This document presents a study comparing the impact of emotional exhaustion on job performance, satisfaction, and depression among nurses in India and China. The study investigates whether organizational commitment mediates or moderates the relationship between emotional exhaustion and its consequences. Data was collected from 683 nurses in India and 451 nurses in China. Emotional exhaustion was found to negatively impact all outcome variables in both samples. Organizational commitment was found to partially mediate the relationships. Commitment also moderated the impact of emotional exhaustion on job satisfaction and depression for Chinese nurses but not Indian nurses, suggesting cultural differences.
This document summarizes a research study on the impact of social capital (networks and relationships) on the retention of mature-aged nurses in hospital settings. The study aims to investigate how existing social capital in the workplace contributes to nurses' intentions to stay. It examines whether this effect differs based on sociability levels or partner status. The theoretical framework is based on social capital theory and social exchange theory. The study seeks to fill gaps in understanding how social capital benefits affective commitment and retention, which have been less explored. The expected outcomes are contributions to theory and practical insights on retaining older nurses.
The Influence of Organisational Citizenship Behaviour, Job Engagement and Soc...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Meaningful and relevant Occupational Therapy PracticeClaudia Megele
Meaningful and relevant Occupational Therapy practice and service delivery. By Kee Hean Lim (Lecturer and Researcher in OT) presented at the OT Enfield Conference (Feb. 2014)
The current issue of Urdhva Mula highlights some of the major
concerns of the Women's Studies movement namely, the location of feminist scholarship within the knowledge economy and the location
of Women's Rights in the overarching concern for human rights. This is of particular importance given that human rights in general and women’s rights in particular are under attack from governmental and political structures, not only in India but globally. Resistance to this
stance finds articulation through a number of broad-based and popular movements like the One Billion Rising, the MeToo movement, the open discourse around LGBTQAI and alternate sexualities, and women from the marginalised sections, such as farmers’ widows in
India, teachers in the US, industrial women workers in Latin American countries. In this bleak scenario the only ray of hope is the solidarity being established across diverse marginalities.
Maithreyi Krishnaraj’s thought-provoking article on feminist research
interrogates the way in which various theoretical strands of feminisms
influence feminist research analysis.
Sujata Bhan’s use of the disability rights discourse and pedagogy with regard to inclusive education and knowledge construction is nuanced with a constructivist approach that is informed by feminist scholarship.
Angst over a related concern finds expression in the open letter to
Major General Bakshi later in this issue.
Through critical reflections and feminist analysis of socioeconomic
and cultural status of Devadasis in Karnataka, Ms. Lavanya brings to
the fore how ritualised patriarchy controls the sexuality, fertility and
Urdhva Mula 2017 vol. 10
5
labour of women. She also critiques the limitations of the
‘rehabilitation package’ offered by the state.
The next three articles examine the exploitation and oppression of
working-class women. In an insightful article on the implications of
economic globalisation, Ruby Ojha shows the impact of
macroeconomic policies on women in both sunrise and sunset
industries and all sectors of the Indian economy. Ceena Paul depicts the measures taken by the trade union movement for empowerment of women in both organised and unorganized/ informal sectors. Nandita Mondal highlights the survival struggles of fisherwomen in Mumbai especially in the context of the entry and dominance of big players in the fishing industry. The same theme is echoed in the Book review by
Dhruv Mankad of Aarti Prasad's book based on her research on much neglected theme of socioeconomic status on nurses in the health care industry.
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Health equity is defined as the absence of unfair and avoidable health disparities between groups. Racial and ethnic healthcare disparities exist and are associated with worse health outcomes. These disparities are caused by deeper social and economic factors known as social determinants of health, such as where people live, work, and play. Achieving health equity requires addressing social inequities and ensuring all groups can attain their highest level of health.
This is a lecture which explores the relationship between everyday occupations, health and well-being. The need for an underpinning theory-base for occupational therapy is presented.
According to the literature, animal therapy has the potential to reduce social isolation, stress, anxiety, and depression in older adults living in nursing homes or retirement communities. The document proposes implementing weekly animal therapy sessions for residents of a Naturally Occurring Retirement Community to increase social engagement and combat feelings of loneliness. Upon providing an initial therapy session with dogs, residents expressed enjoyment and hoped the dogs would return soon. The literature and positive initial response from residents supports that animal therapy can improve psychosocial health and quality of life for older adults.
This document summarizes a research study on the impact of social capital (networks and relationships) on the retention of mature-aged nurses in hospital settings. The study aims to investigate how existing social capital in the workplace contributes to nurses' intentions to stay. It examines whether this effect differs based on sociability levels or partner status. The theoretical framework is based on social capital theory and social exchange theory. The study seeks to fill gaps in understanding how social capital benefits affective commitment and retention, which have been less explored. The expected outcomes are contributions to theory and practical insights on retaining older nurses.
The Influence of Organisational Citizenship Behaviour, Job Engagement and Soc...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Meaningful and relevant Occupational Therapy PracticeClaudia Megele
Meaningful and relevant Occupational Therapy practice and service delivery. By Kee Hean Lim (Lecturer and Researcher in OT) presented at the OT Enfield Conference (Feb. 2014)
The current issue of Urdhva Mula highlights some of the major
concerns of the Women's Studies movement namely, the location of feminist scholarship within the knowledge economy and the location
of Women's Rights in the overarching concern for human rights. This is of particular importance given that human rights in general and women’s rights in particular are under attack from governmental and political structures, not only in India but globally. Resistance to this
stance finds articulation through a number of broad-based and popular movements like the One Billion Rising, the MeToo movement, the open discourse around LGBTQAI and alternate sexualities, and women from the marginalised sections, such as farmers’ widows in
India, teachers in the US, industrial women workers in Latin American countries. In this bleak scenario the only ray of hope is the solidarity being established across diverse marginalities.
Maithreyi Krishnaraj’s thought-provoking article on feminist research
interrogates the way in which various theoretical strands of feminisms
influence feminist research analysis.
Sujata Bhan’s use of the disability rights discourse and pedagogy with regard to inclusive education and knowledge construction is nuanced with a constructivist approach that is informed by feminist scholarship.
Angst over a related concern finds expression in the open letter to
Major General Bakshi later in this issue.
Through critical reflections and feminist analysis of socioeconomic
and cultural status of Devadasis in Karnataka, Ms. Lavanya brings to
the fore how ritualised patriarchy controls the sexuality, fertility and
Urdhva Mula 2017 vol. 10
5
labour of women. She also critiques the limitations of the
‘rehabilitation package’ offered by the state.
The next three articles examine the exploitation and oppression of
working-class women. In an insightful article on the implications of
economic globalisation, Ruby Ojha shows the impact of
macroeconomic policies on women in both sunrise and sunset
industries and all sectors of the Indian economy. Ceena Paul depicts the measures taken by the trade union movement for empowerment of women in both organised and unorganized/ informal sectors. Nandita Mondal highlights the survival struggles of fisherwomen in Mumbai especially in the context of the entry and dominance of big players in the fishing industry. The same theme is echoed in the Book review by
Dhruv Mankad of Aarti Prasad's book based on her research on much neglected theme of socioeconomic status on nurses in the health care industry.
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Health equity is defined as the absence of unfair and avoidable health disparities between groups. Racial and ethnic healthcare disparities exist and are associated with worse health outcomes. These disparities are caused by deeper social and economic factors known as social determinants of health, such as where people live, work, and play. Achieving health equity requires addressing social inequities and ensuring all groups can attain their highest level of health.
This is a lecture which explores the relationship between everyday occupations, health and well-being. The need for an underpinning theory-base for occupational therapy is presented.
According to the literature, animal therapy has the potential to reduce social isolation, stress, anxiety, and depression in older adults living in nursing homes or retirement communities. The document proposes implementing weekly animal therapy sessions for residents of a Naturally Occurring Retirement Community to increase social engagement and combat feelings of loneliness. Upon providing an initial therapy session with dogs, residents expressed enjoyment and hoped the dogs would return soon. The literature and positive initial response from residents supports that animal therapy can improve psychosocial health and quality of life for older adults.
This document discusses the legal and historical context of social work with adults with mental health issues in England. It outlines key legislation like the 1959 and 1983 Mental Health Acts and how they have evolved to increase protections for individuals and allow for community-based treatment. The most recent Mental Health Act of 2007 and Care Act of 2014 take a recovery-oriented approach focused on person-centered care and least restrictive options. The document also examines theories and models used in social work practice, like systems theory and recovery models, as well as issues around diversity, collaboration between medical and social perspectives, and reducing conflicts between approaches.
Developing Emotional Intelligence for Healthcare LeadersYasmin AbdelAziz
Skills in emotional intelligence (EI) help healthcare leaders understand, engage and
motivate their team. They are essential for dealing well with conflict and creating workable
solutions to complex problems.
- The document discusses discrimination faced by minority nurses and its negative impact on their career trajectories. It provides background on the nursing profession and conceptual frameworks of structuration theory and social identity theory to analyze discrimination.
- A literature review found that nurses experience discrimination from supervisors, doctors, patients and their own colleagues. This creates a hostile work environment and negatively affects job satisfaction and retention rates.
- The proposed study will use qualitative interviews of 50 minority and 50 white nurses across two urban hospitals to understand perceived barriers and discrimination faced by minority nurses compared to their white counterparts. Purposive sampling across units and shifts aims to provide a comprehensive examination of the issue.
This document provides an introduction and overview of a course on human occupation for occupational therapy students. The 3-sentence summary is:
The course aims to introduce students to the concept of occupation from an occupational therapy perspective, covering topics like history, philosophy and the relevance of occupation to health. Students will complete workshops, essays, and fieldwork to develop an understanding of humans as occupational beings. The document outlines the course objectives, assessments, schedule, and introduces key concepts and perspectives in occupational therapy.
This summarizes Imogene King's Goal Attainment Theory of Nursing. King defines nursing as a process of interaction between nurse and client to establish goals and carry out actions to achieve them. She views humans as open systems interacting with their environment. The nursing process involves assessment, nursing diagnosis, planning, implementation and evaluation carried out through communication between nurse and client. The goal is for clients to attain their health goals through this process of mutually setting and working towards goals.
The document outlines the American Nurses Association's position statement on incivility, bullying, and workplace violence. It states that nurses and employers have an ethical responsibility to create a safe and respectful work environment free of these issues. The statement defines incivility, bullying, and workplace violence. Incivility includes rude behavior while bullying refers to repeated harmful actions intended to humiliate or distress others. Workplace violence puts nursing's contract with society at risk. The profession must work to eliminate these issues and drive cultural change through acknowledgement, prevention, and addressing harmful actions and inactions.
Dorothy Johnson developed the Behavioral Systems Model in the 1940s. The model views the patient as a behavioral system composed of seven subsystems including attachment, dependency, ingestion, elimination, aggression, sexual, and achievement. The goal of nursing according to the BSM is to help patients maintain behaviors proportional to social demands and modify behaviors to support biological functions during illness. The nursing process in the BSM involves assessing patients' subsystem functions, diagnosing insufficiencies or discrepancies, planning interventions to restore balance, and evaluating subsystem balance.
1) The document discusses a study that explored the daily routines and quality of life of 10 individuals with chronic pain through interviews and assessments. 2) A grounded theory called the "Paradigm of Life" emerged from the data, which found that chronic pain disrupts individuals' occupations and impacts their quality of life. 3) The theory shows how engaging in meaningful occupations can enhance quality of life by providing distraction from pain and a sense of control.
This literature review examines concepts of quality of life for residents in nursing home facilities. It discusses person-centered care which prioritizes resident autonomy, dignity and choice. Culture change aims to shift care from a medical model to a person-centered model through staff education, meaningful activities and consistent staffing. Relationships between residents and family, friends, staff and other residents impact well-being. Daily uplifts and story sharing can help staff build relationships. Resident choice in activities and spirituality can enhance satisfaction. The Selective Optimization with Compensation model describes how older adults adapt to loss of function through selection, optimization and compensation. Overall the literature emphasizes improving quality of life through individualized, enriched care plans.
Betty Neumann developed the Neuman Systems Model, which views clients holistically and focuses on stressors that can disturb a client's usual stability. The model uses primary, secondary, and tertiary prevention interventions to help clients retain, attain, or maintain optimal wellness. Neumann was influenced by general systems theory and saw people as complex systems composed of interrelated biological, psychological, socio-cultural, developmental, and spiritual variables that can be impacted by internal and external environmental stressors. Nursing aims to help the client system maintain stability through interventions that reduce the impact of stressors at different levels of reaction.
This document provides an overview of Afaf Ibrahim Meleis' Transitions Theory. It discusses Meleis' background and career, the development and sources of Transitions Theory, major concepts and assumptions of the theory, theoretical assertions, and the theory's acceptance and applications in nursing practice and education. Transitions Theory examines the patterns and properties of life transitions and conditions that influence healthy transitions.
Abstract—Spiritual health is not given its due importance since long time. But nowadays modern medicine is seen in relation to spiritual health and studies were conducted to find out its effect in various diseases. So this study was conducted on elderly aimed to assess the spiritual health and its association with psycho wellness. For study purpose, 30 cluster technique to identify houses with elderly (≥60 years) in Municipal Corporation area of Jaipur City. After collecting general information Spiritual Health Assessment Scale (SHAS) was used to assess spiritual health and Modified Mini Screen (MMS) was used to assess psycho-wellness in elderly. Data were anlysed and inferred by Chi-square test and ANOVA with Post-hoc Tukey test. Majority of elderly were having poor spiritual health and this spiritual health was strongly associated with psycho-wellness in elderly. Poorer the spiritual health of elderly leads to poorer the psycho-wellness in elderly.
Preserve and Strenghthen Family to promote Mental healthJP Rajendran
The document discusses the important role of family in mental health in India. It notes that traditional Indian families provided key support for the mentally ill through economic assistance, social support, and caregiving. However, families are now under increasing strain due to changes like urbanization and nuclearization. To promote mental health, the document argues that families need more support through policies, services, awareness programs, and research on family-based interventions. Preserving and strengthening family is vital for managing mental health issues in a sustainable way.
Images are personal or stock except for...
6,7 http://static2.businessinsider.com/image/4f9ab672ecad041602000000-480/lost-in-space-danger-will-robinson.jpg
11 http://www.vinylrecords.ch/B/BR/Bronski_Beat/Why_si/bronski-beat-why-1185.jpg
15 World Federation of Occupational Therapists
39 Canadian Association of Occupational Therapists
A Study Of Organizational Role Stress Among Teachers A Critical Literature R...Jim Jimenez
This document summarizes a study on the impact of organizational role stress on university teachers in Haryana, India. It reviews literature on role stress both internationally and within India. The literature shows that role stress negatively impacts job satisfaction, productivity, and health. Studies find higher stress levels among healthcare and female professionals. Comparisons between public and private sector employees show inconsistent differences in stress levels. The review establishes role ambiguity, overload, and lack of resources as key stressors for teachers and other professionals.
Employee well-being influences individual, organizational, and societal outcomes. Work-related stress contributes to 120,000 deaths per year in the U.S. and increased health care costs. It also reduces productivity and increases absenteeism and turnover. Employee well-being spills over to affect family life, with job stress correlating to poorer parent-child relationships and marital problems. However, work can also provide benefits to well-being like daily structure, social contact, and a sense of purpose when organized appropriately. Policies aim to improve well-being could yield individual and economic gains.
1Ms Daniella Fernandes,
2Mr Gajanan (Amey) Karmali
Agnel Entrepreneurship Development Institute, Verna Goa
Abstract: The present study was undertaken to examine the Impact of Schemes Designed for Women in Goa on
their Self-Esteem and Psychological Well-Being. The sample consisted of women belonging from the age group 18-
40 years and above. These women belonged to the various talukas of Goa. The sample comprised of 1050 women.
The tools used in this study included Rosenberg Self-Esteem Scale developed by Morris Rosenberg and the Ryffs
Psychological Well-Being Scale developed by Carol Ryff. Data was analysed by incorporating the t-test and
ANOVA. The results have shown that women who have availed schemes have shown higher level of self-esteem.
Women who have not faced difficulties in applying for schemes have shown higher psychological well-being and
self-esteem. The studies also revealed that women who have received skill training, have their own business and
are employed in an organization show better psychological well-being and self-esteem in comparison to
housewives. Women who are employed show higher level of self-esteem and psychological well-being compared to
women who are unemployed
ACQUIRING EMPLOYEE ENGAGEMENT TO ACHIEVE HIGH QUALITY OF CARE IN PRIMARY HEAL...JIANGUANGLUNG DANGMEI
Quality of care in the primary health care system of India is poor that often leads to high infant mortality and maternal mortality rate in the rural areas. However, there are strong evidences that demonstrate the importance of employee engagement to quality of care and patient satisfaction in the health care industry. Many health care industries have adopted employee engagement as a strategy to enhance the quality of care. Engaging the employees effectively can overcome the challenges faced by the health care system of India in the years to come and will continue to improve quality of services towards the patients. This paper explores the importance and significances of employee engagement to enhance quality of care in the primary health care of India.
Affect of Social Capital on Mental Health OutcomesRuby Med Plus
This research Paper discuss affect of social capital on Mental Health. Psycho social Processes and Social Capital, Empowerment and Social Capital, Social Networks and Social Capital, Measurement of social capital, The Mental Health Index indicators integration, The Social and Mental Well Being Index integration, Health-related Behaviors and Social Capital, Access to Mental Health Services and Amenities, Stressed Problems in Communities affecting social capital and mental health, Model of Overlapping Clusters of Problems, Suicide, Anti-social Behaviour and Social Capital.
This document summarizes a study on the impact of night shift work on the physical and mental health of women working in private hospitals in Mumbai, India. It finds that 71% of respondents accepted night shift work for better pay, and 80% had over 5 years of experience working more than 2 night shifts per week. The study aims to investigate how night shifts affect women's health and job satisfaction by examining their working conditions, lifestyle habits, and reported physical and psychological health issues. Statistical analysis of surveys from 50 female hospital employees found strong correlations between night shift work and negative impacts on lifestyle and health. The study suggests employees working rotating night shifts need special attention due to higher health risks and lower productivity.
This document discusses the legal and historical context of social work with adults with mental health issues in England. It outlines key legislation like the 1959 and 1983 Mental Health Acts and how they have evolved to increase protections for individuals and allow for community-based treatment. The most recent Mental Health Act of 2007 and Care Act of 2014 take a recovery-oriented approach focused on person-centered care and least restrictive options. The document also examines theories and models used in social work practice, like systems theory and recovery models, as well as issues around diversity, collaboration between medical and social perspectives, and reducing conflicts between approaches.
Developing Emotional Intelligence for Healthcare LeadersYasmin AbdelAziz
Skills in emotional intelligence (EI) help healthcare leaders understand, engage and
motivate their team. They are essential for dealing well with conflict and creating workable
solutions to complex problems.
- The document discusses discrimination faced by minority nurses and its negative impact on their career trajectories. It provides background on the nursing profession and conceptual frameworks of structuration theory and social identity theory to analyze discrimination.
- A literature review found that nurses experience discrimination from supervisors, doctors, patients and their own colleagues. This creates a hostile work environment and negatively affects job satisfaction and retention rates.
- The proposed study will use qualitative interviews of 50 minority and 50 white nurses across two urban hospitals to understand perceived barriers and discrimination faced by minority nurses compared to their white counterparts. Purposive sampling across units and shifts aims to provide a comprehensive examination of the issue.
This document provides an introduction and overview of a course on human occupation for occupational therapy students. The 3-sentence summary is:
The course aims to introduce students to the concept of occupation from an occupational therapy perspective, covering topics like history, philosophy and the relevance of occupation to health. Students will complete workshops, essays, and fieldwork to develop an understanding of humans as occupational beings. The document outlines the course objectives, assessments, schedule, and introduces key concepts and perspectives in occupational therapy.
This summarizes Imogene King's Goal Attainment Theory of Nursing. King defines nursing as a process of interaction between nurse and client to establish goals and carry out actions to achieve them. She views humans as open systems interacting with their environment. The nursing process involves assessment, nursing diagnosis, planning, implementation and evaluation carried out through communication between nurse and client. The goal is for clients to attain their health goals through this process of mutually setting and working towards goals.
The document outlines the American Nurses Association's position statement on incivility, bullying, and workplace violence. It states that nurses and employers have an ethical responsibility to create a safe and respectful work environment free of these issues. The statement defines incivility, bullying, and workplace violence. Incivility includes rude behavior while bullying refers to repeated harmful actions intended to humiliate or distress others. Workplace violence puts nursing's contract with society at risk. The profession must work to eliminate these issues and drive cultural change through acknowledgement, prevention, and addressing harmful actions and inactions.
Dorothy Johnson developed the Behavioral Systems Model in the 1940s. The model views the patient as a behavioral system composed of seven subsystems including attachment, dependency, ingestion, elimination, aggression, sexual, and achievement. The goal of nursing according to the BSM is to help patients maintain behaviors proportional to social demands and modify behaviors to support biological functions during illness. The nursing process in the BSM involves assessing patients' subsystem functions, diagnosing insufficiencies or discrepancies, planning interventions to restore balance, and evaluating subsystem balance.
1) The document discusses a study that explored the daily routines and quality of life of 10 individuals with chronic pain through interviews and assessments. 2) A grounded theory called the "Paradigm of Life" emerged from the data, which found that chronic pain disrupts individuals' occupations and impacts their quality of life. 3) The theory shows how engaging in meaningful occupations can enhance quality of life by providing distraction from pain and a sense of control.
This literature review examines concepts of quality of life for residents in nursing home facilities. It discusses person-centered care which prioritizes resident autonomy, dignity and choice. Culture change aims to shift care from a medical model to a person-centered model through staff education, meaningful activities and consistent staffing. Relationships between residents and family, friends, staff and other residents impact well-being. Daily uplifts and story sharing can help staff build relationships. Resident choice in activities and spirituality can enhance satisfaction. The Selective Optimization with Compensation model describes how older adults adapt to loss of function through selection, optimization and compensation. Overall the literature emphasizes improving quality of life through individualized, enriched care plans.
Betty Neumann developed the Neuman Systems Model, which views clients holistically and focuses on stressors that can disturb a client's usual stability. The model uses primary, secondary, and tertiary prevention interventions to help clients retain, attain, or maintain optimal wellness. Neumann was influenced by general systems theory and saw people as complex systems composed of interrelated biological, psychological, socio-cultural, developmental, and spiritual variables that can be impacted by internal and external environmental stressors. Nursing aims to help the client system maintain stability through interventions that reduce the impact of stressors at different levels of reaction.
This document provides an overview of Afaf Ibrahim Meleis' Transitions Theory. It discusses Meleis' background and career, the development and sources of Transitions Theory, major concepts and assumptions of the theory, theoretical assertions, and the theory's acceptance and applications in nursing practice and education. Transitions Theory examines the patterns and properties of life transitions and conditions that influence healthy transitions.
Abstract—Spiritual health is not given its due importance since long time. But nowadays modern medicine is seen in relation to spiritual health and studies were conducted to find out its effect in various diseases. So this study was conducted on elderly aimed to assess the spiritual health and its association with psycho wellness. For study purpose, 30 cluster technique to identify houses with elderly (≥60 years) in Municipal Corporation area of Jaipur City. After collecting general information Spiritual Health Assessment Scale (SHAS) was used to assess spiritual health and Modified Mini Screen (MMS) was used to assess psycho-wellness in elderly. Data were anlysed and inferred by Chi-square test and ANOVA with Post-hoc Tukey test. Majority of elderly were having poor spiritual health and this spiritual health was strongly associated with psycho-wellness in elderly. Poorer the spiritual health of elderly leads to poorer the psycho-wellness in elderly.
Preserve and Strenghthen Family to promote Mental healthJP Rajendran
The document discusses the important role of family in mental health in India. It notes that traditional Indian families provided key support for the mentally ill through economic assistance, social support, and caregiving. However, families are now under increasing strain due to changes like urbanization and nuclearization. To promote mental health, the document argues that families need more support through policies, services, awareness programs, and research on family-based interventions. Preserving and strengthening family is vital for managing mental health issues in a sustainable way.
Images are personal or stock except for...
6,7 http://static2.businessinsider.com/image/4f9ab672ecad041602000000-480/lost-in-space-danger-will-robinson.jpg
11 http://www.vinylrecords.ch/B/BR/Bronski_Beat/Why_si/bronski-beat-why-1185.jpg
15 World Federation of Occupational Therapists
39 Canadian Association of Occupational Therapists
A Study Of Organizational Role Stress Among Teachers A Critical Literature R...Jim Jimenez
This document summarizes a study on the impact of organizational role stress on university teachers in Haryana, India. It reviews literature on role stress both internationally and within India. The literature shows that role stress negatively impacts job satisfaction, productivity, and health. Studies find higher stress levels among healthcare and female professionals. Comparisons between public and private sector employees show inconsistent differences in stress levels. The review establishes role ambiguity, overload, and lack of resources as key stressors for teachers and other professionals.
Employee well-being influences individual, organizational, and societal outcomes. Work-related stress contributes to 120,000 deaths per year in the U.S. and increased health care costs. It also reduces productivity and increases absenteeism and turnover. Employee well-being spills over to affect family life, with job stress correlating to poorer parent-child relationships and marital problems. However, work can also provide benefits to well-being like daily structure, social contact, and a sense of purpose when organized appropriately. Policies aim to improve well-being could yield individual and economic gains.
1Ms Daniella Fernandes,
2Mr Gajanan (Amey) Karmali
Agnel Entrepreneurship Development Institute, Verna Goa
Abstract: The present study was undertaken to examine the Impact of Schemes Designed for Women in Goa on
their Self-Esteem and Psychological Well-Being. The sample consisted of women belonging from the age group 18-
40 years and above. These women belonged to the various talukas of Goa. The sample comprised of 1050 women.
The tools used in this study included Rosenberg Self-Esteem Scale developed by Morris Rosenberg and the Ryffs
Psychological Well-Being Scale developed by Carol Ryff. Data was analysed by incorporating the t-test and
ANOVA. The results have shown that women who have availed schemes have shown higher level of self-esteem.
Women who have not faced difficulties in applying for schemes have shown higher psychological well-being and
self-esteem. The studies also revealed that women who have received skill training, have their own business and
are employed in an organization show better psychological well-being and self-esteem in comparison to
housewives. Women who are employed show higher level of self-esteem and psychological well-being compared to
women who are unemployed
ACQUIRING EMPLOYEE ENGAGEMENT TO ACHIEVE HIGH QUALITY OF CARE IN PRIMARY HEAL...JIANGUANGLUNG DANGMEI
Quality of care in the primary health care system of India is poor that often leads to high infant mortality and maternal mortality rate in the rural areas. However, there are strong evidences that demonstrate the importance of employee engagement to quality of care and patient satisfaction in the health care industry. Many health care industries have adopted employee engagement as a strategy to enhance the quality of care. Engaging the employees effectively can overcome the challenges faced by the health care system of India in the years to come and will continue to improve quality of services towards the patients. This paper explores the importance and significances of employee engagement to enhance quality of care in the primary health care of India.
Affect of Social Capital on Mental Health OutcomesRuby Med Plus
This research Paper discuss affect of social capital on Mental Health. Psycho social Processes and Social Capital, Empowerment and Social Capital, Social Networks and Social Capital, Measurement of social capital, The Mental Health Index indicators integration, The Social and Mental Well Being Index integration, Health-related Behaviors and Social Capital, Access to Mental Health Services and Amenities, Stressed Problems in Communities affecting social capital and mental health, Model of Overlapping Clusters of Problems, Suicide, Anti-social Behaviour and Social Capital.
This document summarizes a study on the impact of night shift work on the physical and mental health of women working in private hospitals in Mumbai, India. It finds that 71% of respondents accepted night shift work for better pay, and 80% had over 5 years of experience working more than 2 night shifts per week. The study aims to investigate how night shifts affect women's health and job satisfaction by examining their working conditions, lifestyle habits, and reported physical and psychological health issues. Statistical analysis of surveys from 50 female hospital employees found strong correlations between night shift work and negative impacts on lifestyle and health. The study suggests employees working rotating night shifts need special attention due to higher health risks and lower productivity.
10 STRATEGIC POINTS
2
10 STRATEGIC POINTS
2
Factors that Influence Utilization of Public Mental Health Services
RSD-851: Residency: Dissertation
Grand Canyon University
October 5, 2020
10 Strategic Points
My Degree: Ph.D.
Program Emphasis: Industrial Organizational Psychology
Ten Strategic Points
Comments or Feedback
Broad Topic Area
Factors that Influence Utilization of Public Mental Health Services
Lit Review
(Theoretical Framework (Theory)
Gaps
Themes
All Citations
Gaps
A. Basu, Rehkopf, Siddiqi, Glymour, & Kawachi (2016). According to the authors, there is a gap here in the changes being experienced in social policies in recent years. It has created a gap among women with low income in South Texas. Accordingly, the authors used the determination of the differences in income to understand the relationships between health outcomes and welfare reforms as it impacts the less privileged women in comparison to the most affected women.
B. Ly, A. (2019). This study focused on the factors that influence the utilization of mental health among Vietnamese Americans and the barriers to seeking help in Texas. The study had 12 participants including providers and community leaders who were familiar with the target population. The findings of the study indicated that there is a gap here in cultural acceptance of mental health treatment. Hence the need to culturally specify mental health intervention to improve mental health utilization in the community. However, the study was limited by the small sample size; therefore, the findings cannot be generalized. Further studies should include more cultural groups to validate the findings of this research.
C. Kwan, P. P., Soniega-Sherwood, J., Esmundo, S., Watts, J., Pike, J., Sabado-Liwag, M., & Palmer, P. H. (2020). The authors of this study aimed to evaluate the facilitators and barriers to mental health utilization among Pacific Islanders. Semi structure interviews were used to collect information from 12 pacific islanders. Trained community leaders recruited eligible candidates for the study. The study was limited by the small sample size. Five themes arose from the study. There is a gap here in regard to cost of healthcare, mental health stigma and language and culture barriers, which were the themes that emerged concerning barriers affecting the utilization of mental health services. The researchers indicated the need for future studies to include a larger sample size to enable generalization of the findings.
D. Volkert, J., Andreas, S., Härter, M., Dehoust, M. C., Sehner, S., Suling, A., . . . Schulz, H. (2018). The aim of this study was to evaluate various aspects of the utilization of mental health services among the elderly. The study had 3,142 participants aged between 65-84 years. Logic regression approach was used to analyze predisposing, enabling, and need factors among the participants. Similarly, the study found that there is ...
10 STRATEGIC POINTS
2
10 STRATEGIC POINTS
2
Factors that Influence Utilization of Public Mental Health Services
RSD-851: Residency: Dissertation
Grand Canyon University
October 5, 2020
10 Strategic Points
My Degree: Ph.D.
Program Emphasis: Industrial Organizational Psychology
Ten Strategic Points
Comments or Feedback
Broad Topic Area
Factors that Influence Utilization of Public Mental Health Services
Lit Review
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A. Basu, Rehkopf, Siddiqi, Glymour, & Kawachi (2016). According to the authors, there is a gap here in the changes being experienced in social policies in recent years. It has created a gap among women with low income in South Texas. Accordingly, the authors used the determination of the differences in income to understand the relationships between health outcomes and welfare reforms as it impacts the less privileged women in comparison to the most affected women.
B. Ly, A. (2019). This study focused on the factors that influence the utilization of mental health among Vietnamese Americans and the barriers to seeking help in Texas. The study had 12 participants including providers and community leaders who were familiar with the target population. The findings of the study indicated that there is a gap here in cultural acceptance of mental health treatment. Hence the need to culturally specify mental health intervention to improve mental health utilization in the community. However, the study was limited by the small sample size; therefore, the findings cannot be generalized. Further studies should include more cultural groups to validate the findings of this research.
C. Kwan, P. P., Soniega-Sherwood, J., Esmundo, S., Watts, J., Pike, J., Sabado-Liwag, M., & Palmer, P. H. (2020). The authors of this study aimed to evaluate the facilitators and barriers to mental health utilization among Pacific Islanders. Semi structure interviews were used to collect information from 12 pacific islanders. Trained community leaders recruited eligible candidates for the study. The study was limited by the small sample size. Five themes arose from the study. There is a gap here in regard to cost of healthcare, mental health stigma and language and culture barriers, which were the themes that emerged concerning barriers affecting the utilization of mental health services. The researchers indicated the need for future studies to include a larger sample size to enable generalization of the findings.
D. Volkert, J., Andreas, S., Härter, M., Dehoust, M. C., Sehner, S., Suling, A., . . . Schulz, H. (2018). The aim of this study was to evaluate various aspects of the utilization of mental health services among the elderly. The study had 3,142 participants aged between 65-84 years. Logic regression approach was used to analyze predisposing, enabling, and need factors among the participants. Similarly, the study found that there is ...
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This study examines the impact of workplace incivility on employee performance, with the mediating role of psychological well-being, among female employees in the health sector of Azad Jammu and Kashmir, Pakistan. The study aims to determine if workplace incivility negatively impacts employee performance, and if psychological well-being mediates this relationship. A structural equation model is used to analyze the data and test the hypotheses. The results show that workplace incivility has a significant negative effect on employee performance. Psychological well-being is also found to have a direct negative impact on performance. Additionally, psychological well-being is shown to mediate the relationship between incivility and performance. The findings suggest that incivility reduces psychological well
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This document summarizes a research study that examined the impact of work-life balance (WLB) on organizational commitment (OC) among women healthcare workers in India. The study found:
1) There was a significant positive relationship between WLB and OC among the 580 female healthcare workers surveyed across several hospitals.
2) Component-wise analysis showed WLB had a positive relationship with affective and normative commitment, but a negative association with continuance commitment.
3) The study highlighted the importance of organizational policies and support for managing the relationship between work and non-work domains to enhance employees' OC.
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Due Week 2 and worth 200 points
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After a trend analysis of several Sentinel Events, “We Care Hospital” fired the Health Care Administrator. As a result, you were hired as the new Health Care Administrator. You have reviewed the Sentinel Event with Dr. John Bradley and discovered several factors that showed the hospital was negligent. The three basic forms for negligence are malfeasance, misfeasance, and nonfeasance. Your first task is to rationalize your answers by using any applicable legal precedents.
Then, prepare a Microsoft PowerPoint 10-slide narrative using a SWOT Analysis. A SWOT Analysis identifies strengths, weaknesses, opportunities, and threats in a situation. Review the video: Strategic Planning and SWOT Analysis. To help you prepare the narrative PowerPoint using Microsoft 365 and older versions, review the video: Record a slide show with narration and slide timings.
Your 10-slide SWOT PowerPoint should follow this format:
1. Slide 1: Cover Page
a. Include the title of your presentation, the course number and course title, your name, your professor’s name, and the date.
2. Slide 2: Background / Executive Summary
a. Describe the details of the situation. Use bullets with short sentences. The title of this slide should be Executive Summary.
3. Slide 3: Thesis Statement
a. Identify the focus of your research. The title of this slide should be Thesis Statement.
4. Slides 4-9: Support
a. Support your thesis statement following the SESC formula: State, Explain, Support, and Conclude. (An overview of using Sublevel 1 and Sublevel 2 headings is provided in the following video: APA Style - Formatting the Title Page, Abstract, and Body).
b. You should include at least three court cases and related peer-reviewed articles from within the past five years. In-text citations should be in the American Psychological Association (APA) format.
5. Slides 10: References
a. Use APA format for your Reference slide. (To help you with APA in-text citations and your Reference list, some students use Citation Machine.
Note: Writing Resources are available from Strayer University’s Writing Center, Tutor.com, and Grammarly.com.
The specific course learning outcomes associated with this assignment are:
· Examine the various applications of the law within the health care system.
· Analyze how such various applications of the law affect decisions in the development and operation of a heal ...
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The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
Healthcare management status of indian statesiaemedu
This document summarizes a research article that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. The researchers ranked the states based on multiple healthcare parameters using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method. A literature review found that most prior work focused on specific healthcare issues rather than comparing progress across states. The study aims to fill this gap by evaluating and ranking states on their public healthcare management performance. The conclusions indicate that states in South India performed better than other parts of the country in terms of public healthcare management.
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The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
An analytical study on investors’ awareness and perception towards the hedge ...iaemedu
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2. 66 Saif-ud-Din et al.
Biographical notes: Saif-ud-Din is an Assistant Professor in the Human
Resources Management Department in the College of Business at King Abdul
Aziz University in the Kingdom of Saudi Arabia. He specialises in the study of
psychological capital, work attitudes and behaviour, burnout and stress
management, employee well-being, employee socialisation, employee
empowerment, and organisational citizenship behaviour. His work has been
presented at the Academy of Management and published in a number of
European and Asian management journals.
Vishwanath V. Baba is a Professor and the Don Pether Chair in Engineering
and Management in the DeGroote School of Business at McMaster University.
He specialises in the study of work related mental health and evidence-based
management. His work has been published in the Journal of Applied
Psychology, Human Relations, Journal of Organizational Behaviour,
International Journal of Human Resource Management among others and has
been presented at major national and international conferences. He teaches
management theory.
Louise Tourigny is a Professor in the Management Department at the
University of Wisconsin-Whitewater. She specialises in the study of job stress,
burnout, depression, absenteeism, leadership, job performance and employee
attitudes. She uses a comparative approach in studying healthcare workers. Her
work was presented at international conferences, including the Academy of
Management, and published in journals such as the International Journal of
Human Resource Management, Cross-cultural Management: An International
Journal, Canadian Journal of Administrative Sciences, and Canadian
Psychology.
This paper is a revised and expanded version of a paper entitled ‘Emotional
Exhaustion and its consequences among nurses in India and China’ presented at
The Seventy Second Annual Meeting of the Academy of Management, Boston,
MA, USA, 10–13 August 2012.
1 Introduction
Emotional exhaustion has been central to the phenomenon of burnout and has been
shown to influence people’s behaviour in organisations quite broadly (Maslach et al.,
2001). Nurses bear the brunt of health care delivery around the globe and their
performance, satisfaction, and mental health have profound implications for the quality of
health care wherever it is delivered. Regardless of the far-reaching impact of emotional
exhaustion, authoritative understanding of the etiology of burnout is confined to the
individualist societies of the West (Khamisa et al., 2013; Maslach et al., 2001; Schaufeli
et al., 2009). Given the documentation that individualist and collectivist societies differ
significantly in their display of organisational behaviour, it is imperative that we test our
models of organisational behaviour developed mostly in individualist contexts in
collectivist cultures to better understand the nuances in their manifestation and to
facilitate their usefulness across cultures (Kagitçibasi, 2002). This study is motivated by:
3. Emotional exhaustion and its consequences 67
1 The need to broaden the context of testing burnout models.
2 The desire for a more comprehensive understanding of organisational commitment
both as a mediator and as a moderator and document context differences across two
cultures.
3 The benefit of locating the study in India and China which together account for over
75% of health care delivery in Asia.
4 The opportunity to compare the model’s performance in two collectivist societies
with uniquely different cultures.
It is a constructive replication and extension of the study of emotional exhaustion by
Cropanzano and his colleagues (2003). It is constructive in the sense that in addition to
testing the mediating role of organisational commitment, we are exploring its moderator
role. We are also extending the scope of the study by locating it in collectivist contexts
but in two different cultures, that of India and China, and expanding the portfolio of
criterion variables.
Health care is becoming a major area of investment in both India and China due to
their rapid economic growth (Yip and Mahal, 2008) and increasing demand for timely
and high quality health care (Yun et al., 2010). Over the past decade the governments of
India and China injected substantial new public funds 1 to 2% of their GDPs-into health
care (Shah and Jenkins, 2000). It is becoming a cause for concern as these demands
increase the stress levels of health care providers resulting in poor mental health such as
burnout and depression. The study of health care professionals in India and China have
indicated that burnout problems have been severe and on the increase, due to excessive
job demand and huge patient-nurse ratio (Kar and Suar, 2014; Li et al., 2003; Sharma,
2007). The paucity of research dealing with issues of mental health in the developing
world creates either a policy vacuum in dealing with such problems or a choice of
inappropriate and ineffective solutions developed in the West (Khamisa et al., 2013; Shah
and Jenkins, 2000). India and China are large economies – ranked 7th and 2nd in terms of
their GDP according to the United Nations – making a significant global impact and
upending the global economic order (Bardhan, 2009). Yet we do not have much
empirical research documenting organisational behaviour in these two ancient Asian
societies, and much less with a comparative optic (Kar, and Suar, 2014). It has also been
documented that health care research performed in the West may not be culturally
relevant to either Indian or Chinese context of healthcare (Higgins et al., 2007). It has
been known that the parameters surrounding health care delivery in individualist societies
such as Australia and Britain are quite different from delivering health care in collectivist
societies such as India and China (Jenkins and Barrett, 2004). In other words, there is a
need for further research about nursing across non-estern cultures (Higgins, et al., 2007).
Apart from the fact that both India and China are large Asian economies that have
attained nationhood around the same time and are collectivist in their cultural orientation,
there are important differences such as population diversity, social norms, health care
traditions and provision that would warrant comparison (Cooke, 2010; Fabrega, 2001;
Higgins et al., 2007; Hsiao, 1995; Lu et al., 2007). Though being collectivist, both
countries have expressed their collectivism differently. India followed more of a
4. 68 Saif-ud-Din et al.
contextual road toward an in-group collectivism while China followed more of a cultural
road toward an institutional form of collectivism (Chand and Ghorbani, 2011). In
addition, it has been pointed out that structural features have caused both India and China
to achieve different health system outcomes over the past quarter century (Bardhan,
2008; Yip and Mahal, 2008). Consequently, our interest is to focus on both India and
China to generate empirical evidence on emotional exhaustion and its behavioural and
psychological consequences in the nursing profession.
1.1 Theory and hypotheses
There is consistent support for the notion that inequity in social exchange is associated
with burnout (Janssen et al., 2010; Van Dierendonck et al., 2001). Emotional exhaustion
is the feeling of being emotionally over-extended and exhausted by ones’ work resulting
in loss of energy, or chronic fatigue (Maslach, 1978). Nurses become emotionally
exhausted when there is ongoing stress due to excessive demands at work with
inadequate support, insufficient resources, and inability to control either the pace or the
volume of work (Halbesleben and Buckley, 2004; Karasek, 1979). Such working
conditions lead to the perception that the exchange between the nurse and the hospital is
no longer fair and that the health care facility she works for is no longer deserving of her
commitment (Kar and Suar, 2014; Lu et al., 2007). Research found a negative association
between emotional exhaustion and organisational commitment supporting this
observation (Cropanzano et al, 2003; Lee and Ashforth, 1996).
The conservation of resources (COR) model would suggest that as excessive demands
deplete energy and exhaust the nurse, she will take steps to conserve her resources and
cut back on her performance (Hobfoll, 1989), feeling less satisfied with her job and
depressed about her condition. Empirical studies show that emotional exhaustion
seriously affects job performance, job satisfaction, and exacerbate depression in the
nursing profession (Baba et al., 1991; Parker and Kulik, 1995; Sheward et al., 2005;
Tourigny et al., 2010). Most of this support however is located in studies from what we
call individualist societies of the West. There is little evidence that such findings are
corroborated in collectivist societies like India and China (Maslach et al., 2001; Schaufeli
et al., 2009). While individual level phenomenon such as mental health allows for
universal theorising, it is important to develop an empirical base for such theorising
across cultures that are different from the original test sites (Bhagat et al., 2012). That is
how we empirically establish the universality of such concepts. Our interest is to do just
that-empirical validation of mental health episodes in these two collectivist societies.
We argue that when someone experiences emotional exhaustion, it is followed by
lower job performance. The COR model would support that as the nurse decides to pull
back on her performance to conserve her resources. This behaviour is validated by the
perception that the parameters of exchange between her and the hospital have shifted
toward greater inequity and that she has to reduce her input to bring balance back to the
exchange (Hobfoll, 1989). In individualist societies, such reasoning is normal. Research
shows a negative link between emotional exhaustion and both task performance and
organisational citizenship behaviour (Halbesleben and Bowler, 2007). However, research
done among Chinese nurses revealed inconsistent trends in the relationships among
variables related to occupational stress and organisational commitment (Lu et al., 2007).
While this hypothesis has indeed been tested among Western nurses, we want to explore
the relationship among nurses in India and China to see whether these patterns, justified
5. Emotional exhaustion and its consequences 69
by theory, exist as they are or whether they are sensitive to the context. There is reason to
believe that in collectivist societies, such a relationship may not be so straightforward
(Higgins et al., 2007; Walumbwa and Lawler, 2003). An obligation toward the
collectivity and a transcendental purpose to work may dispose a nurse to become less
sensitive to emotional exhaustion. Familiar interpretations of performance behaviour in
light of social exchange theory may have to be nuanced differently.
Hypothesis 1a Emotional exhaustion is negatively related to job performance.
Job satisfaction is defined as contentment that an employee feels after a need is fulfilled
(Williams and Sandler, 1995). Nurses start to feel dissatisfied with their jobs, when the
job demands are excessive (Aiken et al., 2002; Lu et al., 2007). Piko (2006) found that
among all the burnout components, emotional exhaustion is most strongly related to job
dissatisfaction. However there is empirical inconsistency in this literature. A one-year
longitudinal study reported that emotional exhaustion is unrelated to job satisfaction
(Wright and Cropanzano, 1998). Other researchers showed that job satisfaction remained
relatively high despite the high prevalence of burnout and suggested that further research
is needed to ascertain why job satisfaction remains high in the presence of burnout
(Kumar et al., 2007). Again, collective societies may configure these relationships
differently (Walumbwa and Lawler, 2003). It sets the stage for a more complex
relationship between burnout and job satisfaction. Therefore, this relationship is worth
further testing.
Hypothesis 1b Emotional exhaustion is negatively related to job satisfaction.
Depression is primarily viewed in terms of negative feelings, self-depreciation, self-
destructive thoughts, and social withdrawal (Leiter and Durup, 1994). While burnout is
an outcome of the quality of the work environment, depression is considered a global
state that encompasses virtually all spheres of one’s life (Tourigny, et al., 2010). This
suggests that the process of being emotionally exhausted and burning out of work may
trigger similar yet more pernicious thoughts that affect one’s total life. While depression
and burnout are closely related, they are certainly not identical twins (Brenninkmeyer
et al., 2001). Researchers found significant positive association between symptoms of
depression and high emotional exhaustion (Baba et al., 1999). It was also suggested that
symptoms of depression increases with high level of emotional exhaustion in the absence
of effective coping mechanisms (Tourigny et al., 2010). What is not clear is whether
these observations hold true in collectivist societies where mental health outcomes
manifest differently (Shah and Jenkins, 2000). Therefore, we posit the following
hypothesis.
Hypothesis 1c Emotional exhaustion is positively related to depression.
Organisational commitment has been receiving considerable attention in the literature due
to its significant impact on work related attitudes and its role as a mediator and moderator
in different work settings (Chirumbolo and Areni, 2005; Chiu and Francesco, 2003;
Restubog et al., 2006, Tourigny et al., 2013). Furthermore, it appears likely that
organisational commitment’s role as mediator or moderator may be influenced by
cultural context. Yousaf (2000) found significant results in testing the mediating role of
organisational commitment between leadership behaviour and both job satisfaction and
job performance in the Middle East. Cropanzano and his colleagues (2003) also found
6. 70 Saif-ud-Din et al.
that organisational commitment was a significant mediator between emotional exhaustion
and work related attitudes in the West. Mattila (2003) used affective commitment as a
moderator which reduced the spillover effects of service failures on future loyalty
behaviours. Leong et al. (1996), deployed organisational commitment as a moderator to
buffer the relationship between occupational stress and stress outcomes. More recently,
Namasivayam and Zhao (2007) have found organisational commitment to moderate the
relationship between work-family conflict and job satisfaction among hospitality
employees in India. Previous research suggests that employees with high organisational
commitment enjoy more job satisfaction and mental and physical health, and have lower
intentions to quit (Begley and Czajka, 1993). Siu (2002) demonstrated that organisational
commitment interacts with stressors to influence job satisfaction and physical well-being.
Theoretically, emotional exhaustion triggered by its work-related antecedents leads to
cognitions of organisational inequity resulting in the diminution of performance and
satisfaction, and giving rise to feelings of depression. Social exchange theory would
support such mediation for organisational commitment where commitment becomes the
medium of exchange between the nurse and the hospital management. On the other hand,
if one were to attribute causes unrelated to stress for the development of organisational
commitment, such as stakes in the organisation and a sense of obligation, it stands to
reason that the presence of organisational commitment may indeed alter both the strength
and pattern of relationship between emotional exhaustion and its consequences. Whether
organisational commitment is a mediator or a moderator may indeed depend upon the
context in which it is developed and displayed. Consequently, we are extending the
mediation model proposed by Cropanzano et al. (2003) to include moderation as well and
testing it in two different non-western collectivist contexts.
Consequently, we hypothesise that:
Hypothesis 2a Organisational commitment will mediate the relationship of emotional
exhaustion and job performance.
2b Organisational commitment will mediate the relationship of emotional
exhaustion and job satisfaction.
2c Organisational commitment will mediate the relationship of emotional
exhaustion and depression.
Hypothesis 3 Organisational commitment will moderate the effect of emotional
exhaustion on:
a Job performance, such that high organisational commitment will
mitigate the effect of emotional exhaustion whereas low
organisational commitment will exacerbate this relationship.
b Job satisfaction, such that high organisational commitment will
alleviate the effect of emotional exhaustion on job satisfaction
whereas low organisational commitment will exacerbate this
relationship and
c Depression, such that high organisational commitment will
alleviate this effect and low organisational commitment will
exacerbate this relationship.
7. Emotional exhaustion and its consequences 71
2 Method
2.1 Sample and procedures
The present study was conducted among nurses in India and China as part of a larger
program of research (Tourigny et al., 2010). Data were gathered from 683 nurses in India
for a response rate of 68 percent, and 550 nurses in China for a response rate of 69% by
means of a structured questionnaire. The corresponding author was given a letter of
introduction to the hospitals by the director of the Institute in India he was affiliated with.
Large (> 500 beds) and medium (> 100 beds) size full service hospitals were contacted in
the state of Uttar Pradesh and in the national capital Delhi, and three in Lucknow (two
large and one medium), and one large hospital in Delhi participated in the study. A
research assistant went to each hospital to distribute the questionnaires to the nursing
staff with the help of the nursing supervisor and the Human Resources Administrator.
The research assistant collected the completed questionnaire from the nursing stations
after two days. In China, the corresponding author’s former student had professional
connections in the health care sector in both Beijing and Dalian. Through her contacts
three large state owned general hospitals, two in Dalian and one in Beijing and some
smaller specialised clinics in Dalian agreed to participate in the survey. Questionnaires
were delivered to the hospitals and were distributed to the nurses by the nursing
supervisor. Completed questionnaires were personally collected by an assistant over a
period of a week. For the Chinese sample, we retained only the respondents from the
state owned general hospitals (n = 451) for purposes of comparison. A vast majority of
both samples is female. There were 93% females and 7% male for nurses who indicated
their gender in the Indian sample, while all the respondents in the Chinese sample were
female. 72% of the Indian nurses and 74% of the Chinese nurses were married. The mean
age for the Indian respondents is 37 with a standard deviation of 11 and the mean age of
Chinese respondents is 32 with a standard deviation is nine.
2.2 Measures
Identical questionnaires were translated into Hindi and Chinese respectively by bilingual
organisational behaviour scholars. The translated versions had been verified and
back-translated into English before data collection to ensure accuracy of meaning.
• Demographic control variables. To minimise the catalytic role of demographics in
the hypothesised relationships, we controlled for age and marital status.
• Emotional exhaustion. Emotional exhaustion is measured with nine items from the
Maslach burnout inventory (MBI), using a scale ranging from one (strongly
disagree) and five (strongly agree) for both samples (Maslach and Jackson, 1981). A
sample item is: “I feel emotionally drained from my work”. The coefficient alpha
reliability value for the Indian sample is .77 and for the Chinese sample, .88.
• Organisational commitment. Organisational commitment for both samples is
measured using the 15 items organisational commitment questionnaire (OCQ), by
Mowday et al. (1979). A five point Likert scale ranging from one (strongly agree)
and five (strongly disagree) is employed. A sample item is ‘I am proud to tell others I
8. 72 Saif-ud-Din et al.
work in this hospital’. The coefficient alpha reliability value for the Indian sample is
.70 and for the Chinese sample, .82.
• Job performance ratings. Job performance ratings were measured by asking the
respondents to report their most recent performance ratings. Single item measures
are generally viewed as more unbalanced than scaled measures although their use in
the literature is not uncommon (Nagy, 2002; Wanous et al., 1997). But this is a
global rating, a metric incorporating many aspects of performance. We also found a
significant positive correlation between job performance rating and attitudinal
measures of organisational commitment and job satisfaction. More importantly, we
found significant negative correlation with emotional exhaustion and depression as
reported in Table 1. These results lend validity and enhance our confidence in the
measure of individual performance rating in this study.
• Job satisfaction. Job satisfaction is measured for both samples with 15 items
covering different facets of job satisfaction by using a five point scale ranging from
one (least satisfactory) and five (most satisfactory) (Tourigny et al, 2010). Sample
items in the questionnaire include: ‘Sense of competence in the job’, ‘satisfaction
from the current income’, the ‘degree of challenge’, and the amount of
appreciation/recognition received from others’. The coefficient alpha reliability value
for Indian sample is .78 and for the Chinese sample, .81.
• Depression. Depression was measured with 20 items (Radloff, 1977) from the Center
for Epidemiological Studies Depression Survey (CES-D) using a four-point
frequency scale ranging from one (rarely or none of the time) to four (most or all of
the time). The CES-D consists of a list of generic symptoms of depression. A sample
item of the survey is: ‘I had trouble keeping my mind on what I was doing’; ‘I
thought my life had been a failure’. The coefficient alpha reliability value for the
Indian sample is .74 and for the Chinese sample, .88.
Table 1 Means, standard deviation, reliability, and correlations: India and China
Variables 1 2 3 4 5 6 7 M SD Alpha
1 Age - .27** .16** .18** .03 .11* –.006 31.88 7.80 -
2 Marital status .39** - .05 –.02 –.03 –.02 .03 1.91 1.57 -
3 Emotional
exhaustion
.10** .13** - –.35** .22** –.29** .47** 3.23 .80 .88
4 Organisational
commitment
.14** .12** –.17** - –.16** .43** –.42** 3.67 .56 .82
5 Performance
ratings
.02 .09* –.19** .20** - –.17** .18** 2.35 .75 -
6 Job
satisfaction
.03 .01 –.07 .18** .10* - –.29** 3.09 .50 .81
7 Depression –.09* –.02 .33** –.22** –.21** –.16** - 2.15 .57 .88
M 36.66 1.90 2.15 3.58 3.52 3.26 1.05 -
SD 10.67 .65 .89 .68 1.61 .55 .45 -
Alpha - - .77 .70 - .78 .74 -
Notes: *p < .05, **p < .01, Indian data below the diagonal.
9. Emotional exhaustion and its consequences 73
In addition, demographic variables indicating age, marital status, and education were
collected using appropriate questions.
3 Results
We use a two-study format for presenting the results. Study 1 focuses on Indian nurses
and study 2, on Chinese nurses. In both studies, we present the direct effects first,
followed by tests for both mediation and moderation in that order. Comparative analysis
of the findings will be presented in the discussion. Table 1 presents the correlation matrix
for Indian nurses (n = 683) below the diagonal, and for Chinese nurses (n = 451) above
the diagonal. Means, standard deviations and alpha values for Indian nurses are presented
in rows and for Chinese nurses in columns.
3.1 Study 1: Indian nurses
3.1.1 Descriptive statistics and correlations
Results in Table 1 for Indian nurses demonstrate that all of the measures have acceptable
reliability coefficients. We found that age is positively related to emotional exhaustion,
organisational commitment, and negatively related to depression. Marital status is
positively related with emotional exhaustion, organisational commitment, and job
performance. As expected, emotional exhaustion is negatively related to organisational
commitment, job performance, and positively related to depression. However, contrary to
our expectation, there was no significant relationship between emotional exhaustion and
job satisfaction. Organisational commitment is negatively related to emotional
exhaustion, depression, and positively related to performance and job satisfaction.
Tests of hypothesis
• We hypothesised emotional exhaustion to be a negative predictor of job performance
after controlling for demographic variables. Hierarchical regression was used to test
this hypothesis. As shown in Table 2, emotional exhaustion has a significant
negative influence on job performance. The overall model was also significant
F= 7.46, p < .01. Therefore, Hypothesis 1(a) is accepted.
• We hypothesised emotional exhaustion to be a negative predictor of job satisfaction.
Hierarchical regression was used to test this hypothesis. As shown in Table 2 this
hypothesis was not supported. The overall model was also non-significant, F = 1.30,
p > .05. Therefore Hypothesis 1b is rejected. However there is the possibility of
indirect and mediation effect of emotional exhaustion on job satisfaction because the
proposed mediator organisational commitment has a significant positive effect on job
satisfaction.
• We hypothesised emotional exhaustion to be a positive predictor of depression. As
shown in Table 2, emotional exhaustion was a significant predictor of depression
after controlling for demographic variables. The overall model was also significant
F= 33.01, p<.01. Therefore hypothesis 1c is supported.
10. 74 Saif-ud-Din et al.
3.1.2 Mediation test
We have suggested that organisational commitment would mediate the relationship
between emotional exhaustion and the criterion variables job performance, job
satisfaction and depression as shown in Figure 1. The mediation effect is tested using the
Baron and Kenny (1986) protocol. The first requirement is that emotional exhaustion
(predictor) must be significantly related to organisational commitment (mediator).
Second, emotional exhaustion must be related to each outcome variables (criterion).
Third, when both emotional exhaustion and the mediator are simultaneously entered into
the equation, the relationship between emotional exhaustion and the criterion variable
must be appreciably smaller than it is when emotional exhaustion is the sole predictor.
After satisfying these conditions, it is important to test the significance of the indirect
path, which is the indirect effect of emotional exhaustion through organisational
commitment, by removing the variance of the direct effect. A formula for conducting this
significance test has been presented by Baron and Kenny (1986), and Sobel (1982).
These formulas yield the critical ratio or Z score which is compared to the critical value
from the standard normal distribution appropriate for a given alpha level. The Z score,
which can be compared with a priori critical value probability for the one-tailed (p < .05),
is ±1.96 or for the two-tailed (p < .01) is ±2.58.
Figure 1 Theoretical model for the mediation and moderation analysis (see online version
for colours)
(–)
Emotional
exhaustion
Organisational
commitment
1. Performance (–)
2. Job satisfaction (–)
3. Depression (+)
Tables 2 and 3 show the hierarchical regression model and the full mediation test
checking whether a mediator (organisational commitment) carries the influence of the
independent variable (emotional exhaustion) on the dependent variables job performance,
job satisfaction, and depression. These tests of Hypotheses 2a, 2b and 2c were done in
three steps. We excluded step 1 from Table 3 because it duplicated step 1 in Table 2
throughout the testing of these hypotheses.
We tested the model shown in Figure 1, by first entering the control variables into the
equation in step 1. Emotional exhaustion followed in step 2. As shown in Table 2,
regression analysis testing main effects found that emotional exhaustion significantly
predicted organisational commitment. The overall model was also significant F = 14.69,
p < .01. Therefore the first criterion for mediation effect is satisfied as outlined by Baron
and Kenny (1986).
11. Emotional exhaustion and its consequences 75
• Emotional exhaustion and job performance. Table 3 displays the mediation test. For
testing Hypothesis 2a which states that commitment mediates the relationship
between emotional exhaustion and job performance, we proceeded by entering the
control variables first, organisational commitment next, and emotional exhaustion in
step 3. The results show that the regression coefficient for emotional exhaustion is
significant, although smaller in size then it was when commitment was excluded (see
Tables 2 and 3). Following from Holmbeck (2002), we compute the significance of
indirect path by conducting the Sobel test. The obtained Z score was significant at
3.36, p < .01. Therefore, despite the fact that emotional exhaustion shows a
significant regression coefficient, it can be concluded that organisational
commitment is a significant mediator thereby supporting Hypothesis 2a.
• Emotional exhaustion and job satisfaction. As noted earlier, emotional exhaustion
has no direct significant relation with job satisfaction. Nevertheless, it is
recommended to proceed with mediation to test the indirect path of emotional
exhaustion by means of organisational commitment. As shown in Table 3
organisational commitment is a positive predictor of job satisfaction. Therefore, by
conducting the Sobel test for the indirect path, the obtained Z score was significant
3.32, p < .01. Thus, the indirect path did exert a significant effect. Consequently,
results support the mediation effect of organisational commitment between
emotional exhaustion and job satisfaction, thereby supporting Hypothesis 2b.
• Emotional exhaustion and depression. Hypothesis 2c posited that commitment
mediated the relationship of emotional exhaustion and depression. Results show that
the regression coefficient for emotional exhaustion is smaller in size than it was
when commitment was excluded. The indirect path for emotional exhaustion through
organisational commitment was also significant and the Z score was 3.23, p < .01.
This indicates that organisational commitment partially mediates the relationship
between emotional exhaustion and depression, thereby supporting Hypothesis 2c.
Findings are presented in Tables 2 and 3.
In summary, the results show that there is a direct and significant effect of emotional
exhaustion on performance and depression with the exception of job satisfaction. In
addition, the mediating role of the organisational commitment is supported for all of the
outcome variables and hence the study endorses the Cropanzano et al. (2003) mediation
for Indian nurses. However, support for mediation does not automatically negate support
for moderation. Given theoretical justifications and empirical corroboration cited earlier,
we proceeded to test the moderation hypothesis.
3.1.3 Moderation test
As illustrated in Figure 1, we use hierarchical moderated regression to assess the
predictive impact of emotional exhaustion and the moderator role of organisational
commitment on the relationship between emotional exhaustion and job performance, job
satisfaction, and depression. Results are presented in Table 4.
13. Emotional exhaustion and its consequences 77
Table 3 Indian nurses: mediation test
JobperformanceJobsatisfactionDepression
Variables
bSEbßbSEbßbSEbß
Step2
Age–0.010.01–0.040.000.000.01–0.000.00–0.08*
Maritalstatus0.210.100.09*–0.010.04–0.020.020.030.03
Organisation
commitment
0.470.090.19***0.150.030.18***–0.140.02–0.22***
R20.040.040.06
ΔR20.040.030.05
Step3
Age–0.000.01–0.030.000.000.02–0.000.00–0.10**
Maritalstatus0.250.100.10*–0.010.04–0.01–0.000.03–0.00
Organisation
commitment
0.420.090.17***0.140.030.17***–0.010.02–0.15***
Emotional
exhaustion
–0.220.07–0.11**–0.020.02–0.040.150.020.30***
R20.060.030.14
ΔR20.010.000.10
Notes:Thesteponeisexcluded,asitisidenticaltostep1formediationtestinTable2.*p<.05.**p<.01.***p<.001.
14. 78 Saif-ud-Din et al.
Table 4 Indian nurses: hierarchical moderated regression results
Dependent variables and standardised beta coefficients
Job performance Job satisfaction Depression
Step 1
Age –0.02 0.03 –0.01
Marital status –0.10* –0.00 0.02
Step 2
Emotional exhaustion –0.12** –0.04 0.32***
Organisation commitment 0.17*** 0.17*** –0.15***
Step 3
Emotional exhaustion ×
Organisation commitment
–0.04 0.10* 0.01
Step 1 ΔR2 0.01* 0.00 0.01*
Step 2 ΔR2 0.05*** 0.03*** 0.14***
Step 3 ΔR2 0.00 0.01* 0.00
Notes: *p < .05; **p < .01; ***p < .001.
The hierarchical regression analysis for the Indian nurses includes the two-way
interaction of emotional exhaustion and organisational commitment. The demographic
variables age and marital status were entered in step 1 of the regression. The predictors,
emotional exhaustion and commitment were entered in step 2. Results presented in
Table 4 show that emotional exhaustion was a significant predictor of job performance,
and depression, but not of job satisfaction.
The two-way interaction term of emotional exhaustion and organisational
commitment was entered in step 3. Contrary to our expectation no significant results were
found for the moderator role of commitment between emotional exhaustion and any of
the outcome variables for the Indian nurses.
We concluded that there is no evidence to support Hypotheses 3a, 3b and 3c for the
Indian nurses. In summary, our findings endorse the mediation model of Cropanazno and
his colleagues (2003) among Indian nurses thus extending the model’s viability in a
collectivist context.
3.2 Study 2: Chinese nurses
3.2.1 Descriptive statistics and correlations
Table 1 presents the correlation matrix for Chinese nurses (n = 451) above the diagonal.
Means, standard deviation, correlations among all the variables, and alpha values are in
vertical columns. All of the measures demonstrate acceptable levels of reliability.
Additionally, as expected, emotional exhaustion is positively correlated with depression
and negatively with organisational commitment and job satisfaction. However, contrary
to expectation, emotional exhaustion shows a significant positive correlation with job
performance. Organisational commitment is negatively related to emotional exhaustion
and depression and positively related to job satisfaction. Again contrary to our
expectation, organisational commitment is negatively related with job performance. We
are already beginning to see differences in the relationships among study variables in the
two apparently collectivist societies.
15. Emotional exhaustion and its consequences 79
Table 5 Chinese nurses: hierarchical regression results for mediation analysis
OrganisationalcommitmentJobperformanceJobsatisfactionDepression
Variables
bSEbßbSEbßbSEbßbSEbß
Step1
Age0.010.000.19***0.100.100.050.100.000.09*0.000.000.10
Maritalstatus–0.020.02–0.07–0.020.02–0.04-0.02–0.050.010.020.03
R20.03–0.000.00–0.00
Step2
Age0.020.000.25***0.000.100.020.100.000.13*–0.000.00–0.01
Maritalstatus–0.020.02–0.07–0.020.02–0.04–0.020.02–0.060.100.020.03
Emotional
exhaustion
0.280.03–0.38***0.200.050.21***–0.190.03–0.31***0.330.030.47***
R20.170.040.090.21
ΔR20.140.040.090.22
Notes:*p<.05.**p<.01.***p<.001.
17. Emotional exhaustion and its consequences 81
Tests of hypothesis
• As shown in Table 5 emotional exhaustion was a significant predictor of job
performance beyond the effect of control variables. The overall model was also
significant F = 6.92, p < .01. Hypothesis 1a is supported.
• Our results show that emotional exhaustion has a significant negative influence on
job satisfaction. The overall model was significant as well F = 12.68, p < .001.
Hypothesis 1b is also supported.
• As proposed in Hypothesis 1c, emotional exhaustion was a significant predictor of
depression beyond the effect of control variables. The overall model was also
significant F = 34.30, p < .001. Hypothesis 1c is also supported.
3.2.2 Mediation test
Tables 5 and 6 show the full mediation test as detailed in study 1. Hypotheses 2a, 2b and
2c were tested in three steps. We excluded step 1 from Table 6 because it duplicated
step 1 in Table 5 throughout the testing of these hypotheses. We repeated the steps
described in study 1 by entering the control variables in step 1 and emotional exhaustion
in step 2. As shown in Table 5 emotional exhaustion has a significant negative influence
on organisational commitment after the control variables. The overall model was also
significant F = 27.44, p < .001. Therefore, the first criterion for mediation according to
Baron and Kenny (1986) is satisfied for the Chinese nurses.
• Emotional exhaustion and job performance: Hypothesis 2a predicted that
commitment mediates the relationship between emotional exhaustion and job
performance. To test this hypothesis, we proceeded to enter the control variables
first, organisational commitment next, and finally emotional exhaustion in the last
step. The results show that the regression coefficient for emotional exhaustion was
significant and no changes were found when commitment was excluded. Results are
presented in Tables 5 and 6. Furthermore, contrary to our expectation, the Z score for
the indirect path was not significant with a low value of acceptable threshold 1.82,
p > .05. Therefore Hypothesis 2a is not supported.
• Emotional exhaustion and job satisfaction: Hypothesis 2b posited that commitment
mediates the relationship of emotional exhaustion and job satisfaction. The
regression coefficient for emotional exhaustion was significant but smaller in size
than it was when commitment was excluded. Results are presented in Tables 5 and 6.
However, despite the fact that emotional exhaustion shows a significant direct effect
on job satisfaction, the Z score for the indirect path revealed by the Sobel test was
significant at 5.17, p < .01. Therefore, it can be concluded that organisational
commitment is a significant mediator of the relationship between emotional
exhaustion and job satisfaction. Consequently, Hypothesis 2b is supported.
• Emotional exhaustion and depression: Hypothesis 2c proposed that commitment
mediated the relationship between emotional exhaustion and depression. Results
show that the regression coefficient for emotional exhaustion is significant but
smaller in size when commitment was excluded. Results are presented in Tables 5
and 6. The value for the indirect path from the Sobel test was also significant, 4.12,
18. 82 Saif-ud-Din et al.
p < .01. Therefore, the findings are consistent with commitment partially mediating
the relationship between emotional exhaustion and depression. Consequently
Hypothesis 2c is supported.
In summary, the results for the Chinese sample support the view that organisational
commitment plays an important role as a mediator between emotional exhaustion and the
outcome variables with the exception of job performance, although the pattern of results
differ from that of the Indian nurses.
3.2.3 Moderation test.
Hypothesis 3a, 3b and 3c were tested using hierarchical regression analysis. The
demographic variables age and marital status were entered in step 1. The independent
variables, emotional exhaustion and commitment were entered in step 2. Results
presented in Table 7 show that emotional exhaustion is a predictor of job performance,
job satisfaction, and depression. The results also show that commitment is a predictor of
job performance, job satisfaction, and depression.
Table 7 Chinese nurses: hierarchical moderated regression results
Dependent variables and standardised beta coefficients
Job performance Job satisfaction Depression
Step 1
Age 0.03 0.09 –0.01
Marital status –0.04 –0.05 0.04
Step 2
Emotional exhaustion 0.21*** –0.14* 0.40***
Organisation commitment –0.01* 0.37*** –0.26***
Step 3
Emotional exhaustion ×
Organisation commitment
–0.04 0.09* –0.10*
Step 1 ΔR2 0.00 0.01 0.00
Step 2 ΔR2 0.07*** 0.11*** 0.30***
Step 3 ΔR2 0.00 0.01* 0.01*
Notes: *p < .05; ***p < .001.
The two-way interaction term of emotional exhaustion and organisational commitment
was entered in step 3 to test the role of organisational commitment as a moderator
between emotional exhaustion and the criterion variables-job performance, job
satisfaction, and depression.
For Hypothesis 3a, organisational commitment does not appear to moderate the
influence of emotional exhaustion on job performance; thus Hypothesis 3a is not
supported. Results are shown in Table 7. For Hypothesis 3b and 3c, results indicate a
two-way interaction between emotional exhaustion and organisational commitment in
predicting job satisfaction and depression. Therefore Hypothesis 3b and 3c are supported.
In order to interpret the direction of the interaction, a slope examination was conducted
by plotting the predictive values of job satisfaction and depression against emotional
exhaustion for three different levels of organisational commitment.
19. Emotional exhaustion and its consequences 83
Figure 2 Moderation effect of organisational commitment on the relationship between emotional
exhaustion and job satisfaction (see online version for colours)
3.25
3.15
3.05
2.95
2.85
Jobsatisfaction
Emotional exhaustion
Low Medium High
Organisational
commitment
High
Medium
Low
Figure 3 Moderation effect of organisational commitment on the relationship between emotional
exhaustion and depression (see online version for colours)
2.6
2.5
2.4
2.3
2.2
2.1
2.0
1.9
Depression
Emotional exhaustion
Low Medium High
Organisational
commitment
High
Medium
Low
Figure 2 presents the interaction effect for job satisfaction and Figure 3, for depression.
The slopes indicate that for nurses whose commitment to the organisation is low to
medium, job satisfaction decreases when they are emotionally exhausted. However, when
organisational commitment is high, the slope depicts no influence of emotional
exhaustion on job satisfaction. Similarly, Figure 3, depict that for nurses whose
commitment to the organisation is low to medium, depression increases when nurses are
emotionally exhausted. However when organisational commitment is high, the slope
shows no influence of emotional exhaustion on depression. Therefore, organisational
20. 84 Saif-ud-Din et al.
commitment seems to buffer the impact of emotional exhaustion on both job satisfaction
and depression. This seems to suggest a role for loyalty activation.
In summary, we found a significant role for organisational commitment both as a
mediator as well as a moderator in the relationship between emotional exhaustion and its
outcomes among Chinese nurses.
4 Discussion
Previous research (Cropanzano et al., 2003; Janssen et al., 2010; Tourigny et al., 2010;
Wright and Cropanzano, 2003), identified psycho-social factors that may intervene and
moderate the negative impacts of emotional exhaustion on psychological and behavioural
outcomes. The results of this study corroborate that observation. Specifically,
organisational commitment was a significant mediator of the relationship between
emotional exhaustion and its outcomes across studies regardless of context. In addition,
we show significant moderator effects for psychological outcomes that are sensitive to
the context. Our contribution comes from extending the model to test the role of
organisational commitment both as a mediator and moderator, with appropriate
theoretical justification in two non-western collectivist cultures. To our knowledge this is
the first study that explores the role of organisational commitment both as a mediator and
as a moderator in the same profession in two different collectivist societies using a
comparative lens. Our findings also seem to suggest that when it comes to organisational
behaviour, all collective societies are not the same. We show both commonalities and
differences between India and China among members of the same profession.
Despite the value contribution of this research mentioned above, the study has some
limitations. It is a cross-cultural study and all of our perceptual measures are self-reports,
giving rise to concerns of common method variance. Second, job performance measure
using a single item rating approach may be more unstable compared to scaled measures.
However, we were guided by the observation that single item measures are useful where
face validity is important (Nagy, 2002; Wanous et al., 1997).
4.1 Research implications
Our findings confirm the value of social exchange theory and the COR model in
explaining organisational behaviour among nurses. We know from the literature that time
pressure, excessive job demands, and lack of material support contribute to emotional
exhaustion which in turn affects one’s commitment to the organisation. Indeed, these are
the outcomes of an unbalanced social exchange relationship between the individual and
the organisation. Empirical data used in this study supported the negative and positive
influence of emotional exhaustion on organisational commitment, job performance, job
satisfaction, and the symptoms of depression in general. We did not find a significant
relationship between emotional exhaustion and job satisfaction among Indian nurses,
which appears consistent with the earlier observations of Wright and Cropanzano (1998).
These results clearly demonstrate that western management and organisational
behaviour theory in the context of mental health among Indian nurses seems to be
independent of the individualist-collectivist cultural dichotomy. One of our objectives
was to examine the role of organisational commitment as a mediator in the context of
social exchange theory. We found for both samples that, emotional exhaustion exerted
21. Emotional exhaustion and its consequences 85
influence through organisational commitment in predicting job performance, job
satisfaction, and depression with the exception of job performance in the case of Chinese
nurses. This study broadened the scope of organisational commitment as a mediator with
two added variables, job satisfaction and depression in a cross-cultural context. These
findings extend the Cropanzano model and its implications to two different collectivist
non-western cultures. Finally, an expanded version of the model was tested to explore a
more complex role for organisational commitment as a viable moderator within the same
theoretical framework.
While our results did not confirm the proposed moderator for organisational
commitment among Indian nurses (see Table 4), it is worth noting that they confirmed
significant moderator effects among Chinese nurses, where organisational commitment
interacted with emotional exhaustion and moderated the negative and positive effects of
emotional exhaustion on job satisfaction and symptoms of depression. The slopes shown
in Figure 2, confirm that emotional exhaustion exhibited its negative and positive
influence on job satisfaction and depression only under conditions of lower
organisational commitment. It is also worth noting that, when organisational commitment
was sufficiently high, the influence of emotional exhaustion on job satisfaction and
depression diminished considerably as can be seen in Figures 2 and 3. No significant
moderation effect of organisational commitment was found for performance. These
results provide some evidence that the role of organisational commitment is more
complex than previously reported. It appears that when it comes to the impact of
emotional exhaustion on performance, organisational commitment mediates this
relationship thus endorsing the Cropanzano et al. (2003) interpretation of social exchange
theory. In other words, it seems to work quite broadly across cultures with behavioural
outcomes of emotional exhaustion (Tourigny et al., 2013). However, when it comes to
the impact of emotional exhaustion on psychological outcomes such as job satisfaction
and depression, the empirical manifestation of social exchange seems to favour an
additional moderator role for organisational commitment. Our results also suggest that
social exchange may have different operational meaning in India and China. The Indians
take a ‘bridging’ approach to social exchange motivated by their in-group collectivism
while the Chinese take a ‘bonding’ approach, motivated by their societal collectivism
(Chand and Ghorbani, 2011). Consequently, organisational and institutional commitment
becomes less relevant to the Indians compared to the Chinese (Chand and Ghorbani,
2011; Gupta et al., 2002).
These findings sustain the possibility that, social exchange theory in the context of
organisational commitment as a mediator seems to support different manifestations
across cultures, in this case in two different non-western collectivist societies such as
India and China. Therefore, our findings suggest that organisational commitment plays
significant roles both as a mediator and as a moderator on the impact of emotional
exhaustion on organisational behaviour and the patterns are culturally sensitive even
within collectivist societies. These results obviously, open the window for testing the
implication of social exchange theory in the context of organisational commitment and its
cultural meaning and manifestations among other collectivist societies.
It was also noted that, Chinese nurses reported slightly stronger organisational
commitment then their Indian counterparts. It is suggested that most Chinese hospitals,
like many other state owned organisations, pay much attention to foster employees’
positive emotional attachment to the organisation. Therefore, it is common practice for
22. 86 Saif-ud-Din et al.
those Chinese organisations to focus on developing the workplace as a harmonious big
family for their employees. Secondly, given China’s long history of centrally planned
economy, it is hard for Chinese employees of the state-owned organisation to quit from
one organisation to another. Therefore, it is pretty common for an employee to have been
working for one state-owned organisation for all of his or her working life. Finally, in
China the unions are usually a part of organisational management that share the common
goals to make employees feel at home in the workplace (Cooke, 2005). This argument
was also supported by Snap and Chan (2000), that union satisfaction is not a significant
predictor of a company commitment in China and found that substantial proportion of
respondents are committed to both company and union. More importantly, it endorses the
notion of institutional collectivism of the Chinese (Gupta et al., 2002).
On the other hand, India is a democratic state, where unions are strong and are often
at variance with the management of the organisation. Indian workers have more
autonomy to join unions and take part in organisational politics. They also have more
options to quit from one job to another. More importantly, in the Indian version of
in-group collectivism, an individual’s role is simultaneously linked to caste, community
and neighbour and reinforced by psychological and social belonging (Gupta et al., 2002;
Parikh and Garg, 1990). Consequently, there is a possibility that employees are less
committed to their organisations compared to their other affiliations, including their
union. We also know that in India females are more committed to unions then males
(Sastry and Joshi, 1996). Our Indian sample is predominantly female therefore, despite
the theoretical robustness of our model, it is important to test it across different
occupations and different cultures where work expectations vary.
4.2 Practical implications
At a more practical level, our results affirm the influential role of organisational
commitment in mitigating the impact of emotional exhaustion on organisational
behaviour. Therefore, it is in the best interest of management to take measures that
enhance the commitment of their employees to the organisation (Chen et al., 2015) It is
also in their best interests to keep the social exchange in balance to ensure better
performance, job satisfaction, and alleviate depression.
5 Conclusions
This study’s contribution comes from broadening the context for testing burnout models
and exploring the role of organisational commitment both as a mediator and as a
moderator. Further, by locating our research in both India and China and following the
two-study format, we are able to unpack the nuances in the etiology of emotional
exhaustion and the differential role of organisational commitment within a collectivist
framework. In a way, our study challenges the monochromatic notion of collectivism and
underscores the need for further research exploring cultural variations in organisational
behaviour within collectivist societies.
23. Emotional exhaustion and its consequences 87
Acknowledgements
Financial support from a research grant from the Social Sciences and Humanities
Research Council of Canada (410-2003-1014) and in the form of a scholarship from the
Higher Education Council of Pakistan are gratefully acknowledged.
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