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University of Nebraska - Lincoln University of Nebraska - Lincoln
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Library Philosophy and Practice (e-journal) Libraries at University of Nebraska-Lincoln
2021
Effect of Knowledge Sharing on Nurse’s Job Satisfaction: The Effect of Knowledge Sharing on Nurse’s Job Satisfaction: The
Mediating Effect of Innovation Behavior Mediating Effect of Innovation Behavior
Ghulam Murtaza Ra>que Dr.
Assistant Professor, University of Sargodha
, ghulam.murtaza692@gmail.com
Khalid Mahmood Dr.
Professor, Institute of Information Management, University of the Punjab
, khalid.im@pu.edu.pk
Follow this and additional works at: https://digitalcommons.unl.edu/libphilprac
Part of the Library and Information Science Commons
Ra>que, Ghulam Murtaza Dr. and Mahmood, Khalid Dr., "Effect of Knowledge Sharing on Nurse’s Job
Satisfaction: The Mediating Effect of Innovation Behavior" (2021).
Library Philosophy and Practice (e-
journal)
. 6037.
https://digitalcommons.unl.edu/libphilprac/6037
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
Effect of Knowledge Sharing on Nurse’s Job Satisfaction: The Mediating Effect of
Innovation Behavior
Dr. Ghulam Murtaza Rafique1 (corresponding author)
Dr. Khalid Mahmood2
1 Assistant Professor at Department of Information Management, University of Sargodha,
Sargodha, Pakistan
2 Professor of Information Management at Institute of Information Management, University
of the Punjab, Lahore, Pakistan
Abstract
Knowledge sharing (KS) plays a vital role in increasing the innovation behavior (IB) of
employees which ultimately causes their job satisfaction (JS). The extant literature indicated a
lack of studies that determined the effect of KS at work place on JS where the mediating role of
IB was also analyzed. As, no study was conducted before on this topic considering professional
nurses as a unit of analysis, therefore, this study extends the scant literature by examining the
effect of KS on nurses’ JS with the mediating effect of IB. The data were collected from 208
currently working professional nurses at public and private sector hospitals of Pakistan using
a quantitative survey questionnaire. Equal sized convenient sampling technique was used to
select the sample from intended population. Simple linear and hierarchical regression was
applied to test the research hypotheses. The findings revealed that KS and IB had positive
significant effect on nurses’ JS. Further, IB fully mediated between the relationship of KS and JS.
This study provides empirical evidence for positive effect of KS on nurses’ IB which significantly
related to their JS. The findings suggest that health care organizations should consider the
importance of KS to enhance innovation capabilities of their employees so that they could be
satisfied with their job, and provide quality care to the patients.
Keywords: Knowledge sharing; Knowledge sharing; Innovation behavior; Job
satisfaction; Nurses; Health care; Hospitals; Lahore; Pakistan.
1
Rafique & Mahmood Effect of KS on JS through IB
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Introduction
Knowledge sharing (KS) is an effective strategy to achieve collaborative benefits in all
types of organizations including healthcare sectors. It has become a vital element of
knowledge management (KM) contributing a lot in individuals’ learning and organizations’
development in todays’ knowledge-based societies. KS is a process of exchanging
individuals’ tacit and explicit information, knowledge, ideas, skills, and experiences that
facilitate innovation at workplace (Wang and Noe, 2010). Previous studies illustrate that KM,
specifically KS, is an imperative antecedent of innovation (Nonaka, 2008). KM and
innovation, mutually correlated and potential factors, play a crucial role to increase
employees’ job satisfaction (JS) by reducing their turn over (Castaneda and Cuellar, 2020;
Kucharska and Bedford, 2019; Kurniawan, et al., 2020; Lei et al., 2019; Malik and Kanwal,
2018; Usmanova et al., in press; Zhao et al., ahead-of-print). Innovation management has
received a considerable attention of researchers and even practitioners over last three
decades, and they accepted it as a driving force for individual and organizational survival,
sustainability, and economic growth (Drach‐Zahavy et al., 2004; Freeman and Soete, 1997;
Yu et al., 2013). Simply, it can be defined as “the generation, acceptance and implementation
of new ideas, processes, products or services” (Thompson, 1965, as cited in Kamaşak and
Bulutlar, 2010, p. 308).
With relation to KS, a several organizational and individual variables are and have
been investigating over time. However, JS and innovation behavior (IB), the
2
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most researched variables in the field of organizational behavior and psychology (Rafique
and Mahmood, 2018; Yiu et al., 2019), have not yet been explored with KS in healthcare
sector, especially in Pakistani context. Previous studies have also empirically proven the
impact of KS on JS (Almahamid et al., 2010; Kianto et al., 2016; Koseoglu et al., 2010) and on
IB (Kang and Lee, 2016; Nguyen et al., 2019; Wijngaards, 2016) of employees working in
different organizations. But, none of the study examined the effect of KS on JS through
mediating innovation, nor selected professional nurses as a unit of analysis. Therefore,
keeping in view the importance of topic, the present study is designed with an aim to
examine the effect of KS on JS of nurses in Pakistan while examining the mediating role of
their innovation.
Related Literature and Hypotheses Development
Knowledge Management and Knowledge Sharing
Knowledge management is an important element of any type of organizations for
sustainable development. It is defined as “a process of collecting and identifying valuable
information (i.e., knowledge acquisition), enabling employees to recover organizational
knowledge (i.e., organizing knowledge), exploiting and beneficially applying knowledge (i.e.,
knowledge leverage), disseminating it through the whole organization (i.e., Knowledge
sharing) and storing the knowledge in a repository (i.e., organizational memory)” (Trivellas
et al., 2015, p. 239). KM embraces two types of knowledge i) tacit/implicit, and ii) explicit
knowledge. The second type of knowledge comprised upon knowledge that could be codified
and transferred from one individual
3
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Library Philosophy & Practice 2021
to another as it exists in print format (documents and databases). Whereas, the first one is
knowledge which is difficult to communicate, store, and/or organize as it resides in
individuals’ minds (Nonaka, 1994). Therefore, most of the organizations, either corporate or
health-care, are investing their efforts to manage tacit type of knowledge in order to fully
implement KM practices and to gain maximum benefits from it. One of a widely discussed
and crucial aspect of KM is KS (Bock and Kim, 2002) that encompasses social interactions
and interpersonal relationships. Essentially, it is an activity of exchanging and combining
one’s knowledge, ideas, practices, and expertise with others (Serban and Luan, 2002).
Knowledge Sharing and Innovation
KS is a strong enabler of innovation and its absence impede innovation. Exchanging
of ideas, knowledge, and skills leads towards creation of innovative ideas (Kremer et. al.,
2019). Organizations that increase their involvement in sharing knowledge of employees
tend to strengthen their innovative capabilities. KS helps individuals by developing various
innovative approaches to meet with problems encountered at workplaces, and thus enhance
their innovative capabilities and work performance (Belso and Diez, 2018). KS-innovation
relationship is and has been studying widely since last five decades. The first known
empirical study that determined the relationship between these two variables came into
scholarly literature in 1973, as Castaneda and Cuellar (2020) claimed. Further, empirical
evidences confirmed a strong association between KS and innovation (Darroch and
4
McNaughton, 2002). The extant literature revealed the effect of KS on innovation behavior
and capabilities of employees working in various types of organizations. For instance, Zhao
et al. (ahead of print) confirmed that outbound sharing of knowledge improved innovation
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
capabilities of employees. Similarly, Ratasuk et al. (2020) revealed that employees exhibiting
a greater amount of KS with colleagues received a high amount of innovative capabilities.
Wijngaards (2016) found a strong effect of knowledge donation (one of a key aspect of KS)
on innovative work behavior of employees. Likewise, Nguyen et al., (2019) found a
significant effect of employees’ willingness to donate and collect knowledge on their
innovative work behavior. As KS among employees occurs; their IB, practices, and/or
capabilities increases together with the increase in competitive advantage of organizations
(Cavusgil et al., 2003; Mura et al., 2013; Podrug et al., 2017). Kim and Park (2017) supported
this notion and found that employees engaging in sharing of knowledge and expertise
improved their level of innovation behavior which instigated overall advancement of
organizations.
In clinical nursing setting, it is also evident that KS is significantly associated with
nurses’ innovation (Moon, 2005). Li‐Ying et al. (2016) investigated the effect of KS behavior
of intensive care unit nurses on their innovation behavior. Their findings showed that three
types of KS: KS through written contributions, organizational communication, and personal
interaction positively correlated with innovation behavior of ICU nurses. Another study was
conducted by Waha et al. (2018) on
5
Malaysian nurses and found a positive significant association of nurses’ tacit KS with their
innovation behavior. Although, a plenty of studies have been carried out on KS-innovation
relationship and the amount is still increasing, however, a scarcity of published research
could be observed in healthcare setting. Therefore, due to the dynamic association between
KS and innovation, following hypothesis is established.
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
H1 – Knowledge sharing impacts positively on innovation behavior.
Knowledge Sharing and Job Satisfaction
JS is an important element of employees’ attitude and has been defined in several
ways over years that indicates its value at workplace. About 85 years ago, the concept of JS
clearly came into front after the work done by Hoppock (1935). Later, a considerable
attention of researchers from the field of Psychology, Business, and Human Resource
Management has been paid to define and explain this concept (Rafique and Mahmood, 2018).
Lock (1976) defined it as a positive or negative attitude of workers towards his/er job.
According to Spector (1997), it is a state of mind, personal feelings, and complex indicator of
emotional well-being of employees about their work. Saeed (2016) elaborated this concept
as:
The difference between what an employee expects from job and what he/she
actually gets from job. When an employee’s expectations from job are less or
equal to what job actually delivers in return, employee is satisfied. On the
contrary, job dissatisfaction results when individual’s expectations are higher
from what the job actually delivers to him/her. (p. 16)
6
JS and KS, the critical elements for employees’ development, have positive association
with each other, therefore, in literature, these two variables are discussed together (Jacobs
and Roodt, 2007). KS and JS play a dynamic role to obtain organizational goals at micro and
macro level. Inter-personal and intra-personal sharing of knowledge leads towards JS which
in turn causes the development of overall organizational performance. Wu et al. (2013)
identified that when employees collaborated with each other by sharing their ideas,
knowledge and skills, they got more chances of promotion which resulted in higher level of
JS. Based on an extensive review of published literature in psychology, organizational
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
behavior, sociology, and educational literature, Rafique and Mahmood (2018) put forth the
view that KS and JS are core influential factors that are strongly associated with each other.
Other studies have also confirmed the association between KS and JS (Kucharska and
Bedford, 2019; Zamir, 2019). Among these studies, mostly were conducted in the field of
organizational behavior (Spector, 1985), however, this phenomenon has rarely been
approached through healthcare setting (Rafique, 2020), specifically in clinical nursing in
Pakistan. Therefore, this hypothesis is framed out.
H2 – Knowledge sharing exerts a significant positive impact on job satisfaction.
Innovation and Job Satisfaction
Innovation has been recognized as a critical element for individual, organizational,
and economic development (Freeman and Soete, 1997). Yu et al., (2013) depicted that
organizational survival and sustainability were linked to the
7
innovation capabilities of employees. The main purpose of innovation is to create new
knowledge to find out feasible solution(s) of the issues at work place by utilizing existing
knowledge and cognitive approaches (Harkema, 2003). This term has been defined in
different ways by various researchers and practitioners, for instance, Barnett (1953) defines
it as something that is new. According to Scott and Bruce (1994), it is "… a process involving
both the generation and implementation of ideas” (p. 606). McSherry and Douglas (2011)
are in view that innovation is regarded as ‘practicing’ for gaining new skills. In nursing
perspective, they define it as:
the encouragement of professionals to utilize their acquired knowledge and
skills to creatively generate and develop new ways of working, drawing on
technologies, systems, theories and associated partners/stakeholders to further
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
enhance and evaluate practice. Innovation in practice is imperative in order to
improve patient safety and quality care; it does not and will not occur in isolation
requiring investment, support and resource allocation from managers, leaders
and governments. (p. 165)
Innovation is a strong predictor of JS (Lee and Ha, 2018; Wei et al., 2020). Mayfield et
al. (2020) identified that innovative work environment bosted the satsfaction level of
employees with their job. Similarly, Jamshed and Siddiqui (2019) confirmed that
organizational innovative culture enhanced JS of employees. Loyola (2019) indicated that
there was a very strong relationship between JS and emloyees’ innovation. The satisfied
workers develop various innovative approaches to meet with problems encountered at
workplaces, and enhance their innovative capabilities and
8
work performance. Han et al. (2010) were in opinion that IB of clinical nurses and the level
of their JS were correlated with each other. Likewise, Barchielli et al. (2019) conducted a
study on Italian nurses and concluded that innovation was a strong leverage factor for their
JS. The research on innovation-JS relationship has been grasping the attention of many
scholars in the field of management sciences and social behavior during last few decades.
However, the studies investigating the relationship between these two variables (innovation
and JS) in healthcare sector are meager especially within developing countries’ context like
Pakistan. This research, thus, proposed the following hypothesis:
H3 – Innovation behavior positively influences nurses’ job satisfaction.
Knowledge Sharing, Job Satisfaction, and Innovation
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
KS may be seen as a precursor of IB which in turn may be considered as an antecedent
of critical work outcome such as JS (Lin, 2006). This argument is also partially supported by
Tufail et al. (2016) who concluded that KS and its practices among employees are related
with JS playing as mediatory role in between social support and innovation. Further, it is also
evident that KS mediated between IB and JS (Tarigh and Nezhad, 2016) and hereafter IB
impacted JS of employees. However, such literature is scarce discussing the role of
innovation as mediator in relation between KS and JS of professional nurses, therefore, the
following research hypothesis is developed.
H4 – Innovation behavior mediates the relationship between KS and JS.
9
On the basis of above-mentioned hypotheses, following conceptual model is
proposed.
Figure 1. Conceptual model of the study
Research Method
Design – To examine the effect of KS on JS of intended population and the role of IB as
mediator, a cross-sectional quantitative approach using a survey method was opted.
Population, Sample, and Data Collection – All the hospitals in Pakistan can be divided into
two main sectors: the public and the private sector. Thus, the population frame of this study
Knowledge
Sharing
Job
Satisfaction
Innovation
Behavior
H1
H2
H3
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
was consisted on currently working professional nurses at both public and private sector
hospitals of one of a second largest populous cities of Punjab, Pakistan i.e. Lahore
(11,126,285 individuals). Lahore is selected as a study setting, because majority of public
and private sector hospitals are situated in this metropolitan city than other cities of
Pakistan. Second, due to time and resources constraint, this city was chosen as a place of
study. Equal size sampling technique was used to select the sample size from the intended
population (50 from each
10
hospital). A sample of 300 voluntary participants were approached through a personally
administered survey questionnaire after getting a permission from administrative head of
each hospital. A total of 242 questionnaires were received back after several follow-ups, out
of which 14 incomplete and poorly filled questionnaires were dropped out. Thus, 228 (76%)
useable questionnaires were entered into SPSS-22 for preliminary data analysis.
Measures
The survey questionnaire was comprised on two sections; the first section covered
the questions about demographic aspects of the respondents e.g. hospital type, gender, age,
designation, and their experience as a professional nurse. While, in the second section of the
survey, pre-validated scales were adopted to measure the study variables (KS, JS, & IB). The
detail of each scale is as follows:
Knowledge sharing – This construct was measured by adopting the scale developed
by Collins and Smith (2006) having eight items. It measured KS attitude, associated perceived
benefits, and KS related self-efficacy on five-point Likert scale ranging from strongly disagree
to strongly agree. The sample item is: “I see benefits in exchanging and combining ideas with
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
one another”. Internal consistency reliability of this scale was 0.91, as reported by its
developer.
Innovation Behavior – Innovation behavior of the respondents was determined by
Scott and Bruce (1994) 06 items scale. The sample items are: “I search
11
out new technologies, product, processes, techniques, and/or ideas” and “I generate creative
ideas”. Scott and Bruce (1994) reported the Cronbach's alpha for the innovation behavior as
0.89.
Job Satisfaction – To study JS of participants, Job Satisfaction Scale for Nurses by Ng
(1993) was used. This scale used 24 items assessing seven facets of JS (Administration, Co-
worker, Career, Patient care, Relationship with supervisor, Nursing education,
Communication). The example items are: “I know that the hospital administration is there to
back nurses up” and “There are enough opportunities on my unit for developing my
professional skills”. Internal consistency reliabilities of this scale reported by Ng (1993) was
0.84.
Reliability of measures – Internal consistency of the measures were assessed
through Cronbach’s Alpha value. The alpha value for KS was .755, while α was .799 and .822
for JS and IB respectively. All values were in the acceptable range of α > .70 showing a good
internal consistency between the items according to the criteria given by Frankfort-
Nachmias and Nachmias (2008).
Table I: Descriptive statistics, internal consistency reliability, KMO, and correlation matrix
Variable
M
SD
Cronbach’s alpha
KMOa
KS
JS
IB
Skewness
Kurtosis
KS
3.70
.557
.755
.782
1
-.210
.577
JS
3.30
.319
.799
.756
.219**
1
-.183
.328
IB
3.69
.609
.822
.757
.379**
.451**
1
-.654
1.636
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
**. p < 0.01
a. Kaiser-Meyer-Olkin (KMO) measure for sampling adequacy (N=208)
12
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
Data Analysis, Results, and Findings
Preliminary Data Analysis
The study deployed statistically robust procedure to analyze the collected data using
Statistical Package for Social Sciences (SPSS) version 22. The collected data were prepared
for testing of underlying hypotheses by dealing with missing and extreme values (outliers),
determining the normality of and multicollinearity among variables. The presence of any of
these issues may negatively impact the study findings (Tabachnick and Fidell, 2007).
Therefore, to avoid any potential negative effect on study findings, the present study met all
the pre-requisite assumptions by replacing the missing values with mean of respective item
(suggested by Hair et al., 2006). Further, outliers were examined to evade any increase in
variability (Cousineau and Chartier, 2010), and, thus, identified outlying cases were removed
by Stem-and-Leaf method (Sekaran, 2003) which results in decreasing of 20 cases that were
not useable for further analyses. To determine the normal distribution of data, standardized
range of Skewness (±1) and Kurtosis (±3) were calculated (Byrne, 2010) and the resulting
values of Skewness and Kurtosis of all the variables were in acceptable range. Further, the
graphical representation (histogram) of study variables showed that mostly frequencies
positioned within the boundary wall of bell-shaped curve that represented a good symmetry
in data (Figure 2). P-Plots also observed that all the frequencies were near to regression line
which indicated that
13
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
the data were normally distributed (Figure 3). Using the suggestions of Hair et al. (2006),
multicollinearity was examined through bivariate correlation which were well below 0.85
for all study variables (Table I).
Since the study collected data of independent and dependent variables from the same
participants, therefore, there may possibly associate the issue of common method bias
(CMB) with the data (Podsakoff et al., 2012). The study thus applied Harman’s single factor
test (Harman, 1976) and the results extracted 14.77% of the total variance (far less than 50
percent) confirming that there was no threat of CMB in the study’s data.
Figure 2. Histogram Figure 3. Normal P-Plot of
Regression Standardized Residual
Demographic Profile of the Respondents
A total of 208 (effective response rate = 69.3%) cases were useable for data analysis
after achieving above mentioned criteria. The results showed that mostly
14
participants (n = 162, 77.9%) were working in public sector hospitals, while 46 (22.1%)
were from private hospitals. Majority of the study participants were female (n = 188, 90.4%);
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
whereas 20 (9.6 %) were male, of which mostly were working in private sector hospitals.
Further, it revealed that majority participants (n = 112, 53.8%) fall in age bracket of up to 30
years, while only 09 (4.3%) were from age of more than 51 years. Mostly participants (n =
143, 68.8%) were designated as charge nurse followed by head nurse (n = 43, 20.7%), nursing
superintendent (n = 10, 4.8%), and nursing supervisor (n = 06, 2.9%). A total of 109 (52.4%)
respondents had experience of up to 5 years as professional nurse, while 41 (19.7%) had
professional experience of 6-10 years. Only 10 (4.8%) respondents were mostly experienced
having more than 25 years of experience (Table II).
Descriptive Statistics, Internal Consistency Reliability, KMO, and Correlation Matrix
Table I showed descriptive analysis (mean and SD), internal consistency reliability of, inter
correlation between the study variables, and KMO measure for sampling adequacy. The
results of descriptive statistics revealed that participants agreed on sharing their knowledge
with others (M = 3.70, SD = .557) and being innovative at work place (M = 3.69, SD = .609),
however, their feelings were week. About the extent of satisfaction towards their job, their
opinion was neutral (M = 3.30, SD = .319). Pearson’s Moment Correlation was applied to test
the association between the study variables (KS, JS, and IB) and results showed that KS was
positively correlated with
15
Rafique & Mahmood Effect of KS on JS through IB
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Table II: Respondents’ profile
SN
Demographic Variables
Frequency
Percent (%)
1
Hospital type
Public sector
162
77.9
Private sector
46
22.1
2
Gender
Male
20
9.6
Female
188
90.4
3
Age
Up to 30 years
112
53.8
31-40
52
25.0
41-50
35
16.8
51 years and above
9
4.3
4
Designation
Charge nurse
143
68.8
Head nurse
43
20.7
Deputy nursing superintendent
1
.5
Nursing superintendent
10
4.8
Nursing supervisor
6
2.9
Assistant director nursing
4
1.9
Deputy chief nursing superintendent
1
.5
5
Experience as a professional nurse
Up to 5 years
109
52.4
6-10 years
41
19.7
11-15 years
14
6.7
16-20 years
18
8.7
21-25 years
16
7.7
26 years and above
10
4.8
Total
208
100
JS (r = .219**) and IB (r = .379**) at p < 0.01, whereas JS was also significantly associated with
IB (r = .451**) at the same significant level. Cohen’s criterion (1988) was used to determine
the strength of association (correlation effect size) between these variables. The criterion is:
0.10 = small, 0.30 = medium, and 0.50 = large. Hence, it can be concluded that all the variables
in this study were positively correlated with
16
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each other, however, their strength of association was medium.
Principal Component Analysis (PCA) was run with varimax rotation and results
confirmed the uni-dimensionality of all three scales used in this study. One of the principal
components of KS explained more than 39% of the total variance explained, and similarly,
for JS and IB, its values were 21% and 53% respectively. Kaiser-Meyer-Olkin (KMO) measure
was applied to determine whether sample was adequate and the resulting values for each
variable showed that the sample size for the present study was sufficient (acceptable > .50)
(Table 1). Bartlett's Test of Sphericity based on correlation was also significant at p < .001
for all scales in this study.
Hypotheses Testing
The proposed hypotheses were tested determining the direct and indirect effect (with
the mediating role of IB) of KS on JS. For direct effects analysis, simple linear regression was
run considering KS as independent while JS and IB as dependent variables. The results
indicated that KS had significant and positive effect on JS (β=.125, p=.001) and IB (β=.414,
p=.000). Thus, H1 and H2 are supported. Whereas, IB also influenced JS significantly well
(β=.236, p=.000) supporting H3 (Table III).
17
Table III: Path Coefficient among variables
Hypothetical relationship
β
p-value
Results
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Library Philosophy & Practice 2021
KS → JS
.125
.001
Supported
IB →JS
.236
.000
Supported
KS → IB
.414
.000
Supported
Test of Mediating Effect. To test the mediating effect of IB between the relationship of KS
and JS, three steps hierarchical regression method was applied by Baron and Kenny (1986).
However, before applying this technique, it’s all three prerequisites were fulfilled. These
prerequisites are: “a). Predictor should have a significant association with predictand; b).
Predictor should have a significant association with the mediating variable; and c).
Table IV: Hierarchical regression analysis
Variables
Model 1
Model 2
Model 3
β
p-value
β
p-value
β
p-value
Control variables
Hospital type
.161
.002
.132
.009
.075
.125
Gender
-.139
.053
-.192
.008
-.139
.043
Age
.045
.218
.066
.070
.048
.158
Designation
-.038
.046
-.034
.069
-.013
.490
Experience
.023
.290
.009
.671
-.004
.856
R2
.102
Independent variable
KS
.132
.000
.058
.132
R2
.151
Ϫ R2
.049
Mediating variable
IB
.185
.000
R2
.240
Ϫ R2
.089
18
The mediating variable should have a significant association with the predictand”. In the
present study, IB mediates the relationship between KS and JS, and hence it fulfills above
stated all three conditions given by Baron and Kenny (1986).
Rafique & Mahmood Effect of KS on JS through IB
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In the first model, using three steps hierarchical regression analysis, all the
demographic variables (hospital type, gender, age, designation, and experience) are dealt as
control variables to control their effect. In the second model, a significant positive effect of
KS was observed on JS (β= .132, p=.000). While in the third model, when IB was introduced
as a mediating variable, the effect of KS on JS decreased from 0.132 to 0.058. This effect was
observed insignificant (p =.132 > .05) after adding IB as mediator (Table IV). However, the
coefficient value of IB in third model noted as significant (β= .185, p < .001). This showed
that IB of Pakistani nurses fully mediated the relationship between KS and JS. Hence, H4 was
accepted.
Figure 4. Hypothesized conceptual framework
Discussion
Probably, to the best of researchers’ knowledge, this is the first study of its kind till
now that determined the effect of KS on Pakistani nurses’ JS with the
19
mediating role of IB. This study makes significant contributions to the theories of KS, JS and
IB. In a systematic review, Rafique and Mahmood (2018) pointed out that KS was a key
antecedent impacting employees’ JS. KS-JS relationship in healthcare sector has received a
Knowledge
Sharing
Job
Satisfaction
Innovation
Behavior
β=.125***
β=.414***
β=.236***
β'=.185***
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
little attention from researchers, therefore, the present study proposed a model (Figure 1)
linking KS and JS with IB.
The findings supported all proposed hypotheses (H1-H4). The results revealed that
KS impacted IB positively. These findings are aligned with the findings of Li‐Ying et al. (2016)
and Waha et al. (2018) who concluded that KS among employees lead towards their IB. Thus,
this study supplements the empirical evidence to verify that KS among employees within
and/or across the organization(s) is an important component for employees’ creativity and
innovation. Shaari et al. (2015) opined that the elements of KS created a cohesive
environment where employees shared their field related experience, novel ideas, and job-
related knowledge with each other. They learnt a lot from one another and consequently
became innovative. KS helps healthcare professionals develop various innovative
approaches during patient care, and enhance their innovative capabilities and hence their
work performance improves. Particularly in healthcare setting, para-medical staff like
nurses need to share best and novel clinical practices with colleagues for delivery of quality
services to the patient, which leads them towards innovation. Also, due to increased pressure
on nurses to provide high quality care to patients (Flaatten, 2012), they engage themselves
in better communication and in several KS activities such as chatting in
20
the coffee room and canteen, sharing experiences that may benefit the group on nurse
meetings and other informal occasions, and/or communicating on professional online
communities (Li‐Ying et al., 2016). It results in solving several issues that they face during
routine clinical practice (Rangachari, 2008). Further, Rafique (2020) also confirmed that KS
impacted IB of Pakistani nurses positively. He found that professional nurses involved in KS
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
activities could create innovative ideas; develop and schedule adequate plans for the
implementation of new ideas; and use new technologies, products, processes, and
techniques.
Nurses always need to improve and develop themselves to deliver quality patient
care (Blakeney et al., 2009; Kalisch and Lee, 2009; van Achterberg et al., 2008) by
implementing novelties during practice (Baker et al., 2010). KS and innovation are
considered basic ingredients of JS, however, empirical evidences on how these variables
affect JS of employees are scarce (Anderson et al., 2014; Lei et al., 2019) especially of
healthcare individuals. Therefore, this study contributed to fill this theoretical gap in the
literature by proposing a research model linking KS and JS with IB. The findings divulged
that relationship between KS and JS fully mediated by IB of nurses. Although Pakistani nurses
were satisfied with their jobs by sharing their knowledge, but IB contributed considerably
in their JS. Hence, JS depended upon KS whereas IB played a mediatory role in between KS
and JS. These findings are in line with the study of Seo et al. (2004) who confirmed that highly
satisfied health care professionals with their job were innovative and provided better
medical
21
services to their patients. Therefore, building and strengthening the mutual KS trends in
health care organizations might be one of the key factors that causes their employees’ JS &
IB, and reduces turnover.
Practical Contributions
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
Based on the empirical analyses, this study provides some practical implications for
nurses’ managers, hospital administrations, and nursing schools’ management to better
understand the casual relationship among KS, IB, and JS.
The results of this study illustrate that KS strongly affects JS of nurses, therefore,
nurses’ managers should consider the importance of KS and its allied practices to foster the
inter-person and intra-person sharing of information and knowledge across the organization
to improve JS level which ultimately causes the improvement in their job performance and
wellbeing, as Suhonen and Paasivaara (2011) asserts. Further, Lei et al. (2019) have proved
that leadership support is very essential to stimulate employees’ willingness to share their
information, knowledge, and ideas. Therefore, top managers in hospitals must encourage
and provide necessary support, help, and even resources to share knowledge among
employees because sharing of knowledge and ideas improves innovation behavior and
capabilities in firms (Podrug et al., 2017). The hospitals directors, managers, and medical
superintendents should play a significant role to nurture KS by establishing a trend of
reward and incentive system for those healthcare workers who share their knowledge with
their colleagues for mutual benefits and organizational development.
22
Second, they must communicate the benefits of KS with employees.
Further, in order to provide better patient care, nurses need to improve their skills,
knowledge, and best practices, which can be achieved through innovation. So, hospital
administration should encourage the innovativeness and novelties among healthcare
professionals during clinical practices, and for the reason, they should provide such
platforms that improve their innovation capabilities so that they may able to deliver quality
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
patient care. The study, therefore, provides targeted implementation of KS practices across
the hospitals to boost IB among healthcare employees especially among nurses, one of a core
group of heath care workers.
Moreover, the top management of nursing schools should focus on developing the
critical thinking of nursing students in order to make them more innovative. Asurakkody and
Kim (2020) described it as:
Helping nursing students to think differently is needed to increase their creativity
and, help them to acquire scientific knowledge and, understand research results.
We believe that promoting innovative work behavior among nursing students
and nurses may support the development of new treatment strategies, produce
exciting future applications for health care, and encourage collaboration with
other professionals and improve the quality of patient care. (p. 2)
Limitations
The following certain limitations should be considered while interpreting the study
results. First, cross-sectional design has limitation of the change in behaviors and attitudes
over time and there is a possibility of emergence of new trends with the
23
passage of time. Therefore, a longitudinal study could be an option to overcome this
limitation. Second, equal sized convenient sampling technique was used in this study to
determine the sample which was supposed to be not representable to whole population.
Third, this study explored the mediating effect of only one factor that is IB, further studies
should be conducted considering other mediating factors for holistic results, as Li‐Ying et al.
(2016) suggested to focus on operational excellence that might increase nurses’ KS. Finally,
this study selected professional nurses working in public and private sector hospitals in
Lahore, Pakistan only as a unit of analysis, therefore, more studies are needed in other cities
Rafique & Mahmood Effect of KS on JS through IB
Library Philosophy & Practice 2021
of Pakistan choosing other health care workers in order to fully understand the relationship
of study variables. As, it also provides a cross-cultural role of KS and IB while impacting JS.
Conclusion
This study provides theoretical and practical implications for knowledge
management, organizational behavior, and innovation literature that can be used to
determine the relationship between KS, JS, and IB. The findings supported the proposed
research hypotheses and concluded that KS and IB had significant and positive effect on JS
of professional nurses. Overall, it can be concluded that KS and IB are the driving forces to
boost JS level among Pakistani professional nurses. Even though KS impacts JS significantly,
but IB also played a mediatory role to enhance JS level of nurses. By considering the
importance of KS culture, the health care organizations can enhance IB of employees so that
they may satisfy with their job, and could provide better services to the patients.
24
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