THE RELATIONSHIP BETWEEN ORGANIZATIONAL JUSTICE AND TURNOVER INTENTION OF HOSPITAL NURSES IN IRAN.

BACKGROUND: Despite advances in science and technology, human resources are of the major capital for organizations. Workforce retention is required to improve organizational efficiencies.
OBJECTIVE: Therefore, in this study, the relationship between organizational justice (as one of the most influential factors) and turnover intention was investigated.
METHODS: This descriptive-analytic study was done in the Comprehensive Jame Women's Hospital of Tehran in 2015. The statistical sample consisted of 135 nursing staff members. The data were collected using a questionnaire of Beugre's organizational justice and analyzed by the use of Spearman's and Anova statistical tests.
RESULTS: Averages of organizational justice was obtained to be 68.85 ± 7.67 . Among different sorts of organizational justice, the highest average score of 75.24 ± 16.68 was achieved relevant to interactional justice. A significant relationship was observed between organizational justice (r = -0.36), interactional justice (r = -0.38), and procedural justice (r = -0.36) and turnover intention, but no relation was found between turnover intention and systemic and distributive justice. Furthermore, there was no relationship between demographic variables, organizational justice, and turnover intention.
CONCLUSION: Considering the prominent role of organizational justice in the personnel's intention to stay or leave and due to the high costs of recruiting and training new staff, managers should pay especial attention to justice and provide their employees' satisfaction and stability in their organizations by creating a positive mindset in them.

1. INTRODUCTION

Employees’ turnover is the process which employees leave their organizations. Turnover can be voluntary (employees intend to leave the organization) or involuntary (managers make employees redundant). Employees’ voluntary turnover has adverse impacts on organizational effectiveness, efficiency and productivity (1, 2). Today, occupational leave is taken into account as one of the challenges raised in all the organizations, regardless of geographic location and type of organization (3). According to Waldman and colleagues, the total cost for a newly recruited nurse averaged 15,825# and the cost of reduced productivity ranged from 6,245# to 15,102# (4). Nurses’ turnover rate is among the highest rates for professional groups (5).

Actually, we should note the importance of this issue by regarding the fact that success or failure largely depend on the ability of an organization to maintain its employees and provide a condition in which they can best perform their duties and activities (9). The organizations that are heedless of keeping their employees will soon face the challenge of shortage of human resources and specific complications of recruitment (7).

Intention to leave is an individual’s perception of leaving his or her job though he or she is already at his or her occupational position (8). Anticipated turnover is a status in which a person thinks or believes he or she would leave his or her current position voluntarily (9). Unlike a real leave, this type of intention is not clear. Intentions are expressed in terms of a particular behavior of interest (10). Intention to leave a job is defined as a mental thinking of likeliness to leave that job (11).

Different factors such as management strategies, lack of sufficient workforce, salaries and profits, stress, feeling of injustice, and attritive factors in an organization can be influential on this perception and the process of leaving profession (12). Among this, organizational justice is noteworthy since it can create and strengthen the mentioned mindset or provide the background for its development (13-20).

Organizational justice is important as a significant motivational tool for organizational behaviors. Justice is a broad and multifaceted concept associated with a philosophical notion of non-discrimination and fair observance of differences within various disciplines and branches (21). Organizational justice describes different individuals and parties’ perceptions of the fairness of behaviors in an organization and their behavioral responses to those perceptions (22).

The organizational justice construct has been partitioned into at least four factors: distributive justice, procedural justice, interactional justice and Systemic justice. Distributive justice and it presents employees’ perceptions about the fairness of managerial decisions relative to the distribution of outcomes such as pay, promotions, etc. In contrast, procedural justice focuses on the fairness of the manner in which the decision-making process is conducted. As a third concept, interactional justice reflects the quality of interpersonal treatment during the implementation of formal procedures of decisions (23). Systemic justice shows personnel’s perception about fair behavior with colleagues, supervisors and procedures in throughout organization and working environment. This factor is just about the entire organization (24).

In case of perception of an organizational injustice, the background for turnover intention will be created. Among all, nurses, who constitute the largest occupational group in hospital organization are of special importance. Nurses’ leave of their profession can lead to their shortage and consequently enhance in the average ages of the rest of nurses (25). For example, according to statistics, more than 40% of the formal workforces in US hospitals are over 50 years (26). All these factors can be the underlying conditions for nurses’ leave that can lead to an increase in the process of personnel turnover and consequently inclining work pressure and stress within a vicious cycle (27).

The purpose of this paper is twofold: first, to determine the level of organizational justice and intention to leave of nursing personnel in Tehran, Iran; and second, to examine the relationship between organizational justice and nurses’ turnover intention.

2. PATIENTS AND METHODS

2.1. Study Design and Participants

This cross-sectional descriptive-analytic study was conducted in 2015. The study environment was the Comprehensive Women’s Hospital of Tehran. The study community included all the nurses in the hospital.

2.2. Instrument

The instrument used in this study was a questionnaire. To measure organizational justice, Beugre’s Questionnaire (28) was utilized. The questionnaire consisted of 35 items on a Likert scale with the options of totally disagree, disagree, impartial, agree, and totally agree to assess the nurses’ perceptions of organizational justice. The items involved the four dimensions of distributive justice, procedural justice, interactional justice, and systemic justice.

The organizational justice questionnaire had face and content validity evaluations by academics and practitioners. Reliability of the questionnaire had been approved by the study of Ya’qubi et al. with a Cronbach’s alpha coefficient of 91% (29). Turnover intention was measured using a single item: “To what extent do you want to leave this organization, if you find another job opportunity?”

2.3. Data collection

Nurses are working in various hospital wards. Due to the low number of nurses, sampling was not done and all the nurses were selected as the only sample (N = n = 135). Informed consent was obtained from all nurses following receipt of information on the purpose of the study, assurances of anonymity and confidentiality. Data collection was undertaken in January 2015.

2.4. Data Analysis

After the questionnaire was completed by nurses, all data were analyzed using the SPSS v20 software. The possible justified scores were varied between 35 and 175. Scores of 70 or lower on the total scale indicate very low, scores between 70 and 95 indicate low, scores between 95 and 122 indicate moderate, scores between 122 and 148 indicate high and scores of 148 or higher indicate very high organizational justice. The results of Kolmogorov-Smirnov test were indicative of the normality of the research variables. The differences between groups were tested with the Anova. Then, the relationship between organizational justice and Turnover intention was investigated by calculating Spearman’s correlation coefficients.

3. RESULTS

The entire sample members (n = 135) in this study were female with the mean ages of 36.45 ± 8 years. Minimum and maximum ages were 22 and 54 years, respectively. Average years of service were 11.91 ± 7.88 years. 98.5% of the sample members (133 persons) had Bachelor’s degrees and 2 persons (0.7%) owned Associate and Master’s degrees. Average justice (totally and based on each dimension) and average Turnover intention within the different age groups are displayed in the following table 1.

Table 1

Mean and standard deviation of justice

The highest and lowest averages of organizational justice were announced by those aged over 50 years at a rate of 70.38 ± 10.79 and the by age group of 40-50 years at a rate of 54/66.54 ± 8.95, respectively.

The test results of Spearman correlation was indicative of a significant relation between the two variables of organizational justice and Turnover intention (p <0.001, r = -0.36). The relationship between the different types of organizational justice and Turnover intention is as shown in Table 2, where a significant negative correlation is observed between Turnover intention and interactional and procedural justice, but no such a relation is displayed between distributive and systemic justice and Turnover intention.

Table 2

The relationship between organizational justice and Turnover intention (Spearman correlation)

The relation between organizational justice and Turnover intention was analyzed using demographic variables (age, years of service, and educational level) and Anova test (Table 3). As it can be seen, there is no relationship between demographic variables, organizational justice, and Turnover intention within the favorite sample.

Table 3

The relationship between organizational justice, Turnover intention, and demographic variables(Anova test)

4. DISCUSSION

Organizational Justice is known as a mental and cognitive predictor of many organizational variables such as Turnover intention (30). In this study, the relation between organizational justice (together with its different dimensions) and Turnover intention of the nursing staff of Tehran Jame Women’s Hospital was investigated.

The findings showed that nurses experienced very low levels of organizational justice (68.85 ± 7.67). This average represents almost unfavorable conditions (average range of 35-175) of organizational justice in the study hospital, showing to be higher than the similar study conducted by Ya’qubi et al. (29) in Iran (41.8). Also, average score of Turnover intention was 47.8 ± 12.47, which represents the variable desirable state in the current study.

Among different types of justice, the highest score belonged to interactional justice (75.24), the result which is similar to the findings of Hassani et al. (16), but differs from those of Ya’qubi et al. (29). Furthermore, the lowest average was obtained to be 62.84 relevant to systemic justice that is not in agreement with the results of a similar study performed by Ya’qubi et al. (24) (their least average related to interactional justice). Interactional justice incorporates the relation between officials and employees of an organization (16), the highest score of which was obtained due to the need for the hospital constructive and appropriate engagements (for having a team nature) in the present study.

The highest score given to organizational justice was 70.38 for those aged over 50 years, while maximum score of distributive justice related to the age group of 20-30 years (70.46) with minimum years of service. Other changes occurred to the averages of the different types of organizational justice in various age groups as well. This issue can be related to the changes of the personnel’s perspectives from the beginning of entering the organization and during their years of service. For example, on arrival at the organization, the staff members were more attentive to personal interactions and attributed particular problems to other individuals, while those with longer job histories showed their systemic attitudes. The results confirm this issue since the highest degree of systemic justice belonged to those aged over 50 years.

Moreover, the results of the statistical tests indicated a significant negative correlation (p < 0.001, r = -0.36) between organizational justice and Turnover intention, which have been corroborated by other studies (13-19, 29, 31-34). This represents that employees’ appropriate conceptions of justice in an organization make the basis for their satisfactions and positive states of mind. Thus, these factors as mediator variables can reduce intentions to leave. Among different kinds of justice, interactional justice (p = 0.00, r = -0.38) and procedural justice (p = 0.00, r = -0.36) had a significant negative correlation with Turnover intention. A similar correlation has been also found by Iyigun and Tamer’s study (34). Additionally, the significant negative relation between interactional justice and Turnover intention is congruent with the studies of Hassani et al. (16), Parker et al. (35) and Jones et al. (36), but inconsistent with the results of Aryee (25) and Nadiri & Tanova (37). Significance of the relationship between procedural justice and Turnover intention is in line with the results of Golparvar and Nadi (38), Radzi et al. (39), and Lambert et al. (40), but not aligned with those of Aqayi’s study (41).

No significant relation was observed between distributive justice and systemic justice and Turnover intention in the present study. This finding did not comply with the results of Aqayi et al. (41) and Zaman et al. (42), who had discovered a significant relationship between them.

In the current study, no relation was found between demographic variables (age, work experience and educational level), organizational justice, and Turnover intention. This result was in agreement with the findings of Samavatian et al. (43). based on the relationship between age and organizational justice but not with the study of Ya’qubi et al. (29) and that of Elovainio et al. (44).

The results of this study clearly portray the role of organizational justice in relation to Turnover intention. Therefore, since labor force is the main asset of any organization, especially in the health sector, it is very important that those responsible in organizations provide the necessary background for the appropriate notion of organizational justice and consequently increase their staff satisfactions and retention. Within this context, it can be stated that the most economical forms of justice are interactional and procedural justice since interactional justice simply requires proper management of interpersonal relationships, while exerting the strongest effect on Turnover intention and procedural justice proven to have a significant relationship with Turnover intention in this study is almost associated with no costs, while presupposing unconditional implementation of the existing rules and procedures in all fields. About other sorts of justice, it can be said that distributive justice (relating to the procedures for distribution of resources) and systemic justice can leave a robust impact on personnel’s satisfaction as a mediator variable and thereby influence on the other organizational variables.

5. CONCLUSION

Due to the above, it is recommended that managers provide the ground for their staff satisfactions and attempt at maintaining them via proper focusing on organizational justice so as to guarantee themselves against the costs of recruitment and training new members. Finally, it should be mentioned that the results of this study just relate to the Comprehensive Women’s Hospital of Tehran and cannot be generalizable to other centers because of the particular circumstances of the study sample (location at one place, accessibility to only female sex, etc.).