Exploring the doctor-patient relationship as a challenge job demand: application of the job demands-resources model in a Chinese public hospital.

In the increasingly commercialized healthcare environment in China, doctor-patient relationship (DPR) is a job demand for doctors that is linked to various motivational outcomes. Drawing on the Job Demands-Resources (JD-R) model, and the conservation of resources theory, we develop a preliminary conceptual model that links Leader Member Exchange (LMX) as a job resource, and DPR as a challenge job demand, to the levels of work engagement and turnover intentions of doctors working in this healthcare environment. Using two-wave data collected from 381 doctors in a public hospital, we found support for the hypothesized model. Results of a series of SEM analyses revealed that LMX was positively related to DPR and work engagement, while DPR partially mediates the path from LMX to work engagement. In addition, LMX is negatively related to turnover intentions through DPR and subsequently work engagement. Theoretically, this study contributes to the development of the JD-R model by investigating the concept of challenge job demand, and its role in the motivational process, with new evidence from healthcare occupations in China. Practically, this study contributes to the limited number of studies on managing the changing nature of the DPR in China, and in seeking potential solutions based on established organizational constructs.

Status, equity and social identification during an intergroup merger: a longitudinal study.

Using an intergroup perspective, this longitudinal study (N=215) examined the adjustment patterns of employees from low vs. high status pre-merger organizations. The first questionnaire was distributed 3 months after the implementation of the merger, whereas the second was completed 2 years later. As predicted, members of the low status group perceived the merger to be implemented in a less fair manner at the start of the merger and reported a decreased adjustment to the merger over time. Members of the high status group showed an increase in adjustment over time, lower in-group bias and a stronger identification with the new merged organization. Path analyses further confirmed that identification with the new merged organization mediated the associations between perceptions of fairness and in-group bias as well as changes in adjustment over time. With its longitudinal design, this study replicates and extends past results by revealing the predictors of adjustment for members of low vs. high status groups involved in an intergroup merger.

Restructuring the multi-professional organization: professional identity and adjustment to change in a public hospital.

The present study explored the multiple identities held by health professionals in a large public hospital that was experiencing organizational change that involved the transition from the traditional use of professional hierarchies to the use of new clinical teams. Consistent with predictions from social identity theory and research, the results of an organization-wide survey (N = 615) reveal the protective role of identification with professional departments during change that threatened group status. Professional departments were the preferred target of identification of employees, and employees who preferred this target reported a stronger sense of identification. Also consistent with our predictions, employees who were members of higher status groups reported greater job satisfaction, higher levels of openness to organizational change, and reduced levels of change-related uncertainty. These results were more pronounced for employees who identified with their professional department. Implications for managing multiple identities during organizational transition are discussed.

A longitudinal study of employee adaptation to organizational change: the role of change-related information and change-related self-efficacy.

This study examined the role of information, efficacy, and 3 stressors in predicting adjustment to organizational change. Participants were 589 government employees undergoing an 18-month process of regionalization. To examine if the predictor variables had long-term effects on adjustment, the authors assessed psychological well-being, client engagement, and job satisfaction again at a 2-year follow-up. At Time 1, there was evidence to suggest that information was indirectly related to psychological well-being, client engagement, and job satisfaction, via its positive relationship to efficacy. There also was evidence to suggest that efficacy was related to reduced stress appraisals, thereby heightening client engagement. Last, there was consistent support for the stress-buffering role of Time 1 self-efficacy in the prediction of Time 2 job satisfaction.