Thesis Work-life and life-work enhancements: Sen's capability approach

MINISTRY OF EDUCATION AND TRAINING UNIVERSITY OF ECONOMICS HO CHI MINH CITY TRẦN THỊ HƯƠNG TRANG WORK-LIFE AND LIFE-WORK ENHANCEMENTS: SEN'S CAPABILITY APPROACH PHD DISSERTATION HO CHI MINH CITY - 2024 MINISTRY OF EDUCATION AND TRAINING UNIVERSITY OF ECONOMICS HO CHI MINH CITY TRẦN THỊ HƯƠNG TRANG WORK-LIFE AND LIFE-WORK ENHANCEMENTS: SEN'S CAPABILITY APPROACH Major: Business Administration Code: 9340101 PHD DISSERTATION SUPERVISOR: Associate Professor Nguyễn Đình Thọ HO CHI MINH CITY - 2024 i ABSTRACT Given various benefits of work-life and life-work enhancements, many studies have investigated their antecedents, moderators, and mediators. Despite of much research endeavors, there are still some significant gaps in these research topics that need to be fulfilled. Particularly, in comparison to the conflict aspect, the attempts at studying the positive facets of work-life balance are relatively fewer. Additionally, the question of whether sense of competence, mindfulness and flow at work, job complexity, meaningful contacts, and meaningful contributions effectively help doctors achieve work-life and life- work enhancements has not been fully answered. Also, the capability approach has been applied in many areas, but not yet extensively in the domain of work. To fill the gaps in the literature and to develop an understanding of work-life and life-work enhancements to contribute to and apply theoretical knowledge to various health sector workforces, this dissertation used Sen’s capability approach (1985) to investigate the roles of sense of competence, mindfulness at work, flow at work, job complexity, meaningful contacts, and meaningful contributions in work-life and life-work enhancements. It also examined the mediating roles of meaningful contacts and meaningful contributions in the relationships between mindfulness at work and work-life enhancement and between job complexity and work-life enhancement and the mediating roles of mindfulness and flow at work in the relationships between sense of competence and work-life and life-work enhancements. Two studies (study 1 and study 2) were conducted with doctors in various provinces in Vietnam. The datasets were used to validate the measures by employing Confirmatory Factor Analysis (CFA) and test the proposed relationships among studied constructs by using Structural Equation Modeling (SEM). Study 1 was employed to test the relationships of mindfulness at work and job complexity on both meaningful contacts and meaningful contributions and, subsequently, on work-life enhancement. The results produced by SEM, based on a sample of 254 doctors in various provinces in Vietnam showed that meaningful contacts and meaningful contributions mediated the impact of mindfulness at work on work- life enhancement and of job complexity on work-life enhancement. Study 2 was conducted to test the impact of sense of competence on both mindfulness and flow at work and, subsequently, on both work-life and life-work enhancements. The findings by SEM, based on a sample of 254 doctors in various provinces in Vietnam indicated that mindfulness and ii flow at work mediated the effects of sense of competence on both work-life and life-work enhancements, but sense of competence did not have any direct effect on both. The research results from study 1 and study 2 contributed to the work-life enhancement and life-work enhancement literature by shedding light on new facilitators of work-life and life-work enhancements and the mediating roles of mindfulness at work, flow at work, meaningful contacts, and meaningful contributions, which have not been thoroughly examined by previous studies; and offering additional empirical evidence for the capacity approach explaining work-life and life-work enhancements in a transitioning economy like Vietnam. As a result, several significant implications could be contributed to academics and practitioners. Keywords: flow at work, job complexity, life-work enhancement, meaningful contacts, meaningful contributions, mindfulness at work, sense of competence, work-life enhancement iii STATEMENT OF AUTHENTICATION ➢ I certify that any content in this dissertation has not previously been submitted for a degree at this or any other institutions. ➢ I also certify that the dissertation is prepared by me. Any help that I have received in my research has been acknowledged. In addition, I certify that all sources and literature used are adequately indicated in the reference. Tran Thi Huong Trang Ho Chi Minh City, May 2024 iv PUBLICATIONS OF THE RESEARCH 1. Trang, T. T. H., & Tho, N. D. (2022). From sense of competence to work–life and life– work enhancements of medical doctors: Sen’s capability approach. Management Research Review. 2. Trang, T. T. H., & Tho, N. D. (2021). Doctors’ work-life enhancement: Sen’s capability approach. International Conference on Business and Finance 2021, 2, 755-760. v ACKNOWLEDGEMENT To be honest, PhD is definitely the most memorable and worth-experiencing but extremely challenging journey that I have been on. The mission would not have been successfully completed without the great support of many people to whom I am greatly indebted. Firstly, I would like to express my deepest gratitude to my supervisor, Associate Professor Nguyen Dinh Tho, who has provided me both extensive personal and professional support and guidance. This work would never have achieved that such success without his insightful comments and advice. Secondly, I want to extend my sincerity to all lecturers of the UEH-ISB PhD program for their knowledgeable delivery, motivation, and encouragement during my research period. I also would like to send my appreciation to my colleagues, my PhD friends, and all related ones for their advice and support during my PhD life. Finally, I am extremely grateful to my parents and my family members whose endless love, caring, and understanding are the ultimate inspiration for me to achieve my goals. It is my family’s unending encouragement that I have great motivation to complete the PhD journey. vi LIST OF FIGURES Figure 2.1: Overall conceptual model of dissertation ..........................................................20 Figure 3.1: Research model of study 1.................................................................................28 Figure 4.1: Research model of study 2.................................................................................52 vii LIST OF TABLES Table 2.1. Summary of empirical studies on the antecedents of work-life enhancement and life-work enhancement ..........................................................................................8 Table 3.1. Summary of new studies/papers on the antecedents of work-life enhancement.29 Table 3.2. Means (M), standard deviations (SD), and standardized CFA loadings (λ) of items in study 1..............................................................................................................37 Table 3.3. Correlations between constructs of study 1.........................................................39 Table 3.4. SEM results of study 1 ........................................................................................43 Table 4.1. Means (M), standard deviations (SD), and standardized CFA loadings (λ) of items in study 2..............................................................................................................58 Table 4.2. Correlations between constructs of study 2.........................................................62 Table 4.3. SEM results of study 2 ........................................................................................65 viii LIST OF ABBREVIATIONS Abbreviation Definition AVE Average variance extracted B Unstandardized regression weight β Standardized regression weight BC Bias-corrected bootstrap estimate CFA Confirmatory factor analysis CFI Confirmatory fit index CR Critical ratio df Degree of freedom EFA Exploratory factor analysis GFI Goodness of fit index IFI Incremental fit index M Mean p p-value RMSEA Root mean square error of approximation SD Standard deviations SE Standard error SEM Structural equation modeling χ2 Chi-square value ix TABLE OF CONTENTS Abstract ...................................................................................................................................i Statement of authentication...................................................................................................iii Publications of the research...................................................................................................iv Acknowledgement..................................................................................................................v List of figures ........................................................................................................................vi List of tables.........................................................................................................................vii List of abbreviations............................................................................................................viii Table of contents ...................................................................................................................ix CHAPTER 1 - INTRODUCTION .....................................................................................1 1.1. Research gaps ................................................................................................................1 1.2. Research objectives .......................................................................................................5 1.3. Research context............................................................................................................5 1.4. Research methods..........................................................................................................6 1.5. Research contributions .................................................................................................6 1.6. Structure of the dissertation.........................................................................................6 CHAPTER 2 – LITERATURE REVIEW AND OVERALL MODEL...........................7 2.1. Theoretical background................................................................................................7 2.1.1. Work-life and life-work enhancements ......................................................................7 2.1.2. Mindfulness at work..................................................................................................13 2.1.3. Flow at work ..............................................................................................................14 2.1.4. Sense of competence..................................................................................................15 2.1.5. Job complexity ...........................................................................................................16 2.1.6. Sustainable employability..........................................................................................17 2.1.7. The capability approach............................................................................................18 2.2. Conceptual framework ...............................................................................................20 2.3. Overall methods...........................................................................................................21 2.3.1. Design and sample.....................................................................................................21 2.3.2. Measurement .............................................................................................................22 2.3.3 Control variables ........................................................................................................23 x CHAPTER 3 – STUDY 1: FROM MINDFULNESS AT WORK AND JOB COMPLEXITY TO WORK-LIFE ENHANCEMENT: SEN’S CAPABILITY APPROACH .......................................................................................................................24 3.1. Introduction ................................................................................................................24 3.2. Theoretical background and hypotheses...................................................................26 3.2.1. The capability approach............................................................................................26 3.2.2. Work-life enhancement.............................................................................................28 3.2.3. Mindfulness at work, job complexity, and work-life enhancement.........................31 3.2.4. The mediating roles of meaningful contacts and meaningful contributions..........32 3.3. Research methods........................................................................................................34 3.3.1. Research context and sample....................................................................................34 3.3.2. Measurement .............................................................................................................35 3.3.3. Control variables .......................................................................................................36 3.4. Data analysis and results ............................................................................................37 3.4.1. Measurement validation............................................................................................37 3.4.2. Common method variance ........................................................................................39 3.4.3. Structural results and hypothesis testing..................................................................40 3.4.3.1. Overall model (M0)..................................................................................................40 3.4.3.2. Mediating effect of meaningful contacts (M1) .........................................................41 3.4.3.3. Mediating effect of meaningful contributions (M2) .................................................42 3.5. Discussions and implications ......................................................................................45 3.5.1. Theoretical implications............................................................................................45 3.5.2. Managerial implications ...........................................................................................46 3.6. Limitations and directions for future research ........................................................48 CHAPTER 4 – STUDY 2: FROM SENSE OF COMPETENCE TO WORK-LIFE AND LIFE-WORK ENHANCEMENTS: SEN’S CAPABILITY APPROACH....................49 4.1. Introduction ................................................................................................................49 4.2. Theoretical background and hypotheses...................................................................50 4.2.1. The capability approach............................................................................................50 4.2.2. Conceptual model ......................................................................................................51 4.2.3. Work-life and life-work enhancements and sense of competence...........................52 4.2.4. Mediating role of mindfulness at work.....................................................................53 xi 4.2.5. Mediating role of flow at work..................................................................................55 4.3. Research methods........................................................................................................56 4.3.1. Research context and sample....................................................................................56 4.3.2. Measurement .............................................................................................................57 4.3.3. Control variables .......................................................................................................60 4.4. Data analysis and results ............................................................................................61 4.4.1. Measurement validation............................................................................................61 4.4.2. Common method variance ........................................................................................62 4.4.3. Structural results and hypothesis testing..................................................................63 4.4.3.1. Overall model (M0)..................................................................................................63 4.4.3.2. Mediating effect of mindfulness at work (M1) .........................................................64 4.4.3.3. Mediating effect of mindfulness at work (M2) .........................................................64 4.5. Discussions and implications ......................................................................................67 4.5.1. Theoretical implications............................................................................................67 4.5.2. Managerial implications ...........................................................................................68 4.6. Limitations and directions for future research ........................................................68 CHAPTER 5 – CONCLUSION ........................................................................................70 5.1. Summary ......................................................................................................................70 5.2. Implications..................................................................................................................70 5.2.1. Theoretical implications............................................................................................71 5.2.2. Managerial implications ...........................................................................................72 5.3. Limitations and future research directions...............................................................74 5.4. Conclusion....................................................................................................................75 REFERENCES ...................................................................................................................76 APPENDICES ....................................................................................................................99 Appendix 1 – Survey questionnaire of study 1 (in English) ...........................................99 Appendix 2 – Survey questionnaire of study 1 (in Vietnamese)...................................100 Appendix 3 – Survey questionnaire of study 2 (in English) .........................................101 Appendix 4 – Survey questionnaire of study 2 (in Vietnamese)...................................103 Appendix 5 – Data analysis for study 1 ..........................................................................105 Appendix 6 – Data analysis for study 2 ..........................................................................117 1 CHAPTER 1 – INTRODUCTION 1.1. Research gaps With globalization, ongoing technological developments, and unexpected pandemics, nature of work and workforce have changed and evolved over the last few decades. Specifically, the employment rates of women and the accompanying emergence of dual career couples have increased (Karkoulian et al., 2016). In this process, employees have developed from more-or-less passive performers of predefined tasks to increasingly autonomous and responsible entrepreneurs in their work, who proactively set their own goals and makes their own choices and shared decisions. However, with these changes, they have faced more difficulty in finding a balance between their profession and personal lives (Mattessich et al., 2017; Unger et al., 2015), which are shown to negatively affect both employees and organizations (Karkoulian et al., 2016). Among various professions, doctors receive special attention as they have meticulous work that requires extremely high accuracy and concentration as well as long working hours consisting of nights, weekends, and public holidays. In fact, the job takes up most of their energy which could have been allocated to family and non-work-related activities. This lifestyle of inflexible work patterns leaves doctors with frequent burnouts, which can lead to increased medical errors, lower patient satisfaction, longer post-discharge recovery times, and decreased professional work effort (Halbesleben & Rathert, 2008; Shanafelt et al., 2015; Shanafelt et al., 2016; West et al., 2009). However, the interaction between work and life can be mutually reinforcing, not merely resulting in conflicts (Aryee et al., 2005). In essence, a variety of resources, opportunities, and support gained in the work (life) domain can be used to enhance one’s psychological functioning in the life (work) domain (Ruderman et al., 2002). Frone (2003) suggested a fourfold taxonomy of work-family balance along the primary dimensions of (a) direction of influence between work and family roles (work to family versus family to work), and (b) the type of effect (conflict vs. 2 facilitation/ enhancement). In other words, the four components of work-family balance are work-to-family conflict, family-to-work conflict, work-to-family enhancement, and family-to-work enhancement (Frone, 2003). Generally, the term work-life is more comprehensive than work-family, as it encompasses different aspects of the individual’s personal life (Adisa et al., 2017; Ng et al., 2017; Rantanen et al., 2011). Following the fourfold taxonomy of work-life balance, this dissertation particularly focuses on the positive facets of work-life balance (including work-life and life-work enhancements) as they are relevant to the case of doctors in Vietnam during the COVID-19 pandemic – the time when the data was collected. Indeed, the pursuit of work-life and life-work enhancements encounters mounting difficulties due to various factors such as the rapid advancements in technology, soaring career expectations, shifting family structures, and the unforeseen disruptions brought about by pandemics like COVID-19. The COVID-19 pandemic in fact, took a heavy toll on medical professionals, leaving them grappling with occupational stress, burnout, sleep disturbances, and mental strain (Ayar et al., 2022; Brazier et al., 2022; Diomidous, 2020; Hwang, 2022; Van Doesum et al., 2023). In light of these challenges, finding effective work-life and life-work enhancements approaches becomes critically important for these professionals as they need to adapt to the demands of the "new normal" world after the COVID-19. An increasing number of studies have investigated the effects of work-life interactions, such as higher performance, higher satisfaction, better health, and positive experiences (Katou, 2022; Lapierre et al., 2018; Premchandran & Priyadarshi, 2019). Given these potential benefits, research has explored the antecedents of both work-life and life-work enhancements, focusing on organizational factors, family characteristics, and personality factors (Greenhaus & Powell, 2006; Lapierre et al., 2018). Compared to organizational and family factors, fewer studies have explored the role of personal factors in work-life and life-work enhancements (Premchandran & Priyadarshi, 2019). Among personality factors, psychological and physical resources, which include personal aspects of the 3 individual or an individual's positive self‐evaluations, play important roles in causing individuals to perceive positive spill over between their work and nonwork domains (Greenhaus & Powell, 2006). With the current high rates of burnout and depression in doctors, the observed links between doctor stress and patient safety, an excessive workload, lack of positive work-life and life-work experiences, and feelings of isolation due to reduced interactions with colleagues during the COVID-19 pandemic and thus, the importance of role enhancements, this dissertation aims to focus on psychological and physical resources, especially sense of competence, mindfulness at work, and flow at work to find out how they affect work-life and life-work enhancements. In fact, every motivational theory in psychology emphasizes perceived competence or sense of competence – an individual's feelings of confidence that he or she has the necessary skills and abilities to understand and solve problems faced and therefore, exert some control over situations (Wagner & Morse, 1975), as playing a central role in intentional behaviors and a motivation for learning and achievement (Ryan & Moller, 2017). In a meta‐analysis of the antecedents of work- family enrichment, Lapierre et al. (2018) indicated self-efficacy (which is akin to sense of competence (Mullan & Sullivan, 2016) has a significant relationship with enrichment. Meanwhile, mindfulness and flow are linked to increased well-being, satisfaction, and performance (Demerouti, 2006; Good et al., 2016; Hülsheger et al., 2013; Reb et al., 2015; Tavčar & Arzenšek, 2019), which in turn may boost doctors’ both work and life experience. Unfortunately, relatively few studies have dealt with both mindfulness and flow at work and even fewer have studied their antecedents, especially those relating to personal resources (Hülsheger et al., 2018; Kalafatoglu & Turgut, 2019; Oades et al., 2017; Zito et al., 2016; Zivnuska et al., 2016). In addition, this dissertation focuses on job complexity, which refers to the cognitive difficulty of the requirements and demands of the occupation (Hunter & Hunter, 1984) as it is a central job characteristic of doctors. Complex jobs are described by more autonomy, skill diversity, and performance feedback while simple jobs involve fewer skills and work approaches (Hatcher et al., 1989). With complex tasks, doctors tend to be more 4 intrinsically motivated to cultivate work devotion and to believe that their work is meaningful and significant (Man & Lam, 2003; Wang et al., 2014). Besides, among seven work values of sustainable employability identified by Van der Klink et al. (2016), this dissertation particularly concentrates on meaningful contacts at work and meaningful contributions to something valuable because they are the most relevant for the case of doctors in Vietnam. Meaningful contacts at work - having or building up meaningful contacts with others – and meaningful contributions - meaningfully contributing to the creation of something valuable, relevant for the collectivist cultures like Vietnam, play important roles in work outcomes and wellbeing (Allan et al., 2016; Lee, 2020; Singh & Jamil, 2021; Steger et al., 2012; Van der Klink et al., 2018). Although it is theoretically plausible for some of the antecedents regarding psychological and physical resources to be causally linked to one another, thus explaining variation in enrichment in a sequential, mediated process (Lapierre et al., 2018) and past studies have investigated some mediators of the relationship between work-life interfaces and its antecedents such as satisfaction and job autonomy (Xu et al., 2018) and job satisfaction (Chen et al., 2017), the question of whether sense of competence, mindfulness and flow at work, job complexity, meaningful contacts, and meaningful contributions at work effectively help doctors achieve work-life enhancement and life-work enhancement has not been fully answered. The capability approach, introduced by Amartya Sen (1985), denotes that someone has the freedom to do or to be what he or she wants to do or to be in relation to the different combinations of possibilities that he or she has. This approach appears to be suitable for the notions from work psychology in which a distinction is made between the potential (capacity) that individuals have to work, and the extent that they are also capable and willing to invest this potential. Unfortunately, the capability approach has been used in many areas, but not yet extensively in the domain of work (Van der Klink et al., 2018). Drawing upon the capability approach of Sen (1985), this dissertation endeavors to fill the gaps in the literature, answering the above research question by investigating the impacts of sense of competence, mindfulness 5 and flow at work, job complexity, meaningful contacts, and meaningful contributions at work, on work-life enhancement and life-work enhancement of doctors. 1.2. Research objectives There are two main objectives in this dissertation: Objective 1: To identify the impact of mindfulness at work and job complexity on both meaningful contacts and meaningful contributions and, subsequently, on work-life enhancement (Study 1). Objective 2: To explore the impact of sense of competence on both mindfulness and flow at work and, subsequently, on both work-life and life-work enhancements (Study 2). 1.3. Research context Similar to many emerging markets like India, Mexico, Indonesia, and Malaysia, Vietnam has witnessed a speedy economic boost in recent decades. Its health systems are experiencing substantial changes in terms of health financing reform and private health sector development. An adequate and skilled health workforce is crucial to attaining the universal health coverage. However, Vietnam suffers from a deficiency and maldistribution of human resources for health (MOH, 2016). Furthermore, this research took place in 2020 amidst the COVID-19 pandemic, a time when medical professionals faced an overwhelming volume of tasks, absence of improvements in their work-life balance, and a sense of seclusion stemming from decreased peer interactions. For these reasons, various hospitals in Vietnam have encouraged their employees to participate in various programs with the hope of attracting and retaining health workers. Specifically, realizing the need to enhance doctors’ work-life balance, in the past several years, hospitals have introduced a number of programs and practices, such as medical education, compulsory regulation, financial incentives, as well as personal and professional support. Therefore, Vietnam is an appropriate case 6 for the study of doctors’ work-life balance, particularly work-life and life-work enhancements. 1.4. Research methods This dissertation employed the survey data collected from 254 doctors in various provinces in Vietnam. The datasets were used to validate the measures by employing Confirmatory Factor Analysis (CFA) and test the proposed relationships among studied constructs by using Structural Equation Modeling (SEM). 1.5. Research contributions The dissertation findings contribute to the literature on work-life balance by shedding light on new facilitators of work-life and life-work enhancements and offering additional empirical evidence for the capability approach explaining work-life enhancement in a transitioning economy like Vietnam. 1.6. Structure of the dissertation This dissertation includes five Chapters with figures, tables, and appendixes, as follows: Chapter 1 presents research gaps, research objectives, and research context. Chapter 2 discusses about literature review and overall model, including theoretical background, conceptual model, design, sample and measurement. Chapter 3 investigates the roles of mindfulness at work and job complexity on both meaningful contacts and meaningful contributions and, subsequently, on work- life enhancement. Chapter 4 examines the role of sense of competence on both mindfulness and flow at work and, subsequently, on both work-life and life-work enhancements. Chapter 5 presents conclusion, including summary, theoretical implications, practical implications, limitations and future directions. 7 CHAPTER 2 - LITERATURE REVIEW AND OVERALL MODEL 2.1. Theoretical background 2.1.1. Work-life and life-work enhancements Significant discussions related to medical doctors’ work-life balance have arisen among academics and practitioners in recent years (Humphries et al., 2020; Nievas & Thaver, 2015; Rich et al., 2016; Sharma & Parmar, 2017). In many cases, the term work-life balance is often used interchangeably with the terms work-family balance (Rantanen et al., 2011), work-family facilitation (Rotondo et al., 2008), and work- family synergy (Beutell et al., 2008). Generally, the term work-life is more comprehensive than work-family, as it encompasses different aspects of the individual’s personal life (Adisa et al., 2017; Ng et al., 2017; Rantanen et al., 2011). Broadly, the definitions of work-life balance and its conceptualizations can be categorized in terms of two key dimensions, namely (1) role engagement in multiple roles in work and non-work life and (2) minimal conflict between work and non-work roles (Sirgy & Lee, 2017). Frone (2003) suggested a fourfold taxonomy of work- family balance along the primary dimensions of (a) direction of influence between work and family roles (work to family versus family to work), and (b) the type of effect (conflict vs. facilitation/enhancement). In other words, the four components of work-family balance are work-to-family conflict, family-to-work conflict, work-to- family enhancement, and family-to-work enhancement (Frone, 2003). Following the fourfold taxonomy of work-family balance, this dissertation specially focused on work-life enhancement and life-work enhancement aspects, which can be defined as “the extent to which participation at work (or home) is made easier by virtue of the experiences, skills, and opportunities gained or developed at home (or work) (Frone, 2003, p. 145). The pursuit of work-life and life-work enhancements encounters mounting difficulties due to various factors such as the rapid advancements in technology, soaring career expectations, shifting family structures, and the unforeseen disruptions