Structural equation model Essay Example

a hidden variable that included seven dimensions identified by Stamps and Piedmont (1986). Fig. 1 visually represents this structural equation model.

Fig. 1. Structural equation model.n=713. Note: The rectangles and circle represent the squared multiple correlations. The arrows display the standardized regression weights. The findings suggest that all seven dimensions of satisfaction play a role in the model. However, pay has the least impact on the latent variable nurses' job satisfaction.

Significant findings indicated that the organizational-structure variables had a notable effect on the model. Specifically, centralization exhibited a substantial negative coefficient of -0.54, whereas formalization and specialization showed positive coefficients of 0.14 and 0.21 correspondingly. Moreover, these three structural variables were found to be correlated.

The model demonstrated that formalization and specialization were positively correlated, while centralization and specialization were negatively correlated. This indicates that centralized hospitals generally have low specialization, leading to lower satisfaction levels. To evaluate how well our model aligns with the data, we utilized goodness-of-fit statistics such as AGFI and CFI, which are appropriate for large samples. The model's fit was moderate, as indicated by an AGFI of 0.

The model had a CFI of 0.874 and explained 40% of the variance in nurses' job satisfaction, with a CFI of 0.874. The residual covariances were large for the pairs 'pay and tasks' and 'pay and organizational policies', indicating a relationship between these variables. Overall, pay was distinct from the other dimensions of satisfaction.

The inclusion of pay in the model would enhance the model. To sum up, pay was not considered significant in examining the connections between organizational structure and job satisfaction. This research specifically focused on the correlation between organizational structure and job satisfaction

among nurses in three general-care hospitals. Existing literature has shown that the relationship between organizational structure and nurses' job satisfaction varies depending on the aspect of satisfaction being studied. Nevertheless, our data also indicated that the relationships identified in previous studies were not universally applicable, as only two propositions could be validated and several of our findings contradicted the literature. The literature suggests that there are negative associations between centralization and satisfaction in relation to autonomy, interaction, organizational policies, and status, which our data supports. Therefore, we have accepted Proposition 1.

Although the level of centralization in the three hospitals was not particularly high (an average of 3.5 on a scale of 7), it was still perceived as being too high, which limited the autonomy of the nurses. According to Kramer and Schmalenberg (2003), the literature suggests that decentralization, along with clear procedures and standards, is the most suitable approach for hospitals, as it allows nurses to have sufficient autonomy. It is also essential to have horizontal communication structures in place, not only among nurses but also between nurses and doctors. When centralization is high, it hinders the interaction among nurses by restricting their freedom to make independent decisions and solve problems, thereby resulting in fewer horizontal relationships. Additionally, nurses expressed significant dissatisfaction with a hospital's organizational policies when they perceived the organization as being overly centralized.

The negative perception of the high impact of management on decision-making in a centralized structure is also reflected in nurses' dissatisfaction with their task requirements. They feel that their workload is too heavy due to the demands of paperwork and hierarchical control. Additionally, the lack of freedom for nurses to

organize their own work leads to suboptimal task allocation and further dissatisfaction with task requirements. Formalizing rules and procedures for greater clarity does not improve the relationship between nurses and doctors or increase satisfaction with autonomy.

The unexpected finding reveals that formalization can actually promote autonomy among nurses (Cumbey and Alexander, 1998). When rules and boundaries are clear, nurses can enjoy considerable freedom. Although the relationship between formalization and satisfaction with autonomy was positive, it was not strong enough to be considered significant. As a result, Proposition 3b was also not supported. It was anticipated that the relationship between specialization and satisfaction would vary depending on the dimensions of satisfaction being considered. However, there is no evidence of a negative relationship between specialization and satisfaction with organizational policies. Therefore, Proposition 2a was rejected. On the contrary, nurses who were able to specialize and utilize their talents fully expressed satisfaction with organizational policies.

Our data supported the proposed positive relationship between specialization and satisfaction with task requirements, status, interaction, and pay. However, the relationship between specialization and satisfaction with task requirements was not significant. Therefore, Proposition 2b was only partially accepted.
Furthermore, specialization had an impact on autonomy, with increased specialization leading to greater autonomy for nurses. This suggests that restructuring organizations to promote more specialization among nurses would result in increased satisfaction. Conversely, nurses who are unable to fully develop through specialization tend to experience dissatisfaction and have limited opportunities for involvement in decision-making and organizing their own work.
To enhance satisfaction, one approach could involve involving nurses with a generic role in management processes, along with doctors and specialized nurses.

According to Campbell et al. (2004), nurses' job satisfaction

increases when they are allowed to participate in decision-making. However, nurses with a more general role often lack the time needed for patient care and important nursing tasks due to additional responsibilities, resulting in a lower status within the organization. Kramer and Schmalenberg (2003) state that this group of nurses also experiences a lower status due to a lack of autonomy. Therefore, it is recommended that more attention be given to improving the work quality of this specific group. These nurses typically have less education, longer tenure, and are predominantly female and part-time workers. They face discrimination in terms of both pay and work quality because there are limited opportunities for specialization. The literature emphasizes the importance of adequately valuing nurses' work in order to enhance job attractiveness and maintain a highly motivated workforce (Campbell et al.).

, 2004). In America, there is often a shortage of people interested in nursing jobs. Maintaining job satisfaction is crucial in preventing nurses from quitting and keeping them motivated (Campbell et al., 2004; Kalliath and Morris, 2002; Price, 2001; Tzeng, 2002). Among the factors affecting job satisfaction, nurses expressed dissatisfaction with their pay. There is a significant disparity between the importance placed on pay and the level of satisfaction derived from it.

According to Stamps and Piedmont (1986), there is a need for improvement in this dimension. The potential to increase nurses' pay depends on national social security budgets and making pay a political issue, which is partly beyond hospitals' control. Considering the significance of pay and its effect on dissatisfaction, intention to quit, work motivation, and patient care, policy makers must recognize the importance of nurses' pay for maintaining

high-quality medical services. The substantial influence of pay on nurses' satisfaction is not limited to America; previous studies in Asia and the U.S. have come to the same conclusion (e.g., Seo et al.).

, 2004). The unhappiness in the medical and care sectors can be alleviated by raising wages, but it is also important to improve other aspects of job satisfaction among nurses. After reaching a satisfactory pay level, factors like autonomy, status, and task requirements become more significant motivators, including recognition. Our research reveals that there are other areas of job satisfaction that need attention. These areas involve structural matters and can be modified or impacted by management.

The study has certain limitations. Firstly, the sample consisted of nurses employed in three American hospitals that offer general medical services. This limited geographical coverage and the small number of hospitals hinder the generalization of the findings to more specialized hospitals. Additionally, the study used a cross-sectional design, which comes with its typical limitations. Conducting longitudinal research would enable the examination of how satisfaction levels change over time.

Several studies have examined work satisfaction, but the connection with organizational structure remains uncertain. This research is significant as it incorporates three key organizational-structure variables - centralization, specialization, and formalization - into the exploration of nurses’ job satisfaction. The study yielded several results. Firstly, specialization exhibits a positive correlation with nearly all dimensions of Stamps and Piedmont's Index of Work Satisfaction. Secondly, pay greatly influences nurses’ satisfaction.

Thirdly, our data suggest that nurses’ involvement in decision-making in hospitals is not hindered by formalization, and therefore nurses’ satisfaction is not at risk. Furthermore, the importance of decentralization in promoting employee satisfaction, particularly among

nurses, is supported. As a result, hospital managers can enhance the quality of their services by increasing nurses’ job satisfaction through greater decentralization, restructuring for more specialization, and potentially even increasing formalization. Finally, it is important to recognize that the perception and factors influencing interaction between doctors and nurses differ from those among nurses themselves. Therefore, this study highlights the need to expand Stamps and Piedmont's model by differentiating between these two types of interaction.

References

1. A. Adams and S. Bond, (2000)
2. “Hospital nurses’ job satisfaction, individual and organizational characteristics”, Journal of Advanced Nursing 32 (3), pp.536–543. M. A. Blegen, (1993)
3. “Nurses job-satisfaction: a meta-analysis of related variables”, Nursing Research 42 (1), pp.

36-41.