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Newton, Cameron, Teo, Stephen, Pick, David, Yeung, Melissa, & Salam-onson, Yenna(2013)Flexibility in change practices and job outcomes for nurses: exploring therole of subjective fit.Journal of Advanced Nursing, 69(12), pp. 2800-2811.
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https://doi.org/10.1111/jan.12198
FLEXIBILITY IN CHANGE PRACTICES AND JOB OUTCOMES FOR NURSES: EXPLORING THE ROLE OF SUBJECTIVE FIT
Associate Professor Cameron Newton BCom, BA(Psych) (Hons), PhD (Org Psych) School of Management Queensland University of Technology Australia E-mail: [email protected] Professor Stephen T.T. Teo BEc, MBA (Int. Business), PhD (HRM) Department of Management AUT Business School AUT University Auckland 1010 New Zealand E-mail: [email protected] Associate Professor David Pick BSc(Hons), MA, PhD School of Management Curtin University Australia E-mail: [email protected] Ms Melissa Yeung BA, Grad Dip InfoTech, M Mgt School of Electrical and Information Engineering University of Sydney Australia E-mail: [email protected] Associate Professor Yenna Salamonson BSc, MA, PhD School of Nursing University of Western Sydney Australia E-mail: [email protected] Correspondence: Please address all correspondence to Cameron Newton on the address details noted above.
Change Practices and Occupational Stress
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FLEXIBILITY IN CHANGE PRACTICES AND JOB OUTCOMES FOR NURSES:
EXPLORING THE ROLE OF SUBJECTIVE FIT Abstract Aims. The present study represents an integration of existing theoretical perspectives on change management, subjective fit, and occupational stress to better understand the effects of change on employee adjustment. Background. While subjective fit with organizational goals and objectives has been shown to have positive effects on employee adjustment its role in the organizational change-occupational stress context is not understood. This represents a caveat in research when considering the notion that those who feel they fit with the organization’s goals may be better equipped to reconcile and deal with change. Design. A cross-sectional survey of nurses from public and nonprofit sector hospitals was conducted. Method. Data were collected from 252 public and nonprofit sector nurses via online surveys. Data were collected from June until October in 2010. Structural equation modeling was used to test the direct and indirect effects among the focal variables. Results. The results showed that public and nonprofit nurses experience flexibility-limiting and flexibility-promoting change initiatives and that these are differentially related to the perception of administrative stressors and adjustment with these relationships directly and indirectly influenced by perceptions of subjective fit. Flexibility-limiting change initiatives lead to lower levels of subjective fit, higher levels of administrative stressors, and less favorable adjustment. On the other hand, flexibility-promoting change practices led to higher levels of subjective fit, lower levels of administrative stressors and ultimately better adjustment. Conclusion. The results further the theoretical understanding of the role of subjective fit in organizational change and occupation stress theories. Keywords: organizational change, administrative stressors, subjective fit, psychological health, job satisfaction, organizational commitment
Change Practices and Occupational Stress
3
Summary Statement
Why is this research or review needed?
The effects of different organizational change practices on nurses experience of
occupational stress is under researched.
Research has yet to unpack the potential mediating role of subjective fit in the
relationship between change practices and nurses’ perceptions of administrative
stressors and job-related attitudes.
What are the three key findings?
Flexibility-promoting change practices had a positive influence on levels of non-
nursing administrative stressors via subjective fit.
Flexibility-limiting change practices (such as downsizing and outsourcing) resulted in
higher levels stressors both directly and via reduced subjective fit.
As nurses experienced more administrative stressors, they tended to report lower
levels of psychological health, job satisfaction, and organizational commitment.
How should the findings be used to influence policy/practice/research/education?
Employers should very clearly justify the need for and positive longer term outcome
of flexibility-limiting change practices.
When flexibility-limiting change initiatives are required, employers should consider
simultaneously introducing other flexibility-promoting initiatives in an effort to buffer
the negative effects of the flexibility-limiting change on subjective fit, administrative
stressors and nurses job-related attitudes.
Change Practices and Occupational Stress
4
INTRODUCTION
Consistent with the world-wide phenomenon in health care management, the Australian
health care sector has been experiencing on-going change at industry, organizational and
work-unit levels. These changes have resulted in the implementation of a variety of
organizational change initiatives relating to team work, empowerment, and performance
management in both public and nonprofit health care organizations. While the relative impact
of different change initiatives is moderately understood in the broader context, research
relating to change in the health sector (and its impact on nurses in particular) is lacking.
Nursing is a high stress occupation (Lim et al. 2010) and while previous research has found
negative consequences of work intensification on the psychological and job outcomes of
nursing staff, there is a lack of empirical evidence on the impact of organizational change
initiatives. More specifically, research has not demonstrated the effects of different types of
change initiatives in relation to nurses’ perceptions of fit with their organizations and their
experience of occupational stress.
Background
The notion of subjective fit with the organization and its values has been demonstrated as
being important to employee adjustment [as measured by affective attitudinal (e.g., job
satisfaction and organizational commitment) and health-related (e.g., psychological health)
variables]. For instance, individuals whose values are aligned with that of their organizations
are more likely to report a higher level of job satisfaction and organizational commitment
(e.g., Cable & DeRue 2002, Newton & Jimmieson 2008). This concept of fit is potentially
relevant to the change-stress-employee adjustment context. Indeed, individuals experiencing
change in the workplace will perceive differing levels of fit with their organization depending
on their impressions of the favorability of the change, which will subsequently reduce or
magnify their interpretation of stressors and adjustment. More specifically, it is possible that
Change Practices and Occupational Stress
5
different types of change initiatives (i.e., initiatives that offer more flexibility in the
workplace versus those that do not) will have an impact of perceptions of fit and occupational
stress. The present study aims to examine the role of subjective fit in the relationships
between change initiatives, perceptions of stressors, and employee adjustment in the nursing
context. As such, a path model is developed based on an integration of change management,
subjective fit, and occupational stress literatures.
Organizational Change, Occupational Stress, and Employee Adjustment
Organizational change occurs in different ways and means many different things. In an
attempt to categorize the different types of change initiatives, Dunford et al. (2007) reviewed
100 books and articles relating to change. They found nine types of organizational practices
implemented by Australian organizations, including the formation of collaborative
networks/alliances, outsourcing of non-core activities, disaggregation of business units,
delayering (e.g., reducing hierarchical levels in the organization), reducing internal and
external boundaries, developing flexible work groups, empowering employees, and the use of
short-term staffing. Some of these change initiatives can be flexibility-limiting in that they
constrict flexibility associated with work processes and employee choice (FL change) while
others can promote flexibility by providing autonomy and more choice in the workplace (FP
change). These organizational practices are prevalent in both the profit and nonprofit sectors
and are consistent with the practices identified in the new public management (NPW)
literatures (e.g., Stanton, Willis, & Young 2005). Stanton et al. identified a range of
organizational practices (such as outsourcing, structural change, and flexible work groups)
implemented as a result of the adoption of new public management in Australian health care
organizations. Furthermore, public and nonprofit organizations have been found to adopt
private sector managerial practices, including a more strategic approach to human resource
management (e.g., Rodwell & Teo 2008).
Change Practices and Occupational Stress
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Overall, many different relationships have been reported with respect to change
initiatives and employee job-related attitudes. These reforms have been widely adopted in
Western nations as a means to increase efficiency, accountability and productivity in the
public sector (Chandler et al. 2002). Hood (2000, p.4) noted that the NPM is a ‘recipe for
correcting the perceived failings of traditional public bureaucracies over efficiency, quality,
customer-responsiveness and effective leadership’. The outcomes though have been mixed.
Diefenbach (2009) found that the New Public Management (NPM)-inspired changes to the
corporate culture and working conditions had detrimental impacts on public sector
employees. NPM reforms have been widely adopted in Western nations as a means to
increase efficiency, accountability and productivity in the public sector (Chandler et al.
2002). Commentators such as Hood (2000, p.4) noted that the NPM is a ‘recipe for correcting
the perceived failings of traditional public bureaucracies over efficiency, quality, customer-
responsiveness and effective leadership’.
Some of the detrimental outcomes of NPM reforms include higher levels of
occupational stressors, a decline in job satisfaction and motivation, and an invisible net of
managerial power and domination. Noblet et al. (2005) for example, found evidence of
increased job and psychological strain. Within the nursing context, Stanton et al. (2005)
reported a number of negative consequences on nursing and health care workers. One
consequence was that managers had less autonomy and resources to support employees in
dealing with increased administrative demands (see Pick et al. 2012). Further, Chang et al.
(2005) and Lim et al. (2010) found the stressors common to nurses included workload and
the work environment, with these stressors manifesting as a result of administrative burdens.
These papers have collectively found that the heightened accountability associated with NPM
placed further pressure on managerial personnel to achieve performance targets, which in
turn exacerbated the level of strain experienced by employees as a result of increasing
Change Practices and Occupational Stress
7
administrative stressors. In this study, administrative stressors are administration related,
contextual stressors. These are different from the stressors encountered by nurses in relation
to patient care, such as those outlined in the nursing stress scale (Gray-Toft & Anderson
1981). These stressors were similar to what others such as Chang et al. (2005) and Lim et al.
(2010) have identified in their studies.
Not all NPM-inspired change necessarily leads to inflated perceptions of stressors and
ultimately strain for employees. For instance, some change initiatives identified by Dunford
et al. (2007) are related to the provision of greater flexibility and autonomy (e.g.,
empowering, reducing internal boundaries, and fostering flexible working groups). The
positive effects of increased flexibility and control are well documented in the stress
literature. Perceived control is theoretically and empirically supported as a buffer of the
negative effects of stressors on strain in Karasek’s (1979) Job Demand Control Model.
Newton (2006) found that employees reported lower levels of change-related and other work
stressors (such as perceived lack of training, unpredictability, overload, and ambiguity) in
organizational cultures characterized by more flexibility and autonomy. This latter result
suggests that organizational changes, which provide more flexibility and perceived control
over the changes, may not be perceived as stressors but more as challenges. Moreover,
Spector and Jex (1998), and Lepine et al. (2005) highlight that having a large amount of work
does not automatically result in negative employee outcomes. High work demands may not
be interpreted as a stressor, but rather a source of challenge; especially when the change
results in more freedom and control.
Hypothesis 1: FL change practices will be related to higher levels of
administrative stressors.
Regardless of the antecedents of stressors, it is well documented that higher
perceptions of work-related administrative stressors are negatively related to employee
Change Practices and Occupational Stress
8
attitudes and outcomes (see Örtqvist & Wincent 2006). In the nursing domain, Tovey and
Adams (1999) noted that nurses in a United Kingdom sample reported lower levels of
satisfaction when they perceived higher levels of stressors related to increased paperwork and
a lack of resources and equipment. Similarly, Zangaro and Soeken (2007) concluded that
there was a strong negative correlation between job stress and job satisfaction among US
nurses. Furthermore, Bartram et al. (2004) found that their sample of Australian nurses who
reported higher levels of job stress tended to report a lower level of job satisfaction.
Hypothesis 2: Higher levels of administrative stressors will be related to lower
levels of job satisfaction.
The effects of administrative stressors have also been found to negatively impact
psychological health. In the general work context, many empirical studies provide evidence
of a negative relationship between role stressors related to overload, ambiguity, and conflict
and employee psychological health (see Jackson and Schuler 1985, Abramis 1994). Similarly,
stress resulting from workplace change has also been found to negatively impact
psychological health (as measured by anger, grumpiness, and withdrawal) (see Stensaker et
al. 2002). In the nursing context, Swanson and Power (2001) found that during organizational
restructuring in a public utility in the UK, employees and managers reported higher levels of
occupational stress that subsequently impacted negatively on their psychological wellbeing.
The present study also aims to explore the relationships between the focal employee
adjustment variables and organizational commitment. Overall, the effect of job satisfaction is
well established. Studies suggest that lower levels of job satisfaction, in turn, impact
organizational commitment (see Huang et al. 2012). For instance, Matthieu (1991) showed
that the influence of job satisfaction on organizational commitment was found to be stronger
than the reverse effect. Similarly, Clugston (2000) concluded that job satisfaction had a
positive causal relationship with organizational commitment. However, little support has been
Change Practices and Occupational Stress
9
found for a direct relationship between psychological health and organizational commitment.
Rather, research has tended to show that psychological health is positively related to job
satisfaction (e.g., Huang et al. 2012).
Hypothesis 3: Higher levels of administrative stressors will be related to lower
levels of psychological health.
Hypothesis 4: Higher levels of psychological health will be related to higher
levels of job satisfaction.
Hypothesis 5: Higher levels of job satisfaction will be related to higher levels of
organizational commitment.
Subjective Fit
Fit between a person and an organization has been theoretically defined in various ways.
Complementary fit occurs when employee characteristics complement the organization
(Muchinsky et al. 1987, Powell 1998). Supplementary fit is a closeness between the
employee’s characteristics and the organization (Kristof 1996). Fit also has been
operationalized differently; subjectively or objectively (see Verquer et al. 2003). Subjective
fit measures how well employees perceive their own characteristics to match the organization
and it has posited such perceptions of fit may be more important than objective and indirect
measures: if an employee believes they are (or are not) similar, this may be all that is needed
to influence attitudinal and behavioral outcomes (see Kristof 1996; Kristof-Brownet et al.
2005).
Positive effects of subjective fit on employee outcomes have dominated research.
Subjective fit has been related to better job satisfaction, organizational commitment,
perceived support, and lower intentions to leave (see Cable & DeRue 2002, Verquer et al.
2003, Newton & Jimmieson 2008, 2009). Further, Meyer et al. (2010) argue that P-O fit is an
important factor in the organization commitment thus affecting intention to stay. This is
Change Practices and Occupational Stress
10
especially the case under conditions of change (Caldwell 2011). Interestingly, the significant
relationships between subjective fit and job-related attitudes have not been replicated with
respect to employee health. While some researchers have found weak yet significant
correlations between subjective fit and psychological health, these effects have become non-
significant when accounting for control variables (such as age, gender, and negative
affectivity) and work stressors (Newton & Jimmieson 2008, 2009).
One important dimension of P-O fit is ‘value congruence’, that is the extent to which
an employee’s values match that of the organization where they are employed (Caldwell
2011). Results suggest that value congruence may act as a buffer for nurses against job
dissatisfaction (Bao et al. 2012). Indeed, value congruence has been for a long time
recognized as a determinant of job satisfaction and organizational commitment (Kristof
1996), as well as intention to quit (Cooper-Thomas & Poutasi 2011).
Hypothesis 6: Higher perceptions of subjective fit will be related to higher levels
of job satisfaction.
Hypothesis 7: Higher perceptions of subjective fit will be related to higher levels
of organizational commitment.
Subjective fit and the change-stressor-employee adjustment relationship
The present study sought to extend the scope of existing research by investigating the
potential of indirect effects of subjective fit on the organizational change-employee
adjustment relationship. Moreover, the prevalence of change (especially, organizational
culture change) in organizations from different industries throughout the world makes
investigating an individual’s fit with an organization particularly vital (Noblet et al. 2006).
Overall, there is some theoretical and empirical evidence to suggest that subjective fit has a
vital role to play in change and stress-related workplace investigations.
The theoretical concepts underlying organizational identification (a sense of ‘oneness’
Change Practices and Occupational Stress
11
with an organization) are similar to subjective fit (Ashforth & Mael 1989). Furthermore,
organizational identification and subjective fit have similar relationships with employee
outcomes (see Saks & Ashforth 1997, Riketta 2005). Organizational identification is based on
Social Identity Theory which allows us to understand how individuals can be part of a social
group (e.g., an organization) through processes of self-categorization (e.g., Tajfel & Turner
1979, Haslam 2001). It highlights the causes of linkages between employees and their
organization; helps in understanding the relative strength of these linkages, and enables
prediction of consequences for group behavior (Haslam et al. 2003). In the present study, a
shared social identity creates a mechanism for social support and coping. Indeed, literature
has found that a shared social identity (which involves a process of categorizing oneself with
a group) leads to higher levels of social support to other in-group members (see Levine et al.
2002, Levine et al. 2005). As such, change-related practices that empower people to access
supportive mechanisms may lead to higher levels of identification or feelings of group
membership. This concept is represented by perceptions of subjective fit in the present study.
It can therefore be theoretically argued that changes which inhibit the formation of and access
to support mechanisms could lead to lower levels of subjective fit with the organization.
Hypothesis 8: Higher perceptions of FP change initiatives will be related to higher
levels of subjective fit.
Hypothesis 9: Higher perceptions of FL change initiatives will be related to lower
levels of subjective fit.
Overall, empirical research investigating subjective fit beyond main effects is still
under researched and the role of subjective fit in a change-related context has yet to be
explored. Nevertheless, several studies guide hypotheses in the present study. For instance,
Boon et al. (2011) found a direct relationship between clear and flexible human resource
(HR) practices and subjective fit. Further, they found that subjective fit mediated the
Change Practices and Occupational Stress
12
relationship between HR practices and organizational commitment. Additionally, Huang et
al. (2005, 2012) have found direct relationships between a supportive culture and clear
communication and more favorable levels of subjective fit. In both studies, subjective fit
mediated the relationships of the independent variables with employee adjustment. While
there is a clear indication from the literature that favorable organizational characteristics can
lead to higher levels of subjective fit, few studies have actually explored the effect of less
favorable or even negative HR or change-related practices. However, the stress literature
provides guidance in formulating expectations. For example, change-related stressors and
organizational stressors such as a lack of resources are negatively related to subjective fit (see
Newton 2006).
The stress literature has found subjective fit to be an important moderator and
mediator in the work stressor-employee adjustment context providing further support for
hypotheses in the present study. Newton and Jimmieson (2008) found that those reporting
higher levels of subjective fit were protected from the negative effects of stressors (such as
ambiguity and conflict) on job satisfaction, intentions to leave, and psychological health. In a
separate study, similar results were found for role overload (Newton & Jimmieson 2008) and
the relationship between subjective fit and employee adjustment has been found to be
mediated by work stressors (Newton & Jimmieson 2006). More specifically, employees
reporting higher subjective fit also reported lower levels of role conflict and ambiguity and
higher levels of job satisfaction and psychological health.
Hypothesis 10: Higher perceptions of subjective fit will be related to lower levels
of administrative stressors.
Hypothesis 11: Subjective fit will mediate the relationship between flexible
change initiatives and levels of administrative stressors.
Hypothesis 12: Administrative stressors will mediate the relationship between
Change Practices and Occupational Stress
13
subjective fit and employee adjustment [i.e., psychological health (H12a) and job
satisfaction (H12b)].
The direct and indirect hypotheses are proposed in the present study and are displayed in
Figure 1 below.
-----------------------------
Insert Figure 1 about here
-----------------------------
THE STUDY
Aim
The aim of the study was to explore the effects of flexibility-promoting and flexibility-limited
change management practices, subjective fit, and occupational stress to better understand the
effects of change on employee adjustment.
Design
A cross-sectional design was employed to test the hypotheses.
Sample/Participants
Over 220,000 registered nurses and 50,000 enrolled nurses are employed in the Australian
health care system. Enrolled nurses work under the supervision of a registered nurses and
typically have a graduate diploma in nursing from a technical college or registered training
organization representing approximately 18 months/two years of training. Overall, 67 percent
of nurses work in the public sector and 33 percent in the private sector (Australian Institute of
Health and Welfare 2010). An online research company sent an email containing a link to the
online survey to 630 members who matched the occupational and background requirements
(such as nurses who were at least 18 years old in age and residing in Australia). Overall, 252
Change Practices and Occupational Stress
14
useable responses were received equating to a response rate of 40%.
Data collection
Data were collected between June and October 2010. The electronic survey consisted of
questions regarding demographic characteristics, perceptions of change initiatives, stressors,
subjective fit, psychological health, and job-related attitudes (e.g., job satisfaction and
organizational commitment).
Ethical considerations
Ethical approval was obtained for the Human Research Ethics Committee at the
administering university.
Data analysis
Preliminary data analyses were conducted using SPSS. These analyses included reliability,
exploratory factor, and correlation analyses. AMOS (Arbuckle 2003) was used to test the path
model. A bootstrapping procedure with 1000 sub-samples was carried out to provide extra
confidence that the results were not sample-specific.
Validity and reliability/Rigor
Pre-validated scales were used in the study.
Organizational change initiatives. Palmer and Dunford (2002) used nine items to
measure organizational change initiatives implemented in Australia. Exploratory factor
analysis resulted in two factors. Factor one demonstrated flexibility-promoting (α = .87)
aspects of organizational change (including empowerment and flexibility) while factor two
comprised flexibility-limiting (α = .81) or delimiting initiatives such as downsizing and
outsourcing. Items were measured on a scale from 1 (not at all) to 5 (a large extent).
Administrative stressors. Following Noblet et al. (2005), we used 34 items to
measure context-specific administrative stressors. Member validation checks and
comparisons with the occupational stress literature (e.g. Cox & Cox 1993) indicated that the
Change Practices and Occupational Stress
15
overall analysis had satisfactory levels of internal and external validity. Items rated by at least
50 percent of respondents as being a moderate, large or major source of stress (that is, a score
of three, four or five on the 5-point scale) were retained for further analysis. Altogether 12
items were retained with items representing resource and time/workload stressors (α = .88).
Example items include ‘Unrealistic performance targets’ and ‘Not having enough time to do
job as well as you would like’. Items were rated on a scale from 1 (not at all) to 5 (a major
source of stress).
Subjective fit. Following Newton and Jimmieson (2008), we used the 3-item scale
from Cable and DeRue (2002) to measure the level of subjective fit (α = .92). This scale has
been validated and used in over 100 workplace studies. An example item is ‘The things that I
think are important are also the things that are important to the organisation’. Subjective fit
was operationalized as a formative scale, rated on a 5-point scale from 1 (strongly disagree)
to 5 (strongly agree).
Job satisfaction. This is measured by using the 15-item scale from Warr et al. (1979)
as respondents were asked to rate their job satisfaction on a 7-point scale from 1 (extremely
dissatisfied) to 7 (extremely satisfied). Items included satisfaction rating with respect to ‘the
physical work conditions’ and ‘taking everything into consideration, how do you feel about
your job as a whole’ (α = .92).
Psychological wellbeing. We used GHQ-12 scale (Goldberg & Williams 1988) to
measure self-perceived psychological health. Respondents were asked how their health had
been in general over the last few weeks by responding to a 4-point scale (e.g., have you been
able to enjoy your day-to-day activities?’) (α = .85). The 4-point scale ranged from 0 (more
so than usual) to 3 (much less than usual) and was reverse-scaled. A higher value implies
higher level of psychological health (or less psychological strain).
Organizational commitment. Following Noblet et al. (2005), we adopted the six item
Change Practices and Occupational Stress
16
scale from Porter et al. (1974). An example item is ‘I really care about the future of this
organisation’. Respondents were asked to rate each item on a 6-point scale ranging from 1
(strongly disagree) to 5 (strongly agree) (α = .91).
RESULTS
Characteristics of the Sample
The respondents (N=252) were mainly female (72 percent) with 77 percent coming from the
public sector and the remaining from the nonprofit sector. Over half of the respondents
worked full time (56 percent) with the remaining sample reporting part time work. Overall,
just over half the respondents were aged 31-50 years old (59 percent) and nearly half of the
sample had worked in their current position for between three to 10 years (46 percent). Just
over 70% of the sample reported having management or supervisory responsibilities.
Preliminary data analyses
Descriptive data (means and standard deviations) and inter-correlations among the focal
variables are displayed in Table 1. Most correlations were low to moderate, indicating that
multicollinearity was not a serious threat to the analyses (Tabachnick & Fidell 2001). Table 1
reveals that while correlation between the two types of change was moderate (r = .62, p <
.01), they were differentially related to the other focal variables. For instance, FL change was
less significantly related to subjective fit (r = .15, p < .05) than FP change (r = .43, p < .01).
A similar result was revealed for organizational commitment. It is also interesting to note that
FL change was not significantly related to psychological health or job satisfaction, while FP
change was significantly and positively related to these same outcome measures. While a
significant bivariate correlation was not found between FL change and administrative
stressors as expected, the nonsignificant correlation between FP change and administrative
stressors was not in line with preliminary expectations. One-way ANOVAs revealed no
significant differences in the focal variable as a function of public or nonprofit sector
Change Practices and Occupational Stress
17
employment, education, managerial level, employment status, or gender.
Common Method Variance
Two analyses were conducted to assess the potential effects of common method variance
(CMV). First, Harman’s single-factor test was run via an exploratory factor analysis in SPSS
using varimax rotation (Podsakoff et al. 2003). The unrotated factor solution revealed that
the single factor accounted for 25% of total variance, which is well below the level that could
suggest a CMV problem. Second, AMOS was used to load all items onto an additional latent
CMV factor. As only an additional 1% of shared variance was accounted for by this latent
factor, CMV was not suggested to be a threat in the present study.
Path Model Analysis
A path model was developed and tested to explore the direct and indirect effects relating to
our hypotheses (see Figure 1) as well as to test the fit of the model to the data. As can be seen
in Table 2, this model (Model 1) was a reasonable fit to the data although the RMSEA and
sRMR indicators were high (CFI = .97; NFI = .95; RMSEA = .08; sRMR = .07). Inspection
of the modification indices further revealed that a path was appropriate between FP change
and psychological health. Once this path was added all AMOS indices revealed a very good
fit of the model (Model 2) to the data (CFI = .99; NFI = .97; RMSEA = .04; sRMR = .04).
-------------------------------------
Insert Table 1 and 2 about here
-------------------------------------
As can be seen in Table 3, all hypotheses proposed in this study were supported. In
addition, a significant path between FP change and psychological health was revealed along
with several non-hypothesized indirect effects. The results support the assertion that FL
change leads to lower levels of subjective fit with the organization, which in turn results in
higher levels of administrative stressors. This, in turn, leads to lower psychological health and
Change Practices and Occupational Stress
18
job satisfaction and ultimately lower levels of organizational commitment. Conversely, the
results also reveal that, as expected, change that promotes flexibility leads to higher levels of
fit with the organization, which in turn leads to lower levels of administrative stressors,
higher levels of psychological health and job satisfaction and ultimately greater
organizational commitment.
---------------------------------
Insert Table 3 about here
---------------------------------
DISCUSSION
The aim of the current study was to examine the causal effect of organizational change
initiatives on employee attitudes such as job satisfaction, psychological wellbeing and
organizational commitment. The next aim was to determine if perceptions of subjective fit
with the organization have an impact on the change-stressor-employee adjustment
relationship. This study shows that public and nonprofit nurses experience different levels of
non-nursing administrative stressors as a result of the implementation of FP change or FL
change initiatives implemented by public and nonprofit health care organizations. FP change
initiatives were found to have a positive influence on the level of non-nursing administrative
stressors via subjective fit, while FL change initiatives (such as downsizing and outsourcing)
resulted in higher level stressors both directly and via subjective fit. As nurses experienced
more administrative stressors, they tended to report lower levels of psychological health, job
satisfaction, and organizational commitment.
The findings showed that change initiatives, especially those that have flexibility
limiting characteristics for nursing work, if not managed effectively, could result in an
increase in administrative stressors (such as resource and time stressors). This represents a
Change Practices and Occupational Stress
19
particularly important outcome in that it is the first study to examine the relationships
between change characteristics and nursing outcomes in this fashion. The findings also
contribute to the empirical evidence on the impact of organizational change in public and
nonprofit sector and how that impacts on work outcomes and employee attitudes. This
illuminates the need for senior management in health care organizations to be cognizant of
the negative work experiences of nursing staff, especially when there is an increasing level of
administrative expectations during organizational change.
However, the results also have broader implications when considering the role of
subjective fit. While previous research has already identified the buffering role of subjective
fit in the work stressor-employee adjustment relationship and its effect on the perception of
stressors (see Newton & Jimmieson 2006, 2009), its role in a change and stress context has
yet to be explored. As such, not only has this study shed new light on the change process as it
occurs specifically for nurses, it has also contributed to the broader literature by examining
and revealing the important role that subjective fit with the organization has in the effect of
different change initiatives on the experience of stress and employee adjustment. At a
strategic level, effective implementation of organizational change initiatives is clearly vital as
it has the potential to unsettle people from their perceptions that they fit with the
organization. The flow on effect of this misfit is potentially deleterious to employees’ abilities
to frame stressors more as challenges. Moreover, such a situation can ultimately lead to less
committed employees at a time when commitment to the organizations objectives is critical
(i.e., during change). While senior management can focus on helping the nursing workforce
to undertake various strategies to cope effectively with stress, the current study has shown
that values alignment is the most important variable, especially as it resulted in higher job
satisfaction, which ultimately led to organizational commitment.
Practical and managerial implications.
Change Practices and Occupational Stress
20
The current study has implications for human resource managers and senior management in
health care organizations. One implication is to focus on selective staffing as the way to
appoint new staff, with the aim of minimizing turnover intentions. Selection tests can be
used to identify those staff who fulfill the technical requirements of the job description and
exhibit the same values as that of the employing organization. McCulloch and Turban (2007)
noted that effective recruitment, by ensuring fit between the new recruits and the hiring
organization, could result in cost savings in relation to recruitment, hiring, training, and
managerial time.
Another important implication is the way in which change is introduced. For instance,
employers need to very clearly justify the need and positive longer-term outcome of FL
change initiatives. Furthermore, when FL change initiatives are required, employers should
actively seek to simultaneously introduce other FP initiatives. This may have the effect of
buffering the negative effects of the FL change on subjective fit and the subsequent
perceptions of administrative stressors and employee adjustment.
Limitations and future research implications
In the current study, we relied on self-complete questionnaire in a cross sectional sample.
Hence, there is a possibility that our findings could be affected by common method bias,
however, two independent analyses have suggested that this threat is not likely. Future studies
could minimize this potential effect by collecting data from multiple sources and/or across
different time periods. Data should also be collected from other occupations to explore the
generalizability of the findings of the present study.
CONCLUSION
This study has shown that senior management must take note of implementing different
aspects of change initiatives in health care organizations. Furthermore, the orientation of
change initiatives in terms of their relationship towards flexibility clearly has effects on the
Change Practices and Occupational Stress
21
extent that employees feel they fit with the organization’s goals and objectives and ultimately
their commitment to the organization. In addition to contributing to better understanding the
effect of subjective fit in change-stressor-employee adjustment relationships, this study has
also highlighted practical implications for health-care human resource managers when they
are undertaking recruitment and implementing change.
Change Practices and Occupational Stress
22
Figure 1. Path Model
Change Practices and Occupational Stress
23
Table 1 Descriptive data for focal variables
Variables
Mean (SD)
1 2 3 4 5 6 7
1 Flexibility limiting change 2.63 (.87) (.81 ) 2 Flexibility promoting change 2.51 (.88) .62** (.87) 3 Subjective fit 2.71 (1.01) .15* .43** (.92) 4 Administration stressors 3.09 (.94) .06 -.09 -.34** (.88) 5 Psychological health 17.48 (5.42) .04 .24** .18** -.30** (.85) 6 Job satisfaction 4.37 (1.03) .09 .32** .51** -.52** .42** (.92) 7 Organizational commitment 4.45 (1.33) .19** .32** .41** -.24** .24** .44** (.91) Note. Cronbach’s (1951) alpha reliability coefficients appears in the diagonal.
* p < .05; ** p < .01.
Change Practices and Occupational Stress
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Table 2 Goodness of fit statistics for confirmatory factor analysis for stressor classifications
Goodness of Fit Statistics Model 1 Value
Model 2 Value
Chi-square 24.74 13.30 DF 18 19 DF/ Chi-square 2.57 1.48 CFI .97 .99 NFI .95 .97 RMSEA .08 .04 Standardized RMR .07 .04
Change Practices and Occupational Stress
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Table 3
Results of Path Analysis
Paths Standardized
path coefficients and significance
Standard error
Hypothesis support
Direct Paths FL change Administration stressors
.12† .06 H1 √
FP change Subjective fit .55*** .08 H8 √ FL change Subjective fit -.19** .08 H9 √ FP change Psychological health
.36
Subjective fit Administration stressors
-.36*** .06 H10 √
Administration stressors -> Psychological health
-.30*** .34 H3 √
Administration stressors -> Job satisfaction
-.33*** .06 H2 √
Subjective fit -> Job satisfaction .36*** .05 H6 √ Psychological health Job satisfaction
.26*** .01 H4 √
Subjective fit Organizational commitment
.20** .08 H7 √
Job Satisfaction Org Commitment
.29*** .08 H5 √
Indirect Paths FP change Subjective fit Administration stressors
-.20** .05 H11 √
FP change Subjective fit Job satisfaction
.28** .05
FL change Subjective fit Administration stressors
.07** .03
FP change Psychological health Job satisfaction
.24** .05
Administration stressors Psychological health Job satisfaction
.08** .02
Subjective fit Administration stressors Psychological health
.11** .03 H12a √
Subjective fit Administration stressors Job satisfaction
.08** .04 H12b √
Psychological health Job satisfaction Organizational commitment
.08** .03
Subjective fit Job satisfaction Organizational commitment
.15** .04
† p=.05; *p<.05; **p<.01; ***p<.001
Change Practices and Occupational Stress
26
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