ABSTRACT

This study investigated the influence of demographic variables (such as gender, age, marital status, length of service and educational qualification) job satisfaction and work locus of control on organizational commitment of medical records personnel in university teaching hospitals in Nigeria.

The study adopted the ex-post-facto type of research design. A total of 359 medical records personnel from 17 Federal and State university teaching hospitals in Nigeria participated in the study. The sampling technique used was the total enumeration technique. The instrument for data collection was the questionnaire called Demographic factors, job satisfaction, work locus of control and organizational commitment scale. Each of the job satisfaction sub-scale, work locus of control subscale, and organizational commitment subscale was duly validated with a reliability coefficient of 0 .90, 0.85, 0.87 respectively using the Cronbach- alpha method. Data collected were analysed using percentages, mean, standard deviation, product moment correlation and multiple Regression Analysis. Research hypothesis were tested at 0.05 level of significance. The results of these analysis revealed that:

  1. there was no significant relationship between gender and organizational commitment of medical records personnel in university teaching hospitals in Nigeria (r = .0 40, p> 0.05);
  2. there was a significant positive relationship between marital status and organizational commitment (r = .137, p < 0.05)
  3. there was a significant positive relationship between age and organizational commitment of medical records personnel in university teaching hospitals in Nigeria (r = .187, p < 0.05)
  4. there was a significant positive relationship between length of service and organizational commitment of medical records personnel in university teaching hospitals in Nigeria. (r = .182 , P< 0.05)
  5. there was no significant relationship between educational qualifications and organizational commitment of medical records personnel (r = -.047, P > 0.05)
  6. there was a significant inverse relationship between work locus of control and organizational commitment of medical records personnel in university teaching hospitals in Nigeria (r = - .131, p < 0.05)
  7. there was a significant relationship between job satisfaction and organizational commitment of medical records personnel in university teaching hospitals in Nigeria (r = .340, P < 0.05)
  8. there was a significant relationship between a combination of independent variables (Demographic variables, work locus of control and job satisfaction} and organizational commitment of medical records personnel (r = .378, P < 0.05)

The independent variables (Demographic factors, work locus of control and job satisfaction) accounted for 14.3 % of the total variance in the dependent variable (organizational commitment). However, work locus of control and job satisfaction were found to be significant predictors of organizational commitment of medical records personnel in university teaching hospitals in Nigeria.

It was concluded from the study that a combination of demographic factors (gender, age, marital status, length of service, educational qualification),work locus of control and job satisfaction have significant influence on the organizational commitment of medical records personnel in university teaching hospitals in Nigeria.

Keywords: Organizational commitment, job satisfaction demographic variables, work locus of control, university teaching hospitals, medical records personnel. (430 words)

CHAPTER ONE

INTRODUCTION

1.1Backgroundto thestudy

Health like food and shelter is one of the basic human needs that must be satisfied. It is generally believed that the social, economic, political, educational and cultural development of any society is largely determined by the health status of the people. And the health status of the people depends on the recognition and elimination of health problems. Mogli (2001) defined health as not merely the absence of diseases, but also protection from factors which predispose to diseases. The World Health Organization (W.H.O) (1946) defined health as the status of complete physical, mental, social well being and not merely the absence of diseases or infirmities.

Modernhealth care is delivered mainly through hospitals of various categories which areregarded as a haven of relief of health care problems. Hospitals are built and maintained for the benefits of patients. Rakich and Darr (1978) described the hospitals as the focal point of health care delivery. Green (1974) stated that hospitals came into being to take care of patients who cannot be looked after in their homes and to return them in a healthy state to their community. He added that the main task the hospital is expected to perform for the society is the care and treatment of those who are sick. It is important to note that in carrying out this task of caring for patients, hospitals require the servicesof well-trained medical personnel, funds, high quality facilities and equipment and a good medical records management system.

According to Mogli (2001) Medical records can be defined “as an orderly written document encompassing the patient’s identification data,health history,physical examination findings,laboratory reports, diagnosis, treatment `and surgical procedures, and hospital course.” This definition clearly shows that medical records are indispensable tools in modern health care delivery. Medical records are of vital importance clinically for immediate diagnosis and treatment of patients. In addition, they are important forthe future welfare of patients. In some cases, medical records could become the deciding factor between life and death.(Mogli, 2001). Since hospitals are established basically to provide good health care for patients, they should have a records management system that will ensure that they have accurate, timely and complete information patients’ care.In other words, records must be accurately written, properly filed and easily accessible. Failure to do this will result in the inability of the hospital to discharge its responsibility to the patients and the communityefficiently and effectively. For instance, medical personnel may find it quite impossible to offer the best treatment to patients if there are no medical records. They may even make wrong diagnosis of a condition and this could have very grave consequences on the health of the patients. To avoid this scenario,medical records personnel are usuallyemployed in the hospitals to organize, manage andprovide efficient medical records services to the hospital, so that its primary goal of caring for the patients could be realized. However, it is important to state that this is possible, only if the medical records personnel are highly committed to their employing organization. Studies have shown that employees who are committed to their employing organization enhance organizational effectiveness through their high levels of job performance and work quality and low levels of tardiness, absenteeism and turnover ( Mathieu & Zajac, 1990; Randall, 1990).

Organizational commitment does not have a generally acceptable definition among authors.However, according to Mathis and Jackson (2000) organizational commitment can be defined as “the degree to which employees believe in and accept organizational goals and desire to remain with the organization.”

Literature has revealed that over the years, there has not been any consensus over the dimension of organizational commitment. This isbecauseorganizational commitment has been conceptualized as either a one-dimensional construct or as a multidimensional construct. However, studies have shown that the most popular view aboutorganizational commitment in recent years is that it is multidimensional in nature. Consequently, different multidimensional models have been proposed by different authors like Allen & Meyer 1990; Angle &Perry,1981; Gordon, Philpot, Burt, Thomson& Spiller 1980; Jaros, Jermier,Koehler& Sincich, 1993; Meyer & Allen, 1984,1991; Mayer& Schoorman,1992, 1998; O’Reilly& Chatman, 1986; PenleyGould,1988 to mention but a few to explain the construct. In addition, studies havedemonstrated that the most popular of all these models among researchers is the three component model proposed by Meyer and Allen (1991).They divided organizational commitment into three components namely affective, continuance and normative commitment respectively.

(i)Affective commitment refers to “the employee’s emotional attachment to, identification with and involvement in the organization. Employees with a strong affective commitment continue employment with the organization because they want to do so. ” This suggests that employee with affective commitment want to remain with an organization.

(ii)Continuance commitment refers to “an awareness of the costs associated with leaving the organization. Employees whose primary link to the organization is based on continuance commitment remain because they need to do so. ”This suggests that employee with continuance commitment will remain with an organization in order to avoid the perceived cost of leaving the organization.

(iii)Normative commitment refers to “a feeling of obligation to continue employment. Employees with a high level of normative commitment feel that they ought to remain with the organization. ”This suggests that employees with a high level of normative commitment will remain with the organization as a way to reciprocate the organization’s investment in them.

Meyer and Allen (1997) stated that a committed employee is one who will stay with the organizationthrough thick and thin, attends work regularly, puts in a full day (and may be more) and protects company assets and who shares company goals.

The study of organizational commitment has attracted the attention of researchers, managers, organizational analysts and many others over the years. This is because studies have shown that it is considered useful in predicting employees’behaviour and for manpower planning in organizations like the teaching hospitals. In addition, studies have shown that employees commitment to their organization has been recognized as one of the major determinants of desirable organizational outcomes such as organizational effectiveness,(Schein, 1970;Steers,1975) higher level of job performance (Van- Maanen, 1975; Ferris, 1981) lower absenteeism (Clegg,1983; Mowday, Steers Porter, 1979) lower turnover(Mowday, Steers & Porter,1979;Marsh & Mannari, 1977; Stumpf Hartman,1984) and lower turnover intentions (Irving, Coleman & Cooper,1997; Popoola, 2005).

Studies have shown that the development of organizational commitment among employees could be influenced by a number of variables. Thesevariables have equally been described as causes or determinants or antecedents of organizational commitment in the literature. For instance, Mowday, Porters and Steers (1982) identified four categories of antecedents of organizational commitment. These are personal factors or characteristics, job characteristics, work experiences, and role- related characteristics.

(i)Personal characteristics or factors consist of those variables which define the individual such as age, tenure, and personality triats.

(ii) Job characteristics such as task autonomy, task variety.

(iii)Work experiences such as perceived pay equity, perceived personal importance to the organization.

(iv)Role-related characteristics such as role conflict, role ambiguity

In addition,Steven, Beyer and Trice (1978) stated that organizational factors such as organizational size, union presence, supervision and centralization of authority could influence organizational commitment of employees.

Driver (1982) is of the view that the commitment of employees could decline if they believe that their organization is not committed to addressing their expectations. Popoola (2005) stated that employees tend to feel less committed to their organization when they experience negative psychological work climate.He listed the consequences of employees’ low levels of organizational commitment in any work place like the civil service as absenteeism, high turnover rate and turnover intensions, transfer of loyalty to non-work activities, inefficiency, job dissatisfaction and low productivity. Luthans (2002) stated that even non –organizational factors or variables such as the availability of alternatives after making the initial choice to join an organization could also influence the organizational commitment of employees.

With respect to Personal or demographic variables , studies conducted into the relationship between personal or demographic variables and organizational commitment revealed that there is a degree of relationship between personal or demographic variables like gender,age,marital status, years of working experience or tenure,educationalqualification,status, race and so on with organizational commitment. For instance, Steers (1977 ) reported that personal variable like need for achievement was significantly related to organizational commitment, while education was inversely related to organizational commitment. Similarly, Popoola (2006 ) stated that personal factors like age, sex, marital status and length of service of records management personnel in state universities have significant positive relationship with their organizational commitment. Whiletheir level of education has a significant negative relationship with their organizational commitment. Also, Aryee and Debrah (1992 ) reported that age has a significant positive effects on organizational commitment of employees.

Another construct that is important to this study is job satisfaction. Job satisfaction could be described as a positive emotional state resulting from evaluating one’s job experiences and job dissatisfaction occurs when these expectations are not met. (Mathis&Jackson, 2000). Robbins(1998) described job satisfaction as a term which refers to an individual’s general attitude towards his or her job.A person with a high level of job satisfaction holds positive attitudes towards the job, while a person who is dissatisfied with his or her job holds negative attitude about the job. Locke (1976) defined job satisfaction as employee’s affective response to various aspects of the job or organization.

Studies have shown that job satisfaction of workers could be determined by a number of variables. These variables have also been described as antecedents of job satisfaction in the literature. For instance,Schultz and Schultz (1986) stated that job satisfaction or dissatisfaction is determined by a large number of factors which include personal factors like age, sex, race, level of intelligence, social status, educational status, length of job experience and recreational activities. Other factors that could influence job satisfactionare work climate, the job itself that is whether employees have a sense of achievement or fulfillment in their work. That is not all, Georgeand Jones (1996) highlighted four factors that couldaffect the level of job satisfaction of a person. These arepersonality, values, the work situation and social influence.

As regards the relationship between job satisfaction and organizational commitment, studies have revealed that although the two constructs are different from each other, they are related. Luthans (2002) highlighted the differences when he stated that job satisfaction is mainly concerned with the employees’ attitude towards the job while organizational commitment is mainly concerned with employees’ attitude towards the organization.

Literature has shown that there is a degree of correlation between organizational commitment and job satisfaction .For instance, Tett and Meyer (1993) reported a strong relationship between job satisfaction and organizational commitment. This implies that job satisfaction and organizational commitmentare capable of influencing each other.This finding suggests that people who are relatively satisfied with their jobs may likely be more committed to the organization and also that people who are relatively committed to the organization are more likely to have greater job satisfaction. The decision to remain with or leave an organization ultimately, is reflected in employee absenteeism and turnover statistics. Individuals who are not satisfied with their jobs or who are not committed to the organization are more likely to withdraw from the organization either occasionally through absenteeism or permanently through turnover.

Nevertheless, Luthans (2002 ) does not believe that there is a strong relationship between job satisfaction and organizational commitment. He argued that there are many employees who though are satisfied with their jobs; dislike the organization they work for. He stated further that on the other hand, there are others who may be dissatisfied with their current jobs but are also very committed to the organization they work for.

In addition, another construct that is important tothis study is work locus of control. Locus of control is a personality variable that evolved from Rotter’s (1954) social learning theory of personality. Locus of control simply refers to a person’s perception of the main causes of events in life.Locus of control can be divided into two namely; Internal locus of control and external locus of control. Individuals with internal locus of controlare called internals. They believe that they have control over their destinies. They tend to be convinced that their own skills, abilities and efforts determine the bulk of their life experiences.While individuals who have external locus of control are called externals. They believe that their destinies are being controlled by external forces such as luck,chance, fate or powerful others.(Rotter,1966)

According to Salazar, Hubbard and Salazar (2002) an individual’s locus of control can have great influence on his/her work and life. A person with an internal locus of control would see challenges as opportunities for learning and professional growth. In contrast, a person with an external locus of control would ignore these challenges because he/she believes that learning would not have any impact on him/her.

Studies have shown that in organizations, employees with internal locus of control do not need as much direct supervision because they are more likely to believe that their work behaviours influence important outcomes such as pay increase, praise, job security and the promotion they receive(George &Jones,1996).As regards the influence of locus of control on organizational commitment, literature has revealed that a few studies have been conducted into this area. Nevertheless, in spite of the scantiness of research, studies conducted by Spector(1982) revealed that internals are committed more to their respective organizations than those who have external locus of control. Similarly, Kinicki and Vecchio (1994) reported that individuals who have internal locus of control are likely to be more committed to their organization than those who have external locus of control. This suggests that locus of control could influence the organizational commitment of workers.

In Nigeria, literature has revealed that a few studies have been conducted into the organizational commitment of records management personnel. For instance, Popoola (2005) conducted a study into the organizational commitment of records management personnel in Ondo state civil service. In addition, Popoola (2007) conducted a study into the organizational commitment of records management personnel in federaluniversities in Nigeria.However, much empirical studies on the organizational commitment of medical records personnel in university teaching hospitals in Nigeria have not yet been conducted. Consequently, it was considered necessary to explore this area.