EFFECT OF JOB SATISFACTION, ORGANIZATIONAL COMMITMENT, AND ORGANISASIONAL CLIMATE ON NURSING SERVICE QUALITY THROUGH ORGANIZATIONAL CITIZENSHIP BEHAVIOR

Grace Tedy Tulak 1 , Suhermin 2 and Ujianto 3 . 1. Sekolah Tinggi Ilmu Kesehatan Kurnia Jaya Persada Palopo. 2. Sekolah Tinggi Ilmu Ekonomi Indonesia Surabaya. 3. Universitas 17 Agustus 1945 Surabaya. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History

Health-care industry paradigm currently requires hospitals providing satisfactory services to meet patients' needs and desires as well as to follow professional and medical codes of conduct. This study aimed to analyze and test the effect of job satisfaction, organizational commitment, and organizational climate on nursing service quality through organizational citizenship behavior (OCB) in the Sawerigading Palopo Public Hospital. Therefore, field survey with questionnaires was applied to collect data. It took samples of 135 nurses working in the Sawerigading Palopo Public Hospital. As the result, OCB did not mediate the effect of job satisfaction on nursing service quality. However, OCB mediated the effect of organizational commitment on nursing service quality. Moreover, OCB mediated the impact of organizational climate on nursing service quality in the Sawerigading Palopo Public Hospital.

…………………………………………………………………………………………………….... Introduction:-
The rapid growth of health care industry lead for business competition among hospitals in local market as well as international market. Hospital is an organization that provides health care services. As a service provider, hospital's service quality is one of important factors that influences customers' satisfaction. In other words, customers generally expect for having the best service quality (Zeithmal & Bitner, 1996). Hence, every hopital intends to afford satisfactory services so that its customers maintain to use the hospital for further health services.
Service quality is the measurement on how accurate has a service been accomodated by a company or service provider to meet the standard of assistant as the customers' desire. It is obvious for a company to improve its service quality by understanding and treating front-line employees promtly since they have direct contact with customers. In other words, the front-line employees are key source for a service provider.
In the health-care industry, health service paradigm obligates every hospital providing qualified services in order to meet patients' needs and desires as well as to follow professional and medical codes of conduct. The presence of nurses are vital in the hospital because they take care of patients every hour. The performance of nurses becomes the determinant of good or bad servive quality in the hospital. Instead, the nurses may do duties out of their job routines; 376 this is called by Organ (1998) as organizational citizenship behavior (OCB). This exemplied as the nurses' intention to help other nurses and to be a volunteer for extra works. Therefore, this study aimed to analyze and examine the effects of job satisfaction, organizational commitment, and organizational climate on the quality of nursing services through organizational citizenship behavior in Sawerigading Palopo Public Hospital.
Theoretical Framework:-Job Satisfaction:-Job satisfaction is basically an individual entity. So It can be different in value system between one and another employee. According to Luthans (1998:126), job satisfaction is defined as a state of positive or amiable emotion that is resulted from routines and experience in the workplace. While, Robbins (2006:63) argues that job satisfaction is a general attitude towards one's job including different amount of reward and of monetary value as compensation that employees expect to earn. Thus, each employee must have distinctive degree of job satisfaction based on his or her value system. Job satisfation is unique, impressive and essential matters for both employees and organizations. It has been considered providing enormous advantages and influences to employess as individuals and to organizations or companies. For individials, previous research results convey motives and sources of job satisfaction that are grounded as ongoing efforts to advance their life in the workplace. And for organizations, research findings recommend employers for understanding ways to improve employee performance as well as cost reduction owing to their employees' changes of attitude and work behaviour. Moreover, Wexley and Yukl (1992) confirm that job satisfaction "...is the way and employee feel about his or her job". In other words, job satisfaction is one's perception and feeling about the feature of his or her own job that is measured by himself or herself in accordance with the most current workplace situation.
Organizational Commitment:-Allen dan Meyer (1997) explain that organizational commitment can be interpreted as the emotional attachment, identification and involvement of individuals with the organization and the desire to be the member of organization. Buchanan and Boswell (2002) also argue that the response systemthat is provided by the organization is often paid less attention by employees. The response system that is aimed to capture employees' loyalty was unsuccessful because the employees are apprehensive to get sanctions when they provide complaints for the company. Thus, Coopey and Harley (1991) indicate that commitment is an individual's psychological bond to his or her organization. Mowday et al. (1982) also convey that organizational commitment relates an understanding for the emergence of exchange between individuals and workplace organization. It is common that an individual associates himself or herself with the organization in the form of salary and of other remuneration he or she receives from the organization. Moreover, organizational commitment arises not only from passive loyalty, but also from the involment of individuals who dedicate their performance for the success of organization. Allen andMeyer (1997) argue that commitment appears in various forms so that each individual may have different commitment towards the organization, the work, the boss, and the group work. Accordingly, Mowday et al. (1982) state three factors that affect an employee's commitment are described as follow: 1. The personnel characteristics include the working period withinan organization as well asthe variety of employees' needs and desires. 2. Job characteristics involve the task identity and the opportunity to interact with co-workers. 3. Working experience includesemployees' past organizational reliability and the way other workers express and talk about their feelings about the organization.
In addition, Mowday et al. (1982) proposed three concepts of organizational commitment components, including affective commitment, continuance comitment, and normative commitment. The first concept relates to emotional and psychological attachment to the organization. It also refers to desires to identify oneself towards the organization where he or she is working. The second conceptrefers to employees' awarenessin comparingthe gains versus losses for staying or leaving an organization. The condition within continuance comitment is generally influenced from some factors, such as: age, working exeprience, and intention to leave the organization. Last, normative commitment encompasses socializationexperiences between employer and employees. This emphasizesemployees to be loyal to their employer owing to compensation they receive, e.g.:educational scholarship that lead employees feel obligedto reciprocate. 1. Conformity is a feeling of restriction enforced by an organization due to external influences. In this dimension, there are various rules, procedures, policies, and regulations that need to be obeyed 2. Responsibility is a trustworthiness given to employees to accomplish particular works to meet an organization's objectives. In this dimension, the employees are recognized whether or not they are reliable to make a decision and to solve problems on each duty given without any control. 3. Standard refers to the specification to accomplish a job. It includes the implementation quality as well as production quality that have been the major priority of every organization. The standard leads a company to maintain its assertive objectives and to prioritize quality to all of its members so that the employees are able to complete the goals successfully. 4. Reward is the compensation given to employees for all jobs that have been done well. In this dimension, the employees are not only criticized, ignored and punished, but also to be rewarded. 5. Organizational clarity is the clearness of objectives and policies that have been considered by a company. So all regulaties in the company are not confusing or complicated, out of focus, and disorganized. 6. Interpersonal relationships and grouping enthusiasm (warmth and support) are drawn as the degree of one's impresson about confidentiality or closeness between people. These are important for organizational characteristic since the employees can have mutual respect and mutual help. Moreover, these characteristics can show the emergence of good relationship between employees. 7. Leadership is a specific standing within an organization. It is referred to one who can be accepted or rejected by members of an organization. Leadership should be based on expertise. A good organization should not be dominated by only one or two people.

Organizational Citizenship Behavior (OCB):-
The concept of OCB is firstly proposed by . He defines OCB as an "...individual behavior that is discretionary, not directly or explicitly recognized by the formal reward system, and that in the aggregate prompts the effective functioning of the organization. By discretionary, we mean that the behavior is not an enforceable requirement of the role or job description that is the clearly specifiable terms of the person's employment contract with the organization; the behavior is rather a matter of personal choice, such that its commision is not generally understood as punishable". Furthermore,  argues that Organizational Citizenship Behavior is an individual choice and initiative. It is not related to the formal reward system within an organization, but it is aggregate to develop the effectiveness of organization. In other words, OCB is not a part of employment qualification and of employees' job descriptions. So if OCB is not demonstrated, the employees will not given a punishment. In addition, Organ (1988) confirms for five dimensions of OCB, involving altruism, courtesy, sportsmanship, civic virtue, and conscientiousness.

Nursing Service Quality:-
Nursing service quality is essential in the health care industry. Tjiptono (2008:85) defines service quality as the assessment on how good a service has been provided to meet the customers' expectation. Accordingly, service quality is determined from an organization's capability to fulfill the demand of customers. The main factors that influence service quality are the expected service and the perception towards perceived service. Moreover, Parasuraman et al. (1998) delineate service quality as the gaps between real services that customers receive and imaginary service that customers desire to have.

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While, health service is defined as the care to community in relation to health facilities and infrastructures (Rienke, 2004:21). This includes health-care personnels, like nurses, so that the community will feel safe and secure to check their health conditions. In daily practices, the health service can be devided into two types of services, such as: Medical Services:-This type of service is described as a self-organizing unit or sole proprietorship (solo practice). It aims to Public Health Service:-This type of service is a grouping organization. Public health service aims to maintain community's health and to prevent illness of community.
Furthermore, the approach that was used in previous studies was nursing service quality with quality model. Many studies prefer using a method of SERVEQUAL (Service Quality) that can discuss and measure the determination of service quality. In some cases, the model of service quality is explored by applying five dimensions of service quality proposed by Parasuraman, Zeithaml and Malholtra (2005) involving tangibles, reliability, responsiveness, assurance, and emphaty.

Conceptual Framework:-
This study aimed to analyze strategies in improving nursing service quality. This was based on the concept of organizational citizenship behavior (OCB) and the models of job satisfaction, organizational commitment, and organizational climate in the Sawerigading Palopo Public Hospital. The concept and models were devoted into a conceptual framework that could disclose the relationships between variables. These are described below:

Hyphothesis Of This Study:-
Job satisfaction is clarified by Robbins dan Judge (2008) as one's positive attitude towards his or her job as the result of self-sevaluation in the workplace. Then, Allen dan Meyer (1990) exlain that organizational commitment refers to the psychological manifestation that characterize the relationships between an employee and the organization. In turn, organizational commitment implicates for a decision to continue or discontinue on the membership of organization. In addition, Jeon and Koh (2014) find a nurse's organizational commitment as a variable in relation to her OCB. The nurses who have higher degree of organizational commitment will accomplish not only the given duties, but also other voluntary tasks (extra effort). If nurses have higher OCB, so the efforts to control nurses will decrease since the nurses are able to maintain their own behaviour as well as to consider the best behaviour for their organizations' advantage. Moreover, Nasiripour et al. (2015) convey that organizational commitment of a nurse can improve nursing service quality. The increasing organizational commitment through the implementations of organizational values, career promotion transparency, and performance assessment can give an impact on nurses' service quality in the hospital. In addition, Meylandani (2013) and Gholami et al. (2015). show that organizational climate has positive and significant impact on the OCB development. Then, Kanten and Ulker (2013) argue that less condusive organizational climate lead for counterproductive employees. Therefore, organizational climate is an importnat factor to raise higher OCB of the nurses as well as to encourage nurses more productive to maintain their nursing service quality optimally. Following the accounts above, this study consider some research hyphothesis as follow: H 1 : Job satisfaction has a significant effect on organizational citizenship behavior. To collect data, this study applied field survey through questionnaires with Likert scales from 1 to 5 (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly disagree).

Research Results:-
This study aimed to analyze and test the effect of job satisfaction, organizational commitment, and organizational climate on nursing service quality through organizational citizenship behavior (OCB) in the Sawerigading Palopo Public Hospital. Therefore, the results of estimated analysis on structural model aee presented on the following figure:      (2013). They argue that job satisfaction have significant influence on OCB and that job satisfaction has not been an important concern for nurses to enjoy their job. In particular, job satisfaction does not relate to the nurses' psychologiacal matters. The higher degree of job satisfaction also did not lead the nurses encouraging to provide OCB in their hospital.
Moreover, organizational commitment had significant influence on OCB of nurses in the Sawerigading Palopo Public Hospital. This can be assumed that the stronger organizational commitment the nurses behave will lead for the better performance of their OCB. Similarly, Ristiana (2013) and Widyanto (2013) proved in their research for the significant effect of organizational commitment on OCB. Thus, nurses whose higher degree of organizational commitment will give a positive impact on doing their jobs in the hospital. They also will provide their best capabilities to accomplish what kinds of duties required in the workplace. Besides, nurses whose greater level of organizational commitment to their hospital will stay longer, work well, and have a sense of belonging at work. Hence, these can develop the nurses' conscientiousness to do advantegous activities for the hospital voluntarily.
In addition, the testing result showed that organizational climate positively influenced the nurses' OCB. This result is consistent with the finding of Meylandani (2013) that shows the positive relationships between organizational climate and OCB. She admitted that the nurses with positive perception on organizational climate were able to work condusively; and such condition led the nurses to develop their OCB higher as well. In brief, good condition will appear when the nurses view good attitude towards their organization and its organizational climate (Runtu dan Widyarini, 2009).
Then, this study found that job satisfaction greatly influenced the nursing service quality in the Sawerigading Palopo Public Hospital. Zumrah (2015) in her research also indicated that job satisfaction positively affected service quality. Therefore, this study argues that nurses, who are satisfied at work, tend to show their positive behaviour and to perform their great abilitities in doing their jobs. The satisfactory nurses likely try their best to provide duties with higher standard of service quality. The nurses with positive behaviour are also willing to get involved in the organization so that they can contribute for optimal nursing service quality.
Organizational commitment also significantly affected the nursing service quality in the Sawerigading Palopo Public Hospital. This is similar with the research result of Nasiripour et al. (2015) concluding that organizational commitment have moderate relationship with nursing service quality.
Instead, the testing result in this study showed that the organizational climate significantly affected the nursing service quality in the Sawerigading Palopo Public Hospital. This finding is similar with a research argumentation by 382 Kanten and Ulker (2013). They find that organizational climate can influence service quality and organizational climate. If the organizational climate is not condusive, so the employees will be counterproductive. Therefore, organizational climate is an important factor to develop nurses' productivity in order to perform the most optimal nursing service quality.
Besides, the nurses' OCB significantly affected nursing service quality in the Sawerigading Palopo Public Hospital. This research result is in line with a research of Badruzaman (2013) concluding that OCB influences service quality given by the nurses to the patients as well as the patients' family. Aldag dan Resckhe (1997) also added that OCB is one of positive and constructive social behaviours. OCB means helping others so it needs to be maintained to provide good service quality in the hopital.
Furthermore, the analysis results in this study demonstrated that job satisfaction could solely and directly influence the nursing service quality without OCB mediation. Otherwise, OCB could not mediate the effect of job satisfaction on the nursing service quality in the Sawerigading Palopo Public Hospital. Clealry, OCB partially mediated the effect of organizational commitment on the nursing service quality. OCB also partially mediated the effect of organizational climate on nursing service quality.

Conclusion:-
This study reveals some conclusions that may valuable for further study. First, the job satisfaction that is higher among nurses in the hospital can directly increase the quality of nursing service, even without the nurses' OCB. Thus, this study argues that creating for higher job satisfaction can be done by increasing a satisfactory for workforce condition as well as by providing higher salary or wages for the nurses. Instead, the nurses' stronger organizational commitment can directly improve the nursing service quality. Theirs can also maintain for the nurses' higher level of OCB in the hospital. Both organizational commitment and OCB, indeed, can advance the nursing service quality performed by the nurses to the patients.
Strethening organizational commitment should be done by enlarging affective and continuous commitment. Then, improving organizational climate can be extended by building up warmth and assistance among nurses with their structural clarity. Furthermore, the nurses' OCB as the mediation for improving the service quality of nurses can play an important role to convey sportmanship and civic virtue. The factor of nursing service quality should be attentively noticed further, especially in relation with the reliability of service quality as the expected standard as well as with the responsiveness of nurses in caring the patients.