{"paper_id":"01c6ffc9-a2a7-496b-ab36-d4a7ea1983f4","body_text":"Association Between Organizational Commitment and the Working Environment Among Care Workers in Long-Term Care Facilities: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Association Between Organizational Commitment and the Working Environment Among Care Workers in Long-Term Care Facilities: A Cross-Sectional Study jiaying zheng, ying zhang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8669748/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 15 You are reading this latest preprint version Abstract Aim: To examine the association between organizational commitment and working environment among care workers in long-term care facilities. Design: A cross-sectional study. Methods: The study was carried out on a total of 282 care workers in 22 long-term care facilities (LTCFs) in Hangzhou City, Zhejiang Province, China. The data were collected using a Demographic Questionnaire, the Organizational Commitment Questionnaire of Chinese Employees and GallupWorkplace Audit. Results: The mean organizational commitment scores of the care workers were 59.62 ± 9.34. The mean working environment scores of the care workers were 42.65 ± 5.61. A statistically significant positive relationship was found between organizational commitment scores and working environment scores (r = 0.541, P = 0.003). Furthermore, the multiple linear regression analysis indicated that the working environment was an independent factor influencing organizational commitment. Conclusions: The results of the study demonstrated a significant association between organizational commitment and the working environment of care workers. Care workers who hold a more positive perception of their working environment exhibit a higher level of organizational commitment. Implication for nursing management: LTCFs should focus on improving the working environment to enhance organizational commitment, which in turn contributes to the effective attraction and retention of care workers. Strategies to achieve this may include offering targeted training programs and providing comprehensive support systems for care workers. Care worker long-term care facilities organizational commitment working environment turnover Figures Figure 1 1 BACKGROUND Population aging is accelerating rapidly worldwide that presents significant challenges for healthcare systems worldwide. China, as the most populous country, is experiencing rapid population aging. The Seventh National Population Census published in 2022 revealed that there were 264.02 million people aged 60 years and over in China, accounting for 18.7% of the total population. This represents a substantial increase of 5.44% points compared to 2010 1 . Projections indicate that by 2040, the number of people aged 60 years and over in China will reach 402 million, constituting approximately 28% of the population 2 . The substantial increase in the aging population, as well as 'one child policy' and the 'empty-nest elderly' phenomenon in China has resulted in a growing demand for long-term care facilities (LTCFs). Unfortunately, human resource in LTCFs is limited 3 – 5 , especially care workers, who provide assistance to residents with daily activities, including feeding, bathing, toileting, and other personal needs 6 . By 2019, the number of care workers in China was only 300,000 7 . Care workers constitute most proportion of the workforce in LTCFs, and they play a vital role as direct care providers for residents, ensuring the quality of care within LTCFs 8 . Consequently, substantial studies have been conducted to explore factors that can improve the supply and retention of care workers in LTCFs. One such factors is organizational commitment, a psychological state that binds employees to their organization 9 . Evidence showed that organizational commitment is associated with turnover intention, job satisfaction and job performance 10 , 11 . Employees with higher levels of commitment are more likely to engage in organizational activities and work towards achieving organizational goals. As such, much efforts have been devoted to exploring the factors influencing organizational commitment, primarily at the individual level 12 . Recent studies have examined the associations between organizational commitment and the working environment, including group cohesion, structural empowerment among nurses 13 , 14 . However, limited research has been conducted among care workers. Given the inadequate research on the association between organizational commitment and the working environment among care workers, this study aimed to address this gap. The objectives of this study were threefold: First, to examine the level of organizational commitment among care workers in China. Second, to assess the working environment experienced by care workers within these facilities. Third, to examine the impact of organizational commitment on the working environment. 2 METHODS 2.1 Research design and setting A cross-sectional study was conducted. A total of 25 LTCFs in in Hangzhou City, Zhejiang Province, China, were initially approached for participation, and 22 of them agreed to participate in this study. 2.2 Participants All care workers employed at these LTCFs were invited to participate if they met the following criteria: (1) had worked in the LTCFs for at least three months, (2) provided direct care services to older adults; (3) were willing to participate and provided informed consent. This study utilized a convenience sampling approach, enrolling care workers who were on duty during the data collection period. 2.3 Study instruments 2.3.1 Demographic questionnaire This questionnaire included age, gender, place of birth (cities or towns), educational level, institutional type, years of experience in LTCFs, and prior engagement in care-related occupations. 2.3.2 Organizational Commitment Scale The Organizational Commitment Scale was developed by Lin 15 to measure the organizational commitment of employee, it was tested for validity and reliability in China, and the Cronbach’s alpha coefficient was 0.67 16 . This is a 25-items scale composed of five subscales: affective commitment, normative commitment, economic commitment, opportunity commitment and ideal commitment. Each subscale consists of five items, and participants are required to rate their responses using a five-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The overall score ranges from 25 to 125. The higher scores mean higher levels of organizational commitment. As this scale had not been previously used with care workers, a content validity test was conducted. Five facility managers, each with more than five years of work experience in LTCFs, were invited to evaluate the content validity of the scale. No modification was made, and the content validity was determined to be 0.840. The Cronbach’s alpha was 0.724 in current sample. 2.3.3 The Gallup 12 Workplace Audit The Gallup 12 Workplace Audit, developed by Gallup, is utilized to assess employee engagement and the working environment 17 . Its validity and reliability were examined within the nursing profession in China, yielding a Cronbach's alpha coefficient of 0.845 18 . This is a 12-item scale consists of four subscales: basic job requirements (items, n = 2), leadership support (n = 4), teamwork (n = 4) and personal development (n = 2). Items responses are rated on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The overall score ranges from 12 to 60. The higher scores mean higher levels of endorsement of the workplace. Five facility managers, each having more than five years of work experience in LTCFs, were invited to evaluate its content validity. No modification was made, and the content validity was determined to be 0.833. The Cronbach’s alpha was 0.717 in current sample. 2.4 Ethical consideration This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The study protocol was reviewed and approved by the Institutional Review Board of Hangzhou Normal University to ensure compliance with both national and international ethical standards. Participation in the survey was voluntary, and all participants were fully informed of their rights. Prior to participation, each participant received a comprehensive Information Sheet detailing the study’s purpose, objectives, methodology, the voluntary nature of participation, and any potential risks. Written consent was obtained from all participants, and the data collected was anonymized to protect privacy. 2.5 Data collection A briefly online meeting was conducted with facility managers to provide a brief introduction to research objectives, the significance of the study, and the data collection process. The purpose of the meeting was to enhance the survey's adherence level. After obtaining consent from LTCFs, the research team visited each facility and delivered print survey packages to eligible and willing participants. The survey package included an informed consent form, and questionnaires. Participants were required to provide consent before proceeding with the questionnaire. The survey package was distributed individually to care workers, and the questionnaire was self-administered. For participants who were illiterate or had difficulty reading, the researcher explained each item in the questionnaire verbally. Participants were also informed of the confidentiality and anonymity of their responses during the data collection and analysis processes. 2.6 Data analysis The data were entered into a database using the Excel application to check accuracy by two researchers, then statistical analysis was performed using SPSS 25.0. Continuous variables were presented as mean ± standard deviation (SD) values and categorical variables as number (n) and frequency (%). The relationship between organizational commitment and working environment was evaluated using Pearson’s correlation coefficient. Multiple liner regression analysis was used to examine the prediction role of working environment and socio-demographic characteristics in organizational commitment. Propensity score matching (PSM) was conducted as a robustness test to examine the stability of the results. Statistical significance was determined when P -values below .05. 3 RESULTS A total of 300 questionnaires were distributed and all returned, resulting in a response rate of 100%. However, 18 questionnaires were incomplete, therefore, 282 valid questionnaires were included in the data analysis. 90.1% of the participants were female, 81.6% was aged between 40–59 years, 51.1% from G- LTCFs. 37.2% had worked in LTCFs more than five years. Table 1 details the socio-demographic characteristics of participants. Table 1 Socio-demographic characteristics of participants (n = 282) Socio-demographic characteristics No. % Age (years) 30–39 33 11.7 40–49 121 42.9 50–59 112 39.7 60–69 16 5.7 Gender Female 254 90.1 Male 28 9.9 Place of birth Cities 44 15.6 Towns 228 84.4 Educational level No education 11 3.9 Primary school education 98 34.8 3-year middle school education 128 45.4 High school education 35 12.4 3-year diploma or 4-year bachelor’s degree 10 3.5 Institutional type G-LTCFs 144 51.1 P-LTCFs 138 48.9 Years of experience in LTCFs < 1 8 2.8 1–5 169 59.9 6–10 51 18.1 ≥ 10 54 19.1 Prior engagement in care-related occupations Yes 58 20.6 No 224 79.4 Number of residents looked after 1–5 98 34.8 6–10 96 34.0 ≥ 10 88 31.2 Table 2 shows that the mean score of the organizational commitment scale was found to be 59.54 ± 9.21. Comparing with the average score for the organizational commitment scale, it was determined that the level of organizational commitment level of care workers in this study was below average. The mean score of the Gallup 12 Workplace Audit was 42.85 ± 5.52. Table 2 Scores of organizational commitment scale and the Gallup 12 workplace audit of care workers scores (n = 282) Mean SD Min Max Organizational commitment scale 59.54 9.21 42 88 Affective commitment 14.24 2.32 8 20 Normative commitment 14.02 2.15 9 20 Economic commitment 10.37 2.84 5 19 Opportunity commitment 9.08 3.00 5 16 Ideal commitment 11.83 2.53 6 20 The Gallup 12 workplace audit 42.85 5.52 31 60 Basic job requirements 7.78 0.93 5 10 Leadership support 12.94 2.51 7 20 Teamwork 14.89 2.21 10 20 Personal development 7.24 1.388 5 10 Table 3 and Fig. 1 show a moderate positive correlation between organizational commitment and the overall Gallup 12 Workplace Audit score (r = 0.558, P = 0.001). All domains except opportunity commitment and economic commitment were moderately positively correlated with the overall Gallup 12 Workplace Audit score. Table 3 Correlation martix between organizational commitment scale and the Gallup 12 workplace audit scores of care workers (n = 282) The Gallup 12 workplace audit Organizational commitment scale Basic job requirements Leadership support Teamwork Personal development Overall score Opportunity commitment -0.084 0.175** 0.145* 0.080 0.120* Economic commitment 0.181 ** 0.329** 0.321** 0.221** 0.364** Ideal commitment 0.218** 0.497** 0.429** 0.447** 0.547** Normative commitment 0.220** 0.413** 0.547** 0.449** 0.556** Affective commitment 0.194** 0.406** 0.421** 0.374** 0.480** Over score 0.188** 0.490** 0.498** 0.416** 0.558** Note: correlation coefficient interpretation guidelines: > 0.00-0.30: weak correlation; > 0.30–0.70: moderate correlation; > 0.70-1.00: strong correlation. * Statistically significant value at the P ≦ .50 level. ** Statistically high significant value at the P ≦ .001 level. All linear regression results are presented in Table 4 . The R square ratio for the linear regression model was 0.597 that represents the 59.7% of the variance for organizational commitment scores explained by the variables in the model. The linear regression model showed that working environment was one of the independent factors of organizational commitment. Each additional score on the Gallup 12 Workplace Audit provided to increase of an average of 0.929 points in the organizational commitment score. PSM was conducted to test the robustness of the results. Based on the overall Gallup 12 Workplace Audit score, the sample was divided into two groups: a high work environment perception group (experimental group) and a low work environment perception group (control group). Nearest-neighbor matching, radius matching, and kernel matching were applied, and the Average Treatment Effect (ATE) of the working environment was estimated. Across all matching methods, the ATE of the working environment remained statistically significant, confirming the robustness of the findings. Table 4 Multifactorial analysis of organizational commitment and the other variables B SE β t value 95% CI P value Gender 2.868 1.576 0.093 1.820 -0.234–5.971 0.070 Age 1.263 0.736 0.105 1.716 -0.186–2.713 0.087 Educational level -0.368 0.594 -0.034 -0.620 -1.537–0.801 0.536 Place of birth 1.528 1.303 0.060 1.173 -1.037–4.094 0.242 Institutional type -1.634 0.979 -0.089 -1.668 -3.562–0.294 0.096 Years of experience in LTCFs 0.433 0.444 0.054 -0.977 -0.440–1.307 0.330 Prior engagement in care-related occupations 1.561 1.182 0.069 1.320 -0.766–3.887 0.188 Number of residents looked after -0.615 0.630 -0.054 -0.976 -1.855–0.625 0.330 The Gallup 12 workplace audit 0.929 0.083 0.588 11.186 0.766–1.093 0.000 4 DISCUSSION The current study examined the association between organizational commitment and working environment among care workers in Chinese LTCFs. The results of the study demonstrated that the organizational commitment was positively related to working environment. This study’s findings show a low level of organizational commitment among care workers in China, as compared to previous studies that utilized the same scale among nurses 19 , 20 . One possible explanation for this finding is the low requirements for care workers in China. In 2019, the Chinese government eliminated the aged care certificates and relaxed the educational requirements for care workers in order to expand the workforce in the elder care industries 21 . The ease of entry into the field without significant investment may contribute to the relatively low level of organizational commitment observed 22 . Furthermore, previous studies have indicated that individual characteristics 22 – 24 , such as working experience, play a significant role in organizational commitment. Individuals with more than five years of work experience tend to exhibit higher levels of commitment due to their familiarity with the tasks and comprehensive understanding of the profession's rules and regulations. Their experience enables them to navigate complex clinic environments more effectively, and make them less likely to burnout. However, 79.9% of the care workers in this study had no prior work experience in the care profession, and only 38.6% had more than five years of experience in LTCFs. Among the four dimensions of the organizational commitment, ‘affective commitment’ was rated the highest among the care workers in this study, while this finding differs from previous studies conducted among nurses 19 , 20 . One possible explanation for this difference may be attributed to the long working hours among care workers, with 40% of them working on a 24-hr shift pattern 25 , while nurses in China working on an 8-hr shift pattern. Moreover, it is common for residents in LTCFs in China to have long-term stays, with many residing in these facilities until the end of their lives. The substantial amount of time care workers spend with residents in such work patterns fosters the development of strong relationships and interpersonal trust. The dependence of residents on care workers and the establishment of rapport create a sense of belonging and responsibility among care workers 26 , 27 . These factors further contribute to the higher level of affective commitment observed among care workers. The opportunity commitment had the lowest scores among the four dimensions of organizational commitment in current study. Similar results have been reported in previous studies 19 , 20 , 28 . Many care workers earn relatively low salaries despite their long working hours 25 , 29 . Additionally, the career advancement opportunities for care workers in China are limited, with a lack of clear career progression paths 27 . Financial constraints and the perceived lack of opportunities for advancement may explain the lower levels of opportunity commitment in this study. The health care environment can be a stressful place to work 30 – 32 , LTCFs are often considered particularly demanding, characterized by high workloads and extensive responsibilities. This study found that care workers had a more positive perception of their working environment compared to nurses, as indicated by a previous study utilizing the same scale 33 . This difference might be explained by the demographic characteristics. The majority of care workers in this study were from rural areas, over 40 years old, and had lower levels of education and limited work experience in LTCFs. Previous studies 33 – 35 showed that factors such as older age, low education levels and short work experience may act as protective factors against experiencing stress of conscience. Meanwhile, these demographic factors may also limit care workers’ capacity to acquire new things and knowledge, leading them attribute a stressful working environment to their own abilities rather than external factors. In line with a previous study conducted among healthcare providers 36 , the basic job requirements dimension obtained the highest mean score among the four dimensions of the working environment, while leadership support received the lowest score. One possible explanation is that the majority of LTCFs in China have implemented an age-friendly environment 37 , which primary aims to enhance the daily activity ability of the residents. This approach also provides convenience for care workers by reducing their involvement in labor-intensive tasks that require manual labor and physical exertion, resulting in the highest score for the basic job requirements dimension. Leadership support received the lowest score among the four dimensions of the working environment. Although incentive systems have been established in most LTCFs, care workers’ income is largely dependent on the number of residents they care for and the complexity of residents’ conditions. Moreover, workload assessments are often subjective and manager-dependent, and the demanding nature of both managerial and care roles may limit effective communication, further contributing to lower perceptions of leadership support. The current study revealed a positive correlation between organizational commitment and the working environment among care workers. And the working environment was identified as one of the most significant influencing factors of organizational commitment. These findings were consistent with previous studies 38 , 39 . This may be explained by Herzberg’s Motivation-Hygiene Theory 40 . The basic job requirements domain of the working environment functions as a hygiene factor that helps prevent dissatisfaction, this domain received the highest scores among the four domains in this study, while this factor alone does not strongly motivate employees; rather, it provides a stable foundation that allows organizational commitment to develop, which may explain the relatively weak correlation with organizational commitment. In contrast, other domains of the working environment, such as leadership support and teamwork, may play a more motivational role. In China, LTCFs primary provide specialized formal care for older people with higher-level care dependence 41 , 42 . The majority of residents in LTCFs have chronic diseases or disabilities 43 , which poses significant challenges for care workers in providing care. They often encounter sudden changes in residents’ health conditions and need to have an understanding of their mental well-being to deliver high-quality care. However, most care workers in this study have a low level of education and limited work experience in caregiving, which makes them more reliant on others when facing difficulties. If care workers receive adequate support and resources from the working environment, such as leadership support, teamwork, to address these challenges, it may enhance their sense of accomplishment, thereby sustaining motivation. Such factors may function as motivators by increasing job satisfaction, fostering a sense of meaning and value in work, and ultimately strengthening organizational commitment. Therefore, improvements in the work environment may potentially have a positive impact on the level of organizational commitment among care workers. This study has several limitations. First, the cross-sectional design limits the ability to determine causality between the working environment and organizational commitment; future longitudinal studies are needed to clarify these relationships. Second, although the instruments used in this study are widely applied in China and demonstrated acceptable internal consistency in the present sample, they were not specifically developed for care workers in LTCFs. Future research should develop context-specific measurement tools to enhance the accuracy of assessments. Third, potential confounding variables (e.g., salary satisfaction, organizational culture) were not explicitly controlled for. These factors may affect both organizational commitment and workplace perceptions, potentially biasing the observed associations. Future research should incorporate a broader range of factors to more comprehensively mitigate potential confounding biases.​ 5 IMPLICATIONS FOR NUSING MANAGEMENT The findings of the current study suggest that enhancing the working environment may be associated with higher levels of organizational commitment among care workers. The assessment of the working environment in this study focused primarily on aspects that can be influenced by managers, including meeting basic job requirements, fostering teamwork and opportunities for personal development, and strengthening organizational support. These areas provide practical directions for managers to address workforce shortages in LTCFs by improving the working environment. At the organizational level, managers should prioritize providing essential resources to ensure that fundamental job demands are met, and provide well-structured training programs that equip care workers with competencies and expertise. Such initiatives may not only enhance opportunity commitment and support professional growth but also help mitigate occupational burnout 44 . At the unit level, establishing work teams that include both experienced and novice care workers can strengthen peer support within the workplace. Experienced care workers can serve as mentors, facilitating skill development, confidence-building, and role adaptation among novices, while also fostering a sense of fulfillment for themselves. Additionally, this approach encourages collaboration, reinforces team cohesion, and contributes to a more positive and supportive work environment. 6 CONCLUSION The current study demonstrated that the working environment was a significant influencing factor of organizational commitment. Managers in LTCFs should be aware of the importance of the working environment and implement strategies to enhance it, as a potential means of enhancing organizational commitment and promoting workforce stability. Declarations Funding Supported by Teaching Development and Reform Project of Hangzhou normal university, under grant number: JG2025322 Author Contribution declaration : Jiaying Zheng: led the study design; developed the experimental framework; statistical analysis of results; wrote the main manuscript text. Ying Zhang: data collection Data Availability declaration: The dataset(s) supporting the conclusions of this article is(are) included within the article (and its additional file(s)). No Competing Interests. Patient or Public Contribution No patient or public contribution. References Main Data of the Seventh National Population Census. Accessed February 16. 2023. http://www.stats.gov.cn/english/PressRelease/202105/t20210510_1817185.html Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;394(10204):1145–58. 10.1016/S0140-6736(19)30427-1 . 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Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 06 Mar, 2026 Reviews received at journal 26 Feb, 2026 Reviews received at journal 24 Feb, 2026 Reviews received at journal 24 Feb, 2026 Reviewers agreed at journal 24 Feb, 2026 Reviewers agreed at journal 20 Feb, 2026 Reviews received at journal 19 Feb, 2026 Reviewers agreed at journal 19 Feb, 2026 Reviewers agreed at journal 19 Feb, 2026 Reviewers agreed at journal 19 Feb, 2026 Reviewers invited by journal 19 Feb, 2026 Editor invited by journal 10 Feb, 2026 Editor assigned by journal 05 Feb, 2026 Submission checks completed at journal 05 Feb, 2026 First submitted to journal 22 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-8669748\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":594737576,\"identity\":\"7e7c61f6-270c-4bb5-a8cb-b1259987bb93\",\"order_by\":0,\"name\":\"jiaying zheng\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBklEQVRIiWNgGAWjYBACxmYgkQDEBiDexwaIqATRWhhnEqMFDkBamHmJ0cLczvxM4uGOWntz9t7Dr2131OUZHGA+eJuHwS4Pt8PYzCQSzxxntuw5l2ade4at2OAAW7I1D0NyMR6/ALW0HWMzuJFjZpzbxpO44QCPmTQPw4HEBpxa2L+BtPAY3H9jZmzZJgHUwv+NgBYekC01EgY3eIwfM7YZgGxhI6Sl2CKx7YCBwZkcM8betoTEmYfZjC3nGCTj1GLYf3zjzZ9tdfYGx88YfwAyEvuONz+88abCDreWBgYWYCwcBrHZINHBDCIMcKgHAnmgkg8MDHVgtR9wqxsFo2AUjIKRDACnEFcgumeiQgAAAABJRU5ErkJggg==\",\"orcid\":\"\",\"institution\":\"Hangzhou Normal University\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"jiaying\",\"middleName\":\"\",\"lastName\":\"zheng\",\"suffix\":\"\"},{\"id\":594737579,\"identity\":\"490557c8-baf0-4709-bda5-a33525ada5e0\",\"order_by\":1,\"name\":\"ying zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Jiangxi Medical College\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"ying\",\"middleName\":\"\",\"lastName\":\"zhang\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-01-22 12:38:37\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-8669748/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-8669748/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":103251842,\"identity\":\"c1293f38-4415-4f19-91c8-14b567a36876\",\"added_by\":\"auto\",\"created_at\":\"2026-02-23 16:11:56\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":89789,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eThe scatter plot diagram for the relationship between organizational commitment and working environment in care workers\\u003c/strong\\u003e\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8669748/v1/a85dcfe201d59783d18e3e65.png\"},{\"id\":103252356,\"identity\":\"ad73f4d6-7477-44da-af64-d24f44d2673f\",\"added_by\":\"auto\",\"created_at\":\"2026-02-23 16:14:27\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1010255,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8669748/v1/9112e559-40ae-494e-a226-8dd8decec6b2.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Association Between Organizational Commitment and the Working Environment Among Care Workers in Long-Term Care Facilities: A Cross-Sectional Study\",\"fulltext\":[{\"header\":\"1 BACKGROUND\",\"content\":\"\\u003cp\\u003ePopulation aging is accelerating rapidly worldwide that presents significant challenges for healthcare systems worldwide. China, as the most populous country, is experiencing rapid population aging. The Seventh National Population Census published in 2022 revealed that there were 264.02\\u0026nbsp;million people aged 60 years and over in China, accounting for 18.7% of the total population. This represents a substantial increase of 5.44% points compared to 2010 \\u003csup\\u003e1\\u003c/sup\\u003e. Projections indicate that by 2040, the number of people aged 60 years and over in China will reach 402\\u0026nbsp;million, constituting approximately 28% of the population \\u003csup\\u003e\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eThe substantial increase in the aging population, as well as 'one child policy' and the 'empty-nest elderly' phenomenon in China has resulted in a growing demand for long-term care facilities (LTCFs). Unfortunately, human resource in LTCFs is limited \\u003csup\\u003e\\u003cspan additionalcitationids=\\\"CR4\\\" citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e\\u003c/sup\\u003e, especially care workers, who provide assistance to residents with daily activities, including feeding, bathing, toileting, and other personal needs \\u003csup\\u003e\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e\\u003c/sup\\u003e. By 2019, the number of care workers in China was only 300,000 \\u003csup\\u003e7\\u003c/sup\\u003e. Care workers constitute most proportion of the workforce in LTCFs, and they play a vital role as direct care providers for residents, ensuring the quality of care within LTCFs \\u003csup\\u003e\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e\\u003c/sup\\u003e. Consequently, substantial studies have been conducted to explore factors that can improve the supply and retention of care workers in LTCFs. One such factors is organizational commitment, a psychological state that binds employees to their organization \\u003csup\\u003e\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e\\u003c/sup\\u003e. Evidence showed that organizational commitment is associated with turnover intention, job satisfaction and job performance \\u003csup\\u003e\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e\\u003c/sup\\u003e. Employees with higher levels of commitment are more likely to engage in organizational activities and work towards achieving organizational goals. As such, much efforts have been devoted to exploring the factors influencing organizational commitment, primarily at the individual level \\u003csup\\u003e\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e\\u003c/sup\\u003e. Recent studies have examined the associations between organizational commitment and the working environment, including group cohesion, structural empowerment among nurses \\u003csup\\u003e\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e\\u003c/sup\\u003e. However, limited research has been conducted among care workers.\\u003c/p\\u003e \\u003cp\\u003eGiven the inadequate research on the association between organizational commitment and the working environment among care workers, this study aimed to address this gap. The objectives of this study were threefold: First, to examine the level of organizational commitment among care workers in China. Second, to assess the working environment experienced by care workers within these facilities. Third, to examine the impact of organizational commitment on the working environment.\\u003c/p\\u003e\"},{\"header\":\"2 METHODS\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.1 Research design and setting\\u003c/h2\\u003e \\u003cp\\u003eA cross-sectional study was conducted. A total of 25 LTCFs in in Hangzhou City, Zhejiang Province, China, were initially approached for participation, and 22 of them agreed to participate in this study.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.2 Participants\\u003c/h2\\u003e \\u003cp\\u003eAll care workers employed at these LTCFs were invited to participate if they met the following criteria: (1) had worked in the LTCFs for at least three months, (2) provided direct care services to older adults; (3) were willing to participate and provided informed consent. This study utilized a convenience sampling approach, enrolling care workers who were on duty during the data collection period.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.3 Study instruments\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec6\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.3.1 Demographic questionnaire\\u003c/h2\\u003e \\u003cp\\u003eThis questionnaire included age, gender, place of birth (cities or towns), educational level, institutional type, years of experience in LTCFs, and prior engagement in care-related occupations.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.3.2 Organizational Commitment Scale\\u003c/h2\\u003e \\u003cp\\u003eThe Organizational Commitment Scale was developed by Lin \\u003csup\\u003e\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e\\u003c/sup\\u003e to measure the organizational commitment of employee, it was tested for validity and reliability in China, and the Cronbach\\u0026rsquo;s alpha coefficient was 0.67 \\u003csup\\u003e16\\u003c/sup\\u003e. This is a 25-items scale composed of five subscales: affective commitment, normative commitment, economic commitment, opportunity commitment and ideal commitment. Each subscale consists of five items, and participants are required to rate their responses using a five-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The overall score ranges from 25 to 125. The higher scores mean higher levels of organizational commitment. As this scale had not been previously used with care workers, a content validity test was conducted. Five facility managers, each with more than five years of work experience in LTCFs, were invited to evaluate the content validity of the scale. No modification was made, and the content validity was determined to be 0.840. The Cronbach\\u0026rsquo;s alpha was 0.724 in current sample.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.3.3 The Gallup 12 Workplace Audit\\u003c/h2\\u003e \\u003cp\\u003eThe Gallup 12 Workplace Audit, developed by Gallup, is utilized to assess employee engagement and the working environment \\u003csup\\u003e\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e\\u003c/sup\\u003e. Its validity and reliability were examined within the nursing profession in China, yielding a Cronbach's alpha coefficient of 0.845 \\u003csup\\u003e18\\u003c/sup\\u003e. This is a 12-item scale consists of four subscales: basic job requirements (items, n\\u0026thinsp;=\\u0026thinsp;2), leadership support (n\\u0026thinsp;=\\u0026thinsp;4), teamwork (n\\u0026thinsp;=\\u0026thinsp;4) and personal development (n\\u0026thinsp;=\\u0026thinsp;2). Items responses are rated on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The overall score ranges from 12 to 60. The higher scores mean higher levels of endorsement of the workplace. Five facility managers, each having more than five years of work experience in LTCFs, were invited to evaluate its content validity. No modification was made, and the content validity was determined to be 0.833. The Cronbach\\u0026rsquo;s alpha was 0.717 in current sample.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec9\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.4 Ethical consideration\\u003c/h2\\u003e \\u003cp\\u003e This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The study protocol was reviewed and approved by the Institutional Review Board of Hangzhou Normal University to ensure compliance with both national and international ethical standards. Participation in the survey was voluntary, and all participants were fully informed of their rights. Prior to participation, each participant received a comprehensive Information Sheet detailing the study\\u0026rsquo;s purpose, objectives, methodology, the voluntary nature of participation, and any potential risks. Written consent was obtained from all participants, and the data collected was anonymized to protect privacy.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec10\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.5 Data collection\\u003c/h2\\u003e \\u003cp\\u003eA briefly online meeting was conducted with facility managers to provide a brief introduction to research objectives, the significance of the study, and the data collection process. The purpose of the meeting was to enhance the survey's adherence level. After obtaining consent from LTCFs, the research team visited each facility and delivered print survey packages to eligible and willing participants. The survey package included an informed consent form, and questionnaires. Participants were required to provide consent before proceeding with the questionnaire. The survey package was distributed individually to care workers, and the questionnaire was self-administered. For participants who were illiterate or had difficulty reading, the researcher explained each item in the questionnaire verbally. Participants were also informed of the confidentiality and anonymity of their responses during the data collection and analysis processes.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.6 Data analysis\\u003c/h2\\u003e \\u003cp\\u003eThe data were entered into a database using the Excel application to check accuracy by two researchers, then statistical analysis was performed using SPSS 25.0. Continuous variables were presented as mean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;standard deviation (SD) values and categorical variables as number (n) and frequency (%). The relationship between organizational commitment and working environment was evaluated using Pearson\\u0026rsquo;s correlation coefficient. Multiple liner regression analysis was used to examine the prediction role of working environment and socio-demographic characteristics in organizational commitment. Propensity score matching (PSM) was conducted as a robustness test to examine the stability of the results. Statistical significance was determined when \\u003cem\\u003eP\\u003c/em\\u003e-values below .05.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"3 RESULTS\",\"content\":\"\\u003cp\\u003eA total of 300 questionnaires were distributed and all returned, resulting in a response rate of 100%. However, 18 questionnaires were incomplete, therefore, 282 valid questionnaires were included in the data analysis.\\u003c/p\\u003e \\u003cp\\u003e90.1% of the participants were female, 81.6% was aged between 40\\u0026ndash;59 years, 51.1% from G- LTCFs. 37.2% had worked in LTCFs more than five years. Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e details the socio-demographic characteristics of participants.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSocio-demographic characteristics of participants (n\\u0026thinsp;=\\u0026thinsp;282)\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSocio-demographic characteristics\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eNo.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e%\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAge (years)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e30\\u0026ndash;39\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e33\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e11.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e40\\u0026ndash;49\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e121\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e42.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e50\\u0026ndash;59\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e112\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e39.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e60\\u0026ndash;69\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e16\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGender\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e254\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e90.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e28\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePlace of birth\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCities\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e15.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eTowns\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e228\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e84.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eEducational level\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNo education\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePrimary school education\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e98\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e34.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e3-year middle school education\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e128\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e45.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh school education\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e12.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e3-year diploma or 4-year bachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInstitutional type\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eG-LTCFs\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e144\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e51.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP-LTCFs\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e138\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e48.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYears of experience in LTCFs\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e1\\u0026ndash;5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e169\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e59.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e6\\u0026ndash;10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e51\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u0026ge;\\u0026thinsp;10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e54\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e19.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePrior engagement in care-related occupations\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e58\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e20.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e224\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e79.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNumber of residents looked after\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e1\\u0026ndash;5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e98\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e34.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e6\\u0026ndash;10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e96\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e34.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u0026ge;\\u0026thinsp;10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e88\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e31.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e shows that the mean score of the organizational commitment scale was found to be 59.54\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;9.21. Comparing with the average score for the organizational commitment scale, it was determined that the level of organizational commitment level of care workers in this study was below average. The mean score of the Gallup 12 Workplace Audit was 42.85\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.52.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eScores of organizational commitment scale and the Gallup 12 workplace audit of care workers scores (n\\u0026thinsp;=\\u0026thinsp;282)\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"5\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMean\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eSD\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eMin\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMax\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eOrganizational commitment scale\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e59.54\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e42\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e88\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAffective commitment\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e14.24\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.32\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormative commitment\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e14.02\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.15\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eEconomic commitment\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e10.37\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.84\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e19\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOpportunity commitment\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9.08\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3.00\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e16\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIdeal commitment\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11.83\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.53\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eThe Gallup 12 workplace audit\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e42.85\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5.52\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e31\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e60\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBasic job requirements\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e7.78\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.93\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLeadership support\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e12.94\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.51\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eTeamwork\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e14.89\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePersonal development\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e7.24\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.388\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e and Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e show a moderate positive correlation between organizational commitment and the overall Gallup 12 Workplace Audit score (r\\u0026thinsp;=\\u0026thinsp;0.558, P\\u0026thinsp;=\\u0026thinsp;0.001). All domains except opportunity commitment and economic commitment were moderately positively correlated with the overall Gallup 12 Workplace Audit score.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eCorrelation martix between organizational commitment scale and the Gallup 12 workplace audit scores of care workers (n\\u0026thinsp;=\\u0026thinsp;282)\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"6\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"5\\\" nameend=\\\"c6\\\" namest=\\\"c2\\\"\\u003e \\u003cp\\u003eThe Gallup 12 workplace audit\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOrganizational commitment scale\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eBasic job requirements\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eLeadership support\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eTeamwork\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003ePersonal development\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eOverall score\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eOpportunity commitment\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e-0.084\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.175**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.145*\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.080\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.120*\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eEconomic commitment\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.181\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.329**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.321**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.221**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.364**\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eIdeal commitment\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.218**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.497**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.429**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.447**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.547**\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eNormative commitment\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.220**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.413**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.547**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.449**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.556**\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAffective commitment\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.194**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.406**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.421**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.374**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.480**\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eOver score\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.188**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.490**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.498**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.416**\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.558**\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"6\\\"\\u003eNote: correlation coefficient interpretation guidelines: \\u0026gt; 0.00-0.30: weak correlation; \\u0026gt; 0.30\\u0026ndash;0.70: moderate correlation; \\u0026gt; 0.70-1.00: strong correlation.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"6\\\"\\u003e* Statistically significant value at the \\u003cem\\u003eP\\u003c/em\\u003e ≦ .50 level.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"6\\\"\\u003e** Statistically high significant value at the \\u003cem\\u003eP\\u003c/em\\u003e ≦ .001 level.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eAll linear regression results are presented in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab4\\\" class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e. The R square ratio for the linear regression model was 0.597 that represents the 59.7% of the variance for organizational commitment scores explained by the variables in the model. The linear regression model showed that working environment was one of the independent factors of organizational commitment. Each additional score on the Gallup 12 Workplace Audit provided to increase of an average of 0.929 points in the organizational commitment score. PSM was conducted to test the robustness of the results. Based on the overall Gallup 12 Workplace Audit score, the sample was divided into two groups: a high work environment perception group (experimental group) and a low work environment perception group (control group). Nearest-neighbor matching, radius matching, and kernel matching were applied, and the Average Treatment Effect (ATE) of the working environment was estimated. Across all matching methods, the ATE of the working environment remained statistically significant, confirming the robustness of the findings.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab4\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 4\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eMultifactorial analysis of organizational commitment and the other variables\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"7\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eB\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eSE\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eβ\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003et\\u003c/em\\u003e value\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e95% CI\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eP\\u003c/em\\u003e value\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGender\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2.868\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.576\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.093\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.820\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-0.234\\u0026ndash;5.971\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.070\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAge\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1.263\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.736\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.105\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.716\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-0.186\\u0026ndash;2.713\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.087\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eEducational level\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e-0.368\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.594\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-0.034\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-0.620\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-1.537\\u0026ndash;0.801\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.536\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePlace of birth\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1.528\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.303\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.060\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.173\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-1.037\\u0026ndash;4.094\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.242\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInstitutional type\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e-1.634\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.979\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-0.089\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-1.668\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-3.562\\u0026ndash;0.294\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.096\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYears of experience in LTCFs\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.433\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.444\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.054\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-0.977\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-0.440\\u0026ndash;1.307\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.330\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePrior engagement in care-related occupations\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1.561\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.182\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.069\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.320\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-0.766\\u0026ndash;3.887\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.188\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNumber of residents looked after\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e-0.615\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.630\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-0.054\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-0.976\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-1.855\\u0026ndash;0.625\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.330\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eThe Gallup 12 workplace audit\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.929\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.083\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.588\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e11.186\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.766\\u0026ndash;1.093\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e\"},{\"header\":\"4 DISCUSSION\",\"content\":\"\\u003cp\\u003eThe current study examined the association between organizational commitment and working environment among care workers in Chinese LTCFs. The results of the study demonstrated that the organizational commitment was positively related to working environment.\\u003c/p\\u003e \\u003cp\\u003eThis study\\u0026rsquo;s findings show a low level of organizational commitment among care workers in China, as compared to previous studies that utilized the same scale among nurses \\u003csup\\u003e\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e\\u003c/sup\\u003e. One possible explanation for this finding is the low requirements for care workers in China. In 2019, the Chinese government eliminated the aged care certificates and relaxed the educational requirements for care workers in order to expand the workforce in the elder care industries \\u003csup\\u003e\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e\\u003c/sup\\u003e. The ease of entry into the field without significant investment may contribute to the relatively low level of organizational commitment observed \\u003csup\\u003e\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e\\u003c/sup\\u003e. Furthermore, previous studies have indicated that individual characteristics \\u003csup\\u003e\\u003cspan additionalcitationids=\\\"CR23\\\" citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e\\u003c/sup\\u003e, such as working experience, play a significant role in organizational commitment. Individuals with more than five years of work experience tend to exhibit higher levels of commitment due to their familiarity with the tasks and comprehensive understanding of the profession's rules and regulations. Their experience enables them to navigate complex clinic environments more effectively, and make them less likely to burnout. However, 79.9% of the care workers in this study had no prior work experience in the care profession, and only 38.6% had more than five years of experience in LTCFs.\\u003c/p\\u003e \\u003cp\\u003eAmong the four dimensions of the organizational commitment, \\u0026lsquo;affective commitment\\u0026rsquo; was rated the highest among the care workers in this study, while this finding differs from previous studies conducted among nurses \\u003csup\\u003e\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e\\u003c/sup\\u003e. One possible explanation for this difference may be attributed to the long working hours among care workers, with 40% of them working on a 24-hr shift pattern \\u003csup\\u003e\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e\\u003c/sup\\u003e, while nurses in China working on an 8-hr shift pattern. Moreover, it is common for residents in LTCFs in China to have long-term stays, with many residing in these facilities until the end of their lives. The substantial amount of time care workers spend with residents in such work patterns fosters the development of strong relationships and interpersonal trust. The dependence of residents on care workers and the establishment of rapport create a sense of belonging and responsibility among care workers \\u003csup\\u003e\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e\\u003c/sup\\u003e. These factors further contribute to the higher level of affective commitment observed among care workers. The opportunity commitment had the lowest scores among the four dimensions of organizational commitment in current study. Similar results have been reported in previous studies \\u003csup\\u003e\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e\\u003c/sup\\u003e. Many care workers earn relatively low salaries despite their long working hours \\u003csup\\u003e\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e\\u003c/sup\\u003e. Additionally, the career advancement opportunities for care workers in China are limited, with a lack of clear career progression paths \\u003csup\\u003e\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e\\u003c/sup\\u003e. Financial constraints and the perceived lack of opportunities for advancement may explain the lower levels of opportunity commitment in this study.\\u003c/p\\u003e \\u003cp\\u003eThe health care environment can be a stressful place to work \\u003csup\\u003e\\u003cspan additionalcitationids=\\\"CR31\\\" citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e32\\u003c/span\\u003e\\u003c/sup\\u003e, LTCFs are often considered particularly demanding, characterized by high workloads and extensive responsibilities. This study found that care workers had a more positive perception of their working environment compared to nurses, as indicated by a previous study utilizing the same scale \\u003csup\\u003e\\u003cspan citationid=\\\"CR33\\\" class=\\\"CitationRef\\\"\\u003e33\\u003c/span\\u003e\\u003c/sup\\u003e. This difference might be explained by the demographic characteristics. The majority of care workers in this study were from rural areas, over 40 years old, and had lower levels of education and limited work experience in LTCFs. Previous studies \\u003csup\\u003e\\u003cspan additionalcitationids=\\\"CR34\\\" citationid=\\\"CR33\\\" class=\\\"CitationRef\\\"\\u003e33\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e35\\u003c/span\\u003e\\u003c/sup\\u003e showed that factors such as older age, low education levels and short work experience may act as protective factors against experiencing stress of conscience. Meanwhile, these demographic factors may also limit care workers\\u0026rsquo; capacity to acquire new things and knowledge, leading them attribute a stressful working environment to their own abilities rather than external factors.\\u003c/p\\u003e \\u003cp\\u003eIn line with a previous study conducted among healthcare providers \\u003csup\\u003e\\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e\\u003c/sup\\u003e, the basic job requirements dimension obtained the highest mean score among the four dimensions of the working environment, while leadership support received the lowest score. One possible explanation is that the majority of LTCFs in China have implemented an age-friendly environment \\u003csup\\u003e\\u003cspan citationid=\\\"CR37\\\" class=\\\"CitationRef\\\"\\u003e37\\u003c/span\\u003e\\u003c/sup\\u003e, which primary aims to enhance the daily activity ability of the residents. This approach also provides convenience for care workers by reducing their involvement in labor-intensive tasks that require manual labor and physical exertion, resulting in the highest score for the basic job requirements dimension. Leadership support received the lowest score among the four dimensions of the working environment. Although incentive systems have been established in most LTCFs, care workers\\u0026rsquo; income is largely dependent on the number of residents they care for and the complexity of residents\\u0026rsquo; conditions. Moreover, workload assessments are often subjective and manager-dependent, and the demanding nature of both managerial and care roles may limit effective communication, further contributing to lower perceptions of leadership support.\\u003c/p\\u003e \\u003cp\\u003eThe current study revealed a positive correlation between organizational commitment and the working environment among care workers. And the working environment was identified as one of the most significant influencing factors of organizational commitment. These findings were consistent with previous studies \\u003csup\\u003e\\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR39\\\" class=\\\"CitationRef\\\"\\u003e39\\u003c/span\\u003e\\u003c/sup\\u003e. This may be explained by Herzberg\\u0026rsquo;s Motivation-Hygiene Theory \\u003csup\\u003e\\u003cspan citationid=\\\"CR40\\\" class=\\\"CitationRef\\\"\\u003e40\\u003c/span\\u003e\\u003c/sup\\u003e. The basic job requirements domain of the working environment functions as a hygiene factor that helps prevent dissatisfaction, this domain received the highest scores among the four domains in this study, while this factor alone does not strongly motivate employees; rather, it provides a stable foundation that allows organizational commitment to develop, which may explain the relatively weak correlation with organizational commitment. In contrast, other domains of the working environment, such as leadership support and teamwork, may play a more motivational role. In China, LTCFs primary provide specialized formal care for older people with higher-level care dependence \\u003csup\\u003e\\u003cspan citationid=\\\"CR41\\\" class=\\\"CitationRef\\\"\\u003e41\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR42\\\" class=\\\"CitationRef\\\"\\u003e42\\u003c/span\\u003e\\u003c/sup\\u003e. The majority of residents in LTCFs have chronic diseases or disabilities \\u003csup\\u003e\\u003cspan citationid=\\\"CR43\\\" class=\\\"CitationRef\\\"\\u003e43\\u003c/span\\u003e\\u003c/sup\\u003e, which poses significant challenges for care workers in providing care. They often encounter sudden changes in residents\\u0026rsquo; health conditions and need to have an understanding of their mental well-being to deliver high-quality care. However, most care workers in this study have a low level of education and limited work experience in caregiving, which makes them more reliant on others when facing difficulties. If care workers receive adequate support and resources from the working environment, such as leadership support, teamwork, to address these challenges, it may enhance their sense of accomplishment, thereby sustaining motivation. Such factors may function as motivators by increasing job satisfaction, fostering a sense of meaning and value in work, and ultimately strengthening organizational commitment. Therefore, improvements in the work environment may potentially have a positive impact on the level of organizational commitment among care workers.\\u003c/p\\u003e \\u003cp\\u003eThis study has several limitations. First, the cross-sectional design limits the ability to determine causality between the working environment and organizational commitment; future longitudinal studies are needed to clarify these relationships. Second, although the instruments used in this study are widely applied in China and demonstrated acceptable internal consistency in the present sample, they were not specifically developed for care workers in LTCFs. Future research should develop context-specific measurement tools to enhance the accuracy of assessments. Third, potential confounding variables (e.g., salary satisfaction, organizational culture) were not explicitly controlled for. These factors may affect both organizational commitment and workplace perceptions, potentially biasing the observed associations. Future research should incorporate a broader range of factors to more comprehensively mitigate potential confounding biases.​\\u003c/p\\u003e\"},{\"header\":\"5 IMPLICATIONS FOR NUSING MANAGEMENT\",\"content\":\"\\u003cp\\u003eThe findings of the current study suggest that enhancing the working environment may be associated with higher levels of organizational commitment among care workers. The assessment of the working environment in this study focused primarily on aspects that can be influenced by managers, including meeting basic job requirements, fostering teamwork and opportunities for personal development, and strengthening organizational support. These areas provide practical directions for managers to address workforce shortages in LTCFs by improving the working environment. At the organizational level, managers should prioritize providing essential resources to ensure that fundamental job demands are met, and provide well-structured training programs that equip care workers with competencies and expertise. Such initiatives may not only enhance opportunity commitment and support professional growth but also help mitigate occupational burnout \\u003csup\\u003e\\u003cspan citationid=\\\"CR44\\\" class=\\\"CitationRef\\\"\\u003e44\\u003c/span\\u003e\\u003c/sup\\u003e. At the unit level, establishing work teams that include both experienced and novice care workers can strengthen peer support within the workplace. Experienced care workers can serve as mentors, facilitating skill development, confidence-building, and role adaptation among novices, while also fostering a sense of fulfillment for themselves. Additionally, this approach encourages collaboration, reinforces team cohesion, and contributes to a more positive and supportive work environment.\\u003c/p\\u003e\"},{\"header\":\"6 CONCLUSION\",\"content\":\"\\u003cp\\u003eThe current study demonstrated that the working environment was a significant influencing factor of organizational commitment. Managers in LTCFs should be aware of the importance of the working environment and implement strategies to enhance it, as a potential means of enhancing organizational commitment and promoting workforce stability.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eSupported by Teaching Development and Reform Project of Hangzhou normal university, under grant number: JG2025322\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor Contribution declaration\\u003c/strong\\u003e\\u003cstrong\\u003e:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eJiaying Zheng: led the study design; developed the experimental framework; statistical analysis of results; wrote the main manuscript text.\\u003c/p\\u003e\\n\\u003cp\\u003eYing Zhang: data collection\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData Availability declaration:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe dataset(s) supporting the conclusions of this article is(are) included within the article (and its additional file(s)).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eNo Competing Interests.\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003ePatient or Public Contribution\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNo patient or public contribution.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eMain Data of the Seventh National Population Census. 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Acta Biomed. 2018;89(7\\u0026ndash;S):60\\u0026ndash;9. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.23750/ABM.V89I7-S.7830\\u003c/span\\u003e\\u003cspan address=\\\"10.23750/ABM.V89I7-S.7830\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-nursing\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"nurs\",\"sideBox\":\"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/nurs/default.aspx\",\"title\":\"BMC Nursing\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Care worker, long-term care facilities, organizational commitment, working environment, turnover\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8669748/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8669748/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eAim: \\u003c/strong\\u003eTo examine the association between organizational commitment and working environment among care workers in long-term care facilities.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eDesign: \\u003c/strong\\u003eA cross-sectional study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMethods: \\u003c/strong\\u003eThe study was carried out on a total of 282 care workers in 22 long-term care facilities (LTCFs) in Hangzhou City, Zhejiang Province, China. The data were collected using a Demographic Questionnaire, the Organizational Commitment Questionnaire of Chinese Employees and GallupWorkplace Audit.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResults: \\u003c/strong\\u003eThe mean organizational commitment scores of the care workers were 59.62 ± 9.34. The mean working environment scores of the care workers were 42.65 ± 5.61. A statistically significant positive relationship was found between organizational commitment scores and working environment scores (r = 0.541, P = 0.003). Furthermore, the multiple linear regression analysis indicated that the working environment was an independent factor influencing organizational commitment.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusions: \\u003c/strong\\u003eThe results of the study demonstrated a significant association between organizational commitment and the working environment of care workers. Care workers who hold a more positive perception of their working environment exhibit a higher level of organizational commitment.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eImplication for nursing management: \\u003c/strong\\u003eLTCFs should focus on improving the working environment to enhance organizational commitment, which in turn contributes to the effective attraction and retention of care workers. Strategies to achieve this may include offering targeted training programs and providing comprehensive support systems for care workers.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Association Between Organizational Commitment and the Working Environment Among Care Workers in Long-Term Care Facilities: A Cross-Sectional Study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-02-23 16:05:37\",\"doi\":\"10.21203/rs.3.rs-8669748/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"decision\",\"content\":\"Revision requested\",\"date\":\"2026-03-06T07:39:39+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-02-26T18:40:40+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-02-24T12:19:59+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-02-24T09:18:50+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"193414735943630300025632687987356607709\",\"date\":\"2026-02-24T08:49:15+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"213592854329536567245756571871219235130\",\"date\":\"2026-02-21T04:29:04+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-02-19T07:54:16+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"78522131884939089770626626259687460778\",\"date\":\"2026-02-19T07:44:22+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"316717974316567058132565160621459513897\",\"date\":\"2026-02-19T07:34:09+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"65270434914064672416072334057603267987\",\"date\":\"2026-02-19T07:14:12+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-02-19T05:52:11+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvited\",\"content\":\"\",\"date\":\"2026-02-10T11:47:25+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-02-05T17:31:27+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-02-05T17:28:59+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"BMC Nursing\",\"date\":\"2026-01-22T11:52:35+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-nursing\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"nurs\",\"sideBox\":\"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/nurs/default.aspx\",\"title\":\"BMC Nursing\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"4a273065-5942-46f9-be46-a0f8a1faa36d\",\"owner\":[],\"postedDate\":\"February 23rd, 2026\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"in-revision\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-03-06T07:54:58+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-02-23 16:05:37\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-8669748\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-8669748\",\"identity\":\"rs-8669748\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}