ARTICLE IN PRESS International Journal of Nursing Studies 45 (2008) 879–887 www.elsevier.com/locate/ijnurstu Emotional labour, job satisfaction and organizational commitment amongst clinical nurses: A questionnaire survey Feng-Hua Yanga,, Chen-Chieh Changb a Department of International Trade, Aletheia University, 32, Chen-Li Street, Tamsui, Taipei 251, Taiwan b Institute of Management, Chung Yuan Christian University, Taiwan Received 21 June 2006; received in revised form 24 January 2007; accepted 3 February 2007 Abstract Background: According to Hochschild’s (1983. The Managed Heart. Berkeley: University of California Press) classification of emotional labour, nursing staff express high emotional labour. This paper investigates how nursing staff influence job satisfaction and organizational commitment when they perform emotional labour. Objectives: This paper examines the relationship between emotional labour, job satisfaction, and organizational commitment from the perspective of nursing staff. Design: A questionnaire survey was carried out to explore these interrelationships. Setting: Teaching hospital in Taiwan. Participants: Questionnaires were distributed to 500 nursing staff; 295 valid questionnaires were collected and analysed—a 59% response rate. Methods: The questionnaires contained items on emotional labour, job satisfaction, and organizational commitment as well as some basic socio-demographics. In addition, descriptive statistics, correlation and linear structure relation (LISREL) were computed. Results: Emotional display rule (EDR) was significantly and negatively related to job satisfaction. Surface acting (SA) was not significantly related to job satisfaction but demonstrated a significantly negative relationship with organizational commitment. Deep acting (DA) significantly and positively correlated with job satisfaction but demonstrated no significance with organizational commitment. The variety of emotions required (VER) was not significantly related to job satisfaction; frequency and duration of interaction (FDI) and negatively related to job satisfaction; and job satisfaction significantly and positively correlated with organizational commitment. Conclusions: We found that some dimensions of emotional labour significantly relate to job satisfaction. Job satisfaction positively affects organizational commitment and has an intervening effect on DA and organizational commitment. r 2007 Elsevier Ltd. All rights reserved. Keywords: Emotional labour; Job satisfaction; Organizational commitment What is already known about the topic? Corresponding author. Tel.: +886 2 26212121x5306; fax: +886 2 86318427. E-mail address: leon@email.au.edu.tw (F.-H. Yang). Nursing staff perform high emotional labour. Employees’ expression of emotional labour influences 0020-7489/$ - see front matter r 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.ijnurstu.2007.02.001 job satisfaction and organizational commitment. ARTICLE IN PRESS F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 880 Correlation coefficients denoting the relationship between emotional labour and job satisfaction range from 0.16 to 0.44. What this paper adds Some dimensions of emotional labour significantly relates to job satisfaction. Job satisfaction has an intervening effect on deep acting and organizational commitment. The theoretical model proposed by this paper is deemed a good fit. 1. Introduction The first definition of emotional labour was proposed by Hochschild (1983). Emotional labour requires that one expresses or suppresses feelings that produce an appropriate state of mind in others; that is, a sense of being cared for in a convivial and safe place. When emotions are transferred from personal behaviours to commodities, organizations have begun to consider using managerial measures to make employees utilize emotional labour to maximize efficiency while working (Morris and Feldman, 1996). Emotional labour is considered by many to be an important part of the role of many health care professionals and it has been the focus of much debate and empirical enquiry within a range of health care settings, especially in nursing (Mann, 2005). According to Hochschild’s (1983) classification of emotional labour, nursing staff are required to express a higher degree of emotional labour compared with other professional and technical staff with similar jobs. Numerous scholars have investigated the role of emotional labour in nursing. According to Mann and Cowburn (2005), nurses who perform emotional labour are able to manage patient reactions by providing reassurance and an outlet for emotions, thus directly impacting their psychological and physical well-being and recovery. Lynch (1989) argued that emotional labour performed by nurses, to a certain extent, generates and maintains ‘‘solidarity relationship.’’ That is, emotional labour establishes an interpersonal relationship and is a symbolic expression of emotional concern and caring that enables patients to feel at ease and trust the nurses’ motives and actions (O’Brien, 1994). Smith and Kleinman (1989), in a study of medical professionals, noted that their development toward emotional neutrality is part of a hidden curriculum. Under great pressure to prove that they are worthy of entering the nursing profession, students are afraid to admit that they are uncomfortable with patients or procedures, typically hiding these feelings behind a ‘‘cloak of competence.’’ Cranny et al. (1992) defined job satisfaction as ‘‘an affective (that is, emotional) reaction to one’s job, resulting from an incumbent’s comparison of actual outcomes with desired (expected, deserved, etc.) outcomes’’. Locke (1969) argued that job satisfaction is the ‘‘pleasurable emotional state resulting from appraisal of one’s job as achieving or facilitating one’s job values’’. Job dissatisfaction, meanwhile, is an unpleasurable emotional state resulting from an appraisal of one’s job as frustrating or blocking the attainment of one’s values. It is therefore clear from the above that job satisfaction is an integral variable of organizational theory. Previous theoretical work on emotional labour suggested a negative relationship between emotional labour and job satisfaction. However, two empirical tests of this relationship (Adelmann, 1989, Wharton, 1993) contradicted the above view. Moorman’s (1993) study found that when only one dimension is used to measure the relationship between emotional labour and job satisfaction, the correlation coefficients range from 0.16 to 0.44, suggesting that measuring emotional labour with only one dimension is inappropriate. Not until Morris and Feldman (1996) used an emotional interaction module to redefine emotional labour. Lin (2000) studied emotional labour and found that it should be measured using five dimensions—emotional display rule (EDR), surface acting (SA), deep acting (DA), variety of emotions required (VER), frequency and duration of interactions (FDI). However, few studies have investigated the relationship between these dimensions and job satisfaction. Ekman (1973) referred to the rules regarding appropriate emotional expression display rules. According to Ekman, display rules are norms and standards of behaviour indicating what emotions are appropriate in a given situation and how these emotions should be publicly expressed. In the topic of display rules, Ashforth and Humphrey (1993) emphasized on the expression aspect whereas Hochschild (1983) noted that managing inner feelings is crucial. Hochschild (1983), who pointed out that emotions cause alienation and estrangements from one’s feelings, further hypothesized that emotional display is negatively correlated with job satisfaction. In SA, employees modify and control their emotional expressions (Morris and Feldman, 1997; Pugliesi, 1999; Lin, 2000). For example, employees may fake a smile when in a bad mood or interacting with a difficult customer. Morris and Feldman (1997) identified conflicts between emotions genuinely felt and emotions to be displayed in organizations as ‘‘emotional dissonance’’. In other words, the act of expressing sanctioned emotions during interpersonal interactions becomes more demanding when expression requires increased effort to control true feelings. Rutter and Fielding (1988) ARTICLE IN PRESS F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 found that a need to suppress inauthenticity felt emotions was negatively correlated with job satisfaction. Hochschild (1983) defined ‘‘deep acting’’ as individuals trying to influence what they feel in to ‘‘become’’ the role they are asked to play. In this case, expressive behaviours and inner feelings are regulated (Zapf, 2002; Lin, 2000). DA is when an employee must expend effort to regulate emotions. During DA, there is a need to actively strive to invoke thoughts, images, and memories to induce a certain emotion (Ashforth and Humphrey, 1993). Broheridge and Grandey (2002) argued that DA involves treating a customer as someone deserving authentic expression, and the positive feedback from a customer can increase personal efficacy. We propose that DA is positively correlated with job satisfaction. Morris and Feldman (1996) opined that emotional work requires expression of a variety of emotions. The requirement to display emotions can be either positive, neutral—in the case of a judge who wants to display dispassionate authority and independence—or negative, e.g., a policeman who shows severity and anger when communicating with drunken adolescents. There are some jobs, such as kindergarten teachers, nurses, and psychotherapists in which a variety of emotions are required (Zapf, 2002; O’Brien, 1994). Frequent changes in the emotions displayed over a limited period require more planning and anticipation on the part of employees, and thus, they entail greater emotional labour and more role load (Morris and Feldman, 1996; Lin, 2000). Therefore, the need to express a variety of emotions should be negatively correlated with job satisfaction. Frequency of emotional displays has been the most examined component of emotional labour (Morris and Feldman, 1996; Zapf, 2002). In fact, more or less, all studies that somehow measured emotion work measured the frequency and it was the basic idea of Hochschild (1983) that too frequent emotional displays would overtax the employees and lead to alienation and exhaustion (Zapf, 2002). Rafaeli (1989) and Sutton and Rafaeli (1988) investigated convenience stores and suggested that the duration of interaction is related to the scriptedness of social interactions. This finding implies that the level of effort required for emotional display in a short period is minimal. Conversely, emotional displays of long duration should require more effort, and thus, increased emotional labour (Morris and Feldman, 1996; Lin, 2000). Thus, FDI should be negatively correlated with job satisfaction. Udo et al. (1997) argued that how satisfied employees feel about their jobs affects their loyalty towards their organizations. Mowday et al. (1982) pointed out that job satisfaction can be an antecedent variable for organizational commitment. A number of studies found that job satisfaction positively correlates with organizational commitment (Martin and Bennett, 1996; Schwepker, 2001). 881 Although there are several definitions of organizational commitment, a common theme in most is that committed individuals believe in and accept organizational goals and values, and are willing to remain within their organizations, and willing to provide considerable effort on their behalf (Mowday et al., 1979). Hence, organizational commitment acts as a ‘‘psychological bond’’ to an organization that influences individuals act in ways that are consistent with the organization’s interests (Porter et al., 1974). High or low organizational commitment is related to employee’s turnover intention (Martin and Bennett, 1996; Schwepker, 2001; Wong and Law, 2002) and productivity (Becker et al., 1996; Martin and Bennett, 1996). Wong and Law (2002) stated that employees’ performance of emotional labour changes their organizational commitment. Grandey (2000) noted that in studying emotional labour, a trend is to measure SA and DA. Thus, this study explores how SA and DA affect organizational commitment. Hochschild (1983) argued that inauthentic SA over time results in a feeling detachment from one’s true feelings and from others’ feelings. Feeling-diminished personal accomplishment is likely when an employee believes that the displays were not efficacious or were met with annoyance by customers (Ashforth and Humphrey, 1993). The inauthenticity of this surface acting process, showing discrepant from feelings, affects employee behaviour (Pugliesi, 1999; Ashforth and Humphrey, 1993). We propose that SA is negatively correlated with organizational commitment. Hochschild (1983) discussed two avenues for DA: (a) exhorting feelings, whereby one actively attempts to evoke an emotion; and, (b) trained imagination, whereby one actively invokes thoughts, images, and memories to induce the associated emotion (thinking of a wedding to feel happy). DA is directly focused on one’s inner feelings (Ashforth and Humphrey, 1993; Mann, 2004); given the increased psychic effort involved in DA, this form of emotional labour is more consistent with a strong concern for one’s customers. We propose that DA is positively correlated with organizational commitment. Based on literature findings and empirical study, this paper investigates the relationship between emotional labour performed by nursing staff and job satisfaction and organizational commitment. 2. Method 2.1. Participants and procedure In total, 500 full-time nurses participated in this study. Participants in this convenience sample returned 295 valid questionnaires—a 59% response rate. The sample was 100% female, of which 28.5% were married. Most (89.5%) were aged o35 years. Most had 43 years of ARTICLE IN PRESS 882 F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 work experience (60%) and 28.5% had X7 years of experience. Wallbott and Scherer (1989) indicated that the use of a questionnaire to collect information about emotional experience and expression can offer a number of advantages, including assess to more emotional experiences over a longer period of time. All respondents participated voluntarily in the study, and assurances of anonymity were made and kept. Non-response bias was checked by means of a time trend extrapolation test in which characteristics of early respondents were compared with those of late respondents (Armstrong and Overton, 1977). No significant differences were identified (F ¼ 0.65, po0.687), suggesting that non-response bias is less likely. 2.2. Measures This study utilized a pretest to enhance reliability and validity. When the corrected item-total correlation was o0.45, and deleting the item increased Cronbach’s a, the item was deleted. Emotional labour was measured with a slightly modified scale developed by Lin (2000). The 24-item measure contained five dimensions—EDR, SA, DA, VER, and FDI. A 7-point Likert scale was used, with anchors ranging from 1 (strongly disagree) to 7 (strongly agree). EDR was the level to which employees reported that their emotional displays were controlled by their jobs. Items asked the extent to which the employee is required by organization to show (or hide) emotion in order to be effective on the job. SA refers to modifying and faking expressions. DA is the extent to which an employee modifies feelings to meet display rules. VER is the need to display different emotions with different patients. FDI is the average number of minutes and rate required for a typical transaction. Four items were deleted after the pretest. Internal consistency was measured using Cronbach’s a with reliability coefficients of 0.79 for EDR (five items), 0.85 for SA (three items), 0.85 for DA (six items), 0.86 for VER (four items) and 0.75 for FDI (two items). Job satisfaction was adopted from the Minnesota Satisfaction Questionnaire (Weiss et al., 1967). It was measured using a 20-item scale containing two dimensions: internal satisfaction (IS) and external satisfaction (ES). A 7-point Likert scale was adopted, with anchors ranging from 1 (strongly disagree) to 7 (strongly agree). No item was deleted during the pretest. Internal consistency was measured using Cronbach’s awith reliability coefficients of 0.92 for IS (twelve items) and 0.83 for ES (eight items). Organization commitment was measured by the Organization Commitment Questionnaire developed by Mowday et al. (1982), which used 15 items containing three dimensions: value commitment (VC), effort commitment (EC) and, retention commitment (RC). A 7-point Likert scale was used, with anchors ranging from 1 (strongly disagree) to 7 (strongly agree). This questionnaire has six reverse items. One item was deleted after the pretest. Internal consistency was measured using Cronbach’s a; reliability coefficients were 0.81 for VC (five items), 0.81 for EC (four items) and 0.87 for RC (five items). Socio-demographic variables, such as age, gender, employment status, and marital status were examined. Table 1 provides the reliability analysis results of emotional labour, job satisfaction and organizational commitment. Each scale had satisfactory reliability with coefficient a above 0.70. Furthermore, this study examined convergent and discriminant validity using confirmatory factor analysis on LISREL VII (Jöreskog and Sörbom, 1982). Evidence of convergent validity was found in the parameter estimates and t-values. First, parameter estimates were high in value and t-values were statistically significant (greater than 2.0), meeting the criteria proposed by Anderson and Gerbing (1988) for convergent validity. Second, the proportion of variation in the indicators captured by the underlying constructs should be higher than the variance due to measurement error (Fornell and Larcker, 1981). The values of the average variance extracted were 0.56 for EDR, 0.65 for SA, 0.61 for DA, 0.78 for VER, 0.74 for FDI, 0.50 for IS, 0.48 for ES, 0.67 for VC, and 0.56 for EC, 0.62 for RC. Almost all exceeded a suggested critical value of 0.50 (Fornell and Larcker, 1981). Table 1 Reliabilities analysis Dimensions Cronbach a Dimensions Cronbach a Dimensions Emotional display rule Surface acting Deep acting Variety of emotional required Frequency and duration of interaction .79 .85 .85 .86 .75 Internal satisfaction .92 External satisfaction .82 Value commitment Effort commitment Retention commitment Emotional labour .89 Job satisfaction Organizational commitment .91 .93 Cronbach a .81 .81 .87 ARTICLE IN PRESS F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 883 goodness-of-fit index (GFI) of 0.90, comparative fit index (CFI) of 0.93, and root mean square residual (RMSE) of 0.049, indicating acceptable fit. Table 3 presents the LISREL estimates of structural model coefficients. The path coefficients from emotional display rule to job satisfaction were significant and negative (g11 ¼ 0.24, t ¼ 2.93). SA was not significantly correlated with job satisfaction (g21 ¼ 0.10, t ¼ 1.25), but significantly and negatively correlated with organizational commitment (g12 ¼ 0.23, t ¼ 3.35). DA was significantly and positively correlated with job satisfaction (g31 ¼ 0.30, t ¼ 3.24), but not with organizational commitment (g22 ¼ 0.10, t ¼ 1.30). Thus, when SA, nurses modify and control their emotional expressions. The inauthenticity of this surface-level process, showing expressions that differ from their feelings, is not significantly related to job satisfaction but significantly related to organizational commitment. DA is the process in which internal thoughts and feelings are altered to meet mandated display rules. DA is significantly related to job satisfaction but not with organizational commitment. VER was not significantly correlated with job satisfaction (g41 ¼ 0.15, t ¼ 1.88). FDI was significantly and negatively correlated with job satisfaction (g51 ¼ 0.16, t ¼ 2.11). Job satisfaction was significantly and positively correlated with organizational commitment (b11 ¼ 0.76, t ¼ 5.26). Going a step further, we explored whether job satisfaction has an intervening effect between SA, DA, and organizational commitment. Table 4 presents the results. Job satisfaction did not have a significant intervening effect on SA (b ¼ 0.08, t ¼ 1.25). Thus, SA cannot affect organizational commitment through job satisfaction. However, job satisfaction demonstrated a significant intervening effect on DA (b ¼ 0.23, t ¼ 3.20). Thus, DA affects organizational commitment through job satisfaction. Discriminant validity can be established by demonstrating that the average variance extracted by a particular construct from its indicators is greater than its squared correlation (shared variance) with another construct (Fornell and Larcker, 1981). Each of the squared phi coefficients between EDR and every other variable in the study was examined. Results indicated that each construct’s average variance extracted was greater than its shared variance with EDR. The following are the shared variances between EDR and SA (0.30), DA (0.01), VER (0.00), FDI (0.35), IS (0.18), ES (0.14), VC (0.13), EC (0.18), and RC (0.14). Results of these analyzes provided evidence for convergent and discriminant validity of the constructs. 3. Results Table 2 provides the means, standard deviations and correlations for variables in this study. EDR was significantly correlated with all job satisfaction subscales and the organizational commitment subscale. Surface acting did not exhibit significant correlation with the job satisfaction subscale but show partial significance with the organizational commitment subscale. DA was significantly correlated with all job satisfaction subscales; however, DA was not significantly correlated with organizational commitment subscales. VER was not significantly correlated with job satisfaction subscales. FDI demonstrated a partially significant correlation with job satisfaction subscales. To test the model presented in Fig. 1, structural equation modelling was implemented by LISREL 8 (Jöreskog and Sörbom, 1982). As recommended by Anderson and Gerbing (1988), covariance matrices were used as input for LISREL analyses. The fit indices for the structural model included a w2/df ratio of 3.12, Table 2 Means, standard deviations, correlation matrix Variables Mean SD 1 2 3 4 5 6 7 8 9 10 l. EDR 2. SA 3. DA 4. VER 5. FDI 6. IS 7. ES 8. VC 9. EC 10. RC 5.46 5.60 6.41 3.91 5.56 5.18 4.59 4.52 4.90 4.49 1.38 1.05 0.57 1.42 1.03 0.93 1.04 0.92 0.95 1.11 1.00 0.47** 0.33** 0.01 0.29** 0.32** 0.35** 0.36** 0.31** 0.33** 1.00 0.26** 0.30** 0.36** 0.05 0.12 0.40** 0.02 0.38** 1.00 0.52** 0.30** 0.63** 0.47** 0.06 0.07 0.07 1.00 0.34** 0.08 0.10 0.17** 0.34** 0.19** 1.00 0.29** 0.01 0.04 0.09 0.11 1.00 0.83** 0.66** 0.56** 0.57** 1.00 0.58** 0.54** 0.53** 1.00 0.65** 0.76** 1.00 0.56** 1.00 Note: EDR, Emotional display rule; SA, surface acting; DA, deep acting, VER, variety of emotional required; FDI, frequency and duration of interaction; IS, internal satisfaction; ES, external satisfaction, VC, value commitment; EC, effort commitement; RC, retention commitment.*po0.05 **po0.01. ARTICLE IN PRESS F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 884 -0.23 SA (X2) 0.10 EDR(X1) -0.24 0.15 VER(X4) -0.16 FDI(X5) 0.30 DA(X3) 0.76 Job satisfaction 0.49 IS(Y1) 0.83 ES(Y2) Organizational commitment 0.81 0.80 VC(Y3) EC(Y4) 0.54 RC(Y5) 0.10 Fig. 1. Structural model coefficients. Note: w2 (df ¼ 26) ¼ 96.83 (P ¼ 0.000), 2. GFI ¼ 0.90, CFI ¼ 0.93, 3. RMSR ¼ 0.049. Table 3 Path coefficient Independent variable Dependent variable Job satisfaction Emotional display rules Surface acting Deep acting Variety of emotional required Frequency and duration interaction Job satisfaction 0.24** (2.93) 0.10 (1.25) 0.3** (3.24) 0.15 (1.85) 0.16* (2.11) Organizational commitment 0.23** (3.35) 0.1 (0.30) 0.76** (5.26) Note: ( ) is t value, *po0.05, **po0.01. Table 4 Intervening effect with job satisfaction Independent variable Dependent variable Organizational commitment Surface acting Deep acting 0.08 (1.25) 0.23** (3.20) Note: ( ) is t value, *po0.05, **po0.01. 4. Discussion Many scholars studying the relationship between emotional labour and job satisfaction found different results given in different subjects and industries. For example, in an exploratory research on flight attendants, Hochschild (1983) contended that having to perform emotional labour causes eventual alienation or estrangement from one’s genuine feelings, and it thereby has detrimental consequences for various aspects of psychological well-being. Morris and Feldman (1997) provided direct empirical evidence that previous research has overemphasized the negative aspects of emotional labour. Sampling employees from multiple job categories in debt collection agencies, military recruiting battalion headquartered and nursing, Morris and Feldman found that emotional dissonance is associated with higher emotional exhaustion and lower job satisfaction. Wharton’s (1993) examination of the emotional labour offered results that often directly contradict earlier studies. Sampling employees from multiple job categories in a large bank and a teaching hospital, Wharton discovered that emotional labour is positively related to job satisfaction, a finding inconsistent with Hochschild’ s (1983). Ashforth and Humphrey (1993) suggested that emotional labour actually might make interactions more predictable and help workers avoid embarrassing interpersonal problems. This should, in turn, help reduce stress and enhance satisfaction. ARTICLE IN PRESS F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 Smith and Kleinman (1989) believed that when medical personnel can maintain a neutral mood, he/she can maintain a proper distance to stay away from psychological unhappiness. However, empirical findings of an integrated approach adopted by this study revealed that the relationship between emotional labour and job satisfaction is uncertain. Emotional labour has been explored in detail elsewhere and explained as involving the regulation and management of feeling (Hochschild 1983, Smith 1992). Theodosius’s (2006) concern was that emotional labour in nursing was considered to be marginalized due to organizational constraints and the low status attached to emotion work within and outside of nursing (James, 1992; Smith, 1992). For Freud, the original emotion only appears unconscious because of its conscious ideational presentation resulting in its repression, but for Hochschild, the original emotion is conscious. For example, a nurse actually feels disgust towards the patient but represses the feeling. In doing so, the idea that the nurse does not feel disgust is interpreted by her conscious mind as caring and kindness, and the emotion is identified as sympathy. The feeling of disgust is never actually unconscious, but the ideational presentation of the nurse as caring has repressed it (Theodosius, 2006). Thus, conscious and unconscious emotion which directly impact on both internal and external behavior patterns can bypass cognitive process (Theodosius, 2006). Hochschild (1983) noted that when services are provided during work, SA may produce mistakes and dissatisfaction, and DA may produce satisfaction. Hochschild was the first scholar to address SA and DA, and she also examined the impact of SA and SA on job satisfaction. However, she only described the relationship between the two variables but did not offer an empirical study to complement it. One of the main objectives of this paper, therefore, is to provide an empirical study for this proposition. Analytical results indicated that SA does not have an obvious effect on job satisfaction, and DA positively affects job satisfaction. Of the five dimensions of job satisfaction, DA has the most positive influence. Empirical results indicated that nurses’ performance of DA does not diminish their level of job satisfaction. Also, when nurses’ inner thoughts and feelings match display rules, their level of job satisfaction rises. This article found no significant relationship between VER and job satisfaction. According to Smith and Kleinman (1989), medical staff can maintain an appropriate distance by preserving a natural mood. In the relevant analysis, VER scored the lowest, indicating that nurses do not have to tailor their emotions to different patients, locations, customers, and levels of staff. The significantly negative relationship between interaction 885 levels and job satisfaction may be caused by nurses having to work long hours, and thus their interaction levels have to be more frequent and lengthier. Mowday et al. (1982) pointed out that job satisfaction can be an antecedent variable for organizational commitment. This study found that a positive relationship exists between job satisfaction and organizational commitment. Furthermore, SA has a negative influence on organizational commitment, indicating that when nurses perform emotional labour that differs from their inner feelings, it will not affect their degree of job satisfaction but depress their organizational commitment. DA does not significantly influence organizational commitment. This finding shows that when emotional labour coincides with inner feelings, job satisfaction is enhanced but the effect on organizational commitment is negligible. Table 4 reveals that job satisfaction is a good mediator of DA. Hospitals can therefore effectively utilize job satisfaction to enhance nursing staff’s organizational commitment. 5. Limitations and future research directions The five-component conceptualization of emotional labour, empirical findings on the effect of emotional labour, and the focus on positive and negative consequences of emotional labour all add to our improving understanding of emotional labour. However, this study has several limitations. The current study is cross-sectional, so the direction of causality cannot be tested. Future research of emotional labour can benefit from longitudinal research designs. The questionnaire assessment of emotional experiences is susceptible to a number of artefacts, such as social desirability and response distortion due to egodefence tendencies (Wallbott and Scherer, 1989). Additionally, questionnaire studies also suffer from common method variance problems (Podsakfoff et al., 2003). Future research can avoid this potential source of confounding by collecting data from additional sources. Another possible limitation of this study was its focus on a teaching hospital; the findings cannot therefore be generalized to all hospitals. Future research can be conducted on various hospitals to overcome this problem. If researchers intend to study whether emotional labour negatively or positively affects organizations, we suggest that they consider different job industries to determine whether different job categories generate different results (Broheridge and Grandey, 2002). Lin and Chen (2001) found that emotional labour has different impacts due to different personal characteristics and experiences. For example, those with high ARTICLE IN PRESS 886 F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 self-monitoring are outgoing, have a strong inclination to cooperate, and have strong interpersonal skills. Also, those with strong awareness of self-image will be the most competent in performing emotional labour and will have a shorter learning time. Thus, in the future, studies can focus on whether employees’ emotional labour is influenced by different personal characteristics. References Adelmann, P.K., 1989. Emotional labour and employee wellbeing. Unpublished Doctoral Dissertation, University of Michigan, Ann Arbor. Anderson, J.C., Gerbing, D.W., 1988. Structural equation modeling in practice: a review and recommended two-step approach. Psychology Bulletin 103 (3), 411–423. Armstrong, J.S., Overton, T.S., 1977. Estimating nonresponse bias in mail surveys. Journal of Marketing Research 14, 396–402. Ashforth, B.E., Humphrey, R.H., 1993. Emotional labour in service roles: the influence of identity. Academy of Management Review 18 (1), 88–115. Becker, T.E., Robert, S.B., Daniel, M.E., Nicole, L.G., 1996. Foci and bases of employee commitment: implications for job performance. Academy of Management Journal 39 (2), 464–482. Broheridge, C.M., Grandey, A.A., 2002. Emotional labour and burnout: compairing two perspectives of ‘‘people-work’’. Journal of Vocational Behavior 60, 17–39. Cranny, C.J., Smith, P.C., Stone, E.F., 1992. Job Satisfaction: How People Feel About their Jobs and How it Affects their Performance. Lexington Press, New York. Ekman, P., 1973. Cross-cultural Studies of Facial Expression: a Century of Research in Review. Academic Press, New York, pp. 169–222. Fornell, C., Larcker, D.F., 1981. Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research 18, 39–50. Grandey, A., 2000. Emotion regulation in the workplace: a new way to conceptualize emotional labour. Journal of Occupational Health Psychology 5 (1), 95–110. Hochschild, A.R., 1983. The Managed Heart. University of California Press, Berkeley. James, N., 1992. Emotional laobur: skill and work in the social regulation of feeling. Sociology of Health and Illness 14 (4), 488–509. Jöreskog, K.G., Sörbom, D., 1982. Recent developments in structural equation modeling. Journal of Marketing Research 19, 404–416. Lin, S.P., 2000. A study of the development of emotional labour loading scale. Sun Yat-Sen Management Review 8 (3), 427–447. Lin, S.P., Chen, Y.A., 2001. The study of display rules and socialization process of the emotional labours. Commerce and Management Quarterly 2 (3), 319–343. Locke, E.A., 1969. What is job satisfaction? Organizational Behavior and Human Performance 4, 309–336. Lynch, K., 1989. Soldiary Labour: its nature and marginalization. The Sociological Review 37, 1. Mann, S., 2004. ‘People-work’: emotion management, stress and coping. British Journal of Guidance and Counseling 32 (2), 205–221. Mann, S., 2005. A health care model of emotional labour; an evaluation of the literature and development of a model. Journal of Health, Organization and Management, Special Issue on Emotion 19 (4), 317–323. Mann, S., Cowburn, J., 2005. Emotional labour and stress within mental health nursing. Journal of Psychiatric and Mental Health Nursing 12, 154–162. Martin, C.L., Bennett, N., 1996. The role of justice judgments in explaining the relationship between job satisfaction and organization commitment. Group and Organization Management 21 (1), 84–104. Moorman, 1993. The influence of cognitive and affective based job satisfaction measures on the relationship between satisfaction and organizational citizenship behavior. Human Relations 46 (6), 759–776. Morris, A.J., Feldman, D.C., 1996. The dimensions antecedents and consequences of emotional labour. Academy of Management Review 21, 986–1010. Morris, A.J., Feldman, D.C., 1997. Managing emotions in the workplace, Journal of Managerial Issues 9 (3), 257–274. Mowday, R., Porter, W.L., Steers, M.R., 1979. The measure of organizational commitment. Journal Vocational Behavior 14, 224–247. Mowday, R., Porter, W.L., Steers, M.R., 1982. Employeeorganization linkage-the psychology of commitment absenteeism and turnover. Academic Press, New York. O’Brien, M., 1994. The managed heart revisited: health and social control. The Sociological Review, 393–413. Podsakfoff, P.M., MacKenzie, S.B., Lee, J.Y., Podsakoff, N.P., 2003. Common method diases in behavioral research: a cirtical review of the literature and recommended remedies. Journal of Applied Psychology 88 (5), 879–903. Porter, W.L., Mowday, R., Steers, M.R., Boulian, P.V., 1974. Orgainzational commitment, job satisfaction and turnover among psychiatric technicians. Journal of Apply Psychological 59, 603–609. Pugliesi, K., 1999. The consequences of emotional labour: effects of work stress, job satisfaction, and well-being. Motivation and Emotion 23 (2), 283–316. Rafaeli, A., 1989. When clerks meet customer: a test of variables related to emotional expression on the job. Journal of Applied Psychology 74, 385–393. Rutter, D.R., Fielding, P.J., 1988. Sources of occupational stress: an examination of British prison officers. Work and Stress 2, 291–299. Schwepker Jr, C.H., 2001. Ethical climate’s relationship to job satisfaction, organizational commitment, and turnover intention in the salesforce. Journal of Business Research 54, 39–52. Smith, A.C., Kleinman, S., 1989. Managing emotions in medical school: students’ contacts with the living and the dead. Social Psychology Quarterly 52 (1), 56–69. Smith, P., 1992. Emotional Labour of Nursing. Macmillan, Houndsmill. Sutton, R.I., Rafaeli, A., 1988. Untangling the relationship between displayed emotions and organizational sales. Academy of Management Journal 31, 461–487. ARTICLE IN PRESS F.-H. Yang, C.-C. Chang / International Journal of Nursing Studies 45 (2008) 879–887 Theodosius, C., 2006. Recovering emotion form emotion management. Sociology 40 (5), 893–910. Udo, G.J., Guimaraes, T., Igbaria, M., 1997. An investigation of antecedents of turnover intention for manufacturing plant managers. International Journal of Operations and Production Management 17 (9), 912–924. Wallbott, H.G., Scherer, K.R., 1989. Assessing emotion by questionnaire. In: Plutchik, R., Kellerman, H. (Eds.), Emotion: Theory, Research, and Experience. The Measurement of Emotion, Vol. 4. Academic Press, New York, pp. 55–82. Weiss, D.J., Davis, R.V., England, G.W., Lofguist, L.H., 1967. Manual for the Minnesota Satisfaction Questionnaire. 887 Industrial Relation Center, University Minnesota, Minneaplois, NM. Wharton, A., 1993. The affective consequences of service work: managing emotions on the job. Work and Occupations 20 (2), 205–232. Wong, C.S., Law, K.S., 2002. The effects of leader and follower emotional intelligence on performance and attitude: an exploratory study. The Leadership Quarterly 13, 243–274. Zapf, D., 2002. Emotion work and psychological well-being: a review of the literature and some conceptual considerations. Human Resource Management Review 12, 237–268.