Effects of Work Content and Work Context on Job Motivation of Hospital Pharmacists-Juniper Publishers

JUNIPER PUBLISHERS-OPEN ACCESS GLOBAL JOURNAL OF PHARMACY & PHARMACEUTICAL SCIENCES

The behavior of employees is influenced by the environment in which they find themselves and dissatisfaction associated with bad working conditions account for employees’ new job searches and actual separations. The objectives of this study were to examine the relationship between work content and motivation, on one hand, and work context and motivation, on the other hand, of hospital pharmacists in Osun state of Nigeria. Eighty seven out of 110 practicing pharmacists in secondary and tertiary hospitals in Osun State were selected randomly. They were then interviewed with the aid of a set of pre-tested semi-structured questionnaire that comprised two sections. The main section employed thirty three items made of statements on a Likert-type scale to elicit information on the relationship between work content, work context and motivation of the respondents. Descriptive statistics including frequencies, percentages and medians were used to summarize the data while linear regression analysis was used to test for relationship between variables at 5% level of significance. The results showed that work content and work context contributed significantly to the regression model, F (1, 89) = 93.68, P =.00) and accounted for 55.6% and 51.3% of the variation in job motivation respectively.
Conclusion: Work content and work content factors are important determinants of job motivation of hospital pharmacists.
Keywords:Work-content; Work-context; Pharmacist; Motivation; Satisfaction; Employees


Introduction

The workplace is a significant part of an individual’s life that affects his or her life and the well-being of the community. Campbell [1] asserts that the average adult spends much of his or her life working, as much as a quarter or even a third of his waking life in work. As much as a fifth to a quarter of the variation in adult life satisfaction can be accounted for by satisfaction with work Campbell [1]. The work environment has effect on the performance level of employees and absence of office building, drugs, equipment etc. can affect the performance of the employees Asigele [2]. The behavior of employees is influenced by the environment in which they find themselves and will be a function of that employee’s innate drives or felt needs and the opportunities he or she has to satisfy those drives or needs in the workplace. Employee motivation has been defined as: “the willingness to exert high levels of effort toward organizational goals, conditioned by the effort’s ability to satisfy some individual need Ramlall [3]. Poor employee motivation can manifest as lack of courtesy to patients; tardiness and absenteeism; poor process quality, such as failure to conduct proper patient examinations; and failure to treat patients in a timely manner Gilson [4]. In the workforce, it can manifest in high staff turnover rates, high vacancy rates and indifferent performance Bennett & Lynne [5]. If employees are never given opportunities to utilize all of their skills, then the employer may never have the benefit of their total performance. Work performance is also contingent upon employee abilities. If they lack the learned skills or innate talents to do a particular job, then performance will be less than optimal. The success of productivity improvement strategy is dependent on employee commitment, job satisfaction, skills and motivation Alshallah [6]. The two-factor theory of Fredrick Herzberg [7] distinguishes between:

Motivators

(e.g. challenging work, recognition and responsibility) that give positive satisfaction, arising from the intrinsic conditions of the job itself, such as recognition, achievement or personal growth.

Hygiene factorss

e.g. status, job security, salary, fringe benefits, work conditions) that do not give positive satisfaction or lead to higher motivation, though dissatisfaction results from their absence. The term “hygiene” is used in the sense that these are maintenance factors. These are extrinsic to the work itself and include aspects such as company policies, supervisory practices or wages/salary. Herzberg’s hygiene factors contribute to the work context dynamics Schermerhorn [8]. According to Herzberg factors that involve job context (hygiene factors) tend to lead to job dissatisfaction Herzberg [7]. When these factors are considered good, or acceptable, workers do not tend to become “satisfied“, they simply become “not dissatisfied Herzberg [7].” Productivity is not restricted – it is just held at an acceptable level. When workers become dissatisfied with any of these factors they tend to restrict output.

Job or work context

This includes the condition or environment in which the specific activities involved in the job take place. It identifies the actual duties and responsibilities associated with the job. They are the factors which are externally controlled by the organization and include company policy, supervision, and relationship with supervision, work conditions, relationship with peers, salary, personal life, relationship with subordinates, status and job security Ruthankoon & Ogunlana [9].

Job content factors

They are the factors which are internally controlled that the individual is responsible for. They include growth, achievement, responsibility, advancement, recognition and the quality of work itself. Another key direction involves identifying the conditions under which rewards increase motivation. A debate exists about whether managers underestimate the power of intrinsic relative to extrinsic rewards for motivating employees Heath [10], or whether there is a discrepancy between what employees say and what they do, such that employees report that extrinsic rewards are relatively unimportant, but the preferences revealed by their behaviours suggest otherwise Rynes [11]. Scholars may take steps to resolve this debate by attending not only to the instrumental features of rewards, but also to their symbolic features. For example, Mickel & Barron [12] propose that rewards will be more likely to increase motivation when they are distributed by high-status authority figures, for high performance and accomplishments and in public ceremonies. This raises a more general issue with respect to rewards.
Lumping all rewards into a common category may obscure the importance of understanding the effects of different types of rewards on motivation. In particular, researchers have focused primarily on pay and financial incentives, giving far less emphasis to more symbolic rewards such as recognition and appreciation, even though these rewards are frequently intended to motivate and can be effective Frey [13]. Herzberg [7] considered compensation as a more potent dissatisfier than as a job satisfier. Herzberg discovered that salary was connected with other factors such as company policy and administration and how it affected advancement, recognition, rewards and work itself. The fairness and timeliness of the compensation system was mainly the cause of dissatisfaction. The working conditions included the amount of work and the physical environment including ventilation, lighting, tools, space and other environmental characteristics Herzberg [7]. A study that explored the relationship between pharmacists‘ job satisfaction, intention to quit the profession and actually quitting, found that those who actually left the profession did so for extrinsic reasons such as physical working condition and long hours Seston [14].
Identifying and assessing the various extrinsic (organizational characteristics) and intrinsic (personal characteristics) factors of a job situation as they potentially relate to the tendency to leave is important for the efficiency and effectiveness of an organization. Under the conceptualization of factors that affect job attitude and cause behaviors, job satisfaction can be viewed as “the sum total of an individual‘s met expectations on the job” Porter & Steers [15]. A study carried out by Ojokuku & Salami [16] at the University of Ilorin teaching hospital concluded that some improvement in motivation could be attributed to how well a hospital’s management organizes and runs the hospital. They also posit “workers’ monetary considerations cannot be gainsaid; however, implementing nonmonetary factors like quality of supervisions, availability of tools and materials to work with, staff welfare and career development also appears to be important in creating satisfaction with job environment.”
Adams [17] equity theory shows how fairness affects motivation of hospital pharmacist. The theory explained that employees are motivated when their inputs (e.g., effort, knowledge, skill, loyalty) are matched by outcomes (e.g., pay, bonuses, benefits, recognition), which creates a sense of equity or fairness. Also according to Adams, when outcomes do not match inputs, the resulting perceptions of inequity leads to distress, which motivates employees to take action to reduce it. The objectives of this study are to examine the relationship between work content and motivation on one hand and work context and motivation on the other hand of hospital pharmacists in Osun state. A worker’s motivation is not an attribute of the individual or the organization; rather, it results from an interaction between the worker and the work environment. The health care sector is important and the quality and efficiency of service depend to a large extent on human labor. Poor health worker motivation can greatly affect health outcomes and patient safety.

Experimental

The study is a descriptive cross-sectional survey of hospital pharmacists in Osun State. It covers pharmacists in secondary and tertiary hospitals in the state and excludes pharmacists in primary health care, private hospitals and other pharmacists outside hospital pharmacy practice. Ethical approval was obtained from the Institute of Public Health Obafemi Awolowo University Ile-Ife Osun State. The study was conducted at Obafemi Awolowo University, Ile-Ife in Osun State in South-western part of Nigeria between January 2015 and August 2015. The towns covered included Ile-Ife, Ilesha, Osogbo, Ijebu-Jesa, Ila, Ikire, Iwo, Ede, Ipetu-Ijesha and Ikirun. All the hospitals (two tertiary and nine secondary) in the State were selected for this study. The population of study comprises of 110 pharmacists from which 87 were selected by random sampling method. Policy makers which include the head of pharmacy unit in each of the hospitals as well as the director of pharmaceutical services (DPS) at the Hospitals Management Board were also selected. The questionnaire for the study had two sections. Section A was designed to elicit demographic information about the respondents. Section B contained statements on work content, work content and job motivation of the pharmacists made of thirty-three items on a Likert-type scale of agreement with alternative responses of neutral, strongly disagree, disagree, agree and strongly agree with weighting scores of 1-5 respectively.
Construct validity was ascertained by the professional judgment of hospital staff members, the researcher’s supervisor and relevant senior Faculties. The internal consistency of the instrument was determined and gave a Cronbach alpha value of 0.84. The questionnaire was subjected to test-retest reliability check over a two week period and gave a test retest reliability coefficient of 0.79. Initial visits were conducted to establish rapport with the participants and to prepare the ground for data collection. The consent of the respondents was obtained as appropriate before administering the questionnaire to them. Out of the hundred and ten questionnaire administered, ninety-one were retrieved for a returning rate of 82.7%. The data were loaded into computer using SPSS package Version 20. The entered data were cleaned of any errors and descriptive statistics techniques such as frequency counts, percentages, weighted averages (WA) and median (Mdn) were used to organize and summarise the data. Inferential statistics including correlation and regression analyses were used to determine significant relationships at 5% level of significance.


Results

Motivators

Table 1 presents the demographic data of pharmacists by age, gender, marital status, religion, hospital type, hospital location, cadre, and length of hospital pharmacy practice. Of the 91 respondents, the highest number of respondents was recorded from Obafemi Awolowo Teaching Hospital Complex, Ile-Ife (40, 44%). A considerable proportion of the respondents were within the age bracket of 30 and 39 years (36, 39.6%). 64.8% (59) of the respondents were males and 35.2%(32) were females. Majority of the respondents were christians (69, 75.6%) and were married (57, 62.6%). 72 (78.7%) of the respondents had 10 years or less of hospital pharmacy experience with 24 (26.4%) of these possessing five years or less of hospital pharmacy practice experience. Only 11 (12.4%) of them had between 11 and 15 years of hospital pharmacy practice. Of the lot, 26 respondents (28.5%) were actually internees with majority of those remaining (22, 24.2%) located within the Grade 1 Pharmacist cadre.
Table 2 presents the relationship of work content and context on the motivation of the pharmacist. The weighted average (WA) scores of the responses for each of the numbered items were computed. In order to examine the association between work content and motivation; and work context and motivation of the hospital pharmacists, the null hypotheses were suggested which states that:
  • There is no relationship between work content and motivation of the hospital pharmacists.
  • There is no relationship between work context and motivation of the hospital pharmacists
These were analysed using Spearman rank correlation coefficient test at a 0.05 level of significance. The work content factors (Growth, Work itself, Responsibility, Advancement, Achievement and Recognition) all had significant relationship with job motivation as moderate correlation values were obtained (Table 3). The work context factors (Interpersonal relationship, Company policy, Supervision, Status, Salary and Job security) had significant relationship with job motivation as moderate correlation values were obtained (Table 4). When all these factors were reduced to two variables ‘work content’ and ‘work context’ factors and correlated with Job motivation, a significant relationship was observed between the variables and Job motivation (Table 5). ‘Work content’ factors gave correlation values of r = .698, P=.00 while ‘Work context’ factors gave correlation values of r = .618, P=.00.
A linear regression analysis was conducted with job motivation as the dependent variable and work content with work context constructs as the independent variables. The result of the analyses (Table 6 & 7) revealed that on one hand work content construct contributed significantly to the regression model F (1, 89) = 111.426, P =.00 and accounted for 55.6% of the variation in job motivation and on the other hand, work context construct contributed significantly to the regression model, F (1, 89) = 93.68, P =.00 and accounted for 51.3% of the variation in job motivation.


Discussion

The results of this study revealed that the work environment of the respondents did not support high productivity and agrees with the work of Asigele [2] who observed that the work environment has effect on the performance level of employees and absence of office building, drugs, equipment etc. can affect the performance of the employees. Also according to Herzberg, factors that involve job context (hygiene factors) tend to lead to job dissatisfaction Herzberg [7]. These factors are externally controlled by the organization and include company policy, supervision, and relationship with supervision, work conditions, relationship with peers, salary, personal life, relationship with subordinates, status and job security Ruthankoon & Ogunlana [9]. Ojokuku & Salami [16] asserted that implementing nonmonetary factors like quality of supervisions, availability of tools and materials to work with, staff welfare and career development also appears to be important in creating satisfaction with job environment. The results of this study also show that for most pharmacists, the work environment did not allow high productivity. According to Alshallah [6], the success of productivity improvement strategy is dependent on employee commitment, job satisfaction, skills and motivation.
The respondents in this study appear to be marginally motivated on their current job and employee motivation has been defined by Ramlall [3] as: “the willingness to exert high levels of effort toward organizational goals, conditioned by the effort’s ability to satisfy some individual need. When employees do not feel motivation towards their jobs as a result of some unmet needs, they would not put their best into it and Gilson [4] posits that poor employee motivation can manifest as lack of courtesy to patients; tardiness and absenteeism; poor process quality, such as failure to conduct proper patient examinations; and failure to treat patients in a timely manner. In the workforce, it can manifest in high staff turnover rates, high vacancy rates and indifferent performance Bennett & Lynne [5].
It was also observed from the results of this study that respondents believed they did not receive recognition for their accomplishments on the job. Herzberg [7] discovered that salary was connected with other factors such as company policy and administration and how it affected advancement, recognition, rewards and work itself, therefore equity and timeliness of the compensation can cause job dissatisfaction. Mickel & Barron [2] work also reveal that rewards will be more likely to increase motivation when they are distributed by high-status authority figures, for high performance and accomplishments and in public ceremonies. Frey [13] inferred that researchers have focused primarily on pay and financial incentives, giving far less emphasis to more symbolic rewards such as recognition and appreciation, even though these rewards are frequently intended to motivate and can be effective. The respondents also reported that the benefits offered by the hospital to meet personal and family needs are not satisfactory. What happens in an employee’s personal life can affect productivity on the job. Family time and personal goals are important to total fulfillment of the employee and if the work does not permit time for other important activities that the employee deems necessary, then it may adversely affect the work.
Most of the respondents reported that favouritism is a problem at the hospital. Favouritism at the workplace displaces the perception of equity by the employees and this can create a lot of problem as expressed by Adams [17] in his work. They also perceived that communication of information and a sense of direction were deficient at the hospitals. The pitfalls of lack of communication would be seen in lack of direction and suboptimal results when the pharmacists are evaluated. The respondents’ reported that the hospitals did not provide support to deliver high standards of quality to patients and this is a major problem if optimized patient care is the goal of the hospitals. Work content and context play significant roles in an employee’s life and Campbell [1] asserts that the average adult spends much of his or her life working and as much as a quarter or even a third of his waking life in work. Also much as a fifth to a quarter of the variation in adult life satisfaction can be accounted for by satisfaction with work. From the foregoing, the correlation obtained between work content, work context and job motivation from this study could easily be understood.


Conclusion

There is strong correlation between work content factors and motivation and between work context factors and motivation of hospital pharmacists. Employers of pharmacy can explore improvements in the content and context of work to increase productivity and maximize profit.


Conflict of Interest

There is no conflict of interest as regards the work done and results obtained in this study and no financial gain is intended.

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