SHEDDING LIGHT ON HEALTHCARE WORKERS’ LABOUR BEHAVIOURS DURING THE COVID-19 PANDEMIC

Uysal H.T.; Ak M.; Güven S.T.

DOI: 10.29141/2218-5003-2023-14-4-5 EDN: PEUGCF

JEL Classification: I10, I12

Shedding light on healthcare workers'

labour behaviours during the COVID-19 pandemic

H. Tezcan Uysal1, Murat Ak2, Seval Türk Güven2

1 Bilecik University, Bilecik, Turkey

2 Karamanoglu Mehmetbey University, Karaman, Turkey

Abstract. The COVID-19 pandemic has had a profound effect on all spheres of the economy. One of the numerous consequences for the health system, in particular, was the disruption of flexible working and the need for its fundamental transformation. The article is intended to analyse and assess the relationships between flexible work perception (FWP), job satisfaction (JS), work-family balance (WFB) and task performance (TP) and examine this relational network cumulatively from the perspective of healthcare workers. The methodological framework of the research includes social exchange theory and the concept of human resources management. The study involved 353 staff members working for one of private medical clinics in the city of Gaziantep, Turkey. The research methods applied are purposeful sampling and online survey. Smart PLS3 statistical program was used to estimate the structural equation model by partial least squares method. The study showed that despite the mobilization of additional resources, TP of healthcare workers during the pandemic significantly decreased. We proved that FWP had a positive effect on task performance. At the same time, lack of flexible working negatively influenced job satisfaction and work-family balance of the employees. We found that poor WFB resulted in a decrease in the respondents' JS and TP. Among the avenues for further research are using the data retrieved from public medical institutions and conducting the investigation in different cities and with varying working conditions.

Keywords: human resources management; job satisfaction; work-family balance; task performance; flexible work perception; healthcare organizations; COVID-19; Turkey.

Article info: received March 21, 2023; received in revised form April 27, 2023; accepted May 11, 2023

For citation: Uysal H.T., Ak M., Güven S.T. (2023). Shedding light on healthcare workers' labour behaviours during the COVID-19 pandemic. Upravlenets/The Manager, vol. 14, no. 4, pp. 73-86. DOI: 10.29141/2218-5003-2023-14-4-5. EDN: PEUGCF.

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Исследование трудового поведения медицинских работников во время пандемии COVID-19

Х.Т. Уйсал1, М. Ак2, С.Т. Гювен2

1 Биледжикский университет, г. Биледжик, Турция

2 Университет Караманоглу Мехметбей, г. Караман, Турция

Аннотация. Пандемия COVID-19 оказала значительное влияние на все сферы хозяйственной жизни. В частности, к ее многочисленным последствиям в отрасли здравоохранения относятся сбой и фундаментальная трансформация подходов к гибкости рабочего времени. Статья посвящена анализу и оценке взаимосвязи между такими факторами труда, как гибкость рабочего времени (FWP), удовлетворенность трудом (JS), баланс работы и досуга (WFB) и эффективность труда (TP). Методологической основой послужили теория социального обмена и концепция управления человеческими ресурсами. Использовались методы детерминированной выборки и онлайн-опроса. Информационную базу составили данные о 353 сотрудниках одной из частных медицинских клиник города Газиантеп (Турция). Моделирование структурными уравнениями осуществлялось с помощью метода частичных наименьших квадратов в программе Smart PLS3. Согласно полученным результатам, несмотря на мобилизацию дополнительных ресурсов, эффективность труда работников сферы здравоохранения во время пандемии значительно снизилась. Доказано, что гибкость рабочего времени положительно влияет на эффективность труда. В то же время отсутствие FWP негативно воздействует на удовлетворенность трудом и ощущение у работников сбалансированности работы и досуга. Установлено, что отсутствие равновесия между трудом и личной жизнью ухудшает отношение медицинского персонала к работе, что, в свою очередь, снижает продуктивность ее выполнения. Перспективными направлениями дальнейших исследований являются анализ трудового поведения медицинских работников государственного сектора, а также варьирование локаций и условий труда. Ключевые слова: управление человеческими ресурсами; удовлетворенность трудом; баланс работы и досуга; эффективность труда; гибкий график работы; медицинские организации; COVID-19; Турция.

Информация о статье: поступила 21 марта 2023 г.; доработана 27 апреля 2023 г.; одобрена 11 мая 2023 г. Ссылка для цитирования: Uysal H.T., Ak M., Güven S.T. (2023). Shedding light on healthcare workers' labour behaviours during the COVID-19 pandem // Управленец. Т. 14, № 4. С. 73-86. DOI: 10.29141/2218-5003-2023-14-4-5. EDN: PEUGCF.

| INTRODUCTION

3 The COVID-19 pandemic, which lasted for over three

£ years, had its impact worldwide. More than six million

g people lost their lives, and the health system collapsed

£ in many countries due to the intense demands for health

£ services, the number of staff and beds that occurred to <

| be insufficient to accommodate all patients. In such cir-1 cumstances, there was a significant rise in understanding the importance of health and respect for healthcare workers. While during the pandemic many companies preferred to dismiss their staff to stay afloat, hospitals provided medical services to patients beyond their daily resources, and healthcare workers continued their work with more effort.

Healthcare workers sacrificed their personal time to satisfy the demands of society during the COVID-19 period that disrupted the flexible work system. Since the hospital environment was among the riskiest areas where the virus was most frequent, healthcare workers were isolated from their families living in the houses provided to them by the institution. Medical specialists found it very difficult to stay motivated while squeezed between work and family, even though that by performing their duties in an altruistic way they acquired kudos in society. Even those medical staff that performed their professional duties effectively, felt stuck in busy working hours and suffered a moral collapse in this chaotic environment. In this context, the routine lives of healthcare workers are spent between work and family and, therefore, they are especially interested in keeping both spheres in balance. The current research focuses on whether these situations affect task performance. The study aims to identify and evaluate the possible relationship between flexible work perception (FWP), work-family balance (WFB), job satisfaction (JS) and task performance (TP) and examines this relational network cumulatively from the perspective of healthcare workers. In this context, the study concentrated on healthcare stuff working amid the COVID-19 outbreak in its most active phase.

LITERATURE REVIEW

Flexible work perception. Working hours and regulations in developed countries have changed quite radically over the past two decades. There is a lot of variety and flexibility in how, when and where people provide services. This is achieved thanks to globalization with competent organizations that compete intensively, benefit from technological developments, attach importance to customer satisfaction, offer qualified products and services [Pettinger, 2002]. As a concept, flexibility means softness, tolerance and easy adaptation to changing situations [Ba-cak, §ahin, 2005]. Generally, flexible work is the incorporation of the concept of flexibility into business life and the transformation of working environment rigidity to soft or flexible conditions [Guzel, 2000]. According to Gon^alvez [2010], flexibility makes adaptations to the employment

conditions the enterprise offers based on its internal (especially capacity) and external (especially economic, social, cultural, legal dimensions) environment.

FWP is the provision of a clear and free working system that allows the employee to realize the conditions and requirements in the work environment by taking advantage of laws such as collective bargaining agreements or service contracts instead of predetermined arrangements in a workplace under the supervision of laws. This new system creates different types and durations of work. In this way, the employee can have a say in the working order and can also structure the working system together with the employer [Eryigit, 2000]. The research on FWP emphasizes that the flexible work system is determined, first, by the employer, which establishes the number of personnel that the organization will employ according to its goals and workscope, and, second, the personnel, which determines the work time with one's own skills and desires. From the employer's perspective, this working style is preferred because it is more suitable for the organization's own system, while for the personnel it is satisfactory as being in line with their private life and desires [Mordo, 2006]. As a result, flexibility stands out as one of the working systems of the new world [Cressey, Jones, 1995].

Among the benefits of flexible working for organizations discovered by the Chartered Institute of Personnel and Development (CIPD) are the following: prevention of absenteeism, stronger motivation, increased interest of employees, ease of recruitment, productivity, greater desire to be in the organization, more accurate skills management, continuity, teamwork, customer service levels, knowledge sharing and innovation1. The flexible work system also allows employees to spend more time on other interests and responsibilities outside the work life, value their family duties and keep a better focus on job functions [Giannikis, Mihail, 2011]. In flexible work styles, employees have an opportunity to arrange their working hours as they wish. Various forms of flexibilisation affect the working time [Hueck, 1994].

In the literature, the flexible work system is divided into four parts: working time flexibility, wage flexibility, functional flexibility, and numerical flexibility. In contrast to the classical working time system with its fixed norms, working time flexibility is the determination of working hours in accordance with the expectations of the employee and employer under certain conditions [Sonmez, 2006]. Wage flexibility means that wage systems are person-oriented and free to be explained separately in terms of productivity, economic structure of the organization, performance, and available capabilities2. Functional flex-

1 Chartered Institute of Personnel and Development (CIPD). (2012). Survey Report of Chartered Institute of Personnel and Development, London.

2 Confederation of Turkish Employers' Unions (TiSK). (1999). Flexibility at work. Ankara: TiSK Publications. (in Turkish)

ibility implies that employees can work in different functions within the same organization. This type of flexibility is worker-centred. Employees gain qualifications by developing their knowledge and experience through different trainings and courses. In this way, employees are brought from a narrow/simple field to a level where they can work with more complex tasks [Top^uk, 2006]. In the definition made by the Organization for Economic Cooperation and Development (OECD), external numerical flexibility is defined as the ease of regulating the number of personnel employed by the company according to its periodic needs. The ease and difficulty of hiring or firing determine the level of flexibility [Dur, 2009].

Work-family balance. People spend a great deal of time and effort on business life, which is essential for earning income and continuing their lives in a better-quality way. The extra time allocated to business life has a negative effect on private and family life. People can compromise their personal lives because of a job that needs to be completed as soon as possible. What is essential in this part is the WFB. In particular, married people should find the right balance between work efficiency, efficiency of their private lives and quality of life [Esin, 2017]. Although the concept of work-life balance gained importance in the 1930s, it has recently come to the fore as a notion examined by different disciplines. The reason for this is the changing importance of people's work, the growing workload, the increasing role of women in business life and the fact that leisure time for the employed is increasingly prominent [Gundogmu§, 2017]. Although WFB was first discussed academically in 1977 by Rosabeth Moss Kanter in the book Work and Family in the USA: A Critical Review and Agenda for Research and Policy, work/life programs existed as early as the 1930s [Lockwood, 2003, p. 2].

In his study on WFB, Johnson [2001, p. 49] says, "Achieving balance means being able to perform a multitude of tasks that encompass an individual's life. Balance requires the individual to respond appropriately to the enormous changes that affect him. There is no single definition of perfect balance, because the concept of balance depends on how individuals manage their own affairs and family duties," and states that work and family interact with each other, and that an event that takes place in the family dimension affects the field of work. Crozier-Durham [2007] argues that the concept of work-family balance is an expression reducing one's life to work and family. The researcher believes that person is considered only within the home/work context, but the expression 'work-life' is much broader and implies that an induvial is free to use their time left over from home and work duties according to their own wishes.

Bielby and Bielby [1989] state that domestic labour and childcare are the main women's obligations, despite the increase in men's contributions to those activities. If woman starts working, she is included in the double-earning family model; the effective combination of work-

ing life and family life in a problem-free and healthy way ° highlights the importance of work-life balance [Yurdakul- 3 Erol, Kose, 2017]. I

The necessity of interaction in work-family life gains g importance in industrial society and in the transition peri- £ od to post-industrial society, especially with the growing < participation of women in business and the increasing | desire to work. However, the recent rise in the number of x double-earning spouses has attracted special attention ¡2' to the concept [Duxbury, Higgins, 2001]. The problem of S individuals experiencing WFB issues and minimizing the | negative impacts is related to establishing a good harmo- £ ny between work and family roles. It was observed that people who maintain a good balance between the two poles are happier and more satisfied. The way to achieve WFB is hidden in individual factors. The fact that the person makes logical choices to achieve balance and is consistent in performing it facilitates his/her adaptation. Additionally, people who use time effectively and live their routine life within the plan can better balance the time they spend for work, family and life [^arikg, ^elikkol, 2009].

When the work-life balance cannot be realized, undesirable consequences may occur for individuals and organizations [Umutlu, 2020], such as family conflicts, work stress, health problems, decrease in production and the employee's commitment to work [Guder, 2019]. Left unresolved, the person's problems in social life may result in action disorders, e.g., work accidents, the use of harmful substances such as cigarettes and alcohol, angry attitudes and disruptive behaviours, the growing tendency to violence. Behavioural outcomes often affect not only people themselves but also the environment around them. The person with alcohol dependence increasing is aggressive which will affect his/her family, personal environment and work environment [Frone et al., 1992, pp. 75-76]. The other consequence of the work-life imbalance that affects people psychologically is life dissatisfaction [Duxbury, Higgins, 2001]. Direct costs caused by the work-life imbalance have immediate effects on the organization. These include absenteeism, employee turnover, work slowdown, and strike. Among the firm's indirect costs are reduced job satisfaction and organizational loyalty, and a decrease in the quality of personal relations [Quick, Nelson, Hurrel, 1997].

Job satisfaction. With the emergence of the human element in organizations, most researchers and academics have started to work on the concept of JS. According to Locke [1976], it is interpreted as "the pleasant and positive emotional state that arises because of evaluating one's work." The concept of JS, which explains the fact that employees enjoy the work they do and like the institution they serve, has been expressed as a reflection of the job advantages and bonuses on the person [Iverson, Deery, 1997]. JS is a concern about the degree to which employees are satisfied with the key labour factors, such as the

I content of the job, autonomy, remuneration, and develop-

3 ment opportunities [Hackman, Oldham, 1975]. If the value

£ judgments, needs and wishes that occur because of the

g person's experiences are in harmony with the work they

£ fulfil, JS can be mentioned. In the context of today's tur-

u

£ moil, the demands of employees from their organization | come to the fore as well as the outputs they provide to the Ü organization. Because of the response to the employees' expectations from the organization, the employee is expected to work more sensitively, effectively and successfully with the satisfaction he will feel. Thus, the concept of JS is crucial in business life [Pekdemir et al., 2006].

Some points regarding JS are summarized as follows [Luthans, 1995]: JS cannot be observed concretely because it is an internal reaction, it can be felt; JS can be explained as the extent to which the employee's expectations regarding job results are met; and JS is linked to many work-oriented actions of employees (wages, promotions, management methods, etc.). The necessity of JS arises when many negative consequences, such as a lack of commitment, isolation, increased number of accidents, etc. are observed. Spector [1997] highlights three important features of JS. Firstly, organizations must be governed by human virtues. Such organizations should be aimed at acting fairly and carefully towards employees. In these processes, the examination of JS is important for the emergence of employees' competence. Secondly, the actions of employees, depending on their level of satisfaction, will affect the order and activities of the organization. However, it is stated that JS will lead to positive outcomes, and dissatisfaction with work will cause employees to exhibit negative actions. Thirdly, JS can be considered a sign of corporate events. Through the measurement of JS, different levels of satisfaction can be explained by different organizational units.

Disagreements among co-workers, behaviour towards achieving goals, various personal and organizational factors, satisfaction or dissatisfaction with work have a direct impact on the overall efficiency and productivity of organizations. Employees are directly affected by high productivity, high JS and morale levels [Tannenbaum, 1992]. When JS is not felt, employees' performance decrease, they perform meaningless actions, and a slowdown in work is monitored. As a result, the organization will face negative consequences, such as staff leaving the job [Sat, 2011]. Therefore, JS is necessary both personally and organizationally. The benefits of JS are as follows: (i) it causes continuity in work, (ii) the number of work accidents decreases, (iii) low rates of work-related illnesses are observed, (iv) individuals feel more comfortable psychologically, (v) peaceful atmosphere at the workplace affects family relationships, (vi) employee loyalty to the organization improves, (vii) the social needs of the individual are satisfied, (viii) the stress level decreases.

Organizations are interconnected and have overlapping content. Organizational systems require employees

with diverse qualifications and skills. This leads to the evaluation of employees with different characteristics within the scope of the organization. Therefore, employees with different levels of competence are differently affected by the organization's policies and regulations [Orucu, Yumu§ak, Bozkir, 2006]. Other important aspects influencing JS are divided into two groups - personal and organizational elements. The first one is composed of age, personality, gender, marital status, education, seniority, and tenure; while the second one consists of salary, job nature and status, interactions with colleagues and managers, communication, promotion opportunities, working conditions, workspace, and managerial attitude [Koca, 2013].

Task performance. TP is viewed as the organisation's expectations from its employees to meet the planned g oals and implement the necessary activities [Chia-Wu, Shu-Ling, Ruei-Yang, 2011]. Viswesvaran and Ones [2000] describe TP as scalable actions, behaviours and outcomes to achieve the goals and objectives of the organisation. In this context, TP refers to the sum of effectiveness and efficiency exhibited by an employee while carrying out the primary obligations that constitute their formal job description. For someone working in a hotel, TP can be explained in terms of the number of people serviced per hour, while for an insurance officer this is the amount of insurance policy he performs a week. TP can also be regarded as the source of the most necessary human contribution, depending on organisational activity [Judge et al., 2001].

Williams and Anderson [1991] state that TP consists of actions that are formally announced, included in the reward system, and framed in job descriptions. Moral characteristics, concrete job descriptions, favourable working spaces and professional competence are critical for high duty performance. It is not always possible to interpret job descriptions clearly. In such cases, it is difficult to explain employee performance. Individual attitudes and actions determine employee productivity and hence the performance of the organization, and include not only work-related but also non-work-related actions, duties and obligations. In other words, TP is mostly associated with the technical aspects and expertise of the work [Kili$, 2006].

According to Van Scotter [2000], "when employees use technical skills and knowledge to produce goods or services through the organization's core technical processes, or when they accomplish specialized tasks that support these core functions, they are engaging in task performance" [pp. 80-81]. This provides support to the technical core, which is then formally recognized as an element of the work [Rotundo, Sackett, 2002]. Borman and Motowid-lo [1993] define the concept of TP as a term that explains the level of impact exhibited by employees who carry out the necessary inputs and services directly or indirectly supporting the core technical operations of an organization and the implementation of technological processes.

The concept of TP is explained in two dimensions as technical-administrative and leadership performance [Mohammed, Mathieu, Bartlett, 2002]. In this context, the former includes planning, paperwork, quality control and other functions, and the latter embraces obligations such as management, motivation, direction and evaluation, etc. [Conway, 1999]. The factors affecting TP are as follows: (i) setting clear goal, (ii) having the adequate resources to achieve the goals, (iii) being knowledgeable about the nature of the situation, (iv) having a functioning feedback loop, (v) having appropriate mental models, (vi) approving, supporting and defending the values, goals and objectives of the organisation.

Al and Anil [2016] found that the JS and performance levels of part-time employees are higher than of those working full-time. In a study conducted on doctors, significant relationships were found between their working hours, certain job conditions, and JS [Mache et al., 2014]. Additionally, in enterprises with flexible schedule workers are protected from work accidents that occur due to fatigue and carelessness experienced during busy working hours because they do not labour overtime. According to a research conducted on the flexible work system, it has been stated that as the suitability of the job for flexibility increases, organizational commitment and JS also increase, and organizational commitment and JS enhance performance [Engizek, 2017]. Therefore, the assumption that FWP of healthcare workers affects TP constitutes hypothesis H1:

H1: A decrease in FWP results in a decrease in TP.

Individuals who experience work-family conflicts are known to have lower performance in the workplace compared to other employees. Additionally, the difficulty of performing too many roles and ever-growing stress increase the rate of absenteeism. This issue not only has an adverse effect on working life but also causes people to be unhappy in their family lives. The lack of WFB has profound consequences in terms of personal life and job employment. Family conflicts also affect personal happiness and work performance [Arslan, 2012]. It is necessary, therefore, to examine the factors that may cause deterioration of WFB in employees, and FWP may be one of these factors. Based on this approach, we formulate hypothesis H2:

H2: A decrease in FWP results in a decrease in WFB.

The concept of flexibility in working life aims to provide the employee and the employer with the opportunities to act more freely without certain rules such as working styles and times, wages, number of employees hired, etc. As a result of these opportunities, it is thought that employees' satisfaction with their job will increase, otherwise the JS levels will decrease. Based on this approach, hypothesis H3 is as follows:

H3: A decrease in FWP results in a decrease in JS.

It is thought that people with impaired WFB have lower performance than other employees of the same organization. As mentioned above, this can result in an

increased rate of absenteeism and dissatisfaction with °

personal lives. The importance of keeping the balance 3

between business and family obliges employees, em- I

ployers, unions and the state to take particular measures g

in this field [Dogrul, Tekeli, 2010]. Hence, we put forward £

hypothesis H4: <

H4: A decrease in WFB results in a decrease in TP. |

The stress and negativity from work have damaging x

consequences for both business and family environ- ¡2'

U

ments. In particular, the classical functions of female em- S ployees in the family and the negativities towards their | responsibilities for their spouses and children may also £ reflect negatively on the work. Some studies on this topic reinforce this idea [Arslan, 2012]. Therefore, it is thought that the deterioration in WFB will cause a decrease in JS. Thus, hypothesis H5 is the following:

H5: A decrease in WFB results in a decrease in JS. High JS in employees engaged in the health sector positively affects patient satisfaction and the quality of patient care. The problems and advances experienced in the sector affect the patients and their relatives as well as the healthcare workers. Employees who are satisfied with their work and perform their responsibilities with pleasure behave in a much friendlier, productive and problemsolving manner. The health sector, which unites several occupational groups under the same roof, requires a team spirit. JS is also important for teamwork carried in a happy and dynamic atmosphere. In comfortable and spacious physical environments, individuals work more peacefully and happily [Ove$, 2014]. In this context, we hypothesize that a decrease in JS within a health organization will have a negative impact on TP of healthcare workers: H6: A decrease in JS results in a decrease in TP.

RESEARCH METHODOLOGY

The population and sample of the research. The population of the research consists of healthcare workers from Turkey. The sample of the study includes employees working in a private hospital serving in Gaziantep, Turkey. Purposeful sampling method was used and data were collected from 353 of 390 people working within the health organization on a voluntary basis. All personnel included in the sample were exposed to the same organizational climate.

The data collection method. Since the study was conducted in a hospital environment with a high risk of transmission due to the COVID-19 pandemic period, data were obtained by applying the online survey method. The questionnaire used to obtain data consists of five sections and a total of 33 articles. The questionnaire includes questions created according to the 5-point Likert scale. The propositions were structured as (1) Strongly disagree, (2) Disagree, (3) Undecided, (4) Agree, (5) Strongly agree, and directed to the participants.

The 11-item scale developed by Apaydin [2011] was used to measure WFB in the employees; the internal con-

sistency coefficient of the scale was found to be 0.840, and the scale had high reliability. The 5-item scale for measuring JS proposed by Judge et al. [1998] and adapted to Turkish by Keser and Bilir [2019] was used; the internal consistency coefficient of the scale was found to be 0.850 and it revealed that the scale had high reliability. The 8-item scale developed by Akpolat and £etin [2020] was used to measure FWP; the internal consistency coefficient of the scale was found to be 0.774 and it determined that the scale had high reliability. To measure TP, the 9-item scale designed by Goodman and Svyantek [1999] and adapted to Turkish by Özer [2018] was used; the internal consistency coefficient of the scale was found to be 0.910 and the scale had high reliability.

The research model. Scanning model was used in the research. In this context, WFB, FWP, JS and TP variables were discussed. As seen in Figure, TP was used as a dependent variable, FWP as independent variable, and WFB and JS variables were used as both dependent and independent variables.

Work and family life balance Hs Job satisfaction

V A

j Л н2 1 H6 г

Flexible work perception Task performance

H,

87.5% of the respondents are in subordinate positions, and 12.5% are in administrator positions. When job title is examined, those working in patient services constitute the largest group of 38.8%.

Table 1 - Descriptive statistics Таблица 1 - Описательная статистика

Conceptual model Модель исследования

Data analysis of the research. In the study, Smart PLS3 [Ringle, Da Silva, Bido, 2015] statistical program was used to estimate the structural equation model by partial least squares method (PLS-SEM). In the context of reliability and validity tests of the scales from which data were obtained, factor loads for item reliability, Cronbach's alpha and combined reliability values (AVE, CR) for internal consistency reliability, average variance values announced for merger validity, cross-loads, Fornell-Larcker criterion and HTMT criterion values were examined for separation validity. After the validity and reliability criteria were met, the estimation of the structural equation model was realized by the partial least squares method.

RESULTS

Table 1 contains descriptive statistics on the participants. It is observed that 39.9% of the sample are male and 60.1% are female employees, and 54.4% of these employees are married. When the respondents' age is examined, 61.1% of them are between the ages of 26-41. In terms of education status, 51% of the employees are university graduates, and 28.6% are high school graduates. When professional service periods are examined, 54.1% of the sample have 1-5 years of experience. As for job position,

Indicators Frequency %

Gender

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Male 141 39.9

Female 212 60.1

Marital status

Single 161 45.6

Married 192 54.4

Age

18-25 years 102 28.9

26-33 years 117 33.1

34-41 years 99 28.0

42-49 years 28 7.9

50 years and older 7 2.0

Educational status

Primary school 72 20.4

High school 101 28.6

Associate degree 83 23.5

Undergraduate 65 18.4

Graduate 32 9.1

Duration of professional service

1-5 years 191 54.1

6-10 years 86 24.4

11-15 years 46 13.0

16 years and over 30 8.5

Position

Subordinate 309 87.5

Administrator 44 12.5

Title

Physician 29 8.2

Nurse 38 10.8

Patient services 137 38.8

IHS officer 62 17.6

Other 87 24.6

Validity and reliability studies were conducted for the scales used in the research. In this context, article reliability, internal consistency reliability, merger validity and dissociation validity were examined. Standardized factor loads were looked at to test article reliability [Hair et al., 2010]. Cronbach's alpha coefficient and composite reliability (CR) coefficient were considered for internal consistency reliability (ICR) [Hair et al., 2017]. Attention was paid to the stated average variance values (AVE) of the expressions for convergent validity [Fornell, Larcker, 1981]. To determine the discriminant validity, cross-loading val-

AVE values were higher than 0.5 and CR values were high- °

er than 0.7 [Hair et al., 2017]. 3

According to the cross-loading results in Table 3, we I

observe that factor load of the variable under which one g

expression is located is higher than the factor load it re- £

ceives in other variables. <

When the Fornell-Larcker criterion in Table 4 is exam- |

ined, we observe that diagonal values are the largest and x

when the HTMT values are examined, all values are below ¡¡i

Ш

z

Ш

Table 2 - Factor loads, AVE and Cronbach's alpha values s> Таблица 2 - Факторные нагрузки, средняя объясненная дисперсия (AVE) и значения коэффициента альфа Кронбаха £

Indicators Items Factor loads Std.H. T value AVE Cr Cronbach's alpha

EC1 0.878 0.018 49.187

FWP EC2 0.859 0.021 41.014 0.628 0.831 0.700

EC3 0.613 0.064 9.656

GP1 0.777 0.037 21.242

GP2 0.761 0.038 20.245

GP3 0.818 0.035 23.350

GP4 0.637 0.059 10.883

TP GP5 0.736 0.058 12.760 0.580 0.925 0.909

GP6 0.765 0.052 14.785

GP7 0.824 0.034 24.129

GP8 0.806 0.048 16.792

GP9 0.712 0.074 9.652

IAYD1 0.742 0.030 24.629

IAYD2 0.829 0.020 42.022

IAYD3 0.812 0.025 32.046

WFB IAYD4 0.857 0.021 41.070 0.518 0.892 0.863

IAYD5 0.809 0.027 29.902

IAYD6 0.558 0.060 9.312

IAYD7 0.532 0.062 8.639

IAYD8 0.511 0.060 8.569

IT1 0.677 0.055 12.362

IT2 0.806 0.032 25.298

JS IT3 0.689 0.042 16.495 0.518 0.841 0.774

IT4 0.650 0.057 11.437

IT5 0.763 0.033 22.841

Table 3 - Cross loadings Таблица 3 - Пересекающиеся нагрузки в модели

Indicators FWP TP WFB JS

EC1 0.878 0.041 -0.409 -0.326

EC2 0.859 0.047 -0.322 -0.275

EC3 0.613 0.202 -0.231 -0.131

GP1 0.125 0.777 0.133 0.184

GP2 0.015 0.761 0.167 0.218

GP3 0.089 0.818 0.142 0.184

GP4 0.012 0.637 0.187 0.259

GP5 0.082 0.736 0.039 0.133

GP6 0.120 0.765 0.037 0.100

GP7 0.114 0.824 0.127 0.136

ues were examined in the Fornell-Larcker table to the values that are the square roots of the AVE values and the HTMT criterion values [Hair et al., 2017; Henseler, Ringle, Sarstedt, 2015]. As shown in Table 2, article reliability was ensured because all factor loads are higher than 0.5. Factor loads below 0.5 (IAYD9-IAYD10-IAYD11, EC4, EC5, EC6, EC7, EC8) were excluded from the analysis. ICR was ensured because Cronbach's alpha values for variables were higher than 0.7, and merger validity was ensured because

■н s

Table 3 (concluded) Окончание таблицы 3

Indicators FWP TP WFB JS

GP8 0.081 0.806 0.074 0.166

GP9 0.059 0.712 0.060 0.111

IAYD1 -0.384 0.122 0.742 0.406

IAYD2 -0.337 0.087 0.829 0.412

IAYD3 -0.301 0.105 0.812 0.371

IAYD4 -0.406 0.025 0.857 0.423

IAYD5 -0.372 0.056 0.809 0.443

IAYD6 -0.150 0.185 0.558 0.253

IAYD7 -0.147 0.250 0.532 0.278

IAYD8 -0.172 0.178 0.511 0.267

IT1 -0.162 0.155 0.223 0.677

IT2 -0.144 0.229 0.340 0.806

IT3 -0.296 0.077 0.487 0.689

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IT4 0.008 0.246 0.213 0.650

IT5 -0.414 0.165 0.435 0.763

0.9. According to the results obtained from Tables 2, 3 and 4, the validity of the decomposition was ensured.

The results of the structural equation model performed after the validity and reliability criteria are met are included in Table 5. According to this table, FWP positively affects TP (fi = 0.238, t = 4.026, p < 0.001), therefore, hypothesis H1 is accepted. FWP negatively affects WFB (fi = -0.421, t = 8.954, p < 0.001), therefore, hypothesis

H2 is supported. FWP negatively affects JS (fi = -0.137, t = 2.269, p < 0.05). Therefore, hypothesis H3 is also supported. Hypothesis H4 is accepted because WFB positively affects TP (fi = 0.136, t = 1.573, p < 0.05]. Hypothesis H5 is accepted since WFB positively affects JS (fi = 0.456, t = 9.738, p < 0.001). JS positively affects TP (fi = 0.240, t = 3.623, p < 0.001), therefore, hypothesis H6 is accepted.

Table 4 - Fornell-Larcker criteria values (square root of AVE) Таблица 4 - Значения критерия Форнелла - Ларкера (квадратный корень AVE)

Indicators FWP TP WFB JS

Fornell-Larcker criteria values FWP 0.792 - - -

TP 0.101 0.762 - -

WFB -0.417 0.154 0.720 -

JS -0.324 0.228 0.507 0.719

HTMT values FWP - - - -

TP 0.162 - - -

WFB 0.498 0.197 - -

JS 0.369 0.273 0.560 -

Table 5 - Structural equation model - Hypothesis test results Таблица 5 - Результаты проверки гипотез методом структурного моделирования уравнениями

Hypotheses ß S.D. T P-value

H1 FWP -> TP 0.238 0.058 4.026 0.000

H2 FWP -> WFB -0.421 0.047 8.954 0.000

H3 FWP -> JS -0.137 0.060 2.269 0.012

H4 WFB -> TP 0.136 0.082 2.573 0.049

H5 WFB -> JS 0.456 0.046 9.738 0.000

H6 JS -> TP 0.240 0.066 3.623 0.000

DISCUSSION AND CONCLUSION

Considering the COVID-19 pandemic, the increasing importance of flexible work practices for institutions in this period is an undeniable fact. The flexible work system, which has become one of the most emphasized topics in the literature, gained importance in hospitals due to the pandemic, but the approach to flexible work in the health system has changed due to the increasing demand for health services. Similarly, WFB has become one of the critical topics of working life in the health sector and often come to the fore as an element that maintains its importance in the agenda of management and management psychology. In this context, analysis of whether the perceptions of healthcare workers about the flexible working system during the COVID-19 pandemic period affect WFB, as well as whether these variables affect the variables of JS and TP, will make an important contribution to the literature. To that end, the estimate of the structural equation model with the partial least squares method is required.

Within the scope of the research, it was determined that flexible work positively affected TP. As the importance of intellectual capital, which can provide the greatest advantage to many companies in the global competitive environment, is increasing, the value given to employees is going up as well. In recent years, companies have started to increase their activities of valuing employees in order to retain their qualified workforce. Employees with a high sense of belonging put more effort into fulfilling their duties and achieving the goals of the organization. Classical rewarding methods such as wage increases are no longer as effective as before in improving employee performance. In this context, organizations must give importance to the quality of business life and working environment. Organizations increase TP by analysing the expectations, interests and needs of employees and providing them with the opportunity to work appropriately and comfortably. Flexible work arrangements can provide advantages to businesses in this respect, as well as increase TP of employees; in organizations, where flexible work order cannot be provided, TP decreases.

The research results show that a decrease in FWP adversely affected WFB. Hospital workers were at the most risk in the pandemic outbreak. The chaos created by the pandemic and the work environment that required intensive and arduous work adversely affected their psychology. Hospital employees, who were in intensive contact with patients, had difficulty in maintaining their WFB caused by the anxiety of getting sick due to these difficult working conditions and the concern of infecting their families with the virus. The vast majority of hospital employees had to spend time apart from their families to prevent the transmission of the virus when the vaccine had not yet been purchased in Turkey and the virus had peaked, but they could not benefit from the flexible work system due to the intense need in health services. In this

o z

context, FWP among healthcare workers had a negative 3 influence on WFB. I

We have also discovered that a decrease in FWP ad- g versely affected JS. During the pandemic, hospitals in Tur- £ key reached their maximum occupancy, and the burden < on healthcare workers increased substantially. In this con- | text, although hospital employees, unlike other sectors, x served with maximum performance, they were among ¡2' those with the least JS in the health system. Job satisfac- S tion of hospital employees who came out of the flexible | work system and experienced constant high anxiety also £ decreased, and the chaotic environment typical of that period became an important factor in making them unsatisfied and unhappy.

The study showed that a decline in WFB adversely affected TP. Healthcare workers devoting sufficient time to themselves and their families fulfil their job responsibilities more willingly and better stick to the goals of the organization. Employees satisfied with their work, family and private life are more effective in performing their duties. However, this situation was observed as a negative factor on TP in healthcare workers who could not provide WFB due to the working environment and social health needs during the pandemic.

According to the research results, JS of healthcare workers whose WFB is impaired is also adversely affected. Contrary to the fact that employees who can achieve WFB enjoy their jobs, the deterioration of the flexible work system, which developed depending on the working environment of health organizations during the pandemic period, triggered the deterioration of WFB. As a result, healthcare professionals have experienced a decrease in job satisfaction levels regarding their work and professional activities.

We also found that a decrease in JS of healthcare workers worsened their duty performance. When all these results are evaluated cumulatively, the concepts of flexible work, TP, JS, and WFB should be handled integrally. Health systems, which collapsed due to the huge pandemic-related demands for health services, have caused the partial or complete disappearance of flexible work methods. Healthcare workers, who were aware of own health being under threat, provided the necessary service by sacrificing family duties and responsibilities. However, WFB, disrupted by this intensive work tempo lacking a flexible work system, also hindered both JS and TP of the employees.

The given research is characterized by a number of limitations, and the key one is that it was carried out in a health institution during the COVID-19 pandemic. Another limitation is that the study is not applied in a public health institution. As a matter of fact, research results can vary with the application of this study in different sectors, locations or hospitals.

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Источники

Akpolat T., £etin M. (2020). Validity and reliability study for developing flexibility scale. Türk Egitim Bilimleri Dergisi/Turkish Journal of Educational Sciences, vol. 18, no. 1, pp. 136-152. https://doi.org/10.37217/tebd.643277. (in Turkish) Al A.D., Anil i. (2016). The comparison of the individual performance levels between full-time and part-time employees: The role of job satisfaction. Procedia - Social and Behavioral Sciences, no. 235, pp. 382-391. https://doi.org/10.1016/j. sbspro.2016.11.048

Apaydin (2011). The relationship between work addiction level of faculty members and work-life balance and work-family-life

balance. Unpublished PhD thesis. Institute of Education Sciences, Ankara University. (in Turkish) Arslan M. (2012). The effects of work-family conflict and family-work conflict on women employee's job satisfaction. Journal

of Individual and Society, vol. 2, no. 3, pp. 99-113. Bacak B., §ahin L. (2005). Evaluation of flexible working styles in terms of occupational health and safety: Opportunities and threats. istanbul Üniversitesi iktisat Fakültesi Mecmuasi / Istanbul Journal of Economics, vol. 55, no. 1, pp. 325-340. (in Turkish) Bielby W.T., Bielby D.D. (1989). Family ties: Balancing commitments to work and family in dual earner households. American

Sociological Association, vol. 54, no. 5, pp. 776-789. https://doi.org/10.2307/2117753 Borman W.C., Motowidlo S. (1993). Expanding the criterion domain to include elements of contextual performance. N. Schmitt &

W.C. Borman (Eds.). Personnel Selections in Organisations (pp. 71-98). Jossey-Bass Publications, San Francisco. £arikg i.H., ^elikkol Ö. (2009). The effects of work-family conflict on organizational commitment and intention to leave. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi / Journal o f Suleyman Demirel University Institute of Social Sciences, vol. 1, no. 9, pp. 153-170. (in Turkish) Chia-Wu L., Shu-Ling C., Ruei-Yang W. (2011). Savouring and perceived job performance in positive psychology: Moderating role of positive affectivity. Asian Journal of Social Psychology, vol. 14, no. 3, pp. 165-175. DOI: 10.1111/j.1467-839X.2010.01340.x Conway J.M. (1999). Distinguishing contextual performance from task performance for managerial jobs. Journal of Applied