key: cord-1037630-c5d99zk9 authors: Diana; Eliyana, Anis; Mukhtadi; Anwar, Aisha title: Creating the Path for Quality of Work life: A Study on Nurse Performance date: 2021-12-29 journal: Heliyon DOI: 10.1016/j.heliyon.2021.e08685 sha: ed09cffd545072b97882746419a4542389b7821c doc_id: 1037630 cord_uid: c5d99zk9 Since March 2020, it is known that Indonesia has experienced the impact of the Corona Virus Disease 2019 (Covid-19) Pandemic, and making health workers at the forefront of potential exposure to the Covid-19 virus because they have to deal with Covid-19 patients every day during the pandemic. The purpose of this study is to focus on developing an empirical model to increase job performance in the hospital to create the right quality of work and still make the organization grow well sustainably. This study will use assistance of quality of work life, organizational commitment, job satisfaction, and psychological empowerment in creating an increase in job performance needed by nurses at the Type B Hospital in Jakarta. This study uses a quantitative approach through a questionnaire survey method conducted on nurses at 36 Type B Hospital in Jakarta, totalling 400 respondents. The sample used in this study was obtained through a purposive sampling technique with the criteria of a service period of more than 2 years. Then the data were analysed using the Structural Equation Model (SEM). Though quality of work life is found to significantly affect organizational commitment, job satisfaction and psychological empowerment, its effect on job performance found to be insignificant. Further findings will be discussed further. Organizations require high-performing workers to fulfill their goals and gain a competitive advantage in today's highly competitive business environment. The health industry is similarly impacted by the Industrial Era 4.0, with consumers placing greater demand on health services, both in terms of quantity and quality. Patients require care that is both quicker and more precise. The government has shown concern by issuing various laws targeted at preserving the quality and competency of health worker graduates, but this is difficult to achieve because obtaining a registration certificate takes a long time. Nurses' performance has an impact on not just customer loyalty, business image, and word-of-mouth communication, but it may also be viewed as a competitive aspect in distinguishing the hospital from its competitors (TETIK, 2016) . Nurses have become significant frontline players in the healthcare sector, and their performance and satisfaction are crucial to the hospital's success. As a result, it can be stated that testing elements that positively influence performance levels is an essential study topic. Pandemic which then elevate the role of medical staff especially nurses. Considering their expose to the virus, nurses are likely to experience increased stress which also refers to stunted growth and development, and consequently has a negative impact on their performance (Ashwini et al., 2014) . Difficulty to handle the stress will also have an impact on their health, personal and professional lives. Hospitals will continue to be faced with the challenges of demand and supply from patients who are constantly changing, especially during the pandemic. In order for the hospital to adapt to tight competition and retain employees well, it requires organizational members who are internally committed (Kaleel et al., 2018a) and with the limited workforce of nurses who fulfill government criteria, hospitals need to optimally improve nurses' commitment and performance to provide good service. In order to achieve the goal of continuous improvement of service quality, organizations in health care must continue to monitor and promote the health and satisfaction of all people involved in the care process (Al-Abri & Al-Balushi, 2014) . In particular, the nurse will help patients to maintain or improve their health and direct them to achieve independence as soon as possible. To achieve this goal, it is more important that nurses build good relationships with patients through psychological empowerment which can refer to the psychological conditions that individuals need to feel control in relation to their work (Catholic et al., 2015) . An empathic attitude with patients can also help in offering adequate care to meet the real needs of those being assisted and to make them feel more satisfied with the treatment process (Dal Santo et al., 2013) . Job satisfaction is defined as the combination of positive or negative feelings employees have about their jobs, Locke with his mostly cited definition describes it as "a pleasant or positive emotional state resulting from an assessment of one's job or work experience" (Dinc et al., 2018a) . Many factors can have an effect on nurse job satisfaction. Job content characteristics, such as autonomy, routine, and role conflict, as well as characteristics of the work environment, such as leadership, supervisory relationships and participation, are all related to job satisfaction. Therefore, knowledge of the factors contributing to job satisfaction is very important for nursing management and leadership, and will be of great use and great importance in the human goals, which are the core of human resource management, and are very important for organizations that want to retain talented employees (Dinc et al., 2018a) . Basically, the definition of organizational commitment emphasizes that employees who are committed to work harder and better have a stronger intention to stay with the organization, compared to employees with low commitment. Organizations need these types of employees to survive and improve the services and products (Setiawan et al., 2019) . In addition, according to Diana et al., (2020) employees with high organizational commitment will make efforts towards organizational targets and organizational values at a high level. Job satisfaction is known to consist of various aspects that have been categorized by many researchers. One such classification includes aspects of satisfaction with salary, with promotions, with colleagues, with the job itself, and with supervision. Job satisfaction is an optimistic emotional state arising from a person's job, which is related to how a person likes their job, a positive view of employees on their work, and job satisfaction is an observable expression of affective reactions to certain jobs (Yuspahruddin et al., 2020) . Job satisfaction is also considered an effective indicator of happiness because it reflects a pleasant state of mind and positive emotions resulting from well-being at work, which is largely determined by human resource management practices (R.M. et al., 2019) . So, it can be stated that a person's thoughts and actions to produce job satisfaction are determined by the individual himself in doing his job. Psychological empowerment is a series of psychological conditions required by individuals to feel control in relation to their work, which also reflects the integration of four cognitions related to work, competence, meaning, self-determination, and impact (Catholic et al., 2015) . Psychological empowerment is also the belief and perception of someone who thinks they can make a difference by having independence in the decision-making process and having the confidence to initiate change, having the ability and skills to determine their own destiny, achieve goals, and feel meaning in the work they do (Kustanto et al., 2020) . Employees that have psychological empowerment can also see themselves as influential in their workplaces and inspire them to be more proactive, independent, and show initiative. In other words, employees who feel empowered at work will develop an active rather than passive orientation towards their job roles (Guerrero et al., 2018) . J o u r n a l P r e -p r o o f Job performance is defined as a measure of good quality and quantity results in a certain period of time influenced by several factors that will be carried out through employees' for achieving organizational goals (Muzakki et al. al., 2019) . Job performance can be a factor that can significantly affect the profitability of an organization, because performance is the results achieved or achievements made in the workplace related to organizational policies, performance features, and organizational practices (Kustanto et al., 2020) . Job performance can also be a construct that is associated with an individual's ability to fulfill the expectation of targets, jobs, and standards set by the organization (Rajper et al., 2020) . In the literature, organizational commitment has been aimed at believing and accepting organizational goals and values in trying harder for the organization and also showing a continuous willingness to maintain one's membership in the organization (Eren & Hisar, 2016) . The desire of employees for organizational commitment and being involved in attendance will also be influenced by the quality of work life. Quality of work life includes evaluation of working conditions, employee satisfaction with their work, management style and the relationship between work life and social life outside of work, or in short, the strengths and weaknesses of the work environment (Eren & Hisar, 2016) . There is also a linear relationship between the quality of work life and organizational commitment in this study. A person with a high quality of work life will also have an increased organizational commitment. According to Kaleel et al., (2018a) quality of work life and organizational commitment are the two most important and fundamental subjects in organizational behavior today. Contemporary employees and employersconcluded that "low levels of employee organizational commitment can be attributed to improper selection and promotion which leads to the preservation of managerial styles and behaviors which have a negative effect on subordinate organizational commitment", therefore the right quality of work life is needed. Quality of work life can function as a program designed to increase and strengthen employee satisfaction for workplace learning and help them manage change and transitions to produce high organizational commitment (Omugo et al., 2016) . A significant positive relationship between quality of work life and organizational commitment can make employees feel more comfortable and happier. This notion is also supported by some previous research J o u r n a l P r e -p r o o f 2018; Eren & Hisar, 2016) which stated that a better quality of work life will lead to higher organizational commitment. H1: Quality of Work Life has a positive effect on Organizational Commitment Quality of work life and job satisfaction are both abstract concepts and are related to the work and work environment in an organization (J. et al., 2017) . It seems that these two concepts are crucial concepts for both the employee and the organizational perspective. Quality of work life can increase employee dignity through job satisfaction and humanizing work (Jabeen et al., 2018) . The scope of quality of work life does not only affect employee job satisfaction but also their life outside of work, such as leisure time, family, and social needs. When employees' needs are not met, they tend to experience work-life stress which may have a negative impact on welfare Literature reviews have emphasized that quality of work life is a strategy to improve employees' quality of life to meet organizational goals and employee needs (J. et al., 2017) . Conversely, successful organizations regard job satisfaction as indispensable to job performance. Quality of work life is also related to organizational conditions and practices that aim to promote the safety, health, and mental and physical satisfaction of employees, to attract and retain employees by creating positive job satisfaction (Acheampong et al., 2016) . Previous Quality of work life will examine the relationship between employees and their work environment (Eren & Hisar, 2016) . Quality of work life is considered better as a strategy that can improve the quality of the relationship between employees and conditions in the work environment, which in turn leads to better organizational effectiveness (Alqarni, 2016) . This is important because ongoing changes in employment can directly affect employees' psychological empowerment by obliging them to learn new procedures and develop new competencies over and above normal job requirements (Catholic et al., 2015) . Psychological empowerment can be enriched with the quality of work life in the workplace, because employees have control over their workload, get support from peers, feel more valued for their achievements and are treated fairly (Tarigan et al., 2020) . The same notion is supported by the J o u r n a l P r e -p r o o f following studies by Patah et al., (2009) ; (Salimi & Saeidian, 2015) ; Türkay et al., (2018) ; Tarigan et al., (2020) . H3: Quality of Work Life has a positive effect on Psychological Empowerment There are several factors that affect job performance of an employee, such as quality of work life which cover most of the most important aspects to increase employee job performance (Thakur & Sharma, 2019) . A better quality of work life is when employees' needs of life are met, which can eventually instill employee loyalty, and in turn support better job performance (Nayak & Sahoo, 2015) . The concept of quality of work life will show positive emotional reactions and individual attitudes towards their work. The most important determinant is an employee who finds the job attractive, has good relationships with managers and colleagues, is allowed to work independently, has sufficient income, and has clear career advancement opportunities (Suyantiningsih et al., 2018) . This will then create benefits for organizations to carry out quality of work life programs effectively, that is an increase in job performance. Employees with the right psychological composition, including being able to meet personal needs, will see and understand the quality of work life provided by the organization with enthusiasm, and then be motivated to show better job performance (K.R. & Dr.A., 2017). Some previous studies (Acheampong et al., 2016; Thakur & Sharma, 2019; Tarigan et al., (2020) ; Suyantiningsih et al., 2018) also found that quality of work life had a positive overall relationship with job performance. H4: Quality of Work Life has a positive effect on Job Performance Job satisfaction is considered as an antecedent of organizational commitment in several studies that show a proper positive relationship (Suyantiningsih et al., 2018) . Employees with positive job satisfaction become an important determinant of organizational commitment (Moon et al., 2014) . Job satisfaction will be an important component of organizational commitment for employees wherever they work (Ashraf, 2020) . Job satisfaction will create employee mental persuasion towards a positive workplace, which will bring positive consequences in the form of higher organizational performance and productivity, and it is said that adequate job satisfaction can result in an increase in organizational commitment (Bashir & Gani, 2019) . In addition, job satisfaction is known to be related to the way employees observe, reflect on, and feel about their work, as an emotional pleasure in assessing their work and work experience J o u r n a l P r e -p r o o f (Ali et al., 2018) . There are many studies that have examined job satisfaction and organizational commitment together and have found a positive and significant relationship between them, such as Sait, (2017) ; Fabi, Lacoursière, & Raymond (2015) ; Ocen, Francis, & Angundaru (2017) ; Mahmood, Akhtar, Talat, Shuai, & Hyatt (2019) ; Suyantiningsih et al., (2018) ; Ashraf, (2020) . H5: Job Satisfaction has a positive effect on Organizational Commitment Psychological empowerment is used as intensive intrinsic motivation, which comes from certain cognitive states related to psychological empowerment which has a significant and positive relationship with employee organizational commitment (Qing et al., 2020) . Through psychological empowerment, it will generate norms that explain how someone must behave and those who follow these norms are obliged to behave reciprocally (Qing et al., 2020) . Most exchange relationships are established when organizations give their followers full support and take good care of them. Furthermore, this relationship leads to valuable work behaviors such as organizational commitment. Employees with psychological empowerment in the workplace will develop an active rather than passive orientation towards their work roles (Guerrero et al., 2018) . In addition, employees with psychological empowerment will feel like and feel able to shape and control their roles and work context. Through psychological empowerment employees can increase their sense of autonomy and self-determination and they feel they can control well the tasks given and the work environment as a whole (Tripathi et al., 2020) Organizational commitment is associated empirically and theoretically with work performance such as job performance. To achieve organizational goals, leaders must inform employees of the desired performance, because employee performance will be directly related to the quality of organizational performance (Karem et al., 2019) . It is known that organizational commitment has become a promising research field because it plays a bridge role in the jon performance that will be produced (Berberoglu, 2015) . Social exchange theory has been used J o u r n a l P r e -p r o o f to explain how organizations implement and also practice various mentoring activities or generate ideas that allow employees to feel the organization trusts them (Babalola, 2016) . As a result, employees develop organizational commitment and lead to increased job performance. Employees with organizational commitment are likely to perform better than employees who are less committed because they exert more effort on behalf of the organization towards its success and strive to achieve its goals and mission (Jafri & Lhamo, 2013) . In today's competitive business world, organizations need high performing employees to meet their goals and to achieve competitive advantage. Therefore, it is highly recommended that organizational managers must describe the performance needed to specifically allow their employees to recognize organizational expectations to meet organizational goals by fostering organizational commitment to employees (Dinc et al., 2018a) . Several studies confirm the influence and strong relationship between organizational commitment and job performance (Chiang & Hsieh (2012) Job satisfaction is proven to increase job performance and efficiency which has a beneficial impact on job satisfaction, because elevated job satisfaction can increase employee productivity based on quality (Karem et al., 2019) . According to this study, individuals who obtain a good level of job satisfaction tend to provide higher job performance to their organization when compared to individuals in other organizations who face low job satisfaction. According to Hendri, (2019) for several years, there has been a strong belief from company managers that employees with high job satisfaction will provide higher job performance than dissatisfied employees, and can also increase company size. Job satisfaction is an effective indicator of happiness because it reflects a pleasant state of mind and positive emotions resulting from well-being in the workplace, which is largely determined by human resource management practices (R.M. et al., 2019) . That way, they will lead to positive behavior in the workplace which is shown by high job performance. In line with previous research that has found a relationship between job satisfaction and job performance Torlak, N. When the term psychological empowerment was coined, researchers paid attention to the relationship with work performance, because the ultimate goal of studying psychological empowerment is to improve work performance, especially in creating higher job performance (Sun, 2016) . Psychological empowerment practices, when applied simultaneously, can be associated with greater productivity, welfare, performance and employee service (TETIK, 2016) . Employees who feel empowered will be more productive than teams without a sense of empowerment so that they will be better able to improve job performance. Furthermore, it will show how well employees do their jobs, the initiatives they take and the sense they show in solving problems and how they use the available resources and the time and energy they spend on their work (TETIK, 2016) . Job performance will be significantly influenced by psychological empowerment dimensions in the form of meaning and self-determination based on job characteristics theory (Hackman & Oldham quoted by (Iqbal et al., 2020) In such a scenario, employees will feel encouraged in the assigned task, and they will exert themselves to work well and are determined to complete their work efficiently (Tripathi et al., 2020) . Some literature has shown a significant correlation between quality of work life and organizational commitment (Gulbahar et al., 2014; Farid et al., 2015; Farjad & Varnous, 2013) . It is also stated by a study conducted by Musabah et al., (2017) that it was found that organizational commitment has an important influence on job performance. Quality of work life that results from the response to various employee desires is one of the important predictors of organizational commitment. This will create a relationship between quality of work life and organizational commitment based on social exchange theory (Ehido et al., 2019) , which creates the belief that employees will receive benefits that will be tied to a strong obligation to return these benefits in a certain way. So that it will lead to an increase in job performance that is right for employees and organizations. With a high organizational commitment will make employees feel that the quality of work life they receive is right which can enable them to improve job performance. Previous research has shown job satisfaction to be a mediating variable for the relationship, including HR Practice with organizational commitment (Mahmood el., 2019) , employee training with organizational commitment (Ocen et al., 2017) , role stressor with organizational commitment (Yousef, 2002) . The three studies show significance when job satisfaction becomes a mediator of the independent variables formed from work conditions with organizational commitment. Here, quality of work life will be related to job characteristics and working conditions (Rekhi & Sharma, 2018) , so this supports the construction of this research where job satisfaction is a mediator in the relationship of quality of work life with organizational commitment. According to Lok & Crawford (2001) in their findings, job satisfaction is proven to be a mediator of organizational commitment and its antecedents. This can include the quality of work life found by various studies (Ayta, 2017; Daud Normala, 2010; Zain et al., 2018) . This can occur because specifically the quality of work life is considered a condition and mediation of job satisfaction as a psychological state in forming organizational commitment. Basically, the construction of the quality of work life relationship with organizational commitment is mediated by job satisfaction based on an attitudinal perspective approach, where this approach focuses on identifying events that contribute to the development of organizational commitment (Starnes & Truhon, 2006) . H11: Quality of Work Life has a positive effect on Organizational Commitment through mediation of Job Satisfaction Fong & Snape (2015) have found that there is evidence of mediation of psychological empowerment in explaining the relationship between leadership empowerment and behavior in the role of job performance. Özarallı, (2015) has revealed that psychological empowerment can moderate the relationship between leadership empowerment and employee creativity which is a significant predictor of job performance. In addition, Bordin et al., (2006) also found that psychological empowerment had a more positive effect on employee job satisfaction when social support was high. Humanizing the workplace and increasing organizational productivity J o u r n a l P r e -p r o o f & efficiency are the main goals of quality of work life (Omugo et al., 2016) . Therefore, employees will be more committed to an organization that provides them with a good quality of work life and allows them to balance work and personal commitments and feel productive and valued, especially if they feel something that inspires them to be more proactive, independent, and show initiatives with psychological empowerment. H12: Quality of Work Life has a positive effect on Organizational Commitment through mediation of Psychological Empowerment Previous research has found that job satisfaction is one of the important considerations of job performance, and that job satisfaction is the result of various factors that employees expect for their contribution to the organization Gazioglu & Tansel, (2006) . The research will be expected to find gaps to consider the dimensions of quality of work life as a predictor of employee job performance. His attention to job satisfaction is an antecedent of quality of work life and job performance as a result of the mediating influence of job satisfaction (Basher Rubel & Kee, 2014) . It is known that the focus of quality of work life occurs on personal reactions from work experience which can be considered as an important determinant of job satisfaction, which leads to a point that satisfied employees have good job performance in the organization (Wright et al., 2007) . Thus, quality of work life can be used as a predictor of job satisfaction and employee job performance as a result of job satisfaction that can be linked. Many researchers show that psychological empowerment has become a mediating variable, such as Seibert et al., (2011); Gregory et al., (2010) and ROSTAMI et al., (2016) , who have conducted research that designed structural models of quality work life and job performance as well as the role of psychological empowerment mediators. Psychological empowerment will lead to increased levels of behavior based on the generally accepted idea that individuals enjoy work more when they feel they are able to do their job well, when they feel their work is meaningful, when they have the autonomy to make decisions about their work, and when they feel like their job has an impact on organizational outcomes (Gregory et al., 2010) .Overall, workers with psychological empowerment will feel that their work contribution is meaningful J o u r n a l P r e -p r o o f and strong in their ability to form a good organization or an appropriate quality work life. In addition, employees who are more suited to their organization will be in a position to demonstrate that job-fit can lead to psychological empowerment of cognition. Psychological cognitive empowerment can then be considered to form a mechanism that will have an impact on a worker who will complete his / her task adequately in fulfilling the results of increasing job performance. This study uses quantitative methods in testing the hypotheses that have been set. According to John W. Creswell (2018), quantitative research is a method of testing objective theory by looking at the connection between variables. Furthermore, John W. Creswell (2018) also stated that quantitative research will create hypotheses and collect data. The instrument's data will be used to assess attitudes and information, which will then be evaluated using statistical techniques and hypothesis testing, with the hypothesis being approved or rejected afterwards. The quantitative approach is the most suited for the purpose of this study, because it examines the relationship between quality of work life on job performance with the mediation of organizational commitment, job satisfaction and psychological empowerment. This research was conducted at an accredited type B hospital in DKI Jakarta. The independent variable in this study is Quality of Work life, the mediating variable in this study is organizational commitment, job satisfaction and psychological empowerment, while the dependent variable in this study is job performance. This study previously conducted a try out to test the measurement scale of the variables, namely in the calculation of 30 samples, and exceed the minimum limit of Cronbach's Alpha (0.06). It can be concluded that the measurement scale used in this study has been supported by preresearch results. All items in this study were measured using a five-point Likert Scale. Sekaran and Bougie (2016) explain that the Likert Scale is used to test how strong the agree or disagree responses are given by the respondents to the statements presented. The Likert scale used in this study has five scales with 1 (strongly disagree) -5 (strongly agree). Quality of Work Life in this study was developed from research by Zin (2004) which consists of seven dimensions of Quality of Work Life, namely compensation, growth and development, participation, physical environment, supervision, social relevance and workplace integration. A higher score indicates a higher level of quality of work life experienced by nurses. Questionaire) which were modified from research by Porter, Mowday, & Steers, (1979) . A higher score indicates a higher level of organizational commitment experienced by nurses. Moreover, Job Satisfaction with the Job Satisfaction Survey (JSS) measurement tool was developed from research by Raddaha et al. (2012) . A higher score indicates a higher level of job satisfaction experienced by nurses. Psychological Empowerment in this study was developed from research by Kundu, Kumar, & Gahlawat (2019) . The scale measured four dimensions of psychological empowerment, namely, enriched understanding of job tasks (EUJT) or meaning, competence in job related abilities (CJRA), level of self-determination (LSD) and overall impact on department (OID). A higher score indicates a higher level of psychological empowerment experienced by nurses. Job Performance in this study was modified from research according to Parker & Kulik (1995) . This study uses two methods to measure Job Performance, namely five measurements that are filled in by employees (Self-Rated Performance) and those carried out by supervisors (Supervisor-Rated Performance). The results are then combined into a single size that complements each other. The type of instrument used in this study is a questionnaire with closed questions meaning that the choices of answers have been priorly determined. A letter explaining the survey's aim and ensuring anonymity was provided with the questionnaire. These respondents were also sent reminders, with the request that they needed to complete answering each item, ensuring that no data was missing. The sampling technique used in this study was purposive sampling with the criteria of a service period of > 2 years. The selection of nurses with a tenure of > 2 years refers to the statement by Brimeyer et al., (2010) that workers with at least two years of experience already have sufficient personal importance of the job that helps predict the variables well. The total population of the study is 7178 nurses. After being selected based on their tenure, 400 nurses met the qualification as the respondents of the study. A questionnaire was distributed to nurses who worked at the 36 Type B Hospital in DKI Jakarta in this study. Because the data obtained on variables X and Y reflects only one moment in time, this design is referred to be cross-sectional (Olsen & George, 2004) . The fundamental argument for choosing a cross-sectional design is that it is thought to be more efficient in terms of utilizing scarce research resources (Spector, 2019). As a result, it would make sense to start a new line of study, one that uses the most efficient means of presenting preliminary proof that the research subject is worthy of consideration. Furthermore, in a more advanced field of research, it is appropriate to adopt a cross-sectional design in order to rule out alternative hypotheses where possible. The distribution of questionnaires had problems with access to J o u r n a l P r e -p r o o f hospitals and limited time for nurses in the midst of the Covid-19 pandemic, so it took time from June to December 2020. Universitas Airlangga, especially its research and development section, has given its ethical permission to this project. Universitas Airlangga's Research and Innovation Institutes which is now known as Development and Innovation Institute for Publishing Journal and Intellectual Property Rights (LIPJIPHKI) is an institute at Universitas Airlangga that is in charge of overseeing a number of areas, including publications and journals, innovation and intellectual property rights, and publishing (Airlangga University Press). This institute is responsible for conducting research and guiding the outcomes of new research products for the community's benefit. This Institute also has the power to grant ethical approval for research conducted by Universitas Airlangga academics. The data analysis technique in this study uses Structural Equation Modeling (SEM), or it is stated as a statistical modeling technique that is very cross-sectional, linear and general in nature. Structural Equation Modeling (SEM) is a factor analysis, path analysis and regression. This study uses SPSS software version 24 to test the validity and reliability of the instrument and Amos v.24 software to test the research model that has been formed based on the formulated hypothesis. In this study, the questionnaire was addressed to nurses who worked at Type B Hospitals in DKI Jakarta. The average results of respondents' responses to each statement item, indicator, and variable were then categorized using the class interval formula guide (Nazir, 2009:379) . The resulting J o u r n a l P r e -p r o o f class interval is 0.80, this value is then used as a guideline to determine the category based on the average interval. Table 4 shows that all variables used in type B hospital nurses in DKI Jakarta are perceived as high category, this is indicated by the average answer score in the range of 3.4 -4.2 (agree / high). Thus, the analysis can be continued to the next stage. intervening constructs, and endogenous constructs is concluded to be fit with the data used. Based on Table 11 , the results of the structural model suitability test (base model) as seen in Figure 6 show that each of them has at least one criterion for absolute fit indices and incremental fit indices that meet the requirements, namely chi-square and RMSEA for absolute fit indices, as well as TLI and CFI for incremental fit indices. Therefore, the structural model (base model) is actually acceptable. However, there are two criteria for absolute fit indices that are still not good (poor fit), namely GFI and Cmin / df, so the researchers want the structural model to be even better by modifying the model. by the structural modification model SEM in Figure 7 . Table 12 shows that the size of the suitability criteria for the modification model is appropriate and much better than the base model, as well as the standardized residual value The covariances are in the ± 2.58 range, it can be concluded that the modified structural model is acceptable and can be continued to the next analysis. Table 14 , it shows that in testing structural relationships, hypothesis testing is carried out to test the significance of the influence between variables, using the critical ratio (CR) value and the probability value (p-value). If the CR value is ≥ 1.96 or the p-value is ≤ 5% significant, J o u r n a l P r e -p r o o f then it is decided that there is a significant influence between these variables, on the contrary, if the CR value is <1.96 or the p-value> level 5% real, then it was decided that there was an insignificant influence between these variables (Hair et al, 2014) . In short it was found that there are seven hypotheses that have a significant influence on each other, and two hypotheses that show no significant relationship with each other. Information: s (significant); ts (not significant) As seen in Table 15 that the next stage of structural model analysis is the testing of structural relationships in the path of the indirect effect. Hypothesis testing to test the significance of this indirect effect is carried out in the same way, namely using the critical ratio (CR) value and the probability value (p-value). If the CR value is ≥ 1.96 or the p-value is ≤ 5% significant, then it is decided that there is a significant effect, on the contrary if the CR value is <1.96 or the p-value> 5% real level, then it was decided that there was an insignificant effect variable (Hair et al., 2014) . After testing the significance of the mediation effect, the next step is to know the nature of the mediation. Detecting the nature of mediation can be seen from the effect of mediation, if the direct effect of exogenous variables on endogenous variables is significant, J o u r n a l P r e -p r o o f and the indirect effect through intervening variables is also significant, then it is said to be partially mediation (Baron & Kenny, 1986 ). On the other hand, if the direct effect of the exogenous variable on the endogenous variable is not significant, while the indirect effect of the intervening variable is significant, then it is said to be fully mediation or perfect meditation. So that in testing the indirect relationship between variables, it was found that there were 2 hypotheses that were proven to be fully mediation, 2 hypotheses that were proven to be partially mediation, and one hypothesis showed that the variables used were unable to mediate. The results show that the estimated parameter of the influence of quality of work life on organizational commitment shows a significant effect with a CR value of 2.057 (> 1.96) and a significance value (p-value) of 0.040 ( 1.96) and a significance value (p-value) of 0.000 (<5% real level). The resulting coefficient of influence is 0.511 (positive), meaning that the higher the quality of work life, the higher the job satisfaction of the nurses. Thus, the second hypothesis which states that quality of work life has a positive and significant effect on job satisfaction at type B hospital nurses in DKI Jakarta, is also acceptable (H2 is accepted). This is in line with previous research Chmiel et al., (2017 That way, nurses at the Type B Hospital in Jakarta are able to make quality of work life very important for the organization which leads to an increase in positive job satisfaction. Furthermore, the increase in job satisfaction of nurses at the Type B Hospital in Jakarta will be of greater use in the planning process of nursing resources that will be carried out by nurses at the Type B Hospital in Jakarta. The results of data analysis show that the estimated parameter of the effect of quality of work life on psychological empowerment also shows a significant effect with a CR value of 11.660 (greater than 1.96) and a significance value (p-value) of 0.000 (less than the real level of 5 %). The resulting coefficient of influence is 0.712 (positive), meaning that the higher the quality of work life, the higher the psychological empowerment of nurses. Thus, the third hypothesis which states that quality of work life has a positive and significant effect on psychological empowerment in type B hospital nurses in DKI Jakarta, is also acceptable (H3 accepted). It can be stated that when the quality of work life in the Type B Hospital in Jakarta is getting higher, it will also affect the increase in psychological empowerment of nurses at the Type B Hospital in Jakarta. These findings are supported by some previous studies by Patah et al., (2009 The results of data analysis show that the estimated parameter of the effect of job satisfaction on organizational commitment shows a significant effect with a CR value of 3.551 (greater than 1.96) and a significance value (p-value) of 0.000 (smaller than the real level of 5%). The resulting coefficient of influence is 0.196 (positive), meaning that the higher the job satisfaction, the stronger the organizational commitment to nurses. Thus, the fifth hypothesis which states that job satisfaction has a positive and significant effect on organizational commitment to type B hospital nurses in DKI Jakarta, is acceptable (H5 accepted). Therefore, it can be stated that when the job satisfaction that occurs in Type B Hospitals in Jakarta is getting higher, it will also affect the increase in organizational commitment to nurses at Type The results of data analysis show that the parameter estimation of the influence of psychological empowerment on organizational commitment also shows a significant effect with a CR value of 5.748 (greater than 1.96) and a significance value (p-value) of 0.000 (smaller than the real level of 5%). The resulting coefficient of influence is 0.466 (positive), meaning that the higher the psychological empowerment, the stronger the organizational commitment to nurses. Thus, the sixth hypothesis which states that psychological empowerment has a positive and significant effect on organizational commitment to type B hospital nurses in DKI Jakarta, is also acceptable (H6 accepted). Therefore, it can be stated that when psychological empowerment that occurs in Type B Hospitals in Jakarta is getting higher, it will also affect the increase in organizational commitment to nurses. This result is in line The results of data analysis show that the estimated parameter of the influence of organizational commitment on job performance shows a significant effect with a CR value of 2.754 (greater than 1.96) and a significance value (p-value) of 0.006 (smaller than the 5% real level). The resulting influence coefficient is 0.181 (positive), meaning that the stronger the organizational commitment of nurses, the higher the job performance. Thus, the seventh hypothesis which states that organizational commitment has a positive and significant effect on job performance in type B hospital nurses in DKI Jakarta, is acceptable (H7 accepted). Therefore, it can be stated that when the organizational commitment that occurs in Type B Hospitals in Jakarta is getting higher, it will also affect the increase in job performance of nurses at Type B Hospitals in The results of data analysis show that the estimated parameter of the effect of job satisfaction on job performance shows an insignificant effect with a CR value of 1.916 (less than 1.96) and a significance value (p-value) of 0.055 (greater than the real level of 5%). The resulting coefficient of influence is only 0.101 (close to zero), meaning that the higher job satisfaction on nurses is not able to have a real impact on improving their job performance. Thus, the eighth hypothesis which states that job satisfaction has a positive and significant effect on job performance at type B hospital nurses in DKI Jakarta, cannot be accepted (H8 is rejected). performance. This can also be triggered because the service standards are getting higher to be achieved, especially in the industrial era 4.0 in the health world. The results of data analysis show that the parameter estimation of the effect of psychological empowerment on job performance shows a significant effect with a CR value of 6.647 (greater than 1.96) and a significance value (p-value) of 0.000 (less than the real level of 5%). The resulting effect coefficient is 0.591 (positive), meaning that the higher the psychological empowerment of the nurses, the higher the job performance. Thus, the ninth hypothesis which states that psychological empowerment has a positive and significant effect on job performance for type B hospital nurses in DKI Jakarta, is acceptable (H9 accepted). Therefore, it can be stated that when psychological empowerment that occurs in Type B Hospitals in Jakarta is getting higher, it will also affect the increase in job performance of nurses at Type B Hospitals in Jakarta. This indicate that nurses at the Type B Hospital in Jakarta who feel psychological empowerment will feel encouraged in the assigned task, and they will exert themselves to work well and are determined to complete it efficiently. Therefore, the psychological empowerment of nurses at the Type B Hospital in Jakarta will act as a driving force to guide behavior in improving job performance. in Jakarta to believe that they are receiving benefits that will be tied to a strong obligation to return those benefits in some way. So that it will lead to an increase in job performance that is appropriate for nurses at Type B Hospitals in Jakarta and its organizations. on organizational commitment produced by nurses at the Type B Hospital in Jakarta has no effect. This finding is not in line with previous studies by Gazioglu & Tansel, (2006) ; Basher Rubel & Kee, (2014) regarding job satisfaction as an antecedent of quality of work life and job performance as a result of the mediating effect of job satisfaction. The results of this study indicate that job satisfaction is not able to make nurses at the Type B Hospital in Jakarta make quality of work life an antecedent that can improve their job performance. That way, it is known that nurses at the Type B Hospital in Jakarta are able to improve their job performance which is influenced by other aspects. Nurses at the Type B Hospital in Jakarta have been able to improve job performance without first having to feel more satisfied. The results of data analysis show that the results of the indirect path significance test QWL→PE→JP show a significant effect with a CR value of 5.762 (greater than 1.96) and a significance value (p-value) of 0.000 (less than the real level of 5 %). Thus, the fourteenth hypothesis which states that quality of work life affects job performance through psychological empowerment mediation in type B hospital nurses in DKI Jakarta is acceptable (H14 accepted). The nature of the mediator is known to be fully mediation, meaning that improving the performance of nurses cannot only rely on the quality of work life, but must also be supported by increasing the psychological empowerment of the nurses, so that their performance can be of this study indicate that nurses at the Type B Hospital in Jakarta with psychological empowerment will feel the contribution of their work is meaningful and feel strong in the nurse's ability to form a good organization or an appropriate quality work life. In addition, nurses at the Type B Hospital in Jakarta will be more suited to the organization they are in, which indicates that their working mechanism will have an impact on completing their duties adequately in meeting the results of increasing job performance. It can be concluded in this study that the direct effect of quality of work life on organizational commitment, job satisfaction, and psychological empowerment showed significant results, while the effect of quality of work life on job performance was not significant. Furthermore, the direct relationship of job satisfaction on organizational commitment showed a significant effect, but on job performance showed an insignificant result. The direct effect of psychological empowerment on organizational commitment and job performance have been shown to be significant. Organizational commitment also significantly affects job performance. attention to the quality that supports the needs of nurses to work optimally and empowered, can create a high level of performance and satisfaction, and can support the success of the hospital. The purpose of the study is to examine factors in the work environment by taking into account commitment, satisfaction, and psychological factors of employees in creating the best quality of service for patients during this pandemic. Based on the findings, it has been proven that the problems faced by nurses who work in stressful and unhealthy conditions during this pandemic can be dealt properly through an appropriate quality of work life approach, involving other variables, namely organizational commitment, job satisfaction and psychological empowerment. It is hoped that the hospital will also continue to grow sustainably beyond the challenging situations that may occur. J o u r n a l P r e -p r o o f This study highlights the positive behavior of human resources that supports the research framework which postulates that the quality of work life of nurses is able to improve performance, especially in the Covid-19 pandemic situation. The findings of the data analysis add to the existing literature in terms of variable development by demonstrating empirically that nurses can improve their performance by improving their quality of work life, but this, contrary to what previous research have found, should be done through mediating variables such as organizational commitment, job satisfaction, and psychological empowerment. Furthermore, how organizations implement various mentoring activities will result in positive behavior and promote the social exchange theory by allowing nurses to believe that the organization trusts them. According to this idea, nurses will tend to reward their organization with activities that benefit both themselves and the organization. This behavior can be seen when a nurse's performance is significant in accomplishing organizational goals, and it is accompanied by numerous factors such as commitment to their work, satisfaction with their work, and a sense that psychological empowerment has been effectively met. Therefore, regardless of how they perceive their quality of work life to be well established, nurses may be more involved in organizational commitment, job satisfaction, and psychological empowerment which will lead to increased job performance. Based on the discussion and conclusions described in this study, this study can be used as a recommendation for management in organizations in measuring the effect of quality of work life on job performance in hospital nurses through the mediation of organizational commitment, job satisfaction and psychological empowerment. This is known to create solutions to save neglected environmental and human values, motivate employees to work harder and better, increase their desire to stay with the organization, generate pleasant states of mind and positive emotions in the workplace, and inspire employees to be more proactive, independent, and show initiative. Furthermore, it can be a construct related with an individual's ability to attain personal and organizational goals through meeting the organization's targets, work, and standards. Based on the average result of job performance variable, nurse's understanding of work procedures has a value of 3.82 indicating that it is an indicator with the smallest mean value. Although the average result is in the high category, it shows the lowest category among other indicators. Thus, nurses are expected to always pay attention to the work procedures J o u r n a l P r e -p r o o f established by the hospital in carrying out their work. Because this can affect the performance results needed in creating good quality work. The study has a drawback in terms of the generalizability of findings. Because we used data from a single profession, namely nurses, the validity of our findings may be hampered when applied to other professional groups or sectors. When extending our findings to other occupational groups or industries, future researchers should use caution. The second limitation is that, due to the pandemic restriction, the surveys were only distributed once since we were mindful of the participants' time constraints during the epidemic. Because all data was acquired at the same time, causality arguments were limited (Antonakis, Bendahan, Jacquart, & Lalive, 2010). Furthermore, because our participants were mainly female, the interpretation of our findings should be applied cautiously to other groups where the male-female ratio is not unbalanced. 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