, and job performance. Methods: The researchers employed a quantitative-cross sectional approach involving the 245 nurses working at the government hospitals of Hail city, Kingdom of Saudi Arabia. The 245 participantswere generated through snowball sampling. Descriptive statistics were used for the demographic profile. The path analysis using analysis of moment structures was utilized to determine the significance between psychosocial work environment, motivation, and job performance, and the mediating effect of work motivation on the psychosocial environment and job performance. Results:There is a high psychosocial work environment support level (x=4.70Â±1.050), moderate work motivation (x=3.87Â± 0.859) and good (33.5%) to excellent (33.5%) work performance of nurses. The psychosocial work environment support found no significant difference to motivation (p>0.029) but significant to job performance (p< 0.002).Meanwhile, the motivation on job performance found not significant (p>0.342). There is no mediating effect of motivation to psychosocial work environment support and job performance. Conclusion:The psychosocial work environment significantly relates to job performance, however, the psychosocial environment on motivation and job performance were found not significant. Conversely, there was no mediating effect of motivation on psychosocial work environment and job performance.


ISSN: 2320-5407
Int. J. Adv. Res. 8(11), 155-161 156 2018). Employee motivation is a vital ingredient within the workplace in relation to its significant influence on employee performance (Nabi et al., 2017). It is an important instrument for improved job satisfaction (Ali et al., 2016). Therefore, driven and experienced personnel is indispensable for any establishment that aims to increase efficiency and customer satisfaction (Dhaliwal, 2016). The Self-Determination Theory (SDT) presupposes that there are two main types of motivation. Extrinsic motivation is the power to behave in a definite means built on outward sources such as reward structures, ratings, appraisals, approbation by others or the fear of sentiments others might have on them. Conversely, intrinsic motivation is interior energy, which endures urges, ingenuity, and determination that emanate from within. Both motivation types stimulate individuals to act positively with interest, inquisitiveness, caution on the enduring ideals, and a particular sense of morality (Deci & Ryan, 2020).
Generally, people are mainly concerned with motivation. Staff requires diverse contending necessities that are determined by several motivators. Consequently, to make the most of organizational performance, institutions and administrators ought to recognize what really inspires employees (Lee & Raschke, 2016). Moreover, in order to create harmony with the personnel in the organization, it is imperative for management to distinguish and be conscious of the desires of the employees (Mohd et al., 2015). Countless studies had been conducted to define the factors affecting the work motivation of employees. These researches underscored the presence of empowerment, recognition, relationship, and job security as important elements in impelling employees' work motivation (Khan, et al., 2018;Rahman, et al., 2018;Nabi, et.al., 2017). These elements support Noe's (2017) definition of a desirable employee workplace in terms of six crucial areas, namely: a controllable workload; selected individual control over the work; support from co-workers and superiors; positive interactions in the workplace; realistically clear functions; and a sense of control or participation in major decisions at work. Therefore, a work environment is far beyond physical components as it includes the institution's psychosocial atmosphere. A psychosocial environment also refers to the interpersonal and social exchanges prompting interactive and evolving activities in the work milieu (Jacobs et al., 2013). Remarkably, a sound psychosocial environment does not only influence employees' motivation but it does affect their job performance as well which is explicitly observed in the role of supervision. With a positive working atmosphere in place, the comprehensibility of the roles and responsibilities of employees can be facilitated in order for them to realize their expected job-related obligations (Samson et al., 2015).
In consideration of the importance of psychosocial support at work, the joint committee of the International Labor Organization (ILO) and the World Health Organization (WHO) substantially discussed and integrated into the Occupational Safety and Health -a tremendous influence on the physical and mental well-being of workers (ILO, 1984). Among the detrimental effects are the thirteen psychological risk factors in the workplace, which the Canadian Centre for Occupational Health and Safety identifies, can lead to increased absenteeism, strain, greater risk for accidents or injuries, and others (CCOHS, 2018).
Nurses perform a diversity of roles and responsibilities when deployed in a variety of health care settings. When assigned in the hospital, nurses deliver care to clients in different units with various levels of complexity. Hence, the highest job performance from nurses is required as they cater to patients' needs for optimum health and function. There had been a few studies conducted elsewhere related to the psychosocial work environment, work motivation, and factors affecting the job performance of various other professionals. However, there has been a dearth of studies investigating the pattern of relationships among these variables involving professional nurses. The recognition of the need and the importance of investigating the perceived psychosocial environment of nurses is of paramount importance. This gives a specific perspective on how nurses are motivated, supported in terms of the psychosocial work environment and their job performance. This study aims to determine the level of motivation, psychosocial work environment support, and job performance. Further, it aims to determine should motivation has a mediating effect on the psychosocial work environment and job performance.

Methods:-Study Design:
This study utilized a quantitative-cross sectional approach.

Setting and Participants:
This study was conducted in the Hail region, Kingdom of Saudi Arabia. It includes nurses from the government hospitals located in the city of Hail. There were 245 nurses who participated in this study generated through snowball sampling. The inclusion criteria for the study respondents to be part of the sampling frame were: (1) with a minimum of three (3) months' experience in the hospital; and (2) a willingness to participate in the study.

Research Instruments:
The study used a four-part questionnaire. The first part of the questionnaire provided information on the demographic profile of the study respondents. More specifically, it generated information on the study respondents' age, gender, civil status, and job title.
The second part of the questionnaire was adopted from the short version of the Copenhagen Psychosocial Questionnaire (COPSOQ). The COPSOQ is a self-reported psychometric instrument composed of forty (40) questions for assessment of the psychosocial work environment. More specifically, the first 16 indicators assess the psychosocial factors at work, while indicators 17, 18, and 19 assess the respondent's health, burnout, and stress, respectively. The first 19 indicators are composed of a pair of questions (i.e., 1A and 1B) except for indicators 13 and 17, which are made up of a single question. Respondents rated questions in indicators 1 to 12, 15, 16, 18, and 19 using a five-point Likert scale from zero to four resulting in a mean value ranging from zero to eight. Indicator 14 is rated using a four-point Likert scale from zero to three giving rise to a mean value ranging from zero to six. Singlequestion indicators 13 and 17 were rated with a four-point Likert scale from zero to three and a five-point Likert scale from zero to four, respectively. Mean values obtained from the first 19 indicators were not rounded and utilized only the first digit for interpretation of the scores. Indicators 20 -23 assess respondent's workplace exposure to undesired sexual attention, threats of violence, physical violence, and bullying, respectively. The COPSOQ was developed by the National Center for the Working Environment in Denmark (NCRWE, 2017) and the validity and reliability of the English version has been well documented (Kristensen et al.,2006).
The third part of the questionnaire was adopted from the Multidimensional Work Motivation Scale (MWMS) developed by Gagne et al in 2014. The MWMS is similarly a self-reported psychometric that elicits the respondents' work motivation through their responses to indicators in six motivational domains identified through the multidimensional conceptualization of motivation postulated by the self-determination theory, namely: (1) amotivation (indicator numbers 1 to 3); (2) extrinsic regulation -social (indicator numbers 4 to 6); (3) extrinsic regulation -material (indicator numbers 7 to 9); (4) introjected regulation (indicator numbers 10 -13); (5) identified regulation (indicator numbers 14 to 16); and (6) intrinsic motivation (indicator numbers 17 -19). The indicators were rated by the respondents through a seven-point Likert scale as follows: 7 with a verbal interpretation of "completely"; 6 with a verbal interpretation of "very strongly"; 5 with a verbal interpretation of "strongly"; 4 with a verbal interpretation of "moderately"; 3 with a verbal interpretation of "a little"; 2 with a verbal interpretation of "very little"; and 1 with a verbal interpretation of "not at all". Reliability and validity of the English version of the MWMS has been well established and documented (Gagne et al, 2014).
The fourth part of the questionnaire is a direct question, which asked the nurses to report their job performance for the past year. The nurses can rate themselves based on the following; good, very good, and excellent.

Data Collection:
Online data gathering was facilitated with a questionnaire in Google Form. The cover section of the questionnaire served as an informed consent form that provided details pertinent to the study, its procedure, aim, risks, and benefits as well as voluntary participation. The research investigators coordinated with the deputy chief nurse of the selected hospital in the process of gathering the data. The online link to the questionnaire was sent to head nurses in the different units of the selected hospital and was subsequently referred to the staff nurses. Daily progress in the number of respondents was reported to the deputy chief nurse of the selected hospital. Data gathering commenced on July 26, 2020 to September 03, 2020.

Statistical Analysis:
Data were coded for analysis through the use of SPSS version 22. The study respondents' demographic characteristics, perceptions of the psychosocial environment, and work motivation were analyzed and presented using descriptive statistics in the form of frequencies, percentages, means, and standard deviations. Path analysis using Analysis of Moment Structures was utilized to determine the mediating effect of work motivation on the relationship between the respondents' perceptions of the psychosocial environment and job performance.
158 Table 1:-Demographic Profiles of the Respondents. Table 2 presents the overall mean and percentage value for psychosocial support, work motivation, and job performance. The psychosocial work environment support level of the participants in this study revealed high scores (x=4.70± 1.050) out of six. Regarding work motivation, the participants have had a moderate work motivation(x=3.87 ±0.859). Meanwhile, staff nurses varies with their job performance rating which ranging from good (33.5%) to excellent (33.5%). The psychosocial work environment support has no significant difference to motivation (p = 0.029) but significant to job performance (p = 0.002).Meanwhile, the motivation on job performance is not significant (0.342). There is no mediating effect of motivation to psychosocial work environment support and job performance.

Discussion:-
This study found that nurses have had a good psychosocial work environment that focuses support to their working condition. The good psychosocial work environment can be due to nurses' good coping mechanism that involves the control of their attention over situations. With the supportive work culture (Pasay-an, 2020) and a positive working atmosphere in place (Samson et al., 2015) the transparency of the job responsibilities of each worker can be facilitated and realized. This study finding indicates that good psychosocial working conditions of nurses can further advance their commitment to work towards better outcomes of patient care. Conversely, the good work motivation among nurses in this study implies that nurses have a good response to the demands of work and their environment. As such, while they are motivated at work, they are expected to accomplish their duties and responsibilities without any pressure. This current finding agrees with Toode (2015) where practicing nurses are beyond moderately motivated to work. The good motivation can give nurses the commitment to perform their duties (Battistelli et al, 2013). Such finding contributes to the understanding and appreciation of the nurse managers in continuing to motivate their employees. Likewise, this study found that nurses are good to excellent job performance, which means that these nurses are expected to delivering quality care to their patients. The good to the excellent job performance of these nurses is assumed to credit to their moderate work motivation. Such finding is similar to Mrayyan and Al-Faouri (2008) and Al-Makhaita et al (2014) where nurses perceived their performance at a good level.
The psychosocial work environment support has no significant difference in motivation. Although this finding has not well explored in the literature but it is assumed that nurses have different motivational factors. This result is in disagreement with Oladipo (2009) where a good working environment could usually result in their good potentials. Earlier literature showed that a good working environment leads the workers to be more motivated and deliver a good result of their work Leblebi, 2012). In fact, the quality of the work environment has an influence on how employees are being motivated and eventually do well in their work (Leblebi, 2012). To Peters and Zelewski (2007) having a well-supported and good workplace environment can decrease absenteeism. This leads the workers to do more and be productive in their work area. This current result is an indication that nurse leaders need to look at the motivational factors that affect the performance of their employees. Moroever, the psychosocial work environment significantly relates to job performance. This means that nurses who have stronger psychosocial support tend to perform well in their job. Researchers like Javaid and colleagues (2018) discussed the implication of putting more pressure on the employees -that having demanding work environment employees will lose control and will not be productive. It is in this context that the support of the nursing leaders to their nurses is of paramount importance. Of note, the current result found that work motivation to the job performance of nurses is not significant. However, Said and colleagues (2015) have demonstrated in their study that motivation is a vital element that increases the job performance and productivity of the employees. Conversely, in order to have a good commitment of employees to their workplace, the organization needs to balance the resources and needs of employees (Alsaqri et al, 2020) for them to be motivated in their work.
Motivation has no mediating effect on the psychosocial work environment and job performance. This means that nurses in this study do not consider motivation as a key factor in a good work environment and job performance. Although this on-going result needs to be cautiously interpreted as this study is self-reported and that over or the under-report may have an impact on the result. This result disagrees with the study of Jayaweera (2014) where work motivation mediates the relationship between working conditions and job performance. Further, earlier research demonstrates the influence of motivation on job performance (Bogdanova&Naunivska, 2008) and employee productivity (Chaudhary & Sharma, 2012).

Study limitation:
The researchers acknowledge some limitations, which include the self-report approach of this study. This can be addressed by way of validating the self-report through interviews. Moreover, the snowball sampling employed in this study does not ensure a good representation of the nurses in the region, thus, the non-generalization of the results. It is highly recommended that future studies should employ systematic or simple random sampling.

Conclusion:-
The psychosocial work environment significantly relates to job performance, however, the psychosocial environment on motivation and job performance were found not significant. Conversely, there was no mediating effect of motivation on psychosocial work environment and job performance.