Work Environment and Situational Motivation of Doctors in Public Sector Hospitals

Objectives: To explore the relationship between work environment and situational motivation among doctors. Methods: Cross sectional research design was used and a sample of N = 100 doctors were employed through purposive sampling technique from public hospital of Lahore. Work Environment Survey and The Situational Motivation Scale were used to assess studied variables. Pearson Product moment correlation and hierarchical regression were used to analysis data. Results: Mean age of the participants was 33 years and mean education level was 18.38 years. Results showed that work environment has significant negative predicting relation with situational motivation of


Introduction
Motivation is the force that directs behaviors towards goal.To be successful in career life, motivation is a key dynamic.Motivation is influenced by many factors like interests, preferences, opportunities, situations and social support etc. Doctors spend half of their day in hospitals, therefore, hospital's environment play very important role in their motivation for work. 1 Arnetz2 argue that in organizations, employees reported to have issues with their supervisor who is not giving them the admiration, they deserve.Supervisors also show strict behaviors to subordinates.Furthermore, he describes that top management limits employees to their tasks.Petterson 3 argues that interaction between colleagues during a task is crucial for accomplishing the organizational goals and visions.Further, he describes that the communication of information must be properly done in a timely manner so that the operations of the tasks are running smoothly.If there is a clash between colleagues, then it is difficult to achieve the objectives of organization. 4Thus, this research was conducted to investigate the effect of work environment on situational motivation of doctors.
Some of the past researches demonstrated the link between work environment and motivation as Elnaga 5 explored the relation among job motivation, work environment and job satisfaction.Results of this research showed that job satisfaction is affected by motivation and work environment.Some studies expose the relation of different aspects of work environment (like, job satisfaction; commitment etc.) with motivation, as Pepe 6 studied employees' level of job satisfaction and commitment influenced by extrinsic motivational dissatisfies result into turnover intentions.He suggested that employees' perception regarding supervisor's support has positive connection with their organizational commitment and job satisfaction and hence, this leads to decrease in their turn over intentions.Some of the motivational researches explored different components of work environment as its determinants.One of the researches conducted on factors influencing workers' motivation in banking setting of Pakistan, used a sample of 150 workers of the various banks in Pakistan.Result showed that financial rewards, personal traits, high salary plans, job design and supervision had positive impact on employee motivation 7 .Similarly, Malik et al 8 studied motivational elements among doctors.A sample of 360 physicians was used.Findings of this research showed that intrinsic and socio-cultural aspects like helping others, prestige and professional growth were vital motivators.While, different organizational aspects less pay and limited chances for higher qualification and incentives other than pay, poor working conditions, personal safety and less personal and social time were demotivators.
It was hypothesized that there is likely to be relation between work environment and situational motivation of doctors.It is also hypothesized the work environment is likely to predict the situational motivation of doctors.

Methods
Cross sectional research design was used in this research.A sample of N = 100 doctors was collected from government hospital through purposive sampling technique.Participants with age more than 25years and having more than one-year of working experience were included in this research.The research plan was first proved by Department Doctoral Program Committee (DDPC).Then keeping in view the ethical consideration, permission was obtained from the authors of the questionnaires.Permission was also sought through hospital administration.Informed consent was obtained participants.Purpose of the research was explained to the participants.Response rate of the participant is 53%, as participants interest level was low.They reported that they were tried and busy therefore refuse to cooperate.SPSS was used for data analysis.Pearson product moment and hierarchal regression was used to analyze the data.

Results
Descriptive statistics showed that mean age of the participants is 33 years.62 were male and 38 were female doctors.Mean education level of the doctors is 18.38 years.Their total working experience was 8.57 years.Overall participants' response rate was 53.Description of the variable were shown in table 1.In order to indicate the predicting effect work environment and interaction of work environment on situational motivation of the doctors, hierarchical regression was used, which is indicated in the following table 3.
Overall models for intrinsic motivation, identified regulation, external regulation and a motivation in block 2 explained 76%, 81%, 73% and 63% of the variance in intrinsic motivation, identified regulation, external regulation and a motivation respectively, F (6, 93) = 3.25, p < .001;F (6,93) = 4.23, p < .001;F (6,93) = 3.14, p < .001;F (6,93) = 2.56, p < .001.These models showed that relation with coworkers is significant negative predict of intrinsic motivation.Similarly, physical working environment is significant negative predict of identified regulation and organizational commitment negatively predict external regulation.When age of the doctors was added in block 1, it appeared to be non-significant predictor of intrinsic motivation, identified regulation, external regulation and a motivation.

Discussion and Conclusion
Results of the study showed that different aspects of work environment had negative association with motivation of doctors to work.Okello and Gilson 11 suggested that in hospital, setting trust relationship with colleagues and supervisors directly and indirectly influence doctors' motivation.Elements like respect, recognition, rewards, communication positively affect employees' desire to work.Findings revealed that in health setting, the relationship among coworkers and supervisors are non-satisfactory, therefore its leads to decrease in their motivation. 12,13Similarly, another research indicates that better supervision has positive impact on employees' motivation. 8n government institutes cleanliness is a major concern.Ignorance towards hospital physical structure and its maintenance leads to the unhealthy and dirty environment which may suffocate the doctors and reduce their motivation for learning and serving 9 .Result of this study also indicated that the way hospitals are facilitating doctors, also negatively influence their motivation.][16][17] Communication is an important factor in any working setting.Communication practice help us to evaluate ourselves, our working and directly affect our motivation.Findings also revealed that communication practices used in hospital leads to decrease in the doctors' motivation towards work. 18,19

Conclusion
This study has some limitations, as this research only included quantitative method of study.To improve the validity of the results some qualitative methods should also be explore.These findings have implications on administrative level as it helps administrators to have look on big picture.It also has implications in education setting, where researchers can explore same factors with more different dimensions and more population.
Hence, it is concluded that these days, public hospitals administration needed to pay special attention on their hospitals' environment, so that doctors' working capacities and affectivity can be enhanced.
Note: * p < .05;** p < .01;*** p < .001;β = Standardized Co efficient; ∆R 2 = R Square change; R 2 = R Square; CoS = Relationship with coworkers and supervisors; PWE = Physical Working Environment; OC = Organizational Commitment; CJQ = Current Job Qualities; OTD = Opportunities of Training and Development; CP = Communication Practices; ADV = Alignment with departmental Visions and Goals.vation.Organizational commitment exhibited negative link with external regulation and a motivation.Current job qualities indicated negative relation with intrinsic motivation, identified regulation and external regulation.Communication practices indicated negative association with intrinsic motivation, identified regulation and a motivation.

Table 1 :
Descriptive statistics and reliabilities of study variables (N=100) SD = standard deviation; Mini = minimum; Max= Maximum; α = cronbach alpha.In order to indicate relation among all the work environment components and situational motivation types, Pearson Product Moment Correlation was used as indicated in table.

Table 2 :
Pearson product moment correlation to reflect the relation among studied variables (N=100)

Table 3 :
Hierarchical Regression showing effect of work environment and interaction of work environment with age on situational motivation of Doctors (N=100).