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Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria.

ABSTRACT: BACKGROUND:Research on organizational justice in hospitals in African countries are limited despite being important for workforce performance and hospital operational efficiency. This paper investigated perceptions and predictors of organizational justice among health professionals in academic hospitals in South-east Nigeria. METHODS:The study was conducted in two teaching hospitals in Enugu State, South-east Nigeria using mixed-methods design. Randomly sampled 360 health professionals (doctors?=?105, nurses?=?200 and allied health professionals, AHPs?=?55) completed an organizational justice scale. Additionally, semi-structured, in-depth interview with purposively selected 18 health professionals were conducted. Univariate and bivariate statistics and multivariable linear regression were used to analyze quantitative data. Statistical significance was set at alpha 0.05 level. Qualitative data were analyzed thematically using NVivo 11 software. RESULTS:The findings revealed moderate to high perception of different dimensions of organizational justice. Doctors showed the highest perception, whereas AHPs had the least perception. Among doctors, age and education predicted distributive justice (adjusted R2?=?22%); hospital ownership and education predicted procedural justice (adjusted R2?=?17%); and hospital ownership predicted interactional justice (adjusted R2?=?42%). Among nurses, age, gender and marital status predicted distributive justice (adjusted R2?=?41%); hospital ownership, age and gender predicted procedural justice (adjusted R2?=?28%); and hospital ownership, age, marital status and tenure predicted interactional justice (R2?=?35%). Among AHPs, marital status predicted distributive justice (adjusted R2?=?5%), while hospital ownership and tenure predicted interactional justice (adjusted R2?=?15%). Qualitative findings indicate that nurses and AHPs perceive as unfair, differences in pay, access to hospital resources, training, work schedule, participation in decision-making and enforcement of policies between doctors and other health professionals due to medical dominance. Overall, supervisors have a culture of limited information sharing with, and disrespectful treatment of, their junior colleagues. CONCLUSION:Perceptions of organizational justice range from moderate to high and predictors vary among different healthcare professionals. Addressing specific socio-demographic factors that significantly influenced perceptions of organizational justice among different categories of health professionals and departure from physician-centered culture would improve perceptions of organizational justice among health professionals in Nigeria and similar settings.

SUBMITTER: Ghasi NC

PROVIDER: S-EPMC7158107 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria.

Ghasi Nwanneka Chidinma NC Ogbuabor Daniel Chukwuemeka DC Onodugo Vincent Aghaegbunam VA

BMC health services research 20200415 1

<h4>Background</h4>Research on organizational justice in hospitals in African countries are limited despite being important for workforce performance and hospital operational efficiency. This paper investigated perceptions and predictors of organizational justice among health professionals in academic hospitals in South-east Nigeria.<h4>Methods</h4>The study was conducted in two teaching hospitals in Enugu State, South-east Nigeria using mixed-methods design. Randomly sampled 360 health professi ...[more]

PMID: 32293438

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Project description:BACKGROUND:Organizational justice is the first virtue in social institutions (J Manage 16:399-432, 1990). It is one of the most determinant factors for an effective utilization of human resources and an essential predictor of organizational success (J Manag Dev 28:457-477, 2009). Employees who perceive fairness are more likely happy with their job and less likely leave their organization (Int J Bus Manage 4:145-154, 2009). Perceived injustice, on the other hand, diminishes motivation of workers to accomplish their duties (Int J Bus Manage 4:145-154, 2009; J Educ Sci Univ Tabriz 2:27-34, 2009). Ethiopia has given emphasis to the expansion of health institutions and increasing the number of health professionals. Despite this, little emphasis has been given the human resource aspect of the health sector. Therefore, this study aims to investigate organizational justice perceptions and turnover intentions among healthcare workers in Amhara region. METHODS:One hundred ninety seven healthcare workers participated in the study. Data were collected through self- report questionnaire and semi-structured interview. The quantitative data were analyzed through MANOVA, multiple regression, and independent samples t-test. The qualitative data were analyzed through thematic analysis. RESULTS:The results of this study revealed that healthcare workers in the public hospitals held low perceived distributive, procedural, interpersonal and informational justice. Similarly, private hospitals healthcare workers had low perceptions on distributive and procedural justice. On the contrary, healthcare workers in private hospitals reported high perception of fairness on interpersonal and informational justice aspects. Both public and private hospital healthcare workers had high turnover intention. The result revealed significant difference in organizational justice perceptions between private and public hospital healthcare workers (F (4, 182)?=?9.17; p?<?.05; partial ?2 =. 168). Organizational justice dimensions (distributive, procedural, interpersonal and informational justice) significantly contributed an additional 9.9% variation in turnover intention (R 2 change?=?.099, F (4,170)?=?4.86, p?<?.05). Distributive justice was the most important predictor of turnover intention (??=?-.23, p <?.05). CONCLUSION:Organizational justice perceptions of healthcare workers significantly predicted turnover intention. Hence, organizational justice should be given due emphasis in designing and implementing policies and strategies of human resource management.

Project description:BackgroundAntipyretics and analgesics, including non-steroidal anti-inflammatory drugs, are medications commonly used in the Kingdom of Saudi Arabia (KSA) and elsewhere to manage fever and pain in the paediatric age group.Research work investigating misuse of these medications in paediatric populations and pertinent healthcare professionals' (HCPs) perceptions as a major determinant of the severity of these errors is scarce.ObjectivesThe aim of this study was to explore the perceptions of HCPs about analgesic and antipyretic use in paediatric patients at four major hospitals in Jeddah, KSA. The study also sought to explore factors believed by HCPs to be associated with occurrence of medication errors and adverse drug reactions (ADRs) due to analgesic and antipyretic use.MethodsA cross-sectional survey employing a pre-piloted online questionnaire with an information sheet was delivered to HCPs in four hospitals in the western region of KSA. The questionnaire comprised a mix of a tick list and open and closed questions with Likert scales for attitudinal statements, and it also comprised items including demographics, healthcare professions and the respondents' work experience, HCPs' views and perceptions relating to occurrence of ADRs and medication errors in children who attended the hospital in the preceding three months and the severity and outcomes of the ADRs.ResultsTwo-hundred seventy-four HCPs were approached, and 200 agreed to participate, yielding a response rate of 73%, including physicians (50%), nurses (24.5%), and pharmacists (16.5%).The majority of HCPs reported that ADRs could be minimized with appropriate actions. They believed that their lack of experience may have contributed to ADRs. Most HCPs (81%) reported that parental knowledge was a key factor contributing to the decreased occurrence of ADRs in children. They also believed that other factors contributed to the occurrence of ADRs, such as lack of reconciliation (65%), parents' anxiety leading to overmedication (69%) and the easy availability of these medications at home (77%).Twenty-nine respondents (n = 29, 14.5%) reported medication errors related to the use of analgesics or antipyretics. Specifically, they reported that possible contributing factors included poor communication of information (69.5%); interruptions (67.5%) and work pressure (66.0%).ConclusionHCPs reported that ADRs and medication errors related to using analgesics and antipyretics in paediatric patients are not uncommon. In their opinion, several factors were associated with occurrence of these events, including parental knowledge about medications and insufficient training of HCPs.

Project description:Healthcare professionals are at higher risk of contracting the new coronavirus disease 2019 (COVID-19). Although appropriate preventive measures are the most important interventions to prevent coronavirus infection among healthcare workers, they are also highly concerned about the consequences of the pandemic. The aim of this cross-sectional study was to assess preventive practices, perceived risk and worry about COVID-19 crisis among healthcare professionals at six public hospitals in Addis Ababa, Ethiopia. A systematic random sampling technique was used to select 1,134 respondents (52.6% females). Data were collected between 9th and 20th June 2020 using self-administered questionnaires. Descriptive statistics were used to summarize the data. A multiple linear regression analysis was performed to identify factors associated with worry about COVID-19 crisis. The highest percentage of respondents were nurses (39.3%) and physicians (22.2%), followed by interns (10.8%) and midwives (10.3%). Wearing facemask (93%) and frequent hand washing (93%) were the commonly reported preventive practices. Perceived risk of becoming infected with coronavirus (88%) and the potential risk of infection to their family (91%) were very high. The mean (median) worry score about COVID-19 crisis was 2.37 (3.0), on 1 to 3 scale, with 1 (not worried) and 3 (highly worried). The majority worried a lot about the health system being overwhelmed by COVID-19 patients (92%), the health of their loved ones (90%) and losing someone due to COVID-19 (89%). Respondents who had previously provided clinical care to Ebola, SARS and cholera patients had significantly lower levels of worry about COVID-19 crisis than participants who had not (β = -1.38, P<0.001). Our findings reveal respondents' widespread practice of preventive measures, highest levels of perceived risk and worry about the COVID-19 crisis. Increased perceived risk and worry about COVID-19 might enable healthcare workers to adopt appropriate preventive measures more effectively against the disease.

Project description:Background: Soldiers' perception of leadership during military deployment has gained research attention as a potentially modifiable factor to buffer against the development of postdeployment post-traumatic stress disorder (PTSD). Within nonmilitary research, the organizational justice (OJ) framework, i.e. distributive justice, procedural justice (PJ) and interactional justice (IJ), has been found to relate to mental health outcomes. Aspects of OJ may, therefore, be protective against PTSD. Objectives: We examined the prospective relationship between aspects of OJ, namely the perceptions of PJ and IJ by subordinate soldiers without leadership obligations in relationship to immediate superiors and PTSD. Method: Participants were soldiers (n = 245) deployed to Helmand Province in Afghanistan in 2009. Logistic regression procedures were used. The primary analysis measured PTSD cases using the Structured Clinical Interview for DSM-IV-TR Axis-I Disorder (SCID) 2½ years after homecoming. PJ/IJ was measured during deployment with a 6-item composite measure ranging from 0 to 12. Supplementary primary analyses were performed with PJ/IJ measured before and immediately after deployment. A secondary PJ/IJ analysis also tested against four postdeployment measures with the Post-Traumatic Stress Disorder Checklist Civilian (PCL-C) dichotomized at screening symptom levels. Results: Higher levels of perceived PJ/IJ for soldiers without leadership obligations during deployment had a prospective relation (OR = 0.86, 95% CI = 0.75-0.98) with PTSD on the SCID 2½ years after homecoming after adjustment for factors including predeployment PTSD symptoms, trauma and combat exposure, and state affectivity. Similar results were found by measuring PJ/IJ before (OR = 0.83, 95% CI = 0.71-0.95) but not immediately after homecoming (OR = 0.97, 95% CI = 0.85-1.11). A relationship with PTSD symptoms at the screening level at the four measurements of PCL-C was found, but only when predeployment PTSD symptoms were not controlled for. Conclusions: These results suggest that PJ/IJ exercised by superiors in relation to military deployments may protect subordinate soldiers against the development of postdeployment PTSD.

Project description:Complementary medicine (CM) is utilized in a growing number of academic centers despite the debate concerning its value, risks and benefits. Healthcare professionals often feel uncomfortable discussing CM with patients, and little is known about their sources of knowledge in the field of CM.To assess healthcare professionals' sources of knowledge and attitude toward CM in an academic hospital.The cross-sectional web-based survey took place from October to December 2013. A total of 4,925 healthcare professionals working at Lausanne University Hospital, Switzerland, were invited to answer the questionnaire.Factors influencing healthcare professionals' opinion toward CM, knowledge and communication about CM.The questionnaire was answered by 1,247 healthcare professionals. The three key factors influencing professionals' opinion toward CM were personal experience, clinical experience and evidence demonstrating the physiological mechanism of CM. Personal experience was more associated with nurses' and midwives' opinion compared to physicians' (80.8% vs 57.1%, OR = 3.08, [95% CI: 2.35-4.05], P<0.001 and 85.3% vs 57.1%, OR = 3.83, [95% CI: 1.95-7.53], P<0.001, respectively) as well as with professionals trained in CM compared to non-trained professionals (86.0% vs 73.2%, OR = 2.60, [95% CI: 1.92-3.53], P<0.001). Physicians relied more on randomized controlled clinical trials compared to nurses (81.3% vs 62.9%, OR = 0.43, [95% CI: 0.33-0.57], P<0.001). A majority of the respondents (82.5%) agreed that they lacked knowledge about CM and 65.0% noted that it was the patient who initially started the discussion about CM.Different professionals used different strategies to forge opinions regarding CM: physicians relied more on scientific evidence, while nurses and midwives were more influenced by personal experience. Regardless of preferred information source, most respondents did not feel prepared to address patient questions regarding CM. Enhancing interprofessional education opportunities is an important strategy to help providers become empowered to discuss CM with patients. This in turn will help patients making informed decisions in their healthcare.

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Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria.

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Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria.

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