Organizational Citizenship Behavior among Nurses: The Influence of Organizational Trust and Job Satisfaction

Abstract

AIM

This study was conducted to determine the relationship between nurses’ organizational citizenship behavior organizational citizenship behavior and organizational trust and job satisfaction.

METHOD

This descriptive study was carried out in March and April 2014 among 429 nurses working in a private hospital which had an International Joint Commission International Accreditation Certificate. “A Descriptive Information Form”, “Organizational Citizenship Behavior Scale”, “Organizational Trust Inventory” and “Minnesota Job Satisfaction Scale” were used in data collection. The required permissions and approvals were obtained from the authors of the scales, the ethics committee and the institution. Frequency, percentage, Pearson Correlation and multiple regression analysis were used in the analysis of the data.

RESULTS

In this study, it was determined that organizational citizenship behavior levels of nurses were high (M=5.45±0.59). It was determined that the nurses demonstrated the highest organizational citizenship behavior with regard to conscientiousness (M=6.10±0.56), and they demonstrated the lowest organizational citizenship behavior with regard to courtesy (M= 4.54±0.69). It was determined that organizational citizenship behavior had a significant positive relationship with organizational trust and job satisfaction (p<0.001). According to the regression analysis, it was determined that organizational trust was explained with 13.5% of the nurses’ organizational citizenship behavior levels while job satisfaction was related to 80.9% of the nurses’ organizational citizenship behavior levels.

CONCLUSION

As a result of this study, it was found that organizational trust and job satisfaction influenced organizational citizenship behavior. Nursing managers should encourage improvements and make plans to teach nurses behaviors beyond those normally expected.

Introduction

Organizational citizenship behavior (OCB) is voluntary, intentional, done without any pressure or force, and without any reward or expectation of benefits (Bolino et al., 2015; Podsakoff et al., 2009). There is no specific law or rule determining these behaviors; they are done through one’s own effort and not by working to a specifically prescribed duty. They are behaviors that are completely dependent on the preferences of the people involved (Uğurlu & Demir, 2016; Wang & Wong, 2011). Such behaviors are aimed at ensuring better interaction between individuals and between the individual and group or organization they are members of, while also fulfilling their organizational roles.

OCB leads to more efficient use of organizational resources, ensures that employees support each other in business-related matters, reduces the time spent by administrators on these tasks and reduces the need for supervision, allowing more time to be allocated to more important tasks (Kazemipour & Amin, 2012). In organizational life, the coordination of the goals of the organization and the individuals is one of the main targets for managers (Bolino, et al., 2015). Huang et al., (2012) stated that nurses’ OCB level strengthens organizational commitment and organizational identity positively. While achieving the goals of the organization, the accomplishment of an individual’s tasks is a basic necessity of working life. In this respect, OCB is considered as an element that balances the achievement of organizational and personal goals (Podsakoff at al., 2009).

Ensuring the continuity of an organization is dependent on the existence of workers who trust the organization, who are self-reliant within the organization, who voluntarily remain in the organization, and who volunteer to make an effort for their organization. There are different considerations, but trust forms the basic foundation (Altunbaş & Baykal, 2010b). If a person believes that she/he is not harmed in organizational relationships, her/his rights and interests are preserved, and she/he has positive feelings about her/his own interests, then she/he will trust the organization (Demirkaya & Kandemir, 2014). Individuals who work in an organization where there is a high level of trust, and who feel they are a valuable and important part of the organization, are more willing to work and are happy when they work (Tekingündüz et al., 2015). In addition, workers who trust managers, coworkers and the organization they work for are able to demonstrate higher OCB levels and improve relationships by increasing their cooperation at all levels. Employees without organizational trust do not show OCB (Altunbas & Baykal, 2010a).

Health workers are able to provide effective and efficient services when they are satisfied with their jobs (Kundak et al., 2015; Tekir et al., 2016). Individuals who are not satisfied with their jobs fulfill their duties by working at low efficiency and performance. However, the main purpose of organizations is to maximize the benefit from the performances of employees as much as possible (Çeler et al., 2016; Öztürk & Şahbudak, 2015). Job satisfaction is accepted as one of the most fundamental determinants of an employee’s OCB level (Yeşilyurt & Koçak, 2014). It is expected that an employee who has job satisfaction will be more positive about the business, help his/her coworkers more, and will improve his/her normal performance (Najafi et al., 2011).

One of the most important factors affecting employee satisfaction is the interaction of employees with each other and with managers. It is necessary to ensure that this situation is positive and that nursing service personnel are managed professionally so that they can provide services of the desired quality and efficiency, and that they trust the institution, the managers and their coworkers. OCB demonstrated by employees in organizations is a factor enhancing success and performance. As the citizenship behavior of the employees increases, the level of business success in the organization also increases. For managers, an increase in the level of business success of employees is an important factor in achieving goals. Increasing job satisfaction and the level of organizational trust also lead to organizational success by increasing the level of organizational citizenship (Altunbas & Baykal, 2010c). This study was conducted to determine the relationship between nurses’ OCB and organizational trust and job satisfaction.

Research Questions

1. Is there a meaningful relationship between the OCB level of nurses and organizational trust and job satisfaction?

2. Do organizational trust and job satisfaction levels of nurses affect OCB?

Method

Study Design

This is a descriptive study.

Sample

The study was conducted in Istanbul between March and April 2014 at a private hospital with 226 beds and 473 nurses with an international Joint Commission International accreditation certificate. 429 nurses who voluntarily agreed to participate in the study formed the sample. 90.6% of the nurses responded to the data collection tools. The response rate was high because the study was conducted at the hospital where the researcher worked.

Measures

A Descriptive Information Form, the Organizational Citizenship Behavior Scale (OCBS), the Organizational Trust Inventory (OTI), and the Minnesota Job Satisfaction Scale (MJSS) were used in the data collection.

Descriptive Information Form

The Descriptive Information Form was prepared by the researchers, contained four questions about personal and occupational characteristics (age, marital status, education, year of working in the institution, and working unit).

The Organizational Citizenship Behavior Scale

Developed by Dolma (2003), OCBS determines how frequently workers demonstrate OCBS. Adapted to nursing by Altuntas and Baykal (2010c) and tested for its validity and reliability in this profession, the OCBS includes 24 items and 5 subscales (altruism, conscientiousness, sportsmanship, courtesy, and civic virtue) for which responses are given using a 7-point scale (7, always; 6, most of the time; 5, more than half of the time; 4, half of the time; 3, less than half of the time; 2, rarely; 1, never). In this study, Cronbach’s overall alpha score for OCBS was 0.85. The scale is assessed based on the mean scores of the subscales, and scores higher than the average score (3.5) indicate high levels of organizational citizenship.

The Organizational Trust Inventory

The OTI used in data collection was developed by Yücel (2006) and was tested for its validity and reliability on the staff and managers of three privately owned institutions operating in the transportation, food, and automotive industries. The inventory was adapted to nursing by Altuntas and Baykal (2010b), and the adapted version was tested for its validity and reliability for nursing. The OTI is a 6-point Likert-type scale (6, totally agree; 5, agree; 4, somewhat agree; 3, somewhat disagree; 2, disagree; 1, totally disagree) with 43 items and 3 subscales (trust in managers, trust in institution, and trust in coworkers). In this study, the overall Cronbach’s alpha value was 0.94. The higher the mean score obtained from each subscale of the OTI (≥4), the higher the level of trust; the lower the mean score (≤3), the lower the level of trust. A mean score between 3 and 4 indicated an average level of trust.

The Minnesota Job Satisfaction Scale

The MJSS was developed by Weiss et al., (1967) and the Turkish validity test was conducted by Baycan (1983). The scale consists of 21 items and two subdimensions (intrinsic satisfaction, extrinsic satisfaction). The highest score that can be obtained from the scale is 100, the lowest score is 20. As scores approach 20 points the satisfaction level decreases and as scores approach 100 points the satisfaction level increases. In this study, the Cronbach alpha coefficient was found to be 0.93.

Data Collection

After information about the content and purpose of the study was provided, the data collection tools were given out and taken back after being filled in by the participants in the same shift.

Data Analysis

A statistician evaluated the data using the SPSS statistics package program. Cronbach’s alpha coefficient, frequency, percentage distribution, descriptive statistics, Pearson’s correlation and multiple linear regression analysis were used.

Ethical Considerations

The designers who developed the scales gave permission by email. Approval was obtained from the Ethics Committee (No: 130.IRB2.44) and written permission was obtained from the institution where the study was conducted. During the data collection phase, participants were informed, and their verbal approvals obtained.

Results

A total of 39.6% of participants were in the age group of 26–30, 71.1% were single, 65.7% had bachelor’s degree and 48.7% were in the surgery and internal medicine services; 73.0% of them had worked in the institution for 5 years or less (Table 1).

Table 1.

Characteristics of the Nurses (n=429)

Characteristics		n	%
Age (χ̄ ± Ss:27.82 ± 5.46)	18–25 years old	169	39.4
	26–30 years old	170	39.6
	31–35 years old	47	11.0
	35 years old and more	43	10.0
Marital status	Married	124	28.9
	Single	305	71.1
Education	Health vocational high school	69	16.1
	Associate degree	27	6.3
	Bachelor’s degree	282	65.7
	Postgraduate	51	11.9
Working unit	Surgery and internal medicine	209	48.7
	Intensive care unit - emergency	88	20.5
	operating room	32	7.5
	Administrative units	43	10.0
	Ambulatory unit	57	13.3
Working time in the institution	5 years and lesser	313	73.0
	6–10 years	71	16.6
	10 years and more	45	10.5

The total mean score for the OCBS was M=5.45±0.59, the subscale with the highest score was conscientiousness (M=6.10±0.56), and the subscale with the lowest score was courtesy (M= 4.54±0.69). The total mean score for the OTI was M=4.29±0.89 and for MJSS it was M=3.56±0.60 (Table 2).

Table 2.

Distribution of Average of Total and Subscales of Scales

		χ̄ ± Ss	Min	Max
Organizational Citizenship Behavior Scale	Conscientiousness	6.10±0.56	4.14	7.00
	Sportsmanship	5.32±1.34	1.25	7.00
	Civic virtue	5.29±1.06	2.20	7.00
	Courtesy	4.54±0.69	2.50	6.00
	Altruism	5.54±1.08	2.00	7.00
	The total means score for the OCBS	5.45±0.59	3.71	6.75
Organizational Trust Inventory	Trust in manager	4.47±1.05	1.41	6.00
	Trust in institution	3.74±1.11	1.00	6.00
	Trust in coworkers	4.48±0.84	1.00	6.00
	The total means score for the OTI	4.29±0.89	1.65	5.88
Minnesota Job Satisfaction Scale	Intrinsic satisfaction	3.73±0.57	2.08	5.00
	Extrinsic satisfaction	5.64±0.79	3.75	7.00
	The total means score for the MJSS	3.56±0.60	2.05	4.90

Note. Min: Minimum, Max: Maximum, OCBS: Organizational citizenship behavior scale, OTI: Organizational trust inventory, MJSS: Minnesota job satisfaction scale

A positive and significant relationship was identified between trust in the manager and all subscales of the OCBS and their sum (p<0.05 and p<0.001, respectively), except for the courtesy (r= 0.08, p=0.091) subscales. It was determined that there was a significant positive relationship between trust in the institution and all subscales of the OCBS and their sum (p<0.05 and p<0.001, respectively), except for the altruism (r= 0.16, p=0.214) subscales (Table 3).

Table 3.

Correlations between the Subscales of OCBS and between the OTI Subscales and the MJSS Subscales

OCBS Subscales	OTI Subscales						MJSS Subscales
	Trust in manager		Trust in institution		Trust in coworkers		Intrinsic satisfaction		Extrinsic satisfaction
	r	p	r	p	r	p	r	p	r	p
Conscientiousness	0.18	0.000*	0.18	0.000*	0.19	0.000*	0.32	0.000*	0.66	0.000*
Sportsmanship	0.25	0.000*	0.26	0.000*	0.24	0.000*	0.39	0.000*	0.85	0.000*
Civic virtue	0.24	0.000*	0.25	0.000*	0.29	0.000*	0.25	0.000*	0.40	0.000*
Courtesy	0.08	0.091	0.09	0.040**	−0.00	0.871	0.18	0.000*	0.22	0.000*
Altruism	0.20	0.000*	0.16	0.214	0.21	0.000*	0.24	0.000*	0.64	0.000*
General level of OCBS	0.31	0.000*	0.31	0.000*	0.31	0.000*	0.44	0.000*	0.89	0.000*

Note. OCBS: Organizational citizenship behavior scale, OTI: Organizational trust inventory, MJSS: Minnesota job satisfaction scale,

^*p<0.001,

^**p<0.05

It was found that there was a significant positive relationship between trust in coworkers and all subscales of the OCBS and their sum (p<0.001), except for the courtesy (r=−0.00, p=0.871) subscales. A positive and highly significant relationship was identified between intrinsic satisfaction and extrinsic satisfaction and all subscales of the OCBS and their sum (p<0.001) (Table 3).

It was determined, according to regression analysis, that there was a low-level and significant relationship between OCBS, trust in manager, trust in institution and trust in coworkers (R=0.368, R²= .135, p<0.001). These subscales explained 13% of the total variance in the OCB of participants. According to the regression coefficient (β), trust in manager, institution and coworkers influenced OCB. The levels of organizational trust are an important determinant of a low level of OCB (Table 4).

Table 4.

Results of Regression Analysis: Identifying the Impact of Organizational Trust on OCB

Variable	B	Standard error	β	t	p
OCB
Constant	4.356	0.148		29.357	0.000*
Trust in manager	0.071	0.036	0.127	2.000	0.046**
Trust in institution	0.081	0.032	0.151	2.526	0.012**
Trust in coworkers	0.106	0.044	0.150	2.415	0.016**
R=0.368	R2=0.13	F= 22.174		p<0.001

Note. OCB: Organizational citizenship behavior,

^*p<0.001,

^**p<0.05

According to the regression analysis, a very high level and significant relationship was identified between OCB and intrinsic and extrinsic satisfaction (R=0.900, R²=0.809, p<0.001). These subscales explained 80% of the total variance of nurses’ OCB. According to the regression coefficient (β), intrinsic and extrinsic satisfaction influenced OCB. The levels of job satisfaction are an important determinant of a high level of OCB (Table 5).

Table 5.

Results of Regression Analysis: Identifying the Impact of Job Satisfaction on OCB

Variable	B	Standard error	β	t	p
OCB
Constant	1.477	0.103		14.399	0.000*
Intrinsic satisfaction	0.084	0.024	0.082	3.508	0.151
Extrinsic satisfaction	0.648	0.018	0.862	36.953	0.000*
R= 0.900	R2= 0.80		F=904.524		p<0.001

Note. OCB: Organizational citizenship behavior,

^*p<0.001,

^**p<0.05

Discussion

This study was carried out to determine the level of OCB of nurses and to evaluate the effect of organizational trust and job satisfaction on OCB. According to the findings of the study, nurses generally demonstrate high OCB levels, the highest being for conscientiousness. These findings show that the nurses were sensitive in terms of coming to work on time, attendance to work, their regularity and punctuality, and had developed positive attitudes. The findings of other studies, in which nurses’ OCB levels were generally high and showed the highest level for conscientiousness, are similar to our findings (Yu et al., 2017; Öztürk & Özata, 2013). Nurses are sensitive in their jobs because they provide care for patients, and neglect and carelessness, including even the smallest mistakes, can cause a great loss. This situation may have had an effect in the emergence of these findings.

According to the findings of the study, nurses showed the lowest OCB with regard to courtesy; it was found that nurses showed negative attitudes in their behaviors, such as not blowing problems out of proportion and contributing to the solution of problems by maintaining constructive attitudes. Altunbaş and Baykal (2010c) also found that the nurses had low courtesy scores, and this finding is similar to our findings. Nurses’ working conditions are hard, their working hours are long, they have disagreements with their team members, their duties are not clearly delimited, and they have insufficient pay. When all these causes are considered, these findings are predictable.

It was found that there was a positive and significant relationship between the nurses’ OCB level and their levels of trust in their manager, institution and coworkers. In studies on this subject, a positive moderate correlation is seen between organizational trust and OCB (Altunbaş & Baykal 2010b). When the nurses’ levels of trust on their manager, institution and coworkers increase, they voluntarily behave more rigorously in fulfilling their duties and perform more efficiently in accordance with the goal of the organization. In addition, when their trust in the institution increases, they avoid making conflicts worse by ignoring negative experiences within the organization, and they display positive levels of OCB by displaying helpful behaviors.

It was determined that there was a positive and significant correlation between the nurses’ OCB levels and their intrinsic and extrinsic satisfaction. OCB is an informal and voluntary activity. As in all professions, the high level of job satisfaction in nursing leads to more voluntary behaviors. An employee with a high level of job satisfaction is likely to demonstrate OCB by helping out his/her friends, volunteering for tasks and having a positive attitude about his/her organization. In the study of Tekir et al., (2016), it was found that the level of burnout of nurses with a low job satisfaction increased. In the study of Huang et al., (2012), it was determined that nurses with low job satisfaction had a decreased level of organizational commitment and increased intention to leave the job. Job satisfaction is important for ensuring the quality and sustainability of health care. Job satisfaction is necessary if nurses are to do additional and voluntary tasks in concert with the goals of the organization.

When the effect of the nurses’ level of organizational trust on OCB was evaluated, it was found that level of organizational trust had an effect on OCB, with a percentage of 13.5%. Koberg et al., (2005) analyzed the OCB levels in employees in different disciplines and found that an employee who had a trust in their coworkers shared more of their problems and responsibilities, and organizational trust accounted for 12% of OCB. A high level of trust in the institution often leads to success in shaping organizational structures, strategic partnerships, harmonious and responsive teams, and effective crisis management. For this reason, steps taken by hospital managers to increase the level of organizational trust, which plays a significant role in the nurses’ development of OCB, will help achieve the goals of the organization and employees.

When the effect of the nurses’ levels of job satisfaction on their OCB levels were evaluated, the level of job satisfaction was found to have an effect on OCB, with a percentage of 80.9%. This high result explains the OCB of the nurses well. Although, as seen in other studies (Deery et al., 2017; Yu et al., 2017; Chen et al., 2013), there are many different variables affecting OCB, an employee who experiences job satisfaction also shows a high level of OCB (80.9%). When studies on job satisfaction and OCB were examined, it was seen that there was a positive relationship between these two concepts and that job satisfaction played a mediating role in OCB (Li et al., 2010; Najafi et al., 2011; Yeşilyurt & Koçak, 2014). Employees who are satisfied with their jobs demonstrate OCB, and this may also contribute to job satisfaction. Employees with job satisfaction contribute to the effectiveness and efficiency of the organization by demonstrating behaviors that exceed normal expectations at work. In this context, managers should increase the levels of job satisfaction of their employees to increase the efficiency and effectiveness of their businesses.

Conclusion and Recommendations

As a result of this study, it was determined that the level of OCB of nurses was high. It was found that nurses mostly demonstrated OCB in terms of coming to work on time, continuity, regularity and punctuality, which fall under the conscientiousness subscales, while they demonstrated the least OCB for not blowing problems out of proportion and contributing to solution of problems through having a constructive attitude, which fall under the courtesy subscale. It was determined that OCB had a significant positive relationship with organizational trust and job satisfaction. It is expected that nurses’ OCB level will increase when their trust and job satisfaction levels increase. Although there are different variables affecting the display of OCB in nurses, it was determined that organizational trust and job satisfaction affected OCB in the ratios 13.5% and 80.9%, respectively. In particular, job satisfaction substantially affected nurses’ OCB levels.

Implications for Nurses

OCB indicates voluntary behaviors of employees which increase performance and productivity. The achievements of an organization depend on nurses’ willingness to go beyond what they need to do to achieve their goals and the goals of the nursing service. To this end, it is important that the nurses are willing to work beyond their basic responsibilities to more effectively achieve the aims of the organization and nursing services.

One of the important elements in the OCB of nurses is their sense of trust in their manager, institution and coworkers. A manager who considers all kinds of suggestions, tries to solve problems quickly and is trusted as sincere, an institution that is trusted in terms of giving support even in difficult circumstances, and is seen as honest and consistent, or a colleague who communicates effectively with the team, helps others and solves problems without conflict, creating a positive environment, all encourage and guide employees to do more work on a voluntary basis.

That nurses have a high level of job satisfaction is very important in terms of the quality of care services and patient satisfaction. Employees who experience satisfaction in their jobs will be more willing to engage in voluntary behaviors, which will positively affect patient care outputs. In addition, nurses with high job satisfaction will contribute to the purpose and goals of the organization by demonstrating behaviors that will exceed normal expectations. For this reason, nursing managers should make plans to ensure that nurses demonstrate higher OCB levels.