Impact of Job Clarity on Nurses ‟ Job Satisfaction : A Moderating Role of Fairness Perception

The main objective of this study was to ascertain the impact of job clarity on nurses‟ job satisfaction in the public hospitals of Sindh province of Pakistan. The results presented a valid and reliable measurement model so that a structural model could be built upon it for testing research hypotheses. Results indicate that job clarity has an insignificant impact on job satisfaction among nurses in Pakistan. Moreover, the fairness perception does not moderate; rather, it is found to be a strong predictor of nurses‟ job satisfaction. In other words, people have a lack of clarity about tasks, roles, and responsibilities, often end up affecting their outcomes. Therefore, it is recommended to strengthen the element of fairness in jobs to boost job satisfaction. HR policies and general policy makers in the organization have a greater role in this regards to ensure that the work and task are divided on fair grounds and so the rewards.


Introduction
Nowadays healthcare system plays a vital role in the development and strengthening of the nation`s wellbeing across the globe (Swayne, Duncan, & Ginter, 2012).The healthcare sector not only serves the basic needs but also provides opportunities for economic expansion (Mahmud & Parkhurst, 2007).According to the Deloitte recent annual report, the global healthcare sector is becoming increasingly competitive where there is a growing need for a committed workforce (Deloitte, 2015).Along with this, job clarity is also a very important and crucial factor while predicting job satisfaction.According to Zeffane and Al-Zarooni (2008) job clarity is how individuals can clearly outline their job roles, expectations and responsibilities in the organization.Job clarity denotes to how employees have been communicated and guided towards the assigned responsibilities and what is expected from them in return (Jansen, Kerkstra, Abu-Saad, & Van Der Zee, 1996).
According to the World Bank database (2016), Pakistan ranks 6 th in the world in terms of population and is listed amongst the under-developing economies.With a population of more than 191 millions, the nation is striving yet struggling in providing basic services and facilities to its people including healthcare, education, food, and security.Especially when it comes to health services, the majority of the population has no access to basic health facilities (Bhatti, Islam, Mirza, & Hadi, 2015).In Pakistan, the health care sector is expanding since the last decade.The healthcare sector comprises both public and private sector hospitals whereby, there are around 1,142 hospitals, 5,499 dispensaries, 5,483 basic health units as per government report (Pakistan Economic Survey, 2015-16).According to the recent report, there are 90,276 registered nurses (Pakistan Economic Survey 2016-17) across the country which results in 1:2104 ratios with the total population (Bhatti et al., 2015).A study by Khaliq, Rehman, and Rashid (2011) argued that nearly 42 percent of the nurses were not satisfied with their jobs in Pakistan.The issue is more severe in public sector hospitals due to no job clarity (Kumar, Ahmed, Shaikh, Hafeez, & Hafeez, 2013;Bushra, Usman, & Naveed, 2011).In Pakistan, the nursing staff has a lot of responsibilities during their job.Sometimes the nurses have to give extra time or late duties as well.They are totally responsible for the health of their patients after the patients come from some surgery or after a doctor"s treatment.Sometimes, nurses have responsibilities even more than doctors" responsibilities because their job role and job description is not clear.Their seniors ask them to stay ready for any type of task which is assigned to them during their duty time.This is one of the reasons which make them unsatisfied with their job.Therefore, job clarity is very important in every field and even in the field of nurses too for leading towards job satisfaction.
The aim of this study is examining the role of job clarity in nurses" job satisfaction with the moderating effect of fairness perception.Taken together, to bridge the aforementioned theoretical and practical gaps, a quantitative study is needed to analyze the impact of job clarity on the nurses" job satisfaction in the public hospitals of Pakistan.This study also attempts to investigate whether fairness perception moderates the relationship between job clarity and nurses" job satisfaction.The remaining part of the study consists of the following sections.Section 2 explains the literature review about the job clarity and job satisfaction.Section 3 describes the methodology.Section 4 clarifies the data analysis and discussion section, and section 5 presents the conclusions and policy recommendations.

Literature Review
Different features of representative job satisfaction have been investigated with the help of various examinations, illustrations, and observations by the the scholars.Previous empirical findings recommend that organizational work attributes such as job clarity, job autonomy, and other factors possess a considerable role in the development job satisfaction amongst the workforce (Konovsky & Cropanzano, 1991;Wright & Davis 2003;Chen, Gully, Eden, 2001;Boyt et al, 2001;Chu, Hsu, Price & Lee, 2003;Chang, Li, Wu, Wang, 2010).Therefore, prominent researchers in the area have been critically appraised in the present study.These authors have reported that job clarity is essential prospects to boost job satisfaction.In the domain of job satisfaction, organizational factors possess significant value and importance which is why, a majority of the studies have attempted to underline how factors in this category can be of prominence for businesses across different occupational settings (Boyt et al, 2001).
Job clarity represents the degree to which required details are clear about the job and how the employee/worker needs to perform his/her job in a way that enhances efficiency and avoid wasting of time (Teas, Wacker, & Hughes, 1979).In the same context, Kelly and Hise (1980) described job clarity that individual employee receives details and understanding about the job clarifying what they are expected to do and what they are not.Kim (2009) stated that job clarity is when tasks and expectations of the job are made clear to the employee.Job clarity was described as an understanding of the following role components: (a) goals of role efficiency, (b) attitude and behavior necessary for goal accomplishment, (c) role limitations, and (d) behavior predicted by those in roles counters (Meleis, 1975;Meleis & Swendsen, 1978).Job clarity is defined as an understanding of job requirements and come up with performance fulfill job requirements as individually (Brief, Schuler & Van Sell, 1981).Previous literature indicated that a high level of job clarity increases job satisfaction resulting in employees" loyalty and trustworthiness with the organization (Zeffane and Al Zarooni, 2008).Role clarity is an important factor to enhance the employee"s job performance (Locke & Latham, 2002).Role clarity reduces the unambiguity of employees and also decreases the risk of mistake during working (Ting, 1997).Furthermore, job clarity helps the employee to understand the job role.
On the other hand, lack of role clarity increases the job dissatisfaction and decreases performance (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964;Kelly & Hise, 1980).Due to lack of clarifications, the negative impact on the job ultimately affects the employee job satisfaction negatively.In the service sector, job clarity provides a chance to service providers to deliver services in a quick and better manner to their customers (Suan, & Nasurdin, 2013).Terje, Göran, and Sander (2011) also defined when a service employee having a lack of role clarity its negative impact on the outputs are likely to happen such as involved employees may offer incorrect information, which leads to the inadequate services to the customers.
Particularly, job clarity is important for employees who are performance and satisfaction focused.According to Terje et al., (2011) job clarity is also significant in the services sector.Furthermore, indicated that a high level of role clarity brings confidence in the employees to perform better and meet the requirements of the customers.Therefore, when an employees" role is clear on what they are expected to do in their job, they are more likely to look with a positive mindset towards their work and show greater zeal to provide services to their customers (Suan, & Nasurdin, 2013).Hence, an employee with a high level of role clarity is expected to deliver high-quality service to customers.
According to Troyer, Mueller, and Osinsky (2000) a higher level of job clarity, reduced the level of issues at job time.Bray and Brawley, (2002) outlined that clear role of employee motivated them to work beyond the expectation of the organization.In United Empire hospital nursing staff, Blumenthal, Lavender, & Hewson (1998) Found that reduced job clarity results in unwanted effects for both company members and for organizational efficiency.Though more common in literature, there are limited positive effects of job clarity on efficiency (Singh, 1993).In fact, some studies have even shown a negative relationship between job clarity and purpose, and subjective measure of service quality (Wetzels, De Ruyter, & Bloemer, 2000), showing that a limited amount of role ambiguity always gave the result of increased and better performance (Lyons, 1971).Locke and Latham (2002) have underlined that job clarity provides clear outlines as to what is expected thus, resulting in employees` satisfaction with the job.Notably, Zeffane and Al-Zarooni (2008) have related it with organizational structuring whereby employee functions and expectations are rooted and mapped.Accordingly, Adams and Bond (2000) studied nurses and their job clarity and found that clarity concerns are critical for them to perform in a better manner and job satisfaction.Further exploration of the literature on job clarity has underlined inconsistent findings for the construct.According to Kroposki et al., (1999), there are job clarity is correlated with employee job satisfaction whereby, Smerek and Peterson (2007) outlined that job clarity is not correlated with job satisfaction.According to Kroposki et al. (1999) that role ambiguity and lack of information about the job which negatively influences job satisfaction.A study conducted by Smerek and Peterson (2007) that staff found insignificance relationship between job clarity and employees job satisfaction.Thus, the previous literature has varying outcomes about the relationship of job clarity and employee job satisfaction.
Based on the above literature, it is clear that job clarity is very essential for analyzing the impact on job satisfaction among nurses.The contrasting results (Tumulty, et al., 1994;Kroposki et al., 1999;Adams & Bond, 2000;Smerek and Peterson, 2007) job clarity will be moderated in their relationship with nurses` job satisfaction.Hence, the current study proposes that the relationship between job clarity will be moderated in their relationship with nurses` job satisfaction.Therefore, the current literature concludes the following proposed research model and hypotheses which are as follows.

Methodology
A sample consisting of 325 questionnaires gathered from the different parts of the Sindh province of Pakistan is used in this study.The data were collected during the span of 12 months from January 2015 to December 2015) through a survey transcribed in English.After the data screening, eleven items were removed on the basis of missing values.In addition, twenty one uni-variate outliers were identified and removed from the dataset.To identify the multivariate outliers, we applied the Mahalanobis distance critical Chi-square function at p<0.001.We found thirteen multivariate outliers on this criterion.Therefore, after excluding 45 invalid responses, the final sample of 280 valid responses was used.The current study deployed a cluster sampling technique.The target population was segregated into groups based on areas and clusters (Kothari, 2004).Out of those clusters, a simple random sample from the groups was selected to respond.This was because the researcher attempted to gather the data on the number of nurses working in each hospital of Sindh province.Our sample includes all the public sector hospitals located in the province of Sindh, Pakistan.This is due to the fact that the researcher tried to acquire the data regarding the number of nurses working in each hospital of Sindh province.The current study covered all the public hospitals, located in Sindh Pakistan.Researcher requested the complete lists of nurses serving in the 43 public hospitals for conducting surveys.Notably, Sindh Health department and Health Ministry of Pakistan are the only government regulatory authorities for hospitals in the country but failed to give the Fairness Perception H1 complete details in this regard.In fact, the list was not available for two reasons.Firstly, the document was not updated, thus it could have provided inappropriate information about the number of doctors in each hospital of Sindh.The conclusions drawn in the present study are unbiased.We followed the guidelines of Dillman (1978) in fulfilling ethical standards.The present study has no biases in attaining any conclusion.The research followed the directions of Dillman (1978) in fulfilling ethical measures.The credentials of the respondents are taken care of with attention and are not biased in any way.Finally, the study is not financed by any public or private organization.

Descriptive Analysis
For a coherent discussion and rational explanation of the results and findings, it is important to have a clear understanding of the respondent"s profile which is presented in Table 1 in this study.This study collected responses from both male and female nurses working in the public hospital of Sindh.There were 146 (52.1 percent) male respondents and 134 (47.9 percent) female respondents.In addition, 90.7 percent respondents were less than 40 years of age and 63.6 percent had attended high school; only 20 respondents were having a nursing diploma, however, 72 (25 percent) respondents were also holding a postgraduate qualification.Moreover, 86 respondents (30.7 percent) possessed less than or up to five years of work experience; 112 respondents (40 percent) between 6 and 10 years; however, the sample included only 19 respondents (6.8 percent) held work experience between 16 and 20 years.
Table 1.Descriptive Statistics The measurement model was developed to determine the convergent validity, discriminant validity and construct reliability of the three latent constructs i.e. fairness perception, job clarity, and job satisfaction.The convergent validity and construct reliability were estimated by using average variance extracted (AVE) and composite reliability (CR).Whereas, the discriminant validity between the six latent variables was estimated by using two widely-used methods i.e.Fornell-Larcker and Heterotrait-Monotrait Ratio (HTMT) matrices.Table 2 also shows that the AVE of each of the five constructs is greater than 0.50 showing a good convergent validity (Hair et al., 2010).Furthermore, as shown in this table, the CR value is greater than 0.70 which shows good construct reliability (Hair et al., 2011;Hair et al., 2012;Sharif & Bukhari, 2014;Arif et al. 22016;Afshan & Sharif, 2016;Sharif & Raza, 2017;Afshan et al. 2018).Moreover, in Table 3, the square root of AVE of each latent construct (which is shown in boldface on diagonal) is also greater than its inter-construct correlations showing the evidence of discriminant validity by using Fornell-Larcker criterion (Fornell & Larcker, 1981;Molina et al. 2007).To further confirm the discriminant validity, we used another method i.e.Heterotrait-Monotrait Ratio (HTMT) matrix (see Table 4) in SmartPLS 3.0.Ramayah, Cheah, Chuah, Ting, & Memon (2016) stated "HTMT refers to the ratio of correlations within the constructs to correlations between the constructs… an estimate of what the true correlation between two constructs would be if they are perfectly measured…" (p.62), using a more stringent criterion i.e.HTMT0.85 (Henseler, Ringle, & Sarstedt, 2015;Kline, 2011).Table 4 shows that all HTMT values are less than 0.85 except 0.874 (HTMT ratio between FP and WA) which also meets HTMT0.90 threshold value (Gold, Malhotra, & Segars, 2001;Henseler et al., 2015;Qureshi, 2015;Ahmed et al. 2017;Nadeem et al 2016;Adil & Qureshi, 2016).Thus, it leads the author to conclude that the discriminant validity was established between the five constructs of this study using both Fornell-Larcker criterion and HTMT ratio methods.Table 5 provides a complete account of hypothesis testing.This table shows fairness perception has a statistically significant and positive impact on job satisfaction (0.492; p = 0.000).However, job clarity has been found statistically insignificant to predict job satisfaction (0.029; p = 0.249).In total, these two exogenous variables predict over 46 percent of the total variance in job satisfaction (R 2 = 0.46) which may be considered as "substantial" predictive accuracy of the structural model (Cohen, 1988).Also, the moderating effect of fairness perception is also insignificant on job satisfaction (-0.069; p=0.214).

Conclusion & Policy Implication
The main objective of this study was to ascertain the impact of job clarity on nurses" job satisfaction in the public hospitals of Sindh province of Pakistan.The results presented a valid and reliable measurement model so that a structural model could be built upon it for testing research hypotheses.Results indicate that job clarity has an insignificant impact on job satisfaction among nurses in Pakistan.Moreover, fairness perception does not moderate rather, it is found to be a strong predictor of nurses" job satisfaction.In other words, people who have a lack of clarity about tasks, roles, and responsibilities often end up affecting their outcomes.Clarity in the assigned role is essential to ensure that the individual is capable of achieving what he/she is destined for.In a similar manner, job clarity is crucial for employees to foster their work understanding and hence, express satisfaction with the job (Kroposki et al., 1991).In the views of Donnelly (1975), job clarity is important to help employees perform at the best of their capabilities.Without clear roles and responsibilities, an organization cannot simply expect its employees to showcase positive behaviors and outcomes (Kim, 2009).Based on the evidence from prior studies, suggesting that job clarity factor is significantly in correlation with employees job satisfaction (Kim, 2009;Reid et al., 2008), this assertion was taken forward to examine how this association results amongst nurses in public sector hospitals in Sindh, Pakistan.Keeping these theoretical evidence beforehand, the present study attempted to test job clarity and job satisfaction.The PLS path modeling approach found job clarity as a statistically insignificant predictor of nurses" job satisfaction.This might be attributed to the fact that there is a shortage of nurses in the healthcare sector of Pakistan and people who choose nursing as their profession tend to understand that they need to work hard to stay on their nursing job.Consequently, in light of the present scenario in Pakistan, male and female nurses are compelled to work as per the directions of hospital management.Besides, data were collected from the public hospitals where a large number of nurses" appointments are made based on political connections or even a phone call from a senior government official, leader of a political party, or bureaucrat.It results in nurses are least bothered about the job clarity.They tend to find their job satisfaction in other extrinsic motivators.Sometimes, the lack of clear information about job tasks results in role ambiguity that may have an undesirable impact on employee job satisfaction (Kroposki, et al., 1999).
The finding underlines the need for medical institutes to ensure that they allocate work evenly and so the reward across their workforce.Particularly for nurses, the present study has outlined that they valued fairness perception and through it, strengthened usage of job clarity features to boost job satisfaction.HR policies and general policy makers in the organization have a greater role in this regards (Weaver & Trevina, 2001) to ensure that the work is divided on fair grounds and so the rewards.The finding is crucial learning for top management and people in key authorities regarding how fairness perceptions can be strategically used as an important work factor to positively enhance employee behaviors and outcomes.There are far greater benefits of fairness perceptions that organizations need to unveil (Choi & Mattila, 2005) in order to ensure the strategic achievement of both individual and organizational objectives.

Figure
Figure 1.Conceptual Framework

Table 2 .
Factor Loading, Cronbach Alpha, Composite Reliability and Average Variance Extracted

Table 5 .
Hypothesis testing using VB-SEM