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YANGON UNIVERSITY OF ECONOMICS
DEPARTMENT OF COMMERCE
PhD PROGRAMME
MOTIVATION, JOB SATISFACTION AND ORGANIZATIONAL
COMMITMENT OF MEDICAL DOCTORS AT PUBLIC
HOSPITALS IN YANGON
THEINGI NWE
AUGUST, 2020
1
YANGON UNIVERSITY OF ECONOMICS
DEPARTMENT OF COMMERCE
PhD PROGRAMME
MOTIVATION, JOB SATISFACTION AND ORGANIZATIONAL
COMMITMENT OF MEDICAL DOCTORS AT PUBLIC
HOSPITALS IN YANGON
Submitted in Partial Fulfillment of the Requirements for the Degree of
Doctor of Philosophy of the Department of Commerce,
Yangon University of Economics, Myanmar
Supervised by Submitted by
Dr. Myint Myint Kyi Theingi Nwe
Professor 4 PhD Za-5
Department of Management Studies
Yangon University of Economics
2
CERTIFICATION
I hereby certify that contents of this dissertation are wholly my own work
unless otherwise referenced or acknowledged. Information from sources is referenced
with original comments and ideas from the writer herself/ himself.
Theingi Nwe
4 PhD Za-5
ABSTRACT3
This thesis intends to explore the factors affecting on motivation and job
satisfaction of medical doctors working at public hospitals in Yangon. This study also
aims to analyze the effect of motivation and job satisfaction on organizational
commitment which elements are affective commitment, continuance commitment and
normative commitment of medical doctors. Simple random sampling method is used
to select 10 hospitals as well as to select 317 medical doctors from whom primary
data are collected through personal interviews by using structured questionnaires.
Multiple linear regression method is applied to analyze the data. From analysis, it is
found that medical doctors’ value and goals, safety, esteem and self-actualization
needs are positive influencing on their motivation at work while social and esteem
needs are effecting on their job satisfaction. Among the organizational factors, pay
and financial incentive, promotion and education opportunity, and leadership and
management practices are positively affecting on motivation while promotion and
education opportunity, relation with co-workers, and leadership and management
practices are influencing on job satisfaction of medical doctors at public hospitals. Job
characteristics such as skill variety, task identity, task significance and autonomy are
positively affecting on both motivation and job satisfaction. However, feedback is
negatively affecting on motivation of medical doctors. From analysis on effect of
motivation and job satisfaction on medical doctors’ commitment, it is found that
motivation is leading to effective and continuance commitment, and both motivation
and job satisfaction are positively relating to normative commitment.
ACKNOWLEDGEMENTS
First and foremost, I would like to thank Professor Dr. Tin Win, Rector and
members of Ph.D Steering Committee for giving me an opportunity to write this Ph.D
thesis.
I hereby wish to enthusiastically show my sincere appreciation to my beloved
and honorable teachers namely; Dr. Khin May Hla, Former Pro-Rector, Dr. Nu Nu Yin,
4
Retired Professor and Head of Department of Management Studies, Dr. Daw Tin Hla,
Senior Expatriate, University of Malaysia Sarawak, Daw Kyi Kyi Sein, Retired
Professor from Department of Commerce, Dr. Maw Maw Khin, Professor and Head
of Department of Statistics, Dr. Nu Nu Lwin, Professor and Head of Department of
Management Studies, Dr. Tin Tin Htwe, Professor of Department of Commerce, and
Dr. Aye Thu Htun, Professor of Department of Commerce, from Yangon University of
Economics, Dr. Thin Thin Myint, Professor and Head of Department of Business and
Economics, Dr. Mya Thandar, Professor of Department of Statistics, for their
guidance and valuable suggestions in my thesis. I am also deeply thankful to
Professor Dr. Soe Thu, Professor and Head of Department of Commerce, Yangon
University of Economics, for taking responsibilities of the Chairman of Ph.D Steering
Committee and for her kind and generous support to finish this thesis.
I would like to convey an exceptional heartfelt gratefulness to my supervisor,
Dr. Myint Myint Kyi, Professor of Department of Management Studies, Yangon
University of Economics for her tolerant and kind supervision throughout various
stages of this thesis, and her enthusiasm and exhausted energy bring this paper to
light.
I would also like to thank medical doctors from public hospitals interviewed
for this research. They all kindly share me their knowledge, experience and
information about motivation, job satisfaction and performance at public hospitals in
Yangon.
Many people have contributed so far to this research’s activities. Special
thanks go to my colleagues of Yangon, Meiktila, and Monywa Universities of
Economics, for their kind assistance in doing research and giving seminars, and their
encouragement. I thank with pleasure to all who have lovingly and patiently helped
and given me special assistance in the accomplishment of this thesis.
5
CONTENTS
Page
ABSTRACT i
ACKNOWLEDGEMENTS ii
TABLE OF CONTENTS iii
LIST OF TABLES v
LIST OF FIGURES vii
LIST OF ABBREVIATIONS viii
CHAPTER 1 INTRODUCTION 1
1.1 Rationale of the Study 4
1.2 Problem Statement 6
1.3 Research Questions 9
1.4 Objectives of the Study 9
1.5 Hypotheses of the Study 9
1.6 Method of the Study 10
1.7 Scope and Limitations of the Study 10
1.8 Organization of the Study 11
CHAPTER 2 THEORETICAL BACKGROUND 12
2.1 Definitions of Motivation, Job Satisfaction and 12
Organizational Commitment
2.2 Theories of Motivation and Job Satisfaction 17
2.3 Theory of Organizational Commitment 24
2.4 Review of Previous Studies 25
6
2.5 Conceptual Framework for the Study 34
CHAPTER 3 OVERVIEW OF PUBLIC HOSPITALS 38
3.1 The Role of Public Hospitals in Myanmar 38
3.2 The Structure of Public Hospitals in Myanmar 40
3.3 The Classification of Public Hospitals in Myanmar 41
3.4 Standard Staff Positions of Government Hospitals 42
3.5 Public Hospitals in Yangon 42
CHAPTER 4 RESEARCH METHODOLOGY 43
4.1 Sampling Procedure 43
4.2 Development of Models for Analysis 45
4.3 Reliability and Validity Test 47
4.4 Research Questionnaires 49
4.5 Data Collection and Data Analysis Method 51
7
CHAPTER 5 ANALYSIS ON MOTIVATION, JOB SATISFACTION, 51AND ORGANIZATIONAL COMMITMENT OF MEDICAL DOCTORS AT PUBLIC HOSPITAL5.1 Profile of Respondents 51
5.2 Antecendents of Motivation and Job Satisfaction of 54
Medical Doctors at Public Hospitals in Yangon
5.3 Motivation, Job Satisfaction and Organizational Commitment 68
of Medical Doctors at Public Hospitals in Yangon
5.4 Analysis on Factors Affecting Motivation of Medical 73
Doctors at Public Hospital in Yangon
5.5 Analysis on Factors Affecting Job Satisfaction of Medical 80
Doctors at Public Hospitals in Yangon
5.6 Analysis on Impact of Motivation on Job Satisfaction of 87
Medical Doctors at Public Hospitals in Yangon
5.7 Analysis on Effect of Motivation and Job Satisfaction on 88
Organizational Commitment of Medical Doctors at Public
Hospitals in Yangon
5.8 Results from Analysis 94
CHAPTER 6 CONCLUSION 97
6.1 Finding and Discussions 97
6.2 Suggestions and Recommendations 105
6.3 Policy Implication 111
6.4 Need for Further Study 113
REFERENCES
APPENDICES
8
LIST OF TABLES
Table No. Title Page
2.1 Working Definitions 36
3.1 Standard Staff Positions of Government Hospital 42
3.2 Bed Discributions of Public Hospital in Yangon 42
4.1 Sample Size of Medical Doctors of Selected Hospitals 44
4.2 Question Items Removed After Survey 45
4.3 Independent and Dependent Variables 46
4.4 Relibility and Validity for Variables 48
5.1 Profile of Medical Doctors Selected Public Hospitals in Yangon
53
5.2 Value and Goals of Medical Doctors at Public Hospital in Yangon
55
5.3 Physiological Needs of Medical Doctors at Public Hospitals in
Yangon 56
5.4 Safety Needs of Medical Doctors at Public Hospitals in Yangon
56
9
5.5 Social Needs of Medical Doctors at Public Hospitals in Yangon57
5.6 Esteem Needs of Medical Doctors at Public Hospitals in Yangon
58
5.7 Self-Actualization Needs of Medical Doctors at Public Hospitals
in 59
Yangon
5.8 Pay and Financial Incentive for Medical Doctors 60
5.9 Training and Supportive Supervision for Medical Doctors 61
5.10 Promotion and Education Opportunity for Medical Doctors 62
5.11 Relationship with Co-workers of Medical Doctors 62
5.12 Leadership and Management Practices for Medical Doctors 63
5.13 Skill Variety of Medical Doctors 64
5.14 Task Identity of Medical Doctors 65
5.15 Task Significance of Medical Doctors 66
5.16 Autonomy of Medical Doctors 67
10
5.17 Feedback of Medical Doctors 68
5.18 Motivation of Medical Doctors 69
5.19 Job Satisfaction of Medical Doctors 70
5.20 Affective Commitment of Medical Doctors 71
5.21 Contunuance Commitment of Medical Doctors 71
5.22 Normative Commitment of Medical Doctors 72
5.23 Results of Multiple Regression Analysis on Motivation 73
5.24 Results of Individual Needs Factors on Motivation 74
5.25 Results of Organizational Factors on Motivation 77
5.26 Results of Job Characteristics on Motivation 79
5.27 Results of Factors Affecting Job Satisfaction 81
5.28 Results of Individual Needs Factors on Job Satisfaction 82
5.29 Results of Organizational Factors on Job Satisfaction 84
5.30 Results of Job Characteristics on Job Satisfaction 86
11
5.31 Analysis of Motivation and Job Satisfaction 88
5.32 Results of Motivation and Job Satisfaction on Affective
Commitment 89
5.33 Results of Motivation and Job Satisfaction on Continuance 90
Commitment
5.34 Results of Motivation and Job Satisfaction on Normative 91
Commitment
5.35 Results of Motivation and Job Satisfaction on Organizational 93
Commitment
12
LIST OF FIGURES
Figure No. Title
13
Page
2.1 Maslow's Hierarchy of Needs 18
2.2 Herzberg’s Two-Factor Theory 21
2.3 Conceptual Model of Bhatnagar 33
2.4 The Conceptual Framework of the Study 35
3.1 Myanmar Government Health Structure 40
3.2 Myanmar Health Services Classification 41
5.1 Summarized Model for The Study 95
14
15
LIST OF ABBREVIATIONS
BEPHS Basic Essential Package of Health Services
DMR Department of Medical Research
DMS Department of Medical Science
DOH Department of Health
DTM Department of Traditional Medicine
ENT Ear–Nose– Throat
HRH Human Resources for Health
M.B.B.S Bachelor of Medicine and Bachelor of Surgery
M.Sc Master of Science (MSc) degree
MNPED Ministry of National Planning and Economic Development
MOH Ministry of Health
MOHS The Ministry of Health & Sport
MRCP Magnetic Resonance Cholangiopancreatography
NCDP National Comprehensive Development Plan
NHP National Health Plan
PBF Performance Base Financing
SPDC State Peace and Development Council (SPDC)
UHC Universal Health Coverage
UHC Universal Health Coverage
WHO World Health Organization
16
CHAPTER 1
INTRODUCTION
Maximizing social welfare is one of the main goals of almost all nations
around the world. Modern society has been increasingly in need of efficient public-
sector health services in recent years. In many countries, particularly the developing
countries have experienced the increased costs of health care services. Thus, the role
of public hospitals in providing cost-effective health care has been accepted in recent
years.
Hospital is included in the health system and its ultimate aim is for providing
good quality health care to the public. Therefore, policymakers are seeking ways to
improve their health systems, resources, sustainability, performance and
responsiveness. Public hospitals are also focusing more on standards of health care. In
Myanmar, many people rely on health care service provided by public hospitals.
Although the private-sector healthcare service providers have more recorded
schedules and patient satisfaction, the service costs are obviously higher than the cost
of public-sector. Moreover, the rules and regulations are stricter in public hospitals for
medical doctors to follow to the prescribed medical standards of practice.
In Myanmar public hospitals, the capacity building as well as the work force
are weak to deliver high level of service performance. It is increasingly becoming
important that policy makers should pay attention more on retention of committed
medical doctors at public hospitals, which will lead to health sector performance.
Thus, the capacity building, retaining committed staff, and their happiness at work are
are at the vital role for high performance at public hospitals.
A quality healthcare service is affected by various factors such as skills and
commitment of doctors and nurses, facilities of hospital, management of hospitals and
so on. Among these factors, human resource is the most important one which cannot
be substituted although finance and facilities can be supplied relatively more easily.
The health workforce is scarce resource which can contribute largely to 17
nation’s health care service system and performance. To provide good quality health
care service, in developing countries like Myanmar, within the very limited resource
constraints, medical staff attitude and contribution are quite supportive.
The presence of highly satisfied and motivated health workforce,
especially doctors, is a key aspect of effective contribution of public healthcare
sector to society. A happy and active medical doctorwill go extra mile to provide
excellent service as possible as he or she can. They will be passionate to upgrade the
performance level of their own and also the level of the performance of their
hospitals. They cannot provide good service to satisfy patients when they are not
satisfied with their jobs (Ovretveit, 1990). Thus, medical doctors need to be motivated
to increase efficiency when providing healthcare services to public. Thus,
management of a public hospital should know the needs of its employees,
especially medical doctors, on which the hopital’s performance largely relies on
(Franco, 2002).
From the aspect of productivity, it is more important in public hospitals than in
private hospitals because of the two factors such as increasing patients’ population
and the problem of staff shortage. Thus, in public hospitals, existing staff, especially
medical doctors, have to provide effective services as much as they can to as many
patients as possible within the short time and limited budget. To provide effective
services to patients, their commitment to their professional work is crucial. Their
satisfaction at work and enthusiasm will influence on their retention, in other words,
commitment to jobs. Organizational success is tied with the passion, enthusiasm and
attitude, which can be combined as motivation, to put all effort and to do their best for
achieving organizational goals effectively and efficiently. Hornby & Sidney (1988)
stated that organizational commitment is influenced by employees’ motivation not
to take leaves and not to be absent, work happily and effectively, and to be eager to
take responsibilities and accountability at work.
Motivation increases the productivity of employees. Motivation is a basic and
positive force that determines the direction of an employee’s behavior in a firm and it
drives employees to perform well at work. Motivation can be regarded as an internal
drive that creates an employee to decide to take action. If their morale is low, their
service quality may be poor, and they may decide to give up their professional career.
18
Thus, it can be considered that motivation and performance are important in health
policy (Mbilinyi, Daniel, and Lie, 2011).
Job satisfaction is necessary to retain well-qualified personnel, especially at
service organizations, particularly, public service organizations like public hospitals.
Although (Herzberg, 2003) and researchers presented that motivation can represent
satisfaction, Kabir (2011) and Kian et al., (2014) stated that motivation and
satisfaction are separated. Although various researchers observed job satisfaction and
motivation with various ways, common point is both have an effect on performance.
In public hospitals of Myanmar, although there are standard procedures, rules
and regulations to be followed by medical doctors, their commitment may be varied
with their motivation and satisfaction. Some staff’s level of motivation is high, but
they may not feel satisfaction from their jobs, while others have both in high levels of
motivation and satisfaction. Similarly, some may be satisfied with jobs, although they
do not work well. Lack of motivation or satisfaction or both can lead to negative
actions such as making wrong decision at the important time for patients, lack of
accountability, absenteeism, lack of cooperation with colleagues, lack of
communication at work and so on. White (2000) described that job satisfaction can be
come out from enjoyable workplace.
Many researchers emphasized more and more on analysis on Job satisfaction
and motivation as the success factors for service organizations. Moreover, it is very
difficult to disguinsh between factors influencing job satisfaction and motivation by
regarding theories which pointed in some ways factors influencing motivation are also
influencing in some ways on job satisfaction. However, there are some research
findings which observed the specific factors influencing on motivation and job
satisfaction separately. Moreover, these two factors will be leading to performance of
employees and organizations, especially in public service organizations like public
hospitals.
Porter et al., (1974) described that commitment consists of the factors such as a high trust in the organization and value its mission and goals, strong desire to stay at the organization. Employees’ commitment become a research fiocus in public health care context because it is a key factor not only in achieving
19
organizational objectives but also in implementing state’s health care plans. Researchers observed that commitment, engagement and organizational citizenship behavior of employees are leading to high performance at public service organizations (Chang, Chi, and Miao, 2007).
This paper intends to explore the factors (personal and institutional) influencing motivation and employee satisfaction, whiuch would be leading to organizational commitment of medical doctors at public hospitals in Yangon.
1.1 Rationale of The Study
Most resource-constrained settings, particularly in public hospitals, suffer
from inadequate strength and skill-mix of medical doctors in their distribution
resulting in acute shortages to meet population needs and achieve national health
targets. Not only availability is problematic, but insufficient productivity, competency
and responsiveness of health workers have also been a serious concern in Myanmar.
In addition to increasing production and ensuring retention of capable health workers,
it is equally important to support to them for consistent comment to heir jobs within
current and emerging challenges. An essential step, among others, for doing so
requires enhancing levels of job satisfaction and motivation of medical doctors.
Wolf (2017) described that an employee can be satisfied with job while
motivation for doing the job can be varied. In some types of organizations,
particularly in public service organizations like public hospitals, it can be seen
obviously that some medical doctors are working with enthusiasm while some are not
doing well. In other words, some are motivated at work when some are not motivated.
However, it is not sure that whether motivated medical doctors are satisfied with their
jobs or not, while some are motivated at work because they like their professional
work itself, others are motivated at work because they would like to continue their
20
academic and professional study.
A large number of factors can influence on employees’ motivation and
satisfaction. Franco (2002) presented a number of features such as individual needs
factors (demographic, self- efficacy, expectations, promotion, skill development,
needs), organizational factors (resources, structure, process, culture) which may
influence employee motivation and job satisfaction in the organization. However, they
have not yet presented which factors are common determinants for both motivation
and job satisfaction of medical doctors in public hospitals, which factors are
influencing specifically on motivation, and which are affecting only on job
satisfaction. Middlemist and Hitt (1981) defined motivation as “the willful desire to
direct one’s behavior toward a goal.” Mathis and Jackson (1982) also supported to
this definition by mentioning motivation as an emotion or desire causing the person to
act. Motivation may be the source to perform performs a particular job while reasons
for doing this job is varried widely (Wolf, 2017). Thus, the factors influencing
motivation will be different among individuals. It is not sure that motivated staffs are
satisfied with their jobs at public hospitals.
At the public hospitals in Myanmar, some medical doctors will be working to
fulfill their certain needs. At these hospitals, it is not sure that employee motivation
will be tie with job satisfcation. The satisfaction can take many forms; satisfaction
with work accomplishment, satisfaction with effort put at work, satisfaction with
helping others.
In the public healthcare sector, there are many hidden issues of factors
influencing medical doctors’ motivation and job satisfaction. The study should
investigate which factors are influencing on motivation and job satisfaction at public
hospitals. If some findings are reliable, top level management can consider the ways to
motivate and satisfy medical doctors who are working in public hospitals. This proof is
urgently needed in Myanmar because Myanmar public hospitals are currently playing at
the major role in national level development of public health. The public hospitals must
run with highly committed medical doctors because only their commitment can upgrade
the public healthcare service quality. Within the constraints such as; lower pay by
comparing with private special clinics and private hospitals, insufficient government
subsidies for medicines and facilities, increasing number of patients and decreasing
21
number of applicants for medical doctors' posts), only medical doctors’ commitment
can provide effective and efficient treatment and medical service to patients at public
hospitals.
According to O’Reilly & Chatman (1986), organizational commitment is
strong intention to stay at an organization, and also to identify with organization by
paying regards to values and norms of this organization. Buchanan (1974) proposes
this concept with three elements: identification, involvement and retention. If medical
doctors have organizational commitment, they are identified with their organizations,
they value the feeling of involvement in their organizations and they can also be loyal
to their organizations. This organizational commitment is relating to their motivation
and satisfaction at work.
Medical doctors working in public hospitals would have a lesser
organizational commitment at their hospitals if they have only motivation with no job
satisfaction. On the other side, medical doctors would be highly committed to their
hospitals if they have motivation accompanying with job satisfaction. If the research
can prove these facts with accurate data and reliable research findings, these are very
beneficial for some authorities and top management who are responsible to high
quality of public health care services and to contribute to national level health sector
improvement. Although it is not yet sufficient, the government is providing more
funds to health care service, and also provides modern health service technology and
equipment in public hospitals of Myanmar. In public hospitals, it is important to retain
existing medical doctors, and it is equally important to upgrade their commitment. If
they are committed to their organizations and their jobs, they will provide effective
health care service to patients and also to the general public. The reasons of highly
committed public medical doctors would be distinct from factors affecting on the
commitment of staff. Staff commitment can be resulted from their job satisfaction and
also from motivation. If a medical doctor is satisfied and motivated by job, he or she
can commit to the job. Thus, the determinants of motivation and job satisfaction of
committed medical doctors working in the public hospitals are interesting areas to do
research.
In summary, this research intends to analyse the motivation and satisfaction, and
their effect on medical doctors’ commitment towards public hospitals in Yangon. The
22
factors driving motivation and job satisfaction in this frame may or may not be the
same. The findings from this study can provide recommendations and some
suggestions to the Ministry of Health and other stakeholders. The results from this
study can also contribute partly to increase the productivity and commitment of
medical doctors at public hospitals.
1.2 Problem Statement
The Ministry of Health and Sport (MOHS)’s main objective ts to implement
the universal health coverage program throughout Myanmar: evary people can access
to quality service from public hospitals. Policy makers and decision makers are also
paying attention to complete success of this program in 2030. Thus, the major aim of
NHP during 2017 and 2021 is to provide Basic Essential Package of Health Service
(BEPHS) to all people in Myanmar (Ministry of Health, 2016).
There are three components of Universal Health Coverage (UHC): population
coverage, service delivery, and financial protection. There are two fundamental
challenges to be addressed to achieve these objectives. The first one is the funding
needed to achieve them and the cooperation needed for effective implementation. The
second one is lack of human resources, especially medical work force. The second
challenge highlighted that retaining medical doctors at public hospitals is a very
important part of restructuring the health care system of Myanmar. Its shortage would
create many problems. In the public healthcare sector of Myanmar, there are several
problems such as growing demand of medical doctors due to increasing population
and decreasing graduates’ desire to work in public hospitals, the cost of health care
services due to limited government budget, and high expectations of patients due to
increasing health awareness and health education. With all these factors, stress has
been accelerated for the existing medical doctors at public hospitals.
In Myanmar, due to budget limitation, most of the public hospitals located
away from capital cities were not equipped with modern healthcare devices and
equipment. It is able to equip fully just to some modern hospitals. Although the
government increases the expenditure to promote public health care quality, it has not
yet covered good quality health care service to people live in all regions of the
country. Public hospitals provide health care subsidies; this has led to overcrowding
23
in the hospitals and lack of capacity to provide flawless services to patients
(Healthcare Guide, 2018). The Myanmar health care system is facing the severe
shortage of human capital, especially nurses and medical doctors.
Due to the growing population and insignificant growth rate of medical doctors
who want to work as public service citizens, the patient doctor ratio is severely
imbalance. According to WHO (2015), the doctor patient ratio is 6: 1000, in Vietnum,
12: 1000, and in Singapore, 19.5: 1000, and in Malaysia, 12: 1000. Workforce
(medical doctors) for public health service are still scarce although government
emphasizes on using budget for recruitment of medical staff such as doctors, nurses
and midwives since 1990s. On the other hand, the need of medical doctors in the
public health care sector is rising due to the number of patients and higher health
awareness in public. Most resource-constrained settings in Myanmar suffer from
sectorial and regional imbalances in resource distribution and result in acute shortages
to meet population needs and achieve national health targets.
The shortage of health care workforce is an impending crisis in a labor
intensive health care delivering systems in Myanmar, especially with the propensity
of medical doctors in public hospitals. The shortage of health care workforce leads to
an imbalance ratio of medical doctors and patients, and it is unlikely to be able to
provide sufficient coverage to reach the millennium development goals of health
sector in Myanmar. To solve the problem of staff shortage at public hospitals, many
reforms are needed to be implemented. Most reforms are needed at the national level:
reform in organizational structure, reform in promotion and transfer rules, reform in
payment system, reform in the provision of facilities and fringe benefits to staff,
reform in the appointment system for staff distribution between urban and rural areas,
and so on. Before complete national level reforms, the urgent emphasis should be on
current productivity and on retention of current staff.
The commitment of medical doctors is the most crucial issue because of more
demanding quality service by patients, increasing number of patients, non-social
working hours (at nights and at weekends), capacity constraints provide enough
rooms, medicines and medical equipment, and so on. Committed medical doctors will
go extra miles to provide effective healthcare services to their patients within such
limitations. Some medical doctors will be dedicated in this field as government staff.
24
They will be working hard at their hospitals because of their commitment. The
commitment of medical doctors at public hospitals largely depends upon their
satisfaction and motivation at work. Their job satisfaction can be resulted from their
personal factors, as well as due to their organizations’ support. Similarly, their
motivation at work can be resulted not only from pay, job security and safety; but also
from their preference of respectable position and having autonomy to make decisions
on the provision of professional service.
To improve contribution and dedication of medical doctors in public hospitals
in Yangon, it is needed to investigate what factors are influencing on their motivation,
satisfaction and level of their commitment to their organizations in their work. A
research is needed to gain these insights, and such insights can highlight the potential
action plan for improving the contribution of existing medical doctors at public
hospitals in Yangon. This research covers these areas so that the findings delivered
from this research might helpful to overcome barriers, particularly barrier in lack of
skillful medical doctors.
25
1.3 Research Questions
The following research questions come out from reviews on some related
theories:
(1) Do individual needs factors, organizational factors, and job characteristics
affect on medical doctors’ motivation at public hospitals in Yangon?
(2) Do individual needs factors, organizational factors, and job characteristics
affect on medical doctors’ job satisfaction at public hospitals in Yangon?
(3) Is there any impact of motivation on doctors’ job satisfaction at public
hospitals in Yangon?
(4) How does motivation and job satisfaction effect on organizational
commitment of medical doctors at public hospitals in Yangon?
1.4 Objectives of the Study
(1) To examine the influence of individual needs factors, organizational factors
and job characteristics on motivation of medical doctors at public hospitals in
Yangon.
(2) To analyze the effect of individual needs factors, organizational factors, and
job characteristics on job satisfaction of medical doctors at public hospitals in
Yangon.
(3) To investigate the impact of motivation on job satisfaction of medical doctors
at public hospitals in Yangon.
(4) To analyze the effect of motivation and job satisfaction on organizational
commitment of medical doctors at public hospitals in Yangon.
1.5 Hypotheses of The Study
The hypotheses of the study are:
(1) The individual needs factors, organizational factors, and job characteristics
have a positive affect on motivation of medical doctors at public hospitals in
Yangon.
(2) The individual needs factors, organizational factors, and job characteristics
26
have a positive affect on job satisfaction of medical doctors at public hospitals
in Yangon.
(3) There has any impact of motivation on job satisfaction of medical doctors at
public hospitals in Yangon.
(4) Medical doctors’ organizational commitment is influenced by their motivation
and job satisfaction at public hospitals in Yangon.
1.6 Method of the Study
The target population of the study is medical doctors at public hospitals in
Yangon. The study uses two-stage sampling: first stage is selecting hospitals and
second stage is selecting medical doctors. At the first stage of the sampling, out of 35
public hospitals, 10 public hospitals are selected by using simple random sampling
method for the study.
As the second stage of sampling, 317 respondents are selected from each
selected hospital at the first stage. Here, the sample size is determined by Yamane’s
formula. The respondents include all levels of medical doctors. The study mainly uses
the primary data regarding job satisfaction, motivation, and organizational
commitment. The data are collected during 2019 March and April. Questionnaires
were distributed to 317 medical doctors working in 10 hospitals in Yangon. Thus, the
findings cannot generalize for all medical doctors in Myanmar.
The primary data are collected by personal interview method from medical
doctors that are randomly selected, and structured questionnaires are used for data
collection. The secondary data sources are records of public hospitals, data from the
World Health Organization, healthcare journals, textbooks, previous research papers,
online academic journals and internet websites. The primary data are analyzed by the
multiple linear regression method and simple linear regression method.
1.7 Scope and Limitations of the Study
This study focuses on factors that affect on motivation and job satisfaction,
and the organizational commitment resulted from these two factors of medical doctors
working at public hospitals in Yangon, Myanmar. The factors which can influence on
motivation and job satisfaction are grouped into three: individual needs factors, 27
organizational factors and job characteristics. Organizational commitment is also
grouped into three: affective commitment, continuance commitment, and normative
commitment.
In this study, one important limitation may be the response to the questions.
Some respondents may be confused with the questions asked in the study. Although a
pilot test and revision of the questions had been made, some respondents still cannot
comprehend what the question filling.
Secondly, this study only focuses on medical doctors at public hospitals in
Yangon. Although the role of nurses working at public hospitals are very crucial for
effective health care service, this study only focus on medical doctors, cannot cover
these factors of nurses due to time constraints. The sample size had been small
because considerable time had been required to collect the sample data. Thus, only ten
hospitals had been selected in the study. Akthough the sample size meets the
requirement for analysis, it does not mean that this study cover the whole healthcare
industry.
Another important limitation is the data collection method. This study used
only the survey method with questionnaire.
1.8 Organization of the Study
This study is organized into six chapters. Chapter one consists of a rationale,
problem statement, research questions, objectives and hypotheses and scope and
limitations, the method of the study, and organization of the study.
Chapter two is the chapter of theories, concepts of main variables of the study and
the conceptual framework of the study. Chapter three presents an overview of public
hospitals in Myanmar which includes the role of public hospitals in Myanmar, the
structure of public hospitals in Myanmar, the classification of public hospitals in
Myanmar, standard staff positions of government hospitals and public hospitals in Yangon.
In chapter four, research methodology consists of the sampling procedure,
development of model for analysis, reliability and validity test, research
questionnaires and data collection and data analysis method.
Chapter five is an analysis chapter, which includes profiles of respondents,
28
analysis on individual needs factors, analysis on organizational factors, analysis on
job characteristics and findings from analysis of testing hypotheses and survey results.
Chapter six is the conclusion which includes a summary of findings,
discussion, suggestions and recommendations, policy implications and needs for
further study.
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CHAPTER 2
THEORETICAL BACKGROUND
This chapter covers definitions, theories and concepts of key variables
included in the research objectives. Previous research findings and conceptual
framework are also presented.
2.1 Definitions of Motivation, Job Satisfaction and Organizational
Commitment
In this study, the three key terms and three influencing factors will discuss in
this section. The supporting two definitions will also be described.
2.1.1 Definitions of Motivation
Many researchers and theorists defined the term motivation diffewrently.
Thus, it is difficult to define motivation with universally accepted definitation. In
some approaches, motivation is resulted from attitude, personality, and learning.
Some researchers assumed that the motivation topic is largely related to psychology
field. However, during recent years, the term motivation is obvious in various
contexts.
Motivation of people is crucial to success or achievement of goals. The three
common dimensions of motivation are needs, drives and incentives. The goals and
targets of an organization cannot be achieved without human motivation or
organization’s members’ motivation. In both psychological and organizational behavior
contexts, motivation will lead to passion and ultimately will be resulted in commitment.
In general, motivation will direct person to act or to try to gain desired outcomes.
Some people will be passionate to do tasks due to their intrinsic rewards such
as their hobby, their happiness and likeliness while others will do tasks due to the
30
external attractions (rewards) such as promotion, salary and facilities.
A person's motives for performing desired tasks cannot be specifically
identified at all times. According to Carr (2005), human motivation will be high when
they have high expecattions to receive some results in future as well as experienced
satisfaction in the past. Barnon (2008) also supported to this point: motivation is the
driving factor of human behavior to do something to achieve something. Some
researchers observed that motivation consists of values, perceptions, beliefs, actions,
and interest: some factors are influencing on cognitive behavior and some are
affecting on non-cognitive behavior.
Mol (1992) presented the difference between movement and motivation:
movement is desire to achieve extrintic rewards and motivation is self-decision to
behave in specific ways. Turner (1995) also supported to this point that self-desire is
sef motivation. Kreitner (1995) presented that motivation results to direction to act to
fill needs and to act in desired direction.
According to Antomioni (1999), if the task is difficult to accomplish, high
level motivation will be needed to be passionate to do the tasks till completion of this
task. Among three aspects of motivation, arousal is the first step involving enthusiasm
will lead to action (Greenberg and Baron, 2000). The second is selecting direction
which mean the strategy or way to be practiced, and the third is persistence which
means that the time to maintain the positive behavior for accomplishing the desired
targets. Robbins (2001) also presented three approaches to motivation: persistence to
target, intensity and ditrection. France, Benett and Kanfer (2002) also explained that
motivation is desire to put energy and persuit to goals.
Motivation can affect largely onaction or behavior (Armstrong, 2016).
Similarly, Middlemist and Hitt (1981) stated that motivation is human desire to
achieve a goal while Saraswathi (2011) described that motivation is willingness to
persist to desired goals. Baron (2008) defined motivation is a set of long process that
arouse, direct, and preserve the behavior toward achieving targets.
Fuller and Marler (2009) also presented the thrre aspects of motivation:
intensity (how hard a person keep his or her desire to gain outcome), direction (the
selected pathway to outcome) and persistence (time horizon to retain right effort to
31
achieve desitred aims). Although various researchers explored different definitions of
motivation, the common findings highlighted that the three aspects of motivationL
drive, energize and action.
In organizations, membrers’ motivation is driving force to erge them to try
hard to reach organizational objectives. Thus, Osabiya (2015) stated that the
performance of a firm can be varied with motivation of its members.
2.1.2 Definitions of Job Satisfaction
Satisafction can be seen from various aspects; satisfaction for
accomplishment, satisfaction for effort, satisfaction for supporting to others,. And so
on. Although there are many different definitions of satisfaction, the specific
measurement for satisfaction is rarely explored.
If the job fulfill the personal goals besides organizational goals, the employee
will be satisfied with this job. Thus, Locke (1991) explained that employee perception
on job should be accounted for one of the criteria in process of appraisal. People place
destinations and values in mind. If their work help them in gainging those
destinations, they are pleased. Vroom (1978) saw that work contentment as “the
useful information of an individual to all facets of the job situation.
Agho, Mueller and Price (1993) express job contentment as the amount to
which employees are satisfied with their work. Job contentment is a notion related to
employee’s point of view and feelings to his or her work (Mullins, 2005). Robbins
(2005) describes job contentment as “a compilation of feelings that one holds towards
his or her work”. Work contentment can also be defiend as an employee’s emotiomal
reaction to different work related facts which result in finding enjoyment, convenience,
belief, rewards, personal growth and several chances such as upward mobility,
appreciation and assessment (Robbins & Judge, 2007; George & Jones, 2005).
As an alternative approach, Sousa-Poza and Sousa-Poza (2007) stated that job
satisfaction is relying on intrinsic aspect and extrinsic aspect of the job: intrinsic
factors are education, effort, working time and extrinsic factors are wages, fringe
benefits, status, working conditions. Thus, an employee’s work contentment is the
32
result of the understanding and affective assessment on job. Constructive attitude on
job shows work contentment and destructive attitudes towards the job show
displeasure (Armstrong, 2008).
All in all; Arnett, Laverie and McLane (2002) summed up that the work
contentment is relating to the self-eveluation of people themselves. McKenna (2000)
also supported to this fact by describing that work contentment is linked to manners
and putlook on work. Oliver (2010), state that satisfaction is resulted from person’s
felling of achievement or accomplishment the complex or difficult tasks: the
achievement feeling may be happiness or pleasant. Giese & Cote, 2000; Oplatka &
Mimon, 2008 also agreed with this finding. However, according to Oplatka and
Mimon (2008), job satisfaction’s definition has not yet identified to be referred in any
context.
From “need” perspective of Maslow (1954), and motivating factor perspective
of Herzberg (1957), Bader (1997) defined job satisfaction as “the degree of
satisfaction of the needs of the individual as a result of engaging in that work or
occupation”. However, Other factors such as feelings, attitudes and the job itself can
also influence on motivation.
From “attitude” perspective by Brayfield and Rothe (1951), employee attitude
towards job affect on satisfaction at organiozational level. Ilies and Judge (2004)
mentioned that job satisfaction based on attitude on job.
By concerning job satisfaction as feeling, job satisfaction is “the basic
disposition of the people toward their work and this involves a collection of numerous
attitudes or feelings” Schultz (1982). According to Oshagbemi (2000), job satisfaction
is varied withemotiona nd feeling with job of employee. Lambert, Hogan and Barton
(2002) presented that job satisfaction is feeling come out from fulfilling personal
needs. According to Griffin et al., (2010), job satisfaction is person’s feeling and
perception on their work or job. Atkins et al (1996) discovered that discontented
hospital staff have negative effect on care quality, patient loyalty and hospital
profitability.
Locke (1976) also stated that work contentment or satisfaction is relating to feeling or attitude on job. Organ (1994) supported to
33
this point. The specific feeling is experienced from their assessed job service (Megginson et al, 1982).
2.1.3 Definitions of Organizational Commitment
As a basic state commitment is then characterized as an employee relationship
with the organization and the decision the employees make to continue membership in
the organization (Meyer, Allen and Smith, 1993)
According to Meyer & Allen (2004), there are three types of commitment;
affective, normative, and continuance commitments. The one who has affective
commitment want to stay within the organization (desire), the one who has normative
commitment remain with the organization as they ought to (moral obligation), and
lastly the one with continuance commitment remain to stay as they must (recognition
of the costs) if not, they will withdraw from the organization.
Organizational commitment is the relative strength of the individual’s
identification with, and involvement in an organization (Armstrong, 2008).
The definitions discussed above show that there are various interpretations of
the concept of organizational commitment. Therefore, based upon the research
objectives and literature review, this study adopts the following definition: employees
with the strong affective commitment remain with the organization because they want
to do so (desire); those with strong normative commitment stay because they feel they
ought to (moral obligation); and those with strong continuance commitment stay
because they have to do so regarding the opportunities and rewards they are receiving
as well as considering the consequences associated with leaving the organization
(Meyer & Allen, 2004).
2.1.4 Definitions of Medical Doctors
Medical doctors are physicians and dentists who are approved and given
privileges to care patients in a hospital or other health care facility. Medical doctors
may work full time or part time and may be employed by a hospital or granted
admitting privileges to practice. Segan’s Medical Dictionary states that doctors of
34
medicine or osteopathy study the prescribed course of study in medicine and surgery
in an authorized medical school or study in osteopathy in an authorized osteopathic
school is registered with the government to practice medicine and surgery.
2.1.5 Definitions of Public Hospital
A public hospital or government hospital is a hospital which is owned by a
government and receives government funding. In some countries, this type of hospital
provides, free of charge, the cost of which is covered by government reimbursement.
A public hospital or government hospital is a hospital administered by officials of the
city, country, state, or nation. The word ‘hospital’ is derived from the Latin word
hospitals, which comes from hospes, meaning a host. The English word ‘hospital’
comes from the French word hospital, as do the words ‘hostel’ and ‘hotel’, all
originally derived from the Latin. The term ‘hospital’ means an establishment for
temporary occupation by the sick and the injured.
A public hospital is expressed as a centre for the care, cure, and treatement of
the ill and injured people, for the study of discusses and for the training of doctors and
nurses.
2.2 Theories of Motivation and Job Satisfaction
In this study, some typical and general concepts and theories are considered to
develop the conceptual framework.
2.2.1 Maslow’s Hierarchy of Needs Theory
Maslow’s hierarchy of needs model is adopted for this paper in order to get
core understanding of employees and motivate them in this fast growing health
industry. The main aspect of Maslow’s model is to increase in demand of learning and
escalate the employees’ commitment. There are five components in this model;
psychological needs, safety needs, social belonging, self-esteem, and self-
actualization.
The Maslow model gives a way for recognizing the difficulties concerning
one’s requirements. How can one motivate staff to face the increase in demand when
35
they have a few resources? The staff can be encouraged to feel secure and admired. If
the leaders should take into account the requirements of the individual, they can offer
problems and chances for meeting those needs.
The specific needs, and the hierarchical order in which they are arranged, are
summarized in Figure (2.1).
36
Figure (2.1) Maslow's Hierarchy of Needs
Fulfillment off the job Need Hierarchy Fulfillment on the job
Source: Maslow (1943)
Generally, the one who works for the first time may look up to physiological needs which is adequate and stable income, and security needs; benefits and safety of workplace. The staff’s self-recognition with physiological needs at work is varianle among the staff. Some employees’ minimum level will be lower or higher than the minimum level of other employees. Thus, physiological needs of individuals should be seen as their minimum needs to work in the organizations. However, in general, the basic salary is the common for employees to identify as physiological needs.
37
Education, Religion,
Hobbies, Personal Growth
Self-
actualization
Needs
Opportunities for training,
Advancement, Growth
Approval of family,
Friends, Community
Esteem Needs Recognition, High Status,
Increased
Family, Friends,
Community group
Social Needs Work groups, Clients,
Coworkers, Supervisors
Freedom from War,
Pollution, Violence
Safety Needs Safe work, Fringe benefits,
Job security
Food, Water, Oxygen Physiological needs Heat, Air, Salary
Although Maslow (1943) mentioned that the physiological needs as needs for physical well-being (heat, air, and basic salary); at modern organizations, employees’ self-identification with physiological needs at work will be varied among individual employees. Some employees’ minimum level will be lower or higher than the minimum level of other employees. Physiological needs of individuals should be seen as their minimum needs to work in the organizations. However, in general, the basic salary is the common for employees to identify as Physiological needs.
According to Maslow (1943), the safety needs may include not only the
factors provided by organizations for employees’ health and safety, but also the
factors provided by organizations for free from hostile environment, free from over
work- load, stress, and burn-out.
Moreover, during recent time, the important factors are organization culture
and atmosphere where employees will feel safe not only for the present time but also
for their future after they stop working. Thus, the pension plan and welfare of
employees at the old age should also be accounted for safety needs. The next step in
social need, staff will consider to work with colleagues who have the same values,
care for them, and trust on them. Mutual understanding among employees is also one
of the social needs.
Once people's basic and safety needs have been satisfied, Maslow (1943)
claims, social needs are activated. There are different levels of social interaction and
that depends on one’s characteristic; introvert or extrovert. Employees prefer to work
in an environment where they are most familiar with and are recognized as important
part of the organization. That indicates that the interpersonal relationship is required
and the leaders of the organization can create an environment that appreciate the
cooperation. In today’s organizations, top management considers some facilities and
programs to be provided for their employees’ social pleasure at work (e.g., sport
clubs, social work teams, and physical exercise facilities). Moreover, good
relationships with superior, peers and subordinates at work are also a kind of social 38
needs. During recent time, at the organizations, especially at the government
organizations, staff pays more attention to the chance to work at the office places
located in the same regions or same cities of their homes located in. This is also the
social need. After being satisfied, a staff may wish higher level requirement of
selfesteemed.
Esteem needs can be seen from two aspects: respect from others (family
members, friends, relatives, colleagues, and general public) and self-respect (respect
oneself in their work, job title, and status). In modern organizations, for employee
motivation at work, top management are considering to provide employees the feeling
of respect for others and respect them by themselves from working at the
organizations. Moreover, if employees have the opportunity to participate in decision
making, their confidence levelmwill be increased. The rewards such as promotion
opportunity, salary increase, recognition and othet external rewards can also lift up the
confidence. Employees also expect fairness in receiving rewards.
Because of self-actualization needs, people will work to become all they are
capable of being. For high performance at work, firms are interested in helping their
staff to become self-recognized by meeting their lower-order requirements. According
to Maslow (1943), lower-order needs ocme first, then higher-order needs followed to
them. To contribute to the organizations by using their full capacity, talent,
experiences, and their creativity, they would firstly fulfill their lower-order needs.
This study assumes that lower ordered needs (Physiological needs, safety
needs, social needs) are concerned with motivation because motivation is the reason
of doing work activities and fulfillment of higher ordered needs (esteem needs and
self-actualization needs) causes job satisfaction for healthcare professionals. These
needs can influence on staff motivation at work if they perceived that these needs can
be fulfilled by working right at their organizations. Work contentment significant that
one enjoys doing a job, doing it well and being praised for one’s attempts. It also
signifies emotion and enjoyment will one’s work.
2.2.2 Acquired Need Theory
According to McClelland (1961), people’s needs are not inherently orginated,
neds can be acquired by passing the life time by time through getting various 39
Area of Satisfaction Motivators influence level of satisfaction.
Motivators- Achievement- Recognition
- Responsibilities- Work itself
- Personal growth
Highly Satisfied
experiences. These needs are affiliation need, power need and achievement need.
Achievement need is strong desire to be master to accomplish complex and difficult
tasks. The employee with this need will be sensitive to accomplishment of tasks, and
to surpass others.
In the personal context, the need for power means individual wants to
influence others. In the organization context, the individual wants to organize or lead
others to achieve the organization goals. The need for affiliation is the need to be
respected and loved by other people. An individual with affiliation need will strive for
good communication and relation with others, and try to develop cooperative rather
than competitive environment, and also try to become good team member.
People with achievement need will continuously try for receiving high
recognition among people, to surpass others, and to be master in accomplishing
complex and difficult tasks. An individual who is achievement-motivated will
rationally favor jobs and responsibilities that certainly satisfy their needs.
2.2.3 Goal-Setting Theory
Commitment in goals will lead to good performance (Erez & Zidon, 1984). If
people are sure that they can attain the goals, their commitment to this job will be
high (Latham and Locke, 1991).
Difficult and high goals can trigger high level of commitment and high level
of motivation. Early et al (1987) proved that the relationship between goals and
performance with the mediating effect of planning. People will expect satisfaction
come out from high achievement when they are trying to reach high goals (Latham &
Locke, 1991).
2.2.4 Herzberg’s Two Factor Theory
Figure (2.2) shows the two-factor theory developed by Herzberg (1959).
Figure (2.2) Herzberg’s Two-Factor Theory
40
41
Source: Herzberg (1959)
Herzberg (2003) resented three areas of satisfaction: dissatisfaction, neutral
(neither satisfied or dissatisfied), and satisfaction. Motivators such as recognition,
supervision and achievement can make motivation while salary, discipline nad so on
can make dissatisfaction. However, the presence of hygiene factors and absent of
motivators will lead to neutral condition. The factors which give job satisfaction and
motivation can be assumed as ‘satisfiers’ or ‘motivators’. The motivators (satisfiers or
higher order needs) are achievable, recognition, the work itself, responsibility and
personal growth).
Achievement: It is the feeling gained after doing complex and difficult taaks
and when surpass others.
Recognition: This is the feeling of receiving praise, rewards or good returns
for hard working or high performance.
The work itself: It is good to help the staff know that the job they are doing is
useful. Setting aims and focusing that their attempts lead to good results. Their job is
necessary to the procedures that make the practice to be successful.
Responsibility: Understanding to do the tasks assigned regarding job
description at work. As the staff grow, they can be added duties for difficult and
important job.
Chance for Promotion: The opportunity for employees to be chosen to get to
higher employment level of the organization.
Pay (salary): Wage is an agreement between the business owner and the staff.
42
If a staff sees that he or she is not fairly paid, he or she will not happy and his or her
performance will be slow.
Supervision: It is action of guiding, directing, and teaching to subordinates to
do assigned tasks on the right way.
Working Conditions: The working condition of the staff has a great effect on
the work they are doing. Up to date facilities, furniture, well ventilated rooms,
spacious and safe staff quarters should be provided for the staff to avoid job discontent.
Policy and Procedure: Policy is similar to disciplines to be followed by staff at
work, and procedure can be seen as standards, guidelines and steps to be compliance
when employee doing the tasks.
Interpersonal Relationships: It is communicating, helping, supporting, asking
help with colleagues, superiors and subordinates.
Status: Status is normally identified with facilities, position, salary and
authority and responsibility.
Security: It is the feeling of secure at work regarding health and safety, and
also relating to potential to gain chance to stay at work for a long time.
When factors relating to lower- order needs (hygiene factors) are poor at the
organization, its staff will feel dissatisfaction, and these needs will not cause
satisfaction or motivation. At the other side, lack of variables related to higher-order
needs (motivating factors) removes satisfaction, and does not cause dissatisfaction:
staff will get feeling of neutral toward work. In practice, especially in relation to
public hospitals in Myanmar, the inference can be made is that hygiene factors will be
relating more to motivation and motivating factors will lead more to satisfaction.
Since hygiene factors can create dissatisfaction at work, staffs who feel lack of
hygiene factors at their organization would leave from these organizations. Although
neutral situation (no satisfaction with no dissatisfaction) would not lead staff to quit
from organizations, dissatisfaction (intolerable feeling) would lead staff to quit from
organizations or they would not do work activities as described in job description
even if they do not quit. Thus, hygiene factors tend to be able to affect motivation.
The motivating factors will create satisfaction. Lacking the motivating factors, staff
will not feel dissatisfaction; they will be at the neutral feeling level at work (no 43
satisfaction with any dissatisfaction). With such feeling, they would do work activities
although they are not happy or satisfied with their jobs. Thus, it seems that motivating
factors are influencing on satisfaction.
2.2.5 Job Characteristics Theory
Hackman (1980) introduced a work features approach to work environment.
There are five job features that help create three fundamental states, that lead to
several personal and job outcomes.
Skill variety includes the use of a number of different skills of the staff. Work
that is high in skill variety is seen by staff as: more difficult because of the range of
skills; relieve boredom from repetition; and gives the staff a feeling of ability.
Task identity is doing a job from the start to the end with a result. When the
staff works on a part of the whole, they are notable to recognize any finished product
with their attempts. They cannot feel any sense of completion for the whole product.
Task significance is the level to which the work has a big impact on the lives
of other people whether those people are in the present institution or in the external
environment.
Autonomy is the level to which the work gives freedom, independence and
right to decide to the staff in planning the job and in finding out the process to be used
in doing the job. It is believed basic in constructing a sence of duty in the staff.
Although most of the staff are eager to work within the wide limitation of an
institution, the staff want some degree of freedom. Autonomy has been very important
to people in the workplace. Feedback is an advice or criticism to someone about
something he or she has done. It provides the staff with direction and information
about his or her performance. It may be positive or negative however, it is good when
it is appropriate. The only way employees can make adjustments in their performance
is to know how they are performing now, not later.
The work feature model shows that the three important fundamental states
affect several personal and job outcomes such as people’s internal job motivation,
growth satisfaction, general job contentment and job effectiveness. The higher the
purposefulness of the job, the more positive the personal and work outcomes will be.
44
When the staff do the work that include high levels of the five core features, they will
be motivated, contented with their work and do the work efficiently.
2.3 Theory of Organizational Commitment
Since the organizational commitment is at the crucial role for organizational
performance and success, in managerial literature, it is the highly focused concept of
researchers. In general, organizational commitment can be seen as the loyalty to an
organization where to stay for a long time. Thus, the organizational commitment can
be defined as employee’s identification with an organization and highgly involvement
in it (Porter et al, 1974). Allen and Meyer (1990), Turner and Chelladurai (2005)
presented the three diemnsions of organizational commitment: affective dimension,
normative dimension and continuance dimension). Meyar and Allen (1997) defined
“affective commitment” as remaining in an organization due to feeling of love this
organization; normative commitment as remaining at an organization with the feeling
of obligation for past received support from it; and continuance commitment as
remaining at an organization with the attitude of they need to stay at this organization.
Continuance commitment is the perceived costs associated with leaving an
organization. That economic benefit in the form of better pay and conditions fosters
this kind of commitment. Many people are committed to staying in their job simply
because they are unwilling to risk losing these things.
The third element of commitment is normative commitment, or employee’s
attitude relating to ethical aspects of remaining in the organization, that it is a moral
issue. People are bound by their values to remain with the organization.
2.4 Reviews of Previous Studies
The previous researchers explored the factors influencing motivation, job
satisfaction and organizational commitment and they grouped these factors into three:
organizational factors, individual needs factors and job characteristics.
2.4.1 Factors Affecting Motivation
Many studies have contributed to understanding the determinants of
45
motivation different health providers. Lambrou et al (2010) identify these job attribute
factors (authority, goal, creativity), remuneration factors (salary, retirement, pension),
co-worker factors (team work, supervisor and fairness) and achievement factors (job
meaningfulness, and interpersonal relationship.) are affecting motivation. Franco et al
(2002) indicate that individual factors (workers’ individual goals, motives, values,
self-concept, expectation, experience of outcomes) and organizational factors
(organizational structure, resources, process, culture, and HRM policies.) are
positively effected on motivation. According to Bhatnagar (2014), individual
characteristics (demographic, capacity, goals, self-concept, and expectation) and
organizational characteristics (resources, process, and organizational culture) are
positively affected on motivation.
Lambert et al (2002) pointed out four factors affecting motivation while
studying medical and nursing staff in a Cyprus public general hospital: job attribute
factors, remuneration factors, co- worker factors and achievement factors. According
to this framework, factors of work motivation can be categorized into the following:
individual factors (workers’ individual goals, motives, values, self-concept,
expectation, experience of outcomes) and organizational factors (organizational
structure, resources, process, culture, and HRM policies). Again, Akintola et al
(2016) stated that organizational characteristics such as promotion to supervisory
positions, acquisition of management skills and experiences, participation in capacity
building, its effect on motivation among supervisors. Stephan et al (2014) also said
that job characteristics influence motivation in service industry.
According to the described above studies, there are generally three certain
variables that correlated with motivation. These are organizational factors, job
characteristics and individual needs factors. Although different literatures tried to
analyze these factors, there are very few studies in analyzing these factors
collectively. In addition, collective study of these factors in healthcare industry in
developing countries is still a gap. Therefore, the present study tries to examine
effects of these three factors collectively for public healthcare industry in Myanmar.
2.4.2 Factors Affecting Job Satisfaction
Csikszentmihalyi (2000) stated that training can provide required skills and
46
competencies for work accomplishment, thus, employee satisfaction can occur. The
organizational factors include pay, promotion and rewards, job security, relationship
with supervisors (Parvin, 2011). Ai-Saadi (2015) examined to determine job
satisfaction among accountants in the Iraqi banking sector.
Bhatangar (2014) studied both individual characteristics (demographic, social,
educational background, and knowledge) and organizational characteristics
(resources, organizational structure, communication process, procedure, and culture)
as the influencing variables for motivation and job satisfaction. Jakfar (2014)
investigated many individual characteristics (age, sex, and marital status, and service
period, ability, personality) and it was found that these are positively correlated with
job satisfaction. Personal factors are age, sex, race, intelligence, religion and social
status. The work itself is also the source of job satisfaction and this study focused on
this part.
According to the presented above studies, there are generally three certain
variables that correlated with job satisfaction. These are organizational factors, job
characteristics and individual needs factors. The present study focuses on these three
factors for the healthcare sector in developing countries. In addition, there is still no
collective study for healthcare sector in Myanmar and this is the urgent need to study
for this sector in Myanmar.
2.4.3 Factors Affecting Motivation and Job Satisfaction
Every factor influencing motivation and job satisfaction has its own
importance and which cannot be neglected. Hackman and Oldham (1976) stated that
three groups of influencing factors such as individual needs factors, organizational
factors and job characteristics. Shalley et al (1995) also presented that these three
factors are influencing on motivation and job satisfaction. This research scoped to 250
health care workers from the public hospitals.
(a) Individual Needs Factors Influencing on Motivation and Job Satisfaction
Franco, Bennett, & Kanfer (2002) stated that individual needs factors such as
workers’ individual goals, motives, values, self-concept; experiences are influencing
on motivation and job satisfaction. Bonenberger and Deutshland (2016) described 47
that the individual characteristics such as demography, capacity, goals, self-concept,
and expectation are influencing on motivation and job satisfaction of human resources
for health in the Eastern region of Ahana.
Rad and Moraes (2009) also supported by this finding with the individual
characteristics (gender, education, title and institution) affecting on motivation and
job satisfaction. This research focused on 950 employees at Hospitals in Iran. Jakfar
(2014) stated that individual characteristics are related to satisfaction. Organizational
culture is a significant influence on work satisfaction of hand-rolled cigarette workers
at the cigarette industry in Madura. Palau et al (2008) stated that gender, education,
title and institution are affecting on motivation and job satisfaction of health care staff
of three hospitals in Bursa, Turkish.
48
(b) Organizational Factors Influencing on Motivation and Job Satisfaction
Franco et al., (2002) stated that organizational factors such as organizational
structure, resource, process, culture, and human resource management practices are
influencing on motivation and job satisfaction. Bhatnagar (2014) described those
organizational characteristics such as resources, process, and organizational culture
are influencing on motivation and job satisfaction of human resources for health in the
Eastern region of Ahana.
Parvin & Kabir (2011) stated that organizational factors such as pay, promotion
and rewards, job security, relationship with supervisors and relationship with co-
workers are affecting on motivation and job satisfaction of employees by surveying on
286 large and small pharmaceutical companies in Dhaka. Lu, While, & Barriball (2005)
described that organizational factors such as intrinsic (e.g., recognition) and extrinsic
factors (e.g., pay) are determinants of job satisfaction. Bhatangar (2014) found that
organizational characteristics such as resources, organizational structure,
communication process, procedure, and culture as the affecting variables for motivation
and job satisfaction of medical staff from Nigeria and India.
Pakistan (2014) focused on medical doctors, dentists and nurses in a Cyprus
public general hospital. Ellickson & Logsdon (2002) indicated that job satisfaction is
relating to promotion. Arnold & Feldman (1996) and Landy (1989) supported to this
finding by explaining the level of promotion has a stronger impact on job satisfaction.
(c) Job Characteristics Influencing on Motivation and Job Satisfaction
Lambrou, Kontodimopoulos, & Niakas (2010) found that the job
characteristics are positively influencing on motivation and job satisfaction.
Bavendum (2000) observed the job characteristics influencing on motivation and job
satisfaction by emphasizing on public primary school teachers in Bangladesh. From
this research, the job characteristics influencing on motivation and job satisfaction are
opportunity, stress, leadership, work standards, fair rewards, and adequate authority
that influence employee satisfaction. AI-Saadi (2015) proved that the job
characteristics influencing on job satisfaction are skill variety, task identity, task
significance, autonomy, and feedback from the job. This research focused on 71
accountants working in the banking sector in Iraq.49
Awang and Ahmad (2010) described that university lecturers’ job satisfaction
is relating to their commitment towards academic activities in Malaysia. Chang et al
(2007) stated that motivation significantly predicted the organizational commitment
of academicians in Malaysian Private Universities.
Hackam & Oldham (1980) presented the job characteristics influencing the
psychological state of employees at work. Skill variety is the chance to use multi
skills to comple the assigned tasks. Task significant means that employees are feeling
that they are doing meaningful tasks and they are contributing to organization’s
success. Task identity means that employees need to do the task from start to end
(they can touch the whole procedure from start to end). Feedback means employees
can see the results directly from their actions. Autonomy means getting freedom to
complete the tasks, to select the strategies and to make decisions at work.
Hirst et al (2009) proved that Job characteristics are affecting on job
satisfaction of employees. Workers who satisfied with job characteristics have
ultimate high job satisfaction although it is not sure that they are motivate or not.
Buys et al (2007) presented the concept of autonomy: freedom or power
transferred to employee to make decision relating to job. As one of the job
characteristics, Hunter (2006) also stated the concept of feedback as the nature of job
giving the auto-chance to receive direct and clear information about the results of
employee’s action relating to job. Gemez-Mejia, Balkan, and Cardy (2005) and
Matteson (2002) pointed that these features of job will laed to employee work
motivation which will result to job satisfaction, good performance, low absenteeism
and low employee turnover.
2.4.4 Motivation, Job Satisfaction and Organizational Commitment
The review of previous studies also focuses on relationships of motivation and
job satisfaction to organizational commitment.
(a) The Relationship between Motivation and Job Satisfaction
Job satisfaction and motivation can be used intrerchangeably, since there is no
universally accepted research finding to distinguish between these two terms. Job
50
satisfaction can be defined as the happiness (pleasure) and affirmation can be received
from a particular job. Job satisfaction can be expressed also as satisfaction with job.
At the other hand, motivation is the drive or motive of a person to do a job
disregarding this job can provide pleasure or not. However, Robert and John (2003)
argued that these tow terms concepts are closely linked because the motivation is
driving force of people to attempt with persuit of specific goal which can fulfill
person’s expectation and need.
Aziri (2011) also argued that these two concepts are closely related. Thus,
many theorists presented these two terms simultateneously. As an example, Singth
and Tiwari (2011) explored the finding that the positive relationship between
motivation and job satisfaction. Nidia and Shagufta (2011) also found that the
correlation of job satisfaction and motivation by analyzing the data collected from 80
middle managers from banks in Pakistan. This study highlighted that the value of
motivation is varided with value of job satisfaction.
Since motivation is closely linked to job satisfaction, organizational factors
supporting to employee work motivation will push them to put additional effort which
will result in good performance, thus, eventually employee will feel satisfaction for
work accomplishment. Chess (1994) also agreed with this fact: same input factors the
motivation and job satisfaction have.
By concerning above findings from previous researchers, motivation and job
satisfaction may have similar influencing factors; however, these two will not affect
on organizational behavior with same ways. Thus, it cannot be concluded that
motivation and job satisfaction have same meanings. Hersey and Blanchard (1988)
observed that motivation is different from satisfaction regarding the returns and
performance impact.
There are some definitions emphasizing the distinction sbetween motivation
and job satisfaction. Motivation is person’s pay-out in action to fulfill his or her
satisfaction needs and job satisfaction is positive emotion or feeling or psychological
state resulted from job (Whiseand and Rush, 1988).
(b) The Relationship between Motivation and Organizational Commitment
51
Meyer, Stanley, Herscovitch, & Topolnytsky (2002) stated that employee
motivation at work is leading bto organizational commitment. Freeman, Rush, &
Lance (1999) and Pool &Pool (2007) also [roved that this relationship. Altindis
(2011) examined this point and proved that this effect in health care service
organizations in Turkey. Rahmawati et al (2005) examined this effect and it is found
that this fact is right also at the non-profit organizations.
There are still very few studies for motivation and commitment among
healthcare sector in developing countries. Therefore, this present study will analyze
this relationship among healthcare professionals from public hospitals in Myanmar.
(c) The Relationship between Job Satisfaction and Organizational Commitment
Some researchers and prcatitioners had been paying attention to job
satisfaction and its effect on commitment at organizations since Hawthorne studies.
The emphasis is even higher since the effect of job satisfaction is obvious on both
individual and organizational performance (Aameri, 2000). Kirsch (1990), Meer
(1995) , Knoop(1995) and McNeese-Smith (1995) also proved this relationship.
Awang and Ahmad (2010) analysed the effect of job satisfaction on
organizational commitment by collecting data from university lecturers in Malyasia.
They also explored the specific factors influencing on job satisfaction: pronotion
opportunity, remuneration, working environment, workload, and relationship with
peers, and leadership style, and also proved that the promotional opportunity,
workload and relationship with peers are positively affecting on job satisfaction which
leads to commitment.
The relationships of motivation, job satisfaction and commitment is also observed
by Tella et al (2007). Teachers’ job satisfaction and organiozational commitment is also
examined by Yucel and Bektas (2012) in Turkey. Satisfaction can be seen from three
aspects: general, intrinsic and extrinsic satisfaction aspects. This concept is examined by
Jonathan, Darroux, Massele, and Kirsch (2013) proved that these satisfaction are leading
to commitment in public secondary school teachers in China.
Nurse job satisfcationn and commitment relationship is examined by Salem et
al (2016) in Kingdom of Saudi Arabia by classifying the satisfaction as intrinsic and
52
extrinsic. Although this study focuses on the health sector, it is a study in developing
country. The research about satisfaction and commitment to health workers, including
medical doctors and nurses are limited especially in developing countries.
All of the above studies are in the service sector and the findings are consistent
with each other, i.e., job satisfaction and commitment are positively correlated.
Although most of the studies are from developing countries, these researchers are not
enough evidence for this present study which focus mainly on the health sector.
2.4.5 Previous Conceptual Model Adapted by This Study
The model developed by Bhatnagar (2014) is mainly adapted in this study
because the research focused on determinants of motivation and job satisfaction
among primary health workers in Nigeria and India. These countries are developing
countries like Myanmar, and this previous research focused on staff working in public
hospitals. The healthcare sector context of countries focused by this previous research
is very close to the context of the Myanmar public healthcare sector. Moreover,
research time-period is 2014, not too early for this study started in 2016. Thus, this
research model is very relevant to be adapted in this study. The conceptual model of
this previous research is shown in Figure (2.3).
53
Intrinsic Processes & Individual Characteristics
Organizational and Work Context
Cultural Factors
Needs, Values, Goals, Expectation, Self-Efficiency
Demographic, Social, and Educational Background
Knowledge
Societal Values & Expectations
Socio-Political & Economic Climate
Job Content
Resources:Inputs, Financial, Non-
financial incentives
Structures:Autonomy, Management,
Feedback, Justice
Process:Communication,
Procedures
Culture:Shared norms, citizenship
behavior, leadership
"PBF" Package
Health Worker
Motivation
Health Worker Job Satisfaction
Health Worker
Performance
Consequences of Health
Worker Performance
Figure (2.3) Conceptual Model of Bhatnagar
54
Source: Bhatnagar (2014)
55
Source: Bhatnagar (2014)
This previous study explored the effect of intrinsic and personal
charavteristics, organizational context factors, and culture of the organization on
medical staff motivation and satisfaction as the forward flow as shown in Figure (2.3).
It is assumed that the motivation and satisfaction of medical staff will lead to their
performance. As the backward flow, their performance will generate some
consequences either positive or negative. These consequences will return to
satisfaction and motivation of staff working at hospitals or health care service
organizations. These motivation and satisfaction will be affecting each other.
This study analyzed both the forward flow of relationships (influencing factors
to motivation and satisfaction to performance) and backward flow of relationship
(performance to motivation and job satisfaction and interaction between motivation
and job satisfaction).
2.5 Conceptual Framework for the Study
In the previous research model, the individual needs factors, cultural factors,
and organizational factors are affecting on employees’ motivation and job
satisfaction. In this study, instead of process and cultural factors, the job
characteristics are considered as influencing factors of motivation and job satisfaction
of medical doctors at public hospitals. The process and cultural factors of the previous
study are neglected in this study because these factors are beyond the control of the
management of public hospitals, and these cultural factors are external environmental
factors and the control is in the national level, not for the organizational level.
The process (communication and procedure) for the work has been learned a
little about it. That’s why these factors are not included in this study. However, in
public hospitals in Yangon, the job characteristics of medical doctors would largely
influence on their motivation and job satisfaction. As some researchers mentioned the
section of “job characteristics influencing motivation and job satisfaction”, this study
also points out that job characteristics can influence on motivation and job satisfaction
of staff working in healthcare sector.
This study excludes some variables from the previous analytical framework such 56
as cultural factors and worker performance. The reasons why remove cultural factor are,
it is very wide scope to be able to analyze within time and cost limitation and it is very
difficult to accurately measure the external environment of present changing conditions
of Myanmar. The culture that is used in each hospital is different. It can find a good
result if the study only unique culture of this kind of culture. In addition, the present
study only focuses on the internal organizational behavior study.
To get organizational commitment, only motivation or job satisfaction is
needed. The conceptual framework of the present study is illustrated in Figure (2.4).
57
Job Satisfaction
Motivation
Organizational Commitment
Affective CommitmentContinuance CommitmentNormative Commitment
Figure (2.4) The Conceptual Framework of the Study
Source: Adapted for This Study
This study adapted to the first part of analysis of previous researcher Bhatnagar
(2014). Although previous researcher analyzed both forward flow relationships and
backward flow relationships, this study only focused on the forward flow of relationship
(from motivation and satisfaction to commitment). In this study, commitment variable is
58
substituted for ‘performance’ variable of previous research because medical doctors’
commitment is more important than their performance at public hospitals, and
performance result from their commitment. Moreover, this study regarded the concepts of
Hersey and Blanchard (1988) on motivation and job satisfaction. They explained that
motivation is largely relative to future returns while job satisfaction is related from
received return from organization.
Here as a result of medical doctor’s motivation and job satisfaction, their
organizational commitment is considered. Their performance can be represented by their
commitment. The other reasons why exclude worker performance is, even though some
studies said that measuring performance in both objectively and subjectively is almost the
same, it is still the best and more accurate to measure in both ways. Instead of this
condition, it is very difficult to collect objective data in this study. That’s why, replaced it
to organizational commitment.
In this study, to learn about what is the most influential point of these three points.
It is important to commit on the work of a doctor. It is to learn the opinions of doctors at a
public hospital. Thus, the organizational commitment is assumed as the result that would
come out from medical doctors’ motivation and job satisfaction of public hospitals.
2.5.2 Working Definitions of the Variables
The definitions of variables are summarized in Table (2.1).
Table (2.1) Working Definitions
No Terms Definitions1 Value
andGoals
“An idea of what is most important in life, and the concept or principles of conduct of a person; one's opinion on what matters in life”
2 Pay and Financial Incentive
“The amount of financial remuneration provided by organization to employees”
3 Training and Supportive Supervision
“The learning opportunities arranged by management of hospitals or government for medical doctors to perform specific tasks better”
4 Promotionand Education
“Career development opportunity in the hospital.The hospital also gave study leave for personal
59
Opportunity development which enables them to learn for further study”
No Terms Definitions5 Relation with
Co-worker“Medical doctors’ relationship with peers, managers and subordinates at hospitals”
6 Leadership andManagement
Practices
“Practices of top level executives to manage and lead medical doctirs at public hospitals”
7 Skill Variety “Multi and different skills to be applied at work by medical doctors to provide health care service to the public”
8 Task Identity “The degree to which the job requires a 'complete' and recognizable piece of work to complete. That is, doing a job from stare to finish with a visible outcome”
9 Task Significance
“A job that impacts on the lives or work of other people, whether in the immediate organization or in the external environment”
10 Autonomy “The degree of the employee's right and autonomy to do his or her job and the individual's preference in arranging the job and even determining the means to achieve the tasks”
11 Feedback “The employee receives the message about his or her performance with the regardless of the performance is good or bad and information”
12 Motivation "Willingness to make and continue an attempt to be effective at work, to accomplish the aims of the organisation or to help the team achieve its objectives"
13 Job Satisfaction “A pleasurable or optimistic mental state that emerges from the appraisal of one's career or employment experiences”
14 Affective Commitment
“The strength of the desires of individuals to want to work with an organization as they agree with its core goals and principles”
15 Continuous Commitment
“Willingness to continue to employ for an organization because of his or her belief that leaving would be expensive”
16 Normative “Employees feel obligated to stick with their
60
Commitment organizations because of influence from others”Source: Own Compilation
61
CHAPTER 3
OVERVIEW OF PUBLIC HOSPITALS
In this chapter, discuss the role of public hospitals in Myanmar, the structure
of public hospitals in Myanmar, the classification of public hospitals in Myanmar, the
nature of the healthcare industry in Myanmar and public hospitals in Yangon.
3.1 The Role of Public Hospitals in Myanmar
The hospitals have followed different roles in society. The hospital takes care
of the sick, on the patient. The basic responsibility of the hospital can be defined as
providing immediate care for the sick and injured. Additionally, a hospital is an
organization which can be classified as social and medical entity and has to provide
primary care to the community as relevant. The hospitals can act as sentinel
surveillance centers for detection, recording and reporting of such cases to the public
health authorities. It has continuing care of patients and regular follow up measures
are taken by hospitals for regular care of patients. Hospitals provide rehabilitation
services through development of physiotherapy and occupational therapy units. There
has provided a support system for education and training of its staff. Research is
carried out on physical, psychological and social aspects of health and diseases.
Regarding health, the Government of Myanmar has been implementing the
health care services for the people by laying down the national health policy,
objectives and process step by step. As the national health policy, the government has
laid down establishment sound health system and enhancement of economic and
social environment conditions related to public health. In addition to these policies,
the government also set the following health objectives in order to raise the health
standard of the country.
(1) To enable citizens with the privilege of living their life to maximum life span.
(2) To make sure people are not threatened by any form of diseases.
38
39
In the health objectives, the government is conducting training qualified
human resources necessary for various healthcare and to use them effectively.
Moreover, health activities are being carried out by cooperating other departments and
organizations related to health. In order to implement fully these objectives, the
government is conducting to enact national health law, necessary preparation and
organizing societies for promoting health programs.
40
Department of Health
Department of Medical Sciences
The Republic of the Union of Myanmar
National Health Committee
Ministry of Health
Department of Health Planning
Department of Medical Research (Lower)
Department of Medical Research (Upper)
Department of Medical Research (Central)
Department of Traditional MedicineDistrict Peace and Development Council
Township Peace and Development Council
District Health Department
Township Health CommitteeTownship Health Department
Cabinet
NHP M&E Committee
State/Regional Peace and Development Council1
State/Region Health Committee
District Health Committee
State/Division Health Department
Ward/Village Peace and Development CouncilWard/Village Tract Health CommitteeStation Hospital
Rural Health Center
Village Volunteers
1. Ministries 2. Myanmar Women's Affairs Federation 3. Maternal & Child Welfare Association 4. Red Cross Society 5. Medical Association 6. Dental Association 7. Nurses Association 8. Health Assistant Association 9. Traditional Medicine Practitioners Association 10. Religious Organization 11. Parent-Teacher Association
3.2 The Structure of Public Hospitals in Myanmar
The structure of Myanmar Government Health Structure can be seen in Figure (3.1).
Figure (3.1) Myanmar Government Health Structure
41
Source: Ministry of Health (1979)
42
Tier-1 General
Tier-1 Specialist Hospitals
Tier-2 150BeddedHospital
Tier-2 100BeddedHospital
Tier-2 50BeddedHospital
Tier-3 25BeddedHospital
Tier-3 15BeddedHospital
Tier-4
StationHospital
3.3 The Classification of Public Hospitals in Myanmar
Myanmar’s primary specialist and general hospitals are located in Yangon,
Mandalay and Naypyitaw. Other division and states in Myanmar have been receiving
the public helath care service although the sufficiency and quality of service may not
be the same as the quality and sufficiency provided in therse three cities. Thus,
government has been implementing various plans and programs for more inclusive
quality health care service. Even though government emphasizes on inclusive health
caré service, there are some regions where people are still suffering from lack of
health care facility (e.g., Northern Kachin State).
In the public sector, there has classified into Tyer-1, Tier-2, Tyer-3, and Tyer-4.
It depends on the types of hospital service and size. Myanmar Health Service
Classification is shown in Figure (3.2).
Figure (3.2) Myanmar Health Services Classification
Public Healthcare
Source: Ministry of Health (2014)
According to the Figure (3.2), in Tier 1, included specialist hospitals, general
hospital with specialist service, between 50 and 150 bedded hospitals are Tier 2, 25 43
and 15 bedded hospitals are Tier 3, and station hospitals are Tier 4.
3.4 Standard Staff Positions of Government Hospitals
The standard staff positions of government hospitals are shown in Table (3.1).
Table (3.1) Standard Staff Positions of Government Hospital
Size of Hospital (Number of Bed)
Types of Position 16 25 50 100 150 200 300
Medical doctors 2 6 8 29 29 106 107
Nurse 6 12 23 87 92 298 301
Technicians 2 8 17 22 29 55 74
Others (Clerical & Auxiliary staff) 7 25 33 63 87 135 162
Total 17 55 81 201 237 594 644
Source: Planning Division, DOH (personal communication, 2012).
3.5 Public Hospitals in Yangon
In Yangon, there are currently 35 public hospitals which are located in
different township. Public hospitals can be segmented by number of beds and these
segments are shown in the Table (3.2).
Table (3.2) Bed Distributions of Public Hospitals in Yangon
No. Range of Beds Number of Hospitals Percent
1 <100 16 45.71
2 101-200 8 22.85
3 201-300 2 5.71
4 301-400 - -
5 401-500 3 8.57
6 >501 6 17.14
Total 35 100
Source: MOH & DOH (2010)
According to Table (3.2), the largest segment which is under 100 beds consists
of 16 hospitals and can be identified as 45.71%. The smallest segments between 201
and 300 beds contain 2 hospitals and can be stated as 5.71% respectively. 44
CHAPTER 4
RESEARCH METHODOLOGY
This chapter consists of five components such as sampling procedure,
implications of pilot test, reliability test, variables in the questionnaire, and testing
assumptions of multiple linear regression method.
4.1 Sampling Procedure
The sampling unit of this study is medical doctors at public hospitals located
in Yangon. The extent (geographical boundary) was within Yangon. In this study,
medical doctors from public hospitals in Yangon are targeted as population. The
period of data collection is during March and April in 2019. This study used samples
of hospitals and medical doctors. The two stages random sampling was applied. At
the first stage, among 35 public hospitals, 10 hospitals in Yangon were selected with
the criteria as simple random sampling.
At the second stage, from each sample hospital, lists of medical doctors were
obtained from each hospital. In selected hospitals, the total population was 1511
medical doctors. To get a sample from the population, Yamane (1973)’s formula is
taken into consideration:
n= N1+N (e)2
N = Population size = 1511
e = level of precision (A 95% confidence level)𝑛 =316. 2742 = 317
Medical doctors from each selected hospital are chosen by proportional allocation
method using the following formula.
43
ni=n∋ ¿N
¿ For data collection, The 317 are randomly selected from 1511 medical
doctors. Table (4.1) shows the sample size taken from selected hospitals.
Table (4.1) Sample Size of Medical Doctors of Selected Hospitals
No Hospitals PopulationNumbers of
Respondents
1 Thingangyun Sanpya Hospital 140 29
2 Women and Child Hospital 134 28
3 North Okalapa teaching and General Hospital 390 81
4 Dagon University Hospital 6 2
5 Insein General Hospital 143 30
6 Yangon University Hospital 7 2
7 Tuberculosis Specialist Hospital (Aung San) 75 16
8 Yangon Special Hospital 73 15
9 Yangon General Hospital 523 109
10 Kabar Aye Sancha Hospital 20 4
Total 1511 317
Source: Survey Data, 2019
Pilot survey was conducted to filter out some question-items from the
questionnaire whether these items are ambiguous for respondents or not supporting to
a research question. To complete and to validate the questionnaire, the pilot study is
conducted during the December, 2018 by making personal interviews with some
doctors in public hospitals.
After a pilot study, the questionnaires are modified by removing some
question items which are ambiguous and unnecessary to be included in the final
version. The modifications made after pilot can be seen in Table (4.2).
44
Table (4.2) Question Items Removed After Survey
No Variable
No. of
Question
Items
No. of
Question
Removed
No. of Question
Items Left After
Removing
1 Value and Goal 11 2 9
2 Esteem needs 6 1 5
3 Training and supportive supervision 7 1 6
4 Leadership and management practices 7 2 5
5 Job Satisfaction 10 2 8
6 Motivation 10 2 8
7 Normative commitment 5 1 4
Source: Survey data, 2019
As shown in Table (4.2), some questions for 16 independent variables are
removed after the pilot study and some questions for motivation, job satisfaction and
organizational commitment are also removed. Questions for all other variables remain
unchanged.
4.2 Development of Models for Analysis
The multiple regressions model is:
Yi = β0 + β1X1i + β2X2i + β3X3i + … + βkXki + ε i
Where:
i = 1,2,3,…,n
j = 1,2,3,…,k
Yi = ith observation of the dependent variable
Xij = ith observation of the jth independent variable
β0 = Constant
β1 = Regression Coefficients for Independent Variables X1
εi = ith independent identically distributed normal error
To practice the multiple linear regression method, the necessary assumptions
of this method must be tested. When running a multiple regression, there are some
45
assumptions to check data in order for the analysis to be reliable and valid.
46
The independent and dependent variables used in multiple linear regression
analysis are shown in Table (4.3).
Table (4.3) Independent and Dependent Variables
Model Dependent Variables Independent Variables1 Motivation Individual Needs Factors
Organizational FactorsJob Characteristics
2 Motivation Individual Needs FactorsValues and Goals Physiological Needs Safety Needs Social Needs Esteem Needs Self-Actualization Needs
3 Motivation Organizational FactorsPay and Financial Incentive Training and Supportive Supervision Promotion and Education Opportunity Relationship with Co-workers Leadership and Management Practices
4 Motivation Job CharacteristicsSkill Variety Task Identity Task Significant Autonomy Feedback
5 Job Satisfaction Individual Needs FactorsOrganizational FactorsJob Characteristics
6 Job Satisfaction Individual Needs FactorsValues and Goals Physiological Needs Safety Needs Social Needs Esteem Needs 47
Self-Actualization Needs
Model Dependent Variables Independent Variables
7 Job Satisfaction Organizational FactorsPay and Financial Incentive Training and Supportive Supervision Promotion and Education Opportunity Relationship with Co-workers Leadership and Management Practices
8 Job Satisfaction Job CharacteristicsSkill Variety Task Identity Task Significant Autonomy Feedback
9 Job Satisfaction Motivation10 Organizational Commitment Motivation
Job Satisfaction 11 Affective Commtment Motivation
Job Satisfaction12 Continuance Commitment Motivation
Job Satisfaction13 Normative Commitment Motivation
Job SatisfactionSource: Current Study
4.3 Reliability and Validity Test
For reliability of data collected from 317 respondents, KMO and the
Cronbach’s Alpha values are tested for all variables for which Likert type scale
questions items are developed. The KMO and Cronbach’s Alpha values of variables
are shown in
Table (4.4).
48
Table (4.4) Reliability and Validity for Variables
No. VariablesCronbach’s
AlphaKMO No. of Items
Individual Needs Factors
1 Value and Goal0.88
0.8699
2 Physiological needs0.95
0.8184
3 Safety Needs0.94
0.8584
4 Social Needs0.93
0.8565
5 Esteem Needs0.82
0.7995
6 Self-Actualization Needs0.92
0.8806
Organizational Factors
1 Pay and Financial incentive0.91
0.8516
2 Training and Supportive Supervision0.96
0.9106
3 Promotion and Education Opportunity0.94
0.7504
4 Relation with Co-Workers0.87
0.7996
5 Leadership and Management Practices0.77
0.7025
49
Job Characteristics
1 Skill Variety0.92
0.8707
2 Task Identity0.92
0.8414
3 Task Significance0.93
0.8806
4 Autonomy0.83
0.7185
5 Feedback0.96
0.9246
1 Motivation0.94
0.8618
2 Job Satisfaction0.93
0.8798
Organizational Commitment
3 Affective Commitment0.93
0.8716
4 Continuance Commitment0.81
0.5835
5 Normative Commitment0.82
0.6224
Source: Survey Data, 2019
As shown in Table (4.4) Cronbach’s Alpha values for individual needs factors,
organizational factors, job characteristics, motivation, job satisfaction, and
organizational commitment are greater than an acceptable score 0.7. Therefore,
internal consistency of items for the concept is excellent. Thus, the reliability of data
for these variables is an acceptable score. This measurement is with five point Likert 50
scales. According to the feedback from the survey, KMO values for individual needs
factors, organizational factors, job characteristics, motivation, job satisfaction, and
organizational commitment are greater than an acceptable score 0.5. Thus, the
patterns of correlation are relatively compact.
4.4 Research Questionnaires
Before conducting full scale survey, a pilot test had been conducted in a small
group of respondents to examine the potential problems with the research. The
questionnaires were distributed to the medical doctors in public hospitals in December
2018. According to pilot test, the minor changes were made for some wordings in the
questionnaire. The reliability of the questionnaires was tested with the pilot data and
some adjustments were made to the original questionnaire. Having done all the
amendments, the full questionnaire survey was distributed to meet the required
sample size. The questionnaire for the current study adapted from previous studies.
For physiological needs, the question items are adopted from Ikenyiri & Ihua-Maduenyi (2012) and Bhatnagar (2014) who explored the items to measure physiological needs. For safety needs, the question items are adopted from Ikenyiri & Ihua-Maduenyi (2012) and Bhatnagar (2014)who explored the items to measure safety needs. For social needs, the question items are adopted from Ikenyiri & Ihua-Maduenyi (2012) and Bempah (2013) who explored the items to measure social needs. For esteem needs variable, the items are adopted from Salem, Baddar, & Al-Mugatti, (2016), Ikenyiri & Ihua-Maduenyi (2012) and Bempah (2013) who explored the items to measure the esteem needs. For self-actualization needs, the items are adopted from Salem, Baddar, & Al-Mugatti, (2016) who explored the items to measure self-actualization needs. The second source is adapted from Onwusah & Awharhievwie (2017), who explored the items to measure self-actualization needs variable.
51
For pay and financial incentive variable, the items are adopted from Onwusah & Awharhievwie (2017), who explored the 6 items to measure pay and financial incentive variable. However, only 3 items out of these 6 are relevant from the first source. The second source is adopted from Parvin & Kabir (2011). For training and supportive supervision variable, the items are adopted from Rajan (2015) and Onwusah & Awharhievwie (2017), who explored the items to measure training and supportive supervision. For promotion and education opportunity variable, the items are adopted from Onwusah & Awharhievwie (2017), who explored the 3 items to measure Promotion and Education Opportunity. However, only 2 items out of these 3 are relevant from the first source. The second source is adopted from Osakwe (2014). For relationship with co-workers variable, the items are adopted from Onwusah & Awharhievwie (2017) who explored the 7 items to measure the relationship with co-worker variable. However, only 2 items out of these 7 are relevant from the first source. The second source is adopted from Mat (2016) and another source is adopted from Ramasodi (2010). For leadership and management practices, the items are adopted from Onwusah and Awharhievwie (2017) who explored the items to measure promotion and education opportunity.
For skill variety, the items are adopted from Maru and Biwott (2013). According to the feedback from pilot survey, all question items can be used. For task identity, the items are adopted from Maru and Biwott (2013). According to the feedback from pilot survey, all question items can be used. For task significant, the items are adopted from Maru and Biwott (2013). According to the feedback from pilot survey, all question items can be used. For autonomy, the items are
52
adopted from Maru and Biwott (2013). According to the feedback from pilot survey, all question items can be used. For feedback variable, the items are adopted from Maru and Biwott (2013). According to the feedback from pilot survey, all question items can be used. For motivation variable, the items are adopted from Mwanje (2010), who explored the 7 items to measure motivation. However, only 5 items out of these 7 are relevant of the first source. The second source is adopted from (Mat, 2016) and other sources are adopted from Rajan (2015) and Rashid (2013). For job satisfaction variable, the items are adopted from Onwusah & Awharhievwie (2017) to measure job satisfaction. However, only 3 items out of them are relevant of the first source. The second source is adopted from Bhatnagar (2014), Choong (2012) and another source is adopted from Parvin & Kabir (2011).
Based on the conceptual framework of the study, the questionnaire is divided
into four main sections A, B, C, and D. In section A, it includes about the
respondents’ profile which are gender, marital status, age, education, work
experience, and position. The objective of demographic question was acquired some
basic information of the respondents. Section B is divided into three factors,
individual needs factors, organizational factors, job characteristics. In individual
needs factors which include the questions about values and goals, physiological
needs, safety needs, social needs, esteem needs, and self-actualization needs. In
organizational factors which include the questions about pay and financial incentive,
training and supportive supervision, promotion and education opportunity,
relationship with co- workers, and leadership and management practices. In job
characteristics, it includes skill variety, task identity, task significances, autonomy, and
feedback. In section C, it includes motivation and job satisfaction. In section D, it
includes three parts. They are affective commitment, continuance commitment, and
normative commitment.
53
4.5 Data Collection and Data Analysis Method
Primary data are collected for the purpose of study and addressing the
problem. Therefore, the main source of getting data for this study is mainly from
primary source. Personal interview method is applied to collect data from randomly
selected ,edical doctors by using structured questionnaires. Data collection took place
in Yangon during March and April 2019.
For data analysis, quantitative method is applied in this study by conducting
the survey in public hospitals. In this approach, descriptive and analytical methods are
applied to reach the research objectives.
54
CHAPTER 5
ANALYSIS ON MOTIVATION, JOB SATISFACTION, AND ORGANIZATIONAL COMMITMENT OF MEDICAL
DOCTORS AT PUBLIC HOSPITAL
This chapter shows the analysis on underlying factors which may influence on
motivation, job satisfaction and the relationship between motivation, job satisfaction
and organizational commitment of medical doctors at public hospitals in Yangon. In
this section, to test the hypotheses as mentioned in Chapter 1, the 10 hospitals are
selected from 35 public hospitals which are located in Yangon.
5.1 Profile of Respondents
For demographic factors of selected hospitals; gender, marital status, age,
education level, working experience and positions are collected from respondents.
The profile of respondents of selected hospitals is shown in Table (5.1).
55
Table (5.1) Profile of Medical Doctors of Selected Public Hospitals in Yangon
No. Demographic Factors No. of Respondents Percentage
1 GenderMale
Female
127
190
40
60
2 Marital StatusSingle
Married
209
108
66
34
3 Age Under 30
30-40
40-50
Above 50
117
138
46
16
37
43
15
5
4 Education M.B.B.S
M.Sc
Doctorate
MRCP
Others
104
159
11
37
6
33
50
3
12
2
5 Working Experience (Years)Up to 5
6-10
11-15
16-20
Above 20
87
158
35
22
15
27
50
11
7
5
6 Positions Assistant Surgeon
Consultant/ Lecturer
Senior Consultant Surgeon
Senior Assistant Surgeon
First Assistant
Post Graduate
Associate Professor
Professor
34
80
39
49
34
56
17
8
11
25
12
15
11
18
5
3
56
Source: Survey Data (2019)
As shown in Table (5.1), the number of female participants is higher than male
participants. The percentage of female participants is 60. With regard to marital
status, majority of the participants are single. The percentage of single participants is
66. Concerning age range, it can be found that the majority of participants are in the
age range of between 30 and 40. The percentage of age range of between 30 and 40 is
43. Regarding the education level, the majority of the respondent’s education is M.Sc.
The percentage of M.Sc degree is 50. As working experience, most of the
respondent’s working experience is between 6 and 10 years. The percentage of
working experience between 6 and 10 years is 50. According to the position, the
majority of participants are lecturer. The percentage of lecturer participants is 25.
5.2 Antecendents of Motivation and Job Satisfaction of Medical Doctors at
Public Hospitals in Yangon
Individual needs factors, organizational factors, and job characteristics effect
on motivation and job satisfaction of medical doctors at public hospitals in Yangon.
5.2.1 Individual Needs Factors of Medical Doctors
In this study, the individual needs factors which are assumed as influencing
factors on motivation and job satisfaction are value and goal, physiological needs,
safety needs, social needs, esteem needs, and self-actualization needs. The mean score
of each statement can range between 1 and 5. Mean values of less than 2.00 were
categorized as low level; mean value between 2.00 and less than 3.50 was moderate
level and mean value of 3.50 or above was categorized as high level. This
categorization is based on Sekaran (2003).
Value and goals can also influence on motivation and job satisfaction. The
value and goals of medical doctors at public hospitals is explored. The analysis is
presented in Table (5.2).
57
Table (5.2) Value and Goals of Medical Doctors at Public Hospital in Yangon
No. Items Mean
1 Setting goals to achieve what they think is important 3.54
2 Feeling meaningful the life when it reached goals 3.33
3 Setting goals based on own interests and plans for the future 3.66
4 Setting detail objectives to track progress 3.58
5 Feeling the goals of the organization are as important as own
goals
3.55
6 Setting short-term goals to achieve long-term goals 3.51
7 Having valuable the outcomes of the job 3.67
8 Having value on medical professional experience 4.06
9 Appreciating the responsibility in a public hospital 3.78
Overall Mean 3.63
Source: Survey Data (2019)
As shown in Table (5.2), the overall mean value of the value and goal score of
respondents is 3.63 (greater than 3.5) that is fairly high level of respondents. It can be
concluded that they prefer to set goals and value their job. Medical doctors participated
in survey value their jobs and also value the goals of their hospitals. Moreover, thay
believe the goals of Myanmar helth care service organizations. They also set the short
term goals and long term goals personally, and they also try to compliance with the
goals of their hospitals. Because of this situation, they take care of their work and value
of their job. They take care on patients and also take acre on their professionalism.
Thus, they are so conscious the standards and guidelines set by their management. The
statement “I value my professional experience in medicine.” gets the highest mean
value 4.06 which means the medical doctors value their skills and experiences. They
can have more experience, thus they can have a good treatment.
Physiological needs can also influence on motivation and job satisfaction.
Here, to measure these variables, the important level used to indicate the level of
respondents to all items (1= not important to 5=very important). In this study, the
58
needs of medical doctors at public hospitals are explored. The Physiological needs of
medical doctors of public hospitals in Yangon can be seen in Table (5.3).
Table (5.3) Physiological Needs of Medical Doctors at Public Hospitals in Yangon
No. Items Mean
1 Importance of pension at my old age (after 60) 3.43
2 Salary of my job 3.40
3 Overtime wages 3.31
4 Accommodation for staff (housing allowance) 3.38
Overall Mean 3.38
Source: Survey Data (2019)
As shown in Table (5.3), the overall mean value of the physiological needs
score is 3.38 that is nearly 3.5. It indicates that they are important and moderate level
of physiological needs. However, according to the results of each item, it is found that
they indicate moderate levels in physiological needs. They perceived that their salary,
overtime wages and accommodation provide by government are not enough to pay
attention to other needs such as for secure life, for love and care on family and social
network, respect from others, and to devote time to show their potential and to try to
achieve higher goals. They need money to pay for basic needs such as food, shelter
and clothes. The statement “Expectation of pension at my old age (after 60)” gets the
highest mean value 3.43 which means the pension is important for their income. Even
though they retired from work, they got a normal income.
Safety needs can also influence on motivation and job satisfaction. Thus, in this
study, the safety needs of medical doctors at public hospitals are explored. The safety
needs of medical doctors at public hospitals in Yangon can be seen in Table (5.4).
Table (5.4) Safety Needs of Medical Doctors at Public Hospitals in Yangon
No Items Mean
1 Feeling of security in this job as a government staff 3.13
2 Earning extra income by working outside of working hours 3.45
59
3 Feeling free from stress by following the guidelines of
government for medical doctors
3.29
4 Having sufficient support to protect from infectious diseases. 3.05
Overall Mean 3.23Source: Survey Data (2019)
As shown in Table (5.4), the overall mean value of the safety needs score is
3.23 (between 2 and 3.5). It indicates that they have a moderate level of safety needs.
During this turbulent time, medical doctors feel unsafe at work regarding adverse
effect on their health, their career and they must be very conscious not to go extra
miles due to the adverse return on them if their action is acditentially varied from
standard procedure. The reture on them will be severe if the consequences of their
action and decision are not as intended. However, since they are civil servants, it is
stable at work. Thus, at the one side they are worrying with nature of work. At the
other side, they are safe with the nature of tenure. The statement “I earned extra
income by working outside out of working hours.” gets the highest mean value 3.45
which means it has a strong impact on a second income to save their life. Even though
the salary is low, if they want to work, they can earn an extra income by working
outside the office hours.
Social needs can also influence on motivation and job satisfaction. Thus, in
this study, the social needs of medical doctors in public hospitals are explored. The
social needs of medical doctors at public hospitals in Yangon can be seen in
Table (5.5).
Table (5.5) Social Needs of Medical Doctors at Public Hospitals in Yangon
No Items Mean
1 Having a big happy family in the hospital 3.11
2 Having the important role of the hospital 3.10
3 Having good relationships with colleagues at work 3.46
4 Having the encouragement of the hospital to explore all sorts
of career opportunities3.29
5 Having mutual understanding among colleagues in the
hospital and department3.22
60
Overall Mean 3.26
Source: Survey Data (2019)
As shown in Table (5.5), the overall mean value of the social needs score of
respondents is 3.26 (between 2 and 3.5). It indicates that they have moderate level of
social needs. The reason for this is that they have good relationship with co- worker
within their work. Their organization encourages them to improve all sorts of career
opportunities. They also have mutual understanding among colleagues in their
hospitals. The statement “I have good relationships with colleagues at work.” gets the
highest mean value 3.45 which means co-workers help each other at work and they
earn respect from their colleagues.
Esteem needs can also influence on motivation and job satisfaction. Thus, in
this study, the esteem needs of medical doctors in public hospitals are explored. The
esteem needs of medical doctors of public hospitals in Yangon can be seen in
Table (5.6).
Table (5.6) Esteem Needs of Medical Doctors at Public Hospitals in Yangon
No Items Mean
1 Feeling of competence at work 3.66
2 Getting respect from others at this job 3.51
3 Feeling of accomplishment from the job. 3.03
4 Solving most problems with the necessary effort 3.64
5 Respecting oneself from working in the public hospitals 3.18
Overall Mean 3.40
Source: Survey Data (2019)
As shown in Table (5.6), the overall mean value of esteem needs is 3.40
(between 2 and 3.5), this is fairly high. It indicates that they have moderate level of
esteem needs. The reason for this is that it is very necessary to be respected by others.
Medical doctors still focus on acceptance by others. The statement “I feel competent
at work.” gets the highest mean value is 3.66. It means that medical doctors have
confidence that they can cure the patients well and medical doctors have the ability to
61
solve the problems successfully. They have a good qualification to treat patients well.
Self-actualization needs can also influence on motivation and job satisfaction.
Thus, the self-actualization needs of medical doctors in public hospitals are explored.
The self-actualization needs of medical doctors at public hospitals in Yangon can be
seen in Table (5.7).
Table (5.7) Self-Actualization Needs of Medical Doctors at Public Hospitals in
Yangon
No Items Mean
1 Having ability to meet the health needs of the community 3.30
2 Using the judgment when solving work-related problem 3.34
3 Using full capacity at work 3.55
4 Feeling free to execute tasks in ones’ own way 3.40
5 Being successful in work 3.36
6 Having the chances for independent thought and
action in the position
3.11
Overall Mean 3.34
Source: Survey Data (2019)
As shown in Table (5.7), the overall mean value of self-actualization needs
score of respondents is 3.34 (between 2 and 3.5). It indicates that they have a
moderate level of self-actualization needs. They feel guilty to take advantage by
putting less effort at work and for not utilizing their talent and skills at full range.
They have strong desire to upgrade the standard of Myanmar’s heal care service
system, especially at the public hospitals. They do not want to hear the bad remarks
from public at the public hospitals. The statement “I use my full capacity at my
work.” gets the highest mean value 3.55. It means that the medical doctors have to
work a full day at work. They are able to perform the most effective and successful
treatment at the hospital.
62
5.2.2 Organizational Factors Provided to Medical Doctors at Public Hospitals
in Yangon
In this study, the organizational factors which are assumed as influencing
factors on motivation and job satisfaction are pay and financial incentive, promotion
and education opportunity, relation with co-worker, leadership and management
practices, and training and supportive supervision. The pay and financial incentive of
medical doctors at public hospitals in Yangon can be seen in Table (5.8).
63
Table (5.8) Pay and Financial Incentive for Medical Doctors
No Items Mean
1 Having enough salary from this job 1.60
2 Being very satisfied with the benefit (vacation,
medical leave, etc.)
1.53
3 Having adequate living expenses with the salary 1.64
4 Having the fair payroll (wages, bonuses, etc.) in organization 1.89
5 Being satisfied with salary increases. 1.89
6 Getting compensation that is matched with the responsibility 1.74
Overall Mean 1.72
Source: Survey Data (2019)
As shown in Table (5.8), the overall mean value of the pay and financial
incentive score of respondents is 1.72 (less than 2). It means that they do not prefer
pay and financial incentive. According to the results of each item, it is found that they
indicate weakness in salaries and benefit from their job. The lowest mean value is
1.53, which statement is “I have the benefits I receive, eg: vacation, medical leave,
free health care, etc.” which means they don’t get any other benefits from their job.
They don’t have public holidays and vacation according to their nature of work and
moreover, they don’t get efficient staff housing. Another lowest mean value is 1.60,
which statement is “I have enough salary from this job.” which means they are not
satisfied with the pay and salary of this job.
Training and supportive supervision can also influence on motivation and job
satisfaction. Thus, in this study, the training and supportive supervision of medical
doctors at public hospitals is explored. The training and supportive supervision of
medical doctors at public hospitals in Yangon can be seen in Table (5.9).
64
Table (5.9) Training and Supportive Supervision for Medical Doctors
No Items Mean
1 Getting delegated work from seniors and supportive
supervision
3.02
2 Allowing the medical doctors to have enough time to learn
new skills for the future
2.90
3 Being satisfied with the in-service training (work-shops,
seminars, etc.)
2.96
4 Getting the training needed to succeed in the position 2.85
5 Having a chance to participate in training activities. 2.87
6 Being satisfied with the support (advice, coaching) from
supervisor
3.22
Overall Mean 2.97
Source: Survey Data (2019)
As shown in Table (5.9), training and supportive supervision of respondents is
2.97 (between 2 and 3.5). It is moderate level on training and supportive supervision.
According to the results of each item, it is found that they indicate weakness in
training activities. The highest mean value is 3.22 and its statement is “I am satisfied
with the support (advice, coaching) I receive from my supervisor”. It can be said that
the supervisors advise and coach them well.
Promotion and education opportunity can also influence on motivation and job
satisfaction. In this study, the perception of the promotion and education opportunity
for medical doctors in public hospitals is explored. The promotion and education
opportunity of medical doctors at public hospitals in Yangon can be seen in
Table (5.10).
65
Table (5.10) Promotion and Education Opportunity for Medical Doctors
No Items Mean
1 Having sufficient opportunity to develop in the work
(seminars, workshops, conferences)
2.81
2 Having a clear and fair promotion policy 2.87
3 Having a chance for further study opportunity 3.12
4 Getting promotions and upward movement in job 3.04
Overall Mean 2.96
Source: Survey Data (2019)
As shown in Table (5.10), the promotion and education opportunity score is
2.96 (between 2 and 3.5). It indicates that they moderately prefer to promotion and
education opportunity. The highest mean value is 3.12 and its statement is “I have a
chance to further study opportunity.” It can be said that the hospital provides more
opportunities to attend further study.
Relation with co-worker can also influence on motivation and job satisfaction.
Thus, in this study, the relation with co-worker of medical doctors in public hospitals
is explored. The relationship with co-workers of medical doctors at public hospitals in
Yangon can be seen in Table (5.11).
Table (5.11) Relationship with Co-workers of Medical Doctors
No Items Mean
1 Having friendly co-workers at the department 3.02
2 Having co-operation and understanding between work groups 2.78
3 Having a good working relationship with colleagues 3.10
4 Being able to depend on colleagues for support 2.75
5 Having a chance for the collaboration with other departments. 2.76
6 Having a clear channel of communication in the workplace 3.09
Overall Mean 2.92
Source: Survey Data (2019)
As shown in Table (5.11), the relationship with co-worker score is 2.92
66
(between 2 and 3.5). It indicates that they moderately prefer to the relation with co-
worker. The statement “I have a good working relationship with my colleagues” is the
highest mean value 3.10 which means that their colleagues usually help each other
and they have a positive relationship with their co-workers.
Leadership and management practices can also influence on motivation and
job satisfaction. Thus, in this study, the leadership and good management practices of
medical doctors in public hospitals is explored. The leadership and good management
practices of medical doctors at public hospitals in Yangon can be seen in Table (5.12).
Table (5.12) Leadership and Management Practices for Medical Doctors
No Items Mean
1 Having satisfactory leadership style at this hospital 1.89
2 Having good policy and procedure in this hospital 2.36
3 Having an effective accountability system within hospital 2.24
4 Having the quality of interaction with supervisor 3.90
5 Having opportunities to participate in decision making to
solve the problems in the organization
2.67
Overall Mean 2.61
Source: Survey Data (2019)
As shown in Table (5.12), the mean value of leadership and management
practices is 2.61 (between 2 and 3.5). It indicates that they moderately prefer
leadership and management practices. The mean value 3.90 is the highest and its
statement is “I have the quality of interaction with my supervisors.” It means that all
the medical doctors in any position always have peer-to-peer and supervisor respect.
5.2.3 Job Characteristics of Medical Doctors at Public Hospitals in Yangon
In this study, job characteristics are assumed as influencing factors on
motivation (skill variety, task identity, task significance, autonomy and feedback). The
skill variety of medical doctors at public hospitals in Yangon can be seen in
67
Table (5.13).
Table (5.13) Skill Variety of Medical Doctors
No Items Mean
1 Having a lot of variety in skills to do in job 3.31
2 Having a good match of job with skills and experience 3.36
3 Having support of hospital with the required skills to do work 3.00
4 Being happy to stay long at this career with existing
professionalism
3.03
5 Being able to do tasks independently from supervisors 2.78
6 Having a chance to use a wider variety of different skills and
talents at work
2.92
7 Having a chance to use the skills to handle the problem at
work
3.07
Overall mean 3.07
Source: Survey Data (2019)
As shown in Table (5.13), the overall mean value is 3.07 (between 2 and 3.5).
It indicates that they moderately prefer skill variety. The reason for this that doctors
must be skilled in science, diagnosis and treatment. As a doctor, they need to have
variety of skills to communicate to patients, nurses, superiors and colleagues, to solve
unexpected problems at work, to negotiate with other organizations for budget
utilization and also for procurement, to be crteative to manage some exceptional cases
within the constraints of lack of resources and so on. They feel more motivated to
work because they have such a skill. The highest mean value is 3.36, which statement
is “The job is a good match for my skills and experience.” which means that they are
pleased to be able to work with their experience and skills. It is a job that matches
their skills.
Task identity can also influence on motivation and job satisfaction. In this
68
study, the task identity of medical doctors in public hospitals is explored. The task
identity of medical doctors at public hospitals in Yangon can be seen in Table (5.14).
69
Table (5.14) Task Identity of Medical Doctors
No Items Mean
1 Arraning jobs from the beginning to end 3.15
2 Having a chance to do a piece of work until getting
patients’ satisfaction
2.99
3 Arranging jobs to view assigned tasks as projects from
start to final completion
3.13
4 Having a chance to discuss with patients and colleagues to
complete the assigned tasks
3.12
Overall Mean 3.09
Source: Survey Data (2019)
As shown in Table (5.14), task identity of respondents is 3.09 (between 2 and
3.5). It indicates that they moderately prefer to task identity. They have to take
responsibility for the job. It is well organized to be able to take care of the job. It is
arranged to be able to understand the details of patient and clients. The highest mean
value is 3.15, which statement is “My hospital is arranged jobs so that I have to do the
job from the beginning to end.” which means the job is arranged to be able to do for a
job at the end. The lowest mean value is 2.99, which statement is “My hospital has a
chance to do a piece of work until getting patient satisfaction.”, which means they
have no chance to fulfill patient satisfaction. They don’t have enough time to explain
the patient in detail.
Task significance can also influence on motivation and job satisfaction. In this
study, the task significance of medical doctors in public hospitals is explored. The task
significance of medical doctors at public hospitals in Yangon can be seen in
Table (5.15).
70
Table (5.15) Task Significance of Medical Doctors
No Items Mean
1 Being an integral part of the organization 3.23
2 Getting feeling that own performance is affecting on a lot of
other people
3.30
3 Having feeling of meaningfulness of doing this job 3.18
4 Having influence on the day-to-day success of the hospital 3.17
5 Having influence on the decisions that significantly affect
the workplace
3.13
6 Being assigned to do important tasks in hospital 3.15
Overall Mean 3.19
Source: Survey Data (2019)
As shown in Table (5.15), the overall mean value of task significance is 3.19
(between 2 and 3.5). It indicates that they moderately prefer on task significance. The
answer to all questions is on average level 3. Their job can affect a lot of other people.
Their job is very significant and important for the community by how well the work is
performed. The judgment of the doctor is greatly affected in the workplace. The
highest mean value is “My job in hospital is one that may affect a lot of other people.”
which means their job is to support the public. Public health care is always carried out
for the public. They perceived that their work whether good or bad will largely effect
on a lot of other people.
Autonomy can also influence on motivation and job satisfaction. Thus, in this
study, the autonomy of medical doctors in public hospitals is explored. The autonomy
of medical doctors at public hospitals in Yangon can be seen in Table (5.16).
71
Table (5.16) Autonomy of Medical Doctors
No Items Mean
1 Providing the opportunity for independent thought and
action
3.31
2 Having the freedom to decide how to do assigned tasks 3.30
3 Allowing to plan how to do work 3.34
4 Being comfortable with sharing own opinion at the
hospital
3.03
5 Receiving a chance to make decisions about what
methods to use to complete the job.
2.78
Overall Mean 3.15
Source: Survey Data (2019)
As shown in Table (5.16), the overall mean value of autonomy is 3.15 which is
lower than 3.5. It indicates that they moderately prefer autonomy. Most of the items
were score round about 3. Therefore, it can be interpreted that medical doctors at
public hospitals are working with moderate level of autonomy in their workplace. At
public hospitals, each of medical doctor has own level of autonomy in the workplace.
Medical doctors always face emergency cases on a daily basis. They need to have
some extent level of autonomy to be able to solve the problem in time. The highest
mean value is “In my hospital, it allows me to plan how I do my work.” I am going to
make a detailed arrangement about my responsibility and I am allowed to deal with
my work by myself.
Feedback can also influence on motivation and job satisfaction. Thus, in this
study, the feedback of medical doctors in public hospitals is explored. The feedback of
medical doctors at public hospitals in Yangon can be seen in Table (5.17).
72
Table (5.17) Feedback of Medical Doctors
No Items Mean
1 Getting information about ones’ own performance in the
hospital
2.96
2 Getting constant feedback from supervisor about the activities
for the patients
3.12
3 Knowing whether the performed is good or not after finishing
a job
3.15
4 Having clearly competent view of ones’ own work
Performance
3.15
5 Knowing timely whether the job or work is efficient or not 3.20
6 Receiving feedback from co-workers 3.32
Overall Mean 3.12
Source: Survey Data (2019)
As shown in Table (5.17), the overall mean value of feedback is 3.12 (between
2 and 3.5). It indicates that they moderately prefer feedback. They can get to know
the operation status of the job in time. They will be able to know their ability through
their co-worker. The highest mean score is 3.32 which statement is “I receive
feedback from my co-worker about my performance on the job.” It means that they
receive responses on their actions from their co-workers.
5.3 Motivation, Job Satisfaction and Organizational Commitment of Medical
Doctors at Public Hospitals in Yangon
In this study, motivation, job satisfaction and Organizational Commitment of
medical doctors at public hospitals in Yangon are analyzed motivation level and job
satisfaction level.
5.3.1 Motivation of Medical Doctors at Public Hospitals in Yangon
In this study, medical doctors are required to respond which factors are
motivated and how much they agree. Motivation of medical doctors at public
hospitals in Yangon can be seen in Table (5.18).
73
No Items Mean
1 Being motivated to work hard 2.98
2 Completing the tasks efficiently and correctly 3.14
3 Feeling pleased to have chosen medicine as a career 3.12
4 Being actively involved in helping to make a great health
care facility
3.14
5 Having similar values with the health facility 2.92
6 Intending to continue further medical study 3.43
7 Being enthusiastic about contribution to the
Organization
3.16
8 Having decided to continue working in a public hospital. 3.40
Overall mean 3.16
Table (5.18) Motivation of Medical Doctors
Source: Survey Data (2019)
As shown in Table (5.18), the overall mean value of motivation of
respondents is 3.16 (between 2 and 3.5). It indicates that they moderately prefer
motivation in this hospital. They can make the most accurate work to be able to work
efficiently. They are aiming to continue the next medical treatment. They are actively
involved in this organization. The highest mean value is 3.43 which statement is “I
intend to continue further medical study.” which means that they are more interested
in medicine and they are planning to continue studying at this hospital.
5.3.2 Job Satisfaction of Medical Doctors at Public Hospitals in Yangon
In this study, medical doctors are required to respond the job satisfaction and
how much they agree. Job satisfaction of medical doctors at public hospitals in
Yangon can be seen in Table (5.19).
74
Table (5.19) Job Satisfaction of Medical Doctors
No Items Mean
1 Being satisfied with the job due to good match with skills and
experience
2.86
2 Being satisfied with the job has more advantages than
disadvantages
2.87
3 Being satisfied with the ability to do work well 3.19
4 Being satisfied with freedom to use ones’ judgment 3.02
5 Being satisfied to continue working in this job 3.19
6 Being satisfied with the professional development activities
and promotion opportunity
2.93
7 Being satisfied with the leadership and good management
practices
2.79
8 Being satisfied with the valuable on medical professional
experience
3.22
Overall Mean 3.00
Source: Survey Data (2019)
As shown in Table (5.19), the overall mean score of job satisfaction of
respondents is 3.00 (between 2 and 3.5). It can be concluded that they moderately
prefer job satisfaction. They satisfied with the job, that’s why they will continue
working. They value medical experience and satisfied the job. The highest mean
value is 3.22 and its statement is “I am satisfied with the valuable on medical
professional experience.” It can be said that their job is very important for them and
they value their medical professional experience.
5.3.3 Organizational Commitment of Medical Doctors at Public Hospitals in
Yangon
This study analysed how medical doctors are required to respond the
commitment and how much they agree. Affective commitment of medical doctors at
public hospitals in Yangon can be seen in Table (5.20).
75
Table (5.20) Affective Commitment of Medical Doctors
No Items Mean
1 Willing to put a great deal of effort beyond that is normally
expected
3.37
2 Feeling of loyalty to this organization 3.39
3 Being expected to spend the rest of career at this
organization
3.34
4 Willing willing to accept almost any type of job assignment
in order to stay at this organization
3.12
5 Considering the organization’s problem as personal problem 3.20
6 Having of "emotionally attached" to this organization. 3.34
Overall Mean Value 3.29
Source: Survey Data (2019)
As shown in Table (5.20), the overall mean value of affective commitment is
3.29 which is lower than 3.5. It indicates that they moderately prefer affective
commitment in their hospital. All of the question items of mean score are round about
3. The highest mean score is 3.39 and its statement is “I feel loyalty to this
organization”. It means that they will continue to keep their loyalty in this group.
Continuance commitment of medical doctors at public hospitals in Yangon
can be seen in Table (5.21).
Table (5.21) Continuance Commitment of Medical Doctors
No Items Mean
1 Being hard to leave this hospital 3.06
2 Believing that too much of life would be disrupted after
leaving this organization now
2.77
3 Very few options to leave from this organization 2.47
4 Not considering working elsewhere 2.78
Overall Mean 2.83
Source: Survey Data (2019)
76
As shown in Table (5.21), the overall mean score of continuance commitment
is 2.83 which is lower than 3.5. It indicates that they moderately prefer continuance
commitment in their hospital. The highest mean value is 3.06 which statement is “It
would be very hard for me to leave my organization right now, even if I wanted to.” It
means that it is not possible to leave from this organization.
The normative commitment of medical doctors at public hospitals in Yangon
can be seen in Table (5.22).
Table (5.22) Normative Commitment of Medical Doctors
No Items Mean
1 Feeling obligated to remain in current hospital 3.37
2 Feeling guilty to leave this hospital now 3.04
3 Working in an organization that deserves loyalty 2.79
4 Having responsibilities for patients in this hospital. 2.56
Overall Means 2.66
Source: Survey Data (2019)
As shown in Table (5.22), the normative commitment of respondents is 2.66
which is lower than 3.5. It can be concluded that they show less preference in
normative commitment in their hospital. The highest mean value is 3.37 and its
statement is “I feel obligated to remain in my current hospital.” It means that they
believe that they have a full responsibility to continue working in this hospital.
According to this study, the overall mean value of the independent variable
and the dependent variable are shown in moderate level. In individual needs factor,
all of mean values are round about 3. In organizational factor, overall mean of most
variables are between 2 and 3.5, which means that they moderately prefer to
organizational factor. These variables are pay and financial incentive, promotion and
education opportunity, relationship with co-worker, leadership and management
practices, training and supportive supervision. In job characteristics, overall mean
value of variable are round about 3, which means that they moderately prefer on job
characteristics. In motivation and job satisfaction, overall mean value of motivation is
3.17 and overall mean value of job satisfaction is 2.96. Here, it states that respondents
prefer motivation more than job satisfaction. The overall mean value of affective 77
commitment is 3.29 which are preferred more than normative commitment and
continuance commitment.
5.4 Analysis on Factors Affecting Motivation of Medical Doctors at Public
Hospital in Yangon
The test is continued to analyze the effect of individual needs factor,
organizational factor, job characteristics and motivation. This analysis is to test the
Hypothesis (1): the dependent variable (individual needs factor; organizational factors
and job characteristics) have a significant effect on the independent variables
(motivation) of medical doctors at public hospitals in Yangon. The result from the
analysis on Hypothesis (1) is shown in Table (5.23).
Table (5.23) Results of Multiple Regression Analysis on Motivation
Independent Variables
UnstandardizedCoefficients
Standardized Coefficient
Sig. Tolerance t VIFB
Std. Error
Beta
(Constant) -.399 .142 .005 -2.820
Individual Needs
Factor.366*** .048 .309 .000 .614 7.619 1.628
Organizational
Factors.236*** .061 .191 .000 .414 3.881 2.414
Job Characteristics .549*** .065 .441 .000 .369 8.438 2.713
R .827
R Square .685
Adjusted R Square .682
F 226.396***Source: Survey Data (2019)
Dependent variable: Motivation
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.23), the multiple regression results for model 1, which
can be interpreted as follows: R2 is 0.685 and adjusted R2 is 0.682, with three
independent variables. This indicates that those individual needs factors,
78
organizational factors, and job characteristics can explain 68.2% variation in
motivation. The value of F-test was 226.396 and it is significant at 1% level.
79
According to the result, individual needs factors, organizational factors, and job
characteristics emerged as the significant variables in explaining the variance in
motivation. If one unit of individual needs factor increases, 0.366 units in motivation
level will increase. If one unit of organizational factor increases, 0.236 units in
motivation level will increase. If one unit of job characteristics increases, 0.549 units in
motivation level will increase. By the results, individual needs factor, organizational
factor, and job characteristics are positive effect on the motivation. According to the
results from analysis, Hypothesis (1) can be supported. A Job characteristic has the
strongest effect on motivation with standardized coefficient beta of 0.441.
The multiple regression analysis is performed to examine the effect of
individual needs factors on motivation. In this analysis, independent variables are
individual needs factors and the dependent variable is motivation. The results from
analysis on individual needs factors affecting on motivation are shown in Table (5.24).
Table (5.24) Results of Individual Needs Factors on Motivation
Independent Variables
UnstandardizedCoefficients (B)
Standardized Coefficient
Sig. Tolerance t VIFB
Std.Error
Beta
(Constant)
-.720.211 .001
-
3.419
Value and Goals .426*** .072 .288 .000 .523 5.925 1.991
Physiological needs .019 .018 .037 .306 .936 1.026 1.068
Safety Needs .140*
**.038 .219 .000 .350 3.687 2.855
Social Needs .038 .053 .049 .467 .278 .729 3.593
Esteem Needs .364*** .057 .290 .000 .602 6.391 1.662
Self-Actualization
Needs .136*** .057 .154 .018 .295 2.376 3.393
R .785
R Square .617
Adjusted R Square .609
80
F 83.084***Source: Survey Data (2019)
Dependent variable: Motivation
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.24), the multiple regression results for model 2, which
can be interpreted as follows: R2 is 0.617 and adjusted R2 is 0.609, with six
independent variables. This indicates that those independent variables can explain
60.9% variation in dependent variable. The value of F-test is 83.084 and it’s highly
significant at 1%.
According to the result, value and goals, safety needs, esteem needs, and self-
actualization needs emerged as the significant variables in explaining the variance in
motivation. If one unit of value and goals increases, 0.426 units in motivation level
will increase. If one unit of safety needs increases, 0.140 units in motivation level will
increase. If one unit of esteem needs increases, 0.364 units in motivation level will
increase. If one unit of self-actualization needs increases, 0.136 units in motivation
level will increase. By the results, promotion and education opportunity is highly
significant at 1% on motivation and relation with co-workers, leadership and good
management practices are highly significant at 1% on motivation.
According to the survey result, their motivation level is not too high (just
above average level). Similarly, their motivation level of value and goals, safety
needs, esteem needs, and self-actualization needs are also not too high. Therefore, it
can be concluded that most of the medical doctors are motivated by these factors at
the average level in public hospitals.
As shown in Table (5.24), medical doctor’s value and goals are positively
affecting on their motivation. In the public hospitals, doctors like to set own targets
and goals for both short and long term. They also have the experience, ability and
skills to set own goals, and they are happy to see the meaningfulness of their goals.
They also value their job and position at public hospitals. The most obvious point is
that they value the reputation at public hospitals, and believe that this reputation can
influence on job opportunities at private hospitals and other area. They are motivated
at work due to these high goals and values.
The safety needs has also a positive influence on motivation of medical
81
doctors. They want to safe on this job as a government staff. They want to be free
from stress by following the guidelines of government for medical staff. They are
motivated at the jobs due to this need.
82
The esteem needs are also influencing on motivation. The medical doctors
have ability to solve the problems by themselves, they are competent to accomplish
their duties. They have their own authority to make some decisions, and they like the
feeling of accomplishing difficult tasks. The most obvious fact in public hospitals is
that they are sure that they are proud of being met the health needs of the community.
Thus, they are motivated by the desire to meet the health needs of the community.
The self-actualization needs are also positively affecting on motivation. They
want to make a decision by themselves for some treatment. Medical doctors like to
solve problems, and to execute their tasks with their ways. They can use their
judgment other related problems in medication. They are also happy with their career
success, and also happy with taking higher responsibilities at the hospitals. Because of
these needs, they are motivated at work.
However, physiological needs and social needs do not effect on motivation.
The overtime wages do not important to them. They do not expect the support, care,
and love from their colleagues and supervisors. They don’t get motivated by working
good relationships with colleagues at work.
Among the individual need factors, esteem needs and value and goals have the
strongest effect on motivation with standardized coefficient beta of 0.290 and 0.288.
In this analysis, the effect of individual needs factors on motivation is also conducted.
In order to find the organizational factors affecting motivation, multiple
regression analysis is also conducted. In this analysis, independent variables are
organizational factors (pay and financial incentive. training and supportive
supervision, promotion and education opportunity, relationship with co-workers, and
leadership and management practices) and the dependent variable is motivation. The
results from analysis on effect of organizational factors on motivation are shown in
Table (5.25).
83
Table (5.25) Results of Organizational Factors on Motivation
Independent
Variables
Unstandardized
Coefficients (B)
Standardized
CoefficientSig. Tolerance t VIF
BStd.
Error
Beta
(Constant) .
83
7
.140 .000 5.990
Pay and Financial
Incentive
.
10
3*
.057 .101 .070 .459 1.818 2.179
Training and
Supportive
supervision
-
.01
2
.062 -.013 .850 .282 -.190 3.545
Promotion and
Education
Opportunity
.52
6*
**
.062 .605 .000 .279 8.504 3.579
Relation with
Co-worker
.
27
5
.066 .225 .125 .489 4.179 2.044
Leadership and
Management
Practices
.37
3*
**
.054 .327 .000 .203 6.906 4.916
R .749
R Square .560
Adjusted R Square .553
F 79.312***Source: Survey Data (2019)
Dependent variable: Motivation
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.25), the multiple regression results for model 3, which
can be interpreted as follows: R2 is 0.560 and adjusted R2 is 0.553, with five
84
independent variables. This indicates that those independent variables can explain
55.3% variation in dependent variable. The value of F-test is 79.312 and its highly
significant at 1%.
According to the result, pay and financial incentive, promotion and education
opportunity, and leadership and management practices emerged as the significant
variables in explaining the variance in motivation. If one unit of pay and financial
incentive increases, 0.103 units in motivation level will increase. If one unit of
promotion and education opportunity increases, 0.526 units in motivation level will
increase. If one unit of leadership and management practices increases, 0.373 units in
motivation level will increase. By the results, pay and financial incentive is 10%
significant on motivation, promotion and education opportunity is highly significant
at 1% on motivation and leadership and management practices is also highly
significant at 1% on motivation.
According to the survey result, their motivation level is not too high (just
above average level). Similarly, their motivational level of payment and financial
incentive, promotion and education opportunity, and leadership and management
practices are also not too high. Therefore, it can he said that most of the medical
doctors are motivated by these factors at the average level in public hospitals.
Promotion and education opportunity have the strongest influence on
motivation. In public hospitals, medical doctors think that their hospital has a clear
and fair promotion policy. They have a chance to get study leave for further studies.
They can expect to get promotions and upward movement in their hospital.
Leadership and management practices are the second highest influence on
motivation. They have opportunities to provide opinions in decision making to solve
the problems of organization. There has an effective accountability system and there
have fair policies and procedures at this hospital. There has satisfactory leadership
style at this hospital. These factors make them feel motivated.
Pay and financial incentive is positively affecting on their motivation. They
motivate with their chances for salary increases. The income will be improved as they
get promoted and more experience. As a government employee, they like to get a
regular income. In a private hospital, they can receive the benefit as pension that they
85
can’t get at a public hospital. The payroll (wages, bonuses, etc.) in their organization
is fair.
Training and supportive supervision is not significant effect on motivation.
Their training period doesn’t have a good skill. They don’t have enough training and
supportive supervision for the internship of the doctors. They are not satisfied with the
in-service training they receive e.g. workshops, seminars, etc.
The relationship with co-workers is an insignificant effect on motivation. The
enthusiasm of working with their colleagues doesn’t make they feel motivated. Even
though there is collaboration between groups, they are not good at being motivated.
Promotion and education opportunity has the strongest effect on motivation
with standardized coefficient beta of 0.605. In this analysis, the effect of
organizational factors on motivation is also conducted.
The results from analysis on effect of job characteristics on motivation are
shown in Table (5.26).
Table (5.26) Results of Job Characteristics on Motivation
Independent
Variables
Unstandardized
Coefficients (B)
Standardized
CoefficientSig. Tolerance t VIF
BStd.
ErrorBeta
(Constant) .109 .133 .413 819
Skill Variety .218*** .083 .196 .009 .200 2.635 5.009
Task Identity .318*** .051 .304 .000 .470 6.277 2.126
Task Significance .371*** .067 .325 .000 .322 5.560 3.102
Autonomy .207*** .073 .199 .005 .227 2.856 4.404
Feedback -.140** .061 -.126 .022 .367 -2.294 2.721
R .810
R Square .657
Adjusted R Square .651
F 119.021***Source: Survey Data (2019)
Dependent variable: Motivation
86
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.26), the multiple regression results for model 4, which
can be interpreted as follows: R2 is 0.657and adjusted R2 is 0.651, with five
independent variables. This indicates that those independent variables can explain
65.1% variation independent variable. The value of F-test is 119.021 and its highly
significant at 1%.
According to the result, skill variety, task identity, task significant, autonomy,
and feedback emerged as the significant variables in explaining the variance in
motivation. If one unit of skill variety increases, 0.218 units with motivation will
increase. If one unit of task identity increases, 0.318 units in motivation will increase.
If one unit of task significant increases, 0.371 units in motivation will increase. If one
unit of autonomy increases, 0.207 units in motivation will increase. The feedback has
negatively effects on motivation. If one unit of feedback increases, 0.140 units in
motivation will decrease. By the results, these factors are highly significant at 1% on
motivation.
The skill variety has influences on motivation. They have many varieties in
skills to do in a public hospital. They can achieve a lot of achievements in the future
as this job has a good skill. This makes motivation for the doctors. The task identity
has influences on motivation. The hospital arranges jobs so that they have to do the
job from the beginning to end. Their tasks are simple and there is no confusion. Job
duties, job requirements and goals are clear and specific.
Task significant also influences on motivation. Their work is the cooperation
of the association. Their job in hospital is one that may affect a lot of other people by
how well the work is performed. Autonomy also influences on motivation. In their
hospital, it allows them to plan how doing the work. They have own decision how
they perform assigned tasks. They can share their opinion at the hospital.
Feedback has a negative effect on motivation. After finishing a job, they know
whether their performance well or not. They can see the good and bad results of
patients by themselves. Even though these results, especially bad results are not
totally due to their efforts and abilities. In public hospitals, patients may be suffering
from shortage of financial, physical and others. For these negative effects on patients,
87
medical doctors may be demotivated. In this analysis, the effect of job characteristics
on motivation is also conducted.
5.5 Analysis on Factors Affecting Job Satisfaction of Medical Doctors at
Public Hospitals in Yangon
The test is continued to analyze the effect of individual needs factor,
organizational factor, job characteristics on job satisfaction. This analysis is to test
Hypothesis (2): individual needs factors, organizational factors, and job
characteristics have a positive effect on job satisfaction of medical doctors at public
hospitals in Yangon. The results from analysis on factors affecting on job satisfaction
of medical doctors at pub lic hospitals in Yangon are shown in Table (5.27).
Table (5.27) Results of Factors Affecting Job Satisfaction
Independent
Variables
Unstandardized
Coefficients (B)
Standardized
CoefficientSig. Tolerance t VIF
BStandard
Error
Beta
(Constant) -.240 .154 .120 -1.560
Individual needs factor .264*** .052 .228 .000 .614 5.064 1.628
Organizational Factor .228*** .066 .189 .001 .414 3.453 2.414
Job Characteristics .566*** .071 .465 .000 .369 8.007 2.713
R .782
R Square .612
Adjusted R Square .608
F 164.373***Source: Survey Data (2019)
Dependent variable: Job Satisfaction
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.27), the multiple regression results for model 5, which
can be interpreted as follows: R2 is 0.612 and adjusted R2 is 0.608, with five
independent variables. This indicates those independent variables can explain 60.8%
variation in dependent variable. The value of F-test is 164.373 and its highly
88
significant at 1%.
According to the result, individual needs factors, organizational factors, and
job characteristics emerged as the significant variables in explaining the variance in
job satisfaction. If one unit of individual needs factor increases, 0.264 units in job
satisfactions level will increase. If one unit of organizational factor increases, 0.228 in
job satisfactions level will increase. If one unit of job characteristics increases, 0.566
units in job satisfactions level will increase. By the results, individual needs factor,
organizational factor, and job characteristics are highly significant at 1% on job
satisfactions.
However, according to the survey results, their job satisfaction level is not too
high (just above average level). Thus, it can be said that most of the medical doctors
are satisfied by their individual needs factors, organizational factors, and job
characteristics at the average level in public hospitals. Job characteristics had the
strongest effect on motivation with standardized coefficient beta of 0.465. The results
shown in Table (5.27) supported to Hypothesis (2).
The analysis is also conducted to test the effect of individual needs factors on
job satisfaction of medical doctors at public hospitals in Yangon. In this analysis,
independent variables are individual needs factors and the dependent variable is job
satisfaction. The results from analysis on effect of individual needs factors on job
satisfaction are shown in Table (5.28).
Table (5.28) Results of Individual Needs Factors on Job Satisfaction
Independent Variables Unstandardized
Coefficients (B)
Standardized
Coefficient
Sig. Tolerance t VIF
B Std. Err
Beta
89
or
(Constant) .092 .239 .700 .386
Value and Goals, .101 .082 .070 .218 .523 1.234 1.911
Physiological Needs .018 .021 .035 .404 .936 .836 1.068
Safety Needs .050 .043 .080 .245 .350 1.165 2.855
Social Needs .112** .060 .146 .061 .278 1.882 3.593
Esteem Needs .340*** .065 .277 .000 .602 5.248 1.662
Self-Actualization
Needs .241 .065 .279 .000 .295 3.701 3.393
R .694
R Square .482
Adjusted R Square .472
F 48.099***Source: Survey Data (2019)
Dependent variable: Job Satisfaction
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.28), the multiple regression results for model 6, which
can be interpreted as follows: R2 is 0.482 and adjusted R2 is 0.472, with seven
independent variables. Thus, the model has accounted for 47.2% of the variance in the
dependent variable. The value of F-test was 48.099 and its highly significant was at
1% level.
According to the result, social needs, esteem needs, and self-actualization
needs emerged as the significant variables in explaining the variance in job
satisfaction. If one unit of social needs increases, 0.112 units in job satisfactions level
will increase. If one unit of esteem needs increases, 0.340 units in job satisfactions
level will increase. If one unit of self-actualization needs increases, 0.24 units in job
satisfactions level will increase. By the results, esteem needs and self-actualization
needs are highly significant at 1% on job satisfactions level. A social need is 10%
significant on job satisfaction.
Although social needs does not influence on motivation, this influence on job
satisfaction. The medical doctors have a good relationships with colleagues at work.
They get encouraged to explore all sorts of career opportunities.90
The esteem needs are also influencing on job satisfaction. The doctors have
ability to solve the problems by themselves; they are competent to accomplish their
duties. They have own judgment to make some decisions, and they like the feeling of
accomplishing difficult tasks. The most obvious fact in public hospitals is that they
are sure that they are proud of being met the health needs of the community. Thus,
they are satisfied as meet the health needs of the community.
The self-actualization needs are also positively affecting on job satisfaction.
They want to make a decision by themselves for some treatment. Medical doctors like
to solve problems, and to execute their tasks with their ways. They can use their
judgment other related problems in medication. They are also happy with their career
success, and also happy with taking higher responsibilities at their hospitals. Thus,
they are satisfied when they fulfill self-actualization needs.
However, according to the survey results, their job satisfaction level is not too
high (just above average level). Thus, it can be said that most of the medical doctors are
satisfied by their social needs, esteem needs, and self-actualization needs at the average
level in public hospitals. Self-actualization needs and esteem needs have the strongest
effect on job satisfaction with standardized coefficient beta of 0.279 and 0.277. In this
analysis, the effect of individual needs factors on job satisfaction is also conducted.
The analysis is also conducted to test the effect of organizational factors on
job satisfaction of medical doctors at public hospitals in Yangon. In this analysis,
independent variables are organizational factors (pay and financial incentive, training
and supportive supervision, promotion and education opportunity, relationship with
co-workers, and leadership and management practices) and the dependent variable is
job satisfaction. The results from analysis on effect of organizational factors on job
satisfaction are shown in Table (5.29).
Table (5.29) Results of Organizational Factors on Job Satisfaction
Independent Variables
UnstandardizedCoefficients (B)
Standardized Coefficient
Sig. Tolerance t VIF
BStd.
Error
Beta
(Constant) .883 .138 .000 6.38491
Pay and Financialincentive .030 .056 .030 .594 .459 .533 2.179
Training andSupportiveSupervision
-.076 .061 -.089 .217 .282 -1.238 3.545
Promotion andEducation Opportunity
.585*** .061 .686 .000 .279 9.546 3.579
Relation withCo-worker
.197*** .065 .164 .003 .489 3.027 2.044
Leadership andManagement Practices
.220*** .064 .197 .002 .203 3.438 4.916
R .742
R Square .551
Adjusted R Square .543
F 76.220***Source: Survey Data (2019)
Dependent variable: Job Satisfaction
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.29), the multiple regression results for model 7, which
can be interpreted as follows: R2 is 0.551 and adjusted R2 is 0.543, with seven
independent variables. Thus the model has accounted for 54.3% of the variance in the
dependent variable. The value of F-test was 76.220 and its highly significant was at
1% level.
According to the result, promotion and education opportunity, relationship
with co-workers, and leadership and management practices emerged as the significant
variables in explaining the variance in job satisfaction. If one unit of promotion and
education opportunity increases, 0.585 unit in job satisfactions level will increase. If 92
one unit of relation with co-workers increases, 0.197 unit in job satisfactions level
will increase. If one unit of leadership and management practices increases, 0.220 unit
in job satisfactions level will increase. By the result, promotion and education
opportunity and relation with co-workers and leadership and management practices
are highly significant at 1% significant on job satisfaction.
Promotion and education opportunity has a significant effect on job
satisfaction. In public hospitals, medical doctors think that their hospital has a clear
and fair promotion policy. They have a chance to get study leave for further studies.
They can expect to get promotions and upward movement in their hospital. That
makes them feel satisfied.
The relationship with co-workers has a significant effect on job satisfaction.
They have friendly co-workers at their department. They have a chance the
collaboration with other departments. They have co-operation and understanding
among work groups. There has a clear channel of communication in their work place.
That makes them feel satisfied.
A leadership and management practice has significant variable in explaining
the variance in motivation. They have opportunities to participate in decision making
to solve the problems of organization. There has an effective accountability system
and there have fair policies and procedures at this hospital. There has satisfactory
leadership style at this hospital. These factors make them feel satisfied.
However, according to the survey results, their job satisfaction level is not too
high (just above average level). Thus, it can be said that most of the medical doctors
are satisfied by their promotion and education opportunity, relationship co-workers,
and leadership and management practices at the average level in public hospitals.
Promotion and education opportunity has the strongest effect on job satisfaction with
standardized coefficient beta of 0.686.
93
The analysis is also conducted to test the effect of job characteristics on job
satisfaction of medical doctors at public hospitals in Yangon. The results from
analysis are shown in Table (5.30).
Table (5.30) Results of Job Characteristics on Job Satisfaction
Independent
Variables
Unstandardized
Coefficients
Standardized
Coefficient
Sig. Tolerance t VIFB
Std.
ErrorBeta
(Constant) .142 .140 .311 1.014
Skill Variety .176** .087 .162 .044 .200 2.023 5.009
Task Identity .285*** .053 .278 .000 .470 5.339 2.126
Task Significance .208*** .070 .186 .003 .322 2.957 3.102
Autonomy .287*** .077 .282 .000 .227 3.755 4.404
Feedback -.040 .064 -.037 .529 .367 -.631 2.721
R .776
R Square .602
Adjusted R Square .596
F 94.107***Source: Survey Data (2019)
Dependent variable: Job Satisfaction
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.30), the multiple regression results for model 8, which
can be interpreted as follows: R2 is 0.602 and adjusted R2 is 0.596, with five
independent variables. The model has accounted for 59.6% of the variance in the
dependent variable. The value of F-test is 94.107 and its highly significant at 1%
level.
According to the result, skill variety, task identity, task significant, and
autonomy emerged as the significant variables in explaining the variance in job
satisfaction. If one unit of skill variety increases, 0.176 units with job satisfactions
level will increase. If one unit of task identity increases, 0.285 units in job
satisfactions level will increase. If one unit of task significance increases, 0.208 units
in job satisfactions level will increase. If one unit of autonomy increases, 0.287 units 94
in job satisfactions level will increase. By the result, skill variety, task identity, task
significant, and autonomy are highly significant at 1% level on job satisfaction.
The skill variety has influences on job satisfaction. They have many varieties
in skills to do in a public hospital. They can achieve a lot of achievements in the
future as they have to use multi skills at their jobs. This makes job satisfaction for the
doctors.
The task identity has influences on job satisfaction. The hospital arranges jobs
so that they have to do the job from the beginning to end. Their tasks are simple and
there is no confusion. Job duties, job requirements and goals are clear and specific.
Task significant also influences on job satisfaction. Their feeling of
meaningfulness and their importance in society are affecting on their job satisfaction.
Autonomy also influences on job satisfaction. In their hospital, it allows them to plan
how doing the work. They have own decision how they perform assigned tasks. They
can share their opinion at the hospital.
However, according to the survey results, their job satisfaction level is not too
high (just above average level). Thus, it can be concluded that most of the medical
doctors are satisfied by their skill variety, task identity, task significant, and autonomy
at the average level in public hospitals. Autonomy and task identity had the strongest
effect on job satisfaction with standardized coefficient beta of 0.282 and 0.278. In this
analysis, the effect of job characteristics on job satisfaction is also conducted.
5.6 Analysis on Impact of Motivation on Job Satisfaction of Medical Doctors
at Public Hospitals in Yangon
This analysis is to test: hypothesis 3, there is no multicollinearity effect of
motivation on job satisfaction of medical doctors at public hospitals in Yangon.
Regression analysis was conducted to test the effect of motivation on job satisfaction.
There was considered job satisfaction as independent variables while motivation was
the dependent variable. Regression analysis of motivation and job satisfaction are
shown in Table (5.31).
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Table (5.31) Analysis of Motivation and Job Satisfaction
Independent
Variable
UnstandardizedCoefficients Standardiz
ed Coefficient
Sig.Toleranc
et
BStanda
rdError
(Constant) 2.585 .103 .000 27.730Motivation .045 .028 .089 .112 1.000 1.595R .089R Square .008Adjusted R Square .005F 2.543***
Source: Survey Data (2019)
Dependent variable: Job Satisfaction
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.31), it is found that motivation has no significant effect
on job satisfaction. According to the results, they are motivated at work but they are
not satisfying in their work. They feel loyalty to this organization because of their
love on this professionalism. According to the theory, there is relationship between
motivation and job satisfaction. However, in public hospitals in Myanmar, medical
doctors are willing to take responsibility and enthusiastic to put their effort and to use
full potential of their talent with respect to their professionalism and their esteem need
(chance to study abroad for further higher degrees) although they are not satisfied
with their job regarding financial and non-financial rewards provided by government.
Thus, the hypothesis (3) is rejected in this case.
5.7 Analysis on Effect of Motivation and Job Satisfaction on Organizational
Commitment of Medical Doctors at Public Hospitals in Yangon
In this study, effect of motivation and job satisfaction on each of the
commitment dimensions are analysed.
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5.7.1 Effect of Motivation and Job Satisfaction on Affective Commitment
The analysis is conducted to test the effect of motivation and job satisfaction
on affective commitment of medical doctors at public hospitals in Yangon. This
analysis is partial fulfillment to test: Hypothesis (4), motivation and job satisfaction
have a positive effect on organizational commitment of medical doctors at public
hospitals in Yangon. The results are shown in Table (5.32).
Table (5.32) Results of Motivation and Job Satisfaction on Affective Commitment
Independent
Variables
Unstandardized
Coefficients
Standardized
Coefficient
Sig. Tolerance t VIFB
Standard
ErrorBeta
(Constant) 1.345 .108 .000 12.414
Motivation .615*** .056 .732 .000 .337 11.078 2.968
Job Satisfaction .002 .057 .002 .978 .337 .028 2.968
R .734
R Square .538
Adjusted R Square .535
F 182.847***Source: Survey Data (2019)
Dependent variable: Affective Commitment
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.32), the multiple regression results for model 10, which
can be interpreted as follows: R2 is 0.538 and adjusted R2 is 0.535, with one
independent variable. Thus the model has accounted for 53.5% of the variance in the
dependent variable. The value of F-test is 182.847 and its highly significant at 1%
level. Motivation is significant at 1% level. The coefficient of 0.615, means that the
motivation has a positive effect on affective commitment and it is expected that every
one unit increase in motivation level would increase the level of affective
commitment by 0.615 unit. Job satisfaction has no effect on affective commitment.
According to the results from analysis, the hypothesis (4) is partially supported.
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5.7.2 Analysis on Effect of Motivation and Job Satisfaction on Continuance
Commitment of Medical Doctors at Public Hospitals in Yangon
The analysis is also conducted to test the effect of motivation and job
satisfaction effect on continuance commitment of medical doctors at public hospitals
in Yangon. This analysis is partial fulfillment to test Hypothesis (4), motivation and
job satisfaction have positively affected on organizational commitment of medical
doctors at public hospitals in Yangon. The results from multiple linear regression
analysis are shown in Table (5.33).
Table (5.33) Results of Motivation and Job Satisfaction on Continuance
Commitment
IndependentVariables
UnstandardizedCoefficients
StandardizedCoefficients
Sig. Tolerance t VIFB
StandardError
Beta
(Constant) .699 .138 .000 5.082
Motivation .6
27
**
*
.070 .637 .000 .337 8.897 2.968
Job Satisfaction .048 .072 .048 .504 .337 .669 2.968
R .677
R Square .458
Adjusted R Square .454
F 132.489***Source: Survey Data (2019)
Dependent variable: Continuance Commitment
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in table (5.33), the multiple regression results for model 11, which
can be interpreted as follows: R2 is 0.458 and adjusted R2 is 0.454, with one
independent variable. Thus, the model has accounted for 45.4% of the variance in the
dependent variable. The value of F-test is 132.489 and it’s highly significant at 1%
level. Motivation is significant at 1% level. The coefficient of 0.615, means that the
100
motivation has a positive effect on continuance commitment and it is expected that
every one unit increase in motivation level would increase the level of continuance
commitment by 0.627 unit. Job satisfaction has not effect on continuance commitment.
According to the results from analysis, hypothesis (4) is partially supported.
5.7.3 Effect of Motivation and Job Satisfaction on Normative Commitment of
Medical Doctors at Public Hospitals in Yangon
The analysis is also conducted to test the effect of motivation and job
satisfaction effect on normative commitment of medical doctors at public hospitals in
Yangon. This analysis is partial fulfillment to test: Hypothesis 4, motivation and job
satisfaction have a positive effect on organizational commitment of medical doctors at
public hospitals in Yangon. The results from analysis are shown in Table (5.34).
Table (5.34) Results of Motivation and Job Satisfaction on Normative
Commitment
Independent
Variables
Unstandardized
Coefficients
Standardized
CoefficientsSig. Tolerance t VIF
BStandard
ErrorBeta
(Constant) .598 .120 .000 4.971
Motivation .600*** .062 .625 .000 .337 9.748 2.968
Job Satisfaction .148** .063 .150 .019 .337 2.348 2.968
R .752
R Square .566
Adjusted R Square .563
F 204.523***Source: Survey Data (2019)
Dependent variable: Normative Commitment
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.34), the multiple regression results for model 12, which
can be interpreted as follows: R2 is 0.566 and adjusted R2 is 0.563, with two
independent variables. This indicates those independent variables can explain 56.3%
variation in dependent variable. The value of F-test is 204.523 and its highly
significant at 1% level. The coefficient of motivation 0.600, means that the motivation 101
has a positive effect on normative commitment and it is expected that every one unit
increase in motivation level would increase the level of normative commitment by
0.600 unit. Similarly, the coefficient of job satisfaction 0.148 means that the job
satisfaction has a positive effect on normative commitment and it is expected that
every one unit increase in motivation level would increase the level of normative
commitment by 0.148 unit.
According to the result, motivation and job satisfaction emerged as the
significant variables in explaining the variance in normative commitment. The
motivation and job satisfaction are highly significant at 1% on normative
commitment. If one unit of motivation increases, 0.600 units in normative
commitment will increase. If one unit of job satisfaction increases, 0.148 units in
normative commitment will increase.
Medical doctors feel that they ‘ought’ it to their organization to continue
working in hospitals. They have the sense of obligation to stay in their hospitals. It is
necessary to keep staying here because of their loyalty. They need to cooperate with
the organization’s goals. They have a sense of obligation for their organization to
promote the society.
The standardized coefficient of motivation 0.625 is higher than the
standardized coefficient of job satisfaction 0.150. Therefore, motivation has a stronger
effect on normative commitment. According to the results from analysis, hypothesis
(4) is supported.
5.7.4 Motivation, Job Satisfaction and Organizational Commitment of Medical
Doctors at Public Hospitals in Yangon
The analysis is also conducted to test the effect of motivation and job
satisfaction on organizational commitment of medical doctors at public hospitals in
Yangon. This analysis is to test hypothesis (4), motivation and job satisfaction have
positive effect on organizational commitment of medical doctors at public hospitals in
Yangon. The results from analysis are shown in Table (5.35).
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Table (5.35) Results of Motivation and Job Satisfaction on Organizational
Commitment
Independent
Variables
Unstandardized
Coefficients
Standardized
CoefficientsSig. Tolerance t VIF
BStandard
ErrorBeta
(Constant) 1.001 .105 .000 9.526
Motivation .569*** .054 .695 .000 .337 10.567 2.968
Job Satisfaction .042 .055 .050 .448 .337 .759 2.968
R .736
R Square .542
Adjusted R Square .539
F 185.941***Source: Survey Data (2019)
Dependent variable: Organizational Commitment
Notes: ***Significant at 1% Level, **Significant at 5% Level, *Significant at 10% Level
As shown in Table (5.35), the multiple regression results for model 13, which
can be interpreted as follows: the model explains that the variation in overall level of
organizational commitment exists as R square value 0.542 and adjusted R2 is 0.539,
with two independent variables. This indicates those independent variables can
explain 53.9% variation in dependent variable. The coefficient of 0.569, means that
the motivation has a positive effect on continuance commitment and it is expected
that every one unit increase in motivation level would increase the level of
continuance commitment by 0.569 unit. Job satisfaction has not effect on
organizational commitment.
The typical five assumption of multiple linear regression analysis are checked
for all models. In this study, the data types and sample size are consistent with the
assumption of multiple linear regression analysis. These are shown in Appendix B.
Assumption one is “the relationship between the independent variables and the
dependent variable is linear”. Model 1,2,3,4,7, and 12 are satisfied for this
auuumption. The remaining models don’t satisfy in this assumption.
Assumption two is that there is no multicollinearity in data. This accumption
103
is to test that the independent variables are not too highly correlated. For the
assumption to be met ( no multicoliniarity is in the independent variables ), VIF
scores are well below 10 and tolerance scores to be above 0.2. All these criteria are
covered in this analysis. But, this test is not included in model 9. The assumption 2 is
not require for model 9.
Assumption three is that the variance of the residuals is constant. Scalter plot
of standardized residuals vs standardized predicted values showed no obvious signs of
funnel shape. Therefore, this assumption is also met. All models are satisfied with the
assumption.
Assumption four is that the values of the residuals are normally distributed.
According to P-P Plot, the closer the dots line to the diagram line, the closer to normal
the residuals are distributed. Therefore, this assumption is met in this analysis for
model 1,2,3,4,7, and 12. The remaining models don’t met in this assumption.
Assumption five is that there are no influential cases biasing the model. This
assumption tested by looking at the Cook’s distance values. All values is not over 1.
Thus, the assumption is also met for all models.
5.8 Results from Analysis
According to the research result, the effective points on motivation and job
satisfaction are shown below. Afterward, that motivation and job satisfaction are
effect on effective commitment, continuance commitment, and normative
commitment. The summarized are shown in Figure (5.1).
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Figure (5.1) Summarized Model for The Study
105
Job
.000
.000.000
.018
.070
.000
.009
.000
.002
.002
.000
.009
.000
.003
.044.000
.003
.000
.000
.000
.000.000
.019
Value and Goal
Individual Needs Factor
Safety Needs
Social Needs
Esteem Needs
Self-Actualization Needs
Pay and Financial IncentivePromotion and EducationRelationship with
Organizational Factors
Skill Variety
Task Identity
Task Significance
Job Characteristics
Autonomy
Feedback
Affective CommitmentContinuance CommitmentNormative Commitment
Organizational
.061
.000
Leadership and Management Practices
.000
.000
.000.000
.005
.022
Source: Research Finding
106
Individual needs factor which include values and goals, and safety needs,
esteem needs, and self-actualization needs are influence on motivation.
Organizational factor which include pay and financial incentive, promotion and
education opportunity, relations with co-workers, and leadership and good
management practices are influence on motivation. Job characteristics are positively
correlated with motivation. Feedback is negatively correlated with motivation.
Organizational factor which include promotion and education opportunity,
relations with co-workers, and leadership and management practices effect on job
satisfaction.
Some factors have joint effect on motivation and job satisfaction of medical
doctorss. Individual needs factors of esteem needs and self-actualization needs,
organizational factors of promotion and education opportunity and relation with co-
worker, and job characteristics are affecting on both motivation and job satisfaction.
Motivation of medical doctorss is significantly effect on all dimensions of
organizational commitment. Job satisfation of medical doctorss has influence on
normative commitment.
107
CHAPTER 6
CONCLUSION
This study was conducted with the aim of identifying the factors (individual
needs factors, organizational factors, and job characteristics) which influence on
motivation, job satisfaction, and analyzing the effect of motivation and job
satisfaction on organizational commitment. Based on the result of the data analysis,
this chapter presents the findings and discussion, suggestion and recommendation, the
policy implication, and needs for further studies.
6.1 Findings and Discussion
The finding of this study supported the importance of the factors that effect on
motivation, job satisfaction and then these two factors effect on organizational
commitment of medical doctors at public hospitals in Yangon. These factors are
measured from the medical doctor’s point of view. The results show that medical
doctors are moderately satisfied with their jobs.
As part of the preliminary analysis, demographic factors of the respondents in
the study are explored according to variables such as gender, marital status, age,
education, work experience, and position. According to the educational level, the
majority of respondents are M.Sc degree. According to the working experience of the
respondents, the majority of respondents have six to ten years’ services. Regarding
their position of respondents, the majority of the respondents are lecturer level.
According to the results, some of the factors indicate a separate effect on
either motivation or job satisfaction of medical doctors and other factors show a joint
effect on both motivation and job satisfaction.
Among six individual needs factors, values and goals, safety needs, esteem
needs, and self-actualization needs influence on motivation. Social needs, esteem
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needs, and self-actualization needs influence on job satisfaction. Esteem needs and
self-actualization needs have a joint effect on both motivation and job satisfaction of
medical doctors in public hospitals in Yangon. According to this result, it can be
concluded that motivation and job satisfaction of medical doctors at public hospitals
in Yangon largely depend on esteem needs and self-actualization needs. This finding
coincides with the previous literature on motivation and job satisfaction of the
employees. Thus, if the public hospitals focus on these factors, the medical doctors
will have a high level of motivation and job satisfaction.
The findings show that value and goals influence on motivation. This finding
coincides with the previous literature on motivation of the employees. It implies that
medical doctors value their work and set goals when they do everything. They set
their goals based on their own interest and plans for the future. Moreover, they value
the outcomes as well as medical professional experience from their jobs. In the public
hospitals, medical doctors like to set own targets and goals for both short and long
term. They also have the experience, ability, and skills to set own goals, and they are
happy to see the outcomes of their goals. They also value their job and position at
public hospitals. They value their professional experience in medicine. They joined
the organization with good intentions and the value of this job. Their value and goal
make a good effort to motivate the doctor’s work. If they value their professional
experience in medicine and reach their goals, they are motivated in the work.
It is found that safety needs has a significant effect on motivation. This finding
coincides with the previous literature on motivation of the employees. Safety needs of
medical doctors can enhance their motivation because they believe this job has a
sense of security for life. They also believed that this government’s work is strong for
them. Although health-sector incomes are low; for example, a doctor gets an average
of K 250,000 and 400,000 a month, safety needs can enhance motivation. It is
believed that self-motivation and the prestigious image of being a government officer,
dedications and sense of professionalism are the main factors for medical doctors to
remain in the low-paying public service. Low salary can be compensated by private
practice after office hours or earnings from other second jobs or both. Their job can
create a safe and secure work environment for them. Their job as government servants
is reliable for life. That makes motivation of doctors in public hospitals.
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The findings show that esteem needs of medical doctors have a significant
effect on both motivation and job satisfaction. This finding coincides with the
previous literature on motivation and job satisfaction of the employees. It implies that
esteem needs of medical doctors can enhance their motivation and job satisfaction
because having confidence in the doctor’s self-confidence makes the work successful
at the work. They can solve most of the problems if they invest the necessary effort
and they are learning new knowledge for personal growth and development that exist
throughout their life. Medical doctors need self-esteem, and self-confidence to be
accepted and valued by others. Medical doctors feel proud of accomplishment they
get from the job. If they are able to accomplish their esteem needs, they are more
motivated and have job satisfaction. Medical doctors need to support accept and
respect of others and to have self-confidence to succeed in their work.
This finding regarding self-actualization need effect coincides with the
previous literature on motivation and job satisfaction of the employees. Self-
actualization needs of medical doctors can enhance their motivation and job
satisfaction because they can achieve their full potential and they have authority to
make a decision, taking responsibility on their job. They have the ability to meet the
health needs of the community. They want to make their own decision in this position.
If they have self-actualization needs, they work hard to become what they want to be
in life and reach their full potential. Thus, medical doctors need the authorization for
them to take responsibility to succeed in their work.
Although social needs do not influence on motivation, it influences on job
satisfaction of medical doctors at public hospitals in Yangon. They need to enjoy
doing their profession. They want to get good relationships with colleagues at work.
As they want social pleasure in public hospitals, they need mutual understanding
among colleagues in their hospital and department. If they are able to help each other,
they are satisfied.
Among five organizational factors, pay and financial incentive, promotion and
education opportunity, and leadership and management practices are significant
effects on motivation. Promotion and education opportunity, relationship with co-
workers, and leadership and management practices are significant effects on job
satisfaction. According to this result, it can be concluded that motivation and job
110
satisfaction of medical doctors in public hospitals in Yangon largely depend on
promotion and education opportunity and leadership and management practices. Thus,
if the management of public hospitals focuses on these factors, the medical doctors
will have a high level of motivation and job satisfaction.
This study finds out that pay and financial incentive is the significant effect on
motivation, but not effect on job satisfaction. This finding coincides with the previous
literature on motivation of the employees. Although the salary of this job is not
satisfactory, the medical doctors can earn extra income from private practice after
office hours or earnings from other second jobs or both. If the hospital management
can increase the salary and compensation to motivate the medical doctors, the best
payback can be one of the key factors affecting motivation, also in this way one can
increase the service quality.
The finding of the study shows that promotion and education opportunity is
the strongest effect on both motivation and job satisfaction. This finding coincides
with the previous literature on motivation and job satisfaction of the employees. The
greater the chances for advancement within the organization, the higher is likely to be
level of motivation and job satisfaction expressed by the medical doctors. The main
purpose of the medical doctors is to take the next study to get a promotion. The
chance for further study is only available in public hospitals. They get sufficient
opportunity for personal and professional development at work. If they are able to get
promotion, education opportunity and upward movement in their hospitals, they are
satisfied with their jobs.
The finding shows that good relationship with co-workers influences on job
satisfaction. This finding coincides with the previous literature on motivation and job
satisfaction of the employees. A good relation with co-worker and good work
conditions can increase medical doctors’ job satisfaction and they will try their best.
Job satisfaction through interpersonal relationship can be achieved through good
relationships with co-workers and supervisors, effective workplace, conflict
resolution, team participative decision-making and good communication with
appropriate feedback. Positive relationship may likely to create positive learning
environment among the colleagues and teamwork. They can get the main attribute
influencing the co- worker satisfaction in groups working, responsibilities of
111
colleagues, intelligence and friendly behavior of a colleague, and competency of
colleagues. Collaboration and clarity of communication of medical doctors can
increase job satisfaction. They have a good working relationship with their
colleagues. If they are able to get a job efficiently with their colleagues, that are
improving their job satisfaction.
Also, it is found that leadership and management practices are significant on
both motivation and job satisfaction. It implies that there has good supervision and
fair and equal management style in their hospitals. This may be due to the fact that
leadership and management practices are efficient and effective policy to accomplish
a job. The cause of medical doctor’s job satisfaction is the respect and recognition
they receive from hospital management. The respect and recognition are highly
important, especially for medical doctors who are direct contact with patients,
patients' relatives, peers and other health care team members. Recognition from
managers for good performance is vital in increasing motivation and job satisfaction
and is central to boosting morale. The medical doctors expect that their supervisor’s
leadership and management practices are supporting them to upgrade their motivation
in the workplace.
The public hospitals need to pay close attention to the insignificant effect of
the failure to come up with positive results. The result shows that training and
supportive supervision is not affected on both motivation and job satisfaction. There
has not enough training and supportive supervision in public hospitals. They have no
chance to participate in training activities to obtain ongoing training. The number of
participants is limited to attend seminars and workshops. There has not enough skilled
staff in their work and the areas of the hospital are not enough for patients. Heavy
workloads and lack of effective training mean that they do not have the time or the
ability to get good performance. Although it’s important for an individual to
continuously learn new skills and practices in order to grow in their field, showing
that hospitals have not concrete training and development programs. Management
should discourage incidences of irrelevant training. Irrelevant training wastes money
and time both for the individual concerned and the hospitals. Career advancement
would only be facilitated if employees go for courses that address training needs as
“identified” in staff appraisals according to the performance improvement plan.
112
According to the results from job characteristics, skill variety, task identity, task
significant, autonomy, and feedback influence on motivation. Skill variety, task
identity, task significant, and autonomy influence on job satisfaction.
This findings show that the skill variety has a positive and a significant effect
on both motivation and job satisfaction. This finding coincides with the previous
literature on motivation and job satisfaction of the employees. Whenever medical
doctors are given an opportunity to make best use of their talents and skills, they
would consider the job as a way of gratifying their aspirations and goals. Their job is
a good match for their skills and responsibilities. They have a chance to use the wide
variety of different skills and talents. Medical doctors who can apply a variety of job
skills have greater autonomy on the job, find greater challenges in their jobs, and tend
toward greater motivation and organizational commitment. Their job requires a lot of
skills and very important for society. This can lead to motivation. According to the
result, it can be interpreted that motivation and job satisfaction of medical doctors in
public hospitals in Yangon largely depend on skill variety.
Regarding the task identity, through analysis revealed that task identity is the
significant and positive effect of motivation and job satisfaction. This finding
coincides with the previous literature on motivation and job satisfaction of the
medical doctors. This factor is the most significant characteristics in performing the
task. The hospital arranges jobs so that they have to do the job from beginning to end.
Job duties, requirements and goals are clear and specific. There are specifically
assigned to their duties and they believe that their jobs are effective for the
community. Thus, it can be interpreted that motivation and job satisfaction of medical
doctors in public hospitals in Yangon largely depend on task identity.
The task significant is an important effect on both motivation and job
satisfaction. This finding coincides with the previous literature on motivation and job
satisfaction of the employees. This may be due to the fact that their job in hospital is
one that may affect a lot of other people by how well the work is performed. The job
in a hospital is very significant and important in the broader scheme of things and it
can influence the day-to-day success of the hospital. Their task assignments are
important in their hospital. This determines the strength of motivation and job
satisfaction. According to the result, it can be interpreted that motivation and job
113
satisfaction of medical doctors in public hospitals in Yangon largely depend on task
significant.
The autonomy is an important effect on both motivation and job satisfaction.
This finding coincides with the previous literature on motivation and job satisfaction
of the employees. There has freedom to decide how they perform assigned tasks. The
hospital provides the opportunity for independent thought and action. There has
freedom to decide how they perform assigned tasks. According to the result, it can be
interpreted that motivation and job satisfaction of medical doctors in public hospitals
in Yangon largely depend on autonomy.
The study found that feedback has a negative effect on motivation. This may
be due to the fact that medical doctors are not optimistic about their contributions and
performance. This is not inspiring them to work even harder. They have a bad
impression from patients about their treatment. The medical doctors receive
information and feedback from their performance. It can be timely known whether
their performance is efficient or not. When they receive a negative sense of feedback
from their patients, they are not motivated in the job.
In this study, it also finds out the organizational commitment of public
hospitals in Yangon. Here, the commitment is divided into three components; namely
affective commitment, continuance commitment, and normative commitment. The
study suggests that there is moderate level of mean value, moderate level commitment
of the medical doctors at public hospitals in Yangon.
Regarding the effective commitment, motivation has significant effect on
affective commitment, but job satisfaction has no effect on affective commitment.
According to this result, it can be interpreted that affective commitment of medical
doctors in public hospitals in Yangon largely depends on motivation. They have
strong believed in the organization and acceptance of the organizational goals and
values, put effort for the organization, and a strong desire to join and keep working in
the organization. When individuals fully embrace the goals and values of the
organization, they become emotionally involved with the organization and feel
personally responsible for the organization's level of success. These individuals
usually demonstrate high levels of performance, positive work attitudes, and a desire
to remain with the organization. They have responsibility for a job in the organization. 114
They always display a sense of pride to the organization and feel themselves as part of
the organization. From this result, that motivation has a significant positive effect on
effective commitment. They have ‘want’ feelings of affective commitment.
Regarding the continuance commitment, motivation is a significant effect on
continuance commitment, but job satisfaction is not affected on continuance
commitment. According to this result, it can be interpreted that continuance
commitment of medical doctors at public hospitals in Yangon largely depends on
motivation. Medical doctors stay a long time here because of costs associated with
leaving. They are going to continue this job to get a good experience and further
learning to get a higher degree. They need to get a lot of new study from this job.
They have the ‘need’ feeling of continuance commitment.
Regarding the normative commitment, motivation and job satisfaction are
significant effect on normative commitment. It can be interpreted that normative
commitment of medical doctors at public hospitals in Yangon largely depends on
motivation and job satisfaction. Since the respondents are more ethically responsible
for their hospital if the hospital provide motivation for them. When individuals remain
with an organization based on expected standards of behavior or social norms, these
individuals value obedience, cautiousness, and formality. Research suggests that they
tend to display the same attitudes and behaviors as those who have affective
commitment. Thus, if the management of public hospitals focuses on motivation and
job satisfaction, the medical doctors will have high levels of normative commitment.
Regarding the organizational commitment, motivation is a significant effect
on organizational commitment. But job satisfaction has no significant effect on
organizational commitment. According to this result, it can be interpreted that
organizational commitment of medical doctors at public hospitals in Yangon largely
depends on motivation. They are considered as members of their organizations and
their attachment to the organization. Because they are passionate, medical doctors are
actively participating in their work and their commitment to their organization. Thus,
if the public hospitals have focused on motivation, the medical doctors will have a
high level of organizational commitment.
According to the assumptions of multiple linear regression, some model meet
with all assumptions. But, some models are not satisfy with some assumptions. Thus, 115
the findings from that models could have some weaknesses.
In summary, the study identifies the most influential factors on motivation and
job satisfaction and these two factors effect on organizational commitment. The study
shows that motivation is the most influential factor on affective commitment,
continuance commitment, and normative commitment of medical doctors at public
hospitals in Yangon. Job satisfaction is the effect on normative commitment, but not
effect on others. Whenever there is an increase in motivation, it will create
organizational commitment.
At public hospitals, some medical doctors are motivated without job
satisfaction. But, some are satisfied with their jobs without motivation. On the other
side, some would be satisfied with their jobs as well as they would be motivated to be
good at work because they can fulfill the needs at their organizations.
6.2 Suggestions and Recommendations
Based on the findings, some relevant recommendations and suggestions can be
made for the improvement of public hospitals. Understanding the influencing factors
affecting doctors’ motivation and job satisfaction will be useful for the organization in
order to manage and maintain the potential and skillful medical doctors within the
organization. On the other hand, motivated and satisfied medical doctors commit to
the organization and increase service quality. The motivated staff will out-perform
their tasks.
From the practical perspective, this study provides key information that makes
helpful for policy makers. It is very important to improve the motivation of medical
doctors.
Their goal is to become learners through continuous education and keep their
knowledge updated and current so that patients can be served effectively. Seminars
and workshops will provide medical doctors’ knowledge and skills to be able to adapt
to changes of technology, changes of treatment methods, and changes in health care
system and new ingredients will also increase knowledge as well as improve
awareness of medical issues. Medical doctors may also aim at becoming highly
specialized in one particular field. Specialization can be advantage individuals as it
116
can mean an increase in salary and enhancement in job responsibilities. Thus, the
management of public hospitals is suggested to improve medical doctors’ value and
goals. The hospital needs to inspire the fellow-workers with share vision, mission,
goals, targets and strategy and also ensure that all these are well understood by them.
The management of public hospitals needs to explore what types of program and
policy to match medical doctors’ value and goals with the hospital’s value and goals.
By developing a relevant program for the medical doctors, their motivation would be
increased and their commitment would be stronger in the current workplace.
The safety needs is very important for the motivation of medical doctors. They
feel that their job is reliable because the government is officially approved. They have
little stress related work, by following the guidelines of government for medical
doctors. They have been promoting standard and safe workplace. They are motivating
at their job due to this need. Thus, the management of public hospitals should explore
the policy to fulfill medical doctors’ safety needs. By developing relevant guidelines
for the medical doctors, their motivation would be increased and their commitment
would be stronger in the current workplace.
At public hospitals, the social needs is considered as one of the effects that
influence on job satisfaction. The positive and highly significant effect of social needs
implies that hospitals should pay particular attention to create enabling opportunities
for the social needs of medical doctors; improve conditions of work. Thus, the
organization is suggested to fulfill medical doctors’ social needs in the workplace to
increase job satisfaction. Thus, the management of public hospitals should explore the
policy about what they can do for this requirement. By developing relevant policy for
the medical doctors, their job satisfaction would be increased and their commitment
would be stronger in the current workplace.
It can be recommended that esteem needs is also important for both motivation
and job satisfaction. The medical doctors have ability to solve the problems by
themselves, they are competent to accomplish their duties, they have own judgment to
make some decisions, and they like the feeling of accomplishing difficult tasks. The
most obvious fact at public hospitals is that they are motivated by the desire to meet
the health needs of the community. They are motivating at work because they have
enough skills and they know their profession. If the medical doctors have the ability
117
to do their work well and able to solve problems at work, they can improve their work
efficiently and they can increase motivation. Thus, the management of public
hospitals should explore the policy to fulfill medical doctors’ esteem needs. By
developing relevant policy for the medical doctors, their motivation would be
increased and their commitment would be stronger in the current workplace.
It can be approved that self-actualization needs is also positively affecting on
both motivation and job satisfaction. Medical doctors have worked at public hospitals
like their authority to make decision, to solve problems, and to execute their tasks with
their ways. They are also happy with their career success, and also happy with taking
higher responsibilities at their hospitals. Because of this needs, they are motivating at
work. It can be concluded that most of the medical doctors are motivated by their self-
actualization needs at the average level of medical doctors. If the medical doctors have
the self-actualization needs to do their work well at work, they can improve their work
efficiently and they can increase motivation and job satisfaction. Thus, the management
of public hospitals should explore the policy to fulfill medical doctors’ self-
actualization needs. By developing relevant policy for the medical doctors, their
motivation would be increased and their commitment would be stronger in the current
workplace.
At public hospitals, pay and financial incentive is important to motivate for the
medical doctors. If the government offers a good salary and other benefits, it would
make happy and motivated to them. Pay system is particularly in relation to medical
doctor’s motivation and morale. Money is a good motivator and actually all medical
doctors work for money. A good salary and good compensations are key factors in
satisfying the job. If the medical doctors have sufficient pay and financial incentive to
do their work well at work, they can improve their work efficiently and they can
increase motivation. Thus, the management of public hospitals should explore the
policy to increase the salary about what they can do for this requirement. By
developing relevant policy for the medical doctors, their job satisfaction would be
increased and their commitment would be stronger in the current workplace
At public hospitals, promotion and education opportunity is considered as an
important factor for both motivation and job satisfaction. As expected, motivation and
satisfaction are high among medical doctors with higher occupational positions. This
118
can be attributed to having more control over the job and more decision making
attitude, along with a more central position between healthcare professionals, a valued
position within the hospital hierarchy, higher salaries and benefits linked to seniority
and more social recognition. The main purpose of the medical doctors is to take the
next study to get a promotion. They want to get sufficient opportunity to develop in
their work. They have prospects for promotion and upward movement in their
hospitals. Medical doctors do not want to stay at their current position and knowledge
level. Medical doctors always want to have improvement for them in some ways If
the medical doctors have promotion and education opportunity to do their work well
at work, they can improve their work efficiently and they can increase motivation and
job satisfaction. Thus, the management of public hospitals should explore what types
of promotion policy and what types of programs for educational opportunity are
important for medical doctors. By developing relevant programs for medical doctors,
their motivation would increase and their commitment would be stronger in the
current workplace.
Relationship with co-workers in this study has a positive and significant
contributory effect on job satisfaction of medical doctors. Job satisfaction through
interpersonal relationship can be achieved through good relationship with co-workers
and supervisors, effective workplace conflict resolution, team participative decision-
making and good communication with appropriate feedback. The public hospitals are
suggested to develop a positive relationship with their co-workers because such
positive relationship may be more likely to learn from each other and team work.
Thus, the management of public hospitals should explore what types of policy and
what types of programs for interpersonal relationship are important for medical
doctors. By developing relevant programs for medical doctors, their job satisfaction
would increase in the current workplace.
The next factor is to improve leadership and good management practices of
public hospitals. The good management and relationship with their supervisor and fair
and equal management style has made motivate and satisfied the medical doctors in
their hospitals. If the management of public hospitals attempt to improve leadership
and management practices, it will improve organizations’ quality, efficiency and
outcomes. It can improve patient satisfaction scores and medical doctors take some
time to listen. They can reduce patient complaints and improve communication 119
between medical doctors and patients and improved continuity of care. Medical
doctors should be encouraged to involve in management process and management
responsibility relevant to their clinical duties. Thus, the management of public
hospitals should explore what types of policy and what types of programs for
management are effective for medical doctors. By developing relevant programs for
medical doctors, their motivation and job satisfaction would increase and their
commitment would be stronger in the current workplace.
The management of public hospitals must consider skill variety of medical
doctors. They have a chance to use the skills that they have to handle the problems in
their jobs. When solving the problems after evaluating a patient's symptoms and
making a diagnosis, doctors have to choose an appropriate treatment. To do this, they
will need critical thinking skills to compare available options. Excellent listening
skills allow physicians to understand their patients' symptoms and concerns. They
need superior verbal communication skills to explain diagnoses to patients and their
families and convey instructions and information about treatment to nurses and others
staff. Effective communication skills are essential to medical doctors that can help to
build a good doctor-patient relationship. The hospitals are suggested to improve the
skill variety of medical doctors to increase motivation. Thus, the management of
public hospitals should explore what types of policy are important for medical doctors
to improve skill variety. By developing the relevant program for medical doctors, their
motivation and job satisfaction would be increased in the current workplace.
Administrators must consider task identity. If their hospitals arrange the jobs to
do from the beginning to the end, the medical doctors have more attachment to the
workplace and increase motivation and job satisfaction. Job duties, job requirements
and goals should be clear and specific. The hospitals are suggested to improve task
identity of medical doctors to increase motivation and job satisfaction. Thus, the
management of public hospitals should explore what types of policy are important for
task identity of medical doctors. By developing the relevant program for medical
doctors, their motivation and job satisfaction would be increased in the current
workplace.
Task significant should be considered for motivation and job satisfaction of
medical doctors. They thought their job is important for the community. They can
120
make own decisions that significantly affect the workplace. The public hospitals
should improve task significant of medical doctors for their motivation and job
satisfaction. Thus, the management of public hospitals should explore what types of
policy are important for medical doctors. By developing the relevant program for
medical doctors, their motivation and job satisfaction would be increased in the
current workplace.
For the motivation and job satisfaction of medical doctors at public hospitals,
autonomy should be considered. According to the data, if the medical doctors have
the chance to participate in the decision making process and problem solving process
in the workplace to some extent, they have more attachment to the workplace and
motivation. The medical doctors’ autonomy refers to the working cultures in which
the medical doctors can make some decisions without referring higher authorities,
they can control work schedule by themselves, and they can give some opinions to a
higher management level. The public hospitals are suggested to empower of medical
doctors to improve motivation. The autonomous working culture for medical doctors
at public hospital is important to increase motivation and job satisfaction. Thus, the
management of public hospitals should explore more effective autonomous working
culture for medical doctors. By developing the relevant program for medical doctors,
their motivation and job satisfaction would be increased in the current workplace.
Public hospitals must consider feedback for their performance. It is a negative
effect on motivation. It shows that the public hospitals need to work on getting and
giving both positive and negative feedback to medical doctors in a timely and
effective way. It would be highly recommended that the hospital develop a positive
feedback that gives medical doctors by reducing bad impression of public.
Motivation should be considered for affective commitment of medical doctors.
They are strong believed the organization and acceptance of the organizational goals
and values, much effort for the organization, and a strong desire to join and keep
working at the public hospitals. They have loyalty to this organization. If they have
motivation in their work, they will have affective commitment and more willingness
to stay at work for a long time and they will not quit from the job. It can be
suggested that the hospitals should concentrate on motivational factors to improve
their motivation.
121
Motivation should be considered for continuance commitment of medical
doctors. To provide effective services to patients, their commitment to their
professional work is crucial. Their commitment is resulted from their motivation. It is
suggested that the organization should concentrate on motivational factors to improve
their motivation. If they have motivation in their work, they will have continuance
commitment and more willingness to stay at work for a long time and they will not
quit from the job. By developing the relevant program for medical doctors, their
motivation would be increased and commitment would be stronger in the current
workplace.
Motivation and job satisfaction has positive effect on normative commitment.
Since the respondents are more ethically responsible for their hospitals if the hospitals
provide motivation for them. They feel the obligation to remain in their current
hospitals. It is suggested that the organization should concentrate on the factors of
motivation and job satisfaction. If they have motivation and job satisfaction in their
work, they will have normative commitment and more willingness to stay at work for
a long time and they will not quit from the job. By developing the relevant program
for medical doctors, their motivation and job satisfaction would be increased and
commitment would be stronger in the current workplace.
In conclusion, the study contributed to the recommendation for individual
needs factors, organizational factors, and job characteristics that influence on
motivation and job satisfaction and organizational commitment of medical doctors at
public hospitals in Yangon. These proposed factors are required to consider by the
public hospitals and the future studies should test on these factors to create a more
complete model of motivation, job satisfaction and organizational commitment. In the
current study, commitment is divided into three components. The other for
organization and policy makers is that they are highly recommended to address
continuous learning in the workplace as suggested in this study as skilled doctors
found that education opportunity influenced their work motivation, on job satisfaction
and performance. Therefore, it could be a significant contribution to the organization
and policy makers to develop a learning policy in their organizations. It is also
suggested that the management of public hospitals should make policies that are clear,
objective and specific to improve worker motivation, satisfaction and performance of
the medical doctors in the workplace.122
It is important for every organization in different sectors to conduct a study on
motivation and job satisfaction and organizational commitment. Highly committed
medical doctors are the density of the organization including public hospitals in
today’s competitive environment. Therefore, it is the need of the time to be watchful
of their motivation and job satisfaction and which factors are related to this level of
commitment. The suggestions and recommendations made in this study can be taken
by the organization for further investigation of factors that are related to
organizational commitment. Satisfied medical doctors tend to be more loyal to
their organization. This may help the public hospitals in enhancing their reputation
and increase motivation and job satisfaction and organizational commitment.
6.3 Policy Implication
The result of this study has important implications for policy makers and
administrators. Policy makers can use results from this study for designing strategies
to further motivate the medical doctors and as a mean of improving their commitment.
For public hospitals in Yangon, the hospital has to implement the policy to
improve the values and goals of medical doctors at public hospitals. They entered the
field of medical workers to get a strong goal. That’s why, the policy makers have to
upgrade its program and design which can foster and motivate medical doctor’s
desirability and feasibility to establish their goals. The policy makers should make
efforts to achieve their goals. The management of public hospitals arranges to invite
the well-known and experienced specialist doctors to give training and to do seminars.
They need to discuss the useful topics for the medical field. Seminars and workshops
are done in order to be familiar with current issues of diseases occurred in society and
environment and methods for curing diseases and the best treatment. Medical doctors
are more motivated when their managers provide them with a clear sense of vision
and mission, listen to them and make them feel recognized and valued no matter what
their job. The essential task of management is to arrange organizational conditions
and methods of operation so that medical doctors can achieve their own goals by
directing their own efforts towards organizational objectives.
The management of public hospitals has to give its staff enough salaries and
facilities to fulfill their safety needs. It has a good command to make their intentions
123
as well as to achieve their goals. The hospital should provide its staff with a good
reputation so that they can work in public hospitals as trustworthy staff.
The management of public hospital encourages its staff by providing many
chances to have the further studies opportunity. They have to create a non-blocking
learning opportunity and a chance to learn more and to be continued to learn
education opportunity. It is recommended that management redesign medical doctors'
jobs to activate the achievement-oriented behavior. This can be done by giving them
more responsibility and by allowing them to make important decisions related to their
work. This would enable them to fulfill their need for achievement and enhance their
job satisfaction.
If the management of public hospitals wants to increase motivation and job
satisfaction of medical doctors, there must be supportive promotion and give staff
opportunities for advancement. Management provides equal promotion opportunities
for medical doctors that would promote them to key positions and increase their
involvement in decision-making. All professional cannot obtain from continuing
education after qualification. Much of what is learned during graduate and post-
graduate education and training become quickly outdated. The continuing
professional development is responsible for individual professional, hospitals and
professional organizations to update their knowledge and improve their skills. The
organization has concerned with adequate production and deployment of skillful
medical doctors in the healthcare system. Highly qualified medical doctors (Master on
doctorate degree holder) have to employ in all public hospitals. That diplomats or
trained medical doctors may be more appointed in all public hospitals. Therefore
qualified medical doctors have to produce in adequate numbers and deployed.
To flourish high standard of patient-centered medical care, they have to
develop effective leadership and better management of hospitals. Health care
professional from respective department should involve in some management process
in addition to their clinical responsibility. The medical doctors have to be able to
understand the instructions of the work guidance in hospitals. The hospitals have to
improve the leadership and guidance of each of departments and the coordination of
the whole hospital association. As for the healthcare level, the hospital management
course is also important. To improve the management, the organization has to invite
124
professionals who are good at management and deal with them. In addition to the
course of medical education, there has required to join the management department
with planning, human resources management, financial management, information/
monitoring and management of stock.
The hospital has to create a good working relationship with their colleagues.
Collaboration and clarity of communication of medical doctors can increase
motivation. Management requires a keen understanding of human nature, the
physiological needs and wants and abilities of people. The hospital has to create a
better relationship between co-workers and provide to help each other. The hospital
has clear role and responsibilities, national standard of care, clinical guidelines,
protocols, ethical standards and regular meeting.
6.4 Needs for Further Study
The study has been limited to 10 hospitals in Yangon and 317 respondents
who had been sampled by the judgment sampling method. The study has not covered
entire district. Moreover, the study has focused the medical doctors working at public
hospitals only, and it has not studied the medical doctors working at private hospitals.
The study has not covered other category of staff in the hospital. Other occupational
groups in the hospital such as nurses, radiographers, laboratory technicians and so on
have not been studied here. The recommendation for further researches would be
provided in the exploration of new models or modifying the proposed model to gain a
better understanding of the relationship between motivation, job satisfaction and
organizational commitments.
Moreover, the result of this study cannot also be extended to private hospitals
as the facilities, working environment and infrastructure will vary from place to place
and organization to organization. The present study furnishes a good base for future
research. The future research scholars can undergo researches in a number of ways
from the findings of this study. The future research can be undertaken to cover the
entire district or other districts with large number of samples. The impact of
motivation and job satisfaction can be studied from point of other variables such as
performance, morals and job engagement.
Further researchers are recommended to find out further influencing factors 125
that are so important to an organization and focus on the reasons why these factors are
important for organizations. Further researchers are recommended to compare the
level of organizational commitment between public and private hospitals in Yangon.
The study focuses only on quantitative measurement which would limit information
on target area. A greater depth of information can be obtained by integrating
qualitative and quantitative methods in further researches on motivation, job
satisfaction and organizational commitment.
Finally, it is important for organizations to understand what actually the
medical doctor needed and wanted in order to improve the organizational
commitment. This is because medical doctors from different hospitals have different
expectations based on their job.
126
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APPENDIX A
Questionnaire for “Individual Needs Factors, Organizational Factors, Job Characteristics and Motivation, Job Satisfaction and Organizational Commitment of Medical Doctors at Public
Hospitals in Yangon, Myanmar”
The questionnaire survey is intended for my research. I am doing a research the influencing factors of individual needs factors, organizational factors, and job characteristic. These factors are effecting on motivation, job satisfaction and that effect on organizational commitment of medical doctors at public hospitals in Yangon. The information you provide will remain definitely confidential and will be used only for dissertation purpose only. So, I would like to request you to answer completely and truly.
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Section A. Profile of Respondents
1. Gender
Male Female
2. Marital Status
Single Married
3. Age (Years)
30 30-40 40-50 50 ≤
4. Education
M.B.B.S M.Sc. Doctorate MRCP Others
5. Work experience (years)
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Up to 5 6-10 11-15 16-20 Above 25
6. Position --------------------------------
Section B.
Please write (Â) at the cell which you would prefer in the table
and answer . Please indicate the extent to which you agree or disagree with the statenebts in the table.
Where 1 = Strongly Disagree, 2 = Disagree, 3 = Neither Agree Nor Disagree, 4 = Agrree, 5 = Strongly Agree.
(I). Individual Needs Factor
Value and Goals 1 2 3 4 5
1 I set goals to achieve what I think is important.
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2 I feel my self meaningful of life when I reached my
goals.
3 I set goals based on my own interests and plans for the
future.
4 I set detail objectives to track my progress.
5 I feel the goals of the organization are as important to
me as my goals.
6 I set short-term goals to help me achieve my long-term
goals.
7 I have valuable outcomes of my job.
8 I have valuable on medical professional experience.
9 I appreciate my responsibility in a public hospital.
Needs 1 2 3 4 5
Physiological Needs
1 The pension is important to me at my old age (after 60).
2 The salary from my job is important to me.
3 The overtime wages are important to me.
4 The housing allowance is important to me
Safety Needs
1 It’s important to safe on this job as a government staff.
2 It’s important to earn extra income by working outside
during out of working hours.
3 It’s important to free from stress by following the
guidelines of government for medical staff.
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4 It’s important to have sufficient support to protect
from infectious diseases.
Social Needs
1 It’s important to get social pleasure at work as a big
happy family in public hospital.
2 It’s important to feel myself as an important role of my
hospital.
3 It’s important to have good relationships with
colleagues at work.
4 It’s important to get encouraged to explore all sorts of
career opportunities.
5 It’s important to feel mutual understanding among
colleagues in my hospital and department.
Esteem Needs
1 It’s important to feel competent at work.
2 It’s important to get respect from others due to this job.
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3 It’s important to get the feeling of accomplishment
from the job.
4 It’s important to solve most problems successfully if I
invest necessary effort.
5 It’s important to respect myself from working in the
public hospitals.
Self- Actualization Needs
1 It’s important to have ability to meet the health needs of
the community.
2 It’s important to use my judgment other related
problems in medication.
3 It’s important to use my full capacity at my work.
4 It’s important to execute my tasks in my own way.
5 It’s important to achieve success in my work.
6 It’s important to have chances for independent thought
and action in my position
II. Organizational Factors
How would you rate the following organizational factors?
160
Scales 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree,
5= Strongly Agree
Organizational Factors 1 2 3 4 5
Pay and financial incentive
1 I have enough salary from this job.
2 I am very satisfied with the benefit (vacation, medical
leaves, pension, etc.) I receive.
3 My salary is adequate for my living expenses.
4 The payroll (wages, bonuses, etc.) in my organization is
fair.
5 I am satisfied with my chances for salary increases.
6 I like with the compensation I get and I think it matches
with my responsibility.
Training and supportive supervision
1 My seniors delegate to me and provide supportive
supervision.
2 My hospital allows the doctors to have enough time to
learn new skills for the future.
3 I am satisfied with the in-service training I receive.
(Workshops, seminars, etc.).
4 I have been provided the training needed to succeed in
my position.
5 I have a chance to participate in training activities to
obtain ongoing training.
6 I am satisfied with the support (advice, coaching) from
my supervisors.
161
Promotion and Education Opportunity
1 I have many opportunities to develop in my work
(seminars, workshops, conference).
2 My hospital has a clear and fair promotion policy.
3 I have a chance to get study leave for further studies.
4 I can expect to get promotions and upward movement
in my hospital.
Relation with co-workers1 I have friendly co-workers at my department.
2 I have co-operation and understanding between work
groups.
3 I have good social relations that I get job satisfaction.
4 I can depend on my colleagues for support.
5 I have a chance the collaboration with other
departments.
6 I have a clear channel of communication in my
workplace.
Leadership and management practices1 There has satisfactory leadership style at this hospital.
2 There have good policies and procedures at this
hospital.
3 There exists an effective accountability system at this
hospital.
4 I have the quality of interaction with my supervisors.
5 I have opportunities to participate in decision making
to solve the problems of my organization.
III. Job Characteristics
162
How would you rote each of the following factors.
Scales 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5= Strongly Agree
Skill Variety 1 2 3 4 5
1 I have a lot of variety in skills to do in a public hospital.
2 The job is a good match for my skills and experience.
3 My hospital supports me with the required skills to do a
kind of work.
4 I would be very happy to spend the rest of my career
with this organization.
5 I am able to act independently of my supervisor in
performing my job function
6 I have chance to using a wider variety of
different skills and talents to complex my work
7 I have a chance to use the skill that I have to handle the
problem in my job
Task Identity
1 My hospital is arranged jobs so that I have to do the job
from the beginning to end.
2 I have a chance to do a piece of work until getting
patient satisfaction.
3 I can arrange jobs so that I may see projects through to
their final completion
163
4 My hospital is arranged jobs so that I have a chance to
discuss with patients/ clients and end users.
Task Significance
1 My job in a hospital is an integral part of the
organization.
2 My job in hospital is one that may affect a lot of other
people by how
well the work is performed
3 My job in a hospital is very significant and important in
the broader scheme of things.
4 My job in a hospital can influence the day-to-day
success of the hospital
5 My job in a hospital can influence the decisions that
significantly affect the workplace
6 Task assignment is efficient in my hospital.
Autonomy
1 My hospital provides for me the opportunity for
independent thought and action
2 I have the freedom to decide how I perform assigned
tasks.
3 In my hospital, it allows me to plan how I do my work.
4 I can be comfortable sharing my opinion at hospital.
5 In my hospital, it gives me a chance to make decisions
about what methods I use to complete my job
164
Feedback
1 The hospital shows me with information about my
performance.
2 The Supervisor provides me with feedback about my
activity.
3 After I finished a job, I know whether I performed well
or not.
4 I have clearly competent view of my work performance
5 I have timely information whether my job is efficient or
not
6 I also receive feedback from my co-worker about my
performance on the job
Section C.
I. Motivation Questionnaire
How would you rate each of the factors relating to motivation?
Scales 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree,
5= Strongly Agree
165
Motivation 1 2 3 4 5
1 I feel motivated to work as hard as I can
2 I always complete my tasks efficiently and
correctly.
3 I like the choice of medicine as a career.
4 I am actively involved in helping to make this a
great health care facility.
5 I find that my values and this health facility’s
values are similar.
6 I intend to continue further medical study.
7 I am enthusiastic about my contribution to the
organization.
8 My decision is to continue working in public
hospital.
II. Job Satisfaction Questionnaire
How would you rate each of the factors relating to job satisfaction.
1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5=
Strongly Agree
166
N
o
Job Satisfaction 1 2 3 4 5
1 I am satisfied with the job is a good match for my
skills and experience.
2 I am satisfied with my job has more advantages
than disadvantages.
3 I am satisfied with the ability to do my work well.
4 I am satisfied with the freedom to use my own
judgment.
5 I am satisfied to continue working in this job.
6 I am satisfied with the professional development
activities and promotion opportunity.
7 I am satisfied with the leadership and good
management practices.
8 I am satisfied with the valuable on medical
professional experience
Section D. Organizational Commitment Questionnaire
How would you rate each of the factors relating to commitment?
Scales 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree,
5= Strongly Agree
167
Organizational Commitment 1 2 3 4 5
Affective Commitment
1 I am willing to put in a great deal of effort beyond
that normally expected in order to help this
organization be successful.
2 I feel loyalty to this organization.
3 I would be very happy to spend the rest of my career
with this organization.
4 I would accept almost any type of job assignment in
order to keep working for this organization.
5 I really feel as if this organization's problems are my
own
6 I feel "emotionally attached" to this organization.
Continuance Commitment
1 It would be very hard for me to leave my
organization right now, even if I wanted to.
2 Too much of my life would be disrupted if I decided
I wanted to leave my organization now.
3 I feel that I have too few options to consider leaving
this organization.
4 I might not consider working elsewhere.
Normative Commitment
1 I feel obligation to remain with my current hospital.
2 I would feel guilty if I left my organization now.
3 This organization deserves my loyalty
4 I have responsibilities for patients in this hospital.
168
APPENDIX - B
RegressionModel Summaryb
Model R R Square
Adjusted R
Square
Std. Error of the
Estimate Durbin-Watson
1 .827a .685 .682 .42748 1.493
a. Predictors: (Constant), JCmean, IFmean1, OFmean1
b. Dependent Variable: Motivationmean1
ANOVAa
Model Sum of Squares Df Mean Square F Sig.
1Regression 124.112 3 41.371 226.396 .000b
Residual 57.196 313 .183
Total 181.308 316
a. Dependent Variable: Motivationmean1
b. Predictors: (Constant), JCmean, IFmean1, OFmean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients t Sig.Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) -.399 .142 -2.820 .005
IFmean1 .366 .048 .309 7.619 .000 .614 1.628
OFmean1 .236 .061 .191 3.881 .000 .414 2.414
JCmean .549 .065 .441 8.438 .000 .369 2.713
a. Dependent Variable: Motivationmean1
169
170
171
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .785a .617 .609 .47355 1.885
a. Predictors: (Constant), Selfmean, Basicmean, Esteemmean1, Safetymean, VGmean1, Socialmean
b. Dependent Variable: Motivationmean1
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 111.790 6 18.632 83.084 .000b
Residual 69.518 310 .224
Total 181.308 316
a. Dependent Variable: Motivationmean1
b. Predictors: (Constant), Selfmean, Basicmean, Esteemmean1, Safetymean, VGmean1, Socialmean
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) -.720 .211 -3.419 .001
VGmean1 .426 .072 .288 5.926 .000 .523 1.911
Basicmean .019 .018 .037 1.026 .306 .936 1.068
Safetymean .140 .038 .219 3.687 .000 .350 2.855
Socialmean .038 .053 .049 .729 .467 .278 3.593
Esteemmean1 .364 .057 .290 6.391 .000 .602 1.662
Selfmean .136 .057 .154 2.376 .018 .295 3.393
a. Dependent Variable: Motivationmean1
172
173
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .749a .560 .553 .50621 1.396
a. Predictors: (Constant), Paymean, Promomean, Relatimean, TSmean1, Leadermean1
b. Dependent Variable: Motivationmean1
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 101.616 5 20.323 79.312 .000b
Residual 79.692 311 .256
Total 181.308 316
a. Dependent Variable: Motivationmean1
b. Predictors: (Constant), Paymean, Promomean, Relatimean, TSmean1, Leadermean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) .837 .140 5.990 .000
TSmean1 -.012 .062 -.013 -.190 .850 .282 3.545
Promomean .526 .062 .605 8.504 .000 .279 3.579
Relatimean .275 .066 .225 4.179 .125 .489 2.044
Leadermean1 .373 .054 .327 6.906 .000 .203 4.916
Paymean .103 .057 .101 1.818 .070 .459 2.179
a. Dependent Variable: Motivationmean1
174
175
Regression
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 119.078 5 23.816 119.021 .000b
Residual 62.230 311 .200
Total 181.308 316
a. Dependent Variable: Motivationmean1
b. Predictors: (Constant), Feedmean, Taskmean, Autonomymean, TSignificantmean, Skillmean
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) .109 .133 .819 .413
Skillmean .218 .083 .196 2.635 .009 .200 5.009
Taskmean .318 .051 .304 6.277 .000 .470 2.126
TSignificantmean .371 .067 .325 5.560 .000 .322 3.102
Autonomymean .207 .073 .199 2.856 .005 .227 4.404
Feedmean -.140 .061 -.126 -2.294 .022 .367 2.721
a. Dependent Variable: Motivationmean1
176
Model Summaryb
Model R R Square
Adjusted
R
Square
Std. Error of
the Estimate
Change Statistics
Durbin-
Watson
R Square
Change F Change df1 df2
Sig. F
Change
1 .810a .657 .651 .44732 .657 119.021 5 311 .000 1.444
a. Predictors: (Constant), Feedmean, Taskmean, Autonomymean, TSignificantmean, Skillmean
b. Dependent Variable: Motivationmean1
177
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .782a .612 .608 .46410 1.754
a. Predictors: (Constant), JCmean, IFmean1, OFmean1
b. Dependent Variable: JSmean1
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 106.215 3 35.405 164.373 .000b
Residual 67.418 313 .215
Total 173.632 316
a. Dependent Variable: JSmean1
b. Predictors: (Constant), JCmean, IFmean1, OFmean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) -.240 .154 -1.560 .120
IFmean1 .264 .052 .228 5.064 .000 .614 1.628
OFmean1 .228 .066 .189 3.453 .001 .414 2.414
JCmean .566 .071 .465 8.007 .000 .369 2.713
a. Dependent Variable: JSmean1
178
179
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .694a .482 .472 .53858 1.878
a. Predictors: (Constant), Selfmean, Basicmean, Esteemmean1, Safetymean, VGmean1, Socialmean
b. Dependent Variable: JSmean1
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 83.711 6 13.952 48.099 .000b
Residual 89.921 310 .290
Total 173.632 316
a. Dependent Variable: JSmean1
b. Predictors: (Constant), Selfmean, Basicmean, Esteemmean1, Safetymean, VGmean1, Socialmean
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant)
.092 .239 .386 .070
VGmean1
.101 .082 .070 1.234 .218 .523 1.911
Basicmean .018 .021 .035 .836 .404 .936 1.068
180
Safetymean
.050 .043 .080 1.165 .245 .350 2.855
Socialmean
.112 .060 .146 1.882 .061 .278 3.593
Esteemmean1
.340 .065 .277 5.248 .000 .602 1.662
Selfmean
.241 .065 .279 3.701 .000 .295 3.393
a. Dependent Variable: JSmean1
181
182
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .742a .551 .543 .50088 1.789
a. Predictors: (Constant), Paymean, Promomean, Relatimean, TSmean1, Leadermean1
b. Dependent Variable: JSmean1
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 95.610 5 19.122 76.220 .000b
Residual 78.023 311 .251
Total 173.632 316
a. Dependent Variable: JSmean1
b. Predictors: (Constant), Paymean, Promomean, Relatimean, TSmean1, Leadermean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) .883 .138 6.384 .000
TSmean1 -.076 .061 -.089 -1.238 .217 .282 3.545
Promomean .585 .061 .686 9.546 .000 .279 3.579
Relatimean .197 .065 .164 3.027 .003 .489 2.044
Leadermean1 .220 .064 .197 3.438 .002 .203 4.916
Paymean .030 .056 .030 .533 .594 .459 2.179
a. Dependent Variable: JSmean1
183
184
RegressionModel Summaryb
Model R
R
Square
Adjusted
R Square
Std. Error
of the
Estimate
Change Statistics
Durbin-Watson
R Square
Change
F
Change df1 df2
Sig. F
Change
1 .776a .602 .596 .47135 .602 94.107 5 311 .000 1.716
a. Predictors: (Constant), Feedmean, Taskmean, Autonomymean, TSignificantmean, Skillmean
b. Dependent Variable: JSmean1
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 104.538 5 20.908 94.107 .000b
Residual 69.094 311 .222
Total 173.632 316
a. Dependent Variable: JSmean1
b. Predictors: (Constant), Feedmean, Taskmean, Autonomymean, TSignificantmean, Skillmean
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) .142 .140 1.014 .311
Skillmean .176 .087 .162 2.023 .044 .200 5.009
Taskmean .285 .053 .278 5.339 .000 .470 2.126
TSignificantmean .208 .070 .186 2.957 .003 .322 3.102
Autonomymean .287 .077 .282 3.755 .000 .227 4.404
Feedmean -.040 .064 -.037 -.631 .529 .367 2.721
a. Dependent Variable: JSmean1
185
186
Regression
Model Summary
Model R R Square Adjusted R Square
Std. Error of the
Estimate
1 .089a .008 .005 .73946
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 1.391 1 1.391 2.543 .112b
Residual 172.242 315 .547
Total 173.632 316
a. Dependent Variable: JSmean1
b. Predictors: (Constant), Meanmotivation
Coefficientsa
Model
Unstandardized Coefficients
Standardized
Coefficients
t Sig.B Std. Error Beta
1 (Constant) 2.858 .103 27.730 .000
Meanmotivation .045 .028 .089 1.595 .112
a. Dependent Variable: JSmean1
187
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .734a .538 .535 .43383 1.775
a. Predictors: (Constant), JSmean1, Motivationmean1
b. Dependent Variable: ACmean
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 68.826 2 34.413 182.847 .000b
Residual 59.097 314 .188
Total 127.924 316
a. Dependent Variable: ACmean
b. Predictors: (Constant), JSmean1, Motivationmean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) 1.345 .108 12.414 .000
Motivationmean1 .615 .056 .732 11.078 .000 .337 2.968
JSmean1 .002 .057 .002 .028 .978 .337 2.968
a. Dependent Variable: ACmean
188
189
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .677a .458 .454 .55087 1.905
a. Predictors: (Constant), JSmean1, Motivationmean1
b. Dependent Variable: CCmean
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 80.411 2 40.205 132.489 .000b
Residual 95.287 314 .303
Total 175.697 316
a. Dependent Variable: CCmean
b. Predictors: (Constant), JSmean1, Motivationmean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) .699 .138 5.082 .000
Motivationmean1 .627 .070 .637 8.897 .000 .337 2.968
JSmean1 .048 .072 .048 .669 .504 .337 2.968
a. Dependent Variable: CCmean
190
191
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .752a .566 .563 .48142 1.852
a. Predictors: (Constant), JSmean1, Motivationmean1
b. Dependent Variable: NCommean
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 94.803 2 47.402 204.523 .000b
Residual 72.775 314 .232
Total 167.578 316
a. Dependent Variable: NCommean
b. Predictors: (Constant), JSmean1, Motivationmean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) .598 .120 4.971 .000
Motivationmean1 .600 .062 .625 9.748 .000 .337 2.968
JSmean1 .148 .063 .150 2.348 .019 .337 2.968
a. Dependent Variable: NCommean
192
193
Regression
Model Summaryb
Model R R Square Adjusted R Square
Std. Error of the
Estimate Durbin-Watson
1 .736a .542 .539 .42073 1.926
a. Predictors: (Constant), JSmean1, Motivationmean1
b. Dependent Variable: OCmean
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 65.828 2 32.914 185.941 .000b
Residual 55.582 314 .177
Total 121.410 316
a. Dependent Variable: OCmean
b. Predictors: (Constant), JSmean1, Motivationmean1
Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF
1 (Constant) 1.001 .105 9.526 .000
Motivationmean1 .569 .054 .695 10.567 .000 .337 2.968
JSmean1 .042 .055 .050 .759 .448 .337 2.968
a. Dependent Variable: OCmean
194
195
Correlations
VG
mean1
Basic
mean
Safety
mean
Social
mean
Esteem
mean1
Self
mean
Motivation
mean1
VGmean1 Pearson
Correlation1 .043 .321** .402** .578** .625** .643**
Sig. (2-tailed) .447 .000 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Basicmean Pearson
Correlation.043 1 .213** .168** -.020 .055 .107
Sig. (2-tailed) .447 .000 .003 .718 .331 .057
N 317 317 317 317 317 317 317
Safetymean Pearson
Correlation.321** .213** 1 .795** .279** .639** .537**
Sig. (2-tailed) .000 .000 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Socialmean Pearson
Correlation.402** .168** .795** 1 .345** .736** .558**
Sig. (2-tailed) .000 .003 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Esteemmean1 Pearson
Correlation.578** -.020 .279** .345** 1 .550** .618**
Sig. (2-tailed) .000 .718 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Selfmean Pearson
Correlation.625** .055 .639** .736** .550** 1 .671**
Sig. (2-tailed) .000 .331 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Motivation mean1 Pearson
Correlation.643** .107 .537** .558** .618** .671** 1
Sig. (2-tailed) .000 .057 .000 .000 .000 .000
N 317 317 317 317 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
196
Correlations
VG
mean1
Basic
mean
Safety
mean
Social
mean
Esteem
mean1
Self
mean JSmean1
VGmean1 Pearson
Correlation1 .043 .321** .402** .578** .625** .490**
Sig. (2-tailed) .447 .000 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Basicmean Pearson
Correlation.043 1 .213** .168** -.020 .055 .089
Sig. (2-tailed) .447 .000 .003 .718 .331 .112
N 317 317 317 317 317 317 317
Safetymean Pearson
Correlation.321** .213** 1 .795** .279** .639** .481**
Sig. (2-tailed) .000 .000 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Socialmean Pearson
Correlation.402** .168** .795** 1 .345** .736** .544**
Sig. (2-tailed) .000 .003 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Esteem mean1 Pearson
Correlation.578** -.020 .279** .345** 1 .550** .542**
Sig. (2-tailed) .000 .718 .000 .000 .000 .000
N 317 317 317 317 317 317 317
Selfmean Pearson
Correlation.625** .055 .639** .736** .550** 1 .635**
Sig. (2-tailed) .000 .331 .000 .000 .000 .000
N 317 317 317 317 317 317 317
JSmean1 Pearson
Correlation.490** .089 .481** .544** .542** .635** 1
Sig. (2-tailed) .000 .112 .000 .000 .000 .000
N 317 317 317 317 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
197
Correlations
Pay mean
Promo
mean
Leader
mean1
Relati
mean TSmean1 JSmean1
Paymean Pearson
Correlation1 .279** .670** .343** .308** .249**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Promomean Pearson
Correlation.279** 1 .707** .661** .812** .730**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Leadermean1 Pearson
Correlation.670** .707** 1 .657** .731** .547**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Relatimean Pearson
Correlation.343** .661** .657** 1 .615** .573**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
TSmean1 Pearson
Correlation.308** .812** .731** .615** 1 .577**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
JSmean1 Pearson
Correlation.249** .730** .547** .573** .577** 1
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
198
Correlations
Pay
mean
Promo
mean
Leader
mean1
Relati
mean TSmean1
Motivation
mean1
Paymean Pearson
Correlation1 .279** .670** .343** .308** .299**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Promomean Pearson
Correlation.279** 1 .707** .661** .812** .725**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Leadermean1 Pearson
Correlation.670** .707** 1 .657** .731** .569**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Relatimean Pearson
Correlation.343** .661** .657** 1 .615** .608**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
TSmean1 Pearson
Correlation.308** .812** .731** .615** 1 .599**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Motivation mean1 Pearson
Correlation.299** .725** .569** .608** .599** 1
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
199
Correlations
Skill
mean
Task
mean
T Significant
mean
Autonomy
mean
Feed
mean
Motivation
mean1
Skillmean Pearson
Correlation1 .660** .742** .871** .713** .722**
Sig. (2-
tailed).000 .000 .000 .000 .000
N 317 317 317 317 317 317
Taskmean Pearson
Correlation.660** 1 .667** .641** .643** .697**
Sig. (2-
tailed).000 .000 .000 .000 .000
N 317 317 317 317 317 317
TSignificant mean Pearson
Correlation.742** .667** 1 .718** .751** .722**
Sig. (2-
tailed).000 .000 .000 .000 .000
N 317 317 317 317 317 317
Autonomy mean Pearson
Correlation.871** .641** .718** 1 .667** .714**
Sig. (2-
tailed).000 .000 .000 .000 .000
N 317 317 317 317 317 317
Feedmean Pearson
Correlation.713** .643** .751** .667** 1 .587**
Sig. (2-
tailed).000 .000 .000 .000 .000
N 317 317 317 317 317 317
Motivation mean1 Pearson
Correlation.722** .697** .722** .714** .587** 1
Sig. (2-
tailed).000 .000 .000 .000 .000
N 317 317 317 317 317 317
200
**. Correlation is significant at the 0.01 level (2-tailed).
Correlations
Skill
mean
Task
mean
TSignificant
mean
Autonomy
mean
Feed
mean JSmean1
Skillmean Pearson
Correlation1 .660** .742** .871** .713** .703**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Taskmean Pearson
Correlation.660** 1 .667** .641** .643** .666**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
TSignificant mean Pearson
Correlation.742** .667** 1 .718** .751** .667**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Autonomy mean Pearson
Correlation.871** .641** .718** 1 .667** .710**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
Feed mean Pearson
Correlation.713** .643** .751** .667** 1 .585**
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
JSmean1 Pearson
Correlation.703** .666** .667** .710** .585** 1
Sig. (2-tailed) .000 .000 .000 .000 .000
N 317 317 317 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
201
Correlations
Motivation
mean1 JSmean1 ACmean
Motivation mean1 Pearson Correlation 1 .814** .734**
Sig. (2-tailed) .000 .000
N 317 317 317
JSmean1 Pearson Correlation .814** 1 .598**
Sig. (2-tailed) .000 .000
N 317 317 317
ACmean Pearson Correlation .734** .598** 1
Sig. (2-tailed) .000 .000
N 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
Correlations
Motivation mean1 JSmean1 CCmean
Motivation mean1 Pearson Correlation 1 .814** .676**
Sig. (2-tailed) .000 .000
N 317 317 317
JSmean1 Pearson Correlation .814** 1 .567**
Sig. (2-tailed) .000 .000
N 317 317 317
CCmean Pearson Correlation .676** .567** 1
Sig. (2-tailed) .000 .000
N 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
Correlations
Motivation mean1 JSmean1 NCommean
Motivation mean1 Pearson Correlation 1 .814** .747**
202
Sig. (2-tailed) .000 .000
N 317 317 317
JSmean1 Pearson Correlation .814** 1 .659**
Sig. (2-tailed) .000 .000
N 317 317 317
NCommean Pearson Correlation .747** .659** 1
Sig. (2-tailed) .000 .000
N 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
Correlations
IFmean1 OFmean1 JCmean
Motivation
mean1
IFmean1 Pearson Correlation 1 .541** .609** .681**
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
OFmean1 Pearson Correlation .541** 1 .759** .693**
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
JCmean Pearson Correlation .609** .759** 1 .774**
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
Motivation mean1 Pearson Correlation .681** .693** .774** 1
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
Correlations
IFmean1 OFmean1 JCmean JSmean1
IFmean1 Pearson Correlation 1 .541** .609** .613**
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
OFmean1 Pearson Correlation .541** 1 .759** .665**
203
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
JCmean Pearson Correlation .609** .759** 1 .746**
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
JSmean1 Pearson Correlation .613** .665** .746** 1
Sig. (2-tailed) .000 .000 .000
N 317 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
Correlations
Motivation mean1 JSmean1 OCmean
Motivation mean1 Pearson Correlation 1 .814** .736**
Sig. (2-tailed) .000 .000
N 317 317 317
JSmean1 Pearson Correlation .814** 1 .616**
Sig. (2-tailed) .000 .000
N 317 317 317
OCmean Pearson Correlation .736** .616** 1
Sig. (2-tailed) .000 .000
N 317 317 317
**. Correlation is significant at the 0.01 level (2-tailed).
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APPENDIX – C
Reliability Test
Value and Goals Physiological Needs
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.888 9 .959 4
Safety Needs Social Needs
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.940 4 .939 5
Esteem Needs Self-Actualization Needs
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.827 5 .916 6
Pay and Financial Incentive Training and Supportive Supervision
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.915 6 .960 6
Promotion and Education
Opportunity Relations with Co-workers
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.948 4 .871 6
Leadership and Management
Practices Skill Variety
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.776 5 .920 7
Task Identity Task Significant
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.929 4 .933 6
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Autonomy Feedback
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.834 5 .960 6
Motivation Job Satisfaction
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.937 8 .929 8
Affective Commitment Continuance Commitment
Cronbach's Alpha N of Items Cronbach's Alpha N of Items
.939 6 .808 4
Normative Commitment
Cronbach's Alpha N of Items
.819 4
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APPENDIX – D
Assumption 1 is “the relationship between the independent variables and the
dependent variable is linear”. The first assumption of Multiple Regression is that the
relationship between independent variables and dependent variable can be
characterized by a straight line. This assumption can be tested by looking at the
distribution of residuals. This can be tested by reviewing the normal probability plot.
Assumption 2 is that “there is no multicollinearity in data”. This assumption is
to test that the independent variables are not too highly correlated. This can be done in
two ways. First, in correlation table, correlations of more than 0.8 may be
problematic. If this happens, it is needed to consider removing one or more of the
independent variables. Second, it can be conducted to more formally check on
independent variables are not too highly correlated. For the assumption to be met (no
multicolliniarity in independent variables), VIFs scores to be well below 10, and
tolerance scores to be above 0.2.
Assumption 3 is that “the variance of the residuals is constant”. This
assumption (assumption of homoscedasticity) is that variation in the residuals (or
number of error in the model) is similar at each point of the model. The scatter plot
should like a random array of dots. If the graph looks like a funnel shape, then it is
likely that this assumption has been violated.
Assumption 4 is that “the values of the residuals are normally distributed”.
This assumption can be tested by looking at the P-P plot for the model. The closer the
dots lie to the diagonal line, the closer to normal the residuals are distributed.
Assumption 5 is that “there are no influential cases biasing the model”. This
assumption can be tested by going back to the data file and looking at the Cook’s
distance values. Any values over 1 are likely to be significant outliers, which may
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place undue influence on the model, and should therefore be removed and analysis
rerun. All these assumptions are tested when making the multiple regression analysis
in this study.
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The validity and reliability of research measures are crucial parts of any survey, which must be assessed and examined in order to make sure of the goodness of the measures used in the research. A reliable research instrument may not be necessarily valid. In this study, the questionnaire is developed by referring to the previous research papers. After the pilot study, the items with Likert type scale are tested for reliability by calculating the Cronbach’s Alpha values and tested for validity.
Reliability is an indicator of the measure’s internal consistency. Internal consistence represents a measure’s homogeneity or the extent to which each indicator of a concept converges on some common meaning and it is measured by correlating scores on subsets of the items which make up a sale (Zikmund et al, 2010). It is used to ensure the degree to which measures are free from random error and therefore yield consistent results. Whenever a scale consists of more than one item, it is important to measure how much they are internally consistent. According to Sekaran (2003), reliability is a measure the concepts. Thus, the extent to which any measurement procedure produces consistent results over time and an accurate representation of the total population under study is referred to as reliability.
The study uses Cronbach’s Alpha as a measure of internal consistency. Cronbach’s Alpha is a reliability coefficient that indicates how well the items in a set are positively correlated to one another (Sekaran, 2003). It is computed in terms of the average interrelations among the items measuring the concept. In addition, Cronbach’s Alpha is range in value from 0, meaning no consistency, to 1, meaning complete consistency. Normally, the scales with a coefficient alpha between 0.80 and 0.90 are considered to have excellent reliability. The scale with a coefficient alpha between 0.70 to below 0.80 is considered as good reliability, while an alpha value between 0.60 to below 0.70 indicates acceptable reliability. The coefficient alpha is between 0.50 to below 0.60 indicates poor reliability, while an alpha value is below 0.50 is considered as unacceptable reliability (Maneikar et al, 2018).
After reliability analysis, the other important parts should be evaluated. These parts are Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy. The KMO statistic varies between 0 and 1. A value of ‘0’ indicates that the sum of partial correlations is largely relative to the sum of correlations, indicating diffusion in the pattern of correlations. A value close to 1 indicates that patterns of correlations are relatively compact and so factor analysis should yield distinct and reliable factors. Kaiser (1974) recommends accepting
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values greater than 0.5 as acceptable. Values below this should lead to either collect more data or rethink which variables to include.
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