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Commitment to the nursing profession: an exploration of factors which may explain its variability Flannery, Suzanne C. 1979

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COMMITMENT TO THE NURSING PROFESSION: AN EXPLORATION OF FACTORS WHICH MAY EXPLAIN ITS VARIABILITY BY SUZANNE C. FLANNERY B.Sc.N. UNIVERSITY OF OTTAWA, 1975 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN;NURSING IN THE FACULTY OF GRADUATE STUDIES (SCHOOL OF NURSING) We accept t h i s t h e s i s as conforming to required standards UNIVERSITY OF BRITISH COLUMBIA OCTOBER 1979 @ Suzanne Catherine Flannery, 1979 In presenting th i s thes is in pa r t i a l fu l f i lment of the requirements for an advanced degree at the Univers i ty of B r i t i s h Columbia, I agree that the L ibrary sha l l make i t f ree ly ava i l ab le for reference and study. I further agree that permission for extensive copying of th is thesis for scho lar ly purposes may be granted by the Head of my Department or by his representat ives. It is understood that copying or publ icat ion of th is thes is for f inanc ia l gain sha l l not be allowed without my writ ten permission. Department of x V ^ ^ r ^ ^ The Univers i ty of B r i t i s h Columbia 2075 Wesbrook P l a c e V a n c o u v e r , Canada V6T 1W5 ABSTRACT The purpose of the study was to determine f a c t o r s which may e x p l a i n v a r i a b i l i t y i n the degree of commitment to t h e i r p r o f e s s i o n among nurses i n B r i t i s h Columbia. A common theme i n the l i t e r a t u r e on commitment to nursing i s that i t i s a powerful f o r c e which shapes a nurse's career. As such, i t i s the r e s p o n s i b i l i t y of the nursing p r o f e s s i o n to understand the nature of commitment. This i n part can be accomplished by having knowledge about f a c t o r s which e x p l a i n v a r i a b i l i t y i n the commitment of nurses to t h e i r p r o f e s s i o n . Review of the l i t e r a t u r e revealed the f a c t o r s to be personal and work-related. Based on the work of A l l u t o and Hrebiniak, a f i v e - p a r t questionnaire was p i l o t t e s t e d , then mailed to a s t r a t i f i e d random sample of four hundred nurses l i v i n g i n the Greater Vancouver D i s t r i c t . Of t h i s number 256 (64%) were returned. The t o t a l number of usable questionnaires following, a process of e l i m i n a t i o n was 217 (54.2%). Data a n a l y s i s took place i n three stages. The p r i n c i p a l f i n d i n g s were as f o l l o w s . F i r s t , an a n a l y s i s of the sub-tests revealed them to be i n t e r n a l l y c o n s i s t e n t w i t h the exception of the P r o f e s s i o n a l A c t i o n s sub-test. The r e l i a b i l i t y estimates of the f i v e sub-tests ranged from r = .93 to r = .52. Second, a n a l y s i s of the demographic data revealed a sample c l o s e l y resembling the population of i n t e r e s t . T h i r d , a stepwise m u l t i p l e r e g r e s s i o n a n a l y s i s produced an R^ of 23%. Four v a r i a b l e s entered the r e g r e s s i o n equation. Of these, three were personal v a r i a b l e s : p r o f e s s i o n a l o r i e n t a t i o n , m a r i t a l status and basic education. The f o u r t h , a work-related v a r i a b l e , was work s a t i s f a c t i o n . Thus, i t was found that c e r t a i n personal and work-related v a r i a b l e s d i d e x p l a i n v a r i a b i l i t y i n commitment, accounting f o r 23% of the t o t a l , v a r i a b i l i t y . T h i s , however, leaves a l a r g e p o r t i o n of the v a r i a b i l i t y unexplained. Of the 77% remaining, 7% i s due to random e r r o r (as i n d i c a t e d by the r e l i a b i l i t y estimate of the Commitment Index r = .93). In view of the f i n d i n g s i n the present study and s i m i l a r f i n d i n g s i n the studies by A l l u t o and Hrebiniak, other untested v a r i a b l e s which may e x p l a i n v a r i a b i l i t y i n commitment need to be researched. In a d d i t i o n to new v a r i a b l e s , a change i n methodology using path a n a l y s i s i n s t e a d of the l i n e a r model i s a l s o recommended. - i i - i -TABLE OF CONTENTS page ABSTRACT ..... i i TABLE OF CONTENTS i v LIST OF TABLES v i LIST OF FIGURES v i i ACKNOWLEDGEMENT v i i i CHAPTER I. INTRODUCTION Overview 1 Statement of the Problem 4 Hypothesis 5 Variables 6 D e f i n i t i o n of Terms 6 Organization of Remaining Chapters 9 CHAPTER II. REVIEW OF THE LITERATURE Introduction 10 The Nature of Commitment 10 L i t e r a t u r e Related to Measuring Commitment 14 Factors Which May Influence Commitment 20 A. Personal Factors 21 B. Work-Related Factors 24 Summary and Conclusion 26 CHAPTER I I I . RESEARCH DESIGN Introduction 30 Data Gathering Instruments A. Background 31 B. Questionnaire 33 C. P i l o t Test 35 Procedure A. Sample Selection 37 B. Data C o l l e c t i o n 45 C. Data Analysis 46 continued.... - i v -CHAPTER IV. DATA ANALYSIS AND DISCUSSION OF FINDINGS I n t r o d u c t i o n 49 Response Rate 49 A n a l y s i s of Demographic Data 50 Sub-Test A n a l y s i s 57 M u l t i p l e Regression A n a l y s i s & D i s c u s s i o n .. 61 CHAPTER V. SUMMARY, CONCLUSION, LIMITATIONS, IMPLICATIONS &. RECOMMENDATIONS FOR FURTHER RESEARCH Summary 68 Conclusions 70 I m p l i c a t i o n s 73 L i m i t a t i o n s 75 Recommendations f o r Further Research 76 FOOTNOTES ' 79 BIBLIOGRAPHY 82 APPENDICES Appendix A: P i l o t Test Questionnaire 85 Appendix B: Study Questionnaire and Covering L e t t e r s 91 Appendix C: Figures 8-11 - Score Frequency Graphs 101 Appendix D: Table V I I I - C o r r e l a t i o n M a t r i x of A l l V a r i a b l e s 104 Appendix E: Table IX - D e t a i l e d Summary of Stepwise Regression and A n a l y s i s of P r o f e s s i o n a l Commitment 107 -v-LIST OF TABLES page I. LIST OF INDEPENDENT VARIABLES 32 I I . DEMOGRAPHIC DATA 50 I I I . FREQUENCIES BY YEAR OF GRADUATION 56 IV. FREQUENCIES BY NUMBER OF YEARS WORK EXPERIENCE 57 V. STATISTICAL PROPERTIES FOR EACH SUB-TEST 58 VI. MEANS AND STANDARD DEVIATION OF VARIABLES 62 V I I . SUMMARY TABLE: REGRESSION ANALYSIS OF PROFESSIONAL COMMITMENT 63 - v i -LIST OF FIGURES page Figure 1. Population Cross Ta b u l a t i o n : Vancouver Chapter by Basic Education by Employment Status by Age 39 2. Population Cross Ta b u l a t i o n : New Westminster by Basic Education by Employment Status by Age 40 3. Population Cross T a b u l a t i o n : North Shore by Basic Education by Employment Status by Age 41 4. Sample Cross Ta b u l a t i o n : Vancouver Chapter by Basic Education by Employment Status by Age 42 5. Sample Cross Ta b u l a t i o n : New Westminster by Basic Education by Employment Status by Age 43 6. Sample Cross Tabulation: North Shore' by Basic Education by Employment Status by Age 44 7. Frequencies by Scores on Commitment Index 60 - v i i -ACKNOWLEDGEMENT Over the course of one and a half years, many individuals have contributed to make possible the completion of this thesis. I would especially like to thank the members of my thesis committee - Dr. Marilyn Willman, Mrs. Ruth E l l i o t t and Dr. Todd Rodgers. They gave generously of their time. Their support and guidance were always cheerfully given. I appreciate the assistance of Sue Rothwell and the Registered Nurses Association of British Columbia in the development of the study sample. Also a large debt of gratitude is due to a l l RNABC members who completed the questionnaire, especially those who enclosed notes of encouragement. In particular, I would like to thank Anne Terrillon for her unending time and patience as she typed, retyped and retyped again. Finally, many thanks to my family and friends who shared with me the frustrations and the satisfactions that were part and parcel of this project. My deepest appreciation is for John, whose love and encouragement carried me through from start to finish. - v i i i -CHAPTER I : INTRODUCTION This i s an age i n which the a b i l i t i e s of h e a l t h p r o f e s s i o n a l s to provide competent and e f f e c t i v e care are under increased p u b l i c s c r u t i n y . As such, s o c i e t y i s demanding, among other, t h i n g s , that i n d i v i d u a l s i n p r o f e s s i o n a l o r g a n i z a t i o n s define and redefine t h e i r values. Commitment to the p r o f e s s i o n i s among these values. However, the concept of commitment challenges the t h i n k i n g as i t evolves a new meaning. I t i s the r e s p o n s i -b i l i t y of the nursing p r o f e s s i o n to determine the meaning or values i t attaches to the concept of commitment. Commitment i s a powerful f o r c e which shapes a nurse's career.1 Understanding commitment and how to e f f e c t i t are important t o o l s f o r nurse educators. They have a major r e s p o n s i b i l i t y i n molding and shaping the nursing student's values and i n promoting the development of commitment to a career i n nursing. I t i s t h i s commitment, among other f a c t o r s , which should keep a nurse a c t i v e i n the p r o f e s s i o n a f t e r she has f i n i s h e d her formal education and cause her to be resp o n s i b l e and accountable f o r her ac t i o n s while nursing. I t i s t h i s commitment which should cause her to take on a le a d e r s h i p r o l e and devote time and energy to implement changes f o r b e t t e r p a t i e n t care. F i n a l l y , commitment to nursing should put a curb on the high a t t r i t i o n rates as more and more nurses choose not to leave nursing out of the sense of commitment k i n d l e d during those e a r l y years i n nursing school. The values the student acquires or develops during these formative years, commitment among them, w i l l see her through her career. Without adequate knowledge and understanding of the concept, nurse - 1 -educators w i l l not be as e f f e c t i v e i n the development of commitment i n t h e i r students. As a young p r o f e s s i o n , nursing i s s t r u g g l i n g to earn and maintain p r o f e s s i o n a l s t a t u s . I f nursing i s to achieve t h i s goal i t must earn p u b l i c respect and c r e d i b i l i t y . Among the many ways of doing t h i s i s to impress upon the p u b l i c that nurses are committed to t h e i r p r o f e s s i o n . However, i n view of the high a t t r i t i o n r a t e s , a doubt i s cast on the strength and nature of t h e i r commitment. Several authors have addressed the i s s u e of high a t t r i t i o n r a t e s . Kramer's work i s among the most d e t a i l e d s t u d i e s . She spent many years e x p l o r i n g the phenomenon and found that many new graduates experience " r e a l i t y shock," an i n a b i l i t y to cope with the discrepancy between the r e a l world of nursing and the i d e a l nursing they experienced as s t u d e n t s . 2 Thus, there i s an i n c r e a s i n g trend f o r nurses to leave t h e i r p r o f e s s i o n and seek other careers. Lamb w r i t e s that the average work l i f e of a nurse i s between 20 and 21 years. This represents only 48% of a p o s s i b l e 44 years i n which a nurse could c o n t r i b u t e to her p r o f e s s i o n . 3 One f a c t o r which may e x p l a i n the high a t t r i t i o n i s the w e l l known f a c t that most nurses are women. Many of these women are married and have a f a m i l y . Devotion and d e d i c a t i o n to being a wife and mother cause them to leave t h e i r nursing career, e i t h e r temporarily or permanently. R i e g l e r , i n an a n a l y s i s of nursing and commitment i n Canada, perceives a problem when she w r i t e s : ; -2-D a i l y , monthly, and y e a r l y the d i r e c t o r of a nursing agency i s confronted w i t h s t a f f turnover. At the same time she i s aware that i n the f i e l d of education, the educators of nursing are concerned with percentages of g i r l s e n t ering nursing and the r e s u l t a n t amount of wastage or a t t r i t i o n . * * The high a t t r i t i o n rates w i t h i n nursing are contrary to p u b l i c expectations. I t i s e s s e n t i a l t h e r e f o r e f o r the nursing p r o f e s s i o n to work toward decreasing these. Nurse educators, head nurses, nursing d i r e c t o r s and, indeed, nurses at a l l l e v e l s , should have knowledge and understanding of the f a c t o r s which c o n t r i b u t e toward high a t t r i t i o n r a t e s . Among these f a c t o r s may be the l a c k of commitment nurses have to t h e i r p r o f e s s i o n . F i n a l l y , the p u b l i c expects p r o f e s s i o n a l s to keep abreast of changes and s c i e n t i f i c advancements i n t h e i r r e s p e c t i v e d i s c i p l i n e s . For nurses to i gain respect and c r e d i b i l i t y as accountable p r o f e s s i o n a l s , they must reassure the p u b l i c that they are keeping abreast of changes i n both nursing and medicine. T h i s , however, demands a commitment from nurses as i n d i v i d u a l s to read the nursing j o u r n a l s , take part i n c o n t i n u i n g education, and i n i t i a t e and/or a c t i v e l y support nursing research. To r e i t e r a t e , the nursing p r o f e s s i o n must a c t i v e l y seek to determine the values i t attaches to the concept of commitment. Commitment i s a very important concept i n nursing. I t i s a powerful force which shapes a nurse's career. Secondly, without commitment from nurses as i n d i v i d u a l s and c o l l e c t i v e l y as a p r o f e s s i o n , they w i l l not be able to gain the respect and c r e d i b i l i t y accorded p r o f e s s i o n a l s by the p u b l i c . However, l i t t l e i s -3-known about the values nurses attach to commitment. If the nursing profession i s to count on commitment from i t s nurses, i t must know more about the concept: i t must know who the committed nurse i s , how committed she i s , and what are the c h a r a c t e r i s t i c s of the committed i n d i v i d u a l . STATEMENT OF THE PROBLEM The theme of the i n v e s t i g a t i o n was the phenomenon of commitment as i t pertained to nurses and t h e i r commitment to t h e i r profession. The purpose of the study was to determine factors which may explain v a r i a b i l i t y i n commitment among nurses l i v i n g i n urban B r i t i s h Columbia. The overriding question to be investigated was as follows: Does commitment to the nursing profession among nurses vary because of diffe r e n c e s i n personal and work-related factors as suggested i n the l i t e r a t u r e addressing commitment? For example, are s a t i s f i e d nurses d i f f e r e n t than those who are not? Are older nurses d i f f e r e n t than younger nurses? What e f f e c t do educational background or place of work exercise on degree of commitment? Does one's professional o r i e n t a t i o n or one's opinions about c o l l e c t i v e bargaining make a difference i n the degree of commitment? It was hoped that answers to these and other related questions would provide an i n d i c a t i o n of why or why not nurses are committed to t h e i r profession, thereby enhancing knowledge about commitment. HYPOTHESIS The t e n a b i l i t y of the f o l l o w i n g t e s t hypothesis: HQ: V a r i a b i l i t y of commitment i s not explained by personal and work-related f a c t o r s , was tested against i t s a l t e r n a t i v e : H J : V a r i a b i l i t y of commitment i s explained by personal and work-related f a c t o r s , employing m u l t i p l e r e g r e s s i o n procedures. In p a r t i c u l a r , the s t a t i s t i c a l -hypotheses were: H 0: R 2 PERSONAL & WORK RELATED = 0 H x: R 2 PERSONAL & WORK RELATED > 0, where the r e s u l t i n g equation included at l e a s t one personal and one work-related f a c t o r . - 5 -VARIABLES The dependent va r i a b l e was a measure of an i n d i v i d u a l ' s degree of commitment to the nursing profession. The'independent variables included factors which were considered determinants of professional commitment. These factors were divided into personal and work-related v a r i a b l e s . The personal v a r i a b l e s , those inherent i n an i n d i v i d u a l ' s personal make-up or background, included: age, gender, marital status, year of graduation, number of years nursing experience, educational background, professional o r i e n t a t i o n and c o l l e c t i v e bargaining o r i e n t a t i o n . Work-related v a r i a b l e s , those associated with the work s i t u a t i o n , included: r e g i s t r a t i o n status, employment status, employment p o s i t i o n , and work s a t i s f a c t i o n . DEFINITION OF TERMS Attitude An enduring system of a f f e c t i v e reactions based upon a cognitive process which r e f l e c t s b e l i e f s which have been learned and which are an antecedent to behaviour.^ Attitude scales measure one dimension of the a f f e c t i v e reactions: negative-positive. -6-C o l l e c t i v e Bargaining Negotiation i n good f a i t h between"an employer or an employer's organization authorized by the employer and a trade union, regarding provisions as to rates of pay, hours of work, or other conditions of employment.^ Nurses' attitudes towards c o l l e c t i v e bargaining were measured by Ponak's C o l l e c t i v e Bargaining Index. 7 Commitment The motivation, based on conviction and l o y a l t y , to act out a behaviour. Also associated with the behaviour i s a deepening involvement i n i t and with the things representing the behaviour.^ Commitment i n the present study was operationally defined as the i n d i v i d u a l ' s motivation to remain a member of the nursing profession given an opportunity to leave i t for an increase i n pay, freedom to be more pr o f e s s i o n a l l y c r e a t i v e , to have more status or to work with people who are f r i e n d l i e r , as measured by the A l l u t o and Hrebeniak Commitment Index.9 Employment Status (a) Regular f u l l - t i m e : Nurses who work 37.5 work hours per week. —7-(b) Regular part-time: Nurses who work more than 15 hours but l e s s than 37.5 hours per week. (c) Casual: Nurses who work f u l l s h i f t s or part s h i f t s on an o n - c a l l basis whenever there i s a shortage of regu l a r f u l l - t i m e or part-time nurses.10 P r o f e s s i o n a l i s m The extent to which an i n d i v i d u a l b e l i e v e s himself to be and/or conducts himself as a member of an occupation r e q u i r i n g s p e c i a l i z e d knowledge and long i n t e n s i v e preparation as measured by H a l l ' s P r o f e s s i o n a l i s m I n v e n t o r y . ^ R e g i s t r a t i o n Status (a) P r a c t i c i n g : R e g i s t r a t i o n status which designates sanction by the RNABC f o r an i n d i v i d u a l to a c t i v e l y p r a c t i c e nursing. (b) N o n - p r a c t i c i n g : Status which designates membership i n the RNABC but which does not san c t i o n a c t i v e nursing p r a c t i c e . Work S a t i s f a c t i o n An i n d i v i d u a l ' s s a t i s f a c t i o n w i t h h i s job and career as measured by Gross-Hurka Job S a t i s f a c t i o n S c a l e . ^ -8-ORGANIZATION OF REMAINING CHAPTERS The balance of the t h e s i s i s organized i n four chapters. In Chapter I I , the review of the l i t e r a t u r e i s presented and the dependent v a r i a b l e , commitment, and the independent v a r i a b l e s are described. The research design and methodology are described i n the t h i r d chapter. Chapter IV, data a n a l y s i s and d i s c u s s i o n , i s a report of the f i n d i n g s . F i n a l l y , i n Chapter V, the summary, c o n c l u s i o n s , i m p l i c a t i o n s , l i m i t a t i o n s and recommendations f o r f u r t h e r research are discussed. i - 9 -CHAPTER I I : REVIEW OF THE LITERATURE INTRODUCTION The purpose of this chapter i s to present a review of the research re l a t e d to commitment. F i r s t , a discussion of the nature of commitment and methods of measuring i t are presented. This i s followed by a discussion of research i n which factors which may influence commitment were investigated. THE NATURE OF COMMITMENT Many persons have attempted to define the term commitment. For some i t holds a V i c t o r i a n aura of devotion. For others, i t i s a popular slogan. It has been described as a philosophy for l i v i n g by some who give i t a more composite meaning. Others have described commitment i n terms of behaviour or conduct. The way i n which i n d i v i d u a l s have defined commitment depends la r g e l y on t h e i r perspective as dictated by t h e i r background and set of values. Authors such as V a i l l o t , Hughes, Nachmias, Gardner and Tarcher have expressed t h e i r understanding of the term as a philosophy for l i v i n g . V a i l l o t defines commitment from an e x i s t e n t i a l perspective. She believes commitment i s a way of l i f e . Individuals assimilate and integrate t h e i r commitment into a l l t h e i r values - s p i r i t u a l , p r o f essional, s o c i a l , and e s t h e t i c . ^ 3 By doing t h i s , V a i l l o t believes that i n d i v i d u a l s , and i n - 1 0 -p a r t i c u l a r the nursing students she taught, could s t r i v e toward a s e l f - f u l f i l l i n g way of l i f e . Hughes, i n a discussion of women i n professional careers, notes that t h e i r commitment must be for a l i f e t i m e and that women must assimilate a professional a t t i t u d e . Such an attitude must r e f l e c t a l i f e t i m e responsi-b i l i t y or commitment towards a professional career. Hughes states that what distinguishes committed professional nurses from non-committed non-professional nurses i s th e i r strong sense of r e s p o n s i b i l i t y . This strong sense of r e s p o n s i b i l i t y i s i n essence a philosophy for l i v i n g that sees them through t h e i r c a r e e r . ^ An example to demonstrate the d i s t i n c t i o n between the professional nurse and the non- professional i s that the professional nurse continues to improve nursing s k i l l s a f t e r her formal education. Nachmias also believes that women committed to t h e i r career must have a si m i l a r responsible a t t i t u d e . ^ It requires that they have a serious i n t e r e s t i n the d i s c i p l i n e , be w i l l i n g to under-take the necessary t r a i n i n g for i t s study and have a desire to contribute to i t s continuation and development. This i n t e r e s t , i n essence, becomes a part of t h e i r i n d i v i d u a l being. Gardner believes that man s t r i v e s to give meaning to his l i f e . He does t h i s by asking questions such as: "To what must I commit myself?"; "What must I l i v e up to?"; and "What are my o b l i g a t i o n s ? " ^ Through th i s questioning, a philosophy for l i v i n g w i l l evolve. Along s i m i l a r l i n e s , Tarcher believes that moving toward commitment suggests pursuit of - 1 1 -s i g n i f i c a n t purposes and that devotion to these purposes becomes a way of l i f e . 1 7 To summarize, V a i l l o t views commitment as a f u l f i l l m e n t of a person's being; Hughes views i t as a l i f e t i m e r e s p o n s i b i l i t y ; Nachmias views i t as an almost t o t a l l i f e involvement; Gardner and Tarcher view i t as a pursuit of s i g n i f i c a n t purposes. In short, these authors view commitment as a way of l i f e : a philosophy f o r l i v i n g . On the other hand, there are those who view commitment from a behavioural perspective as opposed to a p h i l o s o p h i c a l - e x i s t e n t i a l perspec-t i v e . The way an i n d i v i d u a l behaves, as opposed to the way he thinks, becomes the c r i t e r i o n . Two authors, K i e s l e r and Becker, have expressed the nature of commitment i n t h i s manner. K i e s l e r , i n research l i n k i n g behaviour and b e l i e f , studied the psychology of commitment i n terms of s p e c i f i c behaviours.18 ne was not concerned with the thought process behind the behaviour but merely analyzed di s c r e t e actions. He defined commitment as the pledging or binding of the i n d i v i d u a l to behavioural acts. He further distinguished personal commit-ment from behavioural commitment. He defined personal commitment as the "dedication to completion of a l i n e of action," and behavioural commitment consisted of "factors which constrain one to continue a l i n e of a c t i o n . T h e l a t t e r i s p a r t i a l e d into s o c i a l commitment: expecta-tions and norms which a f f e c t continuation of a l i n e of action, and cost commitment: how co s t l y i t i s to change a l i n e of action. Behaviour i s the -12-focus of K i e s l e r ' s research; commitment i s measured by the observation of actions which r e f l e c t changes i n a t t i t u d e . Becker has evolved a d e f i n i t i o n of commitment which c l o s e l y p a r a l l e l s K i e s l e r ' s cost commitment. He introduced the notion of "side-bets" and suggested that a person invests i n his organization or occupation - places side-bets - by staking something he values i n it.20 The more side-bets at stake, the greater becomes the commitment. Commitment i s , therefore, a matter of "accrued investment." The more one invests of himself, the more committed he becomes. As with K i e s l e r , these investments are measured by the a c t i v i t i e s and behaviours the i n d i v i d u a l displays. There are commonalities and d i s t i n c t differences between the several d e f i n i t i o n s of commitment which have been presented. The commonalities are seen among the authors who believe that i n searching for a meaningful and responsible l i f e , a philosophy for l i v i n g w i l l evolve. The d i s t i n c t i o n becomes apparent when you compare t h i s point of view with that of the behaviourist. It moves away from the abstract philosophical perspective to a more concrete perspective; that of observables. From among these d e f i n i t i o n s , a d e s c r i p t i o n of who the committed i n d i v i d u a l i s does not become apparent. Having knowledge about the c h a r a c t e r i s t i c s of a committed person would provide a better understanding of the concept and would contribute toward the evolution of a theory of commitment. - 1 3 -LITERATURE RELATED TO MEASURING COMMITMENT Commitment can be measured from as many d i f f e r e n t perspectives as there are d e f i n i t i o n s . Choosing one s i n g l e d e f i n i t i o n depends on the perspective of the i n v e s t i g a t o r measuring commitment. For example, i f one wishes to study the " s t a t e " of commitment of i n d i v i d u a l s , one could use an e x i s t e n t i a l l y perceived d e f i n i t i o n . The i n d i v i d u a l i s i n a s t a t e of becoming where, as V a i l l o t d e s c r i b e s , " t h i s ever-continuous passage from exi s t e n c e to being i s e f f e c t e d through commitment."21 V a i l l o t ' s research i s embedded i n e x i s t e n t i a l philosophy. The purpose of her study was to describe and compare the p r o f e s s i o n a l worlds of student nurses i n c o l l e g i a t e , diploma and p r a c t i c a l nursing schools. In doing so she examined commitment among the students. She d i d not consider d i s c r e t e a c t i o n s by nurses which would r e v e a l commitment but rather the p a t t e r n of i d e n t i f i c a t i o n making the students' p r o f e s s i o n a l world. She p o s t u l a t e d that some patterns would favour or r e v e a l commitment while others would hinder i t . For example, i f a student i d e n t i f i e s with nursing as a permanent career i t i s l i k e l y she i s more committed. V a i l l o t b e l i e v e d t h a t : ...the a c t i o n s of the committed nurse cease to be a succession of d i s c r e t e t a s k s , r e q u i r i n g her a t t e n t i o n while they l a s t , but to be t i c k e d o f f i n t o a dead past once they are terminated. Her a c t i o n s f a l l i n place i n the t o t a l p a t t e r n of her l i f e , of her being.22 -14-This t o t a l p a t t e r n of her l i f e , her e x i s t e n c e , i s i n part the s i t u a t i o n i n which the nurse f i n d s h e r s e l f . This s i t u a t i o n has been i d e n t i f i e d by V a i l l o t as the p r o f e s s i o n a l world of the student and i t i s t h i s that i s described i n the study. In d e s c r i b i n g t h i s world i t was intended that patterns of i d e n t i f i c a t i o n would emerge which would demonstrate s e l f - f u l f i l l m e n t e f f e c t e d through commitment to nursing. V a i l l o t ' s measurement of commitment con s i s t e d of observing nursing students f o r behavioural patterns which would r e v e a l commitment. I t was hoped that patterns of behaviour would emerge which would demonstrate s e l f - f u l f i l l m e n t e f f e c t e d through commitment to nursing. The study was s u c c e s s f u l i n p r o v i d i n g i n s i g h t i n t o the students' p r o f e s s i o n a l world. I t was p o s s i b l e to see the d i f f e r e n c e s and s i m i l a r i t i e s among the three types of nursing students. However, conclusions about the students' commitment were absent. There was no d i r e c t hypothesis i n reference to commitment; t h e r e f o r e , no conclusions were drawn. A second approach taken to the study of commitment was p s y c h o l o g i c a l i n tone and hinged on the d e f i n i t i o n given by K i e s l e r . Commitment was defined as "the pledging or binding of the i n d i v i d u a l to behavioural a c t s . " 2 3 Commitment was i n t e r p r e t e d as a behavioural phenomenon which e f f e c t i v e l y f r o z e a t t i t u d e s or made them r e s i s t a n t to change. The numerous experiments by K i e s l e r and h i s colleagues focused on one aspect of commitment, that i s , the e f f e c t commitment had on a t t i t u d e s and -15-behaviour. Research c o n s i s t e d of experiments to study the i n t e r a c t i v e e f f e c t s of commitment and dissonance, commitment and r e s i s t a n c e to a t t a c k on one's b e l i e f s , commitment and forewarning of an impending a t t a c k upon one's b e l i e f s , commitment and i n t e r a c t i o n w i t h others and, f i n a l l y , commitment and s e l f - a t t r i b u t i o n ( d e f i n i t i o n of s e l f ) . K i e s l e r described seven experiments conducted under very t i g h t l y c o n t r o l l e d c o n d i t i o n s . The design was e s t a b l i s h e d so there was always an experimental group and a c o n t r o l group. Only the v a r i a b l e commitment was manipulated. The methodology g e n e r a l l y followed the same format f o r each experiment. A t t i t u d e s towards a c e r t a i n issue were measured e i t h e r through a p e n c i l and paper pr e t e s t or an i n t e r v i e w . A counter-attack on the subject's b e l i e f s was conducted. This was then followed by a p o s t - t e s t to determine i f there had been any change i n a t t i t u d e or behaviour. The dependent v a r i a b l e was the amount of a t t i t u d e change that each subject showed as a r e s u l t of the counter-attack. Some of the s i g n i f i c a n t f i n d i n g s were as f o l l o w s : (1) Commitment determined the e f f e c t s of dissonant behaviour and dissonance had no e f f e c t on commitment when subjects were h i g h l y committed. 2-+ (2) Under c o n d i t i o n s of high commitment, subjects were more r e s i s t a n t to a t t a c k on t h e i r b e l i e f s and became more b e h a v i o u r a l l y extreme than they were before the attack.25 -16-(3) The response to forewarning of attack on one's b e l i e f s was determined by previous commmitment ( i . e . , the response of i n d i v i d u a l s with low commitment was to p a r t i a l l y abandon t h e i r b e l i e f s while those who had a high commitment became more extreme i n t h e i r opinions).26 (4) On the basis that commitment to future i n t e r a c t i o n with others has implications for subsequent events that may occur in the group, i t was hypothesized that the greater the commitment to the group, the greater the a t t i t u d e change when attacked from within the group. 2 7 K i e s l e r and his colleagues presented a well-documented case on the psychology of commitment. In doing so, however, they maintained a narrow perspective of what i s a very complicated concept with many connotations and a p p l i c a t i o n s . In maintaining t h i s narrow perspective they examined the concept of commitment i n i s o l a t i o n ; i . e . , "greenhouse method." This represented a weakness i n t h e i r research. Commitment cannot be viewed i n i s o l a t i o n as there are so many intruding v a r i a b l e s . The s i g n i f i c a n t findings l i s t e d e a r l i e r addressed s p e c i f i c variables only. What of the other contributing factors which affected, for example, dissonance or group l o y a l t y at a p a r t i c u l a r point i n time or under c e r t a i n circumstances? Looking at commitment i n i s o l a t i o n , as K i e s l e r and his colleagues d i d , l i m i t e d the g e n e r a l i z a b i l i t y of t h e i r findings to the " r e a l " world, to r e a l s i t u a t i o n s where intruding variables would be acting to influence be-haviour. No provision was made to look at a m u l t i p l i c i t y of i n t e r a c t i n g variables simultaneously. -17-In t u r n i n g to the l i t e r a t u r e outside the realms of nursing and psychology, i t i s evident that much has been w r i t t e n by researchers i n o r g a n i z a t i o n a l management on the development of occupational i d e n t i f i c a t i o n and career commitment among p r o f e s s i o n a l employees. From, t h i s research evolved the Commitment Index, a r e l i a b l e instrument f o r measuring commitment to one's p r o f e s s i o n . The Commitment Index was f i r s t developed by s o c i o l o g i s t s R i t z e r and Tric e ^ S i n a study designed to t e s t e m p i r i c a l l y a theory of commitment developed by' Becker. A high score i n d i c a t e d high commitment and a low score, low commitment. The Index was developed over an eleven-month period. A f t e r 100 i n t e r v i e w p r e t e s t s , a second p r e t e s t was mailed to a random sample of 623 personnel managers l i v i n g i n the United States. A response r a t e of 66.2% was obtained. Although the researchers d i d not go i n t o d e t a i l about how they tested the Index f o r r e l i a b i l i t y and v a l i d i t y , t they claimed a t e s t r e - t e s t r e l i a b i l i t y "ranging from .83 to 1.0."29 The Commitment Index developed by R i t z e r and T r i c e was l a t e r questioned by A l l u t o and Hrebiniak,^0 researchers i n o r g a n i z a t i o n management. They argued that the Index was not s u f f i c i e n t l y s e n s i t i v e . F o llowing some m o d i f i c a t i o n s to improve the u t i l i t y of the Index, A l l u t o and Hrebeniak conducted a second study to t e s t i t e m p i r i c a l l y . The subjects i n the study c o n s i s t e d of 318 teachers and 398 nurses l i v i n g i n western New York State. The mailed questionnaires y i e l d e d response rates of 71% and 81%, r e s p e c t i v e l y . S t a t i s t i c a l a n a l y s i s of the Index went -18-beyond the analysis of the Ritzer-Trice study. Rather than just summing the twelve items in the Index, tests to determine item r e l i a b i l i t y and u t i l i t y were performed. Interitem correlations consisted of a zero-order correlation and an internal criterion test of item r e l i a b i l i t y where each item was correlated with the summation of remaining eleven items. It was found that of the twelve items the most reliable were the four "slight increase" items. The correlations between the "slight increase" items and the total score were 0.69, 0.65, 0.71 and 0.71.31 I n v i e w Q f this, Alluto and Hrebeniak based the f i n a l Commitment Index on the four "slight increase" items. They obtained a Spearman-Brown r e l i a b i l i t y estimate for the four-item scale of 0.79.32 i This four item questionnaire was tested in a subsequent study, involving managers graduating from Engineering and M.B.A. programs. The purpose of this study was to determine i f the Index retained its validity and r e l i a b i l i t y when administered to a different population. The authors concluded that the study yielded similar results. Although a r e l i a b i l i t y estimate was not given, the correlations between each item and total score were 0.61, 0.70, 0.71, 0.5833. Having determined the r e l i a b i l i t y estimate for the Index and having concluded that i t provided a reliable method for measuring commitment, Alluto and Hrebiniak proceeded with the second step. Using personal and work-related information on each subject, the relationship between this information and the subject's commitment level was explored. Having -19-conducted a simple c o r r e l a t i o n a l a n a l y s i s , a more complicated m u l t i p l e r e g r e s s i o n approach was performed to determine the r e l a t i o n s h i p between the subject's commitment l e v e l and the i n t e r a c t i v e e f f e c t s of the personal and work-related v a r i a b l e s . Based on the f i n d i n g s from the review of the l i t e r a t u r e , A l l u t o and Hrebiniak b e l i e v e d that commitment to the p r o f e s s i o n appeared to be a 5 f u n c t i o n of personal and work-related i s s u e s . V a r i a b l e s such as sex, socio-economic background, r e l i g i o n , and years of p r o f e s s i o n a l experience were ca t e g o r i z e d as personal f a c t o r s . Job te n s i o n , employing o r g a n i z a t i o n , and perceptions of r o l e c o n f l i c t were cat e g o r i z e d as work-related f a c t o r s . Based on the f i n d i n g s of t h e i r study, A l l u t o and Hrebeniak concluded that d i f f e r i n g commitment l e v e l s among t h e i r subjects could be explained by the d i f f e r e n c e s i n personal and work-related v a r i a b l e s of each of the subje c t s . FACTORS WHICH MAY INFLUENCE COMMITMENT A s e r i e s of stu d i e s i n v e s t i g a t i n g f a c t o r s which may i n f l u e n c e commitment revealed that the f a c t o r s could be d i v i d e d i n t o two subsets: (A) personal f a c t o r s , and (B) work-related f a c t o r s . The personal f a c t o r s were f u r t h e r d i v i d e d i n t o (1) demographic f a c t o r s , (2) p r o f e s s i o n a l o r i e n t a t i o n , and (3) c o l l e c t i v e bargaining o r i e n t a t i o n . Work-related f a c t o r s were s i m i l a r l y d i v i d e d i n t o (1) demographic f a c t o r s and (2) job s a t i s f a c t i o n . -20-A. Personal Factors 1. Demographic Among the many f a c t o r s which may i n f l u e n c e commitment some are c a t e g o r i z e d as personal f a c t o r s : those f a c t o r s which are inherent i n the i n d i v i d u a l ' s personal make-up or background. Included are demographic f a c t o r s such as gender, age, m a r i t a l s t a t u s , year of graduation, number of years working experience, and educational background. These are c l e a r - c u t and e a s i l y e l i c i t e d data. 2. P r o f e s s i o n a l O r i e n t a t i o n Also included among the personal f a c t o r s may be the i n d i v i d u a l ' s b e l i e f s and a t t i t u d e s toward p r o f e s s i o n a l i s m . Since these are not so c l e a r - c u t and e a s i l y e l i c i t e d , a measurement instrument must be used. . A t e s t used to determine p r o f e s s i o n a l o r i e n t a t i o n i s the H a l l P r o f e s s i o n a l i s m Inventory.34 The Inventory measures the extent to which an i n d i v i d u a l b e l i e v e s himself to be and acts as a p r o f e s s i o n a l . The P r o f e s s i o n a l i s m Inventory was designed by s o c i o l o g i s t H a l l and was f i r s t tested on 328 subjects representing eleven occupational groups ( p h y s i c i a n s , nurses, accountants, teachers, lawyers, s o c i a l workers, stock brokers, l i b r a r i a n s , engineers, personnel managers and a d v e r t i s i n g e x e c u t i v e s ) . The Inventory produced a Kuder-Richardson Formula 20 r e l i a b i l i t y of 0.86.35 -p^ e -21-original inventory consisted of f i f t y items measuring five dimensions in professionalism: (1) using the professional organization as a major referent (2) belief in public service (3) belief in self-regulation (4) sense of calling to the f i e l d , and (5) feelings of autonomy Snizek, also a sociologist, undertook to shorten the Inventory by eliminating weak items. He administered the Inventory to 566 subjects from four occupational groups (aeronautical, nuclear and chemical engineers, physicists and chemists). Using both his own and Hall's data, he used factor analytic procedures to determine the empirical f i t of the items to the five dimensions listed above. He found that approximately half of the items had "less than acceptable factor loadings" (a loading factor of less than .30) on their appropriate theoretical dimensions. By reducing the item numbers from 50 to 25 so that there are five items in each dimension instead of ten, the scale item overlap is diminished. For example, the ^ correlation between dimension one and three dropped from 0.377 to 0.161 in Hall's data and from 0.334 to 0.179 in ySnizek's data. In reducing the number of items, the Inventory's r e l i a b i l i t y decreased slightly; 0.86 to 0.84 for Hall's data, and from 0.80 to 0.79 for Snizek's. 3 6 -22-3. C o l l e c t i v e Bargaining O r i e n t a t i o n Because c o l l e c t i v e bargaining i s part of union a c t i v i t i e s and because the labour r e l a t i o n s d i v i s i o n of the RNABC plays a s i g n i f i c a n t r o l e i n a r t i c u l a t i n g work-related ideas and o b j e c t i v e s held by many nurses, i t was thought that an i n d i v i d u a l ' s o r i e n t a t i o n to c o l l e c t i v e bargaining may i n f l u e n c e commitment. An instrument was developed i n a study by Ponak to measure o r i e n t a t i o n toward c o l l e c t i v e b a r g a i n i n g . 3 ^ The study had two o b j e c t i v e s . The f i r s t was to assess the importance nurses attached to p r o f e s s i o n a l or union goals that were subject matter f o r c o l l e c t i v e bargaining. The second o b j e c t i v e was to i d e n t i f y determinants of the importance attached to the goals. Opinions about c o l l e c t i v e bargaining was one of these determinants. The instrument was developed by Ponak because of the absence of an already e x i s t i n g one which was v a l i d , r e l i a b l e and appropriate f o r nurses. F i f t e e n statements r e l a t i n g to unionism and c o l l e c t i v e bargaining were drawn from nursing j o u r n a l s and from two union a t t i t u d e surveys, one f o r blue c o l l a r workers and one f o r nurses. These statements were administered i n ques-t i o n n a i r e form to a sample of 85 nurses l i v i n g i n Wisconsin. Responses were f a c t o r analyzed. Two t h e o r e t i c a l dimensions emerged: (1) general union a t t i t u d e s , and (2) m i l i t a n c y a t t i t u d e . Only ten items loaded s i g n i f i c a n t l y on the two dimensions, the remaining f i v e were discarded. A p r e t e s t , using the ten item question-n a i r e , was given to a sample of the population o u t l i n e d i n the study. The -23-responses were f a c t o r analyzed. The r e s u l t s again showed two dimensions emerging. The ten item questionnaire was then used i n the study. The responses were f a c t o r analyzed and f o r the t h i r d time the two dimensions emerged. C o e f f i c i e n t s of r e l i a b i l i t y were c a l c u l a t e d , as f o l l o w s : general a t t i t u d e s 0.79; m i l i t a n c y 0.63. 3 8 B. Work-Related Factors 1. Demographic In a d d i t i o n to i n v e s t i g a t i n g personal f a c t o r s , the r e l a t i o n of work-related f a c t o r s to commitment has a l s o been examined. These c o n s i s t of f a c t o r s inherent i n the work s i t u a t i o n or that are d i r e c t l y r e l a t e d to the work s i t u a t i o n . This i n c l u d e s i n f o r m a t i o n such as r e g i s t r a t i o n s t a t u s : whether p r a c t i c i n g or n o n - p r a c t i c i n g ; employment s t a t u s : whether f u l l - t i m e or part-time; and employment p o s i t i o n : whether h o s p i t a l s t a f f nurse, p u b l i c h e a l t h nurse, i n s t r u c t o r , a d m i n i s t r a t o r or other. 2. Job S a t i s f a c t i o n Another work-related f a c t o r , job s a t i s f a c t i o n , was determined by using a b r i e f questionnaire which measures the respondent's s a t i s f a c t i o n with h i s work and career. An instrument was developed f o r t h i s purpose and used by Gross i n a study of school superintendents e x p l o r i n g problems of consensus of r o l e d e f i n i t i o n , conformity to expectations and r o l e c o n f l i c t -r e s o l u t i o n . 3 9 The work s a t i s f a c t i o n questionnaire i n the Gross study -24-was broken down into a job satisfaction scale and a career satisfaction scale. Reliability estimates of .99 and .98, respectively, were obtained in this study.40 The questionnaire was later adapted and modified by Hurka in his doctoral dissertation to study perceived role orientations among nurses in the state of Washington.41 The questionnaire was shortened to five items and the items themselves were reworded so as to be appropriate for nurses. Following a pretest and revisions, the instrument was administered to a sample of nurses. Although the r e l i a b i l i t y coefficients of the revised shortened version were not indicated in the study, Hurka described the instrument as valid and reliable. In summary, factors which are thought to influence commitment can be divided into two categories: personal factors and work-related factors. Personal factors are those inherent in the individual's personal make-up or background. Work-related factors are those considered inherent in the work situation or that are directly related to the work situation. The demographic factors (for example, gender, age, employment status) are elicit e d by using a checklist or fill-in-the-blank format. The beliefs and attitude factors (professionalism orientation, collective bargaining orientation and job satisfaction) are elici t e d by using paper and pencil instruments, developed for that purpose. • 1 -25-SUMMARY AND CONCLUSION A review of the e x i s t i n g l i t e r a t u r e r e l a t e d to the concept of commitment has focused on three major areas. The f i r s t concentrated on describing how the concept had been defined by various authors. No conclusive d e f i n i t i o n was derived; i t was found that a d i f f e r e n t perspec-t i v e of the concept inspired diverse d e f i n i t i o n s . Furthermore, i t was found that these d e f i n i t i o n s did not describe the c h a r a c t e r i s t i c s or q u a l i t i e s a t t r i b u t e d to a committed person. The second area concerned the measurement of commitment. Measurement of commitment i n the studies discussed i n the preceding pages hinged on the way i n which i t was defined. In the f i r s t study, i t was defined by V a i l l o t from an e x i s t e n t i a l i s t perspective. Commitment was i n d i r e c t l y measured by observing behavioural patterns of nursing students which would reveal commitment. Because V a i l l o t had no c r i t e r i a for i d e n t i f y i n g behaviours which would reveal commitment, i t could not be emp i r i c a l l y measured. Furthermore, no hypotheses regarding commitment were formulated at the outset of her study, therefore no conclusions i n reference to commitment could be drawn. The study, however, was successful i n providing i n s i g h t into the student's professional world. Of p a r t i c u l a r s i g n i f i c a n c e , an attempt was made to operationalize a philosophical d e f i n i t i o n of commitment. The second study, that of K e i s l e r , defined commitment from a psychological/behavioural perspective. In an e f f o r t to study the -26-psychology of commitment, i t was measured behaviourally under very rigidly controlled experimental conditions. In maintaining this narrow perspective, the concept of commitment was examined in isolation. This represented a weakness in the research. Commitment cannot be viewed in isolation as there are so many intruding variables. The significant findings listed earlier addressed specific variables only. What of the other contributing factors which affected, for example, dissonance or group loyalty at a particular point in time or under certain circumstances? Looking at commitment in isolation, as Kiesler and his colleagues did, limited the generalizability of their findings to the "real" world, to real situations where intruding variables would be acting to influence behaviour. The intent of Kiesler's research was to study the effect commitment had on behaviour and attitudes. The way one behaves depends on a multiplicity of variables at any one point in time. What was needed therefore was not to look at commitment in isolation, nor to look at behaviours as a measure of commitment attitude, but rather to study commitment with respect to i t s interaction with a multiplicity of variables. The fi n a l study cited (Alluto and Hrebiniak) defined commitment from an attitudinal perspective. Measurement was based on the hypothesis that commitment was affected by the interactive effect of personal and work-related variables, some of which were attitudinal in nature. Of the studies discussed, Alluto and Hrebiniak's was the most empirically sound. They successfully developed a reliable Commitment Index which allowed -27-) o p e r a t i o n a l i z a t i o n of the concept. Furthermore, t h e i r o r i g i n a l findings were supported when the study was r e p l i c a t e d . Having produced a r e l i a b l e instrument, the next phase of t h e i r study was to determine from among the many factors which may influence commitment which of these factors could a c t u a l l y be considered predictors (or c h a r a c t e r i s t i c s ) of a committed person. The methodology of th i s study overcame the weakness of K i e s l e r ' s study. It provided an opportunity to study commitment with respect to i t s i n t e r a c t i o n with a m u l t i p l i c i t y of var i a b l e s . This l e d to the t h i r d area of concern reviewed; the factors thought to influence commitment. These factors were divided into two categories: personal and work-related. A review of the l i t e r a t u r e r e l a t e d to nursing i n B r i t i s h Columbia reveals that there has been no research i n v e s t i g a t i n g commitment among nurses l i v i n g i n the province. Knowledge about the phenomenon of commitment with respect to th i s population of nurses could have implications f o r p r a c t i c i n g nurses, t h e i r employing agencies, nurse educators, and nursing researchers. An expansion of the e x i s t i n g research by A l l u t o and Hrebeniak to determine the l e v e l of commitment among nurses, as well as some of the c h a r a c t e r i s t i c s a t t r i b u t e d to the committed nurse could be useful to the nursing profession i n e f f o r t s to determine the values i t attaches to the concept of commitment. -28-The present study was an attempt to r e p l i c a t e the work of A l l u t o and Hrebeniak. The theme of t h e i r i n v e s t i g a t i o n was to study the r e l a t i o n s h i p of personal and work-related v a r i a b l e s to commitment. Using procedures s i m i l a r to those of A l l u t o and Hrebeniak, a sample of nurses l i v i n g i n urban B r i t i s h Columbia was test e d to determine the r e l a t i o n s h i p of these v a r i a b l e s to commitment. -29-CHAPTER I I I : RESEARCH DESIGN i INTRODUCTION The purpose of the present study was to explore f a c t o r s which may e x p l a i n v a r i a b i l i t y i n the degree of commitment nurses have to t h e i r p r o f e s s i o n . The review of the l i t e r a t u r e i n d i c a t e d that commitment was a l i k e l y f u n c t i o n of two types of f a c t o r s : personal and work-related. This i l e d to the hypothesis that the v a r i a b i l i t y i n commitment to the nursing p r o f e s s i o n may be explained by such f a c t o r s . This hypothesis was addressed using c o r r e l a t i o n a l procedures. A s t r u c t u r e d questionnaire was developed to measure the respondents' commitment l e v e l and to c o l l e c t personal and work-related data. The questionnaire was then mailed to a sample of nurses l i v i n g i n a metropolitan area. The f i r s t s e c t i o n of the chapter summarizes the personal and work-related f a c t o r s used i n the present study. Also included i s a d e s c r i p t i o n of the questionnaire and a d e s c r i p t i o n of the p i l o t study conducted to determine the r e l i a b i l i t y of the instrument. Sample s e l e c t i o n , data c o l l e c t i o n and the s c o r i n g procedure and data analyses f o r the 'present study, are described i n the second s e c t i o n . -30-DATA GATHERING INSTRUMENT A. Background The dependent v a r i a b l e used i n the present study was a measure of an i n d i v i d u a l ' s commitment l e v e l . The personal independent v a r i a b l e s i n c l u d e d the f o l l o w i n g : age, gender, m a r i t a l s t a t u s , year of graduation, number of years working experience, educational background, p r o f e s s i o n a l o r i e n t a t i o n and c o l l e c t i v e bargaining o r i e n t a t i o n . The work-related v a r i a b l e s i n c l u d e d : r e g i s t r a t i o n s t a t u s , employment s t a t u s , employment p o s i t i o n , and work s a t i s f a c t i o n . Many of these v a r i a b l e s were f u r t h e r subdivided to form s e v e r a l "sub" v a r i a b l e s . For example, m a r i t a l status c o n s i s t e d of four c a t e g o r i e s - s i n g l e , married, widowed, and other. Each sub-category was considered a s i n g l e v a r i a b l e f o r s t a t i s t i c a l a n a l y s i s . A complete l i s t of the independent v a r i a b l e s used i n t h i s study i s presented i n Table I . Chapter I I discussed to some extent the reason the independent v a r i a b l e s l i s t e d i n Table I were chosen. Bearing i n mind that the purpose of t h i s study was to explore v a r i a b l e s which may have explained v a r i a b i l i t y i n the degree of commitment nurses had to t h e i r p r o f e s s i o n , v a r i a b l e s thought to have some i n f l u e n c e on commitment were s e l e c t e d . Research on commitment suggested the importance of a wide v a r i e t y of personal and work-related i n f l u e n c i n g f a c t o r s . - 3 1 -TABLE I LIST OF INDEPENDENT VARIABLES PERSONAL WORK-RELATED Age Gender: Female Male M a r i t a l Status: Single Married Widowed Other Year of Graduation Number of Years Work Experience Registration Status: P r a c t i c i n g Non-Practicing Employment Status: Regular Full-Time Regular Part-Time Casual Employment P o s i t i o n : Staff Nurse - Hospital Public Health Nurse Instructor Administrative Other Educational Background Work S a t i s f a c t i o n Basic Education: diploma, degree Continuing Education Professional Orientation: Professional B e l i e f s Professional Actions C o l l e c t i v e Bargaining Orientation - -32-B. Questionnaire The data gathering questionnaire consisted of f i v e sections: a commitment index; a professionalism inventory; background information; a c o l l e c t i v e bargaining scale; and a job s a t i s f a c t i o n scale. Four of the f i v e sections were adapted instruments which had previously been developed and tested i n other studies. A d e s c r i p t i o n of each of these instruments i s found i n Chapter I I . The modifications introduced for the present study are described below: 1. Commitment Index The Commitment Index developed by A l l u t o and Hrebeniak was used without modification i n the present study (Appendix A). 2. Professionalism Inventory The Professionalism Inventory used was i n i t i a l l y the same as the one developed by H a l l . Some minor rewording of weak items was done based upon the re s u l t s of the item analysis of the present study's p i l o t test ( r e f e r to Appendix A and Appendix B for comparison). Also, i n the present study, the Inventory was divided into two parts. Part One consisted of those items which dealt with the respondent's professional b e l i e f s and Part Two of items which dealt with the respondent's professional actions. They were s u b t i t l e d "Professional B e l i e f s " and "Professional Actions," re s p e c t i v e l y . -33-Negatively worded items were appropriately weighted (e.g., on a scale of one to f i v e , a weight of f i v e i s given i f the respondent c i r c l e s one, a weight of one i f she c i r c l e s f i v e ) . The purpose of using the negatively worded items throughout the.sub-tests was to help break "response patterns," a phenomenon often found i n multiple choice questionnaires i n the a f f e c t i v e area. Items which had a negative weight were the following: one, two, three, four, f i v e , eight, eleven, twelve, t h i r t e e n , fourteen, f i f t e e n , seventeen, nineteen, twenty, twenty-one and twenty-five. 3. Background Information The section for background information was designed s p e c i f i c a l l y for t h i s study. The purpose of this section was to gather demographic data r e a d i l y a v a i l a b l e and thought to be r e l a t e d to commitment. 4. C o l l e c t i v e Bargaining Scale The C o l l e c t i v e Bargaining Scale used was developed by Ponak. It also used negatively worded items which included items two, three, f i v e , seven and ten. 5. Work S a t i s f a c t i o n The Job S a t i s f a c t i o n Scale was a l t e r e d i n order to e l i c i t more s p e c i f i c answers. For example, item three of the o r i g i n a l scale was expanded from "How s a t i s f i e d are you with your job when you compare i t to -34-other jobs?" to include part A "which you.have held before," and B, "that are available to nurses." A comparison of the o r i g i n a l instruments with modified versions can be made by reference to Appendix A and Appendix B. C. P i l o t Test The questionnaire was p i l o t tested with a sample of 25 registered nurses l i v i n g i n the Greater Vancouver area. The sample consisted of nurses who had returned to u n i v e r s i t y to do t h e i r master's degree, nurses teaching nursing i n a community college, and t h i r d l y , public health nurses. The responses to the four sub-tests were coded, keypunched and analyzed. Using the LERTAP program to analyse the responses, an item analysis of each item was performed. In addition to item analysis, the program produced an i n t e r n a l consistency estimate for each of the four sub-tests. Item analysis revealed the weaker items. Those which had a low c o r r e l a t i o n with the sub-test were considered weak and were reworded for c l a r i t y . For example, item number one i n the Professionalism Inventory was changed from "I think my profession more than any other profession i s e s s e n t i a l to society" to "I think that my profession more than most other professions i s e s s e n t i a l for society." Item four demonstrated another example. It was changed from "The importance of my profession i s sometimes -35-overstressed" to "The importance of my p r o f e s s i o n i s sometimes understressed." These are only two changes. For f u r t h e r d e t a i l , a comparison of the p i l o t t e s t and the a c t u a l questionnaire used i n the study can be made by r e f e r r i n g to Appendices A and B. The r e l i a b i l i t y estimates, the second part of the a n a l y s i s , i n d i c a t e d that three of the f i v e sub-tests were each i n t e r n a l l y c o n s i s t e n t . The Hoyt estimates of r e l i a b i l i t y were as f o l l o w s : Commitment Index: r = .88; Pr o f e s s i o n a l i s m Inventory, Part A ( p r o f e s s i o n a l b e l i e f s ) : r = .69; Part B ( p r o f e s s i o n a l a c t i o n s ) : r = .70; C o l l e c t i v e Bargaining Index r = .59; Job S a t i s f a c t i o n Index r = .81. The P r o f e s s i o n a l i s m Inventory, Part A ( r = .69) and the C o l l e c t i v e Bargaining Scale ( r = .59) were considered s a t i s f a c t o r y given the small number of items and the f a c t that the a n a l y s i s was conducted at the group l e v e l as opposed to the i n d i v i d u a l l e v e l . Having reworded weaker items and having made a l t e r a t i o n s i n the quest i o n n a i r e format as suggested by respondents, t h e s i s committee members and c o l l e a g u e s , the f i n a l d r a f t of the questionnaire was produced. One of the major a l t e r a t i o n s i n the f i n a l v e r s i o n of the questionnaire was colour coding. Each of the f i v e sub-tests was p r i n t e d on a separate page and on d i f f e r e n t colour paper i n order to help d i f f e r e n t i a t e one s e c t i o n from the next. -36-PROCEDURE A. Sample S e l e c t i o n I Permission was granted by the Registered Nurses A s s o c i a t i o n of BC (RNABC) to s e l e c t a sample of nurses l i v i n g i n A s s o c i a t i o n Chapters 16, 18, and 55 (Vancouver, New Westminster and North Shore, r e s p e c t i v e l y ) . With the a s s i s t a n c e of the RNABC and t h e i r a f f i l i a t e s at the UBC D i v i s i o n of Health Services Research and Development, a random sample was drawn using computerized inform a t i o n housed at the UBC Computer Center. The random s e l e c t i o n procedure followed a s e r i e s of steps. In order to have a c l e a r d e s c r i p t i o n of the population of i n t e r e s t , i n t h i s case urban based nurses, the f i r s t step was to obta i n i n f o r m a t i o n which would describe t h i s p opulation. Percentage d i s t r i b u t i o n s f o r the f o l l o w i n g c h a r a c t e r i s t i c s were obtained f o r each of the three chapters: age, m a r i t a l status by gender, r e g i s t r a t i o n , b a s i c education, c o n t i n u i n g education, employment s t a t u s , and employment p o s i t i o n . This i n f o r m a t i o n provided a d e s c r i p t i o n of, f o r example, the age spread, whether more of the nurses i n these chapters were married than s i n g l e , widowed or other, and whether most had a p r a c t i c i n g as opposed to n o n - p r a c t i c i n g r e g i s t r a t i o n . Based upon the percentage d i s t r i b u t i o n s three c h a r a c t e r i s t i c s were s e l e c t e d f o r s t r a t i f i c a t i o n purposes: age, r e g i s t r a t i o n status and bas i c education. To have a be t t e r perspective of how these c h a r a c t e r i s t i c s were d i s t r i b u t e d a three-way c r o s s - t a b u l a t i o n - bas i c education by r e g i s t r a t i o n -37-status by age group - was obtained f o r each chapter (see Figures 1, 2, 3 ) . Basic education was d i v i d e d i n t o two categories:, diploma and baccalaureate degree. R e g i s t r a t i o n status was d i v i d e d i n t o p r a c t i c i n g and n o n - p r a c t i c i n g c a t e g o r i e s . For the t h i r d c h a r a c t e r i s t i c , s i x age groups were, formed: 21 to 27; 28 to 32; 33 to 37; 38 to 43; 44 to 51; and 52 to 73. For example, as shown i n Figure 1, there was a t o t a l of 4,311 nurses i n the Vancouver chapter. Of t h i s t o t a l , 3,842 recei v e d a diploma and 469 received a baccalaureate degree f o r t h e i r b a s i c nursing education. Within the diploma category, 3,046 held a p r a c t i c i n g status while-796 h e l d a n o n - p r a c t i c i n g s t a t u s . The baccalaureate category had 389 p r a c t i c i n g and 80 non- p r a c t i c i n g nurses. i F i n a l l y , w i t h regard to age, there were 809 nurses who had a diploma who were a c t i v e l y p r a c t i c i n g and who were between the ages of 21 and 27. L i k e w i s e , there were 141 nurses who had a baccalaureate degree who were a c t i v e l y p r a c t i c i n g and who were between the ages of 21 and 27. The next step i n the s e l e c t i o n of the sample was to determine the sample s i z e f o r each stratum. This c o n s i s t e d of determining how many subjects from among the d e s i r e d t o t a l sample s i z e of four hundred would be included i n each of the d i f f e r e n t c a t e g o r i e s . The purpose of t h i s step was to ensure that the three c h a r a c t e r i s t i c s of i n t e r e s t were p r o p o r t i o n a t e l y represented i n the sample. Figures 4, 5 and 6 provide the breakdown f o r the sample. -38-FIGURE 1 POPULATION CROSS TABULATION: VANCOUVER CHAPTER BY BASIC EDUCATION BY EMPLOYMENT STATUS BY AGE VANCOUVER: 4,311 (64.1%) — CHAPTER DIPLOMA: 3,842 (57.1%) BACCALAUREATE: 469 (70%) EDUCATION l oo I PRACTICING: 3,046 (45.3%) NON-PRACTICING: 796 (11.8%) i 1 1 1 1 1 Al A2 A3 A4 A5 A6 PRACTICING: 389 (5.8%) i 1 r 1 1 » Al A2 A3 A4 A5 A6 REGISTRATION NON-PRACTICING: 80 (1.2%) — STATUS i J 1 1 1 1 Al A2 A3 A4 A5 A6 / ~1 1 — 1 1 7 Al A2 A3 A4 A5 A6 — AGE 809 559 429 391 415 443 130 136 113 107 112 1% 141. 103 62 41 23 19 30 10 11 13 AGE A l : 21 - 27 A2: 28 - 32 A3: 33-37 A4: 38 - 43 A5: 44-51 A6: 52 - 73 FIGURE 2 POHJLATICN CROSS TABULATION: NEW WESTMINSTER BY BASIC EDUCATION BY fMLOYMENT STATUS BY AGE — CHAPTER NEW WESTMINSTER: 1,108 (16.5%) — EDUCATION DIPLOMA: 1,052 (15.6%) BACCALAUREATE: 56 (0.8%) PRACTICING: 835 (12.4%) i 1 r 1 1 ' Al A2 A3 A4 A5 A6 177 140 138 142 151 37 NON-PRACTICING: 217 (3.2%) PRACTICING: 40 (0.6%) REGISTRATION NON-PRACnCENG: 16 (0.2%) — STATUS — AGE A 1 A 2 A 3 A 4 A 5 A 6 A 1 A 2 A 3 A 4 A 5 A 6 26 41 47 33 32 38 11 7 9 6 5 2 Al A2 A3 A4 A5 A6 2 7 3 2 2 0 AGE A l : 21 - 27 A2: 28-32 A3: 33 - 37 A4: 38-43 A5: 44-51 A6: 52 - 73 FIGURE 3 POPULATION CROSS TABULATION: NORTH SHORE BY BASIC EDUCATION BY EMPLOYMENT STATUS BY AGE NORTH SHORE: 1,308 (19.5%) CHAPTER DIPLOMA: 1,210 (17.9%) PRACTICING: 912 (13.6%) — i 1 1 Al A2 A3 A4 A5 A6 138 131 155 192 169 127 NON-PRACTICING: 298 (4.4%) Al A2 A3 A4 A5 A6 34 62 54 57 38 53 BACCALAUREATE: 90 (1.3%) EDUCATION PRACTICING: 75 (1.1%) i 1— Al A2 A3 A4 A5 A6 14 22 15 8 10 6 REGISTRATION NON-PRACITCING: 23 (0.3%) — STATUS i 1 1 1 j Al A2 A3 A4 A5 A6 — AGE AGE Al 21 - 27 A2 28 - 32 A3 33 - 37 A4 38 - 43 A5 44 - 51 A6 52 - 73 FIGURE 4 SAMPLE CROSS TABULATION: VANCOUVER CHAPTER BY BASIC EDUCATION BY REGISIRATTON STATUS BY AGE VANCOUVER: 256 (64.0%) — CHAPTER DIPLOMA: 228 (57.0%) BACCALAUREATE: 28 (7.0%) — EDUCATION I I PRACTICING: 181 (45.3%) NON-PRACTICING: 47 (11.8%) PRACTICING: 23 (5.8%) REGISTRATION NON-PRACTICING: 5 (1.3%) — STATUS Al A2 A3 A4 A5 A6 48 33 25 23 25 27 Al A2 A3 A4 A5 A6 8 8 7 6 6 12 Al A2 A3 A4 A5 A6 8 6 4 3 1 1 Al A2 A3 A4 A5 A6 — AGE 2 1 1 1 AGE Al 21 - 27 A2 28 - 32 A3 33 - 37 A4 38 - 43 A5 44 - 51 A6 52 - 73 FIGURE 5 SAMPLE CROSS TABULATION: NEW WESTMINSTER BY BASIC EDUCATION BY REGISTRATION STATUS BY AGE NEW WESTMINSTER: 66 (16.5%) DIPLOMA: 63 (15.8%) PRACTICING: 50 (12.5%) 11 I 1 1 1 1 1 Al A2 A3 A4 A5 A6 8 8 NON-mCTTCING: 13 (3.3%) i 1 1 1 r Al A2 A3 A4 A5 A6 BACCALAUREATE: 3 (0.8%) -'PRACTICING: 2 (0.5%) Al A2 A3 A4 A5 A6 — CHAPTER EDUCATION REGISTRATION NON-PRACTICING: 1 (0.3%) — STATUS , Al A2 A3 A4 A5 A6 — AGE AGE Al : 21 - 27 A2: 28 - 32 A3: 33 - 37 A4: 38 - 43 A5: 44-51 A6: 52 - 73 FIGURE 6 SAMPLE CROSS TABULATION: NORTH SHORE BY BASIC EDUCATION BY REGISTRATION STATUS BY AGE NORTH SHORE: 78 (19.5%) DIPLOMA: 72 (18.0%) BACCALAUREATE: 6 (1.5%) PRACTICING: 54 (13.5%) i % 1 1 1 1 Al A2 A3 A4 A5 A6 8 8 11 10 8 CHAPTER EDUCATION NON-PRACncrNG: 18 (4.5%) PRACTICING: 5 (1.3%) REGISTRATION NON-PRACTICING: 1 (0.3%) — STATUS AGE Al: 21 - 27 A2: 28 - 32 A3: 33-37 A4: 38 - 43 A5: 44-51 A6: 52 - 73 For example, of the t o t a l sample to be s e l e c t e d , 256 subjects (64.0%) had to be members of the Vancouver Chapter. Of t h i s number, 228 subjects (57.0%) were to have received diplomas and 28 (7.0%) t h e i r baccalaureate degree. Within the diploma category 181 (45.3%) of the subjects had to be p r a c t i c i n g and 47 (11.8%) had to be n o n - p r a c t i c i n g . The baccalaureate category had to have 23 (5.8%) subjects with p r a c t i c i n g status and 5 (1.3%) w i t h n o n - p r a c t i c i n g s t a t u s . F i n a l l y , w i t h regard to age, 48 subjects (0.12%) had to have a diploma, have a p r a c t i c i n g status and be between the ages of 21 and 27, while 8 subjects (0.02%) had to have a baccalaureate degree, have a p a r a c t i c i n g status and be between the ages of 21 and 27. The f i n a l step i n the procedure c o n s i s t e d of s e t t i n g up a computer program which randomly s e l e c t e d the de s i r e d number of subjects from each substratum. B. Data C o l l e c t i o n A questionnaire accompanied by a covering l e t t e r was mailed to the four hundred s e l e c t e d subjects e a r l y i n June 1978. A graphic account was kept to monitor d a i l y r e t u r n s . When the graph i n d i c a t e d a d e c l i n i n g r e t u r n i r a t e , eleven days a f t e r the m u l t i - m a i l i n g , a follow-up l e t t e r was mailed ( r e f e r to Appendix B f o r covering and follow-up l e t t e r s ) . By the end of June most of the questionnaires that were to be returned had a r r i v e d . Several a r r i v e d s p o r a d i c a l l y throughout the month of J u l y . However, the c u t - o f f date was the end pf June. -45-C. Data A n a l y s i s The d a t a a n a l y s i s took p l a c e i n t h r e e s t a g e s . The f i r s t was an item a n a l y s i s of each of the f o u r s u b - t e s t s : the Commitment Index, the P r o f e s s i o n a l i s m I n v e n t o r y , the C o l l e c t i v e B a r g a i n i n g Index, and the Job S a t i s f a c t i o n Index. In the second s t a g e , the demographic da t a were a n a l y z e d . T h i r d l y , m u l t i p l e r e g r e s s i o n a n a l y s i s was performed to determine which of the v a r i a b l e s were s i g n i f i c a n t p r e d i c t o r s of commitment. When the r e t u r n of the q u e s t i o n n a i r e s appeared to be complete, the r e s p o n s e s f o r each of the s u b - t e s t s were t r a n s c r i b e d d i r e c t l y as they appeared onto c o d i n g s h e e t s . Demographic i n f o r m a t i o n was a l t e r e d s l i g h t l y i n o r d e r to f a c i l i t a t e a n a l y s i s and was a l s o coded. T h i s was then keypunched through the u n i v e r s i t y keypunch s e r v i c e s w i t h one hundred p e r c e n t v e r i f i c a t i o n . However, as an e x t r a p r e c a u t i o n , a second v e r i f i c a t i o n was performed. For the demographic d a t a , the computer r e c o r d s f o r twenty p e r c e n t of the sample were v e r i f i e d a g a i n s t the a c t u a l q u e s t i o n n a i r e and f o r each s u b - t e s t , the computer r e c o r d s f o r one hundred p e r c e n t of the sample were v e r i f i e d . S u b j e c t s who d i d not complete a l l of the f o u r s u b - t e s t s were o m i t t e d from f u r t h e r a n a l y s i s . M i s s i n g d a t a i n the demographic a r e a were not c o n s i d e r e d as s e r i o u s a t h r e a t to s t a t i s t i c a l a n a l y s i s . T h e r e f o r e , q u e s t i o n n a i r e s w i t h m i s s i n g d a t a i n the demographic s e c t i o n were not e l i m i n a t e d . F o l l o w i n g t h i s p r o c e s s of v e r i f i c a t i o n , the t o t a l number of u s a b l e q u e s t i o n n a i r e s was 217 (54% of the t o t a l sample). - 4 6 -1. Demographic Information The i n t e n t of t h i s stage of a n a l y s i s was to provide a d e s c r i p t i o n of the sample. Simple frequency counts and s e v e r a l c r o s s - t a b u l a t i o n s were made. Because of missing data, the number of subjects v a r i e d . For example, the number of subjects counted under "gender" was 217 w h i l e f o r "age" the number of subjects was 210. Also included i n t h i s a n a l y s i s was a comparison of the proportions of various c l a s s e s w i t h i n the sample with the corresponding proportions i n the population. 2. Sub-test A n a l y s i s Using the LERTAP program, an item a n a l y s i s of each item i n every sub-test was performed. Again the r e s u l t s were surveyed f o r weak items. The a n a l y s i s , a l s o provided the means, standard d e v i a t i o n s and r e l i a b i l i t y estimates f o r each sub-test. 3. M u l t i p l e Regression F i r s t , the zero-order c o r r e l a t i o n s of the independent v a r i a b l e s , personal and work-related, w i t h the dependent v a r i a b l e , commitment, were c a l c u l a t e d . Second, a stepwise m u l t i p l e r e g r e s s i o n was performed to determine which of the independent v a r i a b l e s formed the best set of p r e d i c t o r s . In l i g h t of i n s u f f i c i e n t knowledge, designating an order of -47-entry of each of the v a r i a b l e s would have pre-biased the r e s u l t s . I t was more appropriate to a l l o w s t a t i s t i c a l s e l e c t i o n , 'by stepwise r e g r e s s i o n , to i d e n t i f y the more powerful determinants of commitment. The p r o b a b i l i t y of a Type I e r r o r f o r i n c l u s i o n or d e l e t i o n was set at .05. The a n a l y s i s of data was conducted using the U n i v e r s i t y of B r i t i s h Columbia T.R.P. ( T r i a n g u l a r Regression Package), a program maintained at the UBC Computer Centre. A l s o , f o r v e r i f i c a t i o n , a second program BMD-02R, was used. F i n a l l y , scattergrams were performed i n order to r u l e out the p o s s i b i l i t y of non-linear r e l a t i o n s h i p s between the dependent and independent v a r i a b l e s . Several a l t e r a t i o n s were necessary to f a c i l i t a t e the s t a t i s t i c a l a n a l y s i s . V a r i a b l e s which had such a low frequency as to be i n s i g n i f i c a n t f o r r e g r e s s i o n a n a l y s i s , were excluded. This occurred f o r two v a r i a b l e s : gender and widowed. Another a l t e r a t i o n occurred where three v a r i a b l e s were subsumed under one. Head nurse, a s s i s t a n t supervisor and supervisor were subsumed under the v a r i a b l e a d m i n i s t r a t i o n . A l s o , f o r the contin u i n g education v a r i a b l e , each respondent was rated on a scal e of one to three. One - not taken any contin u i n g education; two - one or two e x t r a courses; and three - more than two, or had taken two and planned to continue. This was then coded under the v a r i a b l e EXTRA f o r diploma nurses and EXTRA I f o r baccalaureate degree nurses. -48-CHAPTER IV: DATA ANALYSIS AND DISCUSSION OF FINDINGS INTRODUCTION The purpose of the study was to explore factors which might explain variability in nursing commitment. It was therefore necessary to determine which factors correlated significantly with commitment and could then be considered predictors of commitment. A stepwise multiple regression analysis was used to determine which of the factors, when considered simultaneously, contributed significantly (p<.05) to the prediction of commitment. The regression analysis is discussed in the latter part of the chapter. This, however, is preceded by a discussion of the response rate, the demographic results and the analysis of the sub-tests in the questionnaire. RESPONSE RATE < Of the four hundred questionnaires mailed, 256 (64.0%) were returned. Of these, ten were returned blank. Thus, of the total number mailed out, 61.5% were potentially useful. Questionnaires were returned unanswered for one of .two reasons: the respondents indicated they were not qualified to answer (e.g., they were retired or they were non-practicing) or respondents no longer lived at the address li s t e d . Questionnaires with missing responses in any of the sub-tests were omitted. This occurred most frequently in sub-test two of the Professionalism Inventory. It appeared -49-that s e v e r a l respondents were not aware that the Inventory continued on the back side of the paper. Questionnaires with missing data i n the demo-graphic s e c t i o n were not omitted. The t o t a l number of usable question-n a i r e s f o l l o w i n g the process of e l i m i n a t i o n was 217, which represented 84.8% of the p o t e n t i a l l y usable questionnaires returned (246) and 54.2% of the t o t a l mailed. ANALYSIS OF DEMOGRAPHIC DATA The demographic c h a r a c t e r i s t i c s of the sample are summarized i n Table I I . Also included are corresponding percentages f o r the pop u l a t i o n , thereby p e r m i t t i n g comparison of the sample with the population. Although the sample c o n s i s t e d of 217 respondents, missing data have caused a d i f f e r e n t N to appear f o r many of the v a r i a b l e s l i s t e d . TABLE I I DEMOGRAPHIC DATA SAMPLE POPULATION VARIABLE NUMBER PERCENTAGE PERCENTAGE 1. GENDER N=217 Female 213 98.2 98.2 Male 4 1.8 1.8 2. MARITAL STATUS N=217 Single 70 32.3 34.8 Married 127 58.5 54.6 Other 20 9.2 11.0 3. AGE N=213 21-27 55 25.8 22.5 28-32 43 20.2 18.1 33-37 35 16.4 15.5 38-43 23 10.8 14.8 44-51 29 13.6 14.4 51 and over 28 13.1 14.2 -50-TABLE I I (continued) SAMPLE POPULATION NUMBER PERCENTAGE PERCENTAGE 4. BASIC EDUCATION Diploma i n Nursing Baccalaureate Degree 5. CONTINUING EDUCATION A. Diploma i n Nursing None D i p l o m a / C e r t i f i c a t e U n i v e r s i t y C r e d i t s Bachelor of Science i n Nursing Bachelor of Ar t s Master of Science i n Nursing Master of Ar t s Other Courses Intend to continue education B. Baccalaureate Degree None D i p l o m a / C e r t i f i c a t e U n i v e r s i t y C r e d i t s Master's Degree Other Courses Intend to continue education R e g i s t r a t i o n Status P r a c t i c i n g N o n -Practicing Employment Status Regular Casual Employing Agency H o s p i t a l P u b l i c Health Educational I n s t i t u t e Other N=217 181 83.4 90.4 36 16.6 9.2 N-181 40 22.0 28.9 36 19.9 21.5 48 26.5 4.8 12 7.0 5.9 .8 4.2 -1 0.5 0.8 1 0.5 5 2.8 8.2 92 50.8 N=36 10 27.8 19.1 1 2.8 0.9 5 13.9 3.2 4 11.1 8.8 15 41.7 4.2 9 25.0 N=212 188 88.7 78.3 24 11.3 21.1 N=188 159 84.6 81.3 29 15.4 18.7 N=197 144 67.9 64.1 27 12.8 8.8 8 3.7 3.6 18 8.5 10.5 -51-TABLE I I (continued) SAMPLE POPULATION NUMBER PERCENTAGE PERCENTAGE Employment P o s i t i o n N=191 S t a f f Nurse - H o s p i t a l 118 61.8 71.9 P u b l i c Health Nurse 20 10.5 _a I n s t r u c t o r 11 5.8 3.9 Head Nurse 17 8.9 5.2 b A s s i s t a n t Supervisor 3 1.6 l . l b Supervisor 10 5.2 2.9 b Other 12 6.3 7.6 a This s t a t i s t i c was not a v a i l a b l e i n the RNABC computer data b These v a r i a b l e s have been subsumed under one v a r i a b l e , " a d m i n i s t r a t i o n " f o r purposes of s t a t i s t i c a l a n a l y s i s The percentage d i s t r i b u t i o n s of the respondents g e n e r a l l y matched the d i s t r i b u t i o n s of the population. Any dis c r e p a n c i e s noted are minor and could be due to non-responses or changes that have occurred between the time the population data were c o l l e c t e d (January 1978) and the time the respondent completed the questionnaire (June 1978). I t can be s a i d therefore that the respondents are r e p r e s e n t a t i v e of the population of nurses r e g i s t e r e d i n Chapters 16, 18 and 55 of the RNABC. -52-1. Gender The majority of respondents were female. . A l l males selected in the sample did respond, however, one questionnaire had to be deleted, leaving four as the total number of male respondents. The percentages.in the sample match exactly those percentages in the population. Since there were so few males in the sample, this variable was not included in multiple regression analysis. 2. Marital Status \ More than half of the respondents were married (58.5%), while almost a third were single (32.3%). The percentage of those married was only slightly more in the population (58.5% as opposed to 54.6%). Since only 1.4% were widowed, this variable was not used in the regression analysis. The category "other" consisted of nurses who were separated, divorced or, in some cases as specified by the respondents, living common-law. 3. Age In contrast to the population, the distribution of nurses in the different age groups was uneven. Whereas in the population the number of nurses declined as the age group increased, the sample deviated slightly in the older age groups. Almost half of.the respondents were under the age of 33 (46%). Of the remaining four age groups, the next two age groups (33-37; 38-43) demonstrated a declining number of nurses in each group. -53-Beyond age 43, there was a s l i g h t i n c r e a s e ; from 10.8% to 13.6% (44-51), and 13.1% (51>). However, the discrepancy between the sample and popul a t i o n was only s l i g h t . 4. Basic Education As i n the popula t i o n , there were more respondents with a diploma i n nursing than a baccalaureate degree (83.4% and 16.6%, r e s p e c t i v e l y ) . However, i t should be noted that a greater proportion of the t o t a l sample hel d the baccalaureate degree (16.6%) than the pr o p o r t i o n found i n the population (9.2%). In t h i s r espect, the sample i s not t r u l y r e p r e s e n t a t i v e of the popu l a t i o n ; the sample has a greater p r o p o r t i o n of baccalaureate prepared nurses. 5. Continuing Education Under t h i s v a r i a b l e , an attempt was made to determine how much co n t i n u i n g education the respondents had taken. Part A (see Table I I ) l i s t s the contin u i n g education taken by diploma nurses, whereas Part B l i s t s that taken by baccalaureate nurses. An o v e r a l l trend among the diploma nurses was that more i n the sample had some form of contin u i n g education than i n the population. The reverse was true f o r the baccalaureate prepared nurses: fewer nurses i n the sample had taken c o n t i n u i n g education courses than i n the population. I t i s a l s o i n t e r e s t i n g to note that a large proportion of the respondents i n d i c a t e d -54-that they intend to continue t h e i r education (50.8% of d ip l ima nurses and 25.0% of the baccalaureate nurses ) . 6. R e g i s t r a t i o n Status The major i ty of the respondents (88.7%) held p r a c t i c i n g r e g i s t r a t i o n whi le only 11.3% he ld n o n - p r a c t i c i n g r e g i s t r a t i o n . There were almost 10% fewer p r a c t i c i n g nurses i n the populat ion (78.3%) than i n the sample and almost 10% more non-prac t i c ing nurses (21.1%) i n the populat ion than i n the sample. This observed discrepancy between the obtained sample proport ion and populat ion proport ion suggests that more of the p r a c t i c i n g nurses tended to f i l l i n the quest ionnaire than d id the n o n - p r a c t i c i n g . 7. Employment Status The majori ty of respondents were employed on a regular basis (84.6%). Again there was a d iscrepancy, but only s l i g h t , between the sample and the populat ion (84.6% and 81.3% r e s p e c t i v e l y ) . The corresponding proport ions of casual employees were 15.4% and 18.7% i n the sample and populat ion . 8. Employing Agency and Employment P o s i t i o n Most of the sample respondents, as i n the populat ion , worked i n a h o s p i t a l (67.9% and 64.1% r e s p e c t i v e l y ) . Fol lowing along with t h i s , most of the respondents worked as s t a f f nurses. It i s i n t e r e s t i n g to note the -55-sample had fewer s t a f f nurses than i s g e n e r a l l y found i n the population (61.8% compared to 71.9%). Correspondingly, more i n s t r u c t o r s (5.8% as opposed to 3*9%), head nurses (8.9% as opposed to 5.2%), a s s i s t a n t s u p e r v i s o r s (1.6% as opposed to 1.1%), and su p e r v i s o r s (5.2% as opposed to 2.9%) were found i n the sample than i n the population. 9. Year of Graduation and Work Exerience Although these type of data were not a v a i l a b l e f o r the popula t i o n , the year of graduation and number of years of work experience were included i n the qu e s t i o n n a i r e . Tables I I I and IV i n d i c a t e the r e s u l t i n g p r o p o r t i o n s . TABLE I I I FREQUENCIES AND PERCENTAGES BY YEAR OF GRADUATION n=217 YEAR OF GRADUATION n % Before 1960 1961-1969 1970-1978 63 67 87 29.0 30.9 40.1 In keeping w i t h the f a c t that the m a j o r i t y of respondents were i n the younger age groups, Table I I I demonstrates that the great e s t number of respondents had graduated i n 1970 and l a t e r . TABLE IV FREQUENCIES AND PERCENTAGES BY NUMBER OF YEARS WORK EXPERIENCE n=197 NUMBER OF YEARS WORK EXPERIENCE n % Under 2 years 22 11.2 2 - 5 years 50 25.4 6 - 7 years 29 14.7 8 - 1 0 years 34 17.3 1 1 - 1 5 years 29 14.7 16 - 20 years 20 10.2 Over 20 years 13 6.6 As shown i n Table IV, s l i g h t l y more than 50% of the respondents reported that they had worked between one and ten years. The gr e a t e s t number of nurses had worked between two and f i v e years. Based on 217 que s t i o n n a i r e s , the demographic data provided i n f o r m a t i o n which described the sample. The sample c o n s i s t e d predominantly of married females i n the younger age c a t e g o r i e s . Most of them had received a diploma i n n u r s i n g , had taken some form of continu i n g education and/or intended to continue t h e i r education and were r e g u l a r l y employed p r a c t i c i n g s t a f f nurses i n a h o s p i t a l . Furthermore, the sample c l o s e l y p a r a l l e l e d the population of nurses r e g i s t e r e d i n Chapters 16, 18 and 55 of the RNABC. SUB-TEST ANALYSIS As wit h the p i l o t t e s t , the sub-test a n a l y s i s c o n s i s t e d of two pa r t s : the item a n a l y s i s and the a n a l y s i s of psychometric p r o p e r t i e s . S u f f i c e i t to say that i n the item a n a l y s i s , almost a l l item c o r r e l a t i o n s improved -57-when compared to the p i l o t t e s t . Of the f i v e s u b - t e s t s , the P r o f e s s i o n a l B e l i e f s sub-test of the P r o f e s s i o n a l i s m Inventory appeared to have the g r e a t e s t number of items whose c o r r e l a t i o n ^ d e c r e a s e d . Note, however, that i t a l s o had a low r e l i a b i l i t y estimate i n both the p i l o t t e s t and a c t u a l study. A summary of some of the psychometric p r o p e r t i e s i s provided i n Table V. TABLE V STATISTICAL PROPERTIES FOR EACH SUB-TEST. N=217 HOYT'S ESTIMATE OF SUB-TEST MEAN PERCENT S.D. PERCENT RELIABILITY Commitment Index 25.30 70.2 6.87 19.1 r=. 93 P r o f e s s i o n a l B e l i e f s 64.46 67.8 7.96 8.4 r=. 65 P r o f e s s i o n a l Actions 18.38 61.3 4.03 13.4 r=. 52 C o l l e c t i v e Bargaining 35.84 71.7 7.56 15.1 r=. 86 Job S a t i s f a c t i o n 21.91 78.3 5.13 18.3 r=. 78 O v e r a l l the r e l i a b i l i t y estimates of each s e c t i o n revealed i n t e r n a l l y c o n s i s t e n t data gathering instruments w i t h the exception of the P r o f e s -s i o n a l i s m Inventory sub-test ( P r o f e s s i o n a l A c t i o n ) . Many of the respondents s a i d they found t h i s s e c t i o n of the P r o f e s s i o n a l i s m Inventory d i f f i c u l t to answer because of the d i f f e r e n c e s i n the p o l a r i t i e s of items. In order to prevent "patterned" responses, both p o s i t i v e l y and n e g a t i v e l y worded items were used (see Chapter I I I ) . Some of the respondents noted on t h e i r questionnaires that t h i s tended to confuse them. But the i n t e n t i o n -58-was to break the positive response pattern which would hopefully assure carefully thought out responses. In addition, examination of the Professionalism Inventory reveals i t to be an affective test. Measurement experts, such as Tuckman, contend that people have a tendency to be more sensitive about disclosing what they feel than what they know and that many adults tend to overreact to or be defensive about measurement of feelings. As such, measurement of the affective domain has a greater potential for being unrealiable than do tests which measure the cognitive domain. Although a l l the sub-tests were affective, the Professional Action sub-test seemed to be the most susceptible to this weakness. Generally, the trend among the respondents was to have a positive attitude toward commitment, professionalism, collective bargaining and job satisfaction. To ill u s t r a t e , i f i t is assumed that 50% i s the midpoint, a mean of 25.3 on the Commitment Index is greater than the midpoint (18) of a possible 36 points. A total of 83.4% of the sample scored above the midpoint (18) - indicating a positive attitude. As shown in Figure 7, the number of respondents who had a score of 25.3 or more (107) is greater than those who scored lower than 25.3 (100). Similar trends are noted with the other sub-tests (see Figures 8, 9, 10 and 11 in Appendix C). -59-26 , 24 •• 22 1 20 18 16 14 12 .. 10 -8 -6 •• 4 2 0 LrU 10 15 —H 20 H t — 25 SCORES 30 35 40. X 25 FIGURE 7: FREQUENCIES BY SCORE ON COMMITMENT INDEX The highest mean expressed as a percentage was found on the Job Satisfaction Index (78.3%). In general, i t seems, the sample respondents are satisfied with their work. -60-In summary, sub-test analysis revealed three internally consistent data gathering instruments. The Professionalism Inventory did not have as strong a r e l i a b i l i t y estimate as the others. This was explained, in part, by the d i f f i c u l t y the respondents had interpreting and answering the items. The general trend among the respondents was a positive attitude toward commitment, professionalism, collective bargaining and work satisfaction. MULTIPLE REGRESSION ANALYSES AND FINDINGS (1) A stepwise multiple regression analysis was performed to test whether any of the independent variables were significant predictors of commitment. The i n i t i a l l i s t of independent variables (Table I, page 32) was altered by deleting the "widow" category and omitting "gender" because of small frequencies. The means and standard deviations for remaining variables are presented in Table VI. Age, year of graduation, number of years working experience, professionalism, employment status, opinions about collective bargaining, and work satisfaction were continuous variables while the categories associated with marital status, educational background, registration status, and employment position were scored dichotomously. (2) The means and standard deviations listed in Table VI were verified by comparing, where possible, these findings with the background frequency and the analysis of the sub-test. The mean age, for example, seems reasonable in view of the fact the majority of respondents were under the age of 37 years. A mean of 0.323 for the "single" category is correct in that 32.3 -61-TABLE VI MEANS AND STANDARD DEVIATIONS OF VARIABLES VARIABLE MEAN STANDARD DEVIATION Age 36.291 11.375 M a r i t a l Status a) S i n g l e 0.323 0.468 b) Married 0.585 0.494 c) Other 0.078 0.269 Year of Graduation 1.888 0.821 Years of Experience 3.719 1.929 Education Background a) Basic (diploma) 0.834 0.373 b) Continuing 2.237 0.784 P r o f e s s i o n a l B e l i e f s 64.493 7.923 P r o f e s s i o n a l A c t i o n 18.397 4.014 C o l l e c t i v e Bargaining 35.972 7.203 R e g i s t r a t i o n Status a) P r a c t i c i n g 0.887 0.318 Employment Status 2.548 0.768 Employment P o s i t i o n a) S t a f f nurse - H o s p i t a l 0.605 0.490 b) P u b l i c h e a l t h 0.103 0.304 c) I n s t r u c t o r 0.056 0.231 d) A d m i n i s t r a t i v e 0.138 0.346 e) Other 0.062 0.241 Commitment 25.359 6.724 -62-(3) The zero-order c o r r e l a t i o n matrix (Appendix D) revealed low c o r r e l a t i o n s between each independent v a r i a b l e and the dependent v a r i a b l e . The highest c o r r e l a t i o n was only r=.36, thus i l l u s t r a t i n g that the degree of a s s o c i a t i o n between each independent v a r i a b l e and the dependent v a r i a b l e was not very strong. This was l a t e r confirmed i n the t h i r d phase of the a n a l y s i s , stepwise m u l t i p l e l i n e a r r e g r e s s i o n . A summary t a b l e showing the order of entry and s i g n i f i c a n c e (p < .05) of the v a r i a b l e s i s provided i n Table V I I . A d e t a i l e d p r e s e n t a t i o n , i n c l u d i n g values of p a r t i a l c o r r e l a t i o n and corresponding p a r t i a l F's, i s provided i n Appendix E. TABLE VII SUMMARY TABLE: REGRESSION ANALYSIS OF PROFESSIONAL COMMITMENT N=217 VARIABLES PARTIAL MULTIPLE INCREASE ENTERED CORRELATION3 R2 IN R 2 Work S a t i s f a c t i o n 0.36 0.129 0.129 P r o f e s s i o n a l B e l i e f s 0.25 0.186 0.057 Separated/Divorced -0.19 0.214 0.028 Diploma Nurse -0.15 0.234 0.020 Note: The four v a r i a b l e s are l i s t e d i n t h e i r order of entry. The remaining v a r i a b l e s d i d not add s i g n i f i c a n t l y (p < .05) to the pro p o r t i o n of variance explained. a at time of entry (4) The most powerful p r e d i c t o r was work s a t i s f a c t i o n (r=.36). This v a r i a b l e alone accounted f o r 12 percent of the t o t a l v a r i a n c e . The procedure followed through three more steps b r i n g i n g i n three more v a r i a b l e s : p r o f e s s i o n a l b e l i e f s , m a r i t a l s t a t u s (separated/divorced), and bas i c education (diploma nurse). Thus, the four v a r i a b l e s l i s t e d i n Table -63-VII account f o r or e x p l a i n 23 percent of the v a r i a b i l i t y of the dependent v a r i a b l e . In other words, 23 percent of an i n d i v i d u a l ' s commitment score i s explained or p r e d i c t e d by the i n d i v i d u a l ' s scores on these four v a r i a b l e s . (5) S c a t t e r p l o t s of the dependent v a r i a b l e against the independent v a r i a b l e s were obtained i n order to check f o r c u r v i l i n e a r r e l a t i o n s h i p s . The s c a t t e r p l o t s d i d not r e v e a l c u r v i l i n e a r r e l a t i o n s h i p between commitment and any of the independent v a r i a b l e s . I t i s therefore safe to assume l i n e a r i t y had not been v i o l a t e d . (6) The use of s c a t t e r p l o t s i s not the best method of t e s t i n g the dependent v a r i a b l e against dichotomous independent v a r i a b l e s f o r c u r v i l i n e a r r e l a t i o n s h i p s . Scatter p l o t s are best used with continuous v a r i a b l e s . Therefore, to have a more r e l i a b l e i n d i c a t o r of the r e l a t i o n -ship between the dependent v a r i a b l e and the dichotomous independent v a r i a b l e s , an a n a l y s i s of variance was performed. The a n a l y s i s revealed that the s i g n i f i c a n c e f o r each of the v a r i a b l e s l i s t e d was greater than the .05 l e v e l of s i g n i f i c a n c e . Therefore, none of the dichotomous independent v a r i a b l e s had a s i g n i f i c a n t r e l a t i o n s h i p w i t h the dependent v a r i a b l e , commitment. (7) I t i s known that with a stepwise m u l t i p l e r e g r e s s i o n procedure, the dominating p r e d i c t o r v a r i a b l e s w i l l be so powerful that they w i l l not a l l o w other weaker but s i g n i f i c a n t v a r i a b l e s to enter the equation. To assure that t h i s was not happening, a second stepwise a n a l y s i s was performed using -64-only the background data v a r i a b l e s . Thus, the scores on the four sub-tests, "professional b e l i e f s , " "professional a c t i o n , " " c o l l e c t i v e bargaining" and "work s a t i s f a c t i o n " were l e f t out. The r e s u l t s , however, only confirmed what the f i r s t analysis had shown. The two variables which entered the equation were the same two which had entered the f i r s t equation. None of the other variables used i n the second analysis was strong enough to enter. Therefore, i t i s concluded that the two dominant variables i n the f i r s t equation, "work s a t i s f a c t i o n " and "professional b e l i e f s " were not overpowering weaker demographic va r i a b l e s . (8) Multiple regression analysis revealed that commitment does vary because of differences i n personal-and work-related v a r i a b l e s . Thus, the n u l l hypothesis was not supported. The stepwise multiple regression analysis indicated that for t h i s sample 23 percent of the variance i n commitment was explained by the extent of an i n d i v i d u a l ' s work s a t i s f a c t i o n , her professional b e l i e f s , by whether or not she was separated/divorced, and by whether or not she was a diploma nurse. The analysis indicated, therefore, that there was a tendency for nurses who were s a t i s f i e d i n t h e i r work, who had strong professional b e l i e f s , who were not separated/divorced, and who were baccalaureate graduates, to have a higher commitment l e v e l than those who were not s a t i s f i e d , had weak professional b e l i e f s , who were separated/divorced or diploma graduates. In summary, i t could be said that the commitment l e v e l of s a t i s f i e d nurses could tend to d i f f e r from those nurses who were not; that an i n d i v i d u a l ' s professional o r i e n t a t i o n did tend to make a difference i n her commitment l e v e l ; that the commitment l e v e l of single and married nurses did tend to -65-d i f f e r from that of separated/divorced nurses; and that an i n d i v i d u a l ' s b a s i c education d i d tend to have a bearing on her l e v e l of commitment. (9) However, i t must be remembered that these four v a r i a b l e s accounted f o r only 23% of the t o t a l v ariance. Thus 77% of the variance was not accounted f o r . Of t h i s 77%, 7% can never be explained. As i n d i c a t e d by the r e l i a b i l i t y of the Commitment Index ( r = .93), .7 or 7% of the variance i s a t t r i b u t e d to random e r r o r . The 70% remaining may be explained by other untested f a c t o r s which could have f a r greater p r e d i c t a b i l i t y . There were a number of s i m i l a r i t i e s between the f i n d i n g s of t h i s study and those of the A l l u t o and Hrebiniak. Although the v a r i a b l e s were not i d e n t i c a l to those which proved s i g n i f i c a n t i n the A l l u t o and Hrebiniak s t u d i e s , they were s i m i l a r i n that they were cat e g o r i z e d as personal or work-related v a r i a b l e s . A second s i m i l a r i t y found between t h i s study and the A l l u t o and Hrebiniak studies was that the work-related v a r i a b l e s were almost always the strongest p r e d i c t o r s and therefore entered the r e g r e s s i o n equations f i r s t . In the present study, "work s a t i s f a c t i o n " entered f i r s t . A f i n a l s i m i l a r i t y noted between t h i s study and the A l l u t o and Hrebiniak s t u d i e s was the percentage of the v a r i a b i l i t y which i s accounted f o r by the independent v a r i a b l e s . In t h e i r f i r s t study, A l l u t o and Hrebiniak document that 12 percent of the variance was accounted f o r by the personal and work-related v a r i a b l e s . 2 In t h e i r second study they found an R 2 of .21.""^ Although these two f i g u r e s were derived from studies designed to account f o r v a r i a b i l i t y i n commitment to an o r g a n i z a t i o n , as -66-opposed to a profession, they serve to i l l u s t r a t e the following point. When compared with the R 2 of .234 obtained i n the present study, i t becomes evident that, i n a l l three studies, personal and work-related variables did not account for a large percentage of explained variance. This strongly supports the need to re-examine the structural model of the commitment phenomenon. Another important fact to note i n the present study was the predominance of low correlations between the dependent variable and the independent variables and the independent variables among themselves. For example, the highest correlation between the dependent variable and -the independent variables was r=.36. The correlations between the independent variables were also low. - 6 7 -CHAPTER V: SUMMARY, CONCLUSIONS, IMPLICATIONS, LIMITATIONS AND RECOMMENDATIONS FOR FURTHER RESEARCH SUMMARY The purpose of the study was to determine whether v a r i a b i l i t y i n the degree of commitment nurses had to t h e i r p r o f e s s i o n was explained by personal and work-related f a c t o r s . Commitment i s a powerful f o r c e which shapes a nurse's career and as such i t i s the r e s p o n s i b i l i t y of nurses, as p r o f e s s i o n a l s , to understand the nature of commitment and the values attached to the concept. The values the p r o f e s s i o n attaches to the phenomenon of commitment are i n part expressed by the l e v e l of commitment of i n d i v i d u a l nurses. Further, having knowledge about the f a c t o r s which e x p l a i n v a r i a b i l i t y i n the commitment of nurses would provide a b e t t e r understanding of the phenomenon and would c o n t r i b u t e toward the e v o l u t i o n of a theory of commitment. In a review of the l i t e r a t u r e , i t was concluded that commitment should be studied w i t h respect to i t s i n t e r a c t i o n with a m u l t i p l i c i t y of v a r i a b l e s . This gave d i r e c t i o n f o r an e m p i r i c a l study using a m u l t i p l e r e g r e s s i o n research design. Based on the work of A l l u t o and Hrebiniak, a f i v e - p a r t questionnaire was f i r s t p i l o t - t e s t e d , then mailed to a s t r a t i f i e d random sample of four hundred nurses l i v i n g i n the Greater Vancouver D i s t r i c t . Data a n a l y s i s took place i n three stages. F i r s t an item a n a l y s i s f o r each of the subtests was performed. The demographic data were then analyzed. F i n a l l y , -68-a multiple regression analysis was performed to determine which of the variables were s i g n i f i c a n t predictors of commitment. Analysis of the sub-tests used to measure commitment, professionalism, opinions about c o l l e c t i v e bargaining and work s a t i s f a c t i o n revealed i n t e r n a l l y consistent sub-tests, with the exception of the Professional Action sub-test. Analysis of the demographic data revealed a sample c l o s e l y resembling the population of i n t e r e s t . O v e r a l l , the sample consisted of females who were predominantly married p r a c t i c i n g diploma nurses with a mean age of 36 years. Most of them worked as s t a f f nurses i n a h o s p i t a l on a regular basis. The majority had taken some form of continuing education arid intended to continue t h e i r education. A stepwise multiple regression analysis produced an R 2 of 23%. Four variables entered the regression equation. Of these, three were personal variables (marital status, basic education, professionalism) and one a work-related v a r i a b l e (work s a t i s f a c t i o n ) . The l a t t e r was the strongest predictor of commitment accounting for s l i g h t l y more than half of the explained v a r i a b i l i t y . Even when the two strongest predictors, work s a t i s f a c t i o n and professional b e l i e f s , were removed from the a n a l y s i s , the same two variables which had already entered the equation, marital status and basic education, entered again. A l l other variables remained out. < Thus, to r e l a t e back to the hypothesis, i t was found that personal and -69-work-related f a c t o r s d i d e x p l a i n some of the v a r i a b i l i t y i n commitment, accounting f o r 23% of the t o t a l v a r i a b i l i t y . V e r i f i c a t i o n procedures assured l i n e a r i t y of the r e l a t i o n s h i p between the dependent v a r i a b l e and continuous independent v a r i a b l e s . A n a l y s i s of variance a l s o assured n o n - s i g n i f i c a n t r e l a t i o n s h i p s between the dependent v a r i a b l e and the dichotomous independent v a r i a b l e s . CONCLUSIONS The present study was c a r r i e d out to provide a b e t t e r understanding of the phenomenon of commitment by i n v e s t i g a t i n g f a c t o r s which were thought to i n f l u e n c e i t . The f o l l o w i n g conclusions were made: (1) The study revealed c o r r e l a t i o n a l , not cause-effect r e l a t i o n s h i p s . As such, the i n t e r p r e t a t i o n of the r e s u l t s had to consider that the independent v a r i a b l e d i d not n e c e s s a r i l y cause the dependent v a r i a b l e . In other words, job s a t i s f a c t i o n , strong p r o f e s s i o n a l b e l i e f s , being s i n g l e or married and being a baccalaureate degree nurse, d i d not n e c e s s a r i l y cause the respondents to have a stronger commitment to the pr o f e s s i o n of nursing. I t could only be s a i d that respondents with these c h a r a c t e r i s t i c s a l s o had a high commitment l e v e l . (2) Although the study demonstrated that commitment i s explained by personal and work-related f a c t o r s at a .05 l e v e l of s i g n i f i c a n c e , a lar g e part (70%) of the variance remains unexplained. This supports -70-the need to re-examine the s t r u c t u r a l model of the commitment phenomenon. A suggestign i n t h i s d i r e c t i o n would be to move away from a "simple" l i n e a r model to a path model i n c o r p o r a t i n g various branches or p a t h s . ^ Perhaps commitment i s not due to one v a r i a b l e added to a second v a r i a b l e added to a t h i r d and f o u r t h v a r i a b l e , as the l i n e a r model assumes. I t may be that one or two v a r i a b l e s may a f f e c t commitment i n d i r e c t l y through another v a r i a b l e which a f f e c t s commitment d i r e c t l y . In a d d i t i o n to a new model, i n c o r p o r a t i o n of d i f f e r e n t v a r i a b l e s , which would b e t t e r measure commitment, would be a second suggestion. (3) Lack of construct v a l i d i t y f o r a l l or some of the sub-tests may, i n p a r t , a l s o account f o r the l a r g e unexplained var i a n c e (70%). Although -the sub-tests .were each considered i n t e r n a l l y c o n s i s t e n t ( w i t h the exception of the P r o f e s s i o n a l A c t i o n s u b - t e s t ) , construct v a l i d i t y i s not assured. The sub-tests may have been measuring something a l t o g e t h e r d i f f e r e n t . For example, although the r e l i a b i l i t y estimate of the Commitment Index was r =.93, i t could be that i n r e a l i t y the Index was measuring something other than commitment. (4) In an attempt to speculate on the cause of the low c o r r e l a t i o n s and t h e i r ambiguous nature, a d i s c u s s i o n of a trend developing w i t h i n the -71-nursing profession may be useful. The trend, labelled by many as an "identity c r i s i s , " has for the past decade become more and more evident. Recent events at the Vancouver General Hospital have, in particular, brought this "identity c r i s i s " to the forefront. A dispute between the nurses and the administration over inadequate practice conditions began in the summer of 1977. The dispute erupted in June 1978. What was at stake in this dispute was "how much control the (nursing) profession should exercise over i t s practice..."45 The nurses contended that " i f they are expected to give safe, competent care, they must have control over the setting in which they deliver that care."46 This assertive stand for more decision-making authority on issues which affected the delivery of nursing care was of historic significance. It reflected the transition or evolu-tion of the nurses as the passive follower of physicians' orders and administrative decisions to the active decision-maker, striving to be responsible and accountable for her actions. The transition which is prevalent throughout many parts of British Columbia, the rest of Canada and indeed North America has, as with any change process, caused uncertainty and unrest among nurses. It is this uncertainty and unrest which has been labelled an "identity c r i s i s . " The questionnaire was distributed one week following the eruption at the Vancouver General Hospital and some of the findings may reflect the inner turmoil or "identity c r i s i s " being experienced by the nurses. Although i t is not possible to predict precisely how or to what extent the events at the Vancouver General Hospital may have \ -72-affected the responses of the nurses, one can speculate that they may very l i k e l y have been affected. This may, i n part, explain the low, unexpected c o r r e l a t i o n s found i n this study. IMPLICATIONS In t h i s study of commitment, i t was found that three personal and one work-related v a r i a b l e accounted for 23% of the variance. Although an explained variance of 23% i s not very large, several implications for p r a c t i c i n g nurses, employing agencies, the professional association, nurse educators and nursing researchers do a r i s e . Of the four v a r i a b l e s , two i n p a r t i c u l a r have implications. The f i r s t i s job s a t i s f a c t i o n . It was concluded that there was a trend among nurses who were committed to t h e i r profession to also be s a t i s f i e d i n t h e i r jobs. Pr a c t i c i n g nurses and t h e i r employing agencies should both be aware of t h i s and s t r i v e to c u l t i v a t e a f u l f i l l i n g , cohesive working environment. Nurse educators should continue e f f o r t s to s e n s i t i z e students to the r e a l i t i e s of the work world. They should also encourage and foster ways and means of creating a s a t i s f y i n g working environment. Introduction to the change process would be useful with a follow-up assignment using the process i n the c l i n i c a l s e t t i n g . Nursing researchers should address themselves to the question of what i t i s that makes nurses s a t i s f i e d or d i s s a t i s f i e d i n their The second variable of i n t e r e s t i s professional b e l i e f s . Nurses i n the sample who had a strong commitment to nursing also tended to have strong professional b e l i e f s . The implications of t h i s f i n d i n g primarily rest with nurse educators. As indicated i n the introduction, nurse educators have the major r e s p o n s i b i l i t y i n molding and shaping nursing students' values and t h e i r professional b e l i e f s . The values the student acquires during these formative years w i l l see her through her career. It i s , therefore, a c r u c i a l time to develop and nurture a sense of profes-sionalism. Nursing students should be made more aware of the a t t r i b u t e s of a profession and professional conduct, as well as the public expectations of a professional. They should be made aware of the importance of reading nursing journals, of the need to continue t h e i r own education a f t e r graduation and of the value of supporting and p a r t i c i p a t i n g i n nursing research. The r e s p o n s i b i l i t y of c u l t i v a t i n g strong professional b e l i e f s rests also with the professional association. Not only must i t conduct i t s e l f p r o f e s s i o n a l l y , i t must i n s p i r e i t s members to do so. Nurses must be motivated to p a r t i c i p a t e i n professional a f f a i r s and to become p o l i t i c a l l y aware and more assertive. Examples of other a c t i v i t i e s which help to promote professional development include the p u b l i c a t i o n of a professional journal, provision of loans or grants for continuing education, conducting and funding nursing research and i n i t i a t i n g programs to assure q u a l i t y of nursing care. -74-F i n a l l y , the implication f or nursing researchers rests i n the need to determine why nurses have strong b e l i e f s , what helps to develop them or what causes nurses to lose them. Job s a t i s f a c t i o n and strong professional b e l i e f s are two important determinants of commitment. The implications of these findings serve to i l l u s t r a t e that, although the findings of the present study were not strong s t a t i s t i c a l l y , they did reveal new knowledge useful to the nursing profession i n i t s e f f o r t to determine the values i t attaches to. the concept of commitment. Furthermore, a foundation from which further studies can develop has been established. LIMITATIONS (1) The survey approach used i n t h i s study presented several l i m i t a t i o n s . As with any questionnaire the researcher had no guarantee that the views and attitudes expressed by the respondents were true. Nor could the researcher v e r i f y whether or not these attitudes correspond to the way i n which the respondent a c t u a l l y behaved. F i n a l l y , the survey approach affords no way of e l i c i t i n g information from the non-respondents unless a s p e c i a l technique such as a follow-up.of a sub-sample of non-respondents i s used. Results obtained from the respondents may have r e f l e c t e d a bias. Therefore generalizations could only be made to the population of "respondents." -75-(2) G e n e r a l i z a t i o n of any of the conclusions could only be made to a population of nurses s i m i l a r to the one used i n the study. Therefore, f a c t o r s found to be s i g n i f i c a n t p r e d i c t o r s of commitment could be g e n e r a l i z e d only to nurses l i v i n g i n a metropolitan area and who had the same demographic c h a r a c t e r i s t i c s as found i n the sample. (3) Because the questionnaire was d i s t r i b u t e d one week f o l l o w i n g the nursing c o n f r o n t a t i o n at the Vancouver General H o s p i t a l , the sample subjects may have been biased by emotional, u n c e r t a i n b e l i e f s and a t t i t u d e s which may have a f f e c t e d t h e i r responses to the questionnaire. RECOMMENDATIONS FOR FURTHER RESEARCH As i n d i c a t e d i n the c o n c l u s i o n , a l a r g e part of the v a r i a b i l i t y i n commitment remained unexplained (70%). This may have been due to the l a c k of construct v a l i d i t y i n the Commitment Index, to the use of the "simple" l i n e a r model and/or to the use of v a r i a b l e s which d i d not i n f l u e n c e commitment. Recommendations f o r f u r t h e r research to overcome these three weaknesses are as f o l l o w s : (1) A study to improve the construct v a l i d i t y of the Commitment Index. This would serve to reassure that the phenomenon which was being measured by the Index t r u l y was commitment. -76-(2) I t was suggested i n the c o n c l u s i o n that a more complex model than the "simple" l i n e a r model be used f o r a n a l y s i s . As commitment i s a very complicated concept, i t may w e l l be that i n order to analyze i t through research, an e q u a l l y complex methodology must be used. (3) In an e f f o r t to determine whether the respondents i n the present study were any d i f f e r e n t than the non-respondents, a sub-sample of non-respondents could be s e l e c t e d f o r study. Comparing the f i n d i n g s of the sub-sample with the responding sample f o r s i g n i f i c a n t d i f f e r e n c e s might provide more i n s i g h t i n t o the phenomenon of commitment. (4) In comparing the present study w i t h the Hrebeniak and A l l u t o s t u d i e s , i t was found t h a t , although the personal and work-related v a r i a b l e s d i d e x p l a i n v a r i a b i l i t y i n commitment, i n a l l three s t u d i e s the R 2 was l e s s than 25%. In view of t h i s f a c t , i t i s p o s s i b l e that other as yet unstudied v a r i a b l e s may have a greater i n f l u e n c e on commitment. The f o u r t h recommendation f o r f u r t h e r research c o n s i s t s of seeking out these v a r i a b l e s . I n t e r v i e w i n g nurses to determine f a c t o r s which the respondents f e l t would most l i k e l y i n f l u e n c e commitment would be one p o s s i b l e methodology. Having e s t a b l i s h e d a new set of v a r i a b l e s and the construct v a l i d i t y of the Commitment Index, the study could then be repeated using a path a n a l y s i s procedure. Following t h i s , the study could be r e p l i c a t e d on a sample of nurses not l i v i n g i n an urban area such as the Greater Vancouver -77-1 D i s t r i c t . If the findings are s i m i l a r , they could be generalized to the population of nurses l i v i n g i n B r i t i s h Columbia. If the findings were not s i m i l a r , the research could expand to determine i f there i s any s i g n i f i c a n t difference between the two samples. This i n turn could lead to further research to explore the c h a r a c t e r i s t i c s which explain the difference i n the commitment of nurses l i v i n g i n an urban s e t t i n g with the commitment of those l i v i n g i n r u r a l B r i t i s h Columbia. ) -78-FOOTNOTES 1 N. Mayes, et a l , "Commitment to Nursing - How Is I t Achieved," Nursing Outlook, ( J u l y 1968): 29 2 M. Kramer, R e a l i t y Shock (St L o u i s : The C.V. Mosby Company 1974): 3 3 M. Grissum and C. Splenger, Womanpower and Health Care, (Boston: L i t t l e , Brown & Company, 1976): 39 4 N. R i e g l e r , "Commitment and Nursing" (Master's Degree, School of P u b l i c Health, U n i v e r s i t y of Michigan, 1967): 3 5 M. Shaw and J . Wright, Scales f o r the Measurement of A t t i t u d e s , (Toronto: McGraw-Hill Book Company, 1967): 10 6 Labour Code of B r i t i s h Columbia, Chapter 122, Section I ( i i ) , (1960): 1 ^ A. Ponak, "Registered Nurses and C o l l e c t i v e Bargaining: An A n a l y s i s of Job Related Goals", (Ph.D. d i s s e r t a t i o n , U n i v e r s i t y of Wisconsin, 1977) ^ D. Krathwohl, B. Bloom and B. Masia, Taxonomy of Edu c a t i o n a l O b j e c t i v e s , (New York: David McKay Company, Inc, 1964): 149 ^ L. Hrebiniak and J . A l l u t o , "Personal and Role-Related Commitment," A d m i n i s t r a t i v e Science Q u a r t e r l y 17, (December 1972): 559 10 C o l l e c t i v e Agreement Between Health Labour R e l a t i o n s A s s o c i a t i o n of BC and RNABC, A r t i c l e 10, (January 1, 1978 - December 31, 19879): 15-16 11 W. Snizek, " H a l l ' s P r o f e s s i o n a l i s m Scale: An Emperical Reassessment," American S o c i o l o g i c a l Review 37, (February 1972): 114 1 2 S. Hurka, "The Registered Nurse as a P r o f e s s i o n a l Employee: A Study of Perceived Role O r i e n t a t i o n s , " (Ph.D d i s s e r t a t i o n , U n i v e r s i t y of Washington, 1970) 1 3 S i s t e r M. V a i l l o t , " E x i s t e n t i a l i s m : A Philosophy of Commitment," American J o u r n a l of Nursing, (March 1966): 501 14 E v e r e t t Hughes, et a l . Twenty Thousand Nurses T e l l Their Story: A Report on the American Nurses A s s o c i a t i o n Studies of Nursing Function, ( P h i l a d e l p h i a : J . B. L i p p i n c o t t Company, 1958): 236 1-- N. Nachmias, "Panel D i s c u s s i o n : The Commitment of a Woman Ent e r i n g a S c i e n t i f i c P r o f e s s i o n i n Present-Day American S c o e i t y , " Women and the  S c i e n t i f i e d P r o f e s s i o n , 32 1^ J . Gardner, Self-Renewal: The I n d i v i d u a l and the Innovative S o c i e t y , New York: Harper & Row, P u b l i s h e r s , 1963): 99 ^ M. Tarcher, Leadership and the Power of Ideas, (New York: Harper & Row, P u b l i s h e r s , 1960): 32 -79-18 c. K i e s l e r , The Psychology of Commitment Experiments Linking Behaviour  to B e l i e f , New York: Academic Press, 1971): x i i 19 i b i d 20 H. Becker, "Notes on Concept of Commitment," American Journal of Sociology, (July 1960): 35 21 S i s t e r M. V a i l l o t , op c i t : 204 22 i b i d 23 C. K i e s l e r , op c i t : 142 24 C. K i e s l e r , i b i d : 63 25 C. K i e s l e r , i b i d : 88 26 C. K i e s l e r , i b i d : 107 27 C. K i e s l e r , i b i d : 125 28 G. Ritzer and H. T r i c e , Theory": 475 29 i b i d : 476 3^  L. Hrebiniak and J . A l l u t o , "Personal and Role-Related Factors i n the Development of Organizational Commitment," Administrative Science Quarterly 17 (December 1972): 555 31 i b i d 3 2 i b i d : 570 33 j . A l l u t o and L. Hrebeniak, "Research on Commitment to Employing Organizations Among Executives," (paper presented to Academy of Management, New Orleans, 1975): 4 34 W. Snizek, "Hall's Professionalism Scale: An Empirical Reassessment," American S o c i o l o g i c a l Review 37 (February 1972): 114 3 5 Ibid 3 6 I b i d : 112 3 7 A. Ponak, "Registered Nurses and C o l l e c t i v e Bargaining: An Analysis of Job Related Goals," (Ph.D. d i s s e r t a t i o n , University of Wisconson, 1977) 38 I b i d : 92 39 N. Gross; W. Mason; A. McEachern. Exploration i n Role Analysis: Studies  of the School Superintendency Role, New York: John Wiley and Sons, Inc, 1958: 323 -80-4 0 N. Gross, ibid 4* S. Hurka, "The Registered Nurse as Professional Employee: A Study of Perceived Role Orientation," (Ph.D dissertation, University of Washington, 1970) 42 Hrebiniak and Alluto, "Personal and Role-Related Factors in the Development of Organizational Commitment": 569 43 Alluto and Hrebiniak, "Preliminary Findings on a Study of Managers Graduating from Engineering and MBA Programs." 44 p. N. Kerlinger and E. J. Pedhauzer, Multiple Regression in Behaviour Research, (Toronto: Holt, Rinehart and Winston, Inc, 1973): 305-330 45 Registered Nurses Association of British Columbia News, "V.G.H.: Special Report," June/July 1978: 3 4 6 Ibid -81-BIBLIOGRAPHY Abdellah, Fay G. and Levine, Eugene. B e t t e r P a t i e n t Care Through Nursing  Research. New York: MacMillan P u b l i s h i n g Co, 1965 A l l u t o , Joseph; Hrebiniak, Lawrence. "Commitment to P r o f e s s i o n : A M u l t i v a r i a t e A n a l y s i s . " School of Management: Working Paper S e r i e s No 144. ( B u f f a l o : State U n i v e r s i t y of New York, 1973) A l l u t o , Joseph; Hrebiniak, Lawrence. "Personal and Role Related Factors i n Development of O r g a n i z a t i o n a l Commitment." A d m i n i s t r a t i v e Science  Quarterly 17. (December 1972): 555-573 A l l u t o , Joseph; Hrebiniak, Lawrence. "Research on Commitment to Employing Organization Among Executives." Paper presented at 35th Annual Meeting, Academy of Management, New Orleans, 10-13 August 1975 A l l u t o , Joseph; Hrebiniak, L.; Alonso, R. "On O p e r a t i o n a l i z i n g the Concept of Commitment." S o c i a l Forces (June 1973): 448-454 Becker, Howard. "Notes on the Concept of Commitment. "The American J o u r n a l of  Sociology 66 ( J u l y 1960): 32-40 Bettelheim, Bruno. "The Commitment of a Woman Ent e r i n g a S c i e n t i f i c P r o f e s s i o n i n Present-Day American Society," i n Women and the S c i e n t i f i c P r o f e s s i o n . Edited by J . M a t t f e l d and C. Van A l l e n . Cambridge, Mass.: The M.I.T. Press, 1965: 3-19 C o l l e c t i v e Agreement between Health Labour R e l a t i o n s A s s o c i a t i o n of BC and  RNABC, A r t i c l e 10, January 1, 1978 to December 31, 1979 Crawford, Claud. "Commitment." The Personnel and Guidance J o u r n a l 9, (May 1966): 901-909 Gardner, John. Self-Renewal: The I n d i v i d u a l and Innovative S o c i e t y . New York: Harper and Row, P u b l i s h e r s , 1963. Grissum, Marlene and Sp l e n g l e r , C a r o l . Womanpower and Health Care. Boston: L i t t l e , Brown & Company, 1976. Gross, N.; Mason, W; McEarchern, A. E x p l o r a t i o n i n Role A n a l y s i s : Studies of the Superintendency Role. New York: John Wiley and Sons Inc, 1958. Hughes, E v e r e t t , et a l . Twenty Thousand Nurses T e l l T h e i r Story: A report on  the American Nurses' A s s o c i a t i o n Studies of Nursing Function. P h i l a d e l p h i a : J.B. L i p p i n c o t t Company, 1958 Hurka, Slavek. "The Registered Nurse as a P r o f e s s i o n a l Employee: A study of Perceived Role O r i e n t a t i o n s . " Ph.D. d i s s e r t a t i o n , U n i v e r s i t y of Washington, 1970. Kramer, Marlene. R e a l i t y Shock. St L o u i s . The C.V. Mosby Company, 1974. -82-Krathwohl, David R., Benjamin S. Bloom and Masia Bertram. Taxonomy of Educational Objectives. Classification of Educational Goals, Handbook II: Affective Domain. New York: David McKay Company, Inc., 1964 Kerlinger, F. N. and E. J. Pedhauzer. Multiple Regression in Behaviour  Research. Toronto: Holt, Rinehart and Winston, Inc., 1973 Kerlinger, Fred N. Foundations of Behavioural Research, 2nd ed. Toronto: Holt Rinehart and Winston, Inc., 1973 Kiesler, Charles. The Psychology of Commitment, Experiments Linking Behavour to Belief. New York: Academic Press, 1971 LaSor, Betsy and E l l i o t t , Ruth. Issues in Canadian Nursing, Scarborough, / Ontario: Prentice-Hall of Canada Ltd, 1977 Nachmias, Vivianne. "Panel Discussion: The Commitment of a Woman Entering a Scientific Profession in Present-Day American Society," in Woman and the  Scientific Profession. Edited by J. Mattfeld and C. Van Allen. Cambridge, Mass: The M.I.T. Press, 1965: 29-34 ^ Ponak, Allan. "Registered Nurses and Collective Bargaining: An Analysis of Job Related Goals." Ph.D. dissertation, University of Wisconsin, 1977. Rees, Mina. "Panel Discussion: The Commitment of a Woman Entering a Scientified Profession i n Present-Day American Society," in Women and  the Scientific Profession. Edited by J. Mattfeld and C. Van Allen. Cambridge, Mass: The M.I.T. Press, 1965: 29-34 Registered Nurses Association, of British Columbia. News. "V.G.H.: Special Report." June/July 1978: 3-7 Riegler, Natalie. "Commitment and Nursing." Dissertation,. University of Michigan, 1967 Ritzer, George and Trice, Harrison. "An Empirical Study of Howard Becker's Side-Bet Theory." Social Forces (June 1969): 475-479 Shaw, Marvin E. and Jack M. Wright. Scales for the Measurement of Attitudes. Toronto: McGraw-Hill Book Company, 1967 Snizek, William. "Hall's Professionalism Scale: An Empirical Reassessment." American Sociological Review 37 (February 1972): 109-114 Strauss, Anselm. Mirrors and Masks: The Search for Identity. I l l i n o i s : The Free Press of Glencoe, 1959 Tarcher, Marten. Leadership and the Power of Ideas. New York: Harper and Row, Publishers, 1966 Turabian, Kate L. A Manual for Writers of Term Papers, Theses and Dissertations, 4th ed., Chicago: The University of Chicago Press, 1973 ' -83-Turabian, Kate L. A Manual f o r W r i t e r s of Term Papers, Theses and D i s s e r t a t i o n s , 4th ed., Chicago: The U n i v e r s i t y of Chicago Press, 1973 V a i l l o t , S i s t e r Madeleine. Commitment to Nursing. Montreal: J . B. L i p p i n c o t t Company, 1961 Winborn, Bob. "Comment on Crawford." The Personnel and Guidance J o u r n a l 9 (May 1966): 909-910 -84-A P P E N D I X A -85-UNIVERSITY OF BRITISH COLUMBIA DEPARTMENT OF NURSING The questionnaire has been divided i n t o f i v e sections. Instructions for each section vary. Please read the i n s t r u c t i o n s c a r e f u l l y before responding to the items. I V V ' • • Please i n d i c a t e by c i r c l i n g the number which corresponds to the way i n which you f e e l i n response to the following question: Suppose you were o f f e r e d a job not i n nursing. Would you leave nursing under any of the following conditions? 1 - Yes, D e f i n i t e l y - Y.D. 2 - Uncertain - U. 3 - No, D e f i n i t e l y Not - N.D.N. Y.D. U. N.D.N 1) With-no-increase i n pay 1 2 ' 3 2)-"With a s l i g h t increase i n pay 1 2 ' 3 3) With., a large increase i n pay 1 2 3 4) 'With no more freedom to be pr o f e s s i o n a l y c r e a t i v e 1 2 5) With s l i g h t l y more freedom to be p r o f e s s i o n a l l y c r e a t i v e . 1 2 _3' 6) With much more freedom to be p r o f e s s i o n a l l y c r e a t i v e 1 2 3 7) With.no more status 1 2 31 8) With s l i g h t l y more status 1 2j 3 9) With much more status 1 21 3 10) To work with people who are no f r i e n d l i e r 1 ~2 . 3 • 11) To work with people who are s l i g h t l y more f r i e n d l y 1 2 ' . 3 ' 12) To .work with people who are much f r i e n d l i e r 1 2 v 3' I I . " The following items should be answered i n l i g h t of the way you yoursel ... •. :. both-feel and behave as a member of the .nursing p r o f e s s i o n a l . ' There are f i v e p o s s i b l e responses to each item. I f , for example, the item describes very w e l l (V.W.) your own a t t i t u d e or behaviour c i r c l e the number corresponding to that response. I f i t corresponds well (W.). poorly (P.) or very poorly (V.P.) c i r c l e the appropriate •, . response. The middle category (?) i s designed to i n d i c a t e an ' e s s e n t i a l l y n e u tral opinion about the item. Remember, answer each item according to the way i n which you both f e e l and behave as a member of the nursing p r o f e s s i o n , i e : how you a c t u a l l y f e e l and behave. 1 - very w e l l V. .W. 2 - w e l l W. 3 - (?) uncertain ? 4 - poor P. 5 - very poor V. .P.. -86-1) I think that my p r o f e s s i o n more than any other profession i s e s s e n t i a l for society. 2) My colleagues have a p r e t t y good idea about each other's competence. 3) People i n t h i s p r o f e s s i o n have a r e a l " c a l l i n g " for t h e i r work. 4) The importance of my p r o f e s s i o n i s sometimes overstressed. 5) I believe the p r o f e s s i o n a l organi-zation should be supported. 6) Some other occupations are a c t u a l l y more important to so c i e t y than mine i s . 7) A problem i n t h i s p r o f e s s i o n i s that no one r e a l l y knows what h i s colleagues are doing. 8) I t i s encouraging to see the high l e v e l of idealism which i s maintained by people i n nursing. 9) The p r o f e s s i o n a l organization doesn't r e a l l y do too much for the average member.. 10) We r e a l l y have no way of judging each other's competence. 11) Most people would stay i n the profession even i f t h e i r incomes were reduced. 12) .. I f ever an occupation i s i n d i s p e n s i b l e , i t i s t h i s one. 13) My colleagues p r e t t y w e l l know how w e l l we a l l do i n our work. 14) There are r e a l l y very few who don't r e a l l y believe i n t h e i r work. 15) I am my own boss i n almost every work-related s i t u a t i o n . 16) There i s not much opportunity to judge how my colleagues do t h e i r work. 17) My own decisions are subject to review 18) Although I would l i k e to I don't r e a l l y read the journals often. 19) I make my own decisions i n regard to what i s to be done i n my work. 20) I r e g u l a r l y attend meetings at the l o c a l l e v e l . 21) I r e g u l a r l y read the p r o f e s s i o n a l journals. 22) I don't have much opportunity to exercise my own judgement. 23) Most of my decisions are reviewed by other people. 24) Other professions are a c t u a l l y more v i t a l to s o c i e t y than mine. 25) The dedication of people i n t h i s f i e l d i s most g r a t i f y i n g . -87-\ - 3 -I I I . To h e l p i n t h e a n a l y s i s , some b a c k g r o u n d i n f o r m a t i o n a b out y o u r s e l f and y o u r work w i l l be o f g r e a t h e l p . T h i s i n f o r m a t i o n w i l l i n no way be u s e d t o i d e n t i f y any i n d i v i d u a l and w i l l be k e p t p r i v a t e and c o n f i d e n t i a l . P l e a s e check t h e box w h i c h c o r r e s p o n d s t o you and y o u r work ( o r mark i n a c t u a l n u m e r i c a l v a l u e where n e c e s s a r y ) . A. SEX: FEMAL: MAL: £ 7 C. AGE: (IN YEARS) B. MARITAL STATUS: SINGLE I 1 MARRIED | ^ | WIDOWED OTHER D. YEAR OF GRADUATION: 19. F. EDUCATION: E. TOTAL NUMBER OF YEARS ACTIVE NURSING PRACTICE SINCE GRADUATION: (IN YEARS) P l e a s e check one. R e g a r d i n g c o n t i n u i n g e d u c a t i o n , check a l l t h a t a p p l y : [None | [ D i p l o m a / C e r t i f i c a t e ) j i e : p u b l i c h e a l t h RN D i p l o m a [ U n i v e r s i t y C r e d i t s i e : n o t r e s u l t i n g i n B.Sc.N. [B a c h e l o r ' s Degree i e : N u r s i n g M a s t e r ' s Degree C o u r s e s o t h e r t h a n n u r s i n g I n t e n d t o seek f u r t h e r e d u c a t i o n • • • • • OR B a c h e l o r ' s Degree R e g a r d i n g c o n t i n u i n g e d u c a t i o n , check a l l t h a t a p p l y : None D i p l o m a / C e r t i f i c a t e | j U n i v e r s i t y C r e d i t s | | i e : n o t a c q u i r e d w i t h d e g r e e [Master' s Degree [ [ C o u r s e s o t h e r t h a n | j ' n u r s i n g I n t e n d t o seek i— i f u r t h e r e d u c a t i o n I I G. REGISTRATION STATUS: PRACTICING \~_ NON-PRACTICING £ ^ _ H. EMPLOYMENT STATUS: REGULAR FULL TIME | ] REGULAR PART TIME [ I CASUAL • -88-- A -I. C U R R E N T E M P L O Y M E N T H O S P I T A L C L I N I C • P U B L I C H E A L T H • • • E D U C A T I O N A L I N S T I T U T I O N |2i O T H E R (please specify) E M P L O Y M E N T P O S I T I O N S T A F F N U R S E • P U B L I C H E A L T H NURSE| j I N S T R U C T O R J ~ ~ j H E A D N U R S E A S S I S T A N T S U P E R V I S O R S U P E R V I S O R • • • IV. L i s t e d below are ten. statements about c o l l e c t i v e bargaining i n general and as i t pertains to reg i s t e r e d nurses. Please c i r c l e the number which corresponds to the way you f e e l about each statement. For each statement please^ i n d i c a t e whether you: 1 - Strongly agree - S.A. 2 - Agree A. 3 - Undecided U. 4 - Disagree D. 5 - Strongly disagree S.D. 1. In the long run, management w i l l do more for employees than w i l l unions. 2. C o l l e c t i v e bargaining i s v i t a l to nurses i n p u r s u i t of t h e i r p r o f e s s i o n a l goals. - 3. Mutual support between nurse as s o c i a t i o n s and unions representing p r o f e s s i o n a l nurses i s a good idea. 4. C o l l e c t i v e bargaining i s a negative force for progress i n Canadian s o c i e t y . 5. I t i s preferable to belong to an organi-zation that i s w i l l i n g to go on s t r i k e i f i t f e e l s such a c t i o n i s necessary. 6. C o l l e c t i v e bargaining by nurses requires a greater expenditure of time and e f f o r t than the p o t e n t i a l gain would j u s t i f y . 7. Economic issues a f f e c t i n g nurses can be dealt with more e f f e c t i v e l y through c o l -l e c t i v e bargaining than i n any other way. 8. C o l l e c t i v e bargaining i s not appropriate for p r o f e s s i o n a l s . 9. Nurses should be p r o h i b i t e d by law from s t r i k i n g . 10. C o l l e c t i v e bargaining by nurses w i l l r e s u l t i n higher q u a l i t y of p a t i e n t care. S.A. A. U. D. S.D. 1 1 1 1 1 1 1 1 2 2 2 2 3, 3 3 3 4 5 4 5 4 5 4 5 4 5 4 5 4 5 4 5 -89-- 5 -Please c i r c l e the number which in d i c a t e s your s a t i s f a c t i o n or d i s s a t i s f a c t i o n with corresponding aspects of your present job. I f not applicable to you and your work, please c i r c l e the number which in d i c a t e s "not a p p l i c a b l e " . 1 - Very well s a t i s f i e d V .S. 2 - F a i r l y s a t i s f i e d F .s. 3 - F a i r l y d i s s a t i s f i e d F. .D. 4 - Very d i s s a t i s f i e d V. .D. 5 - Not a p p l i c a b l e N. .A. v.s. F.S. F.D. V.D. N.A. 2. 3. On the whole are you s a t i s f i e d that the administration accepts you as a p r o f e s s i o n a l expert to the degree to which you f e e l you are e n t i t l e d by reason of your p o s i t i o n , t r a i n i n g and experience? How s a t i s f i e d are you with your present job when you consider the expectations you had when you took the job? How s a t i s f i e d are you with your present job when you compare i t to other nursing jobs? 2 3 4 5 2 3 4 5 2 3 4 5 In answering the following questions as a_ career rather than your present • . (Note format for answering items has 4. How do you f e e l nursing compares with .other types of work? 5. I f you had to do i t over again would you enter nursing? please consider nursing job. changed s l i g h t l y ) 1)- The most s a t i s f y i n g career. 2 - One of the most'satisfying careers. 3 - As s a t i s f y i n g as most careers. 4 - Less s a t i s f y i n g than most careers. 1 - D e f i n i t e l y yes. 2 - Probably yes. 3 - Probably no. 4 - D e f i n i t e l y no. Thank you once again for time and consideration of the questionnaire. I f you have any a d d i t i o n a l comments please f e e l free to express them. I would be most i n t e r e s t e d i n hearing your views regarding subject matter covered i n the questionnaire or regarding the questionnaire i t s e l f . -90-A P P E N D I X B -91-June 9, 1978 Dear Colleague: I am a graduate student at the U n i v e r s i t y of B r i t i s h Columbia, where, i n p a r t i a l f u l f i l l m e n t of a master's degree i n nursing I am carrying out a research project. I would appreciate i t very much i f you would a s s i s t me i n my endeavour by completing the enclosed question-naire which seeks your opinions on d i f f e r e n t aspects of your work as a registered nurse. The aim of the study i s to determine factors which have an in f l u e n c i n g e f f e c t on p r o f e s s i o n a l nurses. Information obtained from t h i s study w i l l have implications f o r nursing p r a c t i c e , education and research. Your p a r t i c i p a t i o n i s important. Although the questionnaire appears long, i t i s designed so that i t can be quickly and e a s i l y completed. Please take time to complete i t , g i v i n g an answer to every question and return i t i n the addressed stamped envelope provided. I would greatly appreciate i t i f you could give t h i s matter your prompt attention, preferably within the next day or so. A l l information w i l l be i n s t r i c t e s t confidence. Please do not put your name on the questionnaire. The number written on the top page of each questionnaire i s only to a i d i n monitoring returns so that you w i l l not be bothered by any follow-up l e t t e r s . Please be assured that at no time w i l l any i n d i v i d u a l nurse be i d e n t i f i e d . A l l information w i l l be aggregated. Results of the study w i l l be a v a i l a b l e i n the Li b r a r y of the Registered Nurses Association. I welcome any a d d i t i o n a l comments or concerns you have. Thank you very much for your p a r t i c i p a t i o n . Yours s i n c e r e l y , Suzanne Flannery, R.N. Graduate Student, Uni v e r s i t y of B r i t i s h Columbia -92-The questionnaire has been divided i n t o f i v e sections i n c l u d i n g a section f o r background information. Instructions f o r each section vary. Please read the i n s t r u c t i o n s c a r e f u l l y before responding to the items. Please ind i c a t e by c i r c l i n g the number which corresponds to the way i n which you f e e l i n response to the following question: Suppose you were of f e r e d a job not i n nursing. Would you leave nursing under any of the following conditions? 1 - Yes, D e f i n i t e l y -r Y.D. 2 - Uncertain - U. 3 - No, D e f i n i t e l y Not - N.D.N. Y.D. U. N.D 1) With no increase i n pay 1 2 3 2) With a s l i g h t increase i n pay 1 2 3 3) With a large increase i n pay 1 2 3 4) With no more freedom to be professionaly creative 1 2 3 5) With s l i g h t l y more freedom to be p r o f e s s i o n a l l y 1 2 3 creat i v e . 6) With much more freedom to be p r o f e s s i o n a l l y creative 1 2 3 7) With no more status 1 2 3 8) With s l i g h t l y more status 1 2 3 9) With much more status 1 2 3 10) To work with people who are no f r i e n d l i e r 1 2 3 11) To worth with people who are s l i g h t l y more f r i e n d l y 1 2 3 12) To work with people who are much f r i e n d l i e r 1 2 3 -94-II. The following items should be answered in light of the way you yourself both feel and behave as a member of the nursing profession. There are five possible responses to each item. If, for example the item describes very well (V.W.) your own attitude or be-haviour cir c l e the number corresponding to that response. If i t corresponds well (W.), poorly (P.) or very poorly (V.P.) ci r c l e the appropriate response. The middle category (?) i s designed to indicate an essentially neutral opinion about the item. Remember, answer each item according to the way in which you both feel and behave as a member of the nursing profession, ie. how you actually feel and behave. 1 - Very Well V.W. 2 - Well W. 3 - (?) Uncertain •? m 4 - Poorly P. 5 - Very Poorly V.P. V.W. W. ? P. V.P. 1) I think that my profession more than most other profession i s essential for society. 2) My colleagues have a pretty good idea about each other's competence. 3) People in this profession have a real "calling" for their work. 4) The importance of my profession i s sometimes understressed. 5) I believe the professional organisation should be supported. 6) Some other professions are actually more important to society than nursing. 7) A problem in this profession i s that no one really knows what is happening with regard to the profession. 8) It is encouraging to see the high level of idealism which is maintained by pdople in nursing. 9) The professional association doesn't really do too much for the average member. 10) We really have no way of judging each other's competence. 11) Most people would stay in the profession even i f their incomes were reduced. 12) If ever an occupation i s indispensible, i t i s this one. 13) My colleagues pretty well know how well we a l l do in our work. (over) 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1.2 3 4 5 1 2 3 4 5 1 2 3 4 5 14) There are r e a l l y very few who don't r e a l l y believe i n t h e i r work. 15) I am my own boss i n almost every work-rel a t e d s i t u a t i o n . 16) There i s not much opportunity to judge how my colleagues do t h e i r work. 17) My own decisions are subject to review 18) Although I would l i k e to I don't r e a l l y read the journals often. 19) I make my own decisions i n regard to what i s to be done i n my work. 20) I re g u l a r l y attend meetings of the l o c a l chapter of the R.N.A.B.C. 21) I r e g u l a r l y read the pr o f e s s i o n a l journals. 22) I don't have much opportunity to exercise my own judgement. 23) Most of my decisions are reviewed by other people. 24) Other professions are a c t u a l l y more v i t a l to society than mine. 25) The dedication of people i n t h i s f i e l d i s most g r a t i f y i n g . 14) There are r e a l l y very few who don't r e a l l y believe i n t h e i r work. 15) I am my own boss i n almost every work-re l a t e d s i t u a t i o n . 16) There i s not much opportunity to judge how my colleagues do t h e i r work. 17) My own decisions are subject to review 18) Although I would l i k e to I don't r e a l l y read the journals often. 19) I make my own decisions i n regard to what i s to be done i n my work. 20) I r e g u l a r l y attend meetings of the l o c a l chapter of the R . N . A . B . C . 21) I r e g u l a r l y read the p r o f e s s i o n a l journals. 22) I don't have much opportunity to exercise my own judgement. 23) Most of my decisions are reviewed by other people. 24) Other professions are a c t u a l l y more v i t a l to society than mine. 25) The dedication of people i n t h i s f i e l d i s most g r a t i f y i n g . 3 I I I . To help i n the analysis, some background information about your-s e l f and your work w i l l be of great healp. This information w i l l i n no way be used to i d e n t i f y any i n d i v i d u a l and w i l l be kept p r i v a t e and c o n f i d e n t i a l . Please check the box which corresponds to you and your work (or mark i n actual numerical value where necessary). A. SEX: B. MARITAL STATUS: FEMALE | J SINGLE MARRIED MALE WIDOWED | OTHER C. AGE: (in years) D. YEAR OF GRADUATION: 19 _ _ F. EDUCATION: Please check one. E. TOTAL NUMBER OF YEARS ACTIVE NURSING PRACTICE SINCE GRADUATION: (in years) RN Diploma | | or Bachelor's Degree Regarding continuing education, check a l l that apply: None Diploma/Certificate i e . p u b l i c health Uni v e r s i t y c r e d i t s i e . not r e s u l t i n g i n B.Sc.N. Bachelor's Degree i e . Nursing Non-Nursing Master's Degree Non-Nursing Courses other than nursing. Intend to seek further education LZJ Regarding continuing education, check a l l that apply: None Diploma/Certificate U n i v e r s i t y c r e d i t s i e . not acquired with degree Master's Degree Non-Nursing Doctorate Courses other than nursing Intend to seek further education V. -97-(over) REGISTRATION STATUS: PRACTICING t NON-PRACTICING I CURRENT EMPLOYMENT HOSPITAL CLINIC PUBLIC HEALTH EMPLOYMENT POSITION STAFF NURSE PUBLIC HEALTH NURSE INSTRUCTOR H. EMPLOYMENT STATUS: REGULAR FULL TIME REGULAR PART TIME CASUAL EDUCATIONAL INSTITUTION OTHER (please specify) HEAD NURSE ASSISTANT SUPERVISOR SUPERVISOR REGISTRATION STATUS: PRACTICING NON-PRACTICING 1 j I. CURRENT EMPLOYMENT HOSPITAL CLINIC PUBLIC HEALTH EMPLOYMENT POSITION • STAFF NURSE PUBLIC HEALTH NURSE INSTRUCTOR H. EMPLOYMENT STATUS: . REGULAR FULL TIME REGULAR PART TIME CASUAL • EDUCATIONAL INSTITUTION OTHER (please specify) HEAD NURSE ASSISTANT SUPERVISOR SUPERVISOR 4 IV. L i s t e d below are ten statements about c o l l e c t i v e bargaining • i n general and as i t pertains to re g i s t e r e d nurses. Please c i r c l e the number which corresponds to the way you f e e l about each statement. For each statement please i n d i c a t e whether you: 1 - Strongly Agree S.A. 2 - Agree A. 3 - Undecided U. 4 - Disagree D. 5 - Strongly Disagree S.D. S.A. A. U. D. S.D. 1. In the long run, management w i l l do more fo r employees than w i l l the Labour Relations D i v i s i o n of the R.N.A.B.C. 2. C o l l e c t i v e bargaining i s v i t a l to nurses i n p u r s u i t of t h e i r p r o f e s s i o n a l goals. 3. Mutual support between nurse associations and unions representing p r o f e s s i o n a l nurses i s a good idea. 4. C o l l e c t i v e bargaining i s a negative force f o r progress i n Canadian society. 5. I t i s preferable to belong to an organi-zation that i s w i l l i n g to go on s t r i k e i f i t f e e l s such action i s necessary. 6. C o l l e c t i v e bargaining by nurses requires a greater expenditure of time and e f f o r t than the p o t e n t i a l gain would justify.. 7. Economic issues a f f e c t i n g nurses can be dealt with more e f f e c t i v e l y through c o l -l e c t i v e bargaining than i n any other way. 8. C o l l e c t i v e bargaining i s not appropriate for p r o f e s s i o n a l s . 9. Nurses should be prohibi t e d by law from s t r i k i n g . 10. C o l l e c t i v e bargaining by nurses w i l l r e s u l t i n higher q u a l i t y of patient care. -99-5 V. Please c i r c l e the number which indicates your s a t i s f a c t i o n or d i s s a t i s f a c t i o n with corresponding aspects of your present job. I f not applicable to you and your work, please c i r c l e the number which indicates "not app l i c a b l e " . 1 - Very s a t i s f i e d V.S. 2 - F a i r l y s a t i s f i e d F.S. 3 - F a i r l y d i s s a t i s f i e d F.D. 4 - Very d i s s a t i s f i e d V.D. 5 - Not applicable N.A. V.S. F.S. F.D. V.D. N.A. , 1. On the whole are you s a t i s f i e d that the administration accepts you as a p r o f e s s i o n a l expert to the degree to which you f e e l you are e n t i t l e d by reason of your p o s i t i o n , t r a i n i n g and experience? 1 2 3 4 5 2. How s a t i s f i e d are you with your present job when you consider the expectations you had when you took the job? 1 2 3 4 5 3. How s a t i s f i e d are you with your job when you compare i t to other jobs: A. which you have held .1 2 3 4 5 B. t h a t are a v a i l a b l e to nurses. 1 2 3 4 5 In answering the following questions please consider nursing as a career rather than your present job. (Note format for answering items has changed s l i g h t l y ) 4. How do you f e e l nursing compares with other types of work? 1 - The most s a t i s f y i n g career. 2 - One of the most s a t i s f y i n g careers. 3 - As s a t i s f y i n g as most careers. 4 - Less s a t i s f y i n g than most careers. 5. I f you had to do i t over again would you enter nursing? 1 - D e f i n i t e l y yes. 2 - Probably yes. 3 - Probably no. 4 - D e f i n i t e l y no. Thank you once again for time and consideration of the questionnaire. I f you have any a d d i t i o n a l comments please f e e l free to express them on the back of the questionnaire or phone me at 688-7351. -100-A P P E N D I X C -101-70 60 50 40 30 20 10 0 "L 40 45 50 55 60 65 70 75 80 85 90' SCORES X 64.5 FIGURE 8: FREQUENCIES BY SCORES ON PROFESSIONAL BELIEFS INVENTORY 100 90 ' 80 "70 w w | - : 6 0 w fe io 30 20 10 0 10 15 30 20 25 SCORER X 18.4 FIGURE 9: FREQUENCIES BY SCORES ON PROFESSIONAL ACTION INVENTORY -102-60-50 -45 " 40 w M U § 3° ZD o* W o r Pi fe 20 |-15 I 10 • 5 . 0 15 20 25 30 35" 40 45 50 SCORES ' X '35.8 FIGURE 10: .FREQUENCIES BY SCORES ON COLLECTIVE BARGAINING SCALE ,42 38 3l4-30 26 o w w pi * 18 .22 14; .10 6 2 10 12 14 16 18 20 22 24. 26 28 30 > SCORES N X 21.9 FIGURE 11: FREQUENCIES BY SCORES ON JOB SATISFACTION SCALE -103-A P P E N D I X D -104-TABLE - VIII-: ._ CORRELATION MATRIX OF ALL VARIABLES STAFF PUBLIC NON— YEAR OF VARIABLES SINGLE MARRIED OTHER AGE DIPLOMA PRACTICING NURSE HEALTH INSTRUCTOR NURSING GRADUATION Single 1.00 Married -0.819 Other -0.201 Age -0.099 Diploma -0.063 Practicing 0.214 Staff Nurse 0.046 Public Health -0.063 Instructor 0.013 Norr-Nurs ing -0.003 Year of Graduation -0.116 Work Experience -0.002 Cent inuing Educat ion -0.005 Employment Status 0.160 Administrator -0.047 OOMMTTMENT 0.148 Professional Beliefs 0.086 Professional Action 0.016 Collective Bargaining -0.130 Work Satisfaction 0.009 1.00 -0.346 1.00 0.013 0.088 1.00 0.002 0.084 0.162 -0.210 -0.004 -0.145 -0.033 -0.026 -0.305 0.093 -0.039 0.028 -0.144 0.251 0.118 0.009 0.001 -0.018 0.061 0.063 0.863 -O.055 0.069 0.732 0.026 0.005 -0.055 -0.1191 -0.044 0.022 0.066 -0.067 0.276 -0.079 -0.171 0.082 -0.061 -0.033 0.238 -0.046 0.061 -0.019 0.058 0.106 -0.047 -0.028 0.018 -0.062 1.00 ' -0.082 1.00 0.264 0.222 1.00 -0.246 -0.006 -0.418 1.00 -0. |S| -O.054 -0.303 -0.083 0.005 -0.351 -0.317 -0.087 0.192 -0.095 -0.279 -0.063 0.128 -0.026 -0.335 0.027 0.0 0.030 -0.183 0.104 -0.079 0.067 -0.197 0.068 -0.037 0.102 -0.528 -0.144 -0.186 0.051 -0.078 0.129 0.014 -0.035 0.029 0.064 -0.055 0.049 -0.215 0.197 0.047 0.139 -0.053 0.021 -0.121 0.281 -0.135 0.201 1.00 H3.063 1.00 0.101 0.074 1.00 0.177 -0.004 0.777 0.148 0.084 -0.007 0.147 0.012 -0.006 -0.104 -0.109 0.273 0.016 -O.041 -0.021 -0.048 -0.004 0.211 0.054 0.135 -0.022 -0.014 -0.003 -0.003 0.073 0.039 -0.046 TABLE VIII(cont'd) VARIABLES WORK EXPERIENCE CONTINUING EDUCATION EMPLOYMENT STATUS ADMINIS-TRATION COMMIT-MENT PROFES-SIONAL PROFES-SIONAL COLLECTIVE BARGAINING WORK SATIS-FACTION Work Experience Continuing Education Employment Status Administrator 1.00 -0.043 0.107 0.267 1.00 0.056 0.069 1.00 0.105 1.00 COMMITMENT 0.101 -0.137 0.165 0.022 1.00 Professional Beliefs Professional Action Collective Bargaining Work Satisfaction 0.178 0.014 -0.044 -0.008 -0.071 0.114 0.178 -0.101 0.046 0.112 -0.065 0.068 -0.072 0.058 0.076 0.021 0.321 0.144 -0.067 0.360 1.00 0.109 0.108 0.254 1.00 0.105 0.170 1.00 -0.066 1.00 ( A P P E N D I X E -107-TABLE ix DETAILED SUMMARY OF STEPWISE REGRESSION ANALYSIS OF PROFESSIONAL COMMITMENT N=217 VARIABLES IN EQUATION VARIABLES NOT IN EQUATION VARIABLES STEP ENTERED F-VALUE TO REMOVE PARTIAL F-VALUE VARIABLES CORRELATION TO ENTER A 6 E 0.112 2.33 Marital Status a) Single 0.155 4.53 b) Married -0.739 1.01 c) Other -0.191 6.93 Year of Graduation -O.005 0.005 Years of Experience 0.118 2.318 Education Background a) Basic Education -0.155 4.48 b) Continuing Education -0.109 2.19 Professional Beliefs 0.254 12.64 Professional Action 0.090 1.51 Collective Bargaining -0.046 0.39 Registration Status a) Practicing -0.056 0.57 Employment Status 0.151 4.29 Employment Position a) Staff Nurse -0.032 0.19 b) Public Health 0.063 0.72 c) Instructor -0.011 0.02 •d) Administrator 0.016 0.05 e) Non-Nursing -O.059 0.64 Age 0.049 0.43 Marital Status a) Single 0.138 3.55 b) Married -0.061 0.69 c) Other -0.187 6.61 Year of Graduation -0.068 0.84 Years of Experience 0.068 0.84 Education Background a) Basic Education -0.172 5.56 b) Continuing Education -0.100 1.85 Professional Action 0.075 1.03 Collective Bargaining -0.083 1.25 Registration Status a) Practicing -0.028 0.14 Employment Status 0.149 4.11 Employment Position a) Staff Nurse 0.51 0.47 b) Public Health 0.061 0.68 c) Instructor 0.007 0.009 d) Administrator 0.037 0.26 e) Non-Nursing -0.057 0.59 1 Work Satisfaction .129 27.40 2 Professional Beliefs Work Satisfaction 0.186 12.64 18.65 -108-TABLE IX (cont'd) VARIABLES IN EQUATION VARIABLES NOT IN EQUATION TEP VARIABLES ENTERED F-VALUE TO REMOVE VARIABLES PARTIAL CORRELATION F-VALUE TO ENTER Other 0.214 6.61 Professional Beliefs 12.29 Work Satisfaction 19.83 Age 0.069 0.88 Marital Status . . • a) Single 0.105 2.014 b) Married -0.138 3.524 c) Other Year of Graduation -0.054 0.544 Years of Experience 0.084 1.29 Education Background a) Basic Education -0.159 4.69 •b) Continuing Education -0.101 1.87 Professional Action 0.088 1.43 Collective Bargaining -0.063 0.72 Registration Status a) Practicing -0.031 0.17 Employment Status 0.143 3.79 Employment Position a) Staff Nurse -0.056 0.57 b) Public Health 0.054 0.53 c) Instructor 0.056 0.57 d) Administrator 0.025 0.11 e) Non-Nursing -0.058 0.62 Other Diploma Professional Belief Work Satisfaction 0.234 5.74 Age : 4.69 Marital Status 13.28 a) Single 17.43 b) Married Year of Graduation Years of Experience Continuing Education Professional Action Collective Bargaining Registration Status a) Practicing Employment Status Employment Position a) Staff Nurse b) Public Health c) Instructor d) Administrator e) Non-Nursing 0.094 0.098 -0.135 -0.027 0.105 -0.104 0.083 -0.059 -€.038 0.134 -0.016 0.019 0.025 0.021 -0.057 1.60 1.75 3.32 0.14 1.99 1.98 1.24 0.64 0.27 3.30 0.05 0.06 0.11 0.08 0.59 -109-

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