A Meta-Analysis of Relationships Between Organizational Culture and Nurse Work Outcomes

Tuesday, 8 July 2008: 10:50 AM
Yueh-Yen Fang, PhD , School of Nursing, Fooyin University, Ta-liao, Kaohsiung, Taiwan
Karen L. Soeken, PhD , School of Nursing (retired), University of Maryland, Baltimore, Baltimore, MD
Mary Etta E. Mills, PhD , School of Nursing, University of Maryland, Baltimore, Baltimore, MD
Meg Johantgen, PhD , School of Nursing, University of Maryland, Baltimore, Baltimore, MD

Learning Objective 1: clarify the relationships among organizational culture and nurse work outcomes (job satisfaction and turnover).

Learning Objective 2: realize moderators that influence the relationships among organizational culture and nurse work outcomes.

There is a constant debate regarding how the concept of organizational culture (OC) should be defined. The inconsistent measurement of OC in empirical studies is a reflection of this problem. The results of empirical studies, though inconsistent, suggest that OC has an impact on nurses' job satisfaction and turnover. A meta-analysis on this subject would clarify the concept of OC, validate its impact on nurses' job satisfaction and turnover in healthcare settings and provide empirical support for managerial decision-making. This report presents a portion of a large meta-analytic study. An extensive literature search of 35 computerized databases, footnote chasing, and search by author was performed to locate primary studies conducted before February, 2007 that examined relationships among OC and two nurse work outcomes (job satisfaction and turnover) of hospital nurses in the U.S. The three cultural patterns of the Organizational Culture Inventory provided taxonomies for categorizing diverse OC measures. Major analytical procedures included: (1) estimation of between study homogeneity and pooled effect sizes; (2) omit-a-study analysis; (3) cumulative analysis; (4) subgroup analysis; (5) meta-regression; (6) sensitivity analysis; and (7) assessment of publication bias. In all, 6769 citations were reviewed and 5 unpublished doctoral dissertations and 6 published journal articles were included in this meta-analysis. Results showed significant but small to moderate relationships between three OC patterns and nurse job satisfaction. A “constructive organizational culture” pattern had the strongest strength of relationship (WES = .37) to satisfaction and low turnover. Of the relationship with nurse job satisfaction, only primary studies in the “aggressive/defensive culture” study group were homogenous. The major moderator variables that contributed to between study heterogeneity of these relationships were region, number of hospitals in the study, and type of nursing unit. A knowledge gap was found in the relationship among OC and nurse turnover.