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Ghaseminejad raeini M, Lakbala P. The Effect of Four Melhem's Empowerment Factors on the Empowerment of Staff in Hormozgan University of Medical Sciences, Iran. EBHPME 2023; 7 (1) :5-12
URL: http://jebhpme.ssu.ac.ir/article-1-410-en.html
Department of Health Services Management, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran , parvin_lakbala@yahoo.com
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A B S T R A C T
Background: The only sustainable competitive advantage of organizations is their employees. Capable and efficient manpower are the most important assets of organizations and communities. This will lead to sustainable development. The purpose of this study was to determine the effect of empowerment through four factors of ability (knowledge and skills, trust, motivation and communication) among the staff of Hormozgan University of Medical Sciences.

 Methods: This was a descriptive study conducted in 2017.The statistical population consisted of 485 staff members of Hormozgan University of Medical Sciences. 215 people were selected by random sampling method. Then, the authors selected samples from each job category through stratified sampling method. To collect information, the authors used a standard empowerment questionnaire based on Melhem's model in addition to the demographic section. After distributing the questionnaire; t-student test and Spearman correlation were used to determine the status of research variables and also the type and extent of the relationship between them.

Results: According to the results of t-student test, the average of all variables was more than 3 indicating the appropriate status of employees' capabilities. Moreover, the results of Spearman correlation test showed that the relationship between independent variables and dependent variables in this test was significant. All research hypotheses (main hypothesis and four sub-hypotheses) were confirmed. The results of the correlation coefficient of the relationship between knowledge and skill variables with empowerment showed a moderate intensity, while the correlation coefficient of the relationship between the variables of motivation, trust and communication with empowerment showed a low intensity.

Conclusion: Due to the appropriate status of employees' empowerment, long-term empowerment programs are proposed to enhance employees' empowerment further.

Key words: Empowerment, Knowledge, Trust, Motivation, Communication
Introduction
Today, the only sustainable competitive advantage of organizations is their employees. Capable and efficient manpower are the most important assets of organizations and communities leading to sustainable development. Therefore training human resources with
self-management ability is important. Employees' empowerment means that people are able to develop their abilities and knowledge and can use this acquired ability to achieve their individual and organizational goals. Employees are empowered to make their own decisions and manage affairs.

With the advent of positive psychology movement in the 1990s, the approach of researchers to organizational behavior changed from the negative aspects of employees' behavior to the capabilities and positive aspects of employees' behavior. The concept of empowerment has been explored by various theorists. Psychological empowerment is one of the new research topics considered by researchers in organizational behavior and human resources. In Oxford dictionary, empowerment means giving someone power or the right to do something (1). Employees' empowerment means freely allowing employees to perform and control their tasks in the best possible way (2). This can affect the behavior of employees in the job and the organization (3).
The four dimensions of psychological empowerment include meaning, competence, self-determination, and impact (4). This is an active reflection of the job role. The authors in previous studies have acknowledged that employees' empowerment leads to better organizational performance (5, 6). Therefore, employees' empowerment will lead to job satisfaction and their commitment to the organization (7-9). Moreover, Studies revealed that if the organization supports the empowerment, employees' trust and commitment to the organization will increase (9-11). Employees' empowerment can be a sign of managers' trust in employees, which leads to mutual trust in employees (9). According to Yahya Melham's research,empowerment factors (trust, incentives, communication and knowledge) make significantly affects employees' contact with the customer (12).
Employees can use their skills and abilities to meet customer needs, which will lead to customer satisfaction, and ultimately, the success of the organization (13).Therefore, organizational leaders should strive to increase employee-customer relationship by increasing employees' information, training, knowledge, and trust (14).
Accordingly, customers' orientation in organizations is defined by having qualified employees with appropriate actions and providing quality services to the customer (14).
Empowering of staff in improving the quality of customer service is also important because of diverse clients from different walks of life. Therefore, the aim of this study is to determine the effect of four factors of Melhem's empowerment on the empowerment of staff of Hormozgan University of Medical Sciences in 2017. The results of this study can be useful for Hormozgan University of Medical Sciences and other similar organizations with regard to improving capabilities of employees.

Materials and Methods
The statistical population of this research included all the employees who worked with the title of expert in university headquarters units of Hormozgan University of Medical Sciences, which was 485 individuals. The stratified sampling method (Morgan's table) was used and 215 people were selected. First, the number of people in each class was determined through stratified sampling. The employees who were present at the time of distribution of the questionnaire and were willing to answer were randomly selected for each category by the interviewer (he was a staff member of the university). Participants were from the university chancellor's office (n= 27), vice chancellor for development and resource management (n= 43), vice chancellor for cultural and students’ affairs (n= 13), vice chancellor for health (n= 43) vice chancellor for education
(n= 16), vice chancellor for research (n= 15), vice chancellor for treatment (n= 30), and vice chancellor for food and medicine (n= 28).

The response rate of the questionnaire was 180 (86 %). Data collection tool was questionnaire. The questionnaire consisted of two sections. First section included demographic characteristics like gender, age, education, work history, etc, and the second section included questions in four empowerment dimensions based on Melhem's research {trust (9 questions), motivation(9 questions), communication and knowledge (6 questions), and skills (6 questions)}. After designing the questionnaire, its face validity, was approved by experts Including 2 lecturers of the University Management Department. For the reliability of the questionnaire, Cronbach's alpha was estimated (0.780). It was 0.701 for trust, motivation 0.852, communication 0.781, and knowledge and skills 0.790.The hypotheses and sub-hypotheses of this research are as follows:
Hypotheses
Trust, motivation, communicationandknowledge, and skills affect the empowerment of Hormozgan University of Medical Sciences staff.
Sub-hypotheses
1- Knowledge and skills affect the empowerment of the staff of the University of Medical Sciences
2- Trust has an effect on the empowerment of the staff of Hormozgan University of Medical Sciences
3- Motivation has an effect on the empowerment of the staff of Hormozgan University of Medical Sciences
4- Communication has an effect on the empowerment of the staff of Hormozgan University of Medical Sciences.
In order to test each hypothesis, Spearman correlation test was used due to the non-normality of the data.
Data were analyzed in SPSS16. Student's t-test and Spearman correlation were used to determine the status of research variables in the sample and also to determine the type and degree of the relationship between them.
This research has been approved with ethics code of HUMS.REC.1396.175from Hormozgan University of Medical Sciences. All stages of data collection have been done with the permission and informed consent of the participants.

Results
Table 1 shows the results of demographic information of the study population. Findings revealed that the majority of participants in this study were women (71.100 %). The age distribution of employees showed that the highest age distribution was related to the age group of 31 to 40 with 51.100 %. Forty nine percent (49 %) of the population had a bachelor's degree, and 33 % had a master's degree.
The authors used Kolmogorov-Smirnov (KS) test to perform statistical analysis and ensure the distribution of research data. KS test revealed that Data in all dimensions of the questionnaire was
not normally distributed. The results of Kolmogorov-Smirnov test for the variables of empowerment, trust, motivation, communication and knowledge, and skills, were obtained as 0.008, 0.000, 0.000, 0.047 and 0.000 (Table 2). Therefore, non-parametric tests were used to analyze data. The results showed that all variables had an average of more than 3. The mean score of the variables of empowerment, trust, motivation, communication and knowledge, and skills were 3.140, 3.600, 3.590, 3.290 and 3.210.

Table 3 shows the results of data analysis using the student's one-way t-test. Given that the questionnaire was based on a 5-point Likert scale, the authors considered mean score to be 3. The significant level of empowerment, trust, motivation, communication and knowledge, and skills was less than 0.050; therefore, the null hypotheses were rejected, and the alternative hypotheses were approved. The higher and lower limits of the 78% confidence interval were both positive. So, the mean score of answers were more than 3.This means that the status of staff empowerment in the HUMS (Hormozgan University of Medical Sciences) was at a suitable level.
In order to test each hypotheses, researchers used Spearman correlation test due to the non-normality of data (Table 4). According to this, there was a moderate correlation between knowledge and
skills and employees' empowerment (r= 0.354,
P-value= 0.000). Spearman correlation test showed that there was a poorly significant correlation between trust  and employees' empowerment
(r= 0.221, P-value= 0.003). Also, there was a poorly significant correlation between motivation and employees' empowerment (r= 0.251, P-value= 0.001). Furthermore, there was a poorly significant correlation between comunication and employees' empowerment (r= 0.294, P-value= 0.000).

In general, the results showed that the studied variables were at an appropriate level. Additionally, there was a significant correlation between the four factors of Melhem's model and employees' empowerment. But,the intensity of this relationship was only moderate for the variable of knowledge and skills, and in other cases, there was a poor intensity (Table 4).
Table 1. Demographic characteristic of the study sample
Variables No Percentage
Education level
Diploma
12 7.00
Associate diploma 11 6.00
Bachelor's degree 88 49.00
Master's degree 60 33.00
Ph.D. 4 2.00
Others/ No answer 5 3.00

SEX
Female 128 71.11
Male 47 26.11
No answer 5 2.78

Age
20-30 19 10.55
31-40 92 51.11
41-50 46 25.56
51-60 11 6.11
No answer 12 6.67

Work experience
< 5 14 7.78
5-14 76 42.22
15-30 80 44.44
No answer 10 5.56

Table 2. Kolmogorov-Simonov test for normality data distribution 
Variables Mean df 95 % confidence interval of the difference Sig. (2-tailed)
Lower Higher
Empowerment 3.14 0.47 1.43 4.55 0.008
Trust 3.60 0.51 2.00 5.00 0.000
Motivation 3.59 0.60 2.00 5.00 0.000
Communication 3.29 0.46 2.30 4.40 0.047
Skill and knowledge 3.21 0.55 1.20 4.60 0.000


Table 3. One-sample t-test for compare average answers of the respondents empowerment
Test Value = 3
Variables Sig. (2-tailed) Mean
difference
95 % Confidence intervalof thedifference
Higher Lower
Empowerment 0.0000 0.1410 0.0717 0.2104
Trust 0.0000 0.5972 0.5229 0.6715
Motivation 0.0000 0.5958 0.5071 0.6846
Communication 0.0000 0.2895 0.2226 0.3565
SkillandKnowledge 0.0000 0.2060 0.1246 0.2875
Table 4. Spearman correlation test for check research hypotheses  
Spearman correlation test Independant variable empowement Status
 Staff  empowerment(4 factors) r 0.425 Moderate
P * 0.000
Knowledge andskill r 0.221 Moderate
P 0.003
Trust r 0.354 Poor
P 0.000
Motivation r 0.251 Poor
P 0.001
Comunication r 0.294 Poor
P 0.000
* P_value ≤ 0.010
Discussion
Results suggest the significance of the relationships between independent and dependent variable in this study. Therefore, all theresearch hypotheses (the hypothesis and four sub-hypotheses) have been confirmed. This is consistent with previous studies in the field of empowerment (4, 12, 15, 16). The value of Spearman's correlation coefficient in this study indicated a moderate relationship between knowledge and skill variables and empowerment. But this relationship was weak in other empowerment variables, such as motivation, trust and communication.
The results showed that all the variables are above the mean of 3 and since the questionnaire options were all five-point Likert scale (from 1 to 5), their level in the statistical sample can be considered appropriate.Itseems that due to the appropriate status of research variables in the statistical sample, immediate action is not necessary to modify the current situation and human resource management. This university can continue its long-term programs in order to empower employees. Results indicated the significance of the relationship between independent variables and dependent variables in this test. Therefore, all research hypotheses have been confirmed. This is consistent withprevious studies in the field of empowerment (4, 12, 16, 17). The relationship between Melham's modeland knowledge and skills is moderate, and forother variables, namely motivation, trust and communication, are poor.
There is a direct relationship between
knowledge and skills and staff empowerment
of Hormozgan University of Medical Sciences, which was moderate. These results are similar of the  studies conducted at Blanchard Empowerment model and others (15-18). The highest correlation between the four variables and empowerment belonged to knowledge and skills. The reason for this can be the university environment of research and communication and constant interaction of staff with professors and students. This has motivated employees to continue their education and acquire knowledge and skills.

According to the results in Spearman correlation test, there is a direct and significant relationship between trust and empowerment of staff of Hormozgan University of Medical Sciences which is verylow.The results of our study were similar to the results of Damar et al. (19) and Velthouse& Thomas et al. (4) studies. The poorest correlation between the variables studied in this study is related to trust. According to the author, since the studied society is a part of the general society of the country, the result can be a reflection of distrust in society. Researchers expected that the effect of trust on employees' empowerment would be higher due to the prevailing atmosphere of cooperation between employees.But,this result is contrary to their expectations and has the poorest correlation with employees' empowerment.
There is a poor,direct, and significant relationship between motivation and staff empowerment of Hormozgan University of Medical Sciences.The results are consistent with what has been achieved in the empowerment model of the Iranian Human Resources (20). Based on the results of the study by Zahrani et al. (15), motivation has not had much effect on the empowerment of university's employees. Although the correlation is significant and positive, it is poor. It seems that the administrative procedures of promotion, reward, etc., which are planned in the human resources department of Hormozgan University of Medical Sciences, do not motivate employees. In this regard, there is a need for further study and research in order to be able to implement motivational plans in the organization with more confidence.There is a direct relationship between the above two variables, namely communication and staff empowerment of Hormozgan University of Medical Sciences, and this relationship is significant, which indicates a veryweak relationship.
The results in this field are consistent with other studies (21, 22). It seems that establishing communication between employees creates empowerment in them. Professors and highly educated people in the study populationcan be one of the reasons. Because these people better understand the value of information sharing through formal and informal communication.

Conclusion
Due to the appropriate status of employees' empowerment, long-term empowerment programs are proposed to further enhance employees' empowerment. Considering the positive and significant relationship between the variables of knowledge and skill, trust, motivation and communication with the empowerment of employees, solutions should be considered to improve the status of independent variables in Hormozgan University of Medical Sciences. Also, developing an integrated program to improve the level of variables of trust, knowledge and skills, motivation and communication to simultaneously improve effective variables in the organization will have an impact on the empowerment of employees of Hormozgan University of Medical Sciences.

Acknowledgements
This paperis a part of Master's theses conducted by Manochehr Ghaseminejad- Raeiniin execuative managent of Islamic Azad university of Bandar Abbas , Iran.The authors thank all the participants takingpart in the study.

Conflict of interests
The authors declared no conflict of interests.

Authors' Contributions
Lakbala P and Ghaseminejad raeini  M designed research; Ghaseminejad raeini M conducted research; Lakbala P and Ghaseminejad raeini M analyzed data; and Lakbala P and Ghaseminejad raeini M wrote the paper; Lakbala P and Ghaseminejad raeini M had primary responsibility for final content. All authors read and approved the final manuscript.

Funding
Non applicable.

 
Type of Study: Original article | Subject: General
Received: 2022/09/19 | Accepted: 2023/03/28 | Published: 2023/03/30

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