Background In China, physicians have long faced long working hours, high stress levels, and tensions between physicians and patients, which can lead to negative behaviors. Understanding physicians’ expectations and requirements of the hospital and increasing satisfaction with their psychological contract can help improve physician motivation and stabilize the hospital team. Aim The study aims to analyze the relationship between physicians’ psychological contract violations and different behavioral choices, encourage hospitals to conclude a balanced psychological contract with physicians, and provide governance and intervention strategies for hospital human resource management. Methods Stratified cluster sampling was used to select 321 physicians from four public hospitals in Beijing for questionnaire surveys. Descriptive statistical analysis, t -test, ANOVA, correlation analysis, and regression models were performed using Stata 15.0 and SPSS 26.0 to analyze the relationship between psychological contract violations, physicians’ EVLN behaviors and organizational justice. Results Psychological contract violation had a positive effect on exit behavior and neglect behavior, and a negative effect on voice behavior and loyalty behavior. Organizational justice plays a mediating role between psychological contract violation and physicians’ exit, voice and loyalty behaviors. Conclusion Psychological contract violation can drive negative behavior among physicians, and organizational justice can play a mediating role in this. Public hospitals should establish a healthy psychological contract with physicians and place a premium on organizational justice to promote constructive behaviors and prevent destructive behaviors. This study constructs a more complete theoretical framework to explain physicians’ behavior, and further dynamic tracking investigations are necessary because the evolution of physicians’ behavior is a dynamic and long-term process.
Background: With the continuous deepening of the new medical reform, the hospital management system has changed, and there have been corresponding changes at the organisational and individual levels. As the main body of medical services, how to effectively motivate physicians is an important issue for hospital management. Purpose: the purpose of this research was to investigate the correlation mechanism between psychological contract violation and the EVLN behavior of physicians in tertiary public hospitals and explore new ideas for encouraging physicians, and provides governance and intervention strategies for management in hospitals. Methodology: Based on related theories such as psychological contract, this research used the stratified cluster sampling method to survey a total of 321 physicians in four public hospitals in Beijing, established an Excel database, and used Stata15.0 to construct regression models to analyse the correlation mechanism between psychological contract violation and the EVLN behavior of physicians in tertiary public hospitals. Findings: Psychological contract violation has a positive effect on exit behavior and neglect behavior, and a negative effect on voice behavior and loyalty behavior. Organisational justice has a mediating effect on the direct correlation mechanism models. Practice Implications: Our results suggest that it is necessary to pay attention to the psychological contract violation of physicians, build a good psychological contract relationship between public hospitals and physicians, and make full use of the role of organisational justice to promote positive behaviors of physicians, and moreover to prevent and curb negative behaviors of physicians.
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