Volume 3, Issue 3 (Spring 2018 -- 2018)                   HDQ 2018, 3(3): 159-166 | Back to browse issues page

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Bakhtiari Z, Fathi D, Hosseini Ahagh M M, Hosseininejad S, Ahmadboukani S. The Relationship Between Workplace Spirituality, Job Satisfaction and Attitude Toward Death Among the Staff of the Emergency Department. HDQ. 2018; 3 (3) :159-166
URL: http://hdq.uswr.ac.ir/article-1-187-en.html
1- Department of Counseling, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran.
2- Department of Educational Sciences, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
3- Department of Public Health, Khalkhal School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
4- Department of Educational Psychology & Counseling, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
5- Department of Educational Sciences, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran. , arezbookani@yahoo.com
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1. Introduction
uman resources are one of the main foundations of any organization. Today, managers are investing in human resources to improve an organization’s effectiveness [1]. In this regard, life satisfaction is an important internal factor in improving employee performance. It means having a perceptual understanding of the needs [2]. Hultell and Gustavsson introduced life satisfaction as a state and not as an attribute, suggesting that life satisfaction measures the respondent’s current state and character and not his/her stable and consistent traits of [3]. Pourmeidani reported that life satisfaction exists when the current situation in family relationships is consistent with the expectations, but the inconsistency between the two factors can lead to dissatisfaction [4]. Pavot defined life satisfaction as a clear sign of a person’s successful adaptation to a change in various situations in life [5]. Adler and Fagly showed that individuals with higher spirituality have the same degree of life satisfaction [6].
It is possible that workplace spirituality plays a role in life satisfaction of employees. In length history, spirituality has always had a deep link with religion and used them equally. Their distinction dates back to the late nineteenth and early twentieth century [7]. Spirituality is beyond religion and is not affiliated to a particular religion [8]. Nasina and Doris reported that the injection of workplace spirituality could improve emotional commitment among employees [9]. Although workplace spirituality has many deep individual and philosophical meanings, most of its definitions include integrity, excellence and solidarity in the workplace and deep values. Ashmos and Duchon referred to workplace spirituality as the next understanding of individual working life that has taken place through meaningful works in social life [10]. Furthermore, Gibbons introduced work spirituality as a concept of integrity, work continuity, and understanding of deep workplace values [11]. There are three different attitudes that imply how spirituality influences individual performance in the organization and workplace: (a) human resources attitude: spirituality improves well-being and quality of life; (b) psychological attitude: spirituality creates work intentionality and meaning; (c) communication attitude: spirituality creates a sense of togetherness, sociality and solidarity among the employees [12]. Altaf and Awan 2011 reported that workplace spirituality plays a role in job satisfaction [13]. Sanoobar and Rahimieghdam reported a direct relationship between the dimensions of workplace spirituality and customer satisfaction [14]. Coleman and Holmes [15] reported that spiritual well-being is directly related to life satisfaction, and Asarudi, Golafshan and Akaberi confirmed the direct relationship between spiritual health and life satisfaction [16].
Attitude toward death and afterlife is considered as one of the most important issues in determining the lifestyle and worldview of people. Attitude toward death is a set of cognitive, affective, and behavioral responses to death. Negative attitudes include death fear and avoidance, whereas positive attitudes include death acceptance [17]. Clug and Sinha conceptualized death acceptance as approximate and relative comfort along with individual awareness of personal mortality [18]. Death acceptance approach expresses belief in good afterlife [19]. Niemeyer showed that neutral acceptance and death acceptance have a positive correlation with psychological health and have a negative correlation with depression. He also found that neutral acceptance has a positive correlation with perceived physical health, whereas avoidance acceptance has a negative correlation with perceived physical and mental health [20]. Mohammadzadeh, Asgharnejad and Ashuri reported that there is an association between death fear and physical and spiritual health [21]. Wong, Peaker and Kesar found that psychological well-being has a positive and weak correlation with neutral and active death acceptance and a negative correlation with death fear and death avoidance [22]. Research indicates that external religious orientation is associated with death fear and death anxiety, and internal orientation is associated with death acceptance [23]. Furthermore, Fathi et al confirmed the mediating role of attitude toward death among spiritual intelligence and components of mental health such as life satisfaction [18].
The employees of the emergency department are often subject to stress, high excitement, anxiety and unpredictability [1]. Therefore, focusing on the attitudes and quality of life of emergency department staff is of importance. Studies have showed that the emergency department staff of hospitals try to perform successful recovery; however, it is difficult for them to accept failure [24, 25]. Emergency department employees are at risk of stress and anxiety, and their long-term effects involve the sudden and painful death of children, the causes of death experience, and participation in recovery efforts [26, 27]. The ability to provide high-quality patient care with low levels of stress helps to maintain better mental and physical well-being [28]. Studies show that the attitude of nurses towards death may affect supportive behaviors when caring for a dying patient [29]. The system of personal, cultural, social and philosophical beliefs affects one’s attitude toward death. The findings of this study focus on the basis for interventions to support emergency staff in order to improve the care of patients. Thus, the present study examined the intermediary role of attitude toward death between workplace spirituality and life satisfaction.
2. Materials and Methods
The present study is descriptive with correlational design. The population included 90 staff of Shiraz Emergency Department selected through simple random sampling in 2016-2017 (Table 1). After necessary coordinations with the Emergency department, the subjects collaborated contentedly. 
Satisfaction With Life Scale (SWLS) by Dinner, Emmons, Larsen and Griffin (1985)
Satisfaction With Life Scale (SWLS) by Dinner, Emmons, Larsen and Griffin (1985) has five questions with 7-Degree Likert scales. To determine the reliability, Esmaili carried out with Oxford Happiness Scale concurrently and reported the concurrent reliability coefficient as 0.66. He used Cronbach’s alpha to determine its reliability and reported a reliability coefficient of 0.80 [30].
Workplace Spirituality Questionnaire
Workplace Spirituality Questionnaire was introduced by Miliman et al, and it measures three dimensions of workplace correlation, meaningfulness in the workplace, and alignment with values. It has 16 items adjusted based on a 5-point Likert scale [31]. The reliability of this questionnaire was 0.82 based on Cronbach’s alpha, which indicates the acceptable reliability of this questionnaire. To determine the validity of this questionnaire, content and ostensible validity were used. It was found that both have content and ostensible validity.
The Death Attitude Profile – Revised (DAP-R); Wong, Peaker and Kesar 1994
The Death Attitude Profile – Revised (DAP-R); Wong, Peaker and Kesar 1994 has 5-degree scales: death fear, neutral acceptance, trend acceptance and avoidance acceptance. It has 32 questions. The reliability and validity were examined in a study in Kerman in which ten faculty members reviewed the content in question of cultural and religious aspects toward death and dying. Test-retest reliability was about 0.63 for DAP-R, and it was different in attitude acceptance. Test reliability-validity coefficient was about 0.67 and was 0.89 for death fear, and it was different in avoidance acceptance. In general, it shows acceptable validity [22]. Finally, the data were analyzed by SPSS and EMOS software.
3. Result
Before examining the hypotheses, the descriptive statistics of the variables (Mean and SD) were investigated, and the relationship between the variables of the research was also studied (Table 2).
The findings of the research show that the average age of the emergency department staff was 28.5 years with a range of 25-49 years. The staff of the emergency department consisted of 65 nurses, 20 interns, and 5 specialists’ doctor. Also, most of the nurses were undergraduate (94.5%); of which, 71 were single and 19 were married.
As Table 3 shows, the indexes imply the model has a fairly good fitting. To answer the research question “Whether dimensions of attitude toward death has an intermediary role between workplace spirituality and life satisfaction?,” the results show that workplace spirituality has an indirect impact on life satisfaction only through the intermediary role of neutral acceptance.
As Figure 1 and Table 3 show, workplace spirituality had a negative effect (β=-0.32, P=0.001) on neutral acceptance and had a positive effect (β=0.21, P=0.03) on active acceptance and life satisfaction (β=0.19, P=0.05). Also, neutral acceptance has a negative impact on life satisfaction (β=-0.32, P=0.05). The Bootstrap command in AMOS was used to examine the intermediary role of each dimension for attitude toward death among the research variables. Table 4 shows the results of this analysis. As shows, only neutral acceptance could play the intermediary role between workplace spirituality and life satisfaction (and (β=-0.27, P=0.00).
4. Discussion
The present study examined the relationship between workplace spirituality and life satisfaction and the intermediary role of attitude toward death among emergency department staff in Shiraz. Our results showed that the workplace spirituality has a positive impact on life satisfaction, neutral acceptance, and active acceptance. Also, among the dimensions of attitude toward death, only neutral acceptance was found to play an intermediary role between workplace spirituality and life satisfaction.
The results show the positive and direct impact of workplace spirituality on life satisfaction. These findings are in line with the results by Altaf & Awan [13], Senobar and Rahimimoghadam [14], Coleman and Holzemer and Asarudi [15], and Golafshan and Akaberi [16]. Workplace spirituality creates a sense of being useful and doing meaningful works among the employees such that they experience a sense of solidarity with the organization and a sense of meaningfulness in the workplace. This is in accordance with Pavot’s definition of life satisfaction as a significant sign of successful individual compatibility with changes in different life situations. The meaning in life is one of the associated factors with life satisfaction [5]. Work is one of the factors that make life meaningful. Meaningfulness in work and positive interpersonal interactions could increase life satisfaction. As the sense of solidarity and meaningfulness in the workplace could lead to life satisfaction, it makes sense to confirm the positive and direct impact of workplace spirituality on life satisfaction.
The results showed that workplace spirituality has a positive and direct impact on neutral acceptance and active acceptance. These findings are in line with the results by Ardlet and Queuing [23], Niemeyer [20], Mohammadzadeh, Asgharnejad and Ashuri [21], and Fathi [18]. Spirituality has a special bond with religion and, as Kesar suggests, death acceptance approach expresses belief in good afterlife which, in turn, shows a religious vision [32]. However, spirituality is an effort to improve sensitivity toward self, others, non-human creatures and God as well, which somehow concentrates on meaningfulness and afterlife. Workplace spirituality is based on meaning and value, and the individual attitude toward death would play a role in the value system and meaningfulness. Death acceptance may help to find the meaning of life.
Confirming the intermediary role of neutral attitude toward death among the variables of workplace spirituality and life satisfaction is one of the main results. However, no study has been done to confirm the indirect impact of workplace spirituality on life satisfaction and the intermediary role of neutral attitude toward death. This can be explained with the positive and direct impact of spirituality on attitude toward death and the positive impact of attitude toward death on life satisfaction [20, 23,22, 18]. 
According to the findings of this research, spirituality in work has a positive and direct effect with life satisfaction. But when spirituality is combined as a positive variable with a neutral acceptance, which is somehow indifferent and ambiguous in relation to death, the effect of spirituality will reverse the satisfaction of life. Considering the framework of the cognitive-behavioral model based on the beliefs of the results, it can be concluded that a neutral attitude, such as irrational and destructive beliefs, is combined with spirituality as an independent and manageable variable and will affect the life satisfaction of the emergency department as an associated variable. This ineffective belief will endanger the obscureness about death, satisfaction and well-being of life in the emergency department.
5. Conclusion
Therefore, it seems logical that the indirect effect of spirituality in work with the satisfaction of life and the role of mediating the attitude of neutral acceptance to death should be confirmed. Some of the limitations of this review have been recognized. Attitude towards death is a complex human phenomenon, and all of the factors influencing these beliefs may not be used by the measuring instruments. According to the results of this study, it is suggested that with the development of continuing education programs and effective coping strategies with the unpleasant consequences of death anxiety, the attitude of death and the identification of obstacles that can be difficult to care for dying patients lead to an increase in the positive attitude of employees towards care for death.
The confidentiality of the information of the participants and the informed consent of all sample individuals were the ethical point of this research. Thanks and appreciation to the staff and the esteemed Emergency Department of Shiraz for cooperation in this research.
Conflict of Interest
The authors declared no conflicts of interest.

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Type of Study: Research | Subject: General
Received: 2018/06/30 | Accepted: 2017/11/14 | Published: 2018/04/1

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