The Citizenship Behaviours of Care Givers: When Meaning and Trust Are Crucial

Crisis in public finances and growth in the demand for healthcare services are placing increased pressure on hospitals to implement high-involvement work practices (HIWP). Yet, studies on the relationship between these practices and organizational performance are rather scarce in the healthcare sector. In addition, past research has mainly examined the direct relationship between HIWP and organizational performance, leaving unclear the process that leads to this performance. This study aims to fill these knowledge gaps by examining the mediating role played by psychological empowerment (PE) in the relationship between HIWP and organizational citizenship behaviours (OCB), an important predictor of the quality of healthcare delivered. Also, because a collaborative relationship with physicians, based on trust, appears to be crucial for the development of a sense of power among healthcare workers, the moderating effect of trust in physicians on the relationship between HIWP and HP is also explored. Hence, the study tests a model depicting specific relationships between HIWP (autonomy, training, sharing information, recognition) and the cognitions associated with PE (competence, self-determination, meaning, impact), these relationships being moderated by trust in physicians. Lastly, the study aims to verify if the cognitions associated with PE, which are proposed to be related to OCB, interact with each other according to a specific sequence. On the basis of a survey conducted among 176 healthcare workers and their immediate supervisors in a hospital located in the province of Quebec, the study shows that the relationship between some aspects of HIWP (autonomy and training) and OCB is a function of meaning and trust in physicians. Also, the cognitions associated with HP appear to be linked with each other according to a particular sequence in which self-determination plays a central role.

Keywords: meaning, psychological empowerment, trust, competence, autonomy, organizational citizenship behaviour, healthcare sector