Evaluation of relationships between organizational climate, organizational voice-silence and organizational cynicism among health workers in public hospitals

The concepts of organizational climate, organizational voice-silence, and organizational cynicism among healthcare employees. Organizational climate refers to the psychological atmosphere reflecting the characteristics of the working environment as perceived by employees, shaped by factors such as communication, support, trust, and justice. Organizational voice is defined as employees' willingness to express ideas, suggestions, or concerns within the organization, whereas organizational silence refers to the deliberate suppression or withdrawal of these expressions. Employee silence is often associated with fear, helplessness, or the perception of not being heard by management. On the other hand, organizational cynicism reflects employees' negative attitudes towards the organization, characterized by distrust, cynicism, and feelings of hopelessness. Cynicism often arises from inconsistent managerial practices, unethical behaviors, and a lack of justice. These three concepts are interconnected; a negative organizational climate reduces employees' willingness to voice concerns while increasing silence and cynicism. Conversely, a positive organizational climate fosters employee participation and engagement while reducing cynicism. The study was conducted among 624 healthcare workers employed in 10 public hospitals affiliated with the Istanbul Provincial Directorate of Health. Relationships between variables were analyzed using correlation and difference tests. For validity analyses, item analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were applied, while reliability analyses included Cronbach's Alpha, CR, and AVE coefficients. The reliability analysis for the organizational climate scale revealed Cronbach's Alpha values of 0.869 for Factor 1, 0.812 for Factor 2, and 0.931 for Factor 3, with an overall scale reliability of 0.852. For the organizational voice-silence scale, Cronbach's Alpha values were 0.942 for Factor 1, 0.915 for Factor 2, and 0.837 for Factor 3, with a total reliability of 0.899. The reliability analysis for the organizational cynicism scale indicated a single-factor Cronbach's Alpha value of 0.939, confirming its high reliability. The findings demonstrate that participants' sociodemographic characteristics significantly influence their organizational climate, organizational voice-silence, and cynicism scores. Gender differences revealed that males scored significantly higher than females in the "Quality and External Orientation" dimension. In terms of age groups, participants aged 40-60 had higher scores in the general organizational climate and the "Interest and Control" dimension. Regarding educational status, individuals with undergraduate, medical specialization, and doctoral degrees scored significantly higher in sub-dimensions and overall organizational climate compared to associate degree holders. Work status comparisons indicated that medical services employees scored higher than administrative services employees, while employees working shift-based schedules scored higher in all sub-dimensions compared to daytime-only workers. Occupational roles revealed that physicians and nurses-midwives had significantly higher organizational climate scores than other professional groups. In the context of organizational voice-silence and cynicism, significant differences were observed based on age, education, work status, and professional experience. Participants aged 19-24 scored higher in defensive voice-silence and cynicism than older age groups. The same age group had significantly higher pro-social voice scores compared to the 40-60 age group. In terms of education, associate degree holders reported higher pro-social voice scores than other educational groups. Work status analysis revealed that administrative service employees had higher cynicism scores, while daytime-only workers had higher cynicism scores compared to shift-based employees. Professional experience comparisons indicated that employees working for less than one year scored higher in defensive voice-silence, while those with 1-5 years of experience had higher pro-social silence and cynicism scores. Job satisfaction and the voluntary selection of profession also significantly influenced the results. Employees satisfied with their jobs reported higher scores across all dimensions of organizational voice-silence and cynicism. Similarly, employees who voluntarily chose their profession demonstrated significantly higher scores in defensive silence, pro-social silence, pro-social voice, and cynicism. Based on these findings, several recommendations are proposed to improve organizational climate and reduce cynicism. Professional development programs tailored to employees' educational levels should be implemented. Communication strategies should address the needs of different age groups to encourage pro-social communication. Balancing workloads and introducing flexible work models can enhance employee satisfaction. Furthermore, motivational support programs should be developed for shift-based employees to strengthen organizational commitment. Finally, inclusive management approaches that consider gender, age, and professional experience differences should be adopted to foster a positive work environment.