Abstracts
Résumé
La crise des finances publiques et l’accroissement de la demande en soins de santé amènent de plus en plus d’hôpitaux à implanter des pratiques de gestion à haute implication (PGHI). Or, les études sur le lien entre ces pratiques et la performance organisationnelle se font plutôt rares dans le secteur hospitalier. De plus, les recherches se sont surtout limitées à montrer l’existence d’un lien direct entre les PGHI et la performance organisationnelle, donnant ainsi peu d’information sur le processus qui mène à cette performance. Cette étude vise à combler ces lacunes en examinant le rôle médiateur joué par l’habilitation psychologique (HP) dans la relation entre les PGHI et les comportements de citoyenneté organisationnelle (CCO) du personnel soignant, un déterminant important de la qualité des soins de santé. De plus, puisqu’une relation de collaboration avec les médecins, basée sur la confiance, serait au coeur du sentiment de pouvoir du personnel soignant, l’effet modérateur de la confiance envers les médecins sur la relation entre les PGHI et l’HP est aussi examiné. Ainsi, l’étude valide un modèle spécifiant des relations différenciées entre les PGHI (autonomie, développement des compétences, partage d’information, reconnaissance) et les cognitions de l’HP (compétences, autodétermination, sens, impact), celles-ci étant modérées par la confiance envers les médecins. Enfin, l’étude cherche à vérifier si les cognitions de l’HP qui inciteraient aux CCO interagissent entre elles selon une séquence prédéterminée. Basée sur un sondage réalisé auprès de 176 employés délivrant des soins de santé et leurs supérieurs immédiats, l’étude suggère que la relation entre certaines PGHI (autonomie et développement des compétences) et les CCO est tributaire du sens du travail et de la confiance envers les médecins. Aussi, les cognitions de l’HP seraient liées entre elles selon une séquence particulière conférant à l’autodétermination un rôle central dans cette séquence.
Mots-clés:
- sens du travail,
- habilitation psychologique,
- confiance,
- compétence,
- autonomie,
- comportements de citoyenneté organisationnelle,
- secteur de la santé
Summary
Crisis in public finances and growth in the demand for healthcare services are placing increased pressure on hospitals to implement high-involvement work practices (HIWP). Yet, studies on the relationship between these practices and organizational performance are rather scarce in the healthcare sector. In addition, past research has mainly examined the direct relationship between HIWP and organizational performance, leaving unclear the process that leads to this performance. This study aims to fill these knowledge gaps by examining the mediating role played by psychological empowerment (PE) in the relationship between HIWP and organizational citizenship behaviours (OCB), an important predictor of the quality of healthcare delivered. Also, because a collaborative relationship with physicians, based on trust, appears to be crucial for the development of a sense of power among healthcare workers, the moderating effect of trust in physicians on the relationship between HIWP and HP is also explored. Hence, the study tests a model depicting specific relationships between HIWP (autonomy, training, sharing information, recognition) and the cognitions associated with PE (competence, self-determination, meaning, impact), these relationships being moderated by trust in physicians. Lastly, the study aims to verify if the cognitions associated with PE, which are proposed to be related to OCB, interact with each other according to a specific sequence. On the basis of a survey conducted among 176 healthcare workers and their immediate supervisors in a hospital located in the province of Quebec, the study shows that the relationship between some aspects of HIWP (autonomy and training) and OCB is a function of meaning and trust in physicians. Also, the cognitions associated with HP appear to be linked with each other according to a particular sequence in which self-determination plays a central role.
Keywords:
- meaning,
- psychological empowerment,
- trust,
- competence,
- autonomy,
- organizational citizenship behaviour,
- healthcare sector
Resumen
La crisis de las finanzas públicas y el incremento de la demanda de servicios de salud ocasionan que una cantidad cada vez más importante de hospitales implanten prácticas de gestión de alta implicación (PGAI). Sin embargo, los estudios sobre el vínculo entre estas prácticas y el rendimiento organizacional son más bien raros en el sector hospitalario.
Es más, las investigaciones se han limitado a mostrar sobretodo la existencia de un vínculo directo entre les PGAI y el rendimiento organizacional, dando así poca información sobre el proceso que lleva a este resultado. Este estudio pretende colmar estas lagunas examinando el rol mediador que juega la habilitación sicológica (HS) en la relación entre les PGAI y los comportamientos de ciudadanía organizacional (CCO) del personal hospitalario, un determinante importante de la calidad de los servicios de salud. Se analiza también el efecto moderador de la confianza en los médicos sobre la relación entre las PGAI y la HS, dado que una relación de colaboración con los médicos, basada sobre la confianza, sería central al sentimiento de poder del personal hospitalario. El estudio valida así un modelo especificando las relaciones diferenciadas entre las PGAI (autonomía, desarrollo de competencias, compartir la información, reconocimiento) y las cogniciones de la HS (competencias, auto-determinación, sentido, impacto), estando éstas moderadas por la confianza en los médicos. En fin, el estudio pretende verificar si las cogniciones de la HS que incitarían a los CCO interactúan entre ellos según una secuencia predeterminada. Basado en un sondaje realizado con 176 empleados que procuran servicios de salud y con sus respectivos superiores inmediatos, el estudio sugiere que la relación entre ciertas PGAI (autonomía y desarrollo de competencias) y los CCO es tributaria del sentido del trabajo y de la confianza en los médicos. Además, las cogniciones de la HS estarían vinculadas entre ellas según una secuencia particular que confiere un rol central a la autodeterminación en esta secuencia.
Palabras claves:
- sentido de trabajo,
- habilitación sicológica,
- confianza,
- competencia,
- autonomía,
- comportamientos de ciudadanía organizacional,
- sector de la salud
Appendices
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