Job Satisfaction and Organizational Commitment : A Case Study of Hospitals in Pakistan

Khursheed Iqbal3 Brains Degree College Peshawar Organizational commitment is the individual's psychological Organizational commitment is the individual's mental attachment to the organization and is perceived as employees’ eager to contribute in organizational achievements feeling satisfied at work. The study aimed at examining the relationship between the organizational commitment and job satisfaction among the nurses of public and private sectors hospitals in Peshawar. The study used a reliable instrument (Cronbach alpha=0.91), developed from the literature, containing 27 items to measure the components of organizational commitment and job satisfaction. A sample size (N=120) was randomly selected, consists of female nurses employed in public and private hospitals in Peshawar. The primary data was analyzed using descriptive statistics, Pearson correlation and regression analysis. The results showed that the affective commitment and normative commitment are significantly positively associated with job satisfaction, while the continuous commitment was not significantly associated with job satisfaction of the nurses in hospitals of Peshawar. The study revealed that employees who are highly committed to the organization have higher level of job satisfaction. It is concluded from the finding of the study that a caring and conducive work environment may play a vital role in creating organizational commitment among employees.

Job satisfaction an outcome of a healthy relationship between people and their work has been focus of attention since the era or industrialization by managers, policy makers and researchers.It is a generalized assumption that the employees who are satisfied at work would perform their duties and responsibilities with high commitment.Thus it is important for employers and employees to know those aspects that can hinder or improve the job satisfaction and consequently affect the performance of organization as well in a competitive environment.Effective management of people at work results in high organizational commitment and can lead to valuable consequences such as increase in effectiveness, productivity, performance and decrease in turnover and absenteeism, at both individual and organizational levels (Fiorita, Bozeman, Young & Meurs, 2007).The demand of the modern era of management and organization is to employ such people who have emotional involvement with the organization and have positive feelings towards the organizational objectives, values and vision.
Health, as a vital industry of services sector, contributes not only in the socio economic growth but also in overall growth of the nation.The era of globalization and information is enforcing organizations to struggle for better health care policies and make it a necessary component of human resource development.Organizational success and development especially in healthcare industry is strongly based on the job satisfaction and organizational commitment of its workforce.Pakistan is experiencing quality issues in health care system and the healthcare workforce is struggling for their job satisfaction from various aspects.Due to limited investigations in the healthcare from such perspective, the study was intended to investigate the relationship between components of organizational commitment and job satisfaction in the hospitals of District Peshawar, Pakistan.The study was conducted on the selected respondents designated as nurses considering their highly sensitive role in the hospitals.The significance of this study may contribute advantage to human resource management in creating the conductive working environment that may increase the job satisfaction and work commitment.Further the study would facilitate the Ministry of Health in making decisions pertaining to the profession.The future research is recommended for doctors and other administrative workers in healthcare industry.
Human job satisfaction at work is a major concern for organizational survival and is studied in most frequently researches.It is important to know how employees feel, experience and perceive about their jobs for achieving the goal of optimal productivity (Kim 2005;Nelson, 2006;Willem, Buelens & Jonghe 2007;Worrell 2004).Job satisfaction refers to the extent to which employees are satisfied with their present work perceiving that their needs and wants are fulfilled (Finn, 2001).Job satisfaction has various features including working environment, organizational commitment (Lane et al., 2010;Vidal, Valle & Aragon, 2007).Job Satisfaction enhances the ability of creativity and productivity of workforce and is directly linked to customer satisfaction (Al-Hussami, 2008).The studies revealed that organizational commitment and job satisfaction are related with each other (Lane et al., 2010;Yang, 2010) .According to Locke, (1976) the work itself, the pay, promotional system, working conditions, supervision, and attitude of coworkers are the dimensions that contribute significantly to employee's job satisfaction.
Organizational commitment is the intensity of an employee having responsibility approach towards the goals of the organization.It is based on the perception of employees that they will achieve personally with the achievements of the organization (Mathieu & Zajac, 1990;Okpara, 2004) along with a robust strategic intervene at various level of organization.It is found a significantly positive relationship between job satisfaction and organizational commitment (Ayeni & Phopoola;2007).Maxwell and Steele (2003) proved in their study that the higher experience with job and co-workers in a tenure have positive impact on commitment, while others found that specific variables such as age, organization and position tenures frequently influence level of organizational commitment of employees (Benekohal et al., 1994;Gregersen & Black, 1992;Mathieu & Hamel, 1989;Mathieu & Zajac, 1990;Williams & Hazer, 1986).
According to Meyer and Allen (1991), a multidimensionality model of organizational commitment is common including affective, continuance and normative components.The affective commitment is one's spiritual attachment and identification with an organization i.e a strong desire to stay in the organization (Mowday, Porter, & Steers, 1982).The continuance commitment is the cost associated with leaving the job i.e leaving the organization will mean pensions, seniority, social status, and access to social networks ,loss of benefits, pay deductions etc. or the fear that one won't be able to find a substitute job (Dawley, et al., 2005;Shahnawaz, & Juyal, 2006;Murray, Gregoire, & Downey, 1991).The normative commitment is perceived as moral obligations and responsibilities to remain with the organization (Meyer & Allen, 1991;Wiener & Gechman, 1977).Individuals with high normative commitment continue with the organization considering it morally right even avoiding the better substitutes (Felfea, et al., 2009).All the three components result in continuing participation in the organization (Ayeni & Phopoola, 2007;Lim,2010;Rodrigues, D. F. L., & Lopes, D. M., 2015).
Studies on organizational commitment provide strong evidences that affective & normative commitments are positively related to organizational outcomes such as performance and citizenship behavior while continuance commitment is negatively related to it (Hackett, Bycio, & Handsdoff, 1994;Shore & Wayne, 1993).Moreover, employees with higher level of affective commitment to their work, job & career exhibit higher levels of continuance and normative commitment (Cohen, 1996).
The study of Carmeli and Freund (2009) proved a positive relationship between external prestige, affective job commitment and job satisfaction.Organizational commitment has significant effect on job satisfaction and can affect the turnover intentions (Bateman & Strasser, 1984;Dubinsky et al. 1990).Several research studies indicated that the managers who are highly committed to organization may have higher level of job satisfaction (Lau & Chong, 2002).According to Irving, Coleman and Cooper (1997) the job satisfaction is positively related to affective and normative commitment.Studies also shown that gender, individual characteristics, and match of job experiences with employee's expectations can influence degree of organizational commitment and job satisfaction (Rosin & Korabik, 1991;Hellriegel, Slocum & Woodman, 2001).
The studies on job satisfaction and organizational commitment and have been focused in scholarly research and literature (Bodla & Danish, 2009) as antecedents of employee's performance (Suma, S., & Lesha, J. (2013).Those investigations proved a positive correlation between job satisfaction and organizational commitment (Mathieu & Zajac, 1990;Darolia et al., 2010;Jamal, 2011) and their relationship has an influence on performance and turnover intent (Clugston, 2000; Suma, S., & Lesha, J. 2013).Khan et al. ( 2010) and Rodrigues, D. F. L., and Lopes, D. M. F. ( 2015) made a comparative inquiry into three dimensions of organizational commitment and found a significantly positive impact of the normative commitment on employees' job performance.

Objectives
To investigate the relationship between affective commitment and job satisfaction 1.To find the association between continuous commitment and job satisfaction.2. To know the relation between normative commitment and job satisfaction.

Hypotheses
H1: There will be significant relationship between affective commitment and job satisfaction.H2: There will be significant relationship between continuous commitment and job satisfaction.H3: There will be significant relationship between normative commitment and job satisfaction.

Method
This quantitative study focuses on analyzing the association between organizational commitment and job satisfaction among the nurses working in the public and private sector hospitals in Peshawar city, Pakistan.The population of the study includes the nursing staff of the public sector hospitals in Peshawar city including Lady Reading Hospital (LRH), Khyber Teaching Hospital (KTH), Hayatabad Medical College (HMC), and the private sector hospitals including Rehman Medical Institute (RMI), and North West General Hospital Peshawar (NWGH).These hospitals are the popular and big hospitals in terms of health facilities, number of patients, number of doctors and nursing staff in the whole province of KPK.One hundred and twenty (n=120) nurses were selected in equal proportion from both the public and private hospitals through random sampling technique.
A reliable questionnaire was used as a research instrument and distributed to the nursing staff with prior consent in the aforementioned hospitals.The section A of questionnaire was to collect the data on demographics, while section B used to measure the affective organizational commitment, section C to measure continuance organizational commitment, section D to measure the normative organizational commitment and section E to determine job satisfaction.

Measurement Items
Variables Figure 1 shows the data analysis model of the study.Following the conceptual framework (as in Fig. 1), through the application of descriptive analysis, Cronbach Alpha test, Pearson Correlation Coefficient analysis and Multiple Regression analysis by using SPSS software version 18.

Demographic Analysis
The demographic characteristics of the sampled respondents are summarized in Fig. 2. As is evident in Fig. 2, fifteen percent data was collected from the KTH, eighteen percent from LRH and seventeen percent from HMC.It can be seen in Fig. 2, data was collected in equal proportion from both the public and private sector hospitals (60 respondents from public and 60 respondents).As described Fig. 2, out of 120 majority respondents were single (74 percent) while, 26 percent were married nurses.

Affective Commitment
Job Satisfaction

Continuance Commitment Nurses of the hospitals in Peshawar City
Normative Commitment

Figure. 2 Demographic Characteristics of Respondents
As presented in Fig. 2, approx.15 percent data was collected from KTH, the 17.5 percent was collected from LRH and HMC and the 24.6 percent data was collected from NW and 25.4 percent data was collected from the RMI hospital.Table 2 shows Cronbach alpha that is done to check the internal consistency of the scales in the instrument (Cronbach's Alpha; Cronbach, 1946).As presented in Table 2, the Cronbach's Alpha value is α=0.91thatdepicts very high reliability of the scale.

Note: AC = Affective commitment, CC=Continuance commitment, NC=normative commitment and JS= job satisfaction
Table 3 shows the descriptive statistics (mean value and standard deviation) of the dependent and independent variables.The summary of descriptive analysis explains that all the variables are evaluated for n=120 based on a five-point scale.In Table 3, the results reveals the mean value for affective commitment is 3.69 with SD = 0.88, the mean value for continuance commitment is 3.41 with SD = 0.68, and the mean value for normative commitment is 3.54 with SD = 0.84.On the other hand, the mean value and standard deviation for job satisfaction (dependent variable) is 3.57 with SD = 0.911 respectively.As is evident data in Table 3, the mean value and standard deviation for dependent variable (job satisfaction) is 3.570 and 0.911 respectively.Moreover, the highest mean value iss recorded for affective commitment (mean value = 3.69), whereas, lowest mean value is observed for continuance commitment (mean value = 3.41).

Correlation Analysis
Pearson Correlation Coefficient analysis is used to determine the degree of relationship between independent and dependent variable (Davies 1971;Cohen 1988).
Table 4 presents Pearson correlation matrix of the dependent and independent variables.As shown in Table 4, moderate positive association was found between affective commitment and continuous commitment (r =.60 percent, p < 0.001).This implied that affective commitment and continuous commitment was positively associated with each other.As described in Table 4, strong positive association was observed between normative commitment and affective commitment (r = approx.77 percent, p-value <0.001).This implied that the association between normative commitment and affective commitment was positive and significant.It can be seen in Table 4, positive association was reported between normative commitment and continuance commitment (r = 59 percent, p-value <0.001).The study concluded that all the three components of organizational commitment (independent variables) have strong positive association with each other.The increase in one brought positive change in other and vice versa.The data presented in Table 4 demonstrated that correlation between job satisfaction and affective commitment was positive (r = 80 percent, p-value <0.001).It implied that affective commitment positively influenced the job satisfaction of nurse's staffs working in the Peshawar city.Data in correlation analysis (Table 4) exhibited positive association between continuance commitment and job satisfaction (r = 61 percent, p-value<0.001).It implied that continuance commitment positively influenced the job satisfaction of nurse's staffs.The correlation analysis, as shown in table 4, depicted that normative commitment was positively linked with job satisfaction ( r = 79 percent, p-value<0.001) .This explains that normative commitment has strong and positive association with job satisfaction.Table 5 indicates that the model as a whole is statistically significant (F=16.29,p=.001], as the p-value is highly statistically significant at p<.005.Job satisfaction is dependent variable while affective commitment, continuance commitment and normative commitment are independent variables in this study.As is clear from the data in table 5, that 1 unit change in affective commitment (AC), brought 0.44 units change in Job Satisfaction.The value of β1=0.44,(t =6.801, pvalue <0.001), as the p-value is less than 0.05 therefore, the null hypothesis is rejected and alternative hypothesis is accepted.This means that affective commitment has relation with job satisfaction.
As can be seen from table 5, that 1 unit change in Continuance Commitment (CC), brought 0.068 unit change in Job satisfaction.The value of β2=0.068,(t =1.004, p<0.31), as the p-value is greater than the 0.05, thus, the null hypothesis of no difference is accepted.This means that continuous commitment has no or least statistically significant influence on job satisfaction.
The analysis, as shown in table 5, illustrates that 1 unit change in normative Commitment (NC), brought 0.35 unit change in Job satisfaction.The β3=0.03, (t=0.37,p=0.001), as p-value is less than the 0.05, hence, the null hypothesis is rejected and alternative hypothesis is accepted.This means that normative commitment has relation with and influence on job satisfaction.Taken together, these findings suggest that there is relationship among components of organizational commitment and job satisfaction of nurses in hospitals of Peshawar.

Discussion
The aim of the study was to investigate the impact of the three components of organizational commitment i.e. affective commitment, continuance commitment and normative commitment on job satisfaction of the Nursing staff in hospitals of Peshawar.The results of co-relation analysis show that all the three components of organizational commitment have strong relationship with each other and that there is significant relationship between affective commitment, normative commitment and continuance commitment with job satisfaction means that when employees are committed with their current job affectively, they perceive high level job satisfaction similar as the results of Shurbagi, A. A. M., & Zahari, I. (2013).
Findings of the study oppose the study of Norizan Ismail (2012) evidencing no significant relationship between the components of organizational commitment and job satisfaction.Though majority evidences found that organizations feel difficulty to manage ethical issues with people having low commitment whereas a caring climate enhances employees' job satisfaction, organizational commitment, and job performance (Alonderiene, 2010;Fry et al., 2012;GanoOverway et al. 2009;Sommer & Kulkarni, 2012;).Employees with a strong affective commitment continue employment with the organization because they want to do so due to the ability of individuals to satisfy their needs at work (Hackman and Oldham, 1976).Allen and Meyer (1990) suggested personal characteristics, job characteristics, work experiences and structural characteristics as major reasons of employee's affective commitment.
Moreover, the normative commitment is influenced by the individual's familial or cultural socialization (Wiener, 1982;Cohen, 2007).

Limitations of the study
The self-reported measures were used in this study to measure the job satisfaction and organizational commitment.Since the respondents were from only three public sector hospitals and two private sector hospitals in Peshawar, so the findings can be replicated for other organizations in the health sector.

Conclusion and Recommendations
The nurses in public and private sector hospitals are stayed in their organization because they are affectively committed to their organization.This study also found that amongst the three components of independent variables, the affective commitment and normative commitment have very strong relationship with job satisfaction while continuance commitment has least relationship with job satisfaction.Among other reasons one may be that these nurses are professionally trained for taking care of patients at hospitals.During the studies they develop loyalty to the profession and as it's a matter of life and death of human beings so they feel the responsibility to perform their duties well.When it comes to the continuance commitment the public sector hospitals are not offering very attractive salaries and promotion system to the professional nurses which decline their continuance commitment to the organization.High employee commitment is the dream of all organizations.For successful organization, the managers should focus on increasing the employees job satisfaction related factors such as work itself, benefit programs, rewards, working conditions, promotions and job rotations.This may help to further increase the interest of employees in their jobs and hence enhance the continuance commitment which will lead to higher degree of job satisfaction.Policy makers and organizational administrators can bring in significant improvement in job satisfaction and performance of the workforce in organizations through the implementation of intrinsic and extrinsic reward for the employees.Genuine reward for the employees will promote organizational citizenship, performance and motivation Figure 1Conceptual Framework

Table 3
Descriptive Analysis (Mean, Standard Deviation of the Sample)

Table 4
Pearson Correlation Matrix of the Major Variables of the Study(N=120)

Table 5
Organization Commitment as a Predictor of Job Satisfaction