306 Organizacija, Volume 53 Issue 4, November 2020Research Papers 1 Received: 5th May 2020; revised: 27th September 2020; accepted: 15th October 2020 Linking Organizational Commitment and Organizational Trust in Health Care Organizations Bulent AKKAYA Manisa Celal Bayar University, Departmant of Business Management, Manisa, Turkey, bulent.akkaya@cbu.edu.tr Background and purpose: Health care organizations should apply new methods to motivate their employees be more effective and successful. This can be achieved by commitment to the organization and trusting their managers. Therefore, health care organizations must take care of the commitment and trust aspects in order to have a full knowl- edge of employees and to increase organizational performance and effectiveness. The present study aims to link sub-dimensions of organizational trust and sub-dimensions of organizational commitment of administrative personnel of health care organizations. Methodology: The survey was conducted among 156 administrative personnel in health organizations in Turkey. Sub-dimensions of organizational trust and sub-dimensions of organisational commitment were linked and correlated. Nyhan and Marlowe’s OTI survey was used for the assessment of organizational trust and Meyer’s and Allen’s OCQ for the assessment of organizational commitment. Correlation, Path analysis and Structural Equation Modelling (SEM) were used to analyse the data with the help of SPSS and SmartPLS programs. Results: Results suggest that trust in organization has a positive impact on effective organizational commitment and continuance organizational commitment, however, has not impact on normative organizational commitment. Addition- ally, trust in supervisors has a positive impact on affective organizational commitment, continuance organizational commitment and normative organizational commitment. Conclusion: Awareness of organizational trust and commitment can be beneficial to leaders and managers, as they can handle, develop and empower their workers better with this information. Moreover, the key point is that all leaders and managers should focus on creating an atmosphere that will make workers very more committed and trusting, hence, to enable them perform beyond their formal duty requirements. Keywords: Organizational trust; Organizational commitment; Health care organizations, Strategic management DOI: 10.2478/orga-2020-0020 1 Introduction The trust in organization and organizational commit- ment has become important issue in health management field. Today, health organizations and their managers are trying to find new ways to boost participation of their per- sonnel and maximize their impact. Organizational trust can lead to collaboration among administrative personnel, teams and organizations. Organizational trust can also lead to enhanced administrative personnel’ commitment to their organizations. Companies need a high degree of in- terpersonal confidence among co-workers in an organiza- tion for positive feedback and evaluation of advanced or- ganizational behaviour. As it is known, organizational trust plays a key role in management and confidence among co-workers (Paliszkiewicz, Koohang, Gołuchowski & Nord, 2014), therefore, is the responsibility of profession- al managers. We are in Industry 4.0 era which maximizes the competitive advantages among health organizations. Responding to the basic needs of administrative personnel in each organization is a priority in Industry 4.0 era. In such an era, for their survival, health organizations need 307 Organizacija, Volume 53 Issue 4, November 2020Research Papers quality human resources to respond well to environmental and technological challenges. In health organizations, ad- ministrative personnel have an important role as they are a bridge between top managers and employees. Thus, one of the most important needs of administrative personnel in health organizations is building organizational trust and providing their organizational commitment. There are two components of organizational trust; trust in the organisa- tion, and trust in supervisor (Nyhan & Marlowe, 1997; Vanhala, Heilmann & Salminen, 2016; Ozturk & Kara- tepe, 2019) and three components of organizational com- mitment; affective, continuance and normative (Meyer & Allen, 1991; Karem, Mahmood, Jameel, & Ahmad, 2019; Almaaitah, Alsafadi, Altahat & Yousfi, 2020). Organiza- tional commitment is commonly identified as the key fac- tor in interactions between personnel and organizations in the management and organizational behaviour literature. The most powerful driving forces for organizational suc- cess are organizational trust and organizational commit- ment (Bastug, Pala, Kumartasli, Günel & Duyan, 2016). Therefore, managers should recognize and be aware of na- ture of trust and its impact on organizational commitment (Sheik-Mohamed, Mohiadeen, & Anisa, 2012). Organ- izations must proactively seek a better understanding of trust and must take steps to improve employee confidence, commitment and trust (Bobbio, Bellan & Manganelli, 2012). Besides managerial, administrative personnel are also an important force in the planning and execution of the health organizational goals (Aryee, Budhwar & Chen, 2002). Hence, maintaining administrative personnel by strengthening their organizational commitment and trust is an issue of highest concern, and hospital administrators should give it priority. There are numerous researches and current studies on organizational commitment and organizational trust with different variables in literature. For example, Dirks and Ferrin (2001) claimed that employee trust is related to several attitudinal outcomes, especially organizational commitment. Ng (2015) studied the relationship between organizational commitment, trust, and organizational identification. Yılmaz (2008) researched organizational trust and organizational commitment in Turkish primary schools. Pranitasari (2020) investigated leadership and or- ganizational commitment. Timuroğlu and Çokgören (2019) linked organizational citizenship and organizational trust while Filiz and Bardakçı (2020) related organizational cli- mate and organizational trust. There are some other current studies, using one or more variables of this research, have similar results (Baird, Tung & Yu, 2019; Jain, Duggal & Ansari, 2019). These findings confirm that organization- al trust and organizational commitment are essential for an effective organization. Many other international stud- ies in different disciplines with different samples, such as nursing and public administration, also claimed that trust in organization has a significant impact on commitment (Cho & Park, 2011). Organizational commitment is also related to psychological empowerment and job satisfac- tion (Jordan, Miglič, Todorović & Marič, 2017). Some national studies in Turkey linked trust and commitment of doctors and nurses (Durukan, Akyürek, & Coşkun 2010) and organizational trust levels of health employees (Filiz & Bardakçı, 2020). However, till now, there have been no studies that focused on the relationship between sub-di- mensions of organizational trust and sub-dimensions of organizational commitment of administrative personnel. This gap has shaped this study’s scientific research model. Thus, this study aims to investigate the relationship among sub-dimensions by conducting an empirical analysis from the perspective of health organizations’ administrative per- sonnel. The research consists of four sections: literature re- view, methodology, findings and interpretations; and the conclusions and implications. Hopefully, this research will help health organization managers to consider the needs of administrative personnel and the factors that influence their commitment and trust in order to improve or arrange successful human resource structures. 2 Literature Review and Hypotheses Organizational trust refers to people’s positive expec- tations and the organization members’ expectations about competence, reliability and benevolence and refers to the trust between the employees and managers in an organiza- tion (Mayer, Davis & Schoorman, 1995). Organizational trust can lead to job satisfaction of employees which is the pre-requirement of organizational commitment. Therefore, organizational trust and commitment in organization and amongst organization members is challenged as a necessi- ty (Durukan et al., 2010). 2.1 Organizational Trust Organizational trust is not a new topic in manage- ment field. Organizational trust is the core element of effective organization (Sadq, Ahmad, Saeed, Othman & Mohammed, 2020). Organizational trust has become the priority of management studies researchers, especially study of organizational behaviour. Organizational trust is the confidence of the employee in the objectives of the organization’s actions and strategies which represent the satisfaction and commitment of the employee to the or- ganization. At the same time, it is the degree of confidence one person has in another’s competence and willingness to behave honestly and predictably (Nguyen, Pham, Le, & Bui, 2020). In other words, organizational trust is the level of confidence that one person has in another’s com- 308 Organizacija, Volume 53 Issue 4, November 2020Research Papers petence and his/her willingness to act in a fair, ethical and predictable manner and is a psychological state which pro- vides feedback on how employees perceive the problems in situations (Ji & Jan, 2020). Thus, organizational trust occurs on both individual and organization level. On the individual basis, the feeling of trust emerges depending on the personal characteristics of the workers and experience in their interpersonal relationships. Various dimensions of trust have been the focus of researchers in the past. But considering in the context of organization there are two dimensions of organizational trust. These are trust in the organisation, and trust in super- visor. Trust in the organization is about the organization members ‘optimistic assumptions regarding individuals’ intentions and actions based on organizational roles, inter- actions, and experiences while trust in supervisor is about the employee’s belief that the executive would keep his / her promises, act fairly and give honest and correct an- swers (Demircan & Ceylan, 2003; Warnock-Smith, Cam- eron & O’Connell, 2020). Researches have shown that trust in supervisors and organizations play a substantial role in building trust of employees (Ji & Jan, 2020). 2.2 Organizational Commitment There are numerous definitions of organizational commitment in literature. But Meyer and Allen (1991) described a more systematic approach to organizational commitment and proposed the three dimensional model in early 90’s. Many appreciations have been given to this model as so far it covers all the basic dimensions (Vanden- berghe, 2008). Organizational commitment is character- ized as the alignment of individuals with organizational values and goals, the willingness to perform duties and exhibit organizational efforts (Meyer & Allen, 1991). Ear- lier researchers found organizational commitment to be a unilateral concept but Meyer and Allen (1991) introduced a multidimensional model of organizational commitment (Masud & Daud, 2019). Organizational commitment has been classified by Meyer and Allen (1991) in three di- mensions. These are affective organizational commitment, continuance organizational commitment and normative organizational commitment. Affective Organizational Commitment (AOC): It is re- lated to organizational behaviours and is characterized as the member of the organization being psychologically or emotionally attached, identified, and involved (Meyer & Allen, 1997). This ensures that members can stay emotion- ally connected to the organization while evoking a sense of identification with the organization and participate more in the goals of the organization. Continuance Organizational Commitment (COC): It means remaining in the organization, as there is no choice (Meyer & Allen, 1997). Namely, the organization mem- ber feels it’s important to remain in the organization for reasons, such as, it’s costly to leave organization, interest in the organization will be lost and time will be wasted. In other words, the organisation’s leader is aware of the risks of leaving the company. Organizational members with ongoing dedication remain as members until a new and more appropriate organization is found for them (Meyer & Allen, 1997). Normative Organizational Commitment (NOC): It means that the members believe that it is moral to stay in the organization. Doubtful members do not want to stay voluntarily in their organizations and do not want to make sacrifices (Meyer & Allen, 1997). To summarize, affective organizational commitment is seen as an emotional connection of the workers to their or- ganization. In other words, employees perform far beyond to receive the stated recompense. Employees with norma- tive commitment have a social obligation to remain with their company. Continuance commitment refers to the cal- culative type of commitment: workers evaluate the impor- tance of retaining organizational membership compared to leaving the organization (Meyer & Allen, 1997). 2.3 Linkage between Organizational Trust and Organizational Commitment Number of positive attitudes and behaviours linked to work have been described as outcomes of organizational trust (Dirks & Ferrin, 2001). For example, it is critical factor for employees’ job satisfaction and performance (Aryee et al., 2002; Meng & Berger, 2019). Thus, organi- zational trust a is key element in organizational behaviours and organizational commitment is one of the key strategies and primary objectives for organizations to protect their advantages in competitive environment because employ- ees with organizational commitment are more adapted, relaxed and competitive (Sadq et al., 2019). In this study, organizational commitment is focused as an outcome of organizational trust. Previous studies indicate that organ- izational commitment is one of the central consequences of organizational trust (Aryee et al., 2002; Jiang, Gollan & Brooks, 2017). One of the most important factors that effected by organizational trust is organizational commit- ment (Yılmaz, 2008). Empirical researches have been con- ducted to relate organizational trust to organizational com- mitment (Baird et al, 2019; Jain, et al., 2019). Researchers have disclosed that organizational trust is a significant predictor of organizational commitment and the positive relationships between dimensions of organizational trust and organizational commitment have been explained by social exchange and HRM practices (Canning, Murphy, Emerson, Chatman, Dweck, & Kray, 2020; Jain et al., 309 Organizacija, Volume 53 Issue 4, November 2020Research Papers 2019). Several empirical studies have also shown a pos- itive link between organizational trust and commitment in different circumstances. Trust in organization has been associated with higher organizational commitment and trust in supervisors has correlated positively with inno- vative behaviour and satisfactions with supervisor (Can- ning et al., 2020). Therefore, it seems rational to anticipate that the degree of organizational trust among employees would affect their commitment to organization (Sadq et al., 2020). Furthermore, previous studies indicate that organ- izational commitment is one of the central consequences of organizational trust (Aryee et al., 2002;) Nevertheless, organizational commitment and organizational trust have a common connection. Also organizational trust may affect organizational commitment (Stinglhamber, 2006). No organization can work without trust among its per- sonnel and managers or can neglect the strong element of trust in doing business (Sadq et al., 2020). The degree of organizational trust defines the organizational composition of the factors that affect it, such as organizational structure, work design, communication, employee performance, commitment and organizational employee attitudes (Baird et al., 2019). Commitment and trust are, therefore, impor- tant factors in such environments. Administrative personnel with a high organizational commitment are able to continue working within the or- ganization and are able to work together to achieve organi- zational objectives. Organisational trust should relate posi- tively with organizational commitment (Chen, Wu, Chang, Lin, Kung, Weng & Lee, 2015). Organizational trust has a high positive association with organizational commitment (Mirza & Redzuan, 2012) and organizational trust strongly influences emotional commitment (Schoorman, Mayer & Davis, 2007). These studies support the notion that organ- izational trust closely relates with organizational commit- ment that creates a good reputation for a company’s busi- ness and increases its attractiveness. Based on previous above presented theoretical review and evidence from previous trust and commitment studies, it is assumed that different dimensions of organization- al trust (trust in supervisor and trust in organization) can be positively associated with employees’ organizational commitment and administrative personnel may highly be committed to their organizations when they have high trust in their organization and supervisors. Thus, the research model is designed in Figure 1 and hypotheses are listed as below. H1: Administrative personnel’ trust in organization is positively linked to their affective organizational commit- ment. H2: Administrative personnel’ trust in organization is positively linked to their continuance organizational com- mitment. H3: Administrative personnel’ trust in organization is positively linked to their normative organizational com- mitment. H4: Administrative personnel’ trust in supervisors is positively linked to their affective organizational commit- ment. H5: Administrative personnel’ trust in supervisors is positively linked to their continuance organizational com- mitment. H6: Administrative personnel’ trust in supervisors is positively linked to their normative organizational com- mitment. 3 Methodology Two dimensions of organizational trust (trust in super- visor and trust in organization) are independent variables and three dimensions of organizational commitment (af- fective, continuance and normative) are dependent varia- bles in this research. Based on this relation, KMO, Bart- lett’s Test and Cronbach Alpha were used to evaluate the variables reliability, normal distribution, and adequacy of data in this research. Correlation analysis was used to test the relations among variables mentioned above. In addi- tion, Path analysis based on Structural Equation Model (Chin, 1998) was used to estimate the relationship between dependent and independent variables. SEM is a statistical technique that is used to determine the factor structure of variables and helps scholars to check for validity (Sarstedt & Cheah, 2019). Partial least square structural equation modelling (PLS-SEM) was used in this study to analyse and test the model owing to the model’s sample size and complexity (Hair, Ringle, & Sarstedt, 2013). SmartPLS (V.3.3.1) and SPSS (V.26) programs were used to evalu- ate the variables reliability and convergent validity. The factor loadings of each item exceeded .70. (See Figure 1). Cronbach’s alpha (α), composite reliability (CR) and av- erage variance extracted (AVE) exceeded 70, .70 and 0.5, respectively (Hair et al., 2013) (see Table 5). 3.1 Sample and Procedure Simple random sampling technique was used to collect data from all eighteen healthcare organizations in Manisa, a city in West of Turkey. The respondents were admin- istrative personnel working in healthcare organizations. They were informed about the purpose of the research, and thereafter they were told that the data they provided would not be shared with third parties. Voluntary partic- ipants took part in the survey from January to December in 2019. About 10-12 respondents were interviewed from each organization. A total of 200 respondents were asked to complete the survey at their comfortable time to en- hance response rate. The sample size was selected based 310 Organizacija, Volume 53 Issue 4, November 2020Research Papers on Comrey and Lee (1992) inferential statistics. According to this statistic, a sample size of below 50 respondents is a weaker sample, a sample size of 100 respondents is weak, 200 respondents sample size is adequate, 300 is good, 500 is very good, and 1000 is excellent. Therefore, a sample size of two hundred (200) respondents was selected. Of 200 responses, 44 forms were eliminated due to missing values or uncompleted. Data was analysed with 156 valid forms for this research (78.0% response rate). 3.2 Measures Considering the objective and design of the study, data were collected by two questionnaires (see Appendixes). The first one is Organizational Trust Inventory developed by Nyhan and Marlowe in 1997 and adapted to Turkish by Demircan in 2003. It consists of 12 questions and two dimensions which are called trust in supervisor and trust in organization. Respondents were asked to rate their trust in organization and trust in supervisor by which their or- ganizations and managers provide better trust; trust in organization (4-items) and trust in managers (8-items). All items were measured on a five-point Likert-type rate (1=very low, 5 = very high). The other one is the Organi- zational Commitment Questionnaire developed by Meyer and Allen (1991). It includes 18 questions and has three dimensions of organizational commitment: affective, con- tinuance and normative. The questionnaire was developed to Turkish by Wasti (2000). Respondents were asked to rate their commitment to their organization by which their organizations provide a better loyalty; affective organiza- tional commitment (6-items), continuance organizational commitment (6-items) and normative organizational com- mitment (6-items). All items were measured on a five-point Likert-type scale (1=strongly disagree, 5 = strongly agree). Both questionnaires were adapted to Turkish culture and language and have been used by many scholars in Turkish and literature which shows the reliability and val- idation of the questionnaires. For example, organizational trust is used for up-to-date researchers such as Kabadayi and Türkay (2020) while organizational commitment is used by Akgerman and Sönmez (2020) in Turkey. 3.3 Data Analysis and Results Some basic demographic statistics of the respondents (education, age, gender, work experience, work unit and organizations) are presented in Table 1. Frequency Percent Age 19-30 41 26,3 31-40 73 46,8 41 years and over 42 26,9 Gender Male 92 58,1 Female 64 41,9 Education High School 34 21,8 Bachelor 94 60,3 Postgraduate 28 17,9 Work Experience Less than 5 years 12 7,7 6-10 years 31 19,9 11-20 years 73 46,8 21 years and over 40 25,6 Working Unit Intensive care 18 11,5 Service 52 33,3 Administrative Units 86 55,2 Organization Government 102 65,4 Private 54 34,6 Table 1: Respondents Profile 311 Organizacija, Volume 53 Issue 4, November 2020Research Papers Before analysing the data, it is necessary to check some statistical values for adequacy of the data and normal distribution. Kaise-Meyer-Olkin (KMO) and Bartlett’s Test are two statistical techniques that can give idea about the adequacy of the sample. The KMO value must be be- tween 0.5 and 1 while Bartlett’s Test must be less than 0.05 (Seçer, 2015). KMO and Bartlett’s Test were performed for both scales used in this study (see Table 2 and Table 3). As seen in Table 2 and Table 3 KMO value is more than 0.5 and Bartlett’s test value is lower than 0.5 that shows that the sample is adequate for both scales. To test the reliability of the scales, Cronbach Alpha (α) was calcu- lated. Cronbach Alpha (α) value is more than 0.70 for both scales, indicating the reliability of the scales. For conducting parametric tests such as T test, Anova, Manova test, Regression and Structural Equation Model, the distribution of data should be normal. p value of the Kolmogorov-Smirnov and Shapiro-Wilks test must be more than 0.05 and Skewness and Kurtosis values must be between +1 and -1 (George & Mallery, 2003). Table 2: KMO and Bartlett’s Test (Organizational Commitment Questionnaire) Kaiser-Meyer-Olkin Measure of Sampling Adequacy. ,710 Bartlett’s Test of Sphericity Approx. Chi-Square 1659,206 df 171 Sig. ,000 Cronbach’s Alpha ,795 Table 3: KMO and Bartlett’s Test (Organizational Trust Questionnaire) Kaiser-Meyer-Olkin Measure of Sampling Adequacy. ,904 Bartlett’s Test of Sphericity Approx. Chi-Square 2409,648 df 55 Sig. ,000 Cronbach’s Alpha ,975 Table 4: Normal Distribution Test Results Dimensions n Kolmogorov-Smirnova Shapiro-Wilk Skew-ness Kurtosis Statistic df Sig. Statistic df Sig. Statistic Statistic Organizational Trust 156 ,095 156 ,058 ,965 156 ,022 -,163 -,855 Organizational Commitment 156 ,107 156 ,069 ,958 156 ,018 ,500 -,539 aLilliefors Significance Correction When checking Table 4, it is seen that the p value is more than 0.05, and Skewness and Kurtosis values are be- tween +1 and -1. Therefore, parametric analysis tests were conducted in this research. The averages, composite reliability standard, AVE and correlation coefficients between the variables gathered from the research are presented in Table 5. According to Table 5, the factor with the highest av- erage is observed to be normative organizational com- mitment while the factor with the lowest is trust in or- ganization. Pearson correlation was calculated to test the relationship between variables. Trust in supervisors has the strongest correlation with Trust in organization (r=0,748, p<0,01) while Trust in organization has the lowest correla- tion with Normative organizational commitment (r=0,549, p<0,01) and the other variables have medium level corre- lation with each other’s. 312 Organizacija, Volume 53 Issue 4, November 2020Research Papers Table 5: Descriptive Results and Correlation Matrix Variables AOC. COC. NOC. TiO. TiS. Affective organizational commitment 1 Continuance organizational commitment 0.686** 1 Normative organizational commitment 0.579** 0.666** 1 Trust in organization 0.619** 0.699** 0.549 1 Trust in supervisors 0.665** 0.719** 0.612** 0.748** 1 Cronbach’s Alpha 0.902 0.863 0.830 0.897 0.836 Composite Reliability 0.924 0.897 0.875 0.928 0.875 AVE 0.671 0.593 0.540 0.763 0.552 Mean 3,964 3,853 3,989 3,867 3,827 **Correlation is significant at the 0.01 level (2-tailed). To assess the psychometric properties of the measure- ment instruments, a null model is estimated with no struc- tural relationships. Reliability is evaluated by Cronbach’s Alpha in addition to the means of composite scale relia- bility (CR) and average variance extracted (AVE). For all measures, PLS-based CR and Cronbach’s Alpha are more than the cut-off value of .70, and AVE is above the cut-off value of .50. As Fornell and Larcker (1981) suggested, the AVE for each construct was more than the squared latent factor correlations between pairs of constructs (see Table 5). The research model was developed with independent variables (trust in supervisor and trust in organization) and dependent variables (affective organizational commitment, continuance organizational commitment and normative or- ganizational commitment). PLS path modelling, which al- lows for explicit estimation of latent variable (LV) scores, was used to estimate the relationship between variables in research model (Figure 1). PLS Graph 3.3.11 and the boot- strapping resampling method were used to test their statis- tical significance. This procedure, firstly, was entailed by generating 500 sub-samples of cases randomly were se- lected from the original data. Then Path coefficients were generated for each randomly selected sub-sample. T-statis- tics were calculated for all coefficients based on their sta- bility across the sub-samples in order to determine which paths were statistically significant (see Table 6). Paths Standard Deviation T Statistics Path coefficient(β) P Values Trust in organization -> Affective Organizational Commitment 0.096 2.584 0.248 0.010 Trust in organization -> Continuance Organizational Commitment 0.088 4.211 0.372 0.000 Trust in organization -> Normative Organizational Commitment 0.130 1.255 0.163 0.210 Trust in supervisors -> Affective Organizational Commitment 0.093 5.997 0.555 0.000 Trust in supervisors -> Continuance Organizational Commitment 0.087 5.792 0.504 0.000 Trust in supervisors -> Normative Organizational Commitment 0.129 4.439 0.573 0.000 RMStheta : 0.149; SRMR: 0.078; Chi-Square: 992.920; GoF: 0.618; NFI: 0.802 Endogenous Variables R2 Affective Organizational Commitment 0.603 Continuance Organizational Commitment 0.710 Normative Organizational Commitment 0.514 Table 6: Testing The Research Model (Path Analysis Results for Organizational Trust and Organizational Commitment) 1 1PLS Graph 3.3.1 was downloaded from (https://www.smartpls.com/downloads (27th.01.2020) 313 Organizacija, Volume 53 Issue 4, November 2020Research Papers Figure 1: The Research Model (Organizational Trust and Organizational Commitment) As presented in Table 6, five hypotheses are largely supported while only one hypothesis rejected. The results show that trust in organization has positive impact on af- fective organizational commitment (β=,248, p<0,01; H1 is supported), on continuance organizational commitment (β=,372, p<0,01; H2 is supported), but has no positive im- pact on normative organizational commitment (β=,163, p>0,05; H3 is rejected). Trust in supervisors has also positive impact on affective organizational commitment (β=,555, p<0,01; H4 is supported), on continuance organ- izational commitment (β=,504, p<0,01; H5 is supported), and on normative organizational commitment (β=,573, p<0,01; H6 is supported). Moreover, the organization- al trust sub-dimensions, trust in supervisors and trust in organization explain 60.3 percent of the variance (R2 = .60) in affective organizational commitment, 71.0 percent of the variance (R2 = .71) in continuance organizational commitment and 51.4 percent of the variance (R2 = .51) in normative organizational commitment which are sub-di- mensions of organizational commitment. 4 Discussion and Conclusion The results of this study showed that organizational trust has direct effect on organizational commitment. It means that the less the trust between employees and top level managers, the greater will be the fear of expression of opinions and lack of guidance for achieving organizational objectives. Moreover, the relation among sub-dimensions of organizational commitment and organizational trust were tested to see the more details about this relationship. 314 Organizacija, Volume 53 Issue 4, November 2020Research Papers In this context, six hypotheses were tested. The results show that participants’ affective organizational commit- ment and continuance organizational commitment are sig- nificantly impacted by their perception of trust in organi- zation. Thus, H1 and H2 are supported(p<0,01). Through increasing trust in the organization, personnel are more pleased with their job and with the organization they work, and personnel will be more affectively and continually committed to their organization. Participants’ normative organizational commitment is not significantly impacted by their perception of trust in organization in contradistinc- tion for. Therefore, H3 is rejected (p>0,05). It means that the personnel believe that due to the trust in organization, it is moral to stay in the organization and doubtful person- nel do not want to be volunteer in their organizations and to make sacrifices. Participants’ affective organizational commitment, continuance organizational commitment and normative organizational commitment are significant- ly impacted by their perception of trust in supervisors. It is seen that H4, H5 and H6 are supported(p<0,01). These three variables are the outcome of supervisor’s organiza- tional trust. Indeed, trust among administrative personnel, supervisors and managers have an impact on organization- al commitment. Trustworthy managers may lead to dif- ferent trusts, knowledge or views based on fulfilling any conditions. Because they can overcome presenting neg- ative outcomes. Furthermore, they can give information or friendly trust in an individual as ideas with the aim of supporting personnel in the organization. This notion posi- tively influences productivity in organization performance and motivation of personnel, and can ultimately increase personnel’ commitment to organization, work, workmates and even managers. The statistical results showed that the relationship be- tween organizational trust and organizational commitment is significant. Canning et al. (2020) support the results of this research. They found that trust in organization was as- sociated with higher organizational commitment and trust in supervisors correlated positively with innovative behav- iour and satisfactions with supervisor. The results of these studies are also supported with the results of the study conducted by Bastug et al. (2016), Sheik-Mohamed et al. (2012). Bastug et al. (2016) found that a significant rela- tionship between trust in director, emotional commitment and continuance commitment while an insignificant rela- tionship among organizational trust sub-dimensions and normative commitment. Sheik-Mohamed et al., (2012) reached the results that show significance of the relation- ship between organizational trust, job satisfaction and or- ganizational commitment. Dynamics and enhancement of motivation of trust among personnel are one of the most important factors of integration. The personnel-trust in organization is success- ful in advancing its goals. Trust, as seen in this study, plays an important role in consistency between personnel and organizations and their managers, and has a special posi- tion. Trust allows the organization to focus on long-term goals and objectives, and may be one of the key compo- nents for effective organizational change. If managers try to increase trust among their employees, they will observe personnel’ commitment and their active behaviours to the changes that have happened inside and outside the organ- ization. Life and sustainability of an organization rely on a close relationship among employees, managers, and their organizations. And the most important factor is the role of manager in this relationship. If manager can give sense of trust and share his/her experiences the performance of organization can be enhanced. As it is stated earlier, shar- ing of experiences and organizational rules impact organizational performance (Cecez-Kecmanovic, Janson & Zupancic, 2010). Finally, awareness of organizational trust and commit- ment can be beneficial to leaders and managers, as they can handle, develop and empower their workers better with this information. Moreover, the key point is that all leaders and managers should focus on creating an atmosphere that will make workers more committed and trusting to enable them to perform beyond their formal duty requirements. In addition to important findings that contribute to lit- erature, this study has also some limitations. Due to time and space limitations, data were collected from a small sample. Also, this research does not address the impact of demographic characteristics on organizational trust and organizational commitment, such as age, education, mari- tal statues and work experience. Finally, while the aim of the study is to provide an overview into the model, it is suggested that future studies can implement more com- prehensive measures, a broader sample of health workers, especially frontline workers, as well as can integrate al- ternative methods to provide a more comprehensive per- spective into these links. Future studies can also provide a clearer insight into the hypothesized relationships through the use of qualitative and/or quantitative measurements with larger samples to handle the use of Mixed method. Future studies can also explore the impact of additional contingency factors on improving the organizational com- mitment and trust of health or some different institutions’ personnel. Literature Akgerman, A., & Sönmez, B. (2020). 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An integrative model of organizational trust: Past, present, and future. Academy of Management Review, 32(2), 344–354. https://doi.org/10.2307/20159304 Seçer, İ. (2015). SPSS ve LİSREL İle Pratik Veri Analizi, [Practical Data Analysis with SPSS and LISREL], 2nd Edition) Ankara: Anı Yayıncılık. Sheik-Mohamed, L., Mohiadeen, A. K. M., & Anisa, H. (2012). Relationship among Organizational Commit- ment, Trust and Job Satisfaction: An Empirical Study in Banking Industry. Research Journal of Management Sciences, 1(2), 1-7. Stinglhamber, F. D. (2006). Perceived Support as a Me- diator of the Relationship Between Justice and Trust A Multiple Foci Approach. Group & Or- ganization Management, 442-468. https://doi. org/10.1177/1059601106286782 Timuroğlu, K., & Çokgören, Ö. (2019). Örgütsel Güven Algısı Ve Örgütsel Vatandaşlık Davranışı İlişkisi [The Relationship between Organizational Trust Perception And Organizational Citizenship Behaviours]. 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[Validity and reliability analysis of the three-dimen- sional organizational commitment scale developed by Meyer and Allen]. 8. Ulusal Yönetim ve Organizasyon Kongresi Bildirileri, 401-410. Warnock-Smith, D., Cameron, D., & O’Connell, J. F. (2020). Organisational Trust: a case Application in the Air Transport Sector. Transport Policy, 88, 69-78 https://doi.org/10.1016/j.tranpol.2020.01.004 Bulent Akkaya (https://orcid.org/0000-0003-1252- 9334) received his Bachelor’s degree in Teaching English Department in 2006 in Kocaeli University and received his master’s degree in 2013 in Business Administration Department in Celal Bayar University. In 2018, he recieved his PhD in Business Administration Management with a specialization in Management field from İzmir Katip Çelebi University. He has been working as Dr. Lecturer in the Department of Office Management-Executive Assistant of Manisa Celal Bayar University in Turkey since 2013. His research interests comprise networks and partnerships in diverse disciplines. He has been working on motivation in organization, distance management, dynamic capabilities, agile leadership, organizational agility, industry 4.0, Leadership 5.0, Society 5.0 and quality of management in contemporary enterprises. He worked as a researcher in four projects and as an executive in a project. He published many articles, book chapters and books both in Turkish and English. Povezava med organizacijsko pripadnostjo in organizacijskim zaupanjem v zdravstvenih organizacijah Ozadje in namen: Zdravstvene organizacije bi morale uporabljati nove metode za motiviranje svojih zaposlenih, da bodo bolj učinkovite in uspešne. To lahko dosežejo z zavezanostjo organizaciji in zaupanjem njihovim menedžerjem. Zato morajo zdravstvene organizacije skrbeti za organizacijsko pripadnost in različne vidike zaupanja, da bodo v celoti poznale zaposlene in povečale uspešnost in učinkovitost. Namen te študije je povezati poddimenzije organi- zacijskega zaupanja in poddimenzije organizacijske zavezanosti administretivnega osebja zdravstvenih organizacij. Zasnova / metodologija / pristop: Podssatke za študijo smo zbrali z anketo, ki je bila izvedena med 156 upravnimi uslužbenci v zdravstvenih organizacijah v Turčiji. Za oceno organizacijskega zaupanja je bila uporabljena raziskava OTI avtorjev Nyhan in Marlowe ter Meyerjev in Allenov OCQ vprašalnik za oceno organizacijske zavezanosti. Za analizo podatkov s pomočjo programov SPSS in SmartPLS smo uporabili korelacijo, analizo poti in modeliranje strukturnih enačb (SEM). Rezultati: Ugotavljamo, da zaupanje v organizacijo pozitivno vpliva na učinkovito organizacijsko zavezanost in nadaljevanje organizacijske zavezanosti, vendar ne vpliva na normativno organizacijsko zavezanost. Poleg tega za- upanje v nadrejene pozitivno vpliva na čustveno organizacijsko zavezanost, željo ostati v organizaciji, in normativno organizacijsko zavezanost. Zaključek: Zavedanje organizacijskega zaupanja in zavzetosti je lahko koristno za vodje in managerje, saj lahko s temi informacijami bolje obvladujejo, razvijajo in opolnomočujejo svoje delavce. Poleg tega je ključno, da se morajo vsi vodje in menedžerji osredotočijo na ustvarjanje vzdušja, zaradi katerega bodo delavci postali bolj zavzeti in bodo bilj zaupali vodjem in bili pripravljeni narediti tudi več kot so formalne zahteve za njihovo delovno mesto. Ključne besede: Organizacijsko zaupanje; Organizacijska zavezanost; Zdravstvene organizacije, Strateško upravlja- nje 318 Organizacija, Volume 53 Issue 4, November 2020Research Papers Appendix A: Organizational Commitment Questionnaire (Meyer and Allen, 1991) Scale: Strongly Disagree :1 Disagree: 2 Neither Agree nor Disagree: 3 Agree: 4 Strongly Agree: 5 AOC-1. It would be very hard for me to leave my department right now, even if I wanted to AOC-2. I do not feel any obligation to remain with my current employer AOC-3. I would be very happy to spend the rest of my career with this department AOC-4. One of the few negative consequences of leaving this department would be the scarcity of available alternatives AOC-5. Even if it were to my advantage, I do not feel it would be right to leave my organization now AOC-6. I really feel as if this department’s problems are my own COC-1. Right now, staying with my department is a matter of necessity as much as desire COC-2. I do not feel a strong sense of “belonging” to my department COC-3. I feel that I have too few options to consider leaving this department COC-4. I do not feel “emotionally attached” to this department COC-5. I would feel guilty if I left my organization now COC-6. I do not feel like “part of the family” at my department NOC-1. This organization deserves my loyalty NOC-2. If I had not already put so much of myself into this department, I might consider working elsewhere NOC-3. Would not leave my organization right now because I have a sense of obligation to the people in it NOC-4. This department has a great deal of personal meaning for me NOC-5. Too much of my life would be disrupted if I decided I wanted to leave my department now NOC-6. I owe a great deal to my organization Appendix B: Organizational Trust Inventory (Nyhan and Marlowe, 1997) Scale: Very Low: 1, Low: 2, Fifty-Fifty: 3, High :4, Very High :5 1. My level of trust that supervisor is technically component at the critical elements of his/her job___. 2. My level of trust that supervisor will make well throughout decisions about his/her job___. 3. My level of trust that supervisor will follow through on assignment is___. 4. My level of trust that supervisor has an acceptable level of understanding of his/her job___. 5. My level of trust that supervisor will be able to do his/her job in acceptable manner is____. 6. When supervisor tells me something, my level of trust that I can rely on what they tell me is___. 7. My trust in supervisor to do the job without causing other problem is_______. 8. My level of trust that supervisor will think through what s/he is doing job is_____. 9. My level of trust that this organization will treat me fairly is________. 10. The level of trust between supervisor and workers in the organization is____. 11. The level of trust the people I work with on regular basis is_____. 12. The degree to which we can depend on each other in this organization is____.