Purpose This study finds out if a satisfied physician will show citizenship behaviour (OCB) in a work environment where psychological contract breach (PCB) exist. Design/methodology/approach Quantitative data from 214 physicians across 26 health-care units were analysed. Research philosophy was positivism, research design was explanatory and study design was cross-sectional. Preliminary tests were conducted. Reflective measurement and structural models were examined. PLS algorithm tool and bootstrapping procedure were utilised. Control variables were sex, age, employment type and tenure. A significant level was set at 5%. Smart PLS 2.0M.3 software was employed. Findings The scientist found support for a significant moderating effect of PCB on the nexus between job satisfaction (JST) and OCB, such that PCB demoralised a satisfied physician in showing OCB. In contrast, a fulfilled psychological contract motivated satisfied physicians to exhibit OCB. Practical implications PCB, if not addressed, may lead satisfied physicians to show low OCB, which has devastating effects for health-care organisations and their patients. Creating balanced, fulfilled and harmonious relationship within physicians will transform the workplace into a more meaningful and purposeful atmosphere. Originality/value This study offers empirical health-care literature on the moderating effect of PCB, a psychosocial stressor, on the direct relationship between JST and OCB, integrating and lengthening the social exchange theory, resource-based theory and activation theory.
Purpose This paper aims to assess the tie-in between psychological contract breach (PCB) and job satisfaction (JST) amongst medical doctors (MDs) working in two stress-prone regions of Ghana, and further analyses the moderating effect of openness to experience (OPE) on this tie-in. Design/methodology/approach Responses from 214 MDs were analysed. Questionnaires were self-administered. Research philosophy was positivism, research approach was quantitative, research design was explanatory and study design was cross-sectional. Test of normality, Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett’s test of sphericity were applied. Both reflective measurement and structural models were assessed. Path coefficients were analysed using partial least squares (PLS) algorithm tool and moderation effect was conducted using the product indicator approach. Control variables were sex ( GEN1 ), age ( GEN2 ), employment type ( GEN3 ) and tenure ( GEN1 ). A significant level was set at 5%. Smart PLS 2.0 M.3 software was used. Findings The analysts found support for a significant moderating effect of OPE on the tie between PCB and JST, such that the consequences of PCB on JST was minimised for MDs who scored high on OPE trait. Practical implications PCB, if not addressed, may lead MDs to be less satisfied with their jobs. In stress-prone health zones where PCB exists, MDs who are inspired, creative, self-sufficient, experimenting and visionary are more likely to be satisfied with their job. Originality/value This study offers health-care literature on the moderating role of OPE personality dimension on the bond between PCB and JST, using PLS-structural equations modelling, which is a superior and robust analytical tool.
Background Task-shifting has been implemented in the United States, Canada, Australia and New Zealand and increasingly in Europe. A cross-country comparison of task-shifting has been lacking across Europe. We assessed task-shifting practices in Europe and other OECD countries, and secondly, performed correlation analyses with OECD data. Methods A survey was developed, pilot tested and sent to 109 country informants in 39 countries covering Europe, the United States, Canada, Australia and New Zealand (response rate 85.3%). Country informants were chosen based on a pre-defined set of criteria. Countries levels of implementation was correlated with OECD secondary data: physician and nurse ratios, education, and primary mode of financing (fee-for-service vs other). Results Eleven countries have implemented extensive task-shifting (Australia, Canada, New Zealand, the Netherlands, US, UK (England, Wales, N. Ireland, Scotland), Finland, Ireland), measured by authority to diagnose, refer, treat and prescribe. However, countries' levels of regulation and financing varied, as did training requirements. The majority of countries showed emerging, yet limited task-shifting where nurses took up some advanced roles within confined boundaries. Five countries did not implement task-shifting. Conclusions Countries most advanced showed variations of the regulatory contexts, which may impact on nurses' practice patterns. Countries with decentralized regulation resulted in uneven levels of implementation, posing barriers to an efficient use of this workforce. Countries in early development stages focused primarily on adapting training capacity. From an international and especially, EU perspective, harmonizing competencies and training – in those countries showing similar levels of advanced practice – will be an important step to ensure the quality of care, avoid potential skill-loss and facilitate the recognition of education in increasingly connected labor markets. Key messages Task-shifting from physicians to nurses is an increasing workforce trend in Europe, however, extent of task-shifting and levels of implementation vary An enabling policy context involves up-to-date regulation, quality education pipeline and a supportive financing structure