Existence Relatedness And Growth Human Needs In Organizational Settings Pdf
File Name: existence relatedness and growth human needs in organizational settings .zip
- Existence, Relatedness, and Growth; Human Needs in Organizational Settings
- Clayton Alderfer
- A New Measure of Quality of Work Life (QWL) Based on Need Satisfaction and Spillover Theories
Almost as if the Neanderthal man did not see the need to progress and accepted circumstances as fact. If this is true then the Homo Sapiens have not only developed psychological and objective needs but have progressively updated them as well.
Existence, Relatedness, and Growth; Human Needs in Organizational Settings
Data availability statement: No additional data are available from the authors. Although China has made remarkable progress in strengthening its primary healthcare system, lack of well-performed primary health workforce is still the bottleneck of deepening the reform.
The objective of this review is to understand the current profile of Chinese primary care workers PCWs and their motivating factors of performance and propose targeted policy suggestions on improving their work performance. Quality assessment and data extraction for the studies closely relevant to performance of PCWs in China were conducted by two reviewers independently.
A total of 36 articles were included; 16 23 participants in the meta-analysis. Regarding the individual level of motivation, 3 overarching themes and 12 subthemes were developed. Moreover, the healthcare system reform policies have inevitable and complex impacts on different levels of human needs, and then influences on the motivation and performance of PCWs. Meta-analysis showed that the overall job satisfaction score among PCWs was 3.
This study suggests low work satisfaction among PCWs in China, with financial incentives and career advancement being two most important motivating factors. A myriad of potentially eligible articles were screened and included using a comprehensive search strategy. Reliability of the study selection, data extraction and quality assessment was ensured by involving two independent reviewers.
In China, the primary healthcare PHC services that include public health services and basic medical health services are provided by community health centres CHCs and their affiliated community health stations CHSs in the urban areas and by township health centres THCs and their affiliated village clinics VCs in the rural areas.
It has been demonstrated that work motivation can influence job satisfaction, hence influencing job performance. Synthesising these motivating factors in different areas of China could help identify the most important motivating factors and appreciate the overall job satisfaction level of PCWs in China.
We searched the PubMed and MEDLINE on June 2, , to identify relevant studies using Medical Subject Headings terms in conjunction with free-text words including all the possible synonyms, alternative terms and spellings 6 to increase sensitivity to any potentially eligible literature. All the search terms were provided in the online supplementary appendix 1. Search results were exported to EndNote X7 to be organised and duplicate records were removed in the first place.
Then two authors exported the citations to Microsoft Excel and conducted the literature screening and selection independently. Divergent judgements were settled through discussion. Therefore, all the studies that explored the level of work motivation, job satisfaction, work stress, turnover intention and the influencing factors of these motivation expressions were included. We also searched for relevant studies found in the references of the included articles and other sources. The included studies adopted either observational or experimental design, and presented primary quantitative or qualitative data.
All the included articles were in English language and published between and Studies were excluded if they did not address the motivating factors for PCWs, or if the participants were not PCWs or did not work in the four types of PHC institutions mentioned above. Extracted data included study design, year or years of study, settings, participants, sample sizes, measurement of motivation, objective, key motivation conclusions and motivating factors.
Motivating factors extracted from the included articles were grouped into four themes: 1 factors concerning the existence needs, including payment, fringe benefits and physical working conditions; 2 factors concerning the relatedness needs, which are concerned with social environment and relationship; 3 factors concerning the growth needs, referring to career or self-development and management environment; 4 factors concerning the health policy context and organisational context that could influence one or more needs categories mentioned above online supplementary appendix 2.
The first three themes of motivating factors represented, at an individual level, three different dimensions of human needs in PHC institutions based on the existence, growth and relatedness ERG framework and the last theme was singled out because different health policies had complex impacts on the performance by influencing more than one dimension of human needs at a macro level.
First, authors aggregated data into motivating factors and extracted all original motivating factors in each article to put them into one of the four themes. Then we identified correlations between the different factors, refined them through discussion and synthesised similar factors into a higher level theme.
The funders of the study had no role in study design; data collection, analysis and interpretation; writing of the report and the decision to submit the paper for publication. We first screened titles and abstracts, and then retrieved and screened the full-texts of potential relevant studies to evaluate their eligibility figure 1. After the full text screening, studies relevant to the human resources of PHC in China were included for us to appreciate the current status of PCWs.
To obtain sufficient information related to the motivation of PCWs, one additional article from reference search was also identified and included after applying the eligibility criteria. A list of the basic characteristics of the included articles can be found in online supplementary appendix 3.
Twenty-five quantitative, seven qualitative and four mixed methods primary studies were included, covering at least 27 provinces of China.
Of the 17 studies concerning rural areas, 8 articles only included village doctors in village clinics as participants, 5 articles only studied health workers in THCs and 4 articles were concerned with rural PCWs in both village clinics and THCs.
As for the risk of bias, more than half of the included studies presented a low risk of bias, with the total score ranging from 6 points to 10 points in online supplementary appendix 3. Financial incentives, workload and the work conditions related to a person's physical needs such as food, clothing and shelter were clustered into factors concerning existence needs.
Another line of inquiry explored the impact of different health system reform policies on motivating factors. For example, in a qualitative study, administrators and front line healthcare workers in PHC institutions mentioned that the increased income after the health system reforms did not fully reflect the increased workload, and those who worked the most were not necessarily rewarded the most, constituting a demotivating factor for some health workers.
Seventeen studies reported work itself and 11 studies reported work relationships table 1. Compared with factors concerning existence needs, the PCWs were more satisfied with the nature of work and work relationships.
Thirteen of the selected studies reported recognition from society including being understood by society and physician-patient relationships table 1. Satisfaction with social status and relationship with patients was significantly associated with job satisfaction.
Six studies reported living environment as a factor concerning relatedness needs table 1 and showed that compared with urban areas, rural areas had greater needs to improve the living environment. Career advancement, training, rewards, management and autonomy relating to a person's needs of personal development were considered as factors concerning growth needs in this review.
Nineteen out of the 36 articles reported the factor of career advancement table 1 , which was considered as the one of top three contributors to satisfaction.
Training was mentioned as a motivating factor by 13 out of the 36 articles table 1. Learning and training were significantly associated with work passion, 19 job satisfaction 15 29 and turnover intention. Health workers preferred more training time for practice-focused training on-site guidance from senior doctors and further clinical education over knowledge-focused training, and favoured such training contents as clinical skills, preventive healthcare and medication knowledge education.
Among the selected studies, the number of studies that reported the motivating factors of rewards, management and autonomy stood at 9, 9 and 14, respectively table 1. According to most of the selected articles, PCWs were relatively satisfied with the decision-making ability of their superiors, the contingent rewards and the opportunities to do work by making decisions on their own and to utilise their professional skills and talents. Motivation was not only influenced by the motivating factors at the individual level, but also by the health sector reforms and specific incentive schemes that target workers.
The gap between the intended and actual consequences of the policies was one of the main determinants of job satisfaction. Take the comprehensive reform of PHC in Shandong as an example, PCWs there on the one hand complained about increased trivialities at work, heavier workload, blurry job description, unsatisfactory income and a lack of professional development, but on the other hand were satisfied with the relationships with the community and low work pressure.
The NEMS included a new National Essential Drugs List to ensure free access to safe and effective medication for the patients, and introduced a series of polices on drug production, pricing and distribution in the hope of promoting the rational use of medications by reducing the reliance on drug sales and profit seeking behaviours. To be more specific, only drugs on the list were allowed to be prescribed in VCs and price mark-ups were forbidden. The impacts of the NEMS varied by region, professional practice and income level.
The NBPHSP starting from provided a package of basic public health services for all residents, with a focus on the management of non-communicable disease. To motivate PCWs to provide preventive health services, the government grants subsidies based on the number of covered residents. At the beginning of this reform, due to the broad scope of basic public health services and limited financial incentives, providers felt that they were under great stress due to the competing demands for their time and complained about the heavy workload, insufficient remuneration, staff shortage, lack of formal professional identity and ineffective performance appraisal.
In addition, providers had to deal with the distrust and disrespect from some residents, 40 46 especially those public health workers who were dismissed as having lower levels of knowledge and skill than specialists. The TVHSIM required THCs, the upper-level health institutions, to direct and supervise VCs in their routine work and their work in medicine, personnel management, financing and the upgrade and maintenance of facilities, resulting in mixed impacts on village doctors.
On the one hand, most village doctors felt more respected under this integrated management because they were more recognised as health workers in a formal health system rather than private drug salesmen. On the other hand, they were not allowed to perform agricultural or any other side activity for extra money, 26 36 which negatively affected their financial conditions.
A total of 19 investigation samples were extracted from these 16 articles with cross-sectional study design, representing more than half of the provinces in China.
The overall job satisfaction score ranged from 1. To be more specific, for most samples drawn from more than three provinces, the satisfaction scores levelled off between 3.
Besides, the score of Xinjiang, the representative of the western areas, was the highest among the included samples. Meta-analysis was approached by combining results weighted by sample size and showed that the overall job satisfaction score among PCWs was 3. But the overall satisfaction mean of rural health workers was lower than that of the urban health workers table 2. This payment method did not work well in reality as to motivate health workers.
How to improve the income level of health workers in primary health delivery system will remain a crucial but tricky issue in the near future. Besides, as shown in our analysis in figure 2 , financial incentives were no longer the sole means to promote motivation, improve job satisfaction and enhance work performance.
More specifically, the lack of chances for professional title promotion and limited career development opportunities were important reasons that lead to turnover intention. This finding is in line with other internationally published studies and underscores the importance of the non-financial as well as the financial incentives. In this review, we found that the PCWs in China are confronted with barriers in fulfilling all of the three levels of human needs. Policymakers must realise that a health worker has multiple needs to be met simultaneously.
In addition, motivation improvement should be prioritised in a way that suits local institutional environments and personal preference. A sole focus on one type of need at a time cannot effectively motivate PCWs. The most prominent factor causing the general dissatisfaction of PCWs, especially the PCWs in rural areas, was the financial rewards from work.
In , the annual income of There is no doubt that imbalance exist among these regions at all levels. As for the satisfactions of PCWs, provinces in the eastern region, with more developed economy and better health facilities, scored higher than provinces in the middle region and lower than provinces in the western region. Considering western China are remote areas with less economic development, the higher job satisfaction of PCWs may be explained by the lower expectations of PCWs, more government subsidies and other central government supports that target remote western areas.
In , China launched a landmark healthcare reform which aims at providing affordable and equitable basic healthcare for all by For example, the brain drain of experienced health workers and the loss of patients from THCs to county hospitals have incurred a great cost.
After the implementation of TVHSIM, the village doctors who had been previously self-employed and not integrated into the formal health delivery system, were managed in the same way as THC staffs and experienced a transformation of their income structure as government subsidy has become an increasing source of income.
They were motivated not only by the more stable financial subsidy from government, but also by the good reputation and respect from local residents as health providers with formal status. However, their income and fringe benefits still lagged behind the regular employees in THCs, which remained an demotivating factor for village doctors.
The rationale for using ERG theory to guide the analysis lies in the fact that this needs-based theory generally encompasses work motivation, provides a useful conceptualisation of what PCWs care about motivating factors and explains their performance in organisations.
The findings of this review suggest that PCWs can be encouraged to perform well by positive motivations responding to satisfying ERG needs, but it should be interpreted with caution because of several limitations. Third, factors related to personal sociodemographic characteristics and mental state were not analysed as motivating factors. They were only exacted from the original article and presented as influencing factors, as shown in the online supplementary appendix 3.
Just as illustrated by the Global Strategy on Human Resources for Health , efforts should be made to improve deployment strategies, working conditions, reward systems, continuous professional development opportunities and career pathways by adopting and implementing evidence-based health workforce policies that are tailored to the local context so as to make the best possible use of limited resources and enhance both capacity and motivation for improved performance.
Contributors: All authors proposed the hypothesis and idea for the systematic review and take responsibility for all aspects of it. QM, BY and HL discussed and contributed to the conceptualisation of this review and the development of review protocol.
BY applied the inclusion criteria. HL and DW extracted the data.
Content uploaded by Cheng-Liang Yang. No, Alderfer was not a physicist and ERG in this case is not a unit of energy equal to joules. ERG theory of motivation is very flexible: it explains needs as a range rather than as a hierarchy. However, he develops some new features that consistently take into consideration the issue of inter-individual differences. Shahriar Sharif Md. It proposes three needs that must all be satisfied in order for an individual to be motivated: existence, relatedness, and growth. He did this by interviewing over professionals.
The earliest studies of motivation involved an examination of individual needs. Specifically, early researchers thought that employees try hard and demonstrate goal-driven behavior in order to satisfy needs. For example, an employee who is always walking around the office talking to people may have a need for companionship, and his behavior may be a way of satisfying this need. At the time, researchers developed theories to understand what people need. Abraham Maslow is among the most prominent psychologists of the twentieth century. His hierarchy of needs is an image familiar to most business students and managers.
A New Measure of Quality of Work Life (QWL) Based on Need Satisfaction and Spillover Theories
His rework is called as ERG theory of motivation. Managers must understand that an employee has various needs that must be satisfied at the same time. According to the ERG theory, if the manager concentrates solely on one need at a time, this will not effectively motivate the employee. Also, the frustration- regression aspect of ERG Theory has an added effect on workplace motivation.
Scientific Research An Academic Publisher. Alderfer, C. Existence, relatedness and growth: Human needs in organizational settings. New York: Free Press.
A new measure of QWL was developed based on need satisfaction and spillover theories. The measure was designed to capture the extent to which the work environment, job requirements, supervisory behavior, and ancillary programs in an organization are perceived to meet the needs of an employee. We identified seven major needs, each having several dimensions. These are: a health and safety needs protection from ill health and injury at work and outside of work, and enhancement of good health , b economic and family needs pay, job security, and other family needs , c social needs collegiality at work and leisure time off work , d esteem needs recognition and appreciation of work within the organization and outside the organization , e actualization needs realization of one's potential within the organization and as a professional , f knowledge needs learning to enhance job and professional skills , and g aesthetic needs creativity at work as well as personal creativity and general aesthetics.