Modern health care is mainly delivered through hospitals that are established to meet the needs of patients. Willan (1990) defines hospital as "a diagnostic and treatment facility providing board and lodging medical care and continuous nursing care for alleviation or care of diseases, illness or injury to in-patients and may be also, outpatients and emergency patients." He adds that the facility must have at least one physician on the permanent staff, make provision for in-patients to remain at least 24 hours and maintain clinical records on all patients.
Medical records are very important in the management and treatment of patients. Huffman (1994) defines medical records "as a compilation of pertinent facts of a patient's life and history including past and present illness(es) and treatments written by health professionals contributing to that patient care." He also states that medical records must be compiled in a timely manner and should contain sufficient data to identify the patient, support the diagnosis or reason for health care encounter, justify the treatment, and accurately document the results.
In addition, Mogli (2001) defines medical records as "an orderly written document encompassing the patient's identification data, health history, physical examination findings, laboratory reports, diagnosis, treatment and surgical procedures and hospital course." According to him the purposes of medical records are:
* To provide a means of communication among physicians, nurses and other allied health care professionals
* To serve as an easy reference for providing continuity in patient care
* To furnish documentary evidence of care provided in the health care facility
* To serve as an informational document to assist in the quality review of patient care
* To protect the patient, physician, and health care institution and its employees in the event of litigation
* To render clinical and administrative data required for budgeting, management service development, planning review, medical education, and medical research
* To supply pertinent patient care information to authorized organizations and third party payers
Medical records personnel play a vital role in the care of patients by ensuring the effective management of medical records in various health care facilities. For them to give in their best service, they must be highly committed to the organization where they are employed.
Organizational commitment has been defined as the degree to which employees believe in and accept organizational goals and desire to remain with the organization (Mathis & Jackson, 2000). Similarly, Wright and Noe (1996) defined organizational commitment as "the degree or extent to which employees strongly identify with the organization and feel attached to it."
Studies have shown that organizational commitment among employees promotes organizational effectiveness through job performance and quality and low levels of tardiness, absenteeism, and turnover (Mathieu & Zajac, 1990, Randall, 1990).
The development of organizational commitment among employees can be influenced variables such as age, marital status, gender, locus of control, and job satisfaction. For the purpose of this study, the influence of locus of control and job satisfaction on organizational commitment will be considered.
Locus of control is a personality variable which refers to individuals' perception of the main causes of events in life. Locus of control can be divided into internal locus of control and external locus of control. Individuals with internal locus of control are called internals. They believe that they have control over their destinies. They tend to be convinced that their own skills, abilities, and efforts determine the bulk of their life experiences. Individuals who have external locus of control are called externals. They believe that their destinies are controlled by external forces such as luck, chance, fate, or powerful others (Rotter, 1966).
Few studies have been done on the influence of locus of control on organizational commitment. Spector (1982) revealed that those who have internal locus of control are more committed to their respective organizations than those who have external locus of control. Similarly, Kinick and Vecchio (1994) reported that individuals who have internal locus of control are likely to be more committed to their organization than those who have external locus of control.
Another variable that is important to this study is job satisfaction. Job satisfaction can be described as a positive emotional state resulting from evaluating one's job experiences and job dissatisfaction occurs when these expectations are not met (Mathis & Jackson, 2000).
Robbins (1998) described job satisfaction as an individual's general attitude towards the job. A person with a high level of job satisfaction holds positive attitudes towards the job. Locke (1976) defines job satisfaction as employee's affective response to various aspects of the job or job situations.
Studies have shown that job satisfaction and organizational commitment are different but related. Luthans (2002) highlights the differences by stating that job satisfaction is mainly concerned with the employee's attitude toward the job, while organizational commitment is mainly concerned with employees' attitude toward the organization.
Tett and Meyer (1993) report that a strong relationship between job satisfaction and organizational commitment. This implies that job satisfaction and organizational commitment are capable of influencing each other. This finding suggests that workers who are relatively satisfied with their jobs may likely be committed to their organization, while on the other hand, workers who are relatively committed to their organization are more likely to have greater job satisfaction. The decision to remain with or leave an organization ultimately, is reflected in employees' absenteeism and turnover statistics. Individuals who are not satisfied with their jobs or who are not committed to the organization are more likely to withdraw from the organization either occasionally through absenteeism or permanently through turnover.
Luthans (2002) is of the opinion that there is no strong relationship between job satisfaction and organizational commitment. He argues that there are many employees who are satisfied with their jobs but dislike the organization they work for. He stated further that there are others who may be dissatisfied with their current jobs, but are very committed to the organization they work for.
Statement of the Problem
Medical records personnel in university teaching hospitals in Nigeria face problems like inadequate staff development/training opportunities, inadequate space for the storage of medical records, poor remuneration, and other adverse conditions of service. It is generally assumed that these problems could negatively affect their level of commitment to the university teaching hospitals that employ them.
This study investigates the influence of locus of control and job satisfaction on the organizational commitment of medical records personnel in university teaching hospitals in Nigeria.
Objectives of the Study
The objectives of this study are to:
Ascertain the influence of work locus of control on the organizational commitment of medical records personnel in university teaching hospitals in Nigeria.
Determine the influence of job satisfaction on the organizational commitment of medical records personnel in university teaching hospitals in Nigeria.
Determine whether the combination of work locus of control and job satisfaction could significantly influence the organizational commitment of medical records personnel in university teaching hospitals in Nigeria.
The research hypothesis for this study are:
There is no significant relationship between work locus of control and organizational commitment of medical records personnel in university teaching hospitals in Nigeria.
There is no significant relationship between job satisfaction and organizational commitment of medical records personnel in university teaching hospitals in Nigeria.
A combination of work locus of control and job satisfaction does not have significant influence on organizational commitment of medical records personnel in university teaching hospitals in Nigeria.
Organizational commitment has variously been defined by different authors and researchers. In general terms, organizational commitment could be described as the level of attachment felt towards the organization in which one is employed. Studies have shown that early researchers treated organizational commitment as a one-dimensional construct. (Mowday, Steers & Porter, 1982; Wiener, 1982; Brown, 1996). Mowday, Steers, and Porter (1982) define organizational commitment as the relative strength of an individual's identification with and involvement in a particular organization. They stated that organizational commitment has three characteristics: strong belief in an acceptance of the organization's goals and values; a willingness to exert considerable effort on behalf of the organization; and, a strong desire to maintain membership in the organization. This definition suggests that organizational commitment is an affective or emotional attachment of employee to the employing organization.
Organizational commitment has recently been widely acknowledged as a multidimensional construct (Allen & Meyer, 1990; Jaros, Jermier, Koehler & Sincich, 1993; Meyer & Allen 1984, 1991, 1997; Mayer & Schoorman, 1992, 1998; O'Reilly & Chatman, 1986). Meyer and Allen (1991) define organizational commitment as a psychological state that characterizes the employee's relationship with the organization and has implications for the decision to continue or discontinue membership in the organization. They divided organizational commitment into three different...