Kontakt X:X | DOI: 10.32725/kont.2026.036
Quality of work life as a conditional mediator between organizational factors and job performance in a decentralized health systemSociální vědy ve zdraví - původní práce
- 1 Universitas Sumatera Utara, Faculty of Public Health, Medan, Indonesia
- 2 Universitas Sumatera Utara, Faculty of Psychology, Medan, Indonesia
Introduction: Quality of Work Life (QWL) is frequently conceptualized as a mediating mechanism linking organizational factors to employee job performance. However, empirical findings across health systems, particularly in decentralized settings, remain inconsistent.
Objectives: This study investigates whether QWL mediates the relationships between organizational commitment, healthy work environment, motivational climate, career development, and job performance among health workers in decentralized primary health care systems.
Methods: Data were collected from 320 health workers working in local government primary health care facilities in Aceh, Indonesia. Structural Equation Modeling using the Partial Least Squares approach (PLS-SEM) was applied to examine direct and indirect relationships among the study variables.
Results: The results indicate that QWL functions as a selective mediator. QWL significantly mediates the effects of motivational climate and career development on job performance but does not mediate the relationships involving organizational commitment and healthy work environment.
Conclusion: These findings suggest that QWL functions as a conditional rather than a universal mediator in decentralized health systems.
Klíčová slova: Decentralized health systems; Health workers; Job performance; Quality of work life
Střet zájmů:
The authors have no potential conflict of interest to declare with respect to the research, authorship, and/or publication of this article.
Vloženo: 12. leden 2026; Revidováno: 29. duben 2026; Přijato: 28. květen 2026; Zveřejněno online: 2. červen 2026
Reference
- Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA 288(16): 1987-1993. DOI: 10.1001/jama.288.16.1987.
Přejít k původnímu zdroji... - Aiken LH, Sloane DM, Ball J, Bruyneel L, Rafferty AM, Griffiths P (2018). Patient satisfaction with hospital care and nurses in England: An observational study. BMJ Open 8(1): e019189. DOI: 10.1136/bmjopen-2017-019189.
Přejít k původnímu zdroji... - Avolio BJ, Zhu W, Koh W, Bhatia P (2004). Transformational leadership and organizational commitment: Mediating role of psychological empowerment and moderating role of structural distance. J Organ Behav 25(8): 951-968. DOI: 10.1002/job.283.
Přejít k původnímu zdroji... - Bakker AB, Demerouti E (2017). Job demands-resources theory: Taking stock and looking forward. J Occup Health Psychol 22(3): 273-285. DOI: 10.1037/ocp0000056.
Přejít k původnímu zdroji...
Přejít na PubMed... - Behzad I, Arezo K, Mohammadi N (2014). Association between quality of worklife and occupational stresses in personal of social security organization in Hamadan province, IR Iran. J Med Res 3(4): 41-45.
- Bossert TJ, Mitchell AD (2011). Health sector decentralization and local decision-making: Decision space, institutional capacities and accountability in Pakistan. Soc Sci Med 72(1): 39-48. DOI: 10.1016/j.socscimed.2010.10.019.
Přejít k původnímu zdroji... - Brooks BA, Anderson MA (2005). Defining quality of nursing work life. Nurs Econ 23(6): 319-326.
- Chinomona R, Dhurup M (2014). The influence of the quality of working life on employee job satisfaction, job commitment and tenure intention in the SME sector in Zimbabwe. S Afr J Econ Manag Sci 17(4): 363-378. DOI: 10.4102/sajems.v17i4.296.
Přejít k původnímu zdroji... - Cropanzano R, Mitchell MS (2005). Social exchange theory: An interdisciplinary review. J Manag 31(6): 874-900. DOI: 10.1177/0149206305279602.
Přejít k původnímu zdroji... - De Simone S, Planta A, Cicotto G (2018). The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction. Appl Nurs Res 39: 130-140. DOI: 10.1016/j.apnr.2017.11.004.
Přejít k původnímu zdroji... - Dieleman M, Gerretsen B, van der Wilt GJ (2009). Human resource management interventions to improve the job performance of health workers in low- and middle-income countries: A realist review. Health Res Policy Syst 7(1): 7. DOI: 10.1186/1478-4505-7-7.
Přejít k původnímu zdroji...
Přejít na PubMed... - Dussault G, Dubois CA (2003). Human resources for health policies: A critical component in health policies. Human Resour Health 1(1). DOI: 10.1186/1478-4491-1-1.
Přejít k původnímu zdroji... - Franco LM, Bennett S, Kanfer R (2002). Health sector reform and public sector health worker motivation: A conceptual framework. Soc Sci Med 54(8): 1255-1266. DOI: 10.1016/S0277-9536(01)00094-6.
Přejít k původnímu zdroji... - Hämmig O (2017). Health and well-being at work: The key role of supervisor support. SSM Popul Health 3: 393-402. DOI: 10.1016/j.ssmph.2017.04.002.
Přejít k původnímu zdroji... - Kanten S, Sadullah O (2012). An empirical research on relationship quality of work life and work performance. Procedia Soc Behav Sci 62: 360-366. DOI: 10.1016/j.sbspro.2012.09.057.
Přejít k původnímu zdroji... - Lake ET, Sanders J, Duan R, Riman KA, Schoenauer KM, Chen Y (2019). A meta-analysis of the associations between nurse work environments and patient outcomes. Med Care 57(5): 353-361. DOI: 10.1097/mlr.0000000000001109.
Přejít k původnímu zdroji...
Přejít na PubMed... - Lu H, Zhao Y, While A (2019). Job satisfaction among hospital nurses: A literature review. Int J Nurs Stud 94: 21-31. DOI: 10.1016/j.ijnurstu.2019.01.011.
Přejít k původnímu zdroji...
Přejít na PubMed... - Mosadeghrad AM, Ferlie E, Rosenberg D (2008). A study of the relationship between job satisfaction, organizational commitment and turnover intention among hospital employees. Health Serv Manag Res 21(4): 211-227. DOI: 10.1258/hsmr.2007.007015.
Přejít k původnímu zdroji...
Přejít na PubMed... - Nayak T, Sahoo CK (2015). Quality of work life and organizational performance: The mediating role of employee commitment. J Health Manag 17(3): 263-273. DOI: 10.1177/0972063415589236.
Přejít k původnímu zdroji... - Nayeri ND, Negarandeh R, Vaismoradi M, Ahmadi F, Faghihzadeh S (2009). Burnout and productivity among nurses. Nurs Health Sci 11(3): 263-270. DOI: 10.1111/j.1442-2018.2009.00449.x.
Přejít k původnímu zdroji...
Přejít na PubMed... - Purohit B, Bandyopadhyay T (2014). Beyond job security and money: Driving factors of motivation for government doctors in India. Hum Resour Health 12: 12. DOI: 10.1186/1478-4491- 12-12.
Přejít k původnímu zdroji... - Sirgy MJ, Efraty D, Siegel P, Lee DJ (2001). A new measure of quality of work life (QWL) based on need satisfaction and spillover theories. Soc Indic Res 55(3): 241-302. DOI: 10.1023/A:1010986923468.
Přejít k původnímu zdroji... - Tsofa B, Molyneux S, Gilson L, Goodman C (2017). How does decentralisation affect health sector planning and financial management? a case study of early effects of devolution in Kilifi County, Kenya. Int J Equity Health 16(1): 151. DOI: 10.1186/s12939-017-0649-0.
Přejít k původnímu zdroji...
Přejít na PubMed... - Van der Heijden B, Demerouti E, de Lange AH, van der Heijde CM (2009). Age effects on the employability-career success relationship. J Vocat Behav 74(2): 156-164. DOI: 10.1016/j.jvb.2008.12.009.
Přejít k původnímu zdroji... - Wei H, Roberts P, Strickler J, Corbett RW (2019). Nurse leaders' strategies to foster nurse resilience. J Nurs Manag 27(4) 681-687. DOI: 10.1111/jonm.12736.
Přejít k původnímu zdroji... - WHO (2010). Increasing access to health workers in remote and rural areas through improved retention. Geneva. [online] [cit. 2026-01-22]. Available from: https://www.who.int/publications/i/item/increasing-access-to-health-workers-in-remote-and-rural-areas-through-improved-retention
- WHO (2020). Global strategy on human resources for health: Workforce 2030. Geneva. [online] [cit. 2026-01-22]. Available from: https://www.who.int/publications/i/item/9789241511131
- Willis-Shattuck M, Bidwell P, Thomas S, Wyness L, Blaauw D, Ditlopo P (2008). Motivation and retention of health workers in developing countries: A systematic review. BMC Health Serv Res 8: 247. DOI: 10.1186/1472-6963-8-247.
Přejít k původnímu zdroji... - Zulkarnain Z, Ginting EDJ, Adnans AA, Sianturi MM (2024a). Organisational justice and work-family conflict: Impact to quality of work life. SA J Hum Resour Manag 22: a2393. DOI: 10.4102/sajhrm.v22i0.2393.
Přejít k původnímu zdroji... - Zulkarnain Z, Ginting EDJ, Novliadi F, Pasaribu SP (2023b). Workplace bullying and its impact on quality of work life. Kontakt 25(1): 31-36. DOI: 10.32725/kont.2023.002.
Přejít k původnímu zdroji... - Zulkarnain Z, Hadiyani S, Ginting EDJ, Fahmi (2024b). Commitment, employee engagement, and readiness to change among oil palm plantation officers. SA J Hum Resour Manag 22: a2471. DOI: 10.4102/sajhrm.v22i0.2471.
Přejít k původnímu zdroji... - Zulkarnain Z, Novliadi F, Widiyanta A, Riadhah CA, Nartova Bochaver S (2026). Well-being among contract healthcare workers: Balancing job demands and personal resources. SA Hum Resour Manag 24: a3385. DOI: 10.4102/sajhrm.v24i0.3385.
Přejít k původnímu zdroji... - Zulkarnain Z, Rahmadani VG, Novliadi F, Nasution A (2023a). Work engagement, work-family conflict, and personality traits: Study among oil palm plantation officers. Qual Access Success 24(194): 361-367. DOI: 10.47750/QAS/24.194.40.
Přejít k původnímu zdroji...
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