Relationship between Job Satisfaction and Organizational Commitment
at Health Tourism Hospital in Malaysia
Ros Intan Safinas Munir, !urhazirah Hashim, Syukrina Alini Mat Ali,
Baharom Ab Rahman and Ramlee Abdul Rahman
UniversitiTeknologi MARA (UiTM), Malaysia, rosint2778@puncakalam.uitm.edu.my
ABSTRACT
The purpose of this study is to gain a better
understanding of the relationship between job
satisfaction and organizational commitment.
Employee satisfaction and retention have always
been important issues for both people who work in
organization and people who study the relationship
between job satisfaction and organizational
commitment. A cross-sectional survey was
conducted on a stratified random sampling of 197
nurses at seven health tourism hospital in Malaysia.
Job Descriptive Index and Organizational
Commitment questionnaire were used to measure
job satisfaction and organizational commitment.
Correlation and stepwise regression analyses
revealed a number of significant relationships
between the two variables. The results indicate that
various facet of job satisfaction have significant
positive relationship with the three dimensions of
organizational commitment: job satisfaction
variables of work, payment and promotion showed
significant relationship with affective commitment
with the values of (ᵝ= 0.255, p<0.05), (ᵝ= .259,
p<0.05) and (ᵝ= .167, p<0.05); job satisfaction
variables of work and payment has a positive
significant relationship with normative commitment
with the values of (ᵝ= 0.339, p<0.05); and (ᵝ= .189,
p<0.05) job satisfaction variables of work and
promotion showed significant relationship with
continuance commitment with the values of (ᵝ=
0.278, p<0.05) and (ᵝ= .213, p<0.05). The findings
add new knowledge that can be used to improved
organizational practices for the retention of
valuable nurses in the hospital.
Keywords:Job Satisfaction; Affective
Commitment; Normative Commitment;
Continuance Commitment.
I I!TRODUCTIO!
Employee satisfaction and retention have always been
important issues for both people who work in
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organization and people who study the relationship
between job satisfaction and organization commitment
(Syptak et al., 1991, Brown &Sargeant, 2007). Zhang &
Kong (2009) stated that individual job satisfaction
affected their turnover intention; organizational
commitment was one of the factors that affected the
turnover intention.
The shortage and turnover among nursing staff is a
recognized problem and great concern in a many
countries (Adam & Bond, 2000, Karsh et al., 2005, Lu,
While &Barriball, 2007). Organizational commitment is
assuming particular importance in nursing because of
national and global shortage (Ward, 2001,
Vanaki&Vagharseyyedin, 2009). According to McShane
(2010), teachers, nurses, prison officer and presidents are
groups of occupation that involved high level of stress.
Ho et. al. (2009) found that nurses’ job satisfaction has a
positive influence on organizational commitment. He
added job satisfaction had the strongest correlation with
organizational commitment. Nurses’ job stress and the
organizational commitment have strong relationships
with job satisfaction (Knoop, 1995, Adams & Bond,
2000, and Lu, et al., 2007). At the same time, Malaysian
Nurses have left their current jobs to find other jobs
because of their perceived lower level of job satisfaction
(Siti Noraini, Rosintansafinas, & Khalid, 2013).
Malaysia is fast becoming a strong competitor in the
global health and medical tourism sector. Given the
potential of health tourism as a foreign exchange earner,
the government has taken a series of proactive measures
to enhance Malaysia as a preferred health tourism
destination. In 10th Malaysian Plan, health tourism aims
at increasing the revenue gained from medical and
wellness tourism by 10% each year. Medical tourism is
chosen because 10th Malaysian Plan (RMK-10) aims at
increasing the revenue gained from medical and wellness
tourism by 10% each year. Thus this study is to
determine the relationship between job satisfaction and
organizational commitment in medical tourism hospital.
II LITERATURE REVIEW
This study attempted to investigate the relationship
between job satisfaction and organizational commitment
amongst nurses in Malaysia, by selecting approximately
seven private hospitals which known as health tourism
hospital.
A. Organizational Commitment
There have been various studies in the literature
addressing the concept of organization commitment.
Organizational commitment reflects positive feelings
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towards the organization and its values. In other words,
is employees’ willingness to contribute to organization
goals. Porter et al. (1974) defined organizational
commitment as an “individual’s belief in and acceptance
of the goals and values of the organization, and a strong
desire to remain in an organization. According to
Mowday et al. (1979), organizational commitment is an
attitude, which exists between the individual and the
organization. It can be describe as the strength of
employee identification or loyalty to the entire
organization.
Meyer and Allen (1993) conceive of organizational
commitment as reflecting three core themes, namely
affective, normative and continuance commitment.
Affective commitment can be seen as wanting to stay
with an organization as a result of the “emotional
attachment to, identification with and involvement in
organization”, normative commitment is a feeling of a
moral obligation to stay with the organization and
continuance commitment as “feeling stuck” and staying
because it is too costly to leave. The level of affective
commitment towards the organization seems to be a
useful predictor of withdrawal behavior (Anton, 2009).
The less that employees feel affectively committed to the
organization, the more likely they are to move to another
organization in search of new opportunities (Meyer,
Stanley, Herscovitch, &Topolnytsky, 2002, Wasti, 2005,
and Anton, 2009). The internalized idea of responsibility
and commitment allows employees continued
membership that is appreciated by a specific organization
(Allen & Meyer, 1990). Meyer & Allen (1997) added the
individual’s awareness or consideration of expenses and
threats linked to leaving the organization, continuance
commitment is considered to be calculative. Individuals
with continuance commitment remain with a specific
organization because of the money they as employees
earn as a result of the time spent in the organization, and
not because they want to.
B. Job Satisfaction
Job satisfaction has been differently by various scholars.
Hoppock (1935) defines job satisfaction as a
“combination of psychological, physical and
environmental circumstances that causes a person to say
“I am satisfied with my job”. In other words, it implies
an effective response to one’s job. Silva (2006) added job
satisfaction as pleasurable feeling that arises from one’s
workplace. Job satisfaction is about the people who want
and need to come to work and the wants boost their
happy feeling. In 1997, Spector believes that job
satisfaction “can be considered as a global feeling about
the job or as a related constellation of attitudes about
various aspects or facets of the job”.
Organizational research indicates that employees develop
attitudes toward such job facets (Taber &Alliger, 1995;
and Johnson & Johnson, 2000). For this study, five facets
of job satisfaction were identified, namely: work, pay,
promotion, co-workers, and supervisors (Smith, Kendall
&Hulin, 1969). Thus, it is possible that job satisfaction
facets are not equally related to other constructs such as
organizational commitment.
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C. Job Satisfaction and Organizational
Commitment
Martin (1982), Francis-Felsenet. al. (1996), and Karsh et.
al. (2005) mentioned the reason that satisfaction and
commitment have received so much attention is that they
have been found to predict turnover intentions. Karsh et.
al. (2005) stated employees with higher commitment and
job satisfaction should be less likely to consider leaving
the facility. Many studies assert the high correlation
between job satisfaction and organizational commitment
(Mathieu, 1991, Yousef, 2002, Rayton, 2006, and Huang
& Hsiao, 2007). Huang & Hsiao (2007) stated
satisfaction is the precursor of commitment; it may
benefit both changing human behavior outcome and
increasing commitment. People will be more committed
to their work if they felt satisfied and appreciated.
Aamodt (2007) indicate that satisfied employees tend to
be committed to an organization, and employees who are
satisfied and committed are more likely to attend work,
stay with an organization, arrive at work on time, perform
well and engage in behaviors helpful to the organization.
III METHODOLOGY
This study is a non-experimental research so-called
correlational research which describes the relationship
among variables (Salkind, 2009). This research is
designed to investigate the relationship between job
satisfaction and organizational commitment. The sample
was drawn from the list of nurses in seven of the selected
Malaysian hospitals. From the accessible of
approximately 500 populations, 197 were selected as
respondents for this study using stratified random
sampling technique. This technique was employed in
order to make sure that the distributions of the nurses are
well dispersed according to the respective hospitals. The
required data for this study were collected by using
survey instrument which consists of a set of structured
questions on job satisfaction and job commitment. These
data were coded and analyzed using SPSS Version 20.
The independent variable in this study is job satisfaction.
Job satisfaction was measured using the Job Descriptive
Index (JDI), designed to measure five facets of a job,
namely work, payment, promotion, supervision, and co-
workers (Smith, Kendall and Hulin, 1969). The
dependent variable is organizational commitment, was
measured using Organizational Commitment Scales
(OCS) by Allen and Meyer (1993). The scale consists of
affective commitment scale (ACS), continuance
commitment scale (CCS), and normative commitment
scale (NCS)
A. Demographic Profile of Respondents
Table 1. Respondent’s Profile.
Frequency Percentage
Hospitals Prince Court 30 15.23
Medical Centre
(PCMC)
MahkotaMedial 30 15.23
Centre (MMC)
Columbia Asia 30 15.23
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 (CAH) range of 0.818 to 0.954 which indicates that the items
Pantai Hospital 30 15.23 measured were targeted to the right respondents. Further,
Melaka (PHM) 29 14.72 results of correlation analysis have shown that all
Putra Specialist 28 14.21 variables are moderately correlated with each other. All
Hospital 20 10.15 variables are significantly correlated with each other with
Melaka the lowest correlation is between co-workers and
(PUTRAM) affective commitment (r = .265, p<0.01) and the highest
Gleneagles correlation is between payment and supervision (r = .751,
p<0.01). Therefore, based on the results, it is confirmed
Hospital
that the measures used in this study are highly reliable,
(GHKL)
thus suggested its readiness for further analyses.
Island Hospital
Penang (IHP) Table 2. The results of a reliability and correlation analysis for Job
Satisfaction and Affective Commitment
Gender Male 24 12.2
N Variables Mea SD
Female 173 87.8 o n 1 2 3 4 5 6
Working Day only 51 26 1 Work 3.76 0.7
Shift 9 (.861)
Evening only 3 1.5 2 Payment 3.02 1.0 .647*
Night only 1 0.5 8 * (.932)
Rotating 142 71.9 3 Promotion 3.47 0.9 .510* .602*
Age <20 years old 4 2.0 2 * * (.949)
21 – 30 years 141 71.6 4 Supervision 3.34 0.8 .648* .751* .626*
old 4 * * * (.882)
31 – 40 years 40 20.3 5 Co-workers 3.78 0.8 .534* .487* .455* .579*
4 * * * * (.954)
old
6 Affective 2.94 0.7 .468* .507* .432* .448* .265* (.818
41 – 50 years 11 5.6 Commitmen 9 * * * * * )
old 1 0.5 t
>51 years old
Working <2 years 54 27.4 Table 3. The results of a reliability and correlation analysis for Job
experience Satisfaction and Normative Commitment
3 – 5 years 82 41.6 N Variables Mea SD
6 – 8 years 32 16.2 o n 1 2 3 4 5 6
>9 years 29 14.7 1 Work 3.76 0.7
9 (.861)
The above table shows that the data for the study were 2 Payment 3.02 1.0 .647*
collected from seven tourism hospitals in Malaysia 8 * (.932)
comprising of PCMC (30), MMC (30), CAH (30), PHM 3 Promotion 3.47 0.9 .510* .602*
2 * * (.949)
(30), PUTRAM (29), GHKL (28) and IHP (20). From
4 Supervision 3.34 0.8 .648* .751* .626*
197 sets of questionnaire collected, 173 sets of 4 * * * (.882)
questionnaire were responded by female, while remaining
5 Co-workers 3.78 0.8 .534* .487* .455* .579*
24 were answered by male. The majority of the 4 * * * * (.954)
respondent’s working shift is rotating (142), followed by 6 Normative 2.94 0.7 .535* .516* .432* .483* .314* (.894
working for a day (51), evening shift (3) and night shift Commitmen 9 * * * * * )
(1). t
Regarding the age distribution of the respondents, most of
them aged in the range of 21 to 30 (141), followed by Table 4. The results of a reliability and correlation analysis for Job
those aged between 31 and 40 (40), those with the age Satisfaction and Continuance Commitment
less than 20 (4), and the rest of the respondents aged more N Variables Mea SD
than 41 (12). Moreover, for their working experience, o n 1 2 3 4 5 6
majority of the respondents (82) have 3-5 years of 1 Work 3.76 0.7
experience on the job, followed by those with less than 2 9 (.861)
years experience (54), 6 to 8 years of experience (32) and 2 Payment 3.02 1.0 .647*
only 29 respondents have experience in nursing more 8 * (.932)
than 9 years.should be selected as available. The use of 3 Promotion 3.47 0.9 .510* .602*
internal hyperlinks within the electronic file is not 2 * * (.949)
encouraged because hyperlinks may not be supported in 4 Supervision 3.34 0.8 .648* .751* .626*
the final version of the electronic proceedings. 4 * * * (.882)
5 Co-workers 3.78 0.8 .534* .487* .455* .579*
B.Reliability Analysis 4 * * * * (.954)
The reliability analysis helps to assess the goodness of a 6 Continuance 2.94 0.7 .498* .483* .463* .465* .314* (.836
measure by computing the Cronbach’s alpha for each Commitmen 9 * * * * * )
measure (Sekaran&Bougie, 2010). Based on the Table 2 t
to 4, the Cronbach’s alphas for all the variables are in the

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 IV FI!DI!GS A!D DISCUSSIO! promotion, supervision and co-workers were not
Hypotheses are tested by testing the influence of the significantly related to affective organizational
elements of job satisfaction namely work, payment, commitment (James et. al., 2007).
promotion, supervision and co-workers towards
Table 6. The Regression Coefficients for Job Satisfaction and Normative
organizational commitment so-called affective Commitment
commitment. The results of the regression analyses have Variables Standardized Beta
shown that there was no multicollinearity problem and Work .339**
there was no serious violation of the assumption of
Payment .189*
independent observations. The multiple regression results
Promotion .117
indicate that a strong relationship existed as hypothesized.
Supervision .086
Meanwhile, R value indicates that a strong association
between the independent and dependent variable exist. Co-workers .073
R² .347
B.Multiple Regression Analysis for Independent Adjusted R² .329
Variables and Dependent Variable F Value 19.559
The purpose of this paper is to examine the relationship Significance F Value .000
between job satisfaction (work, payment, promotion,
supervision, co-workers) and affective commitment. Based on the results in Table 6 above, the result has
Further, findings indicate that there is a positive shown that only job satisfaction variables of work and
relationship between job satisfaction and affective payment has a positive significant relationship with
commitment. The results are shown in Table 5. normative commitment with the values of (ᵝ= 0.339,
p<0.05) and (ᵝ= .189, p<0.05) respectively which
Table 5. The Regression Coefficients for Job Satisfaction and Affective
Commitment
indicates that these variables significantly influence the
normative commitment. However, promotion,
Variables Standardized Beta
supervision and co-workers showed non-significant
Work .255** values of (ᵝ=0.117, p>0.05), (ᵝ=0.086, p>0.05) and
Payment .259** (ᵝ=0.073, p>0.05) which signified that the variables do
Promotion .167* not influence the normative commitment.
Supervision .056 The finding is consistent with the previous study where
Co-workers -1.24 researcher found satisfaction with work and payment
R² .318 variables positively predict normative commitment
Adjusted R² .299 (Lumley et. al. (2011). Dockel et al. (2006) added that
F Value 17.223 satisfaction with their payment and work has a
relationship with normative commitment. Meyer and
Significance F Value .000
Allen (1997) stated high performance based pay creates
an economic obligation for an individual to remain with
Based on the results in Table 4 above, it shown that only an organization. Yang et. al. (2008) found that payment
job satisfaction variables of work, payment and is an important factor affecting overall job satisfaction.
promotion showed significant relationship with affective
commitment with the values of (ᵝ= 0.255, p<0.05), (ᵝ= Table 7. The Regression Coefficients for Job Satisfaction and
.259, p<0.05) and (ᵝ= .167, p<0.05) respectively which Continuance Commitment
indicates that these variables significantly influence the Variables Standardized Beta
affective commitment. However, supervision and co- Work .278**
workers showed non-significant values of (ᵝ=0.056,
Payment .130
p>0.05) and (ᵝ=-1.24, p>0.05) which signified that the
variables do not influence the affective commitment.
Promotion .213**
This finding is consistent with those of previous Supervision .070
researches, which showed that job satisfaction has a Co-workers -.010
positive impact on employees’ commitment to R² .326
organization (Testa, 2001; Nasurdin and Ramayah, 2003; Adjusted R² .307
Lew, 2012). It is conceivable that when employees F Value 17.477
judged the organization to be fair in paying salaries which Significance F Value .000
are competitive and motivates them to give good service
to the customers, positive feelings of well being will be Based on the results in Table 7 above, it shown that only
created (Lew, 2012). In turn, is likely to stimulate them job satisfaction variables of work and promotion showed
to reciprocate by increasing their loyalty to the significant relationship with continuance commitment
organization. with the values of (ᵝ= 0.278, p<0.05) and (ᵝ= .213,
James et. al. (2007) also found significant relationship p<0.05) respectively which indicates that these variables
between satisfaction of work and payment with affective significantly influence the continuance commitment.
organizational commitment. While satisfaction with However, payment, supervision and co-workers showed

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non-significant values of (ᵝ=0.130, p>0.05), `(ᵝ=0.070,
p>0.05) and (ᵝ=-0.10, p>0.05) which signified that the
variables do not influence the continuance commitment.
However, it is contradicted with the study done by Lew,
(2012) which none of the facets of job satisfaction had
significant correlation with continuance commitment.
The findings of this study seem to be in line with research
conducted by Meyer et. al. (1993), which shows job
satisfaction to be significantly negatively associated with
continuance commitment.
V CO!CLUSIO!
The main objective of this study was to determine the
relationship between various facets of job satisfaction
with affective commitment, normative commitment and
continuance commitment. The findings indicate that
work, payment and promotion have significant
relationship with affective commitment; work and
payment have significant relationship with normative
commitment; and work and promotion have significant
relationship with continuance commitment. It can be
concluded that job satisfaction and organizational
commitment are closely related and are both important in
determining the successful of organization. Thus, it will
be beneficial to understand of what facets of job
satisfaction variable lead to increase employees’
commitment. Obviously, high job satisfaction and
organizational commitment will avoid turnover intention
and remain employees in organization. It is hope that
findings of this study would help managers and
practitioners to formulate strategies and program to
overcome turnover problem among employees. In a
nutshell, this study is significant to shed light on various
facets of job satisfaction that affect employees’
commitment to the organization.
ACK!OWLEDGME!T
The authors gratefully acknowledge Ministry of Higher
Education of Malaysia for funding this research under the
Fundamental Research Grant Scheme (FRGS).
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