This study investigated the relationships between patient satisfaction, nurses' job security, job satisfaction, and obedience organizational citizenship behaviors (OCBs) within private hospitals in Damascus and Rural Damascus, Syria. A survey of 325 nurses and 393 patients found that job security positively influences both job satisfaction and obedience OCBs. Both job satisfaction and obedience OCBs fully mediate the relationship between job security and patient satisfaction. Obedience OCBs partially mediate the relationship between job satisfaction and patient satisfaction. The results provide evidence that enhancing nurses' perceptions of job security can improve patient satisfaction.

1. Relating patient satisfaction to
nurses’ job satisfaction, job
security, and obedience OCBs
Ali Bassam Mahmoud
Faculty of Business Administration,
Arab International University and Higher Institute of Business Administration
(HIBA), Department of Human Resource Management, Damascus,
Syrian Arab Republic, and
William D. Reisel
Department of Marketing, St. John’s University, Staten Island,
New York, USA
Abstract
Purpose – This paper aims at investigating the relationships among patient satisfaction, and nurses’
job security, job satisfaction, and obedience OCBs within the setting of private hospitals in Damascus
and Rural Damascus Governorates.
Design/methodology/approach – A cross-sectional survey conducted within private hospitals in
Damascus and Rural Damascus Governorates had resulted in (325) subjects of nurses, and (393)
subjects of patients. Double-translation, face validation, exploratory factor analysis, and Cronbach’s
alpha were used to validate measures used in this study with respect to the Syrian context.
Afterwards, the two samples were aggregated on the basis of hospital-department. That is, 217 cases
had resulted, and were used to test the proposed model, and revise it if required.
Findings – The results indicate that job security positively influences both job satisfaction and
obedience OCBs. Both job satisfaction and obedience OCBs fully mediate the relationship between job
security and patient satisfaction. Obedience OCBs partially mediate the relationship between job
satisfaction and patient satisfaction.
Research limitations/implications – Further investigations in other service-providing settings
(e.g. telecommunications) are needed for more evidence of the model validity. Using cross-sectional
design in testing causalities has been criticized by several researchers, so longitudinal method is
recommended in further investigations for the model. Wider views could be delivered if more of other
attitudinal variables are included in the model.
Practical implications – Better levels of patient satisfaction could be achieved through enhancing
nurses’ perceptions towards job security. Job satisfaction would be an important factor in keeping
positive levels of patient satisfaction, especially when employment at one private hospital lacks
security and stability.
Originality/value – This research comes to be one of the first studies to provide evidence of the full
mediation that job satisfaction and obedience OCBs play regarding the relationship between job
security and patient satisfaction. In addition, this study proves the partial mediation that obedience
OCBs play between job satisfaction and patient satisfaction.
Keywords Job satisfaction, Patient satisfaction, Nursing, Syria, Job security, Obedience
Paper type Research paper
The current issue and full text archive of this journal is available at
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The authors would like to thank the anonymous reviewers for their constructive comments.
Patient
satisfaction
47
International Journal of
Pharmaceutical and Healthcare
Marketing
Vol. 8 No. 1, 2014
pp. 47-61
q Emerald Group Publishing Limited
1750-6123
DOI 10.1108/IJPHM-01-2013-0001