Effcets of Internal Marketing

Effects of Internal Marketing on Nurse Job

Satisfaction and Organizational Commitment:

Example of Medical Centers in Southern Taiwan

Ching-Sheng Chang � Hsin-Hsin Chang*

ABSTRACT: As nurses typically represent the largest percentage of employees at medical centers, their role in

medical care is exceptionally important and becoming more so over time. The quality and functions of

nurses impact greatly on medical care quality. The concept of internal marketing, with origins in the

field of market research, argues that enterprises should value and respect their employees by treating

them as internal customers. Such a marketing concept challenges traditional marketing methods,

which focus on serving external customers only. The main objective of internal marketing is to help

internal customers (employees) gain greater job satisfaction, which should promote job performance

and facilitate the organization accomplishing its ultimate business objectives. A question in the

medical service industry is whether internal marketing can similarly increase the job satisfaction of

nurses and enhance their commitment to the organization. This study aimed to explore the relational

model of nurse perceptions related to internal marketing, job satisfaction, and organizational

commitment by choosing nurses from two medical centers in Southern Taiwan as research subjects. Of

450 questionnaire distributed, 300 valid questionnaires were returned, giving a response rate of 66.7%.

After conducting statistical analysis and estimation using structural equation modeling, findings

included: (1) job satisfaction has positive effects on organizational commitment; (2) nurse perceptions

of internal marketing have positive effects on job satisfaction; and (3) nurse perceptions of internal

marketing have positive effects on organizational commitment.

Key Words: internal marketing, job satisfaction, organizational commitment, structural equation modeling

(SEM).

Introduction

The concept of internal marketing originated in the

field of marketing research in the service industry (Berry,

1981; Gronroos, 1981), emphasizing that enterprises should

value and respect their employees and regard them as “in-

ternal customers” (Longbottom, Osseo-Asare, Chourides,

& Murphy, 2006). Viewing employees as an organization’s

internal customers, Berry (1981) treated employees with

“marketing-like” methods, which allowed the employees

to obtain satisfactory “products”, or “jobs”. Berry and

Parasuraman (1991) pointed out that “internal marketing”

refers to the development of products that meet employees’

needs in order to attract, develop, inspire, and retain quali-

fied employees. Internal marketing is the management phi-

losophy of treating employees as customers, as well as a

development strategy of offering the products (or jobs) that

meet employees’demands in order to win employee loyalty

and organizational commitment (Longbottom et al., 2006).

Employee job satisfaction represents the subjective

attitudes and evaluations of employees toward their overall

work environment and reflects the success of an enterprise

in providing a workplace environment that fully meets em-

ployees’ demands for skill utilization, social value, and

265

Journal of Nursing Research Vol. 15, No. 4, 2007

MBA, Instructor, Department of International Trade & Business Administration, Wenzao Ursuline College of Languages & Doctoral Student,

Graduate School of Business Management, National Cheng Kung University; *PhD, Associate Professor, Department of Business

Administration, National Cheng Kung University.

Received: May 9, 2007 Revised: August 6, 2007 Accepted: September 13, 2007

Address correspondence to: Ching-Sheng Chang, 19F, No. 25, Fu-Kuo Rd., Kaohsiung 81357, Taiwan, ROC.

Tel: 886(7)558-4262; E-mail: [email protected]

achievement, and serves as the judgment indicator for fair-

ness and appropriateness of an organizations’ regulations

(Shimizu, Eto, et al., 2005). Therefore, internal marketing

has a powerful influence on employees’ sense of belong-

ing, isolation, and work motivation (Kudo et al., 2006).

The concept that organizational commitment is regarded as

the identification with an organization was first proposed

by Whyte in 1956, followed by cause-effect models of or-

ganizational commitment with organizational commitment

as the intervening variable, as successively suggested by

Mowday, Porter, and Steers (1982) and Trimble (2006).

Through the research of these scholars, it was found that

employees with strong organizational commitment show

three types of tendencies toward an organization, including

a strong belief in and acceptance of organizational objec-

tives and values; willingness to dedicate more effort to the

organization; and the desire to remain a part of the organi-

zation. Employee job satisfaction gives a precise predic-

tion of organizational commitment (Lambert, Pasupuleti,

Cluse-Tolar, Jennings, & Baker, 2006).

Nurses working at hospitals not only implement inde-

pendent and professional nursing activities in accordance

with doctors’ advice, but also take responsibility for any

immediate threat to patient lives. Thus, the importance of

nurse is undeniable, and the influence of nurse qualities and

capabilities on medical care quality cannot be ignored

(Bernstein, 2005). From a management viewpoint, hospitals

can be seen as enterprises engaged in activities involving the

entire medical system where everything, from the simplest

tasks to systemic planning and management, relies on hu-

man input and control. Therefore, a primary concern of

medical care is to effectively utilize internal marketing to

enhance and develop the job satisfaction and organizational

commitment of nurses in order to promote competitive ad-

vantage (Bernstein, 2005; Longbottom et al., 2006).

In summary of the aforementioned research back-

ground and motives, this study aims to discuss the correla-

tion between nurse job satisfaction and organizational

commitment from the perspective of internal marketing.

The discussion in this research can be generalized into

three parts, as follows:

1. Discussion of the correlation between nurse job satis-

faction and organizational commitment.

2. Discussion of the correlation between nurse percep-

tions of internal marketing and job satisfaction.

3. Discussion of the correlation between nurse perceptions

of internal marketing and organizational commitment.

Because this study aims to discuss correlations among

nurse’s internal marketing, job satisfaction, and organi-

zational commitment, the following research objective-

related hypotheses are proposed:

(1) Hypothesis 1: Nurse job satisfaction has a positive

influence on organizational commitment.

(2) Hypothesis 2: Nurse perceptions of internal market-

ing have a positive influence on job satisfaction.

(3) Hypothesis 3: Nurse perceptions of internal mar-

keting have a positive influence on organizational

commitment.

Literature Review

1. Internal marketing

Gronroos (1981), the scholar who first introduced the

term “internal marketing”, defined the term as the behavior

of selling a corporation to its internal customers (employ-

ees) under the principle that highly satisfied employees

will help create a market-oriented and customer-centered

corporation and, consequently, encourage employees with

customer-oriented awareness (Bernstein, 2005; Long-

bottom et al., 2006). Greene, Walls, and Schrest (1994)

assumed that internal marketing refers to the application of

marketing philosophy and methods to employees who ser-

ve customers in order to utilize and maintain employees

and ensure they strive to finish work. Hence, the concept of

internal marketing sees employees as internal customers

and their work as internal “products”, and, therefore, dedi-

cates efforts to the design of products that better satisfy

employee needs (Longbottom et al., 2006).

Zeithaml and Bitner (2000) indicated that in the ser-

vice triangle, the objective of external marketing is to es-

tablish commitment, interactive marketing to fulfill com-

mitment, and internal marketing to improve the ability to

fulfill commitment. In other words, the three types of

marketing in the service triangle are critical to successful

service and higher corporate profits. Internal marketing is

a communication process, and the purpose is to create the

customer-oriented organizational culture (Bernstein, 2005).

Employees are regarded as corporate partners who coop-

erate with corporations to provide products and services

for external customers. Conduit and Mavondo (2001) di-

vided internal marketing activities into five constructs

based on the seven categories proposed by Gronroos

(2000), with the five constructs related to one another as

revealed in the results of a sample survey (Suzuki et al.,

266

J. Nursing Research Vol. 15, No. 4, 2007 Ching-Sheng Chang et al.

2006). These five constructs are: (1) market training and

education; (2) management support; (3) internal commu-

nication; (4) personnel management; and (5) employee

involvement in external communication. The constructs

suggested by Conduit and Mavondo (2001) were adopted

by this study.

2. Job satisfaction

Robbins (1996) assumed that job satisfaction stands

for the general attitudes that a worker has toward his or her

job, with a high level of job satisfaction indicating a posi-

tive attitude. Job satisfaction refers to a joyful or positive

emotional state regarding work or the work experience

(Shimizu, Eto, et al., 2005; Suzuki et al., 2006). Porter and

Lawler’s (1968) definition of job satisfaction includes both

internal and external satisfaction. Internal satisfaction re-

fers to the causes that create job satisfaction, and are clo-

sely related to the job itself. In other words, it is the level of

satisfaction achieved through the job itself, through facets

such as sense of achievement, growth, self-esteem, inde-

pendence, and sense of control (Shimizu, Feng, & Nagata,

2005; Shimizu, Eto, et al., 2005). External satisfaction, on

the other hand, is indirectly related to the job itself, and

includes such facets as good working environment, wel-

fare, high salary, promotion, etc.

By combining the factors that affect job satisfaction

proposed by domestic and foreign scholars, we can con-

clude the following: Job satisfaction refers to a worker’s

feelings of, or emotional response to, his or her job and

relevant elements (Takeda, Ibaraki, Yokoyama, Miyake,

& Ohida, 2005). Degree of satisfaction depends on the

difference between actual gains and expected gains, and

can be divided into two constructs: internal satisfaction

and external satisfaction. Internal satisfaction refers to the

degree of an individual’s feelings toward, and satisfaction

with, current job activities, independence, creativity, vari-

ation, and opportunities to utilize skills, job duty impor-

tance, job achievements and responsibilities, job stability

and security, contribution to society and social status of

the job, as well as work ethic and values. External satis-

faction refers to the degree of an individual’s satisfaction

with all aspects of the current job not related to job con-

tent. Such includes possibility of promotion, rewards and

praise earned, organizational policies and executive

approaches, technical guidance, and interpersonal rela-

tionships (Castle, Engberg, & Anderson, 2007; Shimizu,

Feng, et al., 2005).

3. Organizational commitment

The concept of organizational commitment has be-

come an important research topic in the field of organiza-

tional behaviors ever since it was first proposed by Whyte

(1956). Porter, Steers, Mowday, and Boulian (1974) sug-

gested that organizational commitment is the degree of an

individual’s identification with, and devotion to, a specific

organization, and includes: (1) value commitment: strong

belief in, and acceptance of, organizational objectives and

values; (2) effort commitment: willingness to dedicate

greater effort to benefit the organization; (3) retention com-

mitment: willingness to remain as a member of an organi-

zation (Lambert et al., 2006; Moss, McFarland, Ngu, &

Kijowska, 2007). Buchanan (1974) believed that organiza-

tional commitment means an individual is attached emo-

tionally to an organization, including identification with,

and acceptance of, organizational objectives and values;

mental devotion to, and concentration on, a job role; and

loyalty to, and affection for, the organization (Dee, Henkin,

& Singleton, 2006). Therefore, the concept of organiza-

tional commitment embraces the following employee fac-

tors: (1) desire to strive to the fullest in order to represent

an organization; (2) desire to remain with an organization;

(3) feelings of belonging and loyalty to an organization;

(4) acceptance of major organizational goals and values;

(5) positive evaluation of an organization. Organizational

commitment refers to a sense of emotional identification

with organizational objectives and values, relevant profes-

sional roles, and an organization and group, with the char-

acteristics of identification, devotion, and loyalty.

According to Meyer, Allen, and Smith (1993), organi-

zational commitment should contain the following three

constructs: (1) affective commitment: members of an orga-

nization are emotionally attached to, identify themselves

with, and feel devoted to, an organization; (2) continuance

commitment: the existence of commitment is based on the

consideration of costs occurring when members leave an

organization; (3) normative commitment: employees are

firmly convinced that loyalty to an organization is an es-

sential and absolutely obligatory value (Erdheim, Wang, &

Zickar, 2006). After a comprehensive survey of scholarly

research from the viewpoint of organizational commitment,

the perspective of Porter et al. (1974) and Trimble (2006)

that organizational commitment can be evaluated as the

degree of individual identification with, and devotion to, a

specific organization, including “strong belief in, and ac-

ceptance of, organizational objectives and values, willing-

267

Effects of Internal Marketing on Nursing J. Nursing Research Vol. 15, No. 4, 2007

ness to dedicate more efforts for organizational benefits,

and willingness to remain a member of an organization,”

was adopted in this study. The three constructs of value

commitment, effort commitment, and retention commit-

ment were chosen as research variables.

4. Relationships among internal marketing, job

satisfaction, and organizational commitment

The most widely accepted viewpoint is that job satis-

faction influences employees’ commitment to an organiza-

tion (Mowday et al., 1982; Trimble, 2006). As pointed out

by scholars who side with this perspective, the concept of

job satisfaction tends to be created from a micro viewpoint,

while organizational commitment is created from a macro

viewpoint (Lambert et al., 2006). As such, job satisfaction

is just a determinant of organizational commitment.

In their studies on the correlation between internal

marketing perceptions and job satisfaction, Berry and

Parasuraman (1991) pointed out that enterprises must pro-

mote services to internal employees first and allow them to

find pleasure in work before employees will be capable of

providing effective service to external customers of the

enterprise. Internal marketing refers to the application of

marketing concepts to an organization’s internal manage-

ment (Longbottom et al., 2006). Thus, the theoretical rela-

tionship and development of internal marketing and orga-

nizational commitment have been generally elaborated by

marketing scholars. Kohli and Jaworski (1990) pointed out

that the employees of an organization with the concept of

internal marketing as its enterprise philosophy have gener-

ally higher job satisfaction and organizational commitment

(Trimble, 2006).

Combining all of the above, we can conclude the fol-

lowing: (1) job satisfaction has positive effects on organi-

zational commitment; (2) nurse perceptions of internal

marketing have positive effects on job satisfaction; and

(3) nurse perceptions of internal marketing have positive

effects on organizational commitment.

Therefore, based on the literature review conducted for

this study. The overall research framework is shown in Figure 1.

Methods

A research framework and research hypotheses were

established at the outset of this study based on research

motives, objectives, and literature review. Afterward, a

questionnaire was designed and sample survey taken. The

development of each construct and methods used for data

analysis will be explained. The limitations on this study are

stated at the end of this paper.

268


Internal Marketing

1. Management support

2. Human resources management

3. External communication

4. Internal communication

5. Education training

Job Satisfaction

1. Internal satisfaction

2. External satisfaction

Organizational

Commitment

1. Value commitment

2. Effort commitment

3. Retention commitment

H1

H2 H3

Figure 1. Conceptual framework of the relationship among internal marketing, job satisfaction, and organizational commitment.

Notes. H1 shows the nurse job satisfaction has a positive influence on organizational commitment. H2 shows nurse perceptions of

internal marketing have a positive influence on job satisfaction. H3 shows nurse perceptions of internal marketing have a positive

influence on organizational commitment.

Data Collection and Sampling

The questionnaire used in this study was drafted after

reviewing a wide range of relevant literature and then

amended through multiple discussion sessions with three

professors and two physicians and experts in order to en-

sure questionnaire content validity of the. Afterward, a

pre-test was conducted on nurses to remove invalid items

and ensure questionnaire content completeness and signifi-

cance so that it would measure effectively correlations

among nurse perceptions of internal marketing, job satis-

faction and organizational commitment. With the nurse of

two medical centers in southern Taiwan as study subjects, a

total of 450 questionnaire were distributed. Of the 318 co-

pies returned, 18 were excluded due to incomplete an-

swers, which gave a total 300 effective copies were re-

trieved and a valid response rate of 66.7%.

Instrument

This questionnaire was constructed as a self-designed,

structured questionnaire after consulting numerous related

articles and repeated discussion with experts. It encompassed

three dimensions, including internal marketing, job satis-

faction and organizational commitment. General factor

analysis was concurrently adopted to verify factor names

and reliability analysis (See Table 1). A 7-point Likert scale

was adopted for scales. As shown in Table 1, Cronbach’s �

values for all dimensions measured higher than .6, indi-

cating adequate questionnaire reliability (Chang, Weng,

Chang, & Hsu, 2006; Onwuegbuzie & Leech, 2005).

Data Analysis Methods

After questionnaires were collected, they were in-

spected and processed in order to exclude copies with in-

complete answers. Valid copies were then assigned num-

bers and filed. Analysis software, including SPSS 11.0 and

LISREL 8.50 (Linear Structural Relationship), was applied

in data analysis and processing, with tests including reli-

ability analysis, descriptive statistics analysis, and struc-

tural equation modeling (SEM).

Structural Equation Modeling (SEM)

The Linear Structural Relationship Model was em-

ployed to examine relationships among internal market-

ing, job satisfaction, and organizational commitment. To

test the research hypotheses, this study primarily used

LISREL 8.50 to do the structural equation modeling (SEM)

in order to assess relationships across various dimensions.

According to Joreskog and Sorbom (1989), structural

equation modeling allows not only the determination of

relationship extent between variables, but also the exami-

nation of chain of cause and effect. This means that results

do not merely show empirical relationships between vari-

ables when defining the practical situation. For this rea-

son, this study chose structural equation modeling to test

hypotheses. This study also used several indices, such as

the ratio of Chi-square, goodness of fit index (GFI),

adjusted goodness of fix index (AGFI), normal fix index

(NFI), and root mean square residual (RMSR) to evaluate

overall model fitness.

269


Table 1.

Names and Reliability Analyses of the Factors of Each Construct

Construct�Factor Name Factor loading Cronbach’s � KMO

Internal Marketing .906 .915

Management support .832

Human resources management .912

External communication .856

Internal communication .808

Education training .872

Job Satisfaction .891 .910

Internal satisfaction .886

External satisfaction .891

Organizational Commitment .861 .887

Value commitment .816

Effort commitment .883

Retention commitment .848

Results

Demographic Characteristics

All of the nurse in this study were female. Roughly

half were aged 30 years or less (49%) and most were not

married (57.7%). In terms of educational level, most held

college degrees or less (60.7%). In terms of seniority, most

had worked for their employer between 3~6 years (30%).

Most worked in a ward (51%) (see Table 2).

Relationships Among Internal Marketing, Job

Satisfaction, and Organizational Commitment

The Linear Structural Relationship Model was ap-

plied to examine relationships among nurse perceptions of

internal marketing, job satisfaction, and organizational

commitment, with results described below.

(1) Relationship between job satisfaction and organiza-

tional commitment

As shown in Figure 2, parameter estimates of the cor-

relation between “job satisfaction” and “organizational

commitment” reveal a path coefficient from job satisfac-

tion to organizational commitment of .56 (t = 17.62), which

reaches significance (p < .05), reflects a positive relation-

ship and indicates that job satisfaction has an evidently

270


OrganizationalCommitment

Job Satisfaction

Internal Marketing

Management

Support

Human Resources

Management

External

Communication

Internal

Communication

Value

Commitment

Effort

Commitment

Retention

Commitment

Internal

Satisfaction

External

Satisfaction

�21

�11 �21

�1

x1 x2 x3 x4

�1 �2 �3 �4

�1

1 2

.56

�6

�7

�8

�9

�2

.55 .72

.58 .46

.52 .46

.69 .48 .66 .79

Education

Trainingx5

�5

.62�10

.62

1

.74

2

.63

.51

.61

�3

�4

�5

.47

.69

.49

.78

3

.52

4

.76

5

Figure 2. Structural equation modeling with internal marketing as the moderator variable between job satisfaction and organiza-

tional commitment. Note. all parameters reach the significance level of p < .05.

Table 2.

Descriptive Statistics of Sample (N = 300)

Variable n %

GenderFemale 300 100

Age30 or under 147 49.031�40 113 37.741�50 040 13.3

Marital StatusMarried 127 42.3Not married 173 57.7

EducationCollege or under 182 60.7Bachelor 101 33.7Master or above 017 05.6

SeniorityLess than 3 years 053 17.73�6 years 090 30.06�10 years 079 26.310 years or above 078 26.0

DepartmentWard 153 51.0Intensive care unit 076 25.3Others 071 23.7

Job TitleNurse 279 93.0Head nurse 021 07.0

positive influence on organizational commitment. Hypoth-

esis 1 is, therefore, accepted.

(2) Relationships among perceptions of internal market-

ing and job satisfaction

As illustrated in Figure 2, parameter estimates of the

path coefficient among “internal marketing” and “job satis-

faction” reveal a path coefficient from internal marketing

to job satisfaction of .52 (t = 12.75), which reaches signifi-

cance (p < .05), reflects a positive relationship, indicating

that internal marketing has an evidently positive influence

on job satisfaction. Hypothesis 2 is, therefore, accepted.

(3) Relationships among perceptions of internal market-

ing and organizational commitment

As illustrated in Figure 2, parameter estimates of the

path coefficient among “internal marketing” and “organi-

zational commitment” reveal a path coefficient from inter-

nal marketing to organizational commitment of .46 (t =

8.63), which reaches significance (p < .05). This reflects a

positive relationship, supporting the premise that internal

marketing has an evidently positive influence on organiza-

tional commitment. Hypothesis 3 is, therefore, accepted.

(4) Table 3 shows the model fit goodness of the LISREL

model, in which the ratio of Chi-square 2.12 is smaller

than the recommended ratio of 3; the GFI exceeds the

recommended value of .9; the AGFI exceeds the rec-

ommended value of .8; the NFI exceeds the recom-

mended value of .9; and the RMSR is lower than the

recommended value of .08 (Bagozzi & Yi, 1988;

Joreskog & Sorbom, 1989).

Discussion

The two major results of this study are (1) job sati-

sfaction has positive effects on organizational commit-

ment; (2) nurse perceptions of internal marketing have po-

sitive effects on job satisfaction; and (3) nurse perceptions

of internal marketing have positive effects on organiza-

tional commitment. The three results are discussed below.

Job satisfaction has an obviously positive influence

on organizational commitment. When nurse job satisfac-

tion increases, organizational commitment is enhanced

correspondingly. In other words, a higher level of job satis-

faction indicates that a nurse is more likely to recognize

organizational values and goals, remain with the organiza-

tion, and dedicate more effort toward accomplishing orga-

nizational objectives in order to assist the organization

develop and succeed. This corresponds with the assertions

of relevant studies in the past. For example, Trimble (2006)

believed that a high level job satisfaction represents employ-

ees’ strong identification with, and loyalty to, an organiza-

tion, willingness to accept hardships and overcome predica-

ments as a team, higher interest in job responsibilities.

Our findings support the statement that internal mar-

keting has a clearly positive influence on job satisfaction

and organizational commitment and that differences in

nurse perceptions with regard to internal marketing posi-

tively influence their job satisfaction. This agrees with

assertions made in previous studies, such as that by Heskett,

Thomas, Lovemen, Sasser, and Schlesinger (1990) propos-

ing a causal model of service profit chain internal service

quality that drives employee satisfaction and that of Long-

bottom et al. (2006), which pointed out that internal mar-

keting aims to provide services to internal employees, pro-

mote employee job satisfaction and facilitate organiza-

tional growth and development.

Study findings also support that internal marketing

has a clearly positive influence on organizational commit-

ment. Differences in nurse perceptions of internal market-

ing positively influence organizational commitment. This

also agrees with assertions made in previous relevant stud-

ies. For instance, Trimble (2006) indicated that employees

have a higher level of job satisfaction and organizational

commitment when organizations adopt marketing concepts

as their enterprise philosophy both internally and exter-

nally. Gronroos (2000) suggested that organization utiliza-

tion of the concept of internal marketing contributes to en-

hanced employee organizational commitment.

Deserving of special attention is that, as internal mar-

keting has a positive influence on job satisfaction and orga-

nizational commitment, differences in nurse perceptions of

internal marketing affect their organizational commitment

in two ways: (A) Internal marketing directly affects orga-

nizational commitment, which represents a direct effect;

271


Table 3.

The Model Fit Goodness of the LISREL Model

Fitness Statistics �2�df. GFI AGFI NFI RMSR

Standard Value < 3 > .9 > .8 > .9 < .08

Conceptual Model 2.12 .92 .91 .92 .036

Note. GFI = Goodness of Fit Index; AGFI = Adjusted GFI;

NFI = Normal Fix Index; RMSR = Root Mean Square Residual.

(B) Job satisfaction is used as an intervening variable to

affect organizational commitment, which represents an

indirect effect. According to the above findings, we learn

that nurse perceptions of internal marketing also positively

influence organizational commitment, with the requirement

of job satisfaction as the intervening variable. This finding

varies from the previous assumption that job satisfaction

alone can positively influence organizational commitment.

In conclusion, hospital operations rely on the active

participation and assistance of nurses. As significant time

and costs are involved in training and cultivating nursing

talent, a way to retain outstanding nurses and reduce turn-

over costs and problems is for employers to pay greater

attention to the needs and expectations of their nursing

staff. Therefore, with regard to human resource manage-

ment and utilization, increasing nurse job satisfaction rep-

resents a practical and sound strategy targeting enhanced

organizational commitment. Therefore, according to the

findings of this study, we can infer that high satisfaction

with job-related activities, independence and creativity;

opportunities to utilize skills; achievements; responsibil-

ity; job stability; service to society; social status; possibil-

ity of promotion, rewards and praise; and organizational

policies and executive measures will influence nurses’

commitment to an organization. This can be reflected in

behavior such as a strong sense of belonging to an organi-

zation, willingness to dedicate efforts toward organization

success, identification with current job, and a desire to

remain in his or her position.

Finally, three research limitations identified for this

paper include:

(1) This study only discussed relationships among nurse

perceptions of internal marketing, job satisfaction,

and organizational commitment. The factors affecting

organizational commitment are quite complicated,

and include other variables such as job characteristics,

work environment, work experience, management

style, and so on, which were not included in the scope

of discussion in this study.

(2) The scope of this study was limited to two medical

centers in southern Taiwan. Thus, the applicability of

study findings to the entire nurse population may be

limited.

(3) Because of time restrictions, this study was conducted

at a single time point and, thus, was not able to assess

relevant long-term factors of influence. Suggestions

for future researchers are to adopt a time crossing

methodology for research design rather than a single

time point. This will provide data at several time peri-

ods and allow the observation of long-term factors

that exert mutual influence over all variables that will

allow for more objective results.

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內部行銷對護理人員的影響 J. Nursing Research Vol. 15, No. 4

內部行銷對護理人員工作滿足與組織承諾之影響

以南部醫學中心為例

張景盛張心馨*

摘要：在醫療人力中，以護理人員所占比率最高，隨著時代進步，護理人員的角色日漸擴

展，在醫療過程中愈來愈有顯著地位，其人員素質與功能，影響醫療品質甚巨。內

部行銷的概念起源於服務業行銷研究之領域，主張企業應該重視並尊重員工、將員

工視為內部顧客，此種行銷概念打破以往只注重外部顧客的傳統行銷手法，最主要

的目的在於使內部顧客（員工）獲得工作上的滿足，增進個人的工作績效，達成組

織最終的營運目標，故透過內部行銷，是否有助於增進護理人員工作滿足，使其樂

為組織效力是醫療實務界所關切的問題。因此，本研究旨在探討護理人員內部行銷

知覺、工作滿足與組織承諾之結構關係模式，採用問卷調查法，以南部兩家醫學中

心之護理人員為研究對象，問卷共發放 450 份，並得到有效問卷 300 份，有效回收

率為 66.7%。進行結構方程模式分析，其結果如下：(1)工作滿足對組織承諾有正向

影響。(2)內部行銷對工作滿足有正向影響。(3)內部行銷對組織承諾有正向影響。

關鍵詞：內部行銷、工作滿足、組織承諾、結構方程模式。

274

文藻外語學院國貿企管系講師暨國立成功大學企業管理研究所博士生 *國立成功大學企業管理系副教授受文日期：96年 5月 9日修改日期：96年 8月 6日接受刊載：96年 9月 13日通訊作者地址：張景盛 81357高雄市左營區富國路 25號 19樓

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