Journal of Nursing Management, 2012

Social support and work engagement: a study of Malaysian nurses

NORAINI OTHMAN

BBA, MSc (Mgt), PhD

and AIZZAT MOHD NASURDIN

B.Sc (Agribusiness), MBA, PhD

Senior Lecturer, School of Business Management, College of Business, Universiti Utara Malaysia, Kedah Darul
Aman, and 2Professor, School of Management, Universiti Sains Malaysia, Pulau Pinang, Malaysia

Correspondence
Noraini Othman
School of Business Management
College of Business
Universiti Utara Malaysia
06010 UUM, Sintok
Kedah Darul Aman
Malaysia
E-mail: n.aini@uum.edu.my

O T H M A N N . & M O H D N A S U R D I N A . (2012) Journal of Nursing Management

Social support and work engagement: a study of Malaysian nurses

Aim This study addressed the question of whether social support (supervisor
support and co-worker support) could contribute to the variance in work
engagement.
Background Nurses, as customer-contact employees, play an important role in
representing the organizations competence. Their attitudes and behaviour toward
patients has a significant influence on patients satisfaction and perception of quality
of service.
Methods The sample comprised 402 staff nurses working in three general hospitals
in Peninsular Malaysia. Variables included demographic information, Utrecht Work
Engagement Scale and Social Support Scale. Data analysis included descriptive
statistics, correlations and regression analysis.
Results Findings indicated that supervisor support was positively related to work
engagement. Co-worker support was found to have no effect on work engagement.
Conclusions Supervisory support is an important predictor of work engagement for
nurses.
Implications for nursing management Nursing management should provide more
training to nurse supervisors and develop nurse mentoring programmes to
encourage more support to nurses.
Keywords: co-worker support, nurses, social support, supervisor support, work
engagement
Accepted for publication: 18 May 2012

Background
Organizations, especially those in the health-care
industry, face unprecedented challenges and competitive pressures. The rising costs of health care, an aging
society with diverse needs and care requirements, new
types of illnesses and ailments, and advancement in
technology have placed greater demands on hospitals
and their employees especially the public hospitals. On
the front line of this dynamic landscape are the nursing
DOI: 10.1111/j.1365-2834.2012.01448.x
2012 Blackwell Publishing Ltd

professionals who must deal with increased calls for

improved patient care and efficiency gains, while at the
same time coping with job stress, fatigue and burnout
(Luthans et al. 2008, Chen et al. 2009).
In the Ninth Malaysian Plan, the government has
given higher priority to improving the health status of
Malaysians and several measures were implemented to
enhance the delivery system and improve the scope and
quality of health care in both public and private sectors
(Kanapathy 2003). Moreover, the government also
1

N. Othman and A. M. Nasurdin

announced several actions regarding health industry

such as promoting Malaysia as an attractive destination
for health tourism and improving the health status of
local individuals, families and communities (Economic
Planning Unit 2006). Accordingly, public hospitals need
adequate numbers of competent and experienced customer-contact employees (e.g. nurses and doctors) to
enable them to participate actively in these programmes. Within health-care organizations, customercontact employees play an important role in providing
quality services to the patients, thus influencing the
success of the organization. Nursing is an important
profession to study as nurses performance has a great
impact on the nature and quality of service provided to
the patients (Cohen & Golan 2007, Chen et al. 2009,
Purdy et al. 2010).
Previous studies have identified nurses attitudes and
behaviours as significant in determining the quality of
health-care services (Cohen & Golan 2007, Al-Ahmadi
2008). According to Moritz et al. (1989) and Willoughby (2011), contributions made by nurses help
portray their organizations competence in health care
because they spend most of their time directly with
patients. In addition, the quality of nursing care has a
strong effect on health-care organizations ability to
provide professional services to the desired standard
(Moritz et al. 1989, Mcsherry & Douglas 2011).
Hence, nurses should employ a favourable attitude in
the form of work engagement. Work engagement has
been acknowledged as one of the positive states that is
considered to be the exact opposite of burnout based on
the emergence of positive psychology the scientific
study of human strength and optimal functioning proposed by Seligman and Csikszentmihalyi (2000). Schaufeli et al. (2006a) argued that engaged employees are
energetic and have an effective relationship with their
work activities, and are therefore able to cope effectively
with their job demands. A study by Schaufeli and Van
Rhenen (2006) has found that engaged employees are
more productive as they often experienced positive
emotions. Generally, organizations expect their employees to be proactive and show initiative, be greatly involved in their work and be committed to high-quality
performance standards. Thus, these organizations require employees who feel energetic and dedicated, and
are absorbed by their work (Bakker & Schaufeli 2008).
To encourage high work engagement within the
nursing workforce, nurses as boundary-spanners of
health-care organizations need to have greater job resources. Bakker and Schaufeli (2008) argued that job
resources are assumed to have a motivational potential,
which can lead to low cynicism, high work engagement
2

and excellent performance. In particular, job resources

might have either an extrinsic motivational role, as they
are instrumental in achieving work goals, or have an
intrinsic motivational role, as they promote employees
growth, learning and development. As nurses jobs will
always contain elements of stressful, difficult situations
and episodes of hardship, job resources are important
elements to help nurses deal with their daily work
activities.
Few studies have investigated the antecedents of work
engagement (Bakker et al. 2005, Mauno et al. 2005,
Hakanen et al. 2006, Langelaan et al. 2006, Llorens
et al. 2007). According to Mauno et al. (2007), research on work engagement has remained scarce because the concept is rather new. Furthermore, they
argue that investigating work engagement among
health-care employees is a worthwhile starting point
and nursing, in particular, is generally considered to be
characterized by an especially high level of employee
engagement and commitment (Hakanen 2004, Mauno
et al. 2005). Given the emerging trend of positive psychology in the literature (Luthans 2002a,b), this study
attempts to examine the role of job resources (supervisor support and co-worker support) as antecedents of
work engagement among Malaysian nurses.

Literature review
Work engagement
Work engagement refers to a positive, fulfilling, workrelated state of mind that is characterized by vigour,
dedication and absorption (Schaufeli & Bakker 2004).
Vigour is a state where individuals experience a high
degree of energy, a strong work ethic and an ability to
persevere when confronted with challenging work
(Schaufeli & Bakker 2004). Dedicated individuals have
an enthusiastic attitude and are motivated and proud of
their work. These individuals also perceive their work
to be important and they describe difficulties as challenges rather than strains. Absorption in work is being
fully immersed in work and feeling happy about ones
work roles. Individuals who are absorbed in their work
perceive time to pass quickly and find it difficult to
separate themselves from work (Schaufeli & Bakker
2004).
According to Bakker et al. (2008), work engagement
is essential as engaged employees: (1) experience pleasure, joy and enthusiasm; (2) enjoy good physical and
psychological health; (3) have better job performance;
(4) show increased ability to create job and personal
resources; and (5) have the capability to transfer their
2012 Blackwell Publishing Ltd
Journal of Nursing Management

Social support and work engagement in Malaysia

engagement to others. Past research has provided evidence that work engagement can be measured reliably
(Schaufeli & Van Rhenen 2006). In addition, work
engagement can be discriminated from related concepts
such as workaholism (Schaufeli et al. 2008), job
involvement and organizational commitment (Hallberg
& Schaufeli 2006).
Numerous studies have provided empirical evidence
on the relationship between work engagement and
work-related outcomes. For example, work engagement
has been found to be positively related to customer
loyalty and employee performance (Salanova et al.
2005, Halbesleben 2010), job satisfaction and organizational citizenship behaviour (Saks 2006, BabcockRoberson & Strickland 2010), in-role performance
(Schaufeli et al. 2006b), employee proactive behaviours
(Salanova & Schaufeli 2008), financial returns
(Xanthopoulou et al. 2009), employee retention (Saks
2006, Halbesleben 2010) and employee well-being
(Halbesleben 2010).

Social support
Social support has been defined as the overall level of
helpful social interaction available on the job from both
co-workers and supervisors (Karasek & Theorell
1990). Supervisory support is a social exchange construct, in which employees perceive the degree to which
supervisors value their contributions and care about
their well-being (Eisenberger et al. 2002). Social exchange theory posits that if employees perceive that
their supervisor supports and cares for their well-being,
they would feel attached to the organization and feel
obligated to return the favour to their supervisor by
staying in the organization. The relationship with a
supervisor is considered as one of the main elements of
employees work environment (Van der Heijden et al.
2010). As stated by Blancero et al. (1996), good
supervisory feedback and constructive communication
between the supervisors and subordinates may increase
employees capabilities.
Hobfoll and Shirom (2000) argued that social support is considered as a potential to obtain resources
beyond those directly possessed by an individual. Social
support has been defined in many ways (Schwarzer
et al. 2004), such as resources provided by others,
coping assistance, an exchange of resources and a
personality trait (Schwarzer & Knoll 2007). When
employees observe their supervisors as supportive, they
believe that their supervisor has concern for their feelings and needs, will provide help and positive feedback,
and assist them in career development (House 1981,
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Journal of Nursing Management

Langford et al. 1997). Conservation of Resources

(COR) theory posits that social support in workplace
restricts the negative impact of emotional exhaustion
related with stressful job-related activities. Several
scholars, such as Sarason et al. (1990) and Kaufmann
and Beehr (1986), found that social support is an
effective resource for assisting employees to cope with
stress, and for their well-being. When employees perceive the absence of support (e.g. feedback) in the
workplace, they will not be able to make investments
for resource gain, while employees who are given positive feedback regarding their job performance are
likely to look for opportunities to develop new skills
and form relevant plans of action (Hobfoll & Shirom
2000, Westman et al. 2005).
Furthermore, Meijiman and Mulder (1998) noted
that job resources such as social support can also play
an extrinsic motivational role as a resourceful work
environment will develop an individuals willingness to
dedicate ones efforts and abilities to the work task.
Hence, the task will be completed successfully and the
work goal will be achieved. For example, co-worker
support and performance feedback will increase the
likelihood of being successful in achieving ones work
goals. Thus, either through the basic satisfaction of
needs or through the accomplishment of work goals, a
positive outcome may be achieved and work engagement would be expected to increase (Schaufeli & Bakker 2004, Schaufeli & Salanova 2007).
Social support has been also found to be an important
antecedent of work engagement (Bakker et al. 2003,
Schaufeli & Bakker 2004, Hakanen et al. 2006, Korunka et al. 2009). For example, Schaufeli and Bakker
(2004) conducted a study among employees from four
different Dutch service organizations: an insurance
company, a pension fund company, an occupational
health and safety service and a home-care institution. In
their study, job resources that included social support
from colleagues and performance feedback were found
to be associated with work engagement. In a study by
Hakanen et al. (2006) among a sample of over 2000
Finnish teachers, supervisory support was found to be
positively linked to work engagement. Similar results
were reported by Llorens et al. (2006) in a Spanish
context. However, De Lange et al. (2008) did not find
any relationship between co-worker support and work
engagement.
In a health-care setting, nurse supervisors are not only
responsible for facilitating learning and enhancing the
understanding of the clinical job performed by the
nurses (Severinsson & Hallberg 1996), they are also
responsible for helping the nurses to increase their skills
3

N. Othman and A. M. Nasurdin

and communication with patients (Severinsson 1996).

Therefore, when nurses in public hospitals perceive
their supervisors as supportive (showing concern for
their feelings and needs, and providing help, information, and constructive feedback), these nurses will feel
obliged to reciprocate by showing a favourable attitude
in the form of work engagement. As the nursing profession is regarded as an emotionally demanding work
environment, the quality of teamwork and co-worker
support is very important (Sherony & Green 2002, Van
der Heijden et al. 2008). Employees who observe a high
level of co-worker support will view the workplace as a
supportive environment in which they have abundant
opportunities to learn from their co-workers.
From this discussion, we propose two hypotheses: (1)
supervisor support will be positively and strongly related to nurses work engagement; (2) co-worker support will be positively and strongly related to nurses
work engagement.

puted. Schaufeli and Bakker (2003) argued that the

total score for work engagement may sometimes be
more practical in empirical research because of the
moderate to high correlations between the dimensions.
Social support
A scale by Susskind et al. (2003), which includes
supervisor support (four items) and co-worker support
(three items) was used to measure social support. This
measure was also used in established studies (Susskind
et al. 2000, 2007). According to Susskind et al. (2007),
the functions of support in service-based organization
derive from two sources: supervisor support and coworker support. All items were measured on a sevenpoint Likert scale ranging from 1 = strongly disagree
to 7 = strongly agree. The Cronbachs alpha coefficients for these two types of supports were 0.95 and
0.94, respectively.

Demographic factors
Method
Samples and procedures
After approval from the Medical Research Ethical
Committee (MREC), Malaysian Ministry of Health
(MOH), 466 questionnaires were distributed to the
nurses with the assistance of the matrons office of
the three main public hospitals in Peninsular Malaysia.
The distribution and collection of the completed questionnaires took about 1 month from mid December
2009 to mid January 2010. Of the 466 questionnaires
distributed, 402 were returned, yielding a response rate
of 86.27%.

Instruments
For the purpose of this study, two instruments were
used to measure the study variables. All items were
rated using Likert scales.
Work engagement
Work engagement was measured using the shortened
nine-item version of the Utrecht Work Engagement
Scale (UWES-9) developed by Schaufeli and Bakker
(2003). This UWES-9 consists of three underlying
dimensions, which are measured with three items each:
vigour, dedication and absorption. Respondents reported on a seven-point Likert scale ranging from
1 = never to 7 = always. The Cronbachs alpha coefficient for this scale is 0.90. For the purpose of analyses,
an overall work engagement factor score was com-

Demographic information such as gender, marital

status, age, race, organizational tenure, job tenure and
educational qualification were also requested.

Data analysis
The Statistical Package for Social Sciences (Version 12;
SPSS Inc., Chicago, IL, USA) was used to perform the
descriptive and inferential statistical analyses. Internal
consistency reliability was assessed using Cronbachs
alpha. Pearsons correlation analysis and regression
analysis were used to test the research hypotheses. The
strength and direction of relationships between variables were measured using Pearsons correlation analysis. Regression analysis was then carried out to
estimate the variance in work engagement that could be
explained by social support (supervisor support and coworker support).

Results
Profile of respondents
Of the 402 respondents, six (1.5%) were males and 396
(98.5%) were females. Most of the respondents (263
staff nurses or 65.4%) were married, while the
remainder were unmarried. The mean age of the
respondents was 30.72 years (SD 7.31). In terms of
ethnicity, the majority of the respondents were Malays
(90.0%), followed by Indians (5.5%), Chinese (3.0%)
and other races (1.5%). Of the respondents, 305
2012 Blackwell Publishing Ltd
Journal of Nursing Management

Social support and work engagement in Malaysia

(75.9%) had basic training and 97 (24.1%) had postbasic training. The mean value for organizational tenure
was 5.92 years (SD 6.04). and the mean value for job
tenure was 6.96 years (SD 6.77). The profile of
respondents of this study is summarized in Table 1.

Means, standard deviations, reliabilities and

correlation of the study variables
Descriptive statistics such as mean scores, standard
deviations, reliabilities and intercorrelations of the
study variables are provided in Table 2.
As shown in Table 2, on average, the level of work
engagement (mean = 5.38, SD 0.90), and supervisor
support (mean = 5.02, SD 1.07) was slightly high. In
contrast, the mean value for co-worker support
(mean = 4.81, SD 0.91) was found to be moderate. The
reliability coefficients for the study variables were above
0.60, which meets the minimum acceptable standard of

Table 1
Profile of respondents
Demographic
variable
Gender
Marital status
Ethnicity

Educational
Qualification

Category

Frequency

Percentage

Female
Male
Married
Unmarried
Malay
Indian
Chinese
Others
Basic training
Post basic training

396
6
263
139
362
22
12
6
305
97
Mean
30.72
5.92

98.5
1.5
65.4
34.6
90.0
5.5
3.0
1.5
75.9
24.1
SD
7.31
6.04

6.96

6.77

Age (year)
Organizational
tenure (year)
Job tenure
(year)

0.6 for exploratory research, as suggested by Hair et al.

(2006). Meanwhile, correlations between the study
variables were found to be significant (P < 0.01).

Regression results
Hierarchical regression analysis was conducted to test
the two hypotheses of this study. Demographic variables such as age, marital status, education, organizational tenure and job tenure were statistically controlled
(Koyuncu et al. 2006, Mauno et al. 2007). The result of
the analysis is summarized in Table 3.
As shown in Table 3, based on model 1, the control
variables accounted for 3% of the variance in work
engagement (r2 = 0.03, F-change = 2.54, P < 0.01). Of
the five control variables, only marital status was significantly related to work engagement ( = 0.12,
P < 0.05). This indicates that nurses who are married
were highly engaged in their work compared with
unmarried nurses. In model 2, by adding the two predictor variables, the r2-value increased to 0.12. This
result shows that the predictor variables were able to
explain an additional 9% of the variance related to
work engagement (r2-change = 0.09, F-change = 13.40,
P < 0.01). This study demonstrated acceptable value of
r2 for psychosocial studies. However, Hair et al. (2006)
recommended that the greater the r2 value, the stronger
would be the predictor in explaining the variations of
the dependent variables. Of the two predictor variables,
supervisor support ( = 0.14, P < 0.01) was found to

Table 3
Regression results of social support on work engagement
Work engagement
(dependent variable)
Independent variables

Table 2
Descriptive statistics, correlations, and reliabilities of the study
variables
Work
Supervisor Co-worker
engagement
support
support

Variables

Mean

SD

Work
engagement
Supervisor
support
Co-worker
support

5.38

0.90

5.02

1.07

0.20**

4.81

0.91

0.13**

(0.84)
(0.75)
0.39**

(0.66)

*P < 0.05, **P < 0.01. Data in parentheses denote the reliability
coefficients for the study variables.
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Journal of Nursing Management

Step 1: Control variables

Age
Marital status
Education
Organizational tenure
Job tenure
Step 2: Predictor variables
Supervisor support
Co-worker support
F-value
R2
Adjusted r2
r2-change
F-change

Model 1
standard b

Model 2
standard b

)0.06
)0.12**
0.01
0.03
0.20

)0.03
)0.12*
0.04
)0.01
0.17

2.54
0.03
0.02
0.03
2.54**

0.14**
0.05
6.76
0.12
0.10
0.09
13.40**

*P < 0.05, **P < 0.01. Dummy coded: marital status (unmarried = 0,
married = 1); and education (basic training = 0, post basic
training = 1).

N. Othman and A. M. Nasurdin

have a positive and significant relationship with work

engagement, thereby, supporting hypothesis 1. Meanwhile, the effect of co-worker support on work
engagement was not significant. The non-existence of a
relationship between co-worker support and work
engagement leads to the rejection of hypothesis 2.

Limitations
Only two predictor variables (supervisor support and
co-worker support) were examined, but other job resources such as performance feedback, supervisory
coaching, rewards, career advancement and job control
may play an important role in predicting work
engagement in health-care settings. Future researchers
may wish to expand the scope of this study by focusing
on these variables. In addition, this study is limited to
staff nurses working in public hospitals in Peninsular
Malaysia. The same research could be expanded and
replicated among other health-care personnel from
public and private hospitals. A larger sample in the
same industry would improve the generalization of the
findings.

Conclusions
The main purpose of this study was to investigate the
effects of social support (supervisor support and coworker support) on work engagement among Malaysian public hospital nurses. Our findings revealed that
supervisor support was a significant predictor of work
engagement. This finding is consistent with those of
previous researchers (Hakanen et al. 2006, Llorens et al.
2006). In health-care settings, nurse supervisors are not
only responsible for facilitating learning and enhancing
the understanding of the clinical job performed by the
nurses (Severinsson & Hallberg 1996), they also help
nurses to increase their skills and communication with
patients (Severinsson 1996). Hence, this study has contributed to enriching the body of knowledge on work
engagement literature within the nursing context.
Furthermore, job resources (e.g. supervisory support)
can play an extrinsic motivational role, because a
resourceful work environment will drive an individuals
willingness to contribute their efforts and abilities to the
work task. The availability of job resources will ensure
that an individuals task will be successfully implemented. Therefore, this study concurs with Blaus
(1964) social exchange theory. In other words, this
study has empirically supported the social exchange
theory developed by Blau (1964), which posited that
when nurses in public hospitals perceive their supervi6

sors as supportive, showing concern for their feelings

and needs, and providing help, information and constructive feedback, these nurses will feel obliged to
reciprocate by displaying a favourable attitude in the
form of work engagement.
However, co-worker support was found to be unrelated to work engagement. This finding is consistent
with the results of other researchers (De Lange et al.
2008). In todays health-care practice environment, the
role of a nurse has become more complicated, with
various responsibilities (Mrayyan 2006). As boundaryspanners, nurses have to deal with many people around
them, such as nursing management, doctors, patients,
supervisors and co-workers; hence, these nurses might
not be able to develop closer relationships with their coworkers. Furthermore, their tight and busy work schedule may restrict them from providing support to their
co-workers. These factors may have accounted for the
lack of relationship between co-worker support and
work engagement.

Implications for nursing management

As supervisory support influences work engagement, it
would be worthwhile for the Malaysian Ministry of
Health and nursing management to provide more
training for nurse supervisors to encourage a greater
range of support to nurses. Moreover, effective nurse
mentoring programmes may promote and develop
strong social support networks among nurse supervisors
and nurses. This will enable the nurse supervisors to
provide greater support in terms of showing concern for
staff nurses feelings and needs, providing help and
information, and providing constructive feedback.
Appropriate amounts of supervisory support to nurses
will enable them to become more engaged in their work.

Source of funding
This study was funded by Ministry of Higher Education
(MOHE) and Universiti Sains Malaysia.

Ethical approval
Ethical approval was granted from Medical Research
Ethical Committee (MREC), Ministry of Health (MOH).

Acknowledgements
The authors gratefully acknowledge Malaysian Higher Education and Universiti Utara Malaysia for doctoral sponsorship
and study leave, and Universiti Sains Malaysia for the USM 2012 Blackwell Publishing Ltd
Journal of Nursing Management

Social support and work engagement in Malaysia

RU-PRGS grant to undertake this research. Appreciation is

also extended to Malaysian Ministry of Health for granting
permission to conduct this research.

References
Al-Ahmadi H. (2008) Factors affecting performance of hospital
nurses in Riyadh Region, Saudi Arabia. International Journal of
Health Care Quality Assurance 22 (1), 4054.
Babcock-Roberson M.E. & Strickland O.J. (2010) The relationship between charismatic leadership, work engagement and
organizational citizenship behaviours. Journal of Psychology
144 (3), 313326.
Bakker A.B. & Schaufeli W.B. (2008) Positive organizational
behaviour: engaged employees in flourishing organizations.
Journal of Organizational Behaviour 29, 147154.
Bakker A.B., Demerouti E., Taris T., Schaufeli W.B. & Schreurs
P. (2003) A multi-group analysis of the job demands-resources
model in four home care organizations. International Journal of
Stress Management 10, 1638.
Bakker A.B., Demerouti E. & Euwema M. (2005) Job resources
buffer the impact of job demands on burnout. Journal of
Occupational Health Psychology 10, 170180.
Bakker A.B., Schaufeli W.B., Leiter M.P. & Taris T.W. (2008)
Work engagement: an emerging concept in occupational health
psychology. Work Stress 22, 187200.
Blancero D., Boroski J. & Dyer L. (1996) Key competencies for a
transformed Human Resource Organization: results of a field
study. Human Resource Management 35 (3), 383403.
Blau P. (1964) Exchange and Power in Social Life. Wiley, New
York, NY.
Chen C.K., Lin C., Wang S.H. & Hou T.H. (2009) A study of job
stress, stress coping strategies and job satisfaction for nurses
working in middle-level hospital operating room. Journal of
Nursing Research 17 (3), 199211.
Cohen A. & Golan R. (2007) Predicting absenteeism and turnover
intentions by past absenteeism and work attitudes: an empirical
examination of female employees in long term nursing
care facilities. Career Development International 12 (5), 416
432.
De Lange A., De Witte H. & Notelaers G. (2008) Should I stay or
should I go? examining longitudinal relations among job resources and work engagement for stayers versus movers Work
and Stress 22 (3), 201223.
Economic Planning Unit (2006) Achieving Better Health: Ninth
Malaysia Plan 20062010. Available at: http://www.epu.
gov.my, accessed 15 April 2009.
Eisenberger R., Stinglhamber F., Vandenberghe C., Sucharski I. &
Rhoades L. (2002) Perceived supervisor support: contributions
to perceived organizational support and employee retention.
Journal of Applied Psychology 87, 565573.
Hair J.F., Black W.C., Babin B.J., Anderson R.E. & Tatham R.L.
(2006) Multivariate Data Analysis, 6th edn. Pearson International Edition, Upper Saddle River, NJ.
Hakanen J.J. (2004) Work-Related Well-Being Among Finnish
Dentists. Finnish Institute of Occupational Health and the
Finnish Dental Association, Helsinki.
Hakanen J., Bakker A.B. & Schaufeli W.B. (2006) Burnout and
work engagement among teachers. Journal of School Psychology 43, 495513.
2012 Blackwell Publishing Ltd
Journal of Nursing Management

Halbesleben J.R.B. (2010) A meta-analysis of work engagement:

relationships with burnout, demands, resources, and consequences. In Work Engagement: A Handbook of Essential
Theory and Research (A.B. Bakker & M.P. Leiter eds),
pp. 102117. Psychology Press, New York, NY.
Hallberg U. & Schaufeli W.B. (2006) Same same but different:
can work engagement be discriminated from job involvement
and organizational commitment? European Journal of Psychology 11, 119127.
Hobfoll S.E. & Shirom A. (2000) Conservation of resources
theory: applications to stress and management in the workplace. In Handbook of Organization Behaviour, 2nd edn. (R.T.
Golembiewski ed.), pp. 5781. Dekker, New York, NY.
House J.S. (1981) Work Stress and Social Support. Addison
Wesley Longman, Boston, MA.
Kanapathy V. (2003) Services Sector Development in Malaysia:
Education and Health as Alternate Services of Growth. Research
Conference, 2021/2, 2003. Available at: http//www.nomur
afoundation.or.jp/data/20030220-21_Vijayakumari_Kanapathy.
pdf, accessed 18 August 2011.
Karasek R.A. & Theorell T. (1990) Healthy Work: Stress, Productivity and the Reconstruction of Working Life. Basic Books,
New York, NY.
Kaufmann G.M. & Beehr T.A. (1986) Interactions between job
stressors and social support: some counterintuitive results.
Journal of Applied Psychology 71 (3), 522526.
Korunka C., Kubicek B., Schaufeli W.B. & Hoonakker P. (2009)
Work engagement and burnout: testing the robustness of
the jobs-demands resources model. The Journal of Positive
Psychology 4 (3), 243255.
Koyuncu M., Burke R.J. & Fiksenbaum L. (2006) Work engagement among women managers and professionals in a
Turkish bank: potential antecedents and consequences. Equal
Opportunities International 25, 299310.
Langelaan S., Bakker A.B., Schaufeli W.B., Van Rhenen W. &
Van Doornen L.J.P. (2006) Do burned-out and work-engaged
employees differ in the functioning of the hypothalamicpituitary-adrenal axis? Scandinavian Journal of Work, Environment and Health 32, 339348.
Langford C.P., Bowsher J., Maloney J.P. & Lillis P.P. (1997)
Social support: a conceptual analysis. Journal of Advanced
Nursing 25 (1), 95100.
Llorens S., Bakker A.B., Schaufeli W.B. & Salanova M. (2006)
Testing the robustness of the job demands-resources model.
International Journal of Stress Management 13, 378391.
Llorens S., Schaufeli W.B., Bakker A.B. & Salanova M. (2007)
Does a positive gain spiral of resources, efficacy beliefs and
engagement exists? Computers in Human Behaviour 23,
825841.
Luthans F. (2002a) The need for and meaning of positive organizational behaviour. Journal of Organizational Behaviour 23,
695706.
Luthans F. (2002b) Positive organizational behaviour: developing
and managing psychological strengths. Academy of Management Executive 16 (1), 5772.
Luthans K.W., Lebsack S.A. & Lebsack R.R. (2008) Positivity in
healthcare: relation of optimism to performance. Journal of
Health Organization and Management 22 (2), 178188.
Mauno S., Pyykko M. & Hakanen J. (2005) The prevalence and
antecedents of work engagement in three different organizations. Psykologia 40, 1630.

N. Othman and A. M. Nasurdin

Mauno S., Kinnunen U. & Ruokolainen M. (2007) Job demands

and resources as antecedents of work engagement: a longitudinal study. Journal of Organizational Behavior 70, 149171.
Mcsherry R. & Douglas M. (2011) Innovation in nursing practice: a means to tackling the global challenges facing nurses,
midwives and nurse leaders and managers in the future. Journal
of Nursing Management, 19, 165169.
Meijiman T.F. & Mulder G. (1998) Psychological aspects of
workload. In Handbook of Work and Organizational Psychology, 2nd edn (P.J. Drenth, H. Thierry & C.J. de Wolff eds),
pp. 533. Erlbaum, Hove.
Moritz P., Hinshaw A.S. & Heinrich J. (1989) Nursing resources
and the delivery of the patient care: the national center for
nursing research perspective. Journal of Nursing Administration 19 (5), 1217.
Mrayyan M.T. (2006) Jordanian nurses job satisfaction, patients
satisfaction and quality of nursing care. International Nursing
Review 53 (3), 224230.
Purdy N., Laschinger H.K.S., Firiegan J., Kerr M. & Olivera F.
(2010) Effects of work environments on nurse and patient
outcomes. Journal of Nursing Management, 18, 901913.
Saks A.M. (2006) Antecedents and consequences of employee
engagement. Journal of Managerial Psychology 21 (7),
600619.
Salanova M. & Schaufeli W.B. (2008) A cross-national study of
work engagement as a mediator between job resources and
proactive behaviour. International Journal of Human Resource
Management 19 (1), 116131.
Salanova M., Agut S. & Peiro J.M. (2005) Linking organizational
resources and work engagement to employee performance and
customer loyalty: the mediation of service climate. Journal of
Applied Psychology 90 (6), 12171227.
Sarason B.R., Sarason I.G. & Pierce G.R. (1990) Traditional
views of social support and their impact on assessment.
In Social Support: An Interaction View (B.R. Sarason &
G.R. Pierce eds), pp. 725. Wiley, New York, NY.
Schaufeli W.B. & Bakker A.B. (2003). UWES-Utrecht Work
Engagement Scale: Test Manual. Department of Psychology,
Utrecht University, Utrecht. Available at: http://www.schaufeli.
com, accessed 9 May 2011.
Schaufeli W.B. & Bakker A.B. (2004) Job demands, job resources
and their relationship with burnout and engagement: a multisample study. Journal of Organizational Behaviour 25, 293315.
Schaufeli W.B. & Salanova M. (2007) Work engagement: an
emerging psychological concept and its implications for
organizations. In Research in Social Issues in Management:
Managing Social and Ethical Issues in Organizations, Vol. 5
(S.W. Gilliland, D.D. Steiner & D.P. Skarlicki eds), pp. 135
177. Information Age Publishers, Greenwich, CT.
Schaufeli W.B. & Van Rhenen W. (2006) About the role of positive and negative emotions in managers well-being: a study
using the job-related affective well-being scale (JAWS). Gedrag
& Organisatie 19, 323344.
Schaufeli W.B., Bakker A.B. & Salanova M. (2006a) The measurement of work engagement with a short questionnaire: a
cross-national study. Educational and Psychological Measurement 66, 701716.
Schaufeli W.B., Taris T.W. & Bakker A.B. (2006b) Dr. Jekyll and
Mr Hyde: on the differences between work engagement and

workaholism. In Research Companion to Working Time and

Addiction (R.J. Burke ed.), pp. 193217. Edward Elgar,
Northampton.
Schaufeli W.M., Taris T.W. & Van Rhenen W. (2008) Workaholism, burnout and engagement: three of a kind or three different kinds of employee well-being? Applied Psychology: An
International Review, 57 (2), 173203.
Schwarzer R. & Knoll N. (2007) Functional roles of social support within the stress and coping process: a theoretical and
empirical overview. International Journal of Psychology 42 (4),
243252.
Schwarzer R., Knoll N. & Rieckman N. (2004) Social support.
In Health Psychology (A. Kaptein & J. Weinman eds),
pp. 158182. Blackwell, Oxford.
Seligman M.E.P. & Csikszentmihalyi M. (2000) Positive psychology: an introduction. American Psychologist 55, 514.
Severinsson E. (1996) Nurses supervisors views of their supervisory style in clinical supervision: a hermeneutical approach.
Journal of Nursing Management 4, 191199.
Severinsson E. & Hallberg L. (1996) Clinical supervisors views of
their leadership role in the clinical supervision process within
nursing care. Journal of Advanced Nursing 24, 151161.
Sherony K.M. & Green S.G. (2002) Co-worker exchange: relationships between co-workers, leadermember exchange, and
work attitudes. Journal of Applied Psychology 87, 542548.
Susskind A.M., Borchgrevink C.P., Kacmar K.M. & Brymer R.A.
(2000) Customer service employees behavioural intentions
and attitudes: an examination o construct validity and a
path model. International Journal of Hospitality Management
19 (1), 5377.
Susskind A.M., Kacmar K.M. & Borchgrevink C.P. (2003) Customer service providers attitudes relating to customer service
and customer satisfaction in the customer-server exchange
(CSX). Journal of Applied Psychology 88 (1), 179187.
Susskind A.M., Kacmar K.M. & Borchgrevink C.P. (2007) How
organizational standards and co-worker support improve restaurant service. Cornell Hotel and Restaurant Administration
Quarterly 48 (4), 370379.
Van der Heijden B.I.J.M., Demerouti E., Bakker A.B. & Hasselhorn H.M. (2008) Work-home interference among nurses: reciprocal relationships with job demands and health. Journal of
Advanced Nursing 62 (5), 572584.
Van der Heijden B.I.J.M., Kummerling A., Van Dam K., Van der
Schoot E., Estryn-Behar M. & Hasselhorn H.M. (2010) The
impact of social support upon intention to leave among female
nurse in Europe: secondary analysis of data from NEXT survey.
International Journal of Nursing Studies 47, 434445.
Westman M., Hobfoll S.E., Chen S., Davidson O.B. & Laski S.
(2005) Organizational stress through the lens of conservation
of resources (COR) theory. In Research in Occupational Stress
and Well-being, vol. 4 (P. Perrewe & D.C. Ganster eds),
pp. 167220. JAI Press, Greenwich, CT.
Willoughby C.M. (2011) A Critical Literature Review Exploring
Work Engagement in the Nursing Profession. Thesis, Azusa
Pacific University, UMI Dissertation Publishing, CA.
Xanthopoulou D., Bakker A.B., Demerouti E. & Schaufeli W.B.
(2009) Work engagement and financial returns: a diary study
on the role of job and personal resources. Journal of Occupational and Organizational Psychology 82 (1), 183200.

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