This paper examined the relationship between the job-related stress of nursing home administrators and the structure of their work setting. Multivariate analysis of covariance (MANCOVA) was used to test the hypothesis that nursing home administrators who are employed in multi-unit, corporate-owned facilities experience more job-related stress than do administrators employed in independent, free-standing organizations. The results indicated that, when controlling for other potential stressors, administrators in corporate-owned nursing homes reported more general job stress and greater role ambiguity than their counterparts in single-unit, autonomous organizations. Recommendations for management strategies and for future studies in this area are discussed.
Alabama State Board of Health (1986). Directory of Health Care Facilities (ADPH-P-BLC-206/Rev 1-86). Montgomery, Alabama: Alabama Bureau of Licensure and Certification.
3.
AlexanderJ. A.FennellM. L. (1986). ‘Patterns of decision making in multihospital systems’. Journal of Health and Social Behavior, 27:14–27.
4.
AlexanderJ. A.MorriseyM. A.ShortellS. M. (1986). ‘Effects of competition, regulation, and corporatization on hospital-physician relationships’. journal of Health and Social Behavior, 27: 220–35.
5.
Arthur Anderson and Company and the American College of Hospital Administrators (1984). Healthcare in the 1990s: Trends and Strategies. Chicago: Author.
6.
BlauP. M. (1964). Exchange and Power in Social Life. New York: Wiley.
7.
BriefA.AldagR. (1976). ‘Correlates of role indices’. Journal of Applied Psychology, 61:468–72.
8.
BurnsL. R.AndersonR. M.ShortellS. M. (1989). The impact of corporate structures on physician inclusion and participation’. Medical Care, 27(10): 967–82.
9.
CampbellD. J.GingrichK. F. (1986). ‘The interactive effects of task complexity and participation on task performance: A field experiment’. Organizational Behavior and Human Decision Processes, 38: 162–80.
10.
CollierH. G. (1989). ‘State of the art in nursing home-hospital joint ventures’. Provider, 15(6): 30–2.
11.
EmersonR. M. (1962). ‘Power-dependence relations’. American Sociological Review, 27: 31–41.
12.
ErezE.EarleyP. C.HulinC. L. (1985). ‘The impact of participation on goal acceptance and performance: A two-step model’. Academy of Management Journal, 28: 50–66.
13.
FarleyJ. L. (1988). ‘An emerging profile of today's professional administrator’. Provider, 14(12): 30–3.
14.
FrenchJ. H. P.CaplanR. D. (1972). ‘Organization stress and individual stress’. In MarrowA. J. (ed) Failure of Success. New York: AMACOM.
15.
FulkJ.BriefA. P.BarrS. H. (1985). ‘Trust-in-supervisor and perceived fairness and accuracy of performance evaluations’, journal of Business Research, 13:301–13.
16.
GibbP. (1985). ‘Appraisal goals and control’. Personnel journal, 64(8): 89–93.
17.
GolembiewskiR. T.MuzenriderR. F.StevensonF. G. (1986). Stress in Organizations: Toward a Phase Model of Burnout. New York: Praeger.
18.
GreenbergJ. (1986). ‘Determinants of perceived fairness of performance evaluations’. Journal of Applied Psychology, 71: 340–2.
19.
HarrisR. J. (1975). A Primer on Multivariate Statistics. New York: Academic Press.
20.
HillerM. D.SugarmanD. B. (1988). ‘Value judgements in long-term care: A survey of NHAs’. Journal of Long-Term Care Administration, 16(4): 5–12.
21.
HouseR.RizzoJ. R. (1972). ‘Role conflict and ambiguity as critical variables in a model of organizational behavior’. Organizational Behavior and Human Performance, 7:467–505.
22.
JacksonS. E.SchulerR. S. (1985). ‘A meta-analysis and conceptual critique of research on role ambiguity and role conflict in work settings’. Organizational Behavior and Human Decision Processes, 36:16–78.
23.
JazwieckiT.McDonnellD. T. (1988). ‘Diversification a must for growth and survival’. Provider, 14(11): 18–20.
24.
KahnR. L.WolfeD. M.QuinnR. P.SnoekJ. D.RosenthalR. A. (1964). Organizational Stress: Studies in Role Conflict and Ambiguity. New York: Wiley.
25.
KerschnerP. A. (1988). ‘ACHA's industry survey: Given the facts, is planning on target?’Provider, 14(10): 12–33.
26.
KingL.KingD. (1990). ‘Role conflict and role ambiguity: A critical assessment of construct validity’. Psychological Bulletin, 107:48–64.
27.
McGeeG. W.FergusonC. E.SeersA. (1989). ‘Role conflict and role ambiguity: Do the scales measure these two constructs?’Journal of Applied Psychology, 74: 815–18.
28.
McKonkieM. L. (1979). ‘A clarification of the goal setting and appraisal processes in MBO’. Academy of Management Review, 4:29–40.
29.
MertonR. K. (1957). Social Theory and Social Structure. Glencoe, IL: Free Press.
30.
MilesR. (1976). ‘A comparison of the relative impacts of role perceptions of ambiguity and conflict by role’. Academy of Management Journal, 19: 25–35.
31.
MintzbergH. (1979). The Structuring of Organizations: A Synthesis of the Research. Englewood Cliffs, NJ: Prentice-Hall.
32.
MullenW. E. (1985). ‘Identification and ranking of stressors in nursing home administration’. The Gerontologist, 25: 370–5.
33.
PearlinL. I.SchoolerC. (1978). ‘The structure of coping’. Journal of Health and Social Behavior, 19: 2–21.
34.
PfefferJSalancikG. R. (1978). The External Control of Organizations: A Resource Dependence Perspective. New York: Harper & Row.
35.
ProvanK. G. (1982). ‘Interorganizational linkages and influence over decision making’. Academy of Management Journal, 25: 443–51.
36.
ProvanK. G. (1984). ‘Interorganizational cooperation and decision making autonomy in a consortium multihospital system’. Academy of Management Review, 9:494–604.
37.
ProvanK. G. (1987). ‘Environmental and organizational predictors of adoption of cost containment policies in hospitals’. Academy of Management Journal, 30: 219–39.
38.
ProvanK. G. (1988). ‘Organizational and decision unit characteristics and board influence in independent versus multihospital system-affiliated hospitals’. Journal of Health and Social Behavior, 29: 239–52.
39.
RizzoJ. R.HouseR. J.LirtzmanS. I. (1970). ‘Role conflict and ambiguity in complex organizations’. Administrative Science Quarterly, 15:150–63.
40.
RubinA.ShuttleworthG. E. (1986). ‘Job turnover among nursing home administrators: An exploratory study’. Journal of Long-Term Care Administration, 14(2): 25–9.
41.
SchoonC. G.HayezS. K. (1987). The entry-level role of nursing home administrators’. The Journal of Long-Term Care Administration, 15(3): 15–19.
42.
ScottW. R. (1983). ‘Health care organizations in the 1980s: The convergence of public and professional control systems’. In MeyerJ. W.ScottW. R.Organizational Environments: Ritual and Rationality. Beverly Hills: Sage.
43.
SmithH. L.FottlerM. D. (1981). ‘Costs and cost containment in nursing homes’. Health Services Research, 16:17–46.
44.
StrahanG. (1987). ‘National Center for Health Statistics: Nursing home characteristics, preliminary data from the 1985 National Nursing Home Survey’. Advance Data from Vital and Health Statistics, No 131, DHHS Pub No (PHS) 87-1250. Public Health Service, Hyattsville, MD.
45.
ThompsonJ. D. (1967). Organizations in Action. New York: McGraw-Hill.
46.
ThompsonJ. D.McEwenW. J. (1958). ‘Organizational goals and environment: Goal-setting as an interaction process’. American Sociological Review, 23: 23–31.
47.
TracyL.JohnstonT. W. (1981). “What do the role conflict and ambiguity scales measure?’Journal of Applied Psychology, 66:464–9.
48.
VignolaM. L. (1987). ‘At the threshold of major change’. Provider, 13(5): 4–6.
49.
WardwellW. I.HymanM.BatsonC. B. (1964). ‘Stress and coronary disease in three field studies’. Journal of Chronic Diseases, 17: 73–84.
50.
WeilP. A.StamL. (1986). ‘Transitions in the hierarchy of authority in hospitals: Implications for the role of the chief executive officer’. Journal of Health and Social Behavior, 27:179–92.
51.
ZuckermanH. S. (1979). ‘Multi-institutional systems: Promise and performance’. Inquiry, 16: 291–314.
52.
ZuckermanH. S. (1989). ‘Redefining the role of the CEO: Challenges and conflicts’. Hospital and Health Services Administration, 34(1): 25–38.
