The relationship between moral intelligence and organizational commitment of nurses

Introduction

Ethical dilemma is a critical issue raised to organizations nowadays since ethics exerts a profound impact on the activities and duty fulfillment of organization employees. ¹ Therefore, organizations need to make their managers and employees adhere to the principles of ethics and the acquisition of ethical intelligence. In so doing, they ensure their organizational survival since adherence to ethics will motivate employees and subsequently improve the quality of services.

In this regard, the most effective phenomenon that can be of great help to managers and a solution to problems is moral intelligence. ² Moral intelligence is the first component of ethical conformity and as the foundation of ethical practice guides the nurses in providing their patients with effective and ethical care. ³ Moral intelligence is the ability to learn, acquire intellectual–physical skills, and environmental adaptations. According to Lennick and Kiel, four principles of moral intelligence are essential for continuous organizational and personal success, including integrity, responsibility, compassion, and forgiveness.

The first component, integrity, means doing the right and telling the truth under any circumstances. ⁴ The second component, responsibility, implies that individuals with high moral intelligence take responsibility for their own behavior and the consequences of that behavior, as well as their mistakes and failures. The third component, compassion, is attention to others. If we are kind and caring to others, they will sympathize with us when needed. The fourth component is forgiveness, which means being aware of your own and others’ faults and mistakes and forgive yourself and others. ³ Therefore, moral intelligence gives our lives purpose and people with high moral intelligence do the right thing. They always act in ways that are consistent with their values and beliefs, have high performance, and always incorporate ethical principles into their behaviors. ⁵

The human resources are the most important assets of an organization and the high quality of this asset brings success, survival, and promotion to organizations. The probability of success would increase in organizations if the members accept the deep-held organizational values, consider themselves a part of it, and commit themselves to step toward organizational goals. ⁶ Organizational commitment is defined as employees’ strong desire to maintain membership in an organization so that the organization represents that employee.

Allen and Mayer’s ⁷ three-component organizational commitment model proposes that commitment is a mental state commitment that defines the individual’s relationship with the organization. In this regard, they argue that commitment has three different components that correspond with different psychological states, including affective, continuance, and normative commitments. Affective commitment refers to psychological and emotional attachment to the organization which motivates the employees to maintain their membership. Continuous commitment means compliance or conformity as a result of reward and punishment. Normative commitment is defined as feeling obliged to remain with an organization.

Therefore, an individual’s pure commitment to an organization reflects each of the distinct mental states. Organizational commitment exerts a great impact on the efficiency and productivity of an organization since such a committed employee considers the organizational goals in alignment with his own and strives to achieve them. ⁸ Non-commitment and low commitment bring serious negative consequences to employees and the organization. They include job quitting, excessive absenteeism, reluctance to stay with the organization, and a drop in customer confidence ⁹ and income and increasing nursing errors. ¹⁰ A high organizational commitment of employees is accompanied by their greater resilience to adapt to organizational changes. ¹¹ This issue is of paramount importance in the professions which are related to community health.

In their study, Lennick and Kiel ¹² demonstrated that low ethical intelligence in employees hinders them from tolerating others’ mistakes and becoming aware of their own shortcomings. In another study, the relationship between ethical intelligence and organizational effectiveness in nurses is investigated. The results of the mentioned study were suggestive of the undeniable impact of ethical intelligence on patients’ satisfaction. ¹³ Moreover, in a review of studies, a significant relationship was detected between professional ethics and organizational commitment. ¹⁴ In addition, another research indicated that moral intelligence can predict job conscience and organizational commitment. ¹⁵ Ethical nursing practice plays an important role in the quality of provided care, patients’ recovery, and achievement of health-related goals. ¹⁶ Therefore, close attention should be turned on the dimensions of moral intelligence in nurses as an ethical guideline for their performance. It can be of utmost importance in their attitude toward adherence to ethical standards in their performance. ¹⁵ Due to the importance of these two issues in nurses’ performance and insufficient studies in this field in Iran, the present study was conducted to investigate the relationship between moral intelligence and organizational commitment of nurses in Arak, Iran.

Methods

This cross-sectional descriptive study was conducted for seven months. The study population consisted of all nurses working in Arak’s hospitals. The sample size was calculated as 176 cases based on the formula of sample size in correlational studies with P = 0.05 and power of 0.8 and r = 0.2 (the least r in subscales) in the study of Dehghani Firozabadi et al. ³

Sampling was performed by two-stage quota sampling. First, given the number of nurses and sample size, the quota of each hospital was determined and then the samples were selected using the list of nurses and random numbers table. Inclusion criteria were having at least the bachelor of nursing. The nurses who had job absence long-term (at least one month) for whatever reason, in six months before study were excluded. Data collection tools consisted of three parts. The first part was demographic questionnaire, the second part was Allen and Meyer’s ⁷ organizational commitment questionnaire with 24 questions that measures the organizational commitment based on a 5-point Likert scale (strongly agree = 5 to strongly disagree = 1). Organizational commitment questionnaire was designed with three components of continuous commitment (eight questions), emotional commitment (eight questions), and normative commitment (eight questions). The validity of this questionnaire has been approved in the study of Dehghani Firozabadi et al. ³ and is used in this study by their consent. The reliability of the questionnaire was assessed in a sample of 20 nurses with Cronbach’s alpha coefficient of 0.89%. The third part of data collection tool was Lennick and Kiel moral intelligence questionnaire with 40 questions that measures moral intelligence based on a 5-point Likert scale (strongly agree = 5 to strongly disagree = 1). Moral intelligence questionnaire was designed with four components of honesty (16 questions), compassion (4 questions), forgiveness (8 questions), and responsibility (12 questions). ¹⁷ The validity of this questionnaire has been approved in the study of Abaszadeh et al. ¹⁸ and is used in this study by their consent. The reliability of the questionnaire was assessed in a sample of 20 nurses with Cronbach’s alpha coefficient of 0.86%.

Data analysis was done by SPSS16. To calculate the descriptive parameters, the descriptive statistics methods (frequency, percentage, standard deviation, mean) and inferential statistics (Pearson correlation coefficient, Fisher’s exact test) were used to determine the relationship between moral intelligence and organizational commitment.

Ethical considerations

This study is the result of research project approved by Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences with ethical code of IR.SBMU.RAM.REC.1394.340. Participants were also informed of the objectives and importance of research and their oral informed consent was obtained and they were assured about the questionnaires being anonymous and confidential. The findings were published with the confidentiality and compliance with laws and publishing ethics considerations.

Results

An overview of the demographic characteristics of the study participants showed that most participants were female married and had bachelor’s degree (Table 1). The mean score of nurses’ moral intelligence was 77.32 and mean score of organizational commitment was 77.77%. Nurses’ intelligence level was very good and the level of organizational commitment was good. There was a relationship between the organizational commitment and moral intelligence (r = 0.32, P < 0.001). There was also a relationship between the dimensions of organizational commitment and the dimensions of moral intelligence (Table 2). Also, the nurses’ organizational commitment was significantly different according to different levels of moral intelligence, so that among 120 nurses (68.2% of total sample) who had high organizational commitment, 90 (84.2%) had moral intelligence of good to high level (Table 3).

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Table 1.

Demographic characteristics of nurses as separated demographic and occupational characteristics.

Property	Group	Frequency	Percent
Sex	Female	157	89.2
	Male	19	10.8
Age	20–30	118	67
	31–40	51	29
	41–50	7	4
Education	Under Bachelor	18	10.2
	Bachelor	139	79
	Upper Bachelor	19	10.8
Employment status	Official	95	54
	Contractual	81	46
Marital status	Single	78	44.3
	Married	98	55.7
Hospital	General	123	69.8
	Specialized	53	30.2

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Table 2.

The relationship between moral intelligence and its dimensions with the dimensions of organizational commitment.

Organization        commitmentMoral intelligence		Affective Commitment	Normative Commitment	Continuous Commitment	Total
Integrity	r	0.259	0.153	0.249	0.273
	p value	0.001*	0.043	0.001*	0.0001*
Forgiveness	r	0.369	0.213	0.382	0.398
	p value	0.0001*	0.004	0.0001*	0.0001*
Compassion	r	0.252	0.158	0.302	0.291
	p value	0.001*	0.036*	0.0001*	0.001*
Responsibility	r	0.274	0.140	0.311	0.302
	p value	0.0001*	0.063	0.0001*	0.0001*
Total	r	0.303	0.172	0.324	0.33
	p value	0.0001*	0.022	0.0001*	0.0001*

*p < 0.05.

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Table 3.

Comparison of organizational commitment based on different levels of nurses’ moral intelligence.

Moral intelligence
Organization commitment	Weak		Good		Very good		Excellent		Total
	Frequency	Percent	Frequency	Percent	Frequency	Percent	Frequency	Percent	Frequency	Percent	Test
Extremely low	3	9.1	0	0	1	1.8	0	0	4	2.3	Fisher’s exact = 18.128P-value < 0.05
Low	11	33.3	18	26.9	11	19.6	5	25	45	25.6
High	19	57.6	48	71.6	42	75	11	55	120	68.2
Excellent	0	0	1	1.5	2	3.6	4	20	7	4
Total	33	100	67	100	56	100	20	100	176	100

Discussion

The mean score of nurses’ organizational commitment was good. This result is not in line with the findings of the studies conducted by Stewart et al. ¹⁹ and Pazargadi and Jahangir ²⁰ who obtained a moderate score for organizational commitment. In the same vein, this finding is not consistent with the results of the study performed in Shiraz by Abaszadeh et al. ²¹ who reported a low level of organizational commitment of nurses. This discrepancy can be ascribed to differences in the workplace, ethical climate, organizational culture, as well as managerial and organizational support. The highest mean score of organizational commitment was detected in the dimension of affective commitment (emotional attachment and sense of belonging to the organization) and the lowest score was reported in the normative commitment dimension (compliance as feeling obliged to remain with the organization). These results were in agreement with the study carried out by Yaghoubi et al. ²² who reported that the highest and lowest mean scores of nurse supervisors were related to emotional and normative commitments, respectively. The high level of affective commitment is a positive point that nurse supervisors should make use to the best of their advantage to improve the quality of nursing care. On the other hand, low normative commitment can be regarded as a considerable alarm to health policymakers and an important topic for future research.

The average score of nurses’ moral intelligence was reported to be at a very good level. This finding is consistent with previous Iranian and non-Iranian studies.^23–26 As indicated in many similar studies, nurses’ moral intelligence was obtained at the upper-moderate level. This high moral intelligence demonstrates the importance they give to acquiring ethical values ​​and is a direct reflection of nurses’ ethical practice in healthcare centers. Nonetheless, self-report bias may be introduced when responding to self-report questionnaires. This inherent limitation of these instruments can encourage respondents to reflect positively on their performance.

Among the dimensions of moral intelligence, integrity had the highest mean score. The results of the study conducted by Sadeghi et al. ¹³ on nurses’ moral intelligence in Hamadan University of Medical Sciences were in line with the results of the current study. Integrity means doing the right things one truly believes in even when it works to your disadvantage. With integrity, nurses can clearly express their principles, values, and beliefs and build confidence.

The important finding of the present study was a significant and positive relationship between nurses’ moral intelligence and organizational commitment. This result is supported by findings obtained in previous studies on the relationship between different ethical concepts and organizational commitment of employees.^3,5,6,25,27 Based on this comparison, it can be concluded that the promotion of professional ethics and organizational commitment are deeply interwoven. Accordingly, the elevation of one of them can lead to the promotion of the other; nonetheless, further studies with more robust methodology are needed to confirm this claim.

Among the components of organizational commitment, affective and normative commitments had the strongest relationship with the dimensions of moral intelligence. This finding is in agreement with the results of previous studies that investigated the relationship between the components of organizational commitment with the concepts of professional ethics.^25,27–29 The employees who have a strong continuance commitment feel they are contributing to the organization’s productivity and are committed to value the organization. ⁹ On the other hand, employees with high moral intelligence try to stay loyal to their organization. They are aware of potential losses imposed on the organization if they quit their job and consider it unethical. This may justify the existence of this relationship.

Among demographic variables, only employment type and work experience had a significant relationship with the organizational commitment of nurses. As employment contract type changes from formal to contractual, nurses’ organizational commitment decreases. The highest organizational commitment was detected in nurses with more work experience. The results of the present study were consistent with the results of the studies conducted by March and Simon ³⁰ and Raisi et al. ³¹ on the relationship between socialization and organizational commitment in nurses in Isfahan. It can be attributed to the fact that with an increase in age or work experience in the organization, the employees’ chance of employment in other workplaces gets limited. This decrease in individuals’ freedom is likely to increase their commitment to the organization. Formal employment of nurses brings them a sense of security, attachment, and persistence. Therefore, they are expected to have more commitment and responsibility than short-term employed nurses. Despite the high value of this finding, further studies that are designed for this purpose are needed in this field.

Conclusion

The results of the present study demonstrated a good level of moral intelligence and organizational commitment, as well as a positive correlation between moral intelligence and organizational commitment in nurses working in Arak hospitals. Ethical concepts are seemingly related to the organizational commitment of staff. Accordingly, given the high importance of this finding in healthcare professions, it can be of great help in promoting ethics in organizations.

According to the results of the current study, it is recommended that further studies be conducted on influential factors affecting the promotion of ethical intelligence and organizational commitment in nurses. Moreover, it is suggested to design some strategies which are in accordance with native culture to develop ethical intelligence and organizational commitment among nurses. On the other hand, since attitudes are not sustainable, the results of this study are not applicable for long periods of time. Therefore, it is recommended that the results be interpreted with caution.