Effect of Organizational Cynicism on Quality of Work Life and Employee Effectiveness among Nursing Staff

Introduction

The health sector is one of the important sectors due to the vital role it plays at the present time. This requires conducting more research to improve the level of service it provides to a wide range of people Society (Rosen et al., 2018). The nursing job is one of the jobs in which there are many sources of pressure, which make workers are dissatisfied with their profession or their organizations, and their low level of quality of work life, which results in negative and cynical expressions that reflect on their job performance (Saleem, 2017). 

Capital had been a bottleneck for many years, but this view is no longer correct. Working and keeping human resource in good shape is the bottleneck (Fatima, 2017). Therefore, after the organizations realize that the main way towards achieving their goals is through the human element. Which has become the subject of interest in many administrative and behavioral researches, which have tested many Various organizational characteristics, such as organizational cynicism, Quality of work life (QWL) and employee effectiveness for the purpose of knowing what surrounds workers in the workplace and how the characteristics of their organizations to perform their work (Al-Kurdi et al., 2020).

Cynicism is among the salient concepts that have emerged in the field of organizational behavior in recent years. Although its synonyms include “skepticism,” “incredulity,” “insecurity,” “disbelief,” “pessimism” and “negation,” in the modern sense, a cynic is “one who finds faults, the one who likes things with difficulty, and the one who criticizes” (Kökalan, 2019). Organizational cynicism can be defined as general or specific attitudes of disappointment, insecurity, hopelessness, anger, mistrust of institutions or persons, group, ideology, and social skills (Peter & Chima, 2018). In other words, organizational cynicism is the negative attitude that is developed by individuals against the organization in which they work (Jiang et al., 2019).

Organizational cynicism is a pessimistic approach that involves three dimensions; the first dimension of organizational cynicism is cognitive (belief)dimension. It is the belief in the organization's lack of honesty. It consists of the belief that the organization's practices are deficient in justice, honesty, and sincerity. Second dimension of organizational cynicism is affective (emotional) dimension that consists of strong emotional reactions towards the organization. The last dimension is behavioral dimensionthat refers to negative tendencies and mainly humiliating attitudes. It consists of negative and frequently critical attitudes. Therefore, Organizational cynicism is a learned response that is affected by workplace experiences
(Mousa, 2018).

Employees who are cynical can influence the entire organization and can hinder the organization from reaching its goals. If majority of employees are cynical, there are chances of having more negative outcomes in the organizations. Thus, these employees will show less commitment to organizations. The chances of employee's turnover are quiet high with more cynicism since more stress and burnout are associated with organizational cynicism. In addition, the organizational cynicism brings negative results to the organization in terms of quality of employee work life and satisfaction (Brown et al., 2019).

Quality of work life (QWL) has become a prime importance in today’s corporate world. Every organization wants to improve the quality of work life of their employees, as the organizations have started believing that good quality of work life can help achieving the desired outcomes. And so, it is important to understand the concept of quality of work life (Gupta et al., 2019).

Quality of Employee Work Life can be defined as the extent to which employees feel a sense of team work within groups and the extent to which the organization provides them with a good work environment and job satisfaction (Kocman & Weber, 2018), QWL is intended to increase an employee’s trust, involvement and problem solving to increase job satisfaction and organizational and employee effectiveness, as work performed by people is an important source of satisfaction (Pio & Tampi, 2018).

Employee effectiveness is a capability of employees to produce a specific, desired effect with minimized costs and in strict compliance with initial requirements. It is a qualitative characteristic that indicates the extent to which targeted problems are addressed and the degree to which preset goals and objectives are achieved by employees (Yusuf et al., 2020). Organizational cynicism has a negative influence on employee effectiveness. However, researchers argue that cynical employees can be a positive force for change by challenging ineffective policies and routines and, consequently, influencing work effectiveness in a positive way, while some studies found that society developed negative attitudes towards those firms and their management (Arslan & Roudaki, 2019).

Significance of the research:

Organizational cynicism studies in Egypt are novel and in its rudimentary stages (Rayan et al., 2018). Also, many of the organizational cynicism studies have been conducted in the developed countries, while there is very limited discussion on this issue in other developing countries. This means that more research is needed to understand organizational cynicism and its consequences in the Egyptian context. Most of the prior literature in organizational cynicism has been devoted towards understanding of its impact on organizational change efforts. It is very important for both academician and practitioners to investigate the impact of organizational cynicism on employees’ attitudes and behaviors (Durrah et al., 2019).

Nurses are the largest employee group in hospitals. Therefore, it is not surprising that hundreds of studies have been conducted on the concepts that are related to nurses’ QWL (Holland, 2019). Previous research suggests that the recruitment and retention of nurses are affected by their QWL (Raeissi et al., 2019). Consequently, it appears that identifying the factors that contribute to QWL can provide critical information for nurse directors in order to design managerial programs that will make the nursing profession more attractive. It is evident that, before nurse directors can explore properly which the most effective strategies are for promoting nurses’ QWL (Querstret et al., 2020).

Also, when the researcher went to Minia University Hospitals during clinical training of students the researcher recognized that there were lack of appreciation and recognition from superiors toward nurses and pessimism view of nurses toward hospital's expectation. also because of nurses comprise a great part of healthcare professionals that provide direct service for those who apply to organizations for healthcare service, must be assessed in terms of organizational cynicism, quality of work life and employee effectiveness, and, all of which that directly influence the efficiency of organization; therefore, the researcher carry out this study.                    

The aim of the research:

The aim of the current study was to assess the effect of organizational cynicism on quality of work life and employee effectiveness among nursing staff.

Research questions:

1-       What are the levels of organizational cynicism, quality of work life and employee effectiveness among nursing staff at Minia University Hospitals? 

2-       What are the relations between organizational cynicism, quality of work life and employee effectiveness among nursing staff at Minia University Hospitals?

Subjects and Methods

Research Design:

A descriptive research design was utilized in the present research.

Setting:

The study was conducted at (Minia University Hospital for Obstetric and Pediatric, Minia University Liver Hospital, as well as Minia University Kidney and Urology Hospital), Minia, Egypt. Affiliated to Minia University Hospitals.

Subjects:

Convenience sample included all nurses who work at the three selected hospitals during the period of data collection (no.=314), classified as follows: Minia University Hospital for Obstetric and Pediatric (no.= 137), Minia University Liver Hospital (no.= 124), as well as Minia University Kidney and Urology Hospital (no.= 53).

Scales of Data collection:

Data collected through using three scales namely: Organizational Cynicism Scale, Quality of Work Life Scale and Employee Effectiveness Scale.

Scale (I): Organizational Cynicism

This scale was divided into two parts:

Part Ι: personal data sheet:  It was used to collect data about nurses encompass item such as age, marital status, educational qualification, salary, years of experience in the nursing field, sex, residence and department.

Part ΙΙ:Organizational Cynicism Scale

Organizational cynicism scale was developed by (Goudarzi et al., 2011). This scale was aimed to measure level organizational cynicism among nursing staff. It consists of 12 statements. It contained three dimensions cognitive cynicism, affective cynicism and behavioral cynicism wherein every dimension had four items. Each item was measured by a five-point Likert scale ranked from 1 (strongly disagree) to 5 (strongly agree).

Scoring system:

Scale ΙΙ: Quality of Work Life

Quality of work life scalewas developed by (Bhopatkar, 2013). This scale was aimed to measure level QWL among nursing staff, it contained (40) items. Each item was measured by a five-point Likert scale ranged from 1 (strongly disagree) to 5 (strongly agree).

Scoring system:

Scale (III): Employee Effectiveness

Employee effectivenessscale was developed by (Bhopatkar, 2013). This scale aimed to measure effectivenessamong nursing staff. It contained (35) items. It contained five dimensions as following training and development (11 items), team spirit and favorable working environment (5 items), role clarity and performance planning (9 items), effective leadership and reward system (5 items) and performance and potential feedback (5 items). Each item was measured by a five-point Likert scale ranged from 1 (strongly disagree) to 5 (strongly agree).

Scoring system:

Validity of the research scales:

The scales were tested for the content validity by a jury of 5 experts in the field of nursing administration and education, the jury composed of two Professor and one Assistant Professor from Faculty of Nursing, Minia University, one Assistant Professor from Faculty of Nursing, Beni Sweif one Assistant Professor from Faculty of Nursing, Cairo Universities. Each of the expert panel was asked to examine the instruments for content coverage, clarity, wording, length, format and overall appearance. And necessary modification was done from jury panel.

Reliability of the research scales:

Reliability of the scales were performed to confirm consistency of scales. The internal consistency measured to identify the extent to which the items of the scales measured what it was intended to measure. Also, the scales were tested for its reliability by using Cronbach alpha test which revealed good internal reliability for the scales; and distributed as follows:

Pilot Study:

A pilot study was conducted on 10% of participants (31 nurses) classified as following: Minia University Hospital for Obstetric and Pediatric (14), Minia University Kidney and Urology Hospital (12) and Minia University Liver Hospital (5). The main purposes of the pilot study were to ascertain the clarity, comprehensiveness and applicability of the scales as well as to estimate the appropriate time required to fill the scales. Based on pilot study there was no modification done, and it was added to final results.

Data Collection Procedures:

• An official letter was granted from the Nursing Faculty Dean at Minia University, Ethical Committee, Nursing Faculty at Minia University.
• The scales were adopted, and translated into Arabic; then collect the jury approval for the scales to collect data of the study.
• Written approvals were obtained from the hospital directors as well as the nursing directors of the three selected hospitals after explaining the purpose of the study.
• After obtaining the permission, the researcher began to introduce herself to the head nurse and nursing staff then, explained the nature, aim of the study and how they should fill the scales.
• A pilot study was done to assure scales clarity and applicability.
• Then the reliability of the scales was done.
• The scales were distributed to all nursing staff. Scales were administered directly and supervised by the researcher with the assistance of head nurse of each unit.
• The researcher distributed those scales for nursing staff through morning, evening, and night shift during the working days. 
• nursing staff were given from 20 minute to 30 minutes to answer the scales. The researcher answers any questions that nursing staff need.
• The actual field work started from the beginning of April 2021 to the end of July 2021 for collecting data. Data collection started three hours before the end of the shift; Nurses from different shifts were asked to fill out scales based only on their experiences. The researcher waited outside the units during the majority of the data collection period, going inside the units after 15 minutes to answer questions.
• The researcher scheduled the visits to each department of each Hospital based on the nursing staff’s schedule of work. The researcher selected three days one day to each Hospital, Saturday for Minia University Hospital for Obstetric and Pediatric, Monday for Minia University Liver Hospital and Wednesday for Minia University Kidney and Urology Hospital.

Administrative design:

• Written permission was obtained from the Faculty of Nursing, Minia University to the Hospital directors to carry out this study.
• The purpose of this study was explained to Hospital directors, nursing directors and head nurses of the three selected hospitals.

Ethical Considerations:

• An official letter was granted from the Research Ethics Committee of the Faculty of Nursing, Minia University
• Approval to conduct the study was obtained from Dean of the Faculty of Nursing, Minia University
• A permission and consent were obtained from director of the Hospitals and nursing directors of the three selected hospitals.
• A permission and consent were obtained from the head of the department and the head nurse working at the three selected hospitals.

Statistical analysis:

The collected data was tabulated, computerized, analyzed and summarized by using descriptive statistical tests to test research questions by using SPSS version (25). Qualitative data were expressed as frequency and percentage. Probability (P-value) is the degree of significance, less than 0.05 was considered significant. The smaller the P-value obtained, the more significant is the result (*) and less than 0.001 was considered highly significant (**).

Results

Table (1): Distribution of the nursing staff’s personal data at the three selected Hospitals (no.=314).

Table (1) illustrates the personal characteristic of the nursing staff, it is observed that (77.7%) of nursing staff age at the three selected Hospitals are ranged between 19-30 year, with Mean ± SD (28.25+7.246). Regarding marital status it is observed that (50.6%) of them are married. About the education qualifications, (69.4%) of them have technical institute of nursing.  Concerning to salary, (65.6%) of them are ranged between 2000-3000 LE, with Mean ± SD (1.54+.767). In relation to Experience, (63%) them have less than 5 years of experience, with Mean ± SD (2.25+.529).

Figure (1): Distribution of the nursing staff regarding their sex (no.=314).

Figure (1) shows that (58.5%) of nursing staff at Minia University Liver Hospital is male, while the highest percent of them at Minia University Kidney and Urology Hospital and Minia University Hospital for Obstetric and Pediatric (62.9%, 78.8% respectively) are female. moreover, it is observed that (60.2%) of them at the three selected Hospitals are female.

Figure (2): Distribution of the nursing staff regarding their residence (no. =314).

Figure (2) shows that the majority of nursing staff at Minia University Liver Hospital, Minia University Kidney and Urology Hospital and Minia University Hospital for Obstetric and Pediatric (67.9%, 78.2%, 80.3% respectively) living in rural residence. Moreover, it is observed that (77.4%) of them at the three selected Hospitals living in rural residence.

Figure (3): Levels of organizational cynicism among nursing staff at the three selected Hospitals (no.=314).

As evident in the figure (3), it is found that (43.4%) of nursing staff at Minia University Liver Hospital has low level of organizational cynicism, while (50%) of them at Minia University Kidney and Urology Hospital has moderate level of organizational cynicism, also (54.7%) of them at Minia University Hospital for Obstetric and Pediatric has moderate level of organizational cynicism. Moreover, it is observed that (50.6%) of them at the three selected Hospitals have moderate level of organizational cynicism.

Figure (4): Levels of quality of work life among nursing staff at the three selected Hospitals (no.=314).

Figure (4) shows that (43.4%) of nursing staff at Minia University Liver Hospital has low quality of work life, while (47.6%) of them at Minia University Kidney and Urology Hospital has moderate level of quality of work life, also (62.8%) of them at Minia University Hospital for Obstetric and Pediatric has moderate level of quality of work life. Moreover, it is observed that (52.5%) of them at the three selected Hospitals have moderate level of quality of work life.

Figure (5): Levels of employee effectiveness among nursing staff at the three selected Hospitals (no. =314).

Figure (5) shows the levels of employee effectiveness among nursing staff at the three selected Hospitals, it is noted that (43.4%) of them at Minia University Liver Hospital has moderate level of employee effectiveness, while (56.5%) of them at Minia University Kidney and Urology Hospital has moderate level of employee effectiveness, also (59.1%) of them at Minia University Hospital for Obstetric and Pediatric has moderate level of employee effectiveness. Moreover, it is observed that (55.4%) of them at the three selected Hospitals have moderate level of employee effectiveness.

Table (2): Correlation between studied variables among nursing staff at the three selected Hospitals (no.= 314).

**Correlation is significant at the 0.01 level (2-tailed) * p≤0.01 (significant) **p≤0.05 (highly significant)

PCC: P – value based on Pearson correlation coefficient

In table (2), it is noted that there is a statistically high significant negative poor correlation between organizational cynicism, quality of work life and employee effectiveness with P- value (.001, .001). While there is positive strong correlation between quality of work life and employee effectiveness with P- value (.001).