Journal of Nursing Research Vol. 15, No.

4, 2007

Effects of Internal Marketing on Nurse Job

Satisfaction and Organizational Commitment:
Example of Medical Centers in Southern Taiwan
Ching-Sheng Chang · Hsin-Hsin Chang*

ABSTRACT: As nurses typically represent the largest percentage of employees at medical centers, their role in
medical care is exceptionally important and becoming more so over time. The quality and functions of
nurses impact greatly on medical care quality. The concept of internal marketing, with origins in the
field of market research, argues that enterprises should value and respect their employees by treating
them as internal customers. Such a marketing concept challenges traditional marketing methods,
which focus on serving external customers only. The main objective of internal marketing is to help
internal customers (employees) gain greater job satisfaction, which should promote job performance
and facilitate the organization accomplishing its ultimate business objectives. A question in the
medical service industry is whether internal marketing can similarly increase the job satisfaction of
nurses and enhance their commitment to the organization. This study aimed to explore the relational
model of nurse perceptions related to internal marketing, job satisfaction, and organizational
commitment by choosing nurses from two medical centers in Southern Taiwan as research subjects. Of
450 questionnaire distributed, 300 valid questionnaires were returned, giving a response rate of 66.7%.
After conducting statistical analysis and estimation using structural equation modeling, findings
included: (1) job satisfaction has positive effects on organizational commitment; (2) nurse perceptions
of internal marketing have positive effects on job satisfaction; and (3) nurse perceptions of internal
marketing have positive effects on organizational commitment.
Key Words: internal marketing, job satisfaction, organizational commitment, structural equation modeling
(SEM).

Introduction refers to the development of products that meet employees’

The concept of internal marketing originated in the
field of marketing research in the service industry (Berry,
1981; Gronroos, 1981), emphasizing that enterprises should
value and respect their employees and regard them as “in-
ternal customers” (Longbottom, Osseo-Asare, Chourides,
& Murphy, 2006). Viewing employees as an organization’s
internal customers, Berry (1981) treated employees with
“marketing-like” methods, which allowed the employees
to obtain satisfactory “products”, or “jobs”. Berry and
Parasuraman (1991) pointed out that “internal marketing”
needs in order to attract, develop, inspire, and retain quali-
fied employees. Internal marketing is the management phi-
losophy of treating employees as customers, as well as a
development strategy of offering the products (or jobs) that
meet employees’ demands in order to win employee loyalty
and organizational commitment (Longbottom et al., 2006).
Employee job satisfaction represents the subjective
attitudes and evaluations of employees toward their overall
work environment and reflects the success of an enterprise
in providing a workplace environment that fully meets em-
ployees’ demands for skill utilization, social value, and

MBA, Instructor, Department of International Trade & Business Administration, Wenzao Ursuline College of Languages & Doctoral Student,
Graduate School of Business Management, National Cheng Kung University; *PhD, Associate Professor, Department of Business
Administration, National Cheng Kung University.
Received: May 9, 2007 Revised: August 6, 2007 Accepted: September 13, 2007
Address correspondence to: Ching-Sheng Chang, 19F, No. 25, Fu-Kuo Rd., Kaohsiung 81357, Taiwan, ROC.
Tel: 886(7)558-4262; E-mail: arthur0660@yahoo.com.tw

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J. Nursing Research Vol. 15, No. 4, 2007
achievement, and serves as the judgment indicator for fair-
ness and appropriateness of an organizations’ regulations
(Shimizu, Eto, et al., 2005). Therefore, internal marketing
has a powerful influence on employees’ sense of belong-
ing, isolation, and work motivation (Kudo et al., 2006).
The concept that organizational commitment is regarded as
the identification with an organization was first proposed
by Whyte in 1956, followed by cause-effect models of or-
ganizational commitment with organizational commitment
as the intervening variable, as successively suggested by
Mowday, Porter, and Steers (1982) and Trimble (2006).
Through the research of these scholars, it was found that
employees with strong organizational commitment show
three types of tendencies toward an organization, including
a strong belief in and acceptance of organizational objec-
tives and values; willingness to dedicate more effort to the
organization; and the desire to remain a part of the organi-
zation. Employee job satisfaction gives a precise predic-
tion of organizational commitment (Lambert, Pasupuleti,
Cluse-Tolar, Jennings, & Baker, 2006).
Nurses working at hospitals not only implement inde-
pendent and professional nursing activities in accordance
with doctors’ advice, but also take responsibility for any
immediate threat to patient lives. Thus, the importance of
nurse is undeniable, and the influence of nurse qualities and
capabilities on medical care quality cannot be ignored
(Bernstein, 2005). From a management viewpoint, hospitals
can be seen as enterprises engaged in activities involving the
entire medical system where everything, from the simplest
tasks to systemic planning and management, relies on hu-
man input and control. Therefore, a primary concern of
medical care is to effectively utilize internal marketing to
enhance and develop the job satisfaction and organizational
commitment of nurses in order to promote competitive ad-
vantage (Bernstein, 2005; Longbottom et al., 2006).
In summary of the aforementioned research back-
ground and motives, this study aims to discuss the correla-
tion between nurse job satisfaction and organizational
commitment from the perspective of internal marketing.
The discussion in this research can be generalized into
three parts, as follows:
1. Discussion of the correlation between nurse job satis-
faction and organizational commitment.
2. Discussion of the correlation between nurse percep-
tions of internal marketing and job satisfaction.
3. Discussion of the correlation between nurse perceptions
of internal marketing and organizational commitment.
266
Ching-Sheng Chang et al.
Because this study aims to discuss correlations among
nurse’s internal marketing, job satisfaction, and organi-
zational commitment, the following research objective-
related hypotheses are proposed:
(1) Hypothesis 1: Nurse job satisfaction has a positive
influence on organizational commitment.
(2) Hypothesis 2: Nurse perceptions of internal market-
ing have a positive influence on job satisfaction.
(3) Hypothesis 3: Nurse perceptions of internal mar-
keting have a positive influence on organizational
commitment.
Literature Review
1. Internal marketing
Gronroos (1981), the scholar who first introduced the
term “internal marketing”, defined the term as the behavior
of selling a corporation to its internal customers (employ-
ees) under the principle that highly satisfied employees
will help create a market-oriented and customer-centered
corporation and, consequently, encourage employees with
customer-oriented awareness (Bernstein, 2005; Long-
bottom et al., 2006). Greene, Walls, and Schrest (1994)
assumed that internal marketing refers to the application of
marketing philosophy and methods to employees who ser-
ve customers in order to utilize and maintain employees
and ensure they strive to finish work. Hence, the concept of
internal marketing sees employees as internal customers
and their work as internal “products”, and, therefore, dedi-
cates efforts to the design of products that better satisfy
employee needs (Longbottom et al., 2006).
Zeithaml and Bitner (2000) indicated that in the ser-
vice triangle, the objective of external marketing is to es-
tablish commitment, interactive marketing to fulfill com-
mitment, and internal marketing to improve the ability to
fulfill commitment. In other words, the three types of
marketing in the service triangle are critical to successful
service and higher corporate profits. Internal marketing is
a communication process, and the purpose is to create the
customer-oriented organizational culture (Bernstein, 2005).
Employees are regarded as corporate partners who coop-
erate with corporations to provide products and services
for external customers. Conduit and Mavondo (2001) di-
vided internal marketing activities into five constructs
based on the seven categories proposed by Gronroos
(2000), with the five constructs related to one another as
revealed in the results of a sample survey (Suzuki et al.,
Effects of Internal Marketing on Nursing
2006). These five constructs are: (1) market training and
education; (2) management support; (3) internal commu-
nication; (4) personnel management; and (5) employee
involvement in external communication. The constructs
suggested by Conduit and Mavondo (2001) were adopted
by this study.
2. Job satisfaction
Robbins (1996) assumed that job satisfaction stands
for the general attitudes that a worker has toward his or her
job, with a high level of job satisfaction indicating a posi-
tive attitude. Job satisfaction refers to a joyful or positive
emotional state regarding work or the work experience
(Shimizu, Eto, et al., 2005; Suzuki et al., 2006). Porter and
Lawler’s (1968) definition of job satisfaction includes both
internal and external satisfaction. Internal satisfaction re-
fers to the causes that create job satisfaction, and are clo-
sely related to the job itself. In other words, it is the level of
satisfaction achieved through the job itself, through facets
such as sense of achievement, growth, self-esteem, inde-
pendence, and sense of control (Shimizu, Feng, & Nagata,
2005; Shimizu, Eto, et al., 2005). External satisfaction, on
the other hand, is indirectly related to the job itself, and
includes such facets as good working environment, wel-
fare, high salary, promotion, etc.
By combining the factors that affect job satisfaction
proposed by domestic and foreign scholars, we can con-
clude the following: Job satisfaction refers to a worker’s
feelings of, or emotional response to, his or her job and
relevant elements (Takeda, Ibaraki, Yokoyama, Miyake,
& Ohida, 2005). Degree of satisfaction depends on the
difference between actual gains and expected gains, and
can be divided into two constructs: internal satisfaction
and external satisfaction. Internal satisfaction refers to the
degree of an individual’s feelings toward, and satisfaction
with, current job activities, independence, creativity, vari-
ation, and opportunities to utilize skills, job duty impor-
tance, job achievements and responsibilities, job stability
and security, contribution to society and social status of
the job, as well as work ethic and values. External satis-
faction refers to the degree of an individual’s satisfaction
with all aspects of the current job not related to job con-
tent. Such includes possibility of promotion, rewards and
praise earned, organizational policies and executive
approaches, technical guidance, and interpersonal rela-
tionships (Castle, Engberg, & Anderson, 2007; Shimizu,
Feng, et al., 2005).
J. Nursing Research Vol. 15, No. 4, 2007
3. Organizational commitment
The concept of organizational commitment has be-
come an important research topic in the field of organiza-
tional behaviors ever since it was first proposed by Whyte
(1956). Porter, Steers, Mowday, and Boulian (1974) sug-
gested that organizational commitment is the degree of an
individual’s identification with, and devotion to, a specific
organization, and includes: (1) value commitment: strong
belief in, and acceptance of, organizational objectives and
values; (2) effort commitment: willingness to dedicate
greater effort to benefit the organization; (3) retention com-
mitment: willingness to remain as a member of an organi-
zation (Lambert et al., 2006; Moss, McFarland, Ngu, &
Kijowska, 2007). Buchanan (1974) believed that organiza-
tional commitment means an individual is attached emo-
tionally to an organization, including identification with,
and acceptance of, organizational objectives and values;
mental devotion to, and concentration on, a job role; and
loyalty to, and affection for, the organization (Dee, Henkin,
& Singleton, 2006). Therefore, the concept of organiza-
tional commitment embraces the following employee fac-
tors: (1) desire to strive to the fullest in order to represent
an organization; (2) desire to remain with an organization;
(3) feelings of belonging and loyalty to an organization;
(4) acceptance of major organizational goals and values;
(5) positive evaluation of an organization. Organizational
commitment refers to a sense of emotional identification
with organizational objectives and values, relevant profes-
sional roles, and an organization and group, with the char-
acteristics of identification, devotion, and loyalty.
According to Meyer, Allen, and Smith (1993), organi-
zational commitment should contain the following three
constructs: (1) affective commitment: members of an orga-
nization are emotionally attached to, identify themselves
with, and feel devoted to, an organization; (2) continuance
commitment: the existence of commitment is based on the
consideration of costs occurring when members leave an
organization; (3) normative commitment: employees are
firmly convinced that loyalty to an organization is an es-
sential and absolutely obligatory value (Erdheim, Wang, &
Zickar, 2006). After a comprehensive survey of scholarly
research from the viewpoint of organizational commitment,
the perspective of Porter et al. (1974) and Trimble (2006)
that organizational commitment can be evaluated as the
degree of individual identification with, and devotion to, a
specific organization, including “strong belief in, and ac-
ceptance of, organizational objectives and values, willing-
267
J. Nursing Research Vol. 15, No. 4, 2007 Ching-Sheng Chang et al.

ness to dedicate more efforts for organizational benefits,
and willingness to remain a member of an organization,”
was adopted in this study. The three constructs of value
commitment, effort commitment, and retention commit-
ment were chosen as research variables.
4. Relationships among internal marketing, job
satisfaction, and organizational commitment
The most widely accepted viewpoint is that job satis-
faction influences employees’ commitment to an organiza-
tion (Mowday et al., 1982; Trimble, 2006). As pointed out
by scholars who side with this perspective, the concept of
job satisfaction tends to be created from a micro viewpoint,
while organizational commitment is created from a macro
viewpoint (Lambert et al., 2006). As such, job satisfaction
is just a determinant of organizational commitment.
In their studies on the correlation between internal
marketing perceptions and job satisfaction, Berry and
Parasuraman (1991) pointed out that enterprises must pro-
mote services to internal employees first and allow them to
find pleasure in work before employees will be capable of
providing effective service to external customers of the
enterprise. Internal marketing refers to the application of
marketing concepts to an organization’s internal manage-
ment (Longbottom et al., 2006). Thus, the theoretical rela-
tionship and development of internal marketing and orga-
nizational commitment have been generally elaborated by
marketing scholars. Kohli and Jaworski (1990) pointed out
that the employees of an organization with the concept of
internal marketing as its enterprise philosophy have gener-
ally higher job satisfaction and organizational commitment
(Trimble, 2006).
Combining all of the above, we can conclude the fol-
lowing: (1) job satisfaction has positive effects on organi-
zational commitment; (2) nurse perceptions of internal
marketing have positive effects on job satisfaction; and
(3) nurse perceptions of internal marketing have positive
effects on organizational commitment.
Therefore, based on the literature review conducted for
this study. The overall research framework is shown in Figure 1.
Methods
A research framework and research hypotheses were
established at the outset of this study based on research
motives, objectives, and literature review. Afterward, a
questionnaire was designed and sample survey taken. The
development of each construct and methods used for data
analysis will be explained. The limitations on this study are
stated at the end of this paper.

Internal Marketing
1. Management support
2. Human resources management
3. External communication
4. Internal communication
5. Education training

Organizational
Job Satisfaction H2 H3 Commitment
1. Internal satisfaction H1 1. Value commitment
2. External satisfaction 2. Effort commitment
3. Retention commitment

Figure 1. Conceptual framework of the relationship among internal marketing, job satisfaction, and organizational commitment.
Notes. H1 shows the nurse job satisfaction has a positive influence on organizational commitment. H2 shows nurse perceptions of
internal marketing have a positive influence on job satisfaction. H3 shows nurse perceptions of internal marketing have a positive
influence on organizational commitment.

268
Effects of Internal Marketing on Nursing
Data Collection and Sampling
The questionnaire used in this study was drafted after
reviewing a wide range of relevant literature and then
amended through multiple discussion sessions with three
professors and two physicians and experts in order to en-
sure questionnaire content validity of the. Afterward, a
pre-test was conducted on nurses to remove invalid items
and ensure questionnaire content completeness and signifi-
cance so that it would measure effectively correlations
among nurse perceptions of internal marketing, job satis-
faction and organizational commitment. With the nurse of
two medical centers in southern Taiwan as study subjects, a
total of 450 questionnaire were distributed. Of the 318 co-
pies returned, 18 were excluded due to incomplete an-
swers, which gave a total 300 effective copies were re-
trieved and a valid response rate of 66.7%.
Instrument
This questionnaire was constructed as a self-designed,
structured questionnaire after consulting numerous related
articles and repeated discussion with experts. It encompassed
three dimensions, including internal marketing, job satis-
faction and organizational commitment. General factor
analysis was concurrently adopted to verify factor names
and reliability analysis (See Table 1). A 7-point Likert scale
was adopted for scales. As shown in Table 1, Cronbach’s a
values for all dimensions measured higher than .6, indi-
cating adequate questionnaire reliability (Chang, Weng,
Chang, & Hsu, 2006; Onwuegbuzie & Leech, 2005).
Table 1.
Names and Reliability Analyses of the Factors of Each Construct
Construct/Factor Name Factor loading
Internal Marketing
Management support .832
Human resources management .912
External communication .856
Internal communication .808
Education training .872
Job Satisfaction
Internal satisfaction .886
External satisfaction .891
Organizational Commitment
Value commitment .816
Effort commitment .883
Retention commitment .848
J. Nursing Research Vol. 15, No. 4, 2007
Data Analysis Methods
After questionnaires were collected, they were in-
spected and processed in order to exclude copies with in-
complete answers. Valid copies were then assigned num-
bers and filed. Analysis software, including SPSS 11.0 and
LISREL 8.50 (Linear Structural Relationship), was applied
in data analysis and processing, with tests including reli-
ability analysis, descriptive statistics analysis, and struc-
tural equation modeling (SEM).
Structural Equation Modeling (SEM)
The Linear Structural Relationship Model was em-
ployed to examine relationships among internal market-
ing, job satisfaction, and organizational commitment. To
test the research hypotheses, this study primarily used
LISREL 8.50 to do the structural equation modeling (SEM)
in order to assess relationships across various dimensions.
According to Joreskog and Sorbom (1989), structural
equation modeling allows not only the determination of
relationship extent between variables, but also the exami-
nation of chain of cause and effect. This means that results
do not merely show empirical relationships between vari-
ables when defining the practical situation. For this rea-
son, this study chose structural equation modeling to test
hypotheses. This study also used several indices, such as
the ratio of Chi-square, goodness of fit index (GFI),
adjusted goodness of fix index (AGFI), normal fix index
(NFI), and root mean square residual (RMSR) to evaluate
overall model fitness.
Cronbach’s a KMO
.906 .915
.891 .910
.861 .887
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J. Nursing Research Vol. 15, No. 4, 2007 Ching-Sheng Chang et al.

Results Table 2.
Descriptive Statistics of Sample (N = 300)
Demographic Characteristics Variable n %
All of the nurse in this study were female. Roughly Gender
half were aged 30 years or less (49%) and most were not Female 300 100
married (57.7%). In terms of educational level, most held Age
30 or under 147 49.0
college degrees or less (60.7%). In terms of seniority, most 31-40 113 37.7
had worked for their employer between 3~6 years (30%). 41-50 040 13.3
Most worked in a ward (51%) (see Table 2). Marital Status
Married 127 42.3
Not married 173 57.7
Relationships Among Internal Marketing, Job
Education
Satisfaction, and Organizational Commitment College or under 182 60.7
The Linear Structural Relationship Model was ap- Bachelor 101 33.7
plied to examine relationships among nurse perceptions of Master or above 017 05.6
internal marketing, job satisfaction, and organizational Seniority
Less than 3 years 053 17.7
commitment, with results described below. 3-6 years 090 30.0
(1) Relationship between job satisfaction and organiza- 6-10 years 079 26.3
tional commitment 10 years or above 078 26.0
As shown in Figure 2, parameter estimates of the cor- Department
Ward 153 51.0
relation between “job satisfaction” and “organizational Intensive care unit 076 25.3
commitment” reveal a path coefficient from job satisfac- Others 071 23.7
tion to organizational commitment of .56 (t = 17.62), which Job Title
reaches significance (p < .05), reflects a positive relation- Nurse 279 93.0
Head nurse 021 07.0
ship and indicates that job satisfaction has an evidently

Value e3
Commitment .78
e1 Internal h1 h2 l3
.51 .47
.74 Satisfaction
l1 Job Satisfaction
.56 Organizational .69
b21 Commitment Effort e4
l4
l2 Commitment .52
.61
e2 External g11 g21
.46 l5 .49
Satisfaction .52
.63

Retention e5
Internal Marketing x1 Commitment .76

l6
.55 l7 l10 .62
.72 l9
l8 .58 .46

Management External Internal Education

x1 Human Resources x2 x3 x4 x5
Support Management Communication Communication Training

d1 .69 d2 .48 d3 .66 d4 .79 d5 .62

Figure 2. Structural equation modeling with internal marketing as the moderator variable between job satisfaction and organiza-
tional commitment. Note. all parameters reach the significance level of p < .05.

270
Effects of Internal Marketing on Nursing
positive influence on organizational commitment. Hypoth-
esis 1 is, therefore, accepted.
(2) Relationships among perceptions of internal market-
ing and job satisfaction
As illustrated in Figure 2, parameter estimates of the
path coefficient among “internal marketing” and “job satis-
faction” reveal a path coefficient from internal marketing
to job satisfaction of .52 (t = 12.75), which reaches signifi-
cance (p < .05), reflects a positive relationship, indicating
that internal marketing has an evidently positive influence
on job satisfaction. Hypothesis 2 is, therefore, accepted.
(3) Relationships among perceptions of internal market-
ing and organizational commitment
As illustrated in Figure 2, parameter estimates of the
path coefficient among “internal marketing” and “organi-
zational commitment” reveal a path coefficient from inter-
nal marketing to organizational commitment of .46 (t =
8.63), which reaches significance (p < .05). This reflects a
positive relationship, supporting the premise that internal
marketing has an evidently positive influence on organiza-
tional commitment. Hypothesis 3 is, therefore, accepted.
(4) Table 3 shows the model fit goodness of the LISREL
model, in which the ratio of Chi-square 2.12 is smaller
than the recommended ratio of 3; the GFI exceeds the
recommended value of .9; the AGFI exceeds the rec-
ommended value of .8; the NFI exceeds the recom-
mended value of .9; and the RMSR is lower than the
recommended value of .08 (Bagozzi & Yi, 1988;
Joreskog & Sorbom, 1989).
Table 3.
The Model Fit Goodness of the LISREL Model
Fitness Statistics c2/df. GFI AGFI NFI RMSR
Standard Value <3 > .9 > .8 > .9 < .08
Conceptual Model 2.12 .92 .91 .92 .036
Note. GFI = Goodness of Fit Index; AGFI = Adjusted GFI;
NFI = Normal Fix Index; RMSR = Root Mean Square Residual.
Discussion
The two major results of this study are (1) job sati-
sfaction has positive effects on organizational commit-
ment; (2) nurse perceptions of internal marketing have po-
sitive effects on job satisfaction; and (3) nurse perceptions
J. Nursing Research Vol. 15, No. 4, 2007
of internal marketing have positive effects on organiza-
tional commitment. The three results are discussed below.
Job satisfaction has an obviously positive influence
on organizational commitment. When nurse job satisfac-
tion increases, organizational commitment is enhanced
correspondingly. In other words, a higher level of job satis-
faction indicates that a nurse is more likely to recognize
organizational values and goals, remain with the organiza-
tion, and dedicate more effort toward accomplishing orga-
nizational objectives in order to assist the organization
develop and succeed. This corresponds with the assertions
of relevant studies in the past. For example, Trimble (2006)
believed that a high level job satisfaction represents employ-
ees’ strong identification with, and loyalty to, an organiza-
tion, willingness to accept hardships and overcome predica-
ments as a team, higher interest in job responsibilities.
Our findings support the statement that internal mar-
keting has a clearly positive influence on job satisfaction
and organizational commitment and that differences in
nurse perceptions with regard to internal marketing posi-
tively influence their job satisfaction. This agrees with
assertions made in previous studies, such as that by Heskett,
Thomas, Lovemen, Sasser, and Schlesinger (1990) propos-
ing a causal model of service profit chain internal service
quality that drives employee satisfaction and that of Long-
bottom et al. (2006), which pointed out that internal mar-
keting aims to provide services to internal employees, pro-
mote employee job satisfaction and facilitate organiza-
tional growth and development.
Study findings also support that internal marketing
has a clearly positive influence on organizational commit-
ment. Differences in nurse perceptions of internal market-
ing positively influence organizational commitment. This
also agrees with assertions made in previous relevant stud-
ies. For instance, Trimble (2006) indicated that employees
have a higher level of job satisfaction and organizational
commitment when organizations adopt marketing concepts
as their enterprise philosophy both internally and exter-
nally. Gronroos (2000) suggested that organization utiliza-
tion of the concept of internal marketing contributes to en-
hanced employee organizational commitment.
Deserving of special attention is that, as internal mar-
keting has a positive influence on job satisfaction and orga-
nizational commitment, differences in nurse perceptions of
internal marketing affect their organizational commitment
in two ways: (A) Internal marketing directly affects orga-
nizational commitment, which represents a direct effect;
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J. Nursing Research Vol. 15, No. 4, 2007
(B) Job satisfaction is used as an intervening variable to
affect organizational commitment, which represents an
indirect effect. According to the above findings, we learn
that nurse perceptions of internal marketing also positively
influence organizational commitment, with the requirement
of job satisfaction as the intervening variable. This finding
varies from the previous assumption that job satisfaction
alone can positively influence organizational commitment.
In conclusion, hospital operations rely on the active
participation and assistance of nurses. As significant time
and costs are involved in training and cultivating nursing
talent, a way to retain outstanding nurses and reduce turn-
over costs and problems is for employers to pay greater
attention to the needs and expectations of their nursing
staff. Therefore, with regard to human resource manage-
ment and utilization, increasing nurse job satisfaction rep-
resents a practical and sound strategy targeting enhanced
organizational commitment. Therefore, according to the
findings of this study, we can infer that high satisfaction
with job-related activities, independence and creativity;
opportunities to utilize skills; achievements; responsibil-
ity; job stability; service to society; social status; possibil-
ity of promotion, rewards and praise; and organizational
policies and executive measures will influence nurses’
commitment to an organization. This can be reflected in
behavior such as a strong sense of belonging to an organi-
zation, willingness to dedicate efforts toward organization
success, identification with current job, and a desire to
remain in his or her position.
Finally, three research limitations identified for this
paper include:
(1) This study only discussed relationships among nurse
perceptions of internal marketing, job satisfaction,
and organizational commitment. The factors affecting
organizational commitment are quite complicated,
and include other variables such as job characteristics,
work environment, work experience, management
style, and so on, which were not included in the scope
of discussion in this study.
(2) The scope of this study was limited to two medical
centers in southern Taiwan. Thus, the applicability of
study findings to the entire nurse population may be
limited.
(3) Because of time restrictions, this study was conducted
at a single time point and, thus, was not able to assess
relevant long-term factors of influence. Suggestions
for future researchers are to adopt a time crossing
272
Ching-Sheng Chang et al.
methodology for research design rather than a single
time point. This will provide data at several time peri-
ods and allow the observation of long-term factors
that exert mutual influence over all variables that will
allow for more objective results.
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內部行銷對護理人員的影響 J. Nursing Research Vol. 15, No. 4

內部行銷對護理人員工作滿足與組織承諾之影響
 以南部醫學中心為例
張景盛 張心馨*

摘 要： 在醫療人力中，以護理人員所占比率最高，隨著時代進步，護理人員的角色日漸擴
展，在醫療過程中愈來愈有顯著地位，其人員素質與功能，影響醫療品質甚巨。內
部行銷的概念起源於服務業行銷研究之領域，主張企業應該重視並尊重員工、將員
工視為內部顧客，此種行銷概念打破以往只注重外部顧客的傳統行銷手法，最主要
的目的在於使內部顧客（員工）獲得工作上的滿足，增進個人的工作績效，達成組
織最終的營運目標，故透過內部行銷，是否有助於增進護理人員工作滿足，使其樂
為組織效力是醫療實務界所關切的問題。因此，本研究旨在探討護理人員內部行銷
知覺、工作滿足與組織承諾之結構關係模式，採用問卷調查法，以南部兩家醫學中
心之護理人員為研究對象，問卷共發放 450 份，並得到有效問卷 300 份，有效回收
率為 66.7%。進行結構方程模式分析，其結果如下：(1)工作滿足對組織承諾有正向
影響。(2)內部行銷對工作滿足有正向影響。(3)內部行銷對組織承諾有正向影響。

關鍵詞： 內部行銷、工作滿足、組織承諾、結構方程模式。

文藻外語學院國貿企管系講師暨國立成功大學企業管理研究所博士生 *國立成功大學企業管理系副教授
受文日期：96 年 5 月 9 日 修改日期：96 年 8 月 6 日 接受刊載：96 年 9 月 13 日
通訊作者地址：張景盛 81357 高雄市左營區富國路 25 號 19 樓

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