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,

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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.

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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

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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.

29

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).

95

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.

96

97

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.

98

99

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).

102

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).

104

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

108

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

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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

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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

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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.

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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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