Does work stress & workplace incivility influence Employee Turnover Intentions? Mediating Role of Work-family Conflict

Shahid Mehmood; Azelin Aziz; Nurul Sharniza Husin

doi:10.36923/ijsser.v5i2.177

Open Access Original Research

Shahid Mehmood ⁽¹⁾ , Azelin Aziz ⁽²⁾ , Nurul Sharniza Husin ⁽³⁾

(1) School of Business Management, Universiti Utara Malaysia , Malaysia

(2) School of business management, Universiti Utara Malaysia , Malaysia

(3) School of business management, Universiti Utara Malaysia , Malaysia

https://doi.org/10.36923/ijsser.v5i2.177

Issue
Vol. 5 No. 2 (2023)

Submitted
February 1, 2023

Published
May 31, 2023

Keywords:

Work Stress, Workplace Incivility, Work-Family Conflict, Turnover Intention, Hospitals Industry, Nurses Turnover

PDF XML

Abstract

Purpose: The purpose of this study was to assess the impact of work stress and workplace incivility on turnover intention and work-family conflict. As well as the role of work-family conflict in mediating the relationship between work stress, workplace incivility, and turnover intention.

Design/methodology/approach: The data was collected by distributing 573 questionnaires to nurses working in the healthcare sector in Punjab, Pakistan. The SPSS (23) statistical package was used to analyze the data, and the model was evaluated using partial least squares (Smart PLS 3.3).

Main Findings: The findings showed that workplace stress and incivility had a direct positive effect on turnover intention. Additionally, there was a positive relationship between work stress and workplace incivility, as well as a negative relationship between work-family conflict and workplace incivility. Work-family conflict positively mediates the relationship between work stress and turnover intention, but there is no such relationship between workplace incivility and turnover intention.

Research limitations/implications: The results provide empirical evidence that work stress, and workplace incivility, are positively related to intent to leave the organization. Furthermore, the conceptual framework of this study can be a guide for future research on turnover intention.

Originality/value: This study is unique, as it is the first study conducted on work stress and workplace incivility in a hospitality setting. The study responded to scholarly calls made to enrich the literature pertaining to work stress, workplace incivility, and its outcomes.

Full Article

Generated from XML file

References

Abdullah, M. A., Mukhtar, F., Wazir, S., Gilani, I., Gorar, Z. & Shaikh, B. T. (2014). The health workforce crisis in Pakistan: a critical review and the way forward. World Health Popul, 15(3), 4-12.

Aboobaker, N., & Edward, M. (2020). Collective influence of work-family conflict and work-family enrichment on turnover intention: exploring the moderating effects of individual differences. Global Business Review, 21(5), 1218-1231. https://doi.org/10.1177/0972150919857015

Abrar, M., Bashir, M., Nureen, N., Shahzadi, Q. (2019). Workplace Terror and its Consequences: Perception of Newly Graduated Nurses of Public Sector Hospitals. Pacific Business Review International, 11(8), 62-73.

Agustini, S. S., Queck, A., & Specht, E. (2008). Modeling of the regenerative heat flow of the wall indirect-fired rotary kilns. Heat Transfer Engineering, 29(1), 57-66. https://doi.org/10.1080/01457630701677171

Ahmad, A. & Omar, Z. (2013). Abusive supervision and deviant workplace behavior: The mediating role of work-family conflict. The Journal of Human Resource and Adult Learning, 9(2), 124- 130.

Ahmad, I. (2021). Emotional Regulation as a Remedy for Teacher Burnout in Special Schools: Evaluating School Climate, Teacher’s Work-Life Balance and Children Behaviour. Frontiers in Psychology, 12, 1-10. https://doi.org/10.3389/fpsyg.2021.655850

Ahmad, I., Thurasamy, R., Shahzad, A., Ullah, M. I., Hussain, A., & Ansari, H. W. A. (2023). COVID-19 impact on dairy sector: The mediating role of knowledge sharing and trust on innovation capability. South African Journal of Economic and Management Sciences, 26(1), 1-11. https://doi.org/10.4102/sajems.v26i1.4591

Allen, S. (2019). 2019 Global health care outlook: Shaping the future.

Amayandeh, H., Juhari, R., & Yaacob, S.N. (2011). The effect of job satisfaction and family satisfaction on work-family conflict (W-FC) and family-work conflict (F-WC) among married female nurses in Shiraz-Iran. Asian Social Science, 7(2), 88-95. https://doi.org/10.5539/ass.v7n2p88

Andersson, L. M., & Pearson, C.M. (1999). Tit for tat? The spiralling effect of incivility in the workplace. Academy of Management Review, 24(3), 452-471. https://doi.org/10.2307/259136

Arevalo, T. (2020). The State of Health Care Industry (2020). Retrieved from: https://policyadvice.net/health-insurance/insights/health-care-industry/ dated: 27/09/2020

Armstrong, G. S., Atkin-Plunk, C. A., & Wells, J. (2015). The relationship between work-family conflict, correctional officer job stress, and job satisfaction. Criminal Justice and Behaviour, 42(10), 1066-1082. https://doi.org/10.1177/0093854815582221

Asghar, M., Gull, N., Bashir, M., & Akbar, M. (2018). The Impact of Work-Family Conflict on Turnover Intentions: The Moderating Role of Perceived Family Supporting Supervisor Behaviour. Journal of Hotel & Business Management, 7(1), 1-11. https://doi.org/10.4172/2169-0286.1000178

Avolio, B. J., Zhu, W., Koh, W., & Bhatia, P. (2004). Transformational leadership and organisational commitment: Mediating role of psychological empowerment and modulating role of structural distance. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 25(8), 951-968. https://doi.org/10.1002/job.283

Ayenagbo, k. (2022). Impact of Globalization, Women's Empowerment, and Maternal Health in Sub-Saharan Africa (SSA). International Journal of Social Sciences and Economic Review, 4(2), 1-09. https://doi.org/10.36923/ijsser.v4i2.157

Azlina, A.A. and Mustapha, N.N. (2012), "Energy, economic growth and pollutant emissions nexus: the case of Malaysia", Procedia-Social and Behavioral Sciences, 65(3), 1-7. https://doi.org/10.1016/j.sbspro.2012.11.082

Basel, A. S., & Fayza, A.B. (2015) Employee turnover, causes, the relationship between turnover and productivity and recommendations to reduce it. Proceedings of the International Conference on Industrial Engineering and Operations Management Dubai, United Arab Emirates (UAE), 2015

Begley, T.M. (1994). Expressed and suppressed anger as predictors of health problems. Journal of Organizational Behavior, 15(6), 503-516. https://doi.org/10.1002/job.4030150603

Blomme, R. J., Van Rheede, A., & Tromp, D.M. (2010). Work-family conflict as a cause for turnover intentions in the hospitality industry. Tourism and Hospitality Research, 10(4), 269-285. https://doi.org/10.1057/thr.2010.15

Boyar, S. L., Maertz Jr, C. P., Pearson, A. W. & Keough, S. (2003). Work-family conflict: A model of linkages between work and family domain variables and turnover intentions. Journal of Managerial Issues, XV(2), 175-190. https://doi.org/10.1037/e518712013-302

Byron, K. (2005). A meta-analytic review of work-family conflict and its antecedents. Journal of Vocational Behavior, 67(2), 169-198. https://doi.org/10.1016/j.jvb.2004.08.009

Carlson, D., Ferguson, M., Hunter, E. & Whitten, D. (2012). Abusive supervision and work-family conflict: The path through emotional labour and burnout. The Leadership Quarterly, 23(5), 849-859. https://doi.org/10.1016/j.leaqua.2012.05.003

Carpenter, N. C., Berry, C. M., & Houston, L. (2014). A meta?analytic comparison of self?reported and other?reported organizational citizenship behaviour. Journal of Organizational Behavior, 35(4), 547-574. https://doi.org/10.1002/job.1909

Chen, IH, Brown, R, Bowers, B. J., & Chang, WY (2015). Work?to?family conflict as a mediator of the relationship between job satisfaction and turnover intention. Journal of Advanced Nursing, 71(10), 2350-2363. https://doi.org/10.1111/jan.12706

Chi, N. W., Yang, J., & Lin, C. Y. (2018). Service worker chain reactions to daily customer mistreatment: Behavioral linkages, mechanisms, and boundary conditions. Journal of Occupational Health Psychology, 23(1), 58. https://doi.org/10.1037/ocp0000050

Cohen, J. (1988). Set correlation and contingency tables. Applied Psychological Measurement, 12(4), 425-434. https://doi.org/10.1177/014662168801200410

Cortina, L. M., Kabat-Farr, D., Leskinen, E. A., Huerta, M., & Magley, V. J. (2013). Selective incivility as modern discrimination in organizations: Evidence and impact. Journal of Management, 39(6), 1579-1605. https://doi.org/10.1177/0149206311418835

Demsky, C. A., Fritz, C., Hammer, L.B. & Black, A.E. (2018). Workplace incivility and employee sleep: The role of rumination and recovery experiences. Journal of Occupational Health Psychology. 24(2), 228-240. https://doi.org/10.1037/ocp0000116

Dodanwala, T. C., San Santoso, D., & Shrestha, P. (2022). The mediating role of work-family conflict on role overload and job stress linkage. Built Environment Project and Asset Management (ahead-of-print). 12(6), 924-939. https://doi.org/10.1108/BEPAM-12-2021-0153

Du Prel, J. B., & Peter, R. (2015). Work-family conflict as a mediator in the association between work stress and depressive symptoms: cross-sectional evidence from the German lidA-cohort study. International Archives of Occupational and Environmental Health, 88 (13), 359-368. https://doi.org/10.1007/s00420-014-0967-0

Duong, M. T., Hussain, I. A., & Subramaniam, A. (2020). Job stress, co-worker support, role expectation conflict and work-life balance among working women: A Quantitative study on Multinational Companies in Vietnam. Test Engineering and Management, 82(1-2), 744-749.

Ebrahimi, H., Hassankhani, H., Negarandeh, R., Jeffrey, C., & Azizi, A. (2017). Violence against new graduated nurses in clinical settings: A qualitative study. Nursing Ethics, 24(6), 704-715. https://doi.org/10.1177/0969733015624486

Ferguson, M. (2012). You cannot leave it at the office: Spillover and crossover of coworker incivility. Journal of Organisational Behaviour, 33(4), 571-588. https://doi.org/10.1002/job.774

Fornell, C., & Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and statistics. https://doi.org/10.2307/3150980

Gallo, L. C., & Matthews, K. A. (2003). Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychological Bulletin, 129(1), 10-51. https://doi.org/10.1037/0033-2909.129.1.10

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The Strategic Management of Health care Organizations. John Wiley & Sons.

Greenhaus, J. H., & Beutell, N. J. (1985). Sources of conflict between work and family roles. Academy of Management Review, 10(1), 76-88. https://doi.org/10.2307/258214

Gull, N., Asghar, M., Bashir, M., Liu, X., & Xiong, Z. (2023). Does a family-supportive supervisor reduce the effect of work-family conflict on emotional exhaustion and turnover intentions? A moderated mediation model. International Journal of Conflict Management, 34(2), 253-272. https://doi.org/10.1108/IJCMA-03-2022-0046

Hair, JF, Hult, GTMM, Ringle, CTMM, Sarstedt, MTM & Thiele, KOM (2017). Mirror, Mirror on the Wall: A Comparative Evaluation of Composite-Based Structural Equation Modelling Methods Journal of the Academy of Marketing Science, 45, 616-632. https://doi.org/10.1007/s11747-017-0517-x

Hair, Jr., JF, Sarstedt, M., Matthews, L. M., & Ringle, C. M. (2016). Identifying and treating unobserved heterogeneity with FIMIX-PLS: Part I-method. European Business Review, 28 (1), 63-76. https://doi.org/10.1108/EBR-09-2015-0094

Han, S. S., Han, J. W. & Choi, E. H. (2015). Effects of nurses' job stress and work-family conflict on turnover intention: Focused on the mediating effect of coping strategies. Asian Women, 31(3), 1-20. https://doi.org/10.14431/aw.2015.09.31.3.1

Haq, I. U. (2014, June). Workplace ostracism and job outcomes: Moderating effects of psychological capital. In Human Capital without Borders: Knowledge and learning for quality of life: Proceedings of the management, knowledge and learning international conference (Vol. 2014).

Harun, I., Mahmood, R., & Som, H. M. (2020). Role Stressors And Turnover Intention Among Doctors In Malaysian Public Hospitals: Work-Family Conflict And Work Engagement As Mediators. PSU Research Review. 6(1), 1-16. https://doi.org/10.1108/PRR-08-2020-0025

Heaphy, E. D. & Dutton, J. E. (2008). Positive Social Interactions And The Human Body At Work: Linking Organizations And Physiology. Academy of Management Review, 33(1), 137-162. https://doi.org/10.5465/amr.2008.27749365

Helmle, J. R., Botero, I. C., & Seibold, D. R. (2014). Factors that influence perceptions of work-life balance in owners of copreneurial firms. Journal of Family Business Management, 4(2), 110-132. https://doi.org/10.1108/JFBM-06-2014-0013

Hendryadi, H. & Zannati, R. (2018). Hubungan Workplace Incivility Dan Turnover Intention: Efek Moderasi Gender. INOVASI, 14(2), 123-133. https://doi.org/10.29264/jinv.v14i2.4088

Henseler, j., ringle, c. M., & Sarstedt, m. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modelling. Journal of the Academy of Marketing Science, 43(1), 115-13. https://doi.org/10.1007/s11747-014-0403-8

Hobfoll, S. E. (2001). The Influence of Culture, Community, And The Nested?Self In The Stress Process: Advancing Conservation Of Resources Theory. Applied psychology, 50(3), 337-421. https://doi.org/10.1111/1464-0597.00062

Hobfoll, S.E. (1989). Conservation of resources: a new attempt at conceptualizing stress. American Psychologist, 44(3), 513-524. https://doi.org/10.1037/0003-066X.44.3.513

Isenhour, L. C., Stone, D. L., Lien, D., Zhang, M., Griffeth, R. W., & Fried, D.D. (2012). Work?family conflict and individual consequences. Journal of Managerial Psychology. 27(7), 696-713. https://doi.org/10.1108/02683941211259520

Islam, T., Ahmad, R., Ahmed, I., & Ahmer, Z. (2019). Police work-family nexus, work engagement and turnover intention: Moderating role of person-job-fit. Policing: An International Journal. 42(5),739-750. https://doi.org/10.1108/PIJPSM-09-2018-0138

Kazi, G. M., & Zadeh, Z. F. (2011). The contribution of individual variables: Job satisfaction and job turnover. Interdisciplinary Journal Of Contemporary Research In Business, 3(5), 984-991.

Khan, T. M., Gang, B., Fareed, Z., & Khan, A. (2021). How does CEO tenure affect corporate social and environmental disclosures in China? Moderating role of information intermediaries and independent board. Environmental Science and Pollution Research, 28, 9204-9220. https://doi.org/10.1007/s11356-020-11315-9

Khan, Z. U., & Muhyuldeen, G. (2020). Investigating the Relationship of Job Stress and Turnover Intentions by Taking Work-Family Conflict and Family Work Conflict as Mediators. Global Sociological Review, V (IV), 30-40. https://doi.org/10.31703/gsr.2020(V-IV).04

Kim, H., & Kao, D. (2014). A meta-analysis of turnover intention predictors among US child welfare workers. Children and Youth Services Review, 47, 214-223.Kline, R. B. (2011). Principles and Practice of Structural Equation Modeling. New York: Guilford Press https://doi.org/10.1016/j.childyouth.2014.09.015

Kim, H., & Kao, D. (2014). A meta-analysis of turnover intention predictors among US child welfare workers. Children and Youth Services Review, 47(3), 214-223. https://doi.org/10.1016/j.childyouth.2014.09.015

Kline, R. B. (2023). Principles and practice of structural equation modeling. Guilford publications. Canadian Studies in Population, 45(3), 95-188. https://doi.org/10.25336/csp29418

Kossek, E. E., Pichler, S., Bodner, T., & Hammer, L. B. (2011). Workplace social support and work-family conflict: A meta?analysis clarifying the influence of general and work-family?specific supervisor and organizational support. Personnel psychology, 64(2), 289-313. https://doi.org/10.1111/j.1744-6570.2011.01211.x

Kusumanegara, I.S. (2018). The Analysis of Factors Constructing Employee Productivity in the Operational Field in PT. Sumber Alfaria Trijaya Branch Lombok. International Research Journal of Management, IT and Social Sciences, 5(1), 55-64. https://doi.org/10.21744/irjmis.v5i1.595

Laeeque, S. H., Bilal, A., Babar, S., Khan, Z., & Ul Rahman, S. (2018). How patient-perpetrated workplace violence leads to turnover intention among nurses: the mediating mechanism of occupational stress and burnout. Journal of Aggression, Maltreatment & Trauma, 27(1), 96-118. https://doi.org/10.1080/10926771.2017.1410751

LaVan, H., & Martin, W. M. (2008). Bullying in the US workplace: Normative and process-orientated ethical approaches. Journal of Business Ethics, 83(2), 147-165. https://doi.org/10.1007/s10551-007-9608-9

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer publishing company.

Lim, S., & Lee, A. (2011). Work and nonwork outcomes of workplace incivility: Does family support help? Journal of Occupational Health Psychology, 16(1), 95-111. https://doi.org/10.1037/a0021726

Lim, S., Cortina, L. M., & Magley, V. J. (2008). Personal and workgroup incivility: impact on work and health outcomes. Journal of Applied Psychology, 93(1), 95-107. https://doi.org/10.1037/0021-9010.93.1.95

Lim, V. K., & Teo, T.S. (2009). Mind your E-manners: Impact of cyber incivility on employees' work attitude and behavior. Information & Management, 46(8), 419-425. https://doi.org/10.1016/j.im.2009.06.006

Lu, Y., Hu, X. M., Huang, X. L., Zhuang, X. D., Guo, P., Feng, L. F., ... & Hao, Y.T. (2017). The relationship between job satisfaction, work stress, work-family conflict, and turnover intention among physicians in Guangdong, China: a cross-sectional study. BMJ Open, 7(5), 014894. https://doi.org/10.1136/bmjopen-2016-014894

Mahfooz, Z., Arshad, A., Nisar, Q. A., Ikram, M., & Azeem, M. (2017). Does workplace incivility & workplace ostracism influence the employees' turnover intentions? Mediating role of burnout and job stress & moderating role of psychological capital. International Journal of Academic Research in Business and Social Sciences, 7(8), 398-413. https://doi.org/10.6007/IJARBSS/v7-i8/3244

Mahmud, A., & Parkhurst, M. (2007). The role of the healthcare sector in expanding economic opportunity. FSG.

Malik, M. S., & Sattar, S. (2019). Effects of Despotic Leadership and Sexual Harassment On Emotional Exhaustion of Employees In Health Sector Of Pakistan: Moderating Role of organizational cynicism. Review of Economics and Development Studies, 5(2), 269-280. https://doi.org/10.26710/reads.v5i2.587

Maloney, K. L. (2018). An Exploratory Study of Registered Nurses' Workplace Expectations, Realities, and Job Satisfaction (Doctoral dissertation, Colorado Technical University).

Mobley, W. H., Horner, S. O., & Hollingsworth, A. T. (1978). An evaluation of precursors of hospital employee turnover. Journal of Applied Psychology, 63(4), 408-414.

Mohammad, A., & Wang, Q. (2019). Factors Contributing Job Satisfaction and Job Performance Of Nurses In The Healthcare Industry.

Namayandeh, H., Juhari, R., & Yaacob, S. N. (2011). The effect of job satisfaction and family satisfaction on work-family conflict (W-FC) and family-work conflict (F-WC) among married female nurses in Shiraz-Iran. Asian Social Science, 7(2), 88-95. https://doi.org/10.5539/ass.v7n2p88

Naseer, A., Perveen, K., Afzal, M., Waqas, A., & Gillani, S. A. (2017). The impact of leadership styles on staff nurses’ turnover intentions. Saudi J Med Pharm Sci, 4929(10B), 1133-1138. https://doi.org/10.36348/sjmps.2017.v03i10.020

Naveed, A., Tharani, A., & Alwani, N. (2010). Sexual harassment at workplace: are you safe?. Journal of Ayub Medical College Abbottabad, 22(3), 222-224. https://doi.org/10.1196/annals.1385.012

Nazir, T., Ahmad, U. N. B. U., Nawab, S., & Shah, S. F. H. (2016). Mediating role of organizational cynicism in relationship between role stressors and turnover intention: evidence from healthcare sector of Pakistan. International Review of Management and Marketing, 6(2), 199-204.

Netemeyer, R. G., Boles, J. S., & McMurrian, R. (1996). Development and validation of work-family conflict and family-work conflict scales. Journal of Applied Psychology, 81(4), 400-410. https://doi.org/10.1037/0021-9010.81.4.400

Ong, M. H. A., & Puteh, F. (2017). Quantitative data analysis: Choosing between SPSS, PLS, and AMOS in social science research. International Interdisciplinary Journal of Scientific Research, 3(1), 14-25.

Pang, Y., Dan, H., Jung, H., Bae, N., & Kim, O. (2020). Depressive symptoms, professional quality of life and turnover intention in Korean nurses. International Nursing Review, 67(3), 387-394. https://doi.org/10.1111/inr.12600

Podsakoff, N. P., LePine, J. A. & LePine, M. A. (2007). Differential challenge stressor-hindrance stressor relationships with job attitudes, turnover intentions, turnover, and withdrawal behaviour: a meta-analysis. Journal of Applied Psychology, 92(2), 438. https://doi.org/10.1037/0021-9010.92.2.438

Qureshi, M. A., Ab Hamidm, K. B., Jeihoony, P., Ali, R., Brohi, N. A., Magsi, R., & Shah, S. M. M. (2018). Is supervisor support matter in job satisfaction? A moderating role of fairness perception among nurses in Pakistan. Academy of Strategic Management Journal, 17(6), 1-10.

Rad, A. M. M., & Yarmohammadian, M. H. (2006). A study of the relationship between managers' leadership style and employees' job satisfaction. Leadership in Health Services, 9(2), 11-28. https://doi.org/10.1108/13660750610665008

Rafique, k.s., & Nazir, K.I. (2018). Human resource for the impact of health policy. Policy Roundtable on Human Resources for Health, Punjab Public Health Agency. Retried from: http://www.ppha.punjab.gov.pk/news-and-highlights/hr-health.html dated: 09/08/2020.

Rahim, A. & Cosby, D. M. (2016). A model of workplace incivility, job burnout, turnover intentions, and job performance. Journal of Management Development, 35(10), 1255-1265. https://doi.org/10.1108/JMD-09-2015-0138

Ramayah, T. J. F. H., Cheah, J., Chuah, F., Ting, H., & Memon, M. A. (2018). Partial least squares structural equation modelling (PLS-SEM) using smartPLS 3.0. An updated guide and practical guide to statistical analysis (2nd ed). Kuala Lumpur, Malaysia: Pearson.

Riasat, F., & Nisar, Q. A. (2016). Does workplace incivility influence employee job stress and turnover intentions by modulating the role of psychological capital? A descriptive study on banking sector Gujranwala; Pakistan. International Journal of Scientific and Engineering Research, 7(12), 17-30. https://doi.org/10.14299/ijser.2016.12.006

Salkind, N.J. (2012). Exploring Research, Eight Edition. USA: Perason Education.

Sekeran, U., & Bougie, R. (2016). Research Methods for Business: A Skill-Building Approach. John Wiley & Sons.

Sharma, N. & Singh, V. K. (2016). Effect of Workplace Incivility on Job Satisfaction and turnover Intention in India. South Asian Journal of Global Business Research, 5(2), 234-249. https://doi.org/10.1108/SAJGBR-02-2015-0020

Shin, S., Oh, S. J., Kim, J., Lee, I., & Bae, S. H. (2020). Impact of nurse staffing on intent to leave, job satisfaction, and occupational injuries in Korean hospitals: A cross?sectional study. Nursing & Health Sciences, 22(3), 658-666. https://doi.org/10.1111/nhs.12709

Shukla, S. & Sinha, S. (2017). Communicative sensitivity in palliative care: a case on the "Happiness Angels" of Rajbala Foundation. Emerald Emerging Markets Case Studies, 7(2), 1-20. https://doi.org/10.1108/EEMCS-05-2016-0063

Spector, P. E., & Goh, A. (2001). The role of emotions in the occupational stress process. Research in Occupational Stress and Well-being, 1, 195-232. https://doi.org/10.1016/S1479-3555(01)01013-7

Summer, L., & Hoadley, J. (2014). The role of Medicaid managed care in health delivery system innovation. New York: Commonwealth Fund.

Tasneem, S., Cagatan, A. S., Avci, M. Z., & Basustaoglu, A. C. (2018). Job satisfaction of health service providers working in a public tertiary care hospital of Pakistan. The Open Public Health Journal, 11(1), 17-27. https://doi.org/10.2174/1874944501811010017

Teo, T.S. H., Srivastava, S.C. & Jiang, L. (2008). Trust and electronic government success: An empirical study. Journal of Management Information Systems, 25(3), 99-132. https://doi.org/10.2753/MIS0742-1222250303

Tremmel, S., & Sonnentag, S. (2018). A sorrow halved? A daily diary study on talking about experienced workplace incivility and next-morning negative affect. Journal of Occupational Health. https://doi.org/10.1037/ocp0000100

Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D. (2004). Nurse burnout and patient satisfaction. Medical Care, 42(2), II57-II66. https://doi.org/10.1097/01.mlr.0000109126.50398.5a

Wilson, N. L., & Holmvall, C. M. (2013). The development and validation of the Incivility from Customers Scale. Journal of Occupational Health Psychology, 18(3), 310-326. https://doi.org/10.1037/a0032753

World Health Organization. (2017). Global diffusion of eHealth: making universal health coverage achievable: Report of the Third Global Survey on eHealth. World Health Organization.

Yildiz, B., Yildiz, H., & Ayaz Arda, O. (2021). Relationship between work-family conflict and turnover intention in nurses: A meta?analytic review. Journal of Advanced Nursing, 77(8), 3317-3330. https://doi.org/10.1111/jan.14846

Zunaidah, Z., Nengyanti, N. & Hadjri, M. I. (2019). Work Stress, Job Satisfaction, and Turnover Intention: Case Study on Regional Development Banks in Southern Sumatera. International Journal of Scientific & Technology Research, 8(7), 583-586. http://repository.unsri.ac.id/id/eprint/99341

Authors

Shahid Mehmood

School of Business Management, Universiti Utara Malaysia

https://orcid.org/0009-0003-6638-8888

shahidmehmood221@gmail.com (Primary Contact)

Azelin Aziz

School of business management, Universiti Utara Malaysia

Nurul Sharniza Husin

School of business management, Universiti Utara Malaysia

Mehmood, S., Aziz, A., & Husin, N. S. (2023). Does work stress & workplace incivility influence Employee Turnover Intentions? Mediating Role of Work-family Conflict. Innovation Journal of Social Sciences and Economic Review, 5(2), 01–14. https://doi.org/10.36923/ijsser.v5i2.177

Download Citation

This work is licensed under a Creative Commons Attribution 4.0 International License.

IJSSER is committed to an open-access model for publishing, ensuring that all of its content is freely available under the terms of the Creative Commons Attribution License (CC BY) 4.0. This policy empowers researchers, academicians, and the general public to freely download, copy, print, and access the links to the full texts of published materials at no cost. Furthermore, authors are encouraged to read, distribute, and submit the published works to their institution's library and any other appropriate repositories.

Smart Citations via scite_

Downloads

Download data is not yet available.

INTRODUCTION

One of the largest industries in the world, contributing to the medical needs of billions of people (Arevalo, 2020). The demand for global healthcare services is tremendous. In 2018, the global healthcare sector was valued at $8.45 trillion. Globally spending on healthcare could exceed $10 trillion by 2022 (Allen, 2019). The global healthcare market industry is growing faster than GDP in most countries, according to the World Health Organisation (WHO, 2017). According to Arevalo (2020), the global healthcare industry generated $1.853 trillion in sales in 2018, an increase of 4.5% from the previous year. Manufacturing and provision of services and products related to health, opportunities for stable economic growth, and employment in economies around the world are affected by the employment of health workers, emerging technology, and capital invested in hospitals, clinics, and other healthcare infrastructure. In fact, these effects lead to improvement of population health (Mohammad & Wang, 2019). Current associations around the world need a workforce that focuses on the stable development and improvement of employers, staff members, and networks over the long way. General well-being is related to the healthcare industry (Ginter, Swayne, & Duncan, 2018). The healthcare sector serves the basic needs of the country and provides economic expansion potential (Mahmud & Parkhurst, 2007). Therefore, healthcare has drawn more attention worldwide and includes departments and properties such as financial, human resources, and physical organisations to provide health services to meet people's needs (Summer & Hoadley, 2014).

In the healthcare industry, nurses are the backbone of delivery services (Vahey, Alken, Sloane, Clarke, & Vargas, 2004). According to Qureshi et al. (2018), nurses have a primary job after doctors provide excellent medical care services. And benefits, especially when it comes to the treatment of patients for good quality patient consideration and the human services framework. In a similar manner, the turnover intention is essential in holding and pulling in qualified staff in healthcare with the goal that they can serve human services in their most ideal (Rad & Yarmohammadian, 2006).

In the Pakistani healthcare sector, almost two-thirds of 64% of nursing workers were unhappy with their prospects for development, low resources, and schedule of work. Most nurses showed an intention to change jobs due to a lack of adequate supervision (Malik & Sattar, 2019). Most of this increased turnover intention among nurses in the Pakistan healthcare sector (Nazir, Ahmed, Nawab, & Shah, 2016).

In developing economies such as Pakistan, due to the tremendous importance of retaining employees to reduce the turnover rate in the healthcare industry among nurses, it grew enormously. Addressing this issue (turnover intention) is essential and urgent since only a satisfied workforce would strive to remain part of the organization for a longer period, further leading to satisfying patients, and clients, contributing as the backbone in developing the financial system.

The issue of turnover intention In Ittefaq Hospital Lahore, Pakistan, the nurses’ turnover rate remains high, as reported by Naseer, Parveen, Afzal, Waqas, and Gillani (2017). Besides, this issue of turnover intention has been witnessed globally (Pang, Dan, Jung, Bae, & Kim, 2020). Along with this, Shin et al. (2020) reported turnover intention among nurses in Korean hospitals Higher nurse-to-patient ratios are the result, which has unfavourable effects.

Similarly, Pakistan is also experiencing a similar problem, as reported by Naseer et al. (2017), reported an issue of high turnover among nurses in Pakistan hospitals due to the high workload and shortage of nurses. In Pakistan, factors behind the high turnover intention of the public health sectors were also linked to a decrease in work productivity, inadequate working conditions, high absenteeism and low staff morale (Naveed, Tharani, & Alwani, 2010); along with this, inadequate resources, high workload, limited quality care (Ebrahimi, Hassankhani, Negarandeh, Jeffrey, & Azizi, 2017), work responsibility, shortage of professional and occupational nurses lack work, planning, and occupational stress (Naseer et al., 2017). However, these factors were found with high turnover intentions.

The healthcare sector of Pakistan, mainly Punjab, faces high turnover intention issues due to many reasons, such as Tasneem, Cagatan, Avci, and Basustaoglu (2018) suggested that increasing work stress among nurses at hospitals in Pakistan, uncivil behaviour (Laeeque et al. 2018). Furthermore, a high turnover intention was also observed among nurses in Punjab, Pakistan, due to WPI faced during work hours. Patients, physicians and patient attendants were reported to have been victims of harassment and incivility from nurses. Ineffective work performance, WFC, and depression were also documented. as reasons for increased turnover intention (Abrar, Bashir, Nureen, & Shahzadi, 2019).

LITERATURE REVIEW

Theoretical Perspective

Designed by Hobfoll, (1988), one of the stress models is the COR (conservation of resources) model. Psychological stress arises due to loss of actual resources, lack of gains in resources, investment in resources, and risk of loss of resources. The conservation of resources theory was designed to describe the core stress and coping process mechanisms (Hobfoll, 1989). COR theory states that loss of resources is the primary mechanism that creates stress reactions (Hobfoll, 1989).

Various studies used COR theory to test the relationship; current studies linked COR theory to work-family conflict and work stress. Lazarus and Folkman (1984) proposed transactional stress theory that defines stress as the difference between demands and resources and illuminates the procedure of stress assessment. The objective for selecting COR theory instead of other theories as a supporting framework is that the current study model talks about work stress and the conflict between family and work. WFC indicates a loss of resources because workers are unable to perform their jobs better. In line with these resource losses, it is expected that the current study model is justified by COR theory in a better way in comparison to other theories.

Based on COR theory, nurses are more involved in coping with challenges when they are feeling stressed at work and receiving more support from their workplace and will try to remain part of the organisation. On the contrary, more stress at work increases the intention to leave (turnover intention). In line with this idea, the present study shows that work stress can cause nursing staff to deplete their emotional and psychological reserves, resulting in occupational stress (work stress), which in turn leads to an intention to leave (turnover intention) the hospital.

Turnover Intention

Employee turnover, according to Basel and Fayza (2015), is a measure of the number of workers who quit and get replaced during a given time frame, such as a year. A percentage of the total workforce is expressed at the beginning of the period.

Work Stress and Turnover Intention

Since many years of empirical research on the relationship between WS (work stress) and turnover intention investigated, much of such literature evidence supported the idea of a positive association between the connection of WS with staff TI (Zunaidah, Nengyanti, & Hadjri 2019). Besides this influencing individual turnover intention, there are many different factors that affect TI. Similarly, work stress is an important factor that influences TI with a positive correlation (Lu Y et al., 2017).

The previous research in question was performed by Azlina and Mustapha (2012), who examined the connection between TI and WS of accounting staff. Job stress has a favourable relationship with the intention to leave a job. According to Haq (2014), an employee who is under much stress at work may want to leave. Shukla and Sinha (2017) also consider the psychological effects of demanding work environments. Workers who experience job-related stress, commonly known as stress at work, are forced to quit their current job. Individuals become exhausted when they experience stress from their jobs' diverse situations and are unable to manage them. In Guangdong Province, China, occupational stress is a factor that influences physicians' intentions to leave their profession. Reduced working hours, increased opportunities for career development and training, and encouragement and support for seniors and the administration can all help to reduce the likelihood of turnover (Lu Y et al., 2017). On the contrary, some studies have shown that WS has a favourable influence on TI (Kim & Kao, 2014; Ahmad et al., 2023).

This can be elaborated as work stress increases, it will increase the employee turnover intention; in another way, lowering the work stress, will be lower the employee turnover intention. According to Zunaidah, Nengyanti, and Hadjri (2019), work stress easily leads to frustrating workers’ turnover intention. In addition to this, Mahfooz, Arshad, Nisar, Ikram, & Azeem (2017) conducted a study in the healthcare sector that exposed that WS was positively related to TI. Based on the evidence from the literature cited above, the higher the work pressure, the higher the TI of the staff. Therefore, the current study has hypothesised that.

H1: Work stress has a positive effect on Turnover intention

Workplace Incivility and Turnover Intention

Since incivility is the sense of disrespect and uncivil behaviour expressed by spoken words, gestures, or actions, rude or uncivil acts, without regard to others, it is an indicator of disrespect and uncivil behaviour (Andersson & Pearson, 1999). Although Mobley et al. (1978) referred to TI as the intention of organisational members to quit their current work and seek other jobs due to job dissatisfaction, WPI can lead staff to leave as it is an important source of stress for individuals (Podsakoff, LePine & LePine, 2007) so it is assumed that incivility experienced leads employees to develop TI (Wilson & Holmvall, 2013) According to Lim and Teo (2009), they voiced concerns about rudeness at work and looked at how it influences workers' inclinations to leave their jobs. Additionally, Cortina et al. (2013) connected workplace misconduct to employees' desire to leave their jobs.

WPI potentially affects employees’ physical and psychological health (Heaphy & Dutton, 2008) Employee TI is the last step on which employees leave work. It starts with uncivil behaviour and ends with TI (Carpenter &Berry, 2015). According to various research, incivility at work due to employees' views and behaviours could lead to job replacement or job searching. For example, Mahfooz et al. (2017) revealed that due to WPI, employees often have less desire to keep their employment, and the research of colleagues and Lim, Cortina, and Magley (2008) additionally found that TI leads to victims of incivility. Consequently, if someone experiences incivility at work, there is a chance that he will become uninterested in it and eventually leave with the intention of changing his position (Riasat & Nisar, 2016).

Researchers have found that WPI is negatively related to productivity and job satisfaction and positively associated with nonattendance, desire, and tardiness to leave (Rahim and Cosby, 2016; Lim, Cortina, & Magley, 2008). Several studies provide important notes on the effects of WPI on TI (Sharma & Singh, 2016). Employees often put in less effort, work a shorter period, and do worse on the job because they have experienced being treated as a victim of WPI (Rahim & Cosby, 2016). That is, the greater the worker's perception of incivility in their workplace, the intention to leave or find new work is higher. So, based on the above-mentioned research, the hypothesis is developed as follows.

H2: Workplace Incivility has a positive effect on Turnover intention.

Work Stress and Work-family Conflict

Consequently, Byron (2005) highlighted that FWC and WFC are key facets of work stress perception. Due to the improvement in education in women, the number of employees in dual-income families is increasing. Therefore, it is mandatory to consider the dual roles of WF that generate stress in people (Armstrong, Atkin-Plunk, & Wells 2015). Additionally, Boyar, Maertz, Pearson, and Keough (2003) stated that when there is high employee demand at work, it increases work pressure, due to which employees become unable to play good family member roles. Based on cited literature review, the current study hypothesised the following relationship. Based on the evidence, the current study hypothesises.

H3: Work stress has a positive effect on work-family conflict.

Relationship of Workplace Incivility with Work-Family Conflict

According to Greenhaus and Beutell (1985), the degree to which employees' capacity to meet the family-to-work conflict is impacted by work-to-family conflict is known as the "work-to-family conflict." As mentioned earlier, WPI may reduce employee resources such as time, energy, and personal resources. When employees experience a reduction in these resources, their ability to fulfil family duties can be reduced. Specifically, Demsky, Fritz, Hammer, and Black (2018) stated that WPI goals are likely to require additional time and cognitive resources to understand their experiences even after their shift, given the ambiguous character of workplace incivility. As a result, they are less able to handle the requirements of their families, as they have limited time and cognitive resources. Additionally, targets of WPI are more possibly thinking about experiences related to working even after the actions (Demsky, Fritz, Hammer, & Black 2018; Ahmad, 2021). Employees will be less engaged in activities to gain resources, such as recovery activities. If they remain away from work, their resources can be reduced, making them less proficient in coping with family demands. Furthermore, people who face workplace incivility also experience negative emotions before quitting their job due to decreased resources, and such harmful effects can increase their time after work without appropriate resource regaining (Tremmel & Sonnentag 2018).

In the end, the conservation of resources (COR) theory of Hobfoll (1989) recommends that a shortage of resources can result in a protective attempt to safeguard the available remaining resources. Thus, when one experiences a loss of resources because of experiencing WPI, they try to save remaining resources by decreasing the investment of resources in the family domain, which creates WFC. Aligned with support to this case, Lim and Lee (2011) resulted in their study that WPI from supervisors positively predicted WFC, while rudeness from subordinates and co-workers did not, while Ferguson (2012) stated that workfellow vulgarity positively associated with WFC.

Lim and Lee (2011) found insignificant results of coworker rudeness and subordinate impoliteness towards WFC as their target audiences were from Singapore, and it is treated as a society of high-power distance (Avolio, Zhu, Koh, & Bhatia, 2004). The huge power gap between employee and supervisor creates workplace incivility from the supervisor more noticeable, which can also affect their nonwork domain; contrarily, incivility from subordinates and coworkers may not be assessed as harmful as compared to incivility from the supervisor, and it may not affect their behaviour and feelings outside of work.

Evidence shows that work-family conflict and different types of misbehaving are positively related. A study by Demsky, Ellis, and Fritz (2014) found that workplace violence was positively associated with WFC. Similarly, Carlson, Ferguson, Hunter, and Whitten (2012) have found that insulting supervision has a positive relationship with the WFC. Workplace incivility is a mixture of hostile and interpersonal actions that are antisocial, that is, full of shocking practices which can change the self-respect of victims and leave them exhausted physically and emotionally, due to which they become incapable of performing their responsibilities domestically (LaVan & Martin, 2008)

The emotion-centred model of the occupational stress method by Spector and Goh (2001) is also helpful in understanding the effects of WPI on WFC. According to Spector and Goh (2001), bullying and physical assault show strong negative emotions in victims. Psychological and physical problems are produced due to such negative emotions (Gallo & Matthews, 2003) and many long-lasting viruses (Begley, 1994), due to which victims do not fulfil family and work roles. Collectively, employees may have less or no resources to fulfil their work-family roles at a higher level of work behaviour. These individuals experience high levels of WFC as a result.

Contrarily, the low-power gap in Western culture, while studying both supervisor and coworker incivility, both have similar effects on employees such that influence from coworker incivility may also extend to the nonwork domain as supervisor discourtesy does (Ferguson, 2012; Ayenagbo, 2022). Although external vulgarity has not been be investigated in previous research work as a predictor of WFC, earlier literature showed that outsider mistreatment at work, such as daily mistreatment on a daily basis, also positively predicted WFC (Chi, Yang, & Lin, 2018).

Based on theoretical and empirical evidence, we assume that WPI from coworkers, outsiders, and supervisors can drain the resources of employees who expect WFC. In addition, the same patterns can be observed within individuals. Employees face more WPI, and their resources are depleted more compared to normal conditions; thus, employees face more WFC. Therefore, the relationship between workplace incivilities to work-family conflict has been hypothesised as follows:

H4: Workplace incivility has a positive effect on work-family conflict.

The Effect of Work-Family Conflict on Turnover Intention

TI is a dependent variable of work-family conflict; TI is defined as a regular change of workers in the employment market among organisations, careers, as well as between the terms of being employed full-time and being jobless (Kazi & Zedah, 2011). The literature shows that those individuals who assert work-family conflict usually leave their jobs. Different research work such as Asghar, Gull, Bashir, and Akbar (2018). Indicate a positive relationship between WFC and turnover intention. Based on Kahn's study, cited by Greenhaus and Beutell (1985), WFC occurs where the burden comes from work to family, which is opposed in a few terms, based on involvement in a work role (family) in such participation in family role (work) is made more complex. According to Isenhour et al. (2012), WFC arises when certain roles demand in one's life, namely the demand in family and work.

According to Netemeyer, Boles, and McMurrian (1996), WFC denotes work-related results, such as the intention of turnover and organisational loyalty. In addition to this, accounting professionals were found to increase the number of job cuts among employees, especially when different work activities conflict with family issues. Although some evidence from the literature, such as Armstrong, Atkin-Plunk, and Wells (2015), does not find such results. Kusumanegara (2018) has investigated the influence of WFC on TI with WS as an intervening variable. Basically, WS as an intervening variable is expected to bridge the effect of WFC on TI, which may affect TI positively.

Turnover intentions are most frequently discussed by scholars. Islam, Ahmad, Ahmed, and Ahmer (2019) showed some of the earlier research on the relationship between work-family conflict and turnover intention and found that work-family conflict substantially affects the working family. After this, Aboobaker and Edward (2020) also found an association between work-family conflict and turnover intention. Various empirical works, such as Harun, Mahmood, and Som (2020) and Chen, Brown, Bowers, and Chang (2015), have also reported positive relationships with TI in the WFC. Contrary to this, there is no link between WFC and TI, and WFC did not influence the intention of turnover (Han Han & Choi, 2015).

In addition, a study by Agustini, Queck and Specht (2008) additionally shows that there is no influence of WFC on intended turnover. 529 workers from the public accounting company in Jakarta and Bandung participated in this study. Because the respondents in this study are senior employees, there is very little chance that WFC will have an impact on their TI at their current employer. Furthermore, According to Yildiz, Yildiz, and Arda (2021), meta-analyses of the relationship between WFC and TI resulted in a reliable positive relationship between all forms of WFC and TI. For individuals facing conflict in their work role, their turnover intention tends to increase. However, there are still questions about why the scarce research on WFC is still affecting TI. Henceforth, following the empirical evidence cited earlier, the current study has been proposed as

H5: Work-family conflict is positively related to turnover intention.

Work-Family Conflict as a Mediator

Consequently, Du Prel and Peter (2014) studied the mediating effect of WFC in the association between WS and miserable signs. According to Blomme, Rheede and Tromp (2010), WFC was used in the study as a mediator between workplace flexibility and TI of staff working in the hospitality industry.

In the past, scholars have associated WFC as a mediating variable with the intention of turnover. Such as (Chen, Brown, Bowers, & Chang, 2015) found a mediating effect of WFC with TI 976 managers showed WFC has a significant negative impact on job satisfaction (Namayandeh, Juhari, & Yaacob, 2011) Similarly, they found a significant mediating role of workload and WFC, WFC mediated the effects of work stress on workplace behaviour (Ahmed & Omar, 2013). Based on the proof of the mediation of WFC, the current study has proposed mediating role of WFC in the relationship between workplace incivility and work stress with TI.

H6: Work-family conflict significantly mediates the relationship between work stress and turnover intention.

H7: Work-family conflict significantly mediates the relationship between workplace incivility and Turnover intention.

Figure 1.Research Framework

METHODOLOGY

Sample Technique and Data Collection

The audience selected for this study was registered nurses working in the public health care sector in the Punjab province. In Punjab's public hospitals, there are a total of 64,848 registered nurses (Rafique & Nazir, 2018). Contact with the managing superintendent (MS) was officially made for the distribution of questionnaires. Being a self-administered approach, the district hospital participants were provided with reasonable time to complete and return the questionnaires. All the questionnaires have been pre-numbered serially to track the sent questionnaires.

The assessment of the measurement model (outer model) is the first step in PLS-SEM analysis. In model evaluation, the measurement model was undertaken to ensure the model's validity and reliability in line with the arguments of Salkind (2012), who gave the rule of thumb for outer loading. According to their rule of thumb, outer loading should be 0.5 and above. For the average variance extracted, it should be above 0.5. Based upon the following argument, all the items in outer loading which are below 0.5 should be deleted one by one with the lowest value, this technique is also validated by (Hair et al., 2016) because it improves the quality of data. The Likert scale was invented by Salkind (2012), who described this technique as measuring behaviour and attitudes. It has been widely used and validated in research studies in various fields of social sciences as the use of a rating scale lets the researcher evaluate the standard deviation and mean on variables and the mid-point of the scale (Sekeran & Bougie, 2016). In line with the original authors of workplace incivility, work-family conflict, work stress, and turnover intention will be measured through a 5-point Likert scale.

The quantitative approach was used to satisfy the research objectives. The quantitative study is the formal and methodological evaluation of the interactions and observes the variables' relationship (Ramayah et al., 2018). Salkind (2012) suggested sampling and stated that “If you are mailing out surveys or questionnaires, count on increasing your sample size by 40%-50% to account for lost mail and uncooperative respondents”. To maintain a suitable average response rate, at least 50% of additional questionnaires were distributed on a model size of 382, and a total number of 573 questionnaires were distributed among nurses concerning in order to assure generalization regarding an average response rate with earlier studies in the same context, Therefore, this study will apply the cluster sampling technique to divide the twenty-five districts covering government hospitals located in different countries geographical regions. In this study, the clusters will be considered 25 districts covering public hospitals in Punjab, Pakistan. When the research design considers many geographic clusters, cluster sampling is highly useful. Sekeran & Bougie (2016) argued that when the population is divided into groups, it requires the selection of cluster samples in order to study specific cases being shared within the cluster.

ANALYSES

This section discusses the model assessment by two main approaches, assessment of the measurement model and assessment of the structural model through Smart PLS.

Demographic profile

The respondents were asked to provide their basic demographic details, including sex, age, marital status, hospital category, qualification, job position, work and experience. A comprehensive view is given in Table 1. Where most of the respondents were women, 383 (93.2%), while the male was only 28 (6.8%). In terms of age, about 211 respondents (51.3%) aged between 20-29 years, which fall under the age less than 30 years old, about 134 (32.6%) respondents with the age range between 30-39 years, while 52(12.65%) respondents are in the age of 40-49 years and followed by 14 respondents (3.41%) for the age ranged 50 and above. The finding of the marital status of the respondents revealed that out of the 411 respondents, 154 (37.47%) are single, and 257 (62.53%) are married. As revealed earlier, the respondents of this study are nurses working in 369(89.78%) district public hospitals of Punjab, while 36(8.76%) respondents are in general categories hospitals and followed by 6(1.46%) respondents belong to other category hospitals in the province of Punjab. Table 1 indicates that with respect to the education level, 371 (90.27%) have accomplished a nursing diploma, followed by 9 (2.19%) who have completed their bachelor, and 31 (7.54%) have achieved their Masters. With respect to the job position of the Respondents, the findings revealed that 260(63.26%) consist of staff nurses, followed by 93 (22.63%) ward manager nurses, and 58 (14.11%)) are other staff. The participants in the survey were also requested to provide their work experience in hospitals. Where 210(51.09%) were less than 5 years experienced; 132 (32.12%) had experienced between 5 to 10 years, 69 (16.79%) had experienced more than 10 years.

Table 1.Demographic Characteristics of the Respondents **Source: Calculated by the author.**
Category	Frequency	Valid %
Gender
Male	28	6.8
Female	383	93.2
Age
20 to 29	211	51.3
30 to 39	134	32.6
40 to 49	52	12.7
50 above	14	3.4
Marital status
Married	257	62.5
Single	154	37.3
Hospital Category
District	369	89.78
General	36	8.76
Other	6	1.46
Qualification
Nursing Diploma	371	90.27
Bachelor's degree	9	2.19
Masters	31	7.54
Job position
Staff Nurse	260	63.26
Ward Manager Nurse	93	22.63
other.	58	14.11
Experience
Less than 1 year	210	51.09
5 to 10	132	32.12
More than 10 years	69	16.79

Validity and Reliability

The reliability and validity of the measurement model were evaluated. The loading of 0.50 composite reliability scores above 0.70 and average variance scores of 0.50 were recommended (Hair et al., 2017). According to current research, all values are above the specified threshold. Table 2 shows the loading, CR and AVE. There are a few products with a low factor loading. These items were removed in order to maintain the recommended thresholds. The current study found that all scores were satisfactory and that the current research had sufficient reliability.

Table 2.Validity and reliability assessmentNote: ws1, ws5, ws7, wfc6, wpi6 were deleted due to low factor loading.
Construct	Loading	CR	AVE
Work Stress		0.838	0.511
Ws2	0.773
Ws3	0.811
Ws4	0.555
Ws6	0.727
Ws8	0.681
Turnover Intention		0.838	0.634
ti1	0.842
ti2	0.836
ti3	0.702
Work-family Conflict		0.853	0.513
Wfc-1	0.718
Wfc-2	0.803
Wfc-3	0.836
Wfc-4	0.715
Wfc-5	0.803
Workplace Incivility		0.856	0.548
Wpi-1	0.732
Wpi-2	0.862
Wpi-3	0.790
Wpi-4	0.686
Wpi-5	0.604

Discriminant Validity

Current research also assessed discriminant validity by Fornell and Larcker (1981) criteria known as the square root of AVE (table 3) and HTMT scores (table 4). Based on square root AVE scores, all values were found to be higher than the corresponding scores. The bold values present the square root of AVE. Based on scores, the current study has found a sufficient level of discriminant validity in the current research model.

Table 3.The square root of AVESquare root of AVE Bold values
	TI	WFC	WPI	WS
TI	0.796
WFC	-0.093	0.716
WPI	0.201	0.282	0.740
WS	0.146	0.556	0.392	0.715

Henseler, Ringle, and Sarstedt (2015) have recommended HTMTinference to assess discriminant validity. The mentioned values for hTMT are HTMT 0.85 (Kline, 2023). In addition to this, Teo, Srivastava, and Jiang (2008) recommended HTMT 0.90. This means that if HTMT values lie below HTMT 0.85 or HTMT 0.90 shows the establishment of adequate discriminant validity. All HTMT values were found to be well below the recommended range. Based on the outcomes, it can be described that the current study established sufficient validity.

Table 4.HTMT CriteriaSource: Calculated by the author
TI	WFC	WPI	WS
TI
WFC	0.180
WPI	0.251	0.351
WS	0.302	0.616	0.505

Variance in Endogenous Factor

Current research also evaluated the variance in endogenous variables through R-square values (Hair et al., 2016; Ramayah et al., 2018). Ong and Puteh (2017) recommended 0.10 and above R2 values. Current research has found a 9.6% variance in turnover intention and a 31.4% variance in work-family conflict. Therefore, there are satisfactory R2 values in the present research.

Table 5.R-square values R²Source: Calculated by the author
Construct	R²	Adjusted R²
Turnover Intention	0.096	0.089
Work-Family Conflict	0.314	0.311

Effect size

Cohen (1988) recommended values for f square are 0.02, 0.15, and 0.35 showing small, medium, and large effects. The results on the effect size are presented in Table 6. Current research found that the medium effect of WFC on TI has a small effect. Workplace incivility on turnover intention and a small effect on work-family conflict Similarly, WS has a small effect on TI and a medium effect on work-family conflict.

Table 6.Effect size (f²)Source: Calculated by the author
Construct	TI	WFC	WS	Effect
Work-Family Conflict	0.055			Small
Workplace Incivility	0.034	0.007		Small
Work Stress	0.034	0.342		Small, Medium

Figure 2.Measurement model

Structural Model Assessment

Based on findings in the structural model, Table 7 represents findings on hypothesised relationships. A total of seven hypotheses were proposed, five hypotheses were accepted, and two hypotheses were rejected based on the p-value and t-value scores H1 between WFCTI (B= -0.270, t value = 4.165, p-value =0.000), H2 WPITI (B=0.190 t-value = 3.314p value = 0.001), H4: WSTI (B= 0.221, t- value = 3.261p value =0.001), H5: WS WFC (B= 0.527, t-value = 11.803p value = 0.000), were accepted during the direct relationship. H3: WPI WFC (B= 0.075, t -value = 1.520 p-value = 0.129) was rejected during the direct relationship. Although in the mediating effect, the work-family conflict was not mediated between WPI and TI (B= -0.020, t value = 1.345, p-value 0.179) and was rejected, WFC significantly mediated the relationship between WS and TI (B= -0.142, t value = 3.858, p-value 0.000) and accepted.

Table 7. **Structural Model Assessment**
path	Beta	SD	T- value	P-value	Decision
WFC TI	-0.270	0.065	4.165	0.000	Accepted
WPI TI	0.190	0.057	3.314	0.001	Accepted
WPI WFC	0.075	0.049	1.520	0.129	Rejected
WS TI	0.221	0.068	3.261	0.001	Accepted
WS WFC	0.527	0.045	11.803	0.000	Accepted
WS WFCTI	-0.142	0.037	3.858	0.000	Accepted
WPIWFCTI	-0.020	0.015	1.345	0.179	Rejected

Figure 3. Structural Model

DISCUSSION

The results were achieved through two main approaches, the measurement model and the structural model through Smart PLS. Current research proposed a positive significant effect of work stress on nurses' intention to turnover in the healthcare sector of Pakistan based on empirical evidence (Zunaidah, Nengyanti, & Hadjri 2019). Current research has found positive and significant effects of WS on TI (WSTI (B= 0.221, t -value = 3.261p- value = 0.001), Current study findings are also in line with empirical evidence in the literature supporting current study findings, such as those who have narrated the adverse effect of work stress that increases TI among nurses. According to Zunaidah, Nengyanti, and Hadjri (2019), work stress easily leads to frustrating workers’ turnover intention. Due to work stress, there are chances of delivering poor and delayed services by nurses, which may harm the organisation in both financial and non-financial aspects (Haq, 2014). Furthermore, there are chances that the effects of work stress show an adverse influence on nurses’ behaviour that ultimately increases the intention to leave the job (Haq, 2014).

Current research has proposed a positive significant effect of WPI on TI based on the evidence in the evidence in the existing literature Sharma and Singh (2016) and Hendryadi and Zannati (2018). When assessing the research model, the current research found a positive significant relationship between WPI and TI WPITI (B=0.190 t-value = 3.314p value = 0.001) as incivility is treated as harmful and disrespectful behaviour at work (Andersson & Pearson 1999), which indicate more toward burnout and exhaustion, directly towards TI. Therefore, based on evidence from the literature, this was a significant direct effect of WPI on TI.

To investigate the proposed relationship, the current study from collected data identified a positive significant connection between work stress and work-family conflict. WSWFC (B= 0.527, t- value = 11.803 p-value = 0.000), based on the findings, the hypotheses stated were supported. Employees, especially female staff in the current study (nurse), have to balance their work and life due to high demands at work, work pressure, deadlines, and family responsibilities (Duong, Hussain & Subramaniam, 2020). All these become stress creators at work in the form of work stress, which ultimately misbalances work and life, so in the end, a conflict is born between work and family (work-family conflict). Hence, organisations should set the best working environment and reduce the workload to a reasonable level. Along with this, special consideration should be given to working hours (Dodanwala, Santoso, & Shrestha 2022) so that work stress can be reduced to the minimum level to avoid work-family conflict. All these stated reasons give clear indications that there is a significant and positive relationship between WS and WFC.

Based on evidence from the literature (Chi, Yang & Lin, 2018), current research proposed a significant positive relationship between WPI and WFC. While evaluating the structural model to test the hypotheses based on the collected data, the current study found a positive insignificant association between workplace incivility and work-family conflict WPIWFC (B= 0.075, t -value = 1.520 p-value = 0.129),) Therefore, based on the findings of the current study, the proposed hypotheses were rejected. Lim and Lee (2011) found insignificant results of workfare and rudeness and subordinate discourteousness toward WFC as their target audiences were from Singapore, and it is treated as a society of high-power distance (Avolio, Zhu, Koh & Bhatia, 2004). The high-power distance between employee and supervisor creates workplace incivility from the supervisor more noticeable, which can also affect their nonwork domain; contrarily, incivility from subordinates and coworkers may not be assessed as harmful as compared to incivility from the supervisor, and it may not affect their behaviour and feelings outside of work.

Based on empirical evidence, such as Aboobaker and Edward (2020) and Harun, Mahmood, and Som (2020) have proposed a positive significant relationship between WFC and turnover intention. During the evaluation of the structural model based on the collected data, the current research found a negative but significant relationship between WFC and TI. WFCTI (B= -0.270,t-value = 4.165, p-value =0.000) Conflict increases when there is a conflict between work and family (Isenhour et al. 2012) due to these conflicts, workers, especially nurses, are overloaded due to a larger number of patients and a shortage of both resources (Maloney, 2018) and supporting staff Abdullah et al. (2014) due to which nurses start thinking of quitting from an existing job. In the long run, a negative relationship between the relationship of work-family conflict and TI is quite possible (Yildiz Yildiz & Arda 2021). Reasons can be several behind this, as nurses can become habitual in dealing with the work-life balance, and another reason could be that the current job of nurses is need-based and they do not see any other suitable option for new jobs, so they tend to show a negative association between WFC and TI.

While evaluating the mediating relationship in the current study, work-family conflict was introduced, and current research found negative but significant results in H6: WSWFCTI (TI (B= -0.142, t value = 3.858, p-value 0.000) and accepted. When assessing mediating hypotheses, the findings showed a higher level of significance in the mediating relationship, and based on the findings, the proposed hypotheses were accepted based on t and p values. The significant findings of the current study are also consistent with the literature, as Khan and Muhyuldeen (2020) discovered that WFC plays a significant mediating role between job stress and TI. According to current research, there is a high level of work stress, as well as a high rate of conflict. However, given the general state of the health industry in Pakistan, including a lack of resources and a shortage of staff, nurses may believe that the same situation will exist in other organisations. As a result, they avoid work-family conflict and try to stay with the same organisation as long as their current job meets their needs. As a result, they may be treating it negatively, which could explain why current research has discovered a significant negative mediating relationship of WFC between WS and TI (Helmle, Botero, & Seibold, 2014). Second, WFC was rejected because it did not mediate the relationship between WPI and TI (B= -0.020, t -value = 1.345, p-value 0.179). A disadvantage According to Gull et al. (2023), WFC is when there is a low level of supervisor support in terms of family life consideration, so this can be narrated that the level of significance depends on the level of supervisor support. According to current research, employees consider leaving their current job due to uncivil behaviour and lack of supervisor support. So, based on evidence, it can be stated that WFC has a negligible mediating effect on workplace incivility and turnover intention.

IMPLICATIONS AND FUTURE RESEARCH

The findings of this study contribute to the body of knowledge on the impact of WS and workplace incivility on TI. Furthermore, current research adds to the literature on the important mediating role of WFC in WS, workplace incivility, and TI relationships. Current research has numerous theoretical implications in terms of resource conservation theory (COR). Workers who are under stress at work are more likely to leave, according to COR theory (Hobfoll, 2001) Thus, it would be difficult for workers, particularly nurses experiencing work stress, to remain in the same organisation, so they consider switching from their current job, resulting in an increase in turnover intention among nurses in the healthcare sector.

Furthermore, COR theory was chosen because it encompasses the overall framework. Work-family conflicts discuss the loss of resources, which causes workers to be unable to maintain a work-family balance, resulting in conflict between work and family (Kossek, Pichler, Bodner & Hammer, 2011). In addition to this COR theory, other employees stop caring about other employees in terms of civil or uncivil behaviour (Hobfoll, 2001). In the current research, there is a high level of uncivil behaviour in the form of workplace incivility (Khan, Gang, Fareed & Khan, 2020). Employees who face negative perceptions are expected to be dealing with a variety of unusual circumstances that affect their personal lives or survive in an environment in which they are losing various resources.

Apart from theoretical implications, current research has a number of practical implications. The findings of the current study will be useful for medical ruling bodies, such as the Pakistan Medical Council, in implementing strategies to address the severe issue of turnover intention. Based on the limited resources available to address the TI problem, this will be beneficial to the entire healthcare industry, particularly the Punjab Ministry of Health. Additionally, by applying current research findings, health professionals can learn to control workplace incivility, work-family conflicts, and work stress. Due to the lack of effective policies, relationships and work environments are a major concern. This study has implications for policymakers who want to create policies that are beneficial to the health industry and better for workers. Furthermore, the findings of the current study will provide valuable information for setting policies for general and special working styles to increase motivation among nurses, which will ultimately lead to a better healthcare sector in Pakistan, despite a shortage of workers.

To begin, current research focuses on healthcare nurses, but future research can cover a broad range of healthcare professionals. Future research can be expanded to include other industries. Second, while this study focused solely on nurses, future research could include leaders and other senior employees to obtain more concrete findings on the reasons for the intention to change jobs. Third, because this study was cross-sectional and only collected data once, future research can be performed longitudinally to measure the cause-and-effect relationship.

CONCLUSIONS

Currently, this study provides various perspectives that workers (nurse) in the healthcare industry experience high work stress workplace incivility, and work-family conflict while working. All these are due to a high workload shortage of staff and other supporting resources. In this study, nurses are facing uncivil behaviour from patients, attendants, and hospital staff. If nurses are not motivated and supported while performing their job in the health centre, this will certainly adversely affect the health industry with respect to the loss of valuable lives of patients, and heavy financial losses are expected in terms of loss of nursing staff due to their switching behaviour from the current job.

Read Counter : 1711 Download : 637

Share Now

Does work stress & workplace incivility influence Employee Turnover Intentions? Mediating Role of Work-family Conflict

Abstract

Full Article

References

Authors

Indexed

ISSN & Website Link

Contact Info

Article Sidebar

Abstract

Full Article

References

Authors

Article Details

Indexed

ISSN & Website Link

Contact Info