Manual Performance and Motivation Strategies for Todays Workforce: A Guide to Expectancy Theory Applications

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  3. Employee motivation

Psychologists have studied human motivation extensively and have formulated a variety of theories about what motivates people. Needs-based theories include Maslow's hierarchy of need, Aldersfer's theory, Herzberg's two factor theory and McClelland's acquired needs theory. Another approach focuses on external factors and their role in understanding employee motivation e. Skinner's reinforcement theory. Theories based on intrinsic factors focus on internal thought processes and perceptions about motivation e.

Adam's equity theory, Vroom's expectancy theory, Locke's goal setting theory [ 2 ]. In the health care field, attaining health objectives in a population depends to a large extent on the provision of effective, efficient, accessible, viable and high-quality services. The health workforce, present in sufficient numbers and appropriately allocated across different occupations and geographical regions is arguably the most important input in a unique production process and has a strong impact on overall health system performance [ 3 ].

The lack of explicit policies for human resource management has produced, in most countries, imbalances that threaten the capacity of health care systems to attain their objectives [ 4 ]. The workforce in the health sector has specific features that cannot be ignored and motivation can play an integral role in many of the compelling challenges facing healthcare today [ 5 ]. In this area, the task of motivation is exacerbated by i the nature of the economic relationship between those using the system and the system itself physicians, patients and hospitals and ii the heterogeneity of the workforce to be managed [ 6 ].

Health organizations are faced with external pressures that cannot be effectively met without appropriate adjustments to the workforce and the development of the workforce thus appears to be a crucial part of the health policy development process [ 7 ]. Cyprus has been a member of EU since The health system is a typical South Mediterranean system, with provision of health care services from both the private and public sectors.

Cyprus has the second lowest share of public expenditure to total health expenditure Health indicators are above the EU average, with life expectancy at The public health sector system consists of eight hospitals and a number of primary health care centers around the country.

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The hospitals offer services for primary, secondary and tertiary care. The health system is currently undergoing major changes, and in a new General Health System is expected to be implemented, which is to be based on contributions by the employers and the employees. Human resources management practices in the public health sector in Cyprus are centralized. Recruitment and selection is conducted by the Civil Service Committee appointed by the President of the Republic every five years. Consequently, hospital management is practically unable to ensure employee motivation, due to a lack of autonomy.

There is a problem of split accountability of personnel, as doctors and other health professionals are accountable centrally to the Medical Services, dentists to the Dental Services, psychiatrists to the Mental Health Services and administrative officers to the Ministry of Finance and other Ministries. All public sector physicians are salaried employees of the Ministry of Health and belong to a centralized civil service staffing system that allocates them to posts based on defined needs. A plan to make hospitals autonomous is now in place in the Ministry of Health, and it is emphasized that the development of this autonomy will be the prerequisite of the implementation of the new General Health System [ 9 ].

Although employee motivation is a significant element of health systems' performance, it is largely understudied [ 10 ]. The purpose of this study was to investigate: i how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, ii the association between job satisfaction and motivation iii the motivational drive of socio-demographic and job related factors in terms of improving performance in this hospital.

A validated instrument [ 11 ] addressing four work-related motivators job attributes, remuneration, co-workers and achievements was used. Two categories of health care professionals, doctors including dentists and nurses working in the hospital participated. Job satisfaction was cross-related to these motivational factors.

The main focus was on potential differences between the two categories of professionals. An instrument developed for measuring motivation based on Maslow's and Herzberg's theories was used in the present study. It consists of 19 items which are grouped under four distinct motivational factors. The job attributes factor encompasses 7 items: authority, goals, creativity opportunities, clear duties, job control, skill exploitation and decision-making. The co-workers factor encompasses 5 items: teamwork, job pride, appreciation, supervisor and fairness.

The achievements factor encompasses 3 items: job meaningfulness, earned respect and interpersonal relationships [ 11 ]. All items are neutrally phrased as "In your case, how important is..

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Responses are provided on a five-point unipolar adjective scale, in which 1 corresponds to "not at all" , 2 to "a little bit" , 3 to "moderately" , 4 to "very" and 5 to "extremely. The survey included a single question relevant to job satisfaction which was measured on a scale as well.

The most frequently argued advantages of single item measures for measuring overall job satisfaction are brevity, increased face validity, high correlation with multi-item satisfaction measures and increased sensitivity in measuring changes in job satisfaction [ 12 , 13 ]. Socio-demographic data on age, gender, education, and work-related data such as years in service, department and managerial position were also collected. The present study was conducted in the Nicosia General Hospital which is the largest on the island with a capacity of beds.

Its operation started in and today it employs doctors and nurses.

In total 67 doctors and nurses responded to the questionnaire, with an overall response rate of The sample was analyzed as a whole and by professional subgroup. For each motivation factor, summated scores were calculated on a scale, with higher scores corresponding to higher motivation to perform better by that particular factor.

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Parametric t-test and ANOVA were used for comparisons according to gender, education, age and job-related variables such as years in service, department and if the respondent appraised subordinates. Multivariate analyses, with each motivation factor the dependent variable, and sociodemographic, work-related and job satisfaction variables as independent predictors were conducted. Internal consistency reliability was tested via Cronbach's alpha coefficient and compared with the respective values observed during the development of the instrument [ 11 ].

All analyses were performed with SPSS version The majority of the respondents were female By subgroup, doctors were predominantly males The age distribution was: Regarding hospital sector, Only Overall and sub-sample frequency distribution by demographic and job-related variables.

The highest ranked motivator was achievements , which was significantly higher than all the others both for the overall sample, and by professional subgroup. The second highest ranked motivator overall was remuneration , however doctors ranked co-workers as the second strongest motivating factor.


The scores for remuneration were statistically significantly different overall and by subgroup. The lowest ranked motivator by both groups was job attributes. The four scales showed high internal consistency reliability and Cronbach's alpha coefficient was found to be in accordance with the respective developmental values [ 11 ]. Specifically, alpha was 0. On the other hand, the single-item satisfaction scale showed a moderate correlation with each of the motivation factors, with Pearson's r ranging between 0.

Mean scores 1 SD by motivating factor and job satisfaction for the entire sample and by professional subgroup.

Interestingly, the motivating effect of remuneration was significantly different by professional category, and appeared to be influenced by gender and by sector for doctors. Job attributes encompasses intrinsic motivators such as decision-making, creativity and skill exploitation.

Employee motivation

Female doctors reported being more motivated by this factor than their male colleagues. The scores for this factor were practically identical in all groups and no statistically significant differences were observed. This motivator was ranked second among doctors and third among nurses. This motivator was ranked as the strongest by both doctors and nurses.

However, the doctor and nurse subgroup analyses did not reveal any statistically significant differences. The subgroup analyses showed statistically significant differences in 4 cases. Reporting high satisfaction from work was positively and significantly associated with higher scores in all motivational factors, for both professional categories. The only motivator significantly affected by variables other than satisfaction was remuneration. Specifically in the nurses group, stronger motivation by remuneration aspects was associated with female gender, fewer years in service and occupying a managerial position, whereas in the doctors subgroup with female gender.

This variable i. Cyprus's health system faces challenges such as accession into the E. Changes in health care are continuous and at an accelerated pace; with these changes the need for more inspiring employees is emerging. How does one motivate employees in the face of increased demands, particularly when they are being asked to meet these demands with fewer resources? Expectancy is a person's belief that they will or will not be able to reach the desired outcome.

Instrumentality is the belief that a strong performance will be well rewarded. Force is a person's motivation to perform. As Human Relations management took hold, increasing intrinsic motivation and attending to individuals became a larger concern for employers. Employers that set realistic and challenging goals for their employees create employee motivation. Once in the pattern of setting goals, employees can also develop goal commitment, where they are more likely to stick to jobs until they are finished.

Employees that work along side their employers in the goal-setting process have the intrinsic benefit of participating in decisions, which can lead to higher motivation as they are empowered in their workplace. Gary Latham collaborated with Edwin Locke to expand upon his goal setting theory of motivation with five key principles designed to motivate the accomplishment and completion of a particular objective. The five key principles are:. From Wikipedia, the free encyclopedia. This section does not cite any sources. Please help improve this section by adding citations to reliable sources.

Unsourced material may be challenged and removed. December Learn how and when to remove this template message. See also: Work motivation and Job satisfaction. Contemporary Management. Library and Information Center Management. Retrieved 9 April Journal of Applied Psychology. Professional Psychology. Organizational behavior. Judge, Tim. Edition 16 ed. The Psychology Record. Journal of Occupational and Organizational Psychology.

Journal of Personality. Hackman and G. Work Redesign.