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Chapter I

THE PROBLEM

Introduction

Knowledge management is one of the youngest management disciplines (Serenko

& Bontis, 2013) which is committed to the study of creation, organization, distribution,

and use of knowledge in organizations (Castaneda, 2015; Ju, et. al., 2006; Lin, 2014). A

fundamental behavior in the facilitation of these processes is knowledge sharing behavior

(KSB). Sharing knowledge is not an automatic action, but highly dependent on human

factors (Castaneda, et. al., 2015; Castaneda & Toulson, 2013; Storey & Barnett, 2002).

Healthcare service is interdisciplinary or multidisciplinary that sharing of

knowledge among different disciplines is vital in the care of patients. It is important that

healthcare institutions have well-established knowledge management systems to bring

about a better collaboration among members of the hospital workforce. This will greatly

impact patient care by producing better patient outcomes.

Aksoy, et. al. (2016) insinuates the significance of knowledge and sharing of

knowledge for individual employees as well as for the organization. Accordingly, the

knowledge sharing effectiveness develops a positive impact among members of the

organization, most specifically in the realization of organizational goals. Apparently,

knowledge sharing generates a positive impact on the employees’ performance

collaborating in reaching the set goals of the organization.

The impact of knowledge sharing alongside the collaboration of employees was

perceived on the organizations’ operational performance in various sectors. A

considerable number of findings support the importance of knowledge sharing systems in

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an organizational setting. Knowledge sharing attributes, on the other hand, are acquired

through interactions as well as experiences. The knowledge sharing attributes are also

considered never totally complete or a hundred percent of its accuracy. Thus, knowledge

sharing attributes are validated through application, experience, and interaction and not

by subject matter experts (Sabeeh, et. al., 2018).

In this manner, the study focused on finding out the perceived knowledge sharing

attributes in terms of the participant’s organizational support, subjective norms and self-

efficacy and which particular attribute predicts knowledge sharing intention and

knowledge sharing behavior among healthcare professionals in consideration of the

current state of health emergency due to the COVID-19 pandemic.

The devastating COVID-19 pandemic from a global perspective has resulted in an

unpredicted and huge amount of information being gathered and disseminated along with

a potential impact on realtime responses of the healthcare sector (Nathavitharana, et. al.,

2020).

Ammirato, et. al. (2020) pointed out that compared to other natural disasters, the

devastating effects of the pandemic can be actively controlled and alleviated by managers

and organizations’ leaders, through decisions that are accurate and timely. It is evident

that decision makings are crucial in managing the proliferation of the virus. Moreover,

the effectiveness of decision makings highly dependent on the capability in creating,

sharing, collecting, transferring, and expand the knowledge that is essential in effective

and proficient processing of knowledge management in a time of pandemics.

Solving problems and making optimal decisions in healthcare is heavily

dependent on access to knowledge. In today’s increasingly complex environment, it is

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rapidly becoming essential for healthcare organizations to effectively manage both

internal knowledge and externally generated knowledge in order to provide the best

possible healthcare, achieve operational excellence and foster innovation. A well-

organized and effective strategy for knowledge management in healthcare can help

organizations achieve these goals. Established as a discipline in 1991, knowledge

management is generally defined as the process of capturing, developing, sharing, and

effectively using knowledge. Knowledge management efforts typically focus on strategic

objectives such as improved performance, competitive advantage, innovation, the sharing

of lessons learned, integration, and continuous improvement (Haughom, 2020).

A report published in 2012 by the Agency for Healthcare Research and Quality

(AHRQ), cited strong evidence that clinical decision support systems and knowledge

management IT systems can be effective in improving healthcare process measures

across diverse settings using both commercially and locally developed systems. It is

likely that these systems will become a key part of the IT infrastructure of all healthcare

organizations over the next few years.

According to Saqib, et. al., (2017); Epetimehin & Ekundayo (2011), knowledge

management initiatives can benefit organizations to share important organizational

understandings, decrease redundant work, avoid repeating the same mistakes, retain

intellectual capital, and adapt to changing environments and markets over time. Edenius,

et. al. (2010) in their study further looked at how knowledge can be managed across

boundaries when implementing innovations. They concluded knowledge can be shared

both on the semantic and pragmatic level.

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Knowledge sharing behavior, particularly in healthcare encompasses individual

factors such as incentives, reciprocity, subjective norms, and behavioral control; and

organizational factors including organizational structure, support of the CEO, learning

climate, information technology systems, as well as trust.

Abidi (2020) additionally pointed out that there is an increased global demand for

accountable and effective clinical practices and decision making, proficient clinical

pathways, decision making, best possible resource utilization, continuous improvement of

health outcomes, furthermore establishment of a health-conscious society. These goals

entail enhancement of the existing practices of knowledge-sharing in the sphere of

distinctiveness, particular component, ad hoc, as well as activities inclined with a

combined knowledge-sharing endeavor.

In a study about the utilization of IT systems to enable Knowledge Management

in the field of healthcare, it was revealed that strong evidence defends the effectiveness of

clinical decision support systems and knowledge management IT systems, particularly in

improving health care process measures (Haughom, 2014).

Rao (2020) on the other hand suggests that the importance of effective knowledge

management which includes speedy connectivity, content platforms, interaction with the

community, and a culture of trust were highlighted during the pandemic responses.

On the concept of knowledge management and translation, the fit-as-mediation

was specified by Asiaei and Bontis (2019) as an approach that translates knowledge-

related factors such as knowledge resources and process capabilities into enhanced

performance.
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Conversely, in a study conducted by Gider, et.al. (2015), it was elucidated that

barriers to knowledge sharing within hospitals are medium level. Accordingly, the study

further revealed that barriers to knowledge sharing with regards to the attitudes of

physicians were dependent on the hospital ownership status, gender, as well as position,

and departments. On the other hand, nurses’ perceptions of trust and shared vision were

found statistically significant and have direct effects with regard to knowledge sharing.

Thus, it is important that hospital administrators along with the head of knowledge

officers should persuade optimistic intentions towards knowledge sharing (Chang et. al.,

2011). Lee and Hong (2014) described that reciprocity, behavioral control, as well as

trust are considered factors that affect hospital employees’ knowledge sharing intention,

knowledge sharing behavior, and innovation behavior.

In the Philippine context, the Department of Health (DOH) formulated knowledge

sharing management of which general functions include the formulation of plans and

policies along with appropriate and sufficient programs and standards for the

employment of systems, alongside with the process improvement, development of

systems and software, creation and maintenance of information and communication

technology (ICT) solutions, which include related security requirements and management

of data, information as well as knowledge sources and systems. The DOH also aims to

establish and manage the management information system and knowledge systems,

which also include the health portal. Along with these, the DOH endeavors to efficiently

manage the literacy and training services for health human resources, which embraces

knowledge management tools and applications (Department of Health, 2020).

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While several studies have been conducted about knowledge management,

literature, and studies on knowledge management, studies in the healthcare field are

scarce. The localization of this study in Ormoc City was a discovery of new knowledge

or information as there was no study being conducted yet in the local scene about the

variables being studied. The City of Ormoc implements programs, various projects, and

services promoting the health and well-being of every Ormocanon, establishes preventive

measures and control of diseases among the population at risk, provides protection to

individuals, families, and communities exposed to hazards and risks.

This study provided a practical value to the healthcare profession through the

output of the study which can be utilized by healthcare institutions to better manage

information in their respective organizations. The researcher is hopeful that this scholarly

work will bring about positive results as the researcher is full of determination and

interest in the variables being studied to be able to contribute to the healthcare system,

particularly with regards to knowledge sharing and as being a healthcare professional.

Theoretical Framework

This study was anchored to the following theories: Theory of Reasoned Action

by Ajzen (1985) and Planned Behavior Ajzen (1988), supported by Social Exchange

Theory (SET) by Homans (1958).

The Social Exchange Theory was used for the knowledge sharing concept of the

study. Social Exchange Theory (SET) is defined as an exchange of a valuable resource

that is expected to benefit between two parties. In this theory, practice to maximize the

benefit and reduce the cost that will affect the individual actions are illustrated (Blau,

1964 as cited in Razaka, et. al., 2016). According to the antecedent of SET, it is a theory
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that describes the rational behavior of the individual to perceive the possibility of rewards

that they would gain from the social exchange. There must be an actor that has his own

perception to another and has a belief to create the other’s perceptions needs. In a recent

study by Cry and Choo (2010) as cited in Razaka, et. al. (2016), they revised the

Social Exchange Theory on Planned Behavior Ajzen (1988)

Theory (SET) by Theory of Reasoned Action Ajzen (1985)
Homans (1958)

 Subjective Norm Knowledge sharing

 Self-efficacy intention

 Perceived Knowledge sharing

Organizational behavior
Support
 Subjective Norm
 Self-efficacy
Four groups of healthcare
workers in Private Health
Institutions in Ormoc City

Knowledge sharing Knowledge management

Enhancement Plan framework/model
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Figure 1. Schematic diagram of the study utilizing the Social Exchange Theory
(SET) by Homans (1958), the Theory of Reasoned Action by Ajzen (1985), and the
Theory on Planned Behavior by Ajzen (1988).

original concepts of SET and found that SET depended on the belief of individual

propensity to share and individual’s social value orientation. This refers to the individual

preferences (subjective attitudes or norms) regarding the distribution of outcomes to self

and others in the sharing situation. In other words, the SET has regarded to the maximum

benefits and reduce costs that incurred when an individual exchange with others. There

are two categories of social exchange theory which are rewarding and social relations

exchange. The scholar Blau (1964) as cited in Razaka, et. al. (2016) was conceptualized

into four types of rewards: (i) Money, (ii) Social approval, (iii) Self- esteem or respect,

and (iv) Compliances. In certain particular needs of an individual, money might be

appropriate and valuable to the individual exchange. However, in another perspective of

social relations, social approval, self-esteem, and compliance are the most influential

towards the social relations exchange. This finding was supported that this study argues

that social exchange theory postulates people interact with others based on a self-

interested appraisal of the costs and benefits.

Another scholar also supported that individual seeks to maximize their benefits

and minimize their costs when exchanging resources with others (Molm, 2001 as cited in

Razaka, et. al., 2016). These benefits need not be tangible since individuals may engage

in an interaction with the expectation of future reciprocity. Reciprocity is defined as all

exchanges operate under the assumption that people who grant the benefits or valuable

resources will receive rewards in turn as payment for value received. In this particular
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concept, it can be summarized that most of the recipients and the receiver will gain

benefits when they exchange something with each other (Razaka, et. al., 2016).

The study is further anchored on the Theory of Reasoned Action (TRA) which is

a social psychology model that explained the intention behavior reasons (Ajzen, 1985).

This theory is widely used by many scholars to determine the intention of individual

behavior in a multidisciplinary area. In this study, the theory of reasoned action focuses

on the knowledge sharing intention and behavior among healthcare workers. The

intention of an individual to perform a behavior influenced by a positive attitude and

social norms is the degree to which an individual perceives how others approve the

individual’s participation in a specific behavior (Bock, et. al., 2005). This theory

represents the attitude and social norms that influence the individual intention of

knowledge sharing behavior. Attitude defines as a disposition to respond favorably or

unfavorably to the self, others, and the environment (Ajzen, 1985). While social norm is

defined as the way individuals think and expectation from others towards individual

actions. Some studies had been done by using TRA to explore the different variations in

knowledge sharing behavior. Bock and Kim (2002) explored the relationship between (i)

expected associations and contributions and (ii) expected rewards as variable to

determine the individual attitude and social norm represent as well as business climate.

The result highlights that attitude toward KS and subjective norms have a positive effect

on knowledge sharing behavior. In the recent study exploring the sense of self-worth

(Teh & Yong, 2011), while another studied such as in role behavior (Bock, et. al., 2005)

and business citizenship behavior (Williams & Anderson, 1991 as cited in Razaka, et. al.,

2016). Furthermore, as founded from TRA, organizational support is derived based on

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how an individual’s intention and behavior are perceived and their support towards

knowledge sharing.

Theory of Planned Behavior (TPB) is essentially an extension of the Theory of

Reasoned Action (TRA) that includes measures of perceived behavioral control (Ajzen,

1988). TPB defines the individual’s intention to perform a given behavior. The keyword

intentions in the general study are assumed to capture the motivational factors that derive

the individual behavior in terms of their effort, willingness to perform the behavior. In

TPB, the assumption might be when the stronger the intention, attitude, subjective norms,

intention to knowledge sharing, and knowledge sharing behavior to engage in behavior,

the more likely should be its performance (Ajzen, 1991). The idea was revised from TRA

that belief the intention of individual behavior influenced by the attitude, social norms,

and additional new dimension as introduced by Ajzen (1991) is perceived control

behaviour (PCB). According to the scholar's theory, perceived behavioral control is about

beliefs of individual skills and opportunities to engage in a behavior. It is the extent to

which a person feels able to perform the behaviour in two conditions (i) individual able to

control over the behavior and (ii) level of individual confidence being able to perform or

not perform the behavior. However, the original concept of perceived control behavior

was adapted from Bandura (1992). The scholar highlights that concept of perceiving

control behavior similar to represent individual perceived of their self-efficacy. Self-

efficacy is defined as a judgment or perception of an individual capability to perform a

particular course of action. In addition to Bandura’s theory, the roles of perceived

behavioral control strongly influenced by the individual confidence in their ability to

perform that course of action. While referring to Bandura (1991), found that self-efficacy
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can influence the individual willingness and unwillingness to choose the activities,

prepare them to participate, and influence their effort to the performance. Thus, the TPB

introduces the construct of perceived control behavior as a new element to the TRA in

determining the individual intention and individual behavior. This will cover the self-

efficacy concept as well in the study.

Based on the diagram, the study has determined the knowledge sharing attributes

in terms of the perceived organizational support, subjective norm, and self-efficacy as

well as the knowledge sharing intention and behavior among healthcare workers in

private healthcare institutions in Ormoc City. Such theory models were utilized by the

researcher of this study to assess if, certainly, the knowledge sharing attributes predict

intention and behavior toward knowledge sharing by looking at its correlation. The

significant difference among the knowledge sharing intention and knowledge sharing

behavior among the four groups of health care workers was also compared.

More specifically the study sought to find out the perceived knowledge sharing

attributes in terms of the participant’s organizational support, subjective norms and self-

efficacy and which particular attribute predicts knowledge sharing intention and

knowledge sharing behavior. The study also intended to know about the knowledge

sharing intention and knowledge sharing behavior of the four groups of healthcare

workers. Moreover, the study aimed to propose a knowledge sharing enhancement plan

centered on the findings of the study.

Statement of Purpose
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This study was endeavored to assess whether the knowledge sharing attributes

predict knowledge sharing intention and knowledge sharing behavior. Further, the study

assesses whether the knowledge sharing intention correlates with knowledge sharing

behavior. Furthermore, the study compares the significant difference in the knowledge

sharing intention and knowledge sharing behavior among four groups of healthcare

workers in the private healthcare institutions in Ormoc City, for the third quarter of 2020.

Specifically, the following research questions were raised:

1. What is the knowledge sharing attributes as perceived by the four groups of

healthcare workers in terms of:

1.1 organizational support;

1.2 subjective norms; and

1.3 self-efficacy?

2. What is the knowledge sharing intention of the four groups of healthcare workers?

3. What is the knowledge sharing behavior of the four groups of healthcare workers?

4. Which knowledge sharing attributes predict:

4.1 knowledge sharing intention; and

4.2 knowledge sharing behavior?

5. Is there a significant relationship between knowledge sharing intention and

knowledge sharing behavior?

6. What is the significant difference in knowledge sharing attributes among healthcare

workers in terms of classifications:

4.1 perceived organizational support;

4.2 subjective norms; and

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4.3 self- efficacy

7. Is there a significant difference in knowledge sharing intention among healthcare

workers?

8. Is there a significant difference in knowledge sharing behavior among healthcare

workers?

9. What knowledge management framework or model can be proposed based on the

findings of the study?

10. What knowledge sharing enhancement plan can be proposed based on the findings of

the study?

Statement of Null Hypotheses

The following null hypotheses were tested at 0.5 level of significance:

Ho1: The knowledge sharing attributes do not predict knowledge sharing

intention.

Ho2: The knowledge sharing attributes do not predict knowledge sharing

behavior.

Ho3: There is no significant relationship between knowledge sharing intention

and knowledge sharing behavior.

Ho4: There is no significant difference in knowledge sharing attributes among

healthcare workers.

Ho5: There is no significant difference in knowledge sharing intentions of the

four groups of health care workers.

Ho6: There is no significant difference in knowledge sharing behavior among

healthcare workers.
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Significance of the Study

At this time wherein, it is evident that healthcare is one imperative service that is

predominantly needed as we continuously battle against the pandemic. This study was

deemed significant in providing efficient healthcare services, primarily at this time of the

pandemic. Specifically, this study is significant to the following:

Patients/ Clients. Outcomes of this research are believed significant to patients

and clients because of the important factors that knowledge sharing takes part in the

provision of services, particularly in the collaborative aspect within and among the

healthcare professionals. Specifically, knowledge sharing will keep the patients informed

and updated, especially of the current situation about the pandemic, and be advised of the

necessary actions to take in order to keep themselves aware and safe. Thus, the delivery

of healthcare services resulting from knowledge sharing will ensure patients and clients

of efficient and effective healthcare performance.

Healthcare Professionals. Results of this study are reckoned beneficial to

healthcare professionals, particularly in perceiving the merit of knowledge sharing as a

tool to providing significant information among patients, more importantly at this time

where everyone is battling against the pandemic and it is imperative for the patients to

keep informed and aware of the important aspect of safety and precautionary measures

against the pandemic.

Top Management. Findings of this research are deemed significant to healthcare

providers, particularly the top management because of their crucial role in the

establishment, execution, and realization of strategic approaches toward effectual

delivery of healthcare services, wherein knowledge sharing is a vital instrument to

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employ among members of the organization in order for them to efficiently disseminate

the necessary information, particularly to patients who are the primary recipients of

medical attention.

Policy Makers. Gathered information through a review of literature and studies

along with the results of the survey shall bring significance to the government and

policymakers in establishing the needed support of the healthcare systems of the nation

and for the interest of the citizenry. In this endeavor, knowledge sharing is predominantly

necessary to consider by the policy makers enabling them to provide appropriate

regulations pertaining to the dissemination of information and support they needed

campaign for particular health concerns of which, knowledge sharing is of value.

Department of Health (DOH). This research is deemed beneficial to

DOH, particularly in the application of a proficient system for healthcare services

and providers, both public and private, where knowledge sharing is a significant

factor. Findings of this study shall be beneficial to DOH, specifically on the

concept of knowledge sharing as one of the tools that can be used in order to

promote coordination among key personnel along with the staff.

The Researcher. Being in the medical field, the researcher will be benefited

most from the foregoing study because of the enlightenment about the contribution of

knowledge sharing, particularly on the aspect of taking the lead in the healthcare

organization, along with the value of systematic, organized communication, and sharing

of knowledge towards the realization of patients’/clients’ wellbeing.

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Future Researchers. This research shall be significant to future researchers in the

establishment of their study in a similar discipline. Information gathered in the course of

this research shall contribute to their objectives, particularly on knowledge sharing.

Definition of Terms

The following terminologies were operationally defined for clarity and better

understanding:

Health workers in this research are the medical services, nursing services,

administration and support, and ancillary services, wherein professional functions are to

protect and improve the health of their communities. The foregoing research shall

determine the knowledge sharing behavior and intention of the four healthcare groups of

health workers furthermore determine knowledge sharing attributes and their impact on

the healthcare workers’ knowledge sharing behavior and intention.

Knowledge Management Framework or Model refers to the structure that aims

at enhancing knowledge gathering, sharing, application, and retention within clinical

development and enables the effective and successful implementation of a clinical quality

management system. The very important factor of the knowledge management

framework shall be investigated in this study to further ascertain its core inference in the

establishment of an innovative healthcare system, especially in facing the current

pandemic. The knowledge management framework is founded from the knowledge

sharing attributes, intention, and behavior among the four groups of healthcare workers,
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supported by the Theory on Planned Action and Planned Behavior, Social Exchange

Theory.

Knowledge Sharing is about the interaction of patient information or knowledge

between healthcare professionals. In this research, knowledge sharing is endeavored to

determine its crucial influence in the realization and delivery of innovative healthcare

systems through examination of knowledge sharing intentions and behavior.

Knowledge Sharing Attributes are knowledge sharing systems that are

classified into incident report databases; alert systems; best practices databases; lessons-

learned systems; and expertise locator systems. In this research, the attributes of

knowledge sharing will be examined to establish the needed basis to form the innovative

healthcare system delivery.

Knowledge Sharing Behavior is a process of voluntary transferring or

disseminating knowledge originating from one person to another or group in an

organization. The value and significance of sharing behavior shall be analyzed in this

research to further determine its relationship to the innovative approach as healthcare

services are delivered to the nation, considerably this time of the pandemic.

Knowledge Sharing Enhancement Plan is a program that aims at increasing

staff productivity, product and service quality, and deliverable consistency by capitalizing

on intellectual and knowledge-based assets. This paper intends to examine the role of

knowledge sharing enhancement plans for healthcare organizations to ascertain its

significance to the innovative healthcare system.

Knowledge Sharing Intention is a representation of a future course of action to

be performed. As an illustration, if an individual deems that he has the capability to share

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knowledge, he may then possess the intention to share knowledge. Thus, this paper shall

examine the set motivation program consistent with the actual knowledge and expert

knowledge.

Perceived Organizational Support (POS) is about employees’ perception with

regards to the extent to which the organization values their contribution as well as cares

about their wellbeing. It has been found that POS has significant consequences on

employee performance and wellbeing. This research shall investigate the relationship of

POS to the Innovative Healthcare Systems and the components of Knowledge Sharing,

particularly at this point wherein pandemic continuously challenges the effectiveness of

healthcare professionals.

Self-efficacy (SE) is the confidence of an individual towards their capability to

accomplish a task or achieve a goal. In this paper, Self-efficacy being an important factor

in the delivery of efficient healthcare services will be examined in order to establish

justification about its significance to innovative healthcare system that can be employed,

especially during this pandemic.

Subjective Norms (SN) are the beliefs that an important group or individual will

approve as well as back up a specific behavior. Moreover, subjective norms are

influenced by perceived social demands that persuaded a person to behave in a particular

instance along with their motivation to conform to other people’s views. This paper shall

look into the social pressure from top management to colleagues within the organization

and how sharing of knowledge is carried out and ascertain its relationship towards the

innovative healthcare systems.

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Chapter II

REVIEW OF LITERATURE AND STUDIES

This chapter discusses the related literature and studies derived from substantial

sources that shall supported the reliability of the present research pertaining to

Knowledge Sharing toward establishment of Approaches to Innovative Health Care

Systems.

The level of knowledge sharing intention is differed in most part and in

accordance with the designation category, academic field, job specifications and

responsibilities, as well as working experience. It was furthermore asserted that sense of

competence as well as confidence is crucial in order to be engaged in knowledge sharing

process (Shaari, et. al., 2014).

Conversely, the level of knowledge sharing can also vary with the working

environment and the characteristics of the organization, of which it was found that there

is a need to design a systematic knowledge management system to facilitate the constant

as well as effectiveness of knowledge sharing across clinical settings (Kim & Park,

2015).

Knowledge Management

Kunsman (2019) states that considering the fast technological movements, the

concept of knowledge sharing turns out to be very significant, especially that employees

face and have access to a vast of information. Knowledge sharing is not only recognized

for the internal communication between executives and employees, but it also helps in the

development of unified and committed workforce. Given the importance of knowledge

sharing, there are yet other organizations that do not clearly get its concept or they are not
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even focused on knowledge sharing culture. On account of the fast innovative and

technological pressures, knowledge sharing approach necessitates establishment towards

a more beneficial return.

As an illustration of teams’ support and organizational structure, administrative

support for instance in a healthcare environment provides collaboration basically through

operation, which include managing of human factor in the organization, managing client

care, managing of information systems, recordkeeping, supervision of financial health of

the organization, management of human capital, and management of medical and legal

regulations including the internal policies. These functions of administrative support play

pivotal role in as far as collaboration on knowledge sharing activities are concern.

Another illustration is the diverse function of other team. For instance, Smith

(2020) explained the responsibilities of nurses, which is to advocate care for individuals

regardless of ethnicity and religious affiliations. Other responsibilities of nurses include,

recording of history and symptoms, advocate for health and wellbeing of patient, perform

diagnostic tests, provide the needed education for patients pertaining management of

illnesses, and others. Their different roles though dissimilar as compared to other

departments and teams in an organization, their importance in the attainment of

organizational objectives are crucial.

The same aspect of various functions of team in an organization was explained by

Van Santen (2019) clarifying that medical doctor possess intensive knowledge, which is

deemed vital in the performance of their responsibilities to patients. It is a known reality

that insufficient knowledge sharing among physicians may cause major medical errors

that form certainty of threat to the safety of the patients.

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Having the significance of each department and every member of the

organization, Kim and Park (2015) explicate that the level of knowledge sharing can be

differed by working environment and the characteristics of the organization, of which the

need to design a systematic knowledge management system utilizing information

technology in order to facilitate the consistent as well as effectiveness of knowledge

sharing across clinical settings is important.

Postolache (2017) asserts that it is crucial for an organization to recognize

knowledge sharing as necessary element towards the attainment of organizational

success. Knowledge sharing facilitates decision making aptitude, establishes learning

organizations, and promotes innovation and cultural change. Thus, it is evident that

proper managing of knowledge can bring numerous benefits to the organization. What is

also perceived vital is that communication and relationships among employees can be

developed because of knowledge sharing, regardless of their respective departments.

Lee and Hong (2014) pointed out the promotion of knowledge sharing culture in

hospital environment, wherein consistent knowledge sharing can be promoted among

employees through changing of employees’ attitudes and behavior to embrace the

knowledge sharing advocacy. In hospital setting, knowledge management is

implemented for the management of intellectual resources and employees’ hospital

functions and styles through provision of new ideas, tools, services, and systematic

approaches, of which results are envisioned toward innovative behavior in the

organization. Accordingly, the process of knowledge management is aimed towards

realization of competencies and higher levels of performance. Thus, healthcare providers

and hospitals must take the initiative to establish a well-rounded knowledge through
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motivation among employees to adopt and continually practice knowledge sharing,

furthermore develop innovation within the organization.

The study conducted by Nilsen, et. al. (2020) shows that changes that are clearly

emphasized and communicated among staff have instigated the chances to achieve

success. Participants of the research stated that it is of importance for them to fully

comprehend the need for organizational change along the benefits they will serve.

Moreover, respondents of the study specified that they predominantly value the

organizational objectives, particularly those that are focused towards the benefits of the

patients.

According to the study of Sabeeh, et. al. (2017), healthcare organizations

endeavor to utilize their organizational knowledge. Accordingly, the shared knowledge

of medical workers and practitioners has direct impact on the quality of healthcare

delivery and services. The study utilized qualitative methodology pertaining to

knowledge sharing within the hospital context, particularly physicians’ acquisition of

knowledge, staff’s participation in the knowledge sharing, knowledge sharing culture; IT

based knowledge sharing, and the involvement of top management. The research

revealed the recognition of knowledge sharing should be taken into account to achieve

organizational success in healthcare organization.

A research conducted by Asurakkody and Shin (2018) showed that the defining

attributes toward innovative behavior were opportunity exploration, idea generation, idea

search, idea communication, promotion of idea, idea championing, application, and

overcoming obstacles. Furthermore, it was revealed that innovative behavior resulted to

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job productivity, lower levels of job burnout, job satisfaction, solving the organizational

problems, organizational commitment, organizational efficiency, and effectiveness.

The foregoing assimilated and reviewed literature and studies provided the

evidences that are deemed substantial to the foregoing paper. The review specifies the

significance of organizational knowledge and the contribution of knowledge sharing in

the organizational context and attainment of goal, particularly in realization of innovative

change of which, in this study is focused to the healthcare system delivery.

The attributes of knowledge sharing are also factors that are perceived essential.

However, top management support plays a vital responsibility in the process of

knowledge sharing, predominantly in understanding individual behavior of team players

and provision of the needed resources towards efficient and effective development and

implementation of knowledge sharing program.

Organizational Support on Knowledge Management

According to Campos de Oliveira, et. al. (2017) that in the viewpoint of strategic

and systematic processes in healthcare industry, encompassing the quality management

philosophy to address the technological advances, competitiveness in the marketplace,

and the demands that are on the rise are essential factors that should be given profound

value. In view of the competitive advantage, Al Shaar, et. al. (2015) emphasized that top

management support is a very crucial issue, particularly in the achievement and

maintenance of being at the forefront. In fact, many scholars have been persuaded to

investigate the interaction between top management and innovation.

According to Khan, JavedIqbal, and Long (2014), top management is responsible

to structure the framework of the organization, along with the provision of the needed
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resources. Top management support could be in many forms like, extending help to

teams in dealing with hurdles, exhibiting commitment to the work, or motivating the

people in the organization. It could be observed that top management support helps in

availability of financial needs of the organization, timely and appropriate allocation of

human factor and other physical resources, systematic delegation of essential power to

proper heads and teams in order to achieve a successful task or project.

Øygarden (2020) argues that in a field of activity, wherein organizational changes

that contravene with the existing institutions, organizational change is described as

divergent. It shall be noted that in the past decades where managerial logic initiatives

were relentlessly endeavored, health care organizations remain immensely inclined by the

professional logic. In the sphere of introducing the concepts of changes that are anchored

to the notion of managerial function or market sense and associate them into the vocation

of health service professionals could bring about the notion of divergence that could

furthermore result to conflict in countenance of organizational change. In addition, this

scenario is perceived to create resistance rather than manifestation of willingness to

participate. This, according to Øygarden is supported by researches demonstrating that

initiatives to foster quality improvement in hospitals most of the time, fail to realize the

anticipated outputs. In addition, it is a known fact that it is highly crucial to incorporate

health care professionals in the processes of quality improvement that is aimed to

continually improve health care services.

According to Pomare, et. al. (2019), organizational change is a common point of

discussion in as far as health systems are concern. Just like any other organizations,

success of an endeavor is attached to the involvement of the players, which also consist
 25

of their awareness and personal engagement to change. Also, redevelopment of long-

standing hospitals is a frequent scenario however hospital personnel’s understanding and

experiences pertaining to change are not commonly discussed.

Orth (2015) insinuates that everything in life changes. Our ability to grow, learn,

and thrive is determined by our response to change. Organization’s resiliency is

perceived on its capability to deal and cope with disturbance and persistence on the

process of change in numerous situations and ranges.

Different scenario and considerations take place when an organization undertakes

change, which encompass the structure, systems, strategies, and workforce. Moreover, it

should also take into account the various methods of organizational change pertaining to:

the situation that needs change; the proper implementation of change; the establishment

of suitable plans and controls to sustain change; and in the most part, the presence of a

credible team leader who influences the major decisions during the change project (Al-

Haddad, 2014).

Sullivan, et. al. (2011) pointed out that in both operational and strategic levels,

change is ever present realism that influences all organizations. Thus, it is imperative to

implement opportunities to planned change processes in real-time initiatives towards the

improvement of organizational efficacy. Since organizational change has been noted as

important element to a successful organization, the mere avenue to its realization is being

ready for change, having people and structures prepared and capable of change. In

obtaining this sort of environment, it is crucial to define the role of the managers and

leaders as responsible to the progress of change. Thus, it is a vital requirement for

leaders of the organization to effectively execute planning and manage change.

 26

Reychav and Weisberg (2014) asserted the influence of intention in sharing

explicit knowledge to an equal extent either or both directly and indirectly. It was

underscored that in any type of organization, competitive advantage is attained from

individual employees possessing knowledge and the capability of an organization to

influence a particular knowledge to its benefit. The implementation, management, as

well as sustainability of knowledge sharing process generate better concept of decision

making, more rapidly turnaround times, augmented organizational communications,

along with a higher level of interaction and collaboration among members of the

organization.

Awowale (2017) asserts that in healthcare, decision making is perceived

challenging because of complexities, nevertheless decision making is recognized of its

importance given due significance to high stakes of hospital concerns like: decision

making by doctors to take action, especially when the lives of their patients are in great

risk, also heads of the hospitals are obliged to provide quality healthcare considering the

inadequacy of resources while they have at the same time be focused on income

generation. In addition, they have to comprehend priorities with regards to competition,

meet the statutory and regulatory requirements, and ensure that competition is addressed

despite insufficient resources and simultaneously establish policies that for the general

operation of healthcare system.

According to Ibrahim, et. al. (2016) POS is considered as construction of

motivation. Apparently, employees tend to become physically involved in tasks and be

emphatically connected to people as required by their job, wherein motivation also plays

a significant role. In addition, it was pointed out that POS is derived in the form of
 27

developmental encounters as provided by constructed organization for the workers. It

was also clarified that POS, particularly for creativity is the independent variable to

dependent variable of creativity alongside developmental experiences being the

moderator.

According to Usman and Musa (2016), it is important to appreciate the reality that

the organization in the same way, benefited of the knowledge sharing process and

activities among the members of the organization. In addition, knowledge sharing

likewise offers various forms of knowledge that are stored within the organization that

flow from the employees to the whole organization department, it is evident that the

employees equally share the advantages that knowledge sharing offers. Having this

sphere, increasing the exchange and communication among the employees will improve

employees’ knowledge along with the degree of productivity of organization. Therefore,

the motivation provided by the organization reflects as crucial factor in the success of

knowledge sharing.

Ahmadya, et. al. (2016) provides that an organization’s effort to set up an

organizational structure manifests a systematic thinking. As furthermore described,

elements, relationships between elements and structure as a generality composing a unit

is how an organizational structure is composed. Thus, exhibiting a systematic view of

organizational structure brings about the implication that the structure is built having the

composition of hard elements on one side and soft elements on the other surface. In

addition, organizational structure is presented as an exhibit of organizational activities,

division of functions, coordination of each unit to the other, as well as control. How all
 28

of these are presented in a clearer view, an organizational structure is illustrated in form

of a chart.

The Global Health Workforce Alliance (2020) stresses that incentives in the form

of financial rewards and as part of reward systems are not sufficient to meet the aim to

retain and motivate health workers. It is therefore suggested that schemes that shall

effectively address the objective should be characterized in the following approach:

objectives should be clearly defined; they should be realistic and attainable; health

professionals’ needs and preferences should be indicated; carefully designed and

strategic; they should describe an appropriate context; fair and transparent; and they

should encompass financial and non-financial elements.

According to Blacketal (2019), there are several factors that influence the

establishment of rewards systems in organizations. It is however agreed that reward

systems have greater influence on job performance, retention, employees’ commitment,

job satisfaction, as well as occupational and organizational choice. Additionally, it is

agreed that both individual employees’ satisfaction and organizational effectiveness have

seen to have far-reaching consequences on account of the reward systems. Nevertheless,

it is unfortunate that some cases of reward systems have vague concepts that punish good

performance or restrain creativity. The classifications of rewards in favor of the

employees to recompense their efforts and contribution to the organization are extrinsic

or intrinsic rewards. The extrinsic rewards are those that are external to the employees’

work like, salaries and wages, fringe benefits, promotions, and recognition and praise

from others. The intrinsic rewards in contrast are those that are directly related to the
 29

performance of the job such as, feelings of task accomplishment, autonomy, and personal

growth and development that come from the job.

Cristianson, et. al. (2020) state that there has been an evenly long been curiosity

about the effects of the cost of health services to the services consumers seek out and use

and the connotation of the overall costs at different levels of performances. However,

very less research was conducted addressing the effects of financial incentives,

particularly on the delivery of quality of care. Samari (2019) provides that definition of

incentives is vague and it should be based on a particular sector. In healthcare field,

incentive could be understood as either rewards or punishment as a consequence of their

work environment. Incentives are also a channel in achieving goals and set objectives in

a range of health institutions. Incentives are also envisioned as external undertakings that

are conceptualized and formed based on specific purpose directed to individuals, group of

people, or motivation of an organization.

Slyter (2019) indicates that Information Technology (IT) systems are considered

as the application of innovation in order to address organizational issues on a broader

extent. Regardless of specific function a member of IT plays, he is presumed to work in

collaboration with other members of the organization pertaining to technology concerns,

either big or small. Accordingly, there are three crucial pillars of accountability that an

IT department operates: Governance, which deals with the amalgamation of various

policies and processes that establish the assurance of effective IT systems that are aligned

in accordance to the organizational objectives and necessities; Operations, which

characterized a catch all category implemented for daily work within the IT department,

which include the provision of technical support, maintenance of network, along with
 30

security and device management; and Hardware and Infrastructure, of which focus is

directed towards the physical components of IT infrastructure consisting of setup and

maintenance of equipment such as, routers, servers, phone systems, as well as individual

devices like desktops and laptops. The IT plays a significant role in the organization,

however, maintaining a level of service standard, security, and connectivity are deemed

enormous responsibilities, but they just few of the tasks; countless potentials and

challenges are imminent in IT.

IT in healthcare systems has made and incessantly contributes to a vast realm of

medical field. The intensified utilization of electronic medical records (EMR), tele-

health services, as well as mobile gadgets, medical practitioners and professionals, along

with their patients are benefited of the innovative approaches and devices. Having the

technological adaptation, more hospitals and physicians are perceived to have greater

opportunities and access to the needed information in a matter of second. Utilization of

technology in medical research helps scientists in the examination of diseases that shall

produce antibodies against them. These of profound importance vaccines against viruses

and life-threatening illnesses prevent their spread and save thousands of lives. In reality,

WHO’s reports stress that over 3 million lives are saved every year because of vaccines.

In addition, vaccines help in the prevention of dreaded viruses (White, 2019).

Perceived Organizational Support (POS) on Knowledge Sharing

It was emphasized by Eisenberger, et. al. (2016) that knowledge sharing is of

mutual advantage to both the organization and employees. Accordingly, it is important

 31

for the organization to appreciate the importance of employees as above all, sources of

human capital. Moreover, POS was defined as employees’ perception of the organization

pertaining to how they are given the value and importance, particularly their efforts and

contributions, along with the care of the employees’ well-being, wherein both the

employees and the organization will take the consequential advantage.

In addition, it was highlighted that POS is soundly steered by leadership,

constructive Human Resource practices, work environment that is desirable, and fair

treatment. In the assessment of POS, employees focus, particularly to the organizational

practices in which the organization has substantial discretion, as contrast with the

organizational practices compelled by external constraints, which include government

regulations and sets of policies along with market competition for the employees

(Eisenberger, et. al., 2016).

Castaneda and Rios (2013) provide that POS supports the construction of

reciprocity in an employee, most specifically in his contribution to the organizational

objectives, wherein significant relationship in the concept of organizational commitment

was also perceived, along with quality of work, and lesser rotation. Accordingly,

whenever POS tends to produce awareness of reciprocity, it could probably be

predictable that an employee would be sharing his knowledge.

Huda and Othman (2014) asserted that organization’s motivation influences

employees’ sharing of knowledge. Trust and reputation on the other hand were also

identified motivators that influence successful sharing of knowledge. Thus, the

importance of organizational support as motivational factors justifies the success of the

employment and implementation of knowledge sharing. Furthermore, the organizational

 32

motivation as paramount objective in realizing the effectiveness of knowledge sharing is

perceived of greater importance.

Subjective Norms (SN) on Knowledge Management

In changing individuals’ behavior necessitates beyond understanding along with

the way in changing attitude towards behavior. The notion how a person wants people to

behave is likely diverse for different group of people. Thus, the motives to submit what

is normal for a specific group will most likely be the strongest. The aggregation of the

beliefs therefore is the normal expectation and the desire to comply turns out to be as the

subjective norm. Changing the normative beliefs along with the motivation to comply or

the subjective norm is in the same manner of importance as understanding individuals’

attitudes towards behavior. In absence however of suitable subjective norms, there is no

point of changing the behavior, for attitudes towards behavior remains in the hands of a

person. In addition, to create the needed and appropriate subjective norms rests in the

hands of leaders (Change Factory, 2020).

Punniyamoorthy and Asumptha (2019) claimed that the behavior over knowledge

sharing is established in which an owner of knowledge actually shares their knowledge

with other members of their organization, while intention studies an employee’s

willingness to connect with knowledge sharing. It was furthermore emphasized that both

human and technical perspectives are of equal importance to knowledge sharing.

However, in as far as effectual knowledge sharing is concern, information and

technological aspect play significant role. As furthermore asserted, the different

functions of each group, the significance of the SN to the attitude path emphasizing what

the members of the group feel with regards to knowledge sharing as a result of social
 33

pressure, which furthermore indicates the causal path created from SN to perceived

behavioral control revealing that behavior in knowledge sharing depends on the

individual feelings pertaining to how others viewed them. Consequently, information

and technological aspect play significant part in the enhancement of effectual knowledge

sharing.

Self-Efficacy (SE) on Knowledge Management

Olowodunoye (2015) implied the significance of SE towards the success of

knowledge management along with its predicting role on knowledge sharing behavior

among employees. The reproduction of expertise is an important element that is for the

most part dependent on the self- efficacy and job tenure of the workers. It was further

provided that any particular organization providing effective and efficient utilization of

knowledge may be of superior advantage as compared to other organizations. Every

employee serves as knowledge generator, of which self-efficacy is an essential

determinant, particularly in engaging in knowledge sharing endeavor. Self-efficacy may

be conceptualized as the evaluation of one’s own ability on the ground of mastery of

particular job or phenomenon. Moreover, self-efficacy is about an employee’s judgment

of his/her capability to organize and execute a certain course of action.

Memba (2018) also suggests that self-efficacy is about confidence in a person’s

capability to perform behaviors that drive in the performance of specific performance

objectives. Additionally, it displays confidence in the aptitude to exert further control

over one’s own emotion, behavior, as well as social environment. It is deemed that

people having pronounced self-efficacy are most likely to possess higher level of

commitment, significantly in the completion and realization of tasks delegated to them.

 34

Moreover, it was shown that concept of self-efficacy provides guidance in shedding light

to people searching and trying new experiences in a more philosophical manner. Self-

efficacy is also believed as an approach in organizing groups and teams that provides

managers of individual employees a framework in the establishment of standards of

behavior as well as success in organizations.

Ali and Ameer (2016) argue that only companies who are geared up with

continuous learning and upgrade their business design in accordance to the needed

challenges and changes such as, economic activities and technological transformations

can survive along with the test of time. Considering further that there are changes that

are considered productive, nonetheless, some changes are undesirable. These occurrences

have the possibility that may ruin an organization, or create threats to the totality of

corporate performance. Hence, being organized and resilient are necessary in

countenance of the survival as well as growth an organization of which, learning climate

is reckoned vital in the establishment of coping strategy under the current and demanding

environment.

Furthermore, Francis (2015) implies that organizations of learning are perceived

in the aspects of innovation, satisfaction of employees, core competencies, as well as

organizational decision-making. Francis furthermore provides that the edifice of learning

strategy should comprise of exploration of learning or finding new knowledge or

information and exploitation of learning or harnessing knowledge. Accordingly, in

maximizing potentials, particularly concerning performance, it was suggested that

organizations have their own preferences in as far as learning styles are concern.
 35

On the other hand, Calina (2017) specifies that learning climate is a tool wherein,

team players would be able to diversify towards innovation. Moreover, through the

process of learning, workers are able to share in-depth information, employ profound

critical thinking, appreciate diverse ideas, and are believed to share unique ideas. Thus,

those employees with have high level of self-efficacy are perceived to be more involved

in activities as compared to those having low self-efficacy. In essence, knowledge

sharing behavior may be determined by self-efficacy of individual employee, in the same

manner as self-efficacy may be developed through engaging in knowledge sharing

behavior (Olowodunoye, 2015).

Knowledge Sharing Intention on Knowledge Management

It is evident that healthcare sector faces massive challenges, particularly on costs

modernization of operations. Aside from these demands, healthcare providers are

expected to produce an outcome-based care, wherein they are being compensated on the

quality of care and not the quantity. Reciprocity is described as a process that focuses

towards mutual benefits through exchanging of things with other people. The rule of

reciprocity is regarding social norm, wherein, if someone does some favor to you, you are

in the same manner obliged to return the good gesture. The process of socialization plays

a significant part in as far as development of this need to reciprocate. Reciprocity also

takes a vital role, especially in persuading others to adopt a particular belief or behaviors.

Types of reciprocity comprise of generalized, balanced, as well as negative. Taking a

closer look to reciprocity norm, many cases will actually signify the good return of

reciprocity; as it guides individuals to engage and commit in social give and take process

(Cherry, 2020).
 36

According to Alsaqqa (2020), hospital setting is organized with various roles and

diverse expertise. However, all of the competence is considered of importance in the

professional care provided to the patients. The knowledge along with varied approaches

is developed in every department in the context of hospital organization to ensure that

encouragement to hospital players in various means are provided to further guarantee that

needs of the patients are extended. Moreover, the hospital organization needs to fully

understand the important factors of the organization, primarily the overall system, and the

structure and culture of the organization, in order to successfully employ the knowledge

sharing activities taking into account the responsibilities of each individual or group, of

which different functionality provides diverse intention in sharing of knowledge.

Additionally, knowledge management was found an important element in as far as

forming the knowledge intention among various departments in healthcare organization is

of greater concern.

Knowledge Sharing Behavior on Knowledge Management

Purc and Lagun (2018) pointed out that innovative solutions in the organization

are created by the employees; hence the behaviors of employees are significant to the

organizational innovation objective. Purc and Lagun further claim that good ideas of

individuals are based of innovation; thus, it is essential to extend the needed

understanding towards the role that individuals and their personal characteristics play in

the achievement of innovative initiatives.

Lee and Hong (2014) argue that innovative behavior is considered as crucial

element in as far as growth and survival of hospital organizations are concern.

Considering that public health and healthcare providers are well positioned to leverage
 37

knowledge in global perspective, it is reckoned that having different approaches such as

innovation shall outperform competitors in terms of market share as well as growth.

According to Appel-Meulenbroek, et. al. (2018) flows of knowledge sharing within the

organization are imperative, particularly for the successful implementation of innovation.

Moreover, knowledge sharing behavior was also believed significantly related to various

antecedents of knowledge sharing. This indicates that identifying responsibilities and

functions of every department and each individual employee would generate more

employee involvement and tacit knowledge sharing rather than steering on group’s

structure.

Harrison (2020) suggests that trust allows individuals to have faith or belief to

others without the feeling of being compelled for their own protection with legal

provisions at every aspect. In organizational context, trust is greatly based on the account

of interactions between organizations. Moreover, trust is even developed when behavior

goes with that of the expectations. Most of the time, trust is associated with reputation

and ethics, moreover deemed significant to relationships in business because it is evident

that business negotiations typically demand a high level of good faith and trust.

According to Grossman (2019), there are important ways that leaders, regardless

of levels, can build in the organization by aligning actions with words: Recognizing that

building trust undertakes hard work; Be honest and supportive; It is good to be quiet

sometimes; Consistency is the key; Model the behavior that is sought; and Build

accountability. Trust influences ability of a leader to inspire as well as inspire

employees. When employees trust a leader they are confident of his decision making

even in times of uncertainty because of their expectation that the leader will do what he
 38

says. Building trust requires alignment of words and actions and considered as key pillar

in the attainment of organizational success.

Van Muller (2019) provides that when employees have the feeling of being unsafe

at work, their productivity could be effected and abridged drastically. It can be observed

that an environment created and maintained wherein employees perceive a high level of

trust, it will head towards to an optimistic working atmosphere of lesser stress and

reduced turnover of personnel. Hence, it is imperative to have access pertaining to the

information that deals with the level of trust of the employees and their experiences about

it. Nevertheless, if trust is not part of the requisites at a certain level, it is advisable to

enhance trust in order for an organization to grow.

Adeyelure, et. al. (2019) revealed in a study that most the healthcare professionals

are doing the knowledge sharing without even noticing they are actually doing it,

considering that has been a practice as part of daily routine. As further revealed, ICT

takes a very significant role in knowledge sharing, particularly in hospitals. It is common

for healthcare professionals to use ICT in their everyday tasks. It was also found that

there are quite a number of challenges in knowledge sharing. Those that were identified

as challenges include time constraints, technology constraints, and language barrier.

Apparently, the study found that most of the employees blamed management for not

sufficiently imparting the necessary role in order to encourage knowledge sharing.

Among the challenges Adeyelure, Kalema, and Motlanthe found out that those challenges

of knowledge sharing are on account of their respective nature of work and most

especially the size of the hospital and number of patients they handle.
 39

In a study conducted by Sihombing (2011), it was shown that there is no

relationship between subjective norms and behavioral intention, which means that

intention in knowledge sharing was not in relation with perspective social pressure from

significant referents. However, the conducted study recognized the concept of TPB,

acknowledging that knowledge sharing predicts knowledge sharing behavior in terms of

subjective norms. As further revealed in a study conducted by Chhajer, et. al. (2018), it

was shown that higher levels of self-efficacy as well as optimism predict higher levels of

cognitive, emotional, and physical engagement. In the same manner that the higher

levels of cognitive, emotional, and physical engagement significantly predict

performance. In addition, the study also showed that significant indirect impacts support

the mediating role of job engagement, take note of the relationship between the

psychological strengths as well as performance outcome. Therefore, individual

employees’ self-efficacy, alongside optimism, and job engagement can possibly be

developed through designing and implementation of business initiatives found of

relevance to positive change.

Zhang and Ng (2013) indicated that knowledge sharing is positively influenced by

perceptions of knowledge self-efficacy as shown in their conducted research. The study

furthermore substantiated that the information and communication (ICT) is significant on

employees’ perceived behavioral control and knowledge sharing.

In terms of self-efficacy, Olowodunote (2015) revealed that knowledge behavior

is determined by self-efficacy. Nonetheless, it was moreover asserted that self-efficacy

may be developed by way of engagement in knowledge sharing behavior. As

furthermore narrated, the disposition and response of individual employees pertaining to

 40

the organization is seen as function of organizational justice as well as equality on the

perspective of individual employees. Most of the time, these viewpoints are not

recognized being a written policy, nonetheless it may as well be considered as strong

determinants of employees’ commitment on knowledge sharing behavior.

In a study conducted by Van Santen (2019), it was suggested that when it comes

to knowledge sharing, the enormity of knowledge sharing on the perspective of medical

doctors is remarkable, emphasizing further their crucial role in assuring health and

wellness of the patients. It is in the same way that possession of insufficient knowledge

among physicians may tremendously cause problems that will bring about threat to the

safety of the patients. As further supported by the conducted study, it was revealed that

social norms was the strongest influencer on knowledge behavior, which additionally

indicate that the intention of medical doctors to share knowledge positively related to

knowledge sharing behavior.

The Pandemic in Philippine Context

In the Philippines the very first case of COVID-19, a 38-year-old female was

reported on 20 January 2020. The required contact tracing and further investigation was

then conducted wherein, it was found that two more positive cases thereafter were

recorded. The first and the third cases have recovered, however the second case

unfortunately died on 1st of February 2020. The investigation furthermore revealed that

the three cases had travel history in Wuhan City in China, where the COVID-19 was

reported to derive. Subsequent cases on the other hand were recorded as local

transmission, following contact tracing that revealed of no travel history outside the

Philippines (WHO, 2020).

 41

Consequently, a working party called Incident Management Team along with the

Emergency Operating Centre was activated by the DOH. To appropriately address

critical issues of national level, the Inter Agency Task Force (IATF) together with the

Inter Agency Technical Working Group (IATWG) that shall tackle the key decisions on

Management of Emerging Infectious Diseases, involving major government agencies like

the Department of Foreign Affairs (DFA), Department of Tourism (DOT), Department of

Interior and Local Government (DILG), and others were also created WHO (2020).

According to WHO, the inflated cases of COVID-19 in the Philippines compelled

the DOH to raise the Alert System Code Red sublevel 1 in order to address the needed

mobilization of resources such as procurement of crucial logistics and supplies. DOH

furthermore endorsed the use of protective measures including hand washing, social

distancing, using of mask, avoidance of mass gatherings and unnecessary travel. Other

agencies are also noted in their support to DOH as Filipinos struggles against the

pandemic, they are: the National Disaster Risk Reduction Management Council

(NDRRMC), the Philippine Red Cross, and other significant agencies. WHO on the

other hand, is in support of DOH, particularly on aspects of surveillance, infection

prevention and control, risk communication, contingency planning, and laboratory

capacity (WHO, 2020).

The Philippine Healthcare System. The decentralization context of the

government is seen to affect the national objectives for health (NOH). The Philippine

government healthcare insurance, PhilHealth, merely covers inpatient care and

inadequate financial support. The unsystematic, inadequacy of facilities, healthcare

personnel and specialists are results of highly uneven processes. However, it is perceived
 42

that several programs are deployed but monitoring and sustainability are seen to intensify

the issues. Satisfaction of patients and user experience are nonetheless exhibiting

improvements, nevertheless billing concerns such as charges set by the hospital,

specifically those that are not covered by PhilHealth relentlessly drains patients. One

more thing to note is the limited number of healthcare facilities to balance the growing

population, provision of physicians, inadequacy on the condition of care, as well as

physician observance of the clinical practice that contribute to low quality of healthcare

services.

The DOH’s perseverance to improve health outcomes and provision of protection

impoverishing effects of mounting costs of care and ensure responsiveness of the health

system to the population’s health needs were embodied in several iterations and proposals

of its health reform policies. However, strong political support and wider fiscal space do

not right away produces effect on a particular health system performance, as

insufficiency of institutional capacity to translate policy into effective program

implementation, monitoring and evaluation is perceived. It is deemed that increased

financial resources for health will allow overlapping areas in financing and delivering

health services occur, as in the case of maternal and child health care and TB

management (Dayrit, et. al., 2018).

The Healthcare Professionals in the Philippines. The entry to the health

professions is regulated by the government in order to ensure that level of control over

the practice and delivery of quality healthcare are well imposed in the country. Under the

Professional Regulation Commission (PRC) Professional Regulatory Boards that exercise

administrative, quasi-legislative and quasi-judicial powers, prescribe the course

 43

requirements, administer and conduct the licensure examinations, administer oaths, and

issue the requirements, and other practices and tasks. In order to ensure the maintenance

of competency and professional standards PRC is tasked to handle certification of

specialists and physicians in accordance to the standards and legal practices.

Synthesis

Most importantly, the present stance wherein people around the globe are

confronting against the pandemic, delivery of effective healthcare system is crucial.

Enhancement of knowledge sharing is predominantly of magnitude in the provision of

efficient and fast healthcare services. Furthermore, the review of literature and studies

emphasized that knowledge sharing takes the forefront in as far as communication and

transfer of knowledge are concern. Hence, as innovative healthcare services is

considered for its significance as further justified in the literature review and related

studies, knowledge sharing is deemed to be of greater value and contribution in

realization towards the establishment innovative healthcare services.

This study was limited on the assessment of the relationship between knowledge

sharing intention and knowledge sharing behavior. The research furthermore covered the

knowledge sharing attributes predicting knowledge sharing intention and knowledge

sharing behavior. To raise reliable and significant results towards knowledge

management, essential data were collected among the respondents who are healthcare

workers in four private hospitals in the City of Ormoc, for the third quarter of 2020, as

further categorized in the methods of the study. The respondents were sub-divided into

four groups; medical services, nursing services, administration and support, and ancillary
 44

services. Thus, other matters in relation to knowledge sharing and management and other

groups of healthcare workers not specified herein were not covered by the study.

Upon thorough review of existing studies related to the research, a literature gap

was identified. Although KSA, KSI and KSB are well explored topic in the field of

research, there are only very limited studies conducted among healthcare professionals. It

also remained to be an unexplored topic since none has been done and conducted among

healthcare professionals in the locality of Ormoc City. Thus, this study will be relevant to

the body of knowledge and may help in addressing knowledge sharing challenges among

healthcare professionals. Consequently, the important concepts that this paper was

intended to realize was the establishment of enhancement plan through the

implementation of knowledge management system.

Chapter III

RESEARCH METHODOLOGY

This chapter presented the methodology being used in the study in terms of the

design, environment, participants of the study including the inclusion and exclusion

criteria, sampling technique, instrumentation, data gathering procedures, data analysis,

and ethical considerations.

Design
 45

This study used the two different designs, the descriptive correlational

(predictive) and comparative (non-causal) research design. A descriptive design aims to

accurately and systematically describe a population, situation or phenomenon. It can

answer what, when, where, when and how questions, but not why questions (McCombes,

2019). This design was used to determine the knowledge sharing attributes

(organizational support, subjective norms, self-efficacy), knowledge sharing intention

and behavior.

According to Pressbook (n.d.), in a correlational research, the researcher measures

two continuous variables with little or no attempt to control extraneous variables and then

assesses the relationship between them. This design was used to assess the relationship

between the knowledge sharing intention and behavior. Further, the study utilized the

predictive design as it assessed whether the knowledge sharing attributes predict

knowledge sharing intention and behavior.

On the other hand, a comparative research essentially compares two groups in an

attempt to draw a conclusion about them. Researchers attempt to identify and analyze

similarities and differences between groups and these studies are most often cross-

national, comparing two separate people groups (Richardson, 2018). In the study, the

knowledge sharing attributes, intention, and behavior will be compared among four

groups of healthcare workers (medical, nursing service, ancillary, and administration and

support groups). The study utilized a non-causal comparative design as the study is non-

experimental.

Environment
 46

This research was conducted in the four private hospitals in Ormoc City, namely,

OSPA- Farmers Medical Center, Ormoc Doctor’s Hospital, Clinica Gatchalian- Mount

Grace Hospital, Inc. and Ormoc Maternity & Children’s Hospital. Ormoc, officially the

City of Ormoc is a first class independent component city in the province of Leyte in the

region of Eastern Visayas of the Philippines. It has a population of 215, 031 inhabitants.

The natives of this city are called Ormocanons, with most being Cebuano speakers, as

with the whole western and southern parts of the island of Leyte. A definite number of

Waray speakers are also present within the city. The Ormoc City healthcare community is

comprised of one public district hospital, four private hospitals, and the Ormoc Red Cross

blood bank. OSPA- Farmers Medical Center and Ormoc Doctor’s Hospital are secondary

level hospitals (formerly Tertiary Level) with its full capacity of 111 and 200 beds

respectively. Clinica Gatchalian- Mount Grace Hospital, Inc. is a primary hospital with a

100-bed capacity, while Ormoc Maternity & Children’s Hospital is a primary category

hospital as well. Securing the safety of patients who go to hospitals for a health problem

and minimizing the errors coming from health care professionals is a major concern. In

terms of knowledge sharing in these institutions, the researcher have observed that nurses

and doctors tend to share their knowledge mostly with colleagues in their own

professional group, they communicate mostly with peers to stay up-to-date; they

communicate less with the other groups. Medical errors, especially those caused by a

failure to communicate are a pervasive problem in these organizations. In today’s health

care system, delivery processes involve numerous interfaces and patient handoffs among

multiple healthcare practitioners with varying levels of educational and occupational

training. During a course of hospital stay, a patient may interact with 50 different
 47

employees, including physicians, nurses, technicians, and others. Effective clinical

practice thus involves many instances where critical information must be accurately

communicated. Team collaboration is essential.

Respondents

The participants of the study were 200 healthcare workers in various private

hospitals in Ormoc City. The participants of the study were subdivided into four groups

where 50 were chosen from the medical services (13 each from the secondary level and

12 each from the primary level), 50 were chosen from the nursing service (13 each from

the secondary level and 12 each from the primary level), 50 were chosen from the

ancillary services (13 each from the secondary level and 12 each from the primary level),

and 50 were chosen from the administration and support services (13 each from the

secondary level and 12 each from the primary level).

Sampling Technique. The study employed the quota sampling. According to

Explorable.com (2020), quota sampling is a non-probability sampling technique wherein

the assembled sample has the same proportions of individuals as the entire population

with respect to known characteristics, traits or focused phenomenon. The first step in

non-probability quota sampling is to divide the population into exclusive subgroups. In

which in the study they were subdivided into four groups. Then, the researcher identified

the proportions of these subgroups in the population; this same proportion was applied in

the sampling process. In the study, 50 respondents were equally distributed to each group.

50 were chosen from the medical services (13 each from the secondary level and 12 each

from the primary level), 50 were chosen from the nursing service (13 each from the

secondary level and 12 each from the primary level), 50 were chosen from the ancillary
 48

services (13 each from the secondary level and 12 each from the primary level), and 50

were chosen from the administration and support services (13 each from the secondary

level and 12 each from the primary level). Finally, the researcher selected subjects from

the various subgroups while taking into consideration the proportions noted in the

previous step. The final step ensured that the sample is a representative of the entire

population. It also allowed the researcher to study traits and characteristics that are noted

for each subgroup.

Inclusion and Exclusion Criteria. For respondents who participated in the

study, the following criteria were set. Respondents were of legal age, regardless of sex,

religion, socio-economic status, educational background, and marital status. They were

employed in any of the private healthcare institutions in Ormoc City regardless of status

whether contractual, probationary, or regular. They were employed for at least 3 months

already in their respective institutions. Only those who were willing to give voluntary

consent participated in the study. Excluded in the study were also those employees who

were awaiting the effective dates of their resignation, end of contract and retirement.

Health care workers classified as vulnerable subjects were excluded from the study such

as pregnant and persons with disability as they are at high risk of CoViD-19.

Instrument

The research instrument of this research was standardized and adopted from the

study, conducted by Castaneda, et. al. (2016), entitled “Determinants of knowledge

sharing-intention and knowledge sharing behavior in a public organization” which was

published in different international peer-reviewed journals. The questionnaire was

composed of subparts, namely: perceived organizational support (POS) with 8 items,

 49

subjective norms (SN) with 7 items, self-efficacy (SE) with 4 items, knowledge sharing

intention (KSI) with 4 items, and knowledge sharing behavior (KSB) with 4 items. All in

all, there were 27 items. The construct validity of the tool using exploratory factor

analysis as used in the study of Castaneda, et. al. (2016) yielded the following omega

values: POS - .796; SN - .816; SE - .925; KSI - .944; and KSB - .933.

The instrument was rated accordingly utilizing a 7-point likert scale where 1 is for

strongly disagree, 2 for disagree, 3 for somewhat disagree, 4 is for neither agree nor

disagree, 5 is for somewhat agree, 6 is agree, and 7 is strongly agree. In interpreting the

score for the individual items and subparts the average or mean were computed. The

following parametric scores and interpretation were used: 1.00 – 1.86 is very low; 1.87 –

2.72 is somewhat low; 2.73 – 3.58 is low; 3.59 – 4.44 is moderate; 4.45 – 5.30 is

somewhat high; and 5.31 – 6.16 is high; and 6.17 - 7.00 is very high.

Data Gathering Procedure

This study commenced with a title defense, subsequent approval of the research

title, and a transmittal letter addressed to the Dean of the College of Nursing was

submitted for the approval of the conduct of the study. A transmittal letter was also sent

to the different heads or Chief of Hospitals of the private healthcare institutions in Ormoc

City. Only those who gave consent were included in the study. A draft of the manuscript

was submitted for a design hearing. After compliance on the recommendations during the

design hearing, the study was submitted to the University of the Visayas– Institutional

Review Board (UV-IRB) for ethical approval. The recruitment of respondents was

commenced after a notice to proceed was issued.

 50

Primarily, permission from the participants were sought through consent forms in

order to allow voluntary participation; both for the face-to-face and online conduct of the

study. . Hospital Ethics committee from each of the hospitals was consulted for ethical

issues that arise. The researcher sought help from the Human Resource Department of the

private institution in the distribution of the questionnaires. An enumerator was

commissioned to assist the researcher in the data gathering. However, the researcher

ensured that distribution and retrieval of the questionnaires were done by the researcher

primarily, if possible, or the enumerator. Other options for data gathering were done

through the use of online platforms with the aid of an online expert. Where physical

contact was prohibited, the questionnaires were accessed through ‘Google forms’ or the

questionnaires were sent through emails or ‘Facebook messenger’. To this recruitment

was done using online platforms and link or the soft copy was sent to the participants

who consented to participate voluntarily.

In the course of actual gathering of pertinent data among the four groups of

healthcare workers, no untoward incident was encountered and recorded. All the four

groups of healthcare workers were cooperative. Retrieval rate was 100%, of which no

questionnaire was wasted. The uploaded questionnaires on social media platforms like,

Google forms and Facebook messenger were accomplished by those who opted to

participate via online survey. However, majority of the participants preferred to respond

by way of filling out the hard copy questionnaire distributed by the researcher with the

aid of herein mentioned hospital personnel.

 51

Data were collated and treated with the appropriate statistical treatment. All

answered questionnaires in soft copies were deleted and hard copies on the other hand

were destroyed through shredding.

Statistical Treatment of Data

The following statistical tools were used to analyze the data:

Weighted Mean. The weighted mean was used to apply the weight or determine

the significance among variables as presented in the statement of the problem. This was

used to determine the knowledge sharing attributes (perceived organizational support and

subjective norms, the knowledge sharing self-efficacy), knowledge sharing intention and

behavior.

Linear regression. This was used in order to assess whether the knowledge

sharing attributes predict knowledge sharing intention and knowledge sharing behavior.

Analysis of Variance (ANOVA). This was used to compare the difference in the

knowledge sharing attributes, intention, and behavior among healthcare workers.

Ethical Considerations

The following ethical principles were strictly observed in the conduct of the

study:

Protection of Human Rights. To protect the human rights of the respondents of

the study, respect, beneficence, and justice were observed. To observe respect, two

convictions were abided: (a) individuals were treated as autonomous agents and (b)

protection were given to persons with diminished autonomy. For beneficence to happen,

they were treated in an ethical manner by respecting their decisions and protecting them

from harm and making sure that effort to secure their well-being. In observing
 52

beneficence, two rules were observed: they were not harmed and maximized possible

benefits and minimize possible harms. For justice, the principle of “fairness in

distribution” or what is deserved” was observed. The following were also observed: (a) to

each person an equal share, (b) to each person according to individual need, (c) to each

person according to individual effort, (d) to each person according to societal

contribution, and (e) to each person according to merit. They were allowed to ask as

many questions as possible and they were allowed to refuse to answer questions

appertaining to the study.

Transparency. It was the intention also of the researcher to publish the study in a

referred journal. Further, the study was submitted for either oral or poster presentation in

a research congress. Output of the study was recommended for use in the private

healthcare services respondents were working.

Risk-Benefit Ratio Determination. The Risk-Benefit Assessment was conducted

prior to the start of the study. It showed that there were more benefits than risks thus this

study were pursued.

Risks. The following were the major potential risks which the researcher have

removed: (a) Physical harm, including unanticipated effects in the course of answering

the questionnaires; (b) Physical discomfort, fatigue, or boredom from answering the

questionnaire; (c) psychological or emotional distress resulting from self-disclosure,

introspection, fear of the unknown, discomfort with strangers, fear of eventual

repercussions, anger or embarrassment at the type of questions being asked as they will

do self-evaluation; (d) social risks, such as the risk of stigma, adverse effects on personal
 53

relationships, loss of status especially if the evaluation yields negative results; (e) loss of

privacy; (f) loss of time; and (g) monetary costs.

Benefits. The following were the major potential benefits derived from the study:

(a) access to potentially beneficial intervention that might be unavailable to them; (b)

comfort in being able to discuss their situation or problem with a friendly, objective

person; (c) increased knowledge about themselves or their conditions, either through

opportunity for introspection and self-reflection or through direct interaction with

researchers; (d) escape from normal routine, excitement of being part of a study; and (e)

satisfaction that information they provide may help others with similar problem or

conditions.

Content, Comprehension and Documentation of Informed Consent. To

comply with the voluntary consent, respondents of the study were made to sign an

informed consent with the following contents.

Participant Status. The participants in this particular research were healthcare

workers in different private healthcare facilities in Ormoc City. Their status was taken

cared of with full confidentiality. The respondents were assured that the present research

will in no way affect their employment or social status. They were also informed of the

nature of the study being educational.

Study Goals. The goal of the study was to assess the relationship between

knowledge sharing intention and knowledge sharing behavior. This study further

assessed whether the knowledge sharing attributes predict knowledge sharing intention

and knowledge sharing behavior among healthcare workers in the private healthcare
 54

institutions in Ormoc City, for the third quarter of 2020 as source of needed data and

substantial information.

Type of Data. The data collected were quantitative in nature utilizing the

quantitative descriptive-correlational (predictive), comparative (non-causal) research

design.

Procedures. A written approval to conduct a research was secured from the

adviser and the Dean of the Faculty of Nursing. The instrument was presented to the

adviser to obtain the needed checking and endorsement to the research respondents.

Subsequent consent, the aim of the research was explained to the participants. Moreover,

anonymity and voluntary participation in the foregoing study were ensured to all

respondents without coercion or pressure. Confidentiality was furthermore assured,

along with the confirmation that the present study was merely utilized as part of the

educational prerequisite of the proponent and that their inputs were treated in strict

secrecy. A more detailed discussion on the data gathering procedure was furthermore

discussed under the Data Gathering Procedure section.

Nature of Commitment. Respondents were required to answer the questionnaires

for 10 - 15 minutes. This was done at their most convenient time such as after work or

break time.

Sponsorship. The researcher solely funded the study and there were no sponsors

for the study.

Participants’ Selection. The respondents were selected through quota sampling

with the aid of the inclusion and exclusion criteria and there were no discrimination in the

selection process.
 55

Potential Risks. Potential risks were identified by the researcher and were

removed in the conduct of the study. The researcher was present to answer the questions

and prevent boredom or emotional stress from answering the questionnaire. They were

given privacy and were asked to answer the questionnaire at their most convenient time

and place to avoid loss of time and other related resources. There were no physical,

psychological, social or economic risks associated with the study.

Alternatives. There were no alternatives as the study did not introduce

interventions and treatments as the study was purely non-experimental.

Compensation. No incentives or compensation were given because the study was

answered through a questionnaire and voluntary. Thanking the respondents was the only

way to reciprocate the favor from answering the questionnaire. The respondents directly

benefitted through acquiring new knowledge about the study.

Confidentiality pledges. Confidentiality and privacy were observed all throughout

the course of the study.

Voluntary Consent. The study was voluntary in nature. It was the respondents’

full will to participate.

Right to Withdraw and Withhold Information. If respondents feel that they were

not comfortable with the study or feel not safe, the participants were given the right to

withdraw or withhold information without the consequence of being punished or

penalized.

Contact Information. If respondents have questions about the study, they can

contact the researcher or the university’s Institutional Review Board at (032) 416-7990 or

email at uvirb2017@gmail.com.
 56

Authorization to Access Private Information. No authorization was needed in

the study as it did not access records. The study only involved distribution of

questionnaires to the qualified respondents.

Privacy and Confidentiality Procedures. Privacy and confidentiality were

strictly observed. To protect the privacy and confidentiality of the data to be collected the

following were observed: (a) identifying information (example: name and address) from

participants were only obtained as needed; (b) assigning of identification number to each

participant and attaching the ID number were done rather than other identifiers to the

actual data; (c) maintained identifying information in private file; (e) entering no

identifying into computer files was done; (f) destroying identifying information quickly

was applied. All soft and hard copies of the questionnaire were destroyed after the study.

Debriefing, Communication, and Referrals. Being gracious and polite to the

respondents was observed if there were questions regarding the questionnaire. A

debriefing was done in order to allow the respondents to ask questions or if there were

complaints. Further, the researcher during the retrieval of the questionnaire conveyed her

gratitude to the respondents and their participation was greatly appreciated by the

researcher.

Conflict of Interest. There was a possibility of a conflict interest where the

respondents were from the hospital where the study was conducted. However, the

researcher’s participation was mainly to distribute and retrieve the questionnaires. The

researcher prohibited herself in becoming a respondent of the study. The questionnaire

was used as instrument and means of gathering data. A third party (enumerator) was
 57

sought or the Chief Nurse of the hospital was asked to help facilitate the distribution of

questionnaires and prevent conflict of interest.

Incentives or Compensation. Respondents were not given any incentives or

compensation for their participation, instead they were personally thanked by the

researcher or the enumerator for their participation in the study. Words of gratitude were

the means of thanking them.

Collaborative Study Terms of Reference. The study was done solely in

compliance with the requirements of the researcher’s doctorate degree. There were no

collaborations entered into with another party. Intellectual property rights and publication

rights and information and responsibility sharing were solely owned by the University

and the researcher. The study was conducted in the different healthcare facilities in

Ormoc City. Research utilization was done in the said healthcare facilities in Ormoc City

as this was part of the agreement upon allowing the study to be conducted in the said

institution. A copy of the study was furnished to the hospital. Thus, terms of reference

were not applicable in the study.

Recruitment. Where a face-to-face recruitment was allowed, compliance to local

and national executive orders and guidelines were strictly complied such as social

distancing, and the wearing of masks and face shield by the researcher and the

enumerator. Random recruitment in online platforms with the aid of an online expert was

also done by directly messaging the prospective participant and was assessed if qualified

to participate. Consent of their participation on on-line survey was obtained. The

inclusion and exclusion criteria served as the reference in the recruitment of respondents.
 58

Vulnerability Assessment. No vulnerable subjects were included in the study. In

the event that a vulnerable subject was identified from among the respondents, he or she

was automatically excluded from the study

 59

Chapter IV

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter presents analysis and interpretation of gathered data. Results of the survey based on the statement of the problem

are presented hereunder substantiated with literature and studies.

Knowledge Sharing Attributes as Perceived by Healthcare Workers—Perceived Organizational Support

Table 1 presents the data on the knowledge sharing attributes as perceived by healthcare workers in terms of organizational

support.

Table 1

Knowledge Sharing Attributes as Perceived by Healthcare Workers--Perceived Organizational Support

Administration and
Medical Service Nursing Services Ancillary Services Overall
Support Services
(n=50) (n=50) (n=50) (n=200)
(n=50)
Attributes Mean Mean Mean Mean Mean
SD Int SD Int SD Int SD Int SD Int
score score score score score
Perceived
Organizational
support (POS)
1. The organization
values my 1.1 1.1
4.98 SH 5.18 1.27 SH 5.34 H 5.66 1.19 H 5.29 1.20 SH
contribution to 2 5
its well-being.
2. The organization 3.60 1.3 M 2.88 1.51 L 3.05 1.2 L 3.64 1.52 L 3.28 1.43 L
fails to 4 0
 60

appreciate any
extra effort from
me.
3. The organization
would ignore any 1.0 1.1
3.22 L 2.80 1.46 L 2.90 L 3.38 1.38 L 3.08 1.28 L
complaint from 4 5
me.
4. The organization
really cares 0.9 1.1
4.66 SH 4.98 1.29 SH 5.20 SH 5.00 1.58 SH 4.96 1.26 SH
about my well- 8 1
being.
5. Even if I did the
best job possible,
1.2 1.0
the organization 3.38 L 2.90 1.53 L 2.90 L 3.54 1.42 L 3.18 1.34 L
3 7
would fail to
notice.
6. The organization
cares about my
1.1 1.0
general 4.58 SH 4.94 1.27 SH 5.08 SH 4.88 1.55 SH 4.87 1.27 SH
1 7
satisfaction at
work.
7. The organization
1.1 1.0
shows very little 3.36 L 2.96 1.47 L 3.00 L 3.56 1.42 L 3.22 1.32 L
9 9
concern for me.
8. The organization
takes pride in my 0.9 1.0
4.70 SH 4.76 1.35 SH 5.04 SH 4.84 1.53 SH 4.84 1.24 SH
accomplishments 1 7
at work.
Factor mean 0.4 0.2
4.06 M 3.93 0.30 M 4.06 M 4.31 0.32 M 4.09 0.38 M
9 9
 61

Legend: 1.00 – 1.86 is very low; 1.87 – 2.72 is somewhat low; 2.73 – 3.58 is low; 3.59 – 4.44 is moderate; 4.45 – 5.30 is somewhat high; and 5.31 – 6.16 is high;
and 6.17 - 7.00 is very high.

The ancillary services and the administration and support services were high in being valued by the organization in terms of

their contribution to its well-being. However, the medical services and the nursing services were somewhat high only. In terms of the

organization failing to appreciate any extra effort from them, the medical services had a moderate level on this aspect while the rest of

the three services had a low interpretation on the item. As for the organization ignoring any complaint from them, all of the four

groups of services had a low interpretation on this item. On the organization really caring about their well-being, all four groups of

services had a somewhat high interpretation. Further, on the item that even if they did the best job possible, the organization failing to

notice was low for all the four groups of services. As for the organization caring about their general satisfaction at work, all groups

rated it as somewhat high. In terms of the organization showing very little concern for them, it was rated as low for all the groups. And

lastly, on the organization taking pride in their accomplishments at work, it was rated as somewhat high for all the groups. Overall, in

terms of the attribute of perceived organizational support, while all had a similar interpretation of moderate, the administration and

support services scored the highest (4.31) which was followed by both the medical services and the ancillary services (4.06) and lastly

by the nursing services (3.93).

The above results imply that healthcare workers to some degree recognized that the organization value their contribution to the

organization, particularly the administration and support. This further signify that the administration and support predominantly
 62

recognizes that having some degree of recognition of organizational support contributes to positive perception of employees towards

beliefs and attitudes about the organization and its objectives pertaining to knowledge sharing.

The above findings agree with Eisenberger, et. al. (2016) emphasizing that for mutual advantage to both the organization and

employees, it is important for the organization to recognize the value of employees as predominant sources of human capital.

Accordingly, POS is defined as employees’ perception of the organization pertaining to how they are valued, particularly their work

contributions along with the care of the employees’ well-being, wherein both the employees and the organization will be the

advantage. Moreover, Eisenberger, et. al. (2016) additionally revealed that studies also found that employees having with high POS

face less stress at work and perceived to be more inclined to work and they tend to be more creative in the improvement of the

operations. The theory of POS in addition supports that employees view their organization as having a disposition to view them either

favorably or unfavorably as apparent in the treatment the organization provides.

According to Qiang, et. al. (2020), organizational support influences employees’ perception with regards to organizational

atmosphere. During the COVID-19 pandemic, organizational support plays a significant role, particularly on emotional needs,

development of psychological safety, and condensing the negative effects of the pandemic. Conversely, when employees perceive job

support from the organization, an increase in psychological safety reduces the impact of psychosocial stress.

Hass, et. al. (2020) suggests the importance of upholding the well-being of workers at this point, wherein COVID-19 pandemic

has significantly affected them. It is thus essential for the organization to promote workers’ well-being through healthier work design
 63

that eventually leads to four significant and crucial needs, compassion, hope, stability, and trust. It is apparently important that

organization values and extends support to workers during these difficult times.

Knowledge Sharing Attributes as Perceived by Healthcare Workers—Subjective Norms

Table 2 presents the data on the knowledge sharing attributes as perceived by healthcare workers in terms of subjective norms.

Table 2

Knowledge Sharing Attributes as Perceived by Healthcare Workers—Subjective Norms

Administration and
Medical Service Nursing Services Ancillary Services Overall
Support Services
(n=50) (n=50) (n=50) (n=200)
(n=50)
Attributes Mean Mean Mean Mean Mean
SD Int SD Int SD Int SD Int SD Int
score score score score score
Subjective norms
(SN)
1. In the
organization I
work for, leaders
0.8 0.8
expect that 5.56 H 5.76 0.74 H 6.30 VH 5.60 1.73 H 5.81 1.15 H
8 6
collaborators
share knowledge
with each other.
2. With respect to
knowledge
0.8 0.8
sharing, I want 5.24 SH 5.66 0.94 H 6.16 H 5.38 1.61 H 5.61 1.17 H
9 9
to do what
leaders expect.
3. I am motivated 5.45 0.8 H 5.22 0.91 SH 5.92 0.9 H 5.36 1.66 H 5.49 1.16 H
 64

to share my
4 2
knowledge.
4. People who are
important to me
believe that I 0.8 0.8
5.36 H 5.64 0.80 H 6.28 VH 5.90 1.11 H 5.80 0.97 H
should share my 8 6
knowledge with
others.
5. With respect to
knowledge
sharing, I want
0.7 0.8
to do what is 5.58 H 5.60 0.93 H 6.24 VH 5.96 0.90 H 5.85 0.91 H
8 7
expected of me
by important
people.
6. In the
organization I
work for, my
colleagues 0.9 0.8
5.42 H 5.50 0.86 H 6.28 VH 6.16 0.82 H 5.84 0.94 H
expect that I 3 6
share my
knowledge with
them.
7. With respect to
knowledge
sharing, I want 0.9 0.8
5.36 H 5.50 0.86 H 6.20 VH 6.12 0.75 H 5.80 0.93 H
to do what my 4 8
colleagues
expect.
Factor mean 0.6 0.8
5.46 H 5.55 0.81 H 6.20 VH 5.78 1.01 H 5.74 0.88 H
6 2
 65

Legend: 1.00 – 1.86 is very low; 1.87 – 2.72 is somewhat low; 2.73 – 3.58 is low; 3.59 – 4.44 is moderate; 4.45 – 5.30 is somewhat high; and 5.31 – 6.16 is high;
and 6.17 - 7.00 is very high.

In terms of attribute of subjective norms, on the item that in the organization they work for, leaders expect that collaborators

share knowledge with each other, this was rated as very high by the ancillary services while the medical services, nursing services, and

the administration and support services rated it as high. On the item that with respect to knowledge sharing, they want to do what

leaders expect, this was rated as high by the nursing services, ancillary services, and the administration and support services while the

medical services rated it as somewhat high. On being motivated to share their knowledge, this was rated as high except for the nursing

services where it was rated as somewhat high. On the item that people who were important to them believe that they should share their

knowledge with others, this was rated as very high by the ancillary services while the medical services, nursing services, and the

administration and support services rated it as high. Also, on the item that with respect to knowledge sharing, they want to do what is

expected of them by important people, this was rated as very high by the ancillary services while the medical services, nursing

services, and the administration and support services rated it as high. On the item where in the organization they work for, their

colleagues expect that they share their knowledge with them, the ancillary services rated it as very high while all the other three

groups, it was rated as high. In terms of the item that knowledge sharing, they want to do what their colleagues expect, this was again

rated as very high by the ancillary services while the other remaining three groups rated it also as high. Overall, the attribute on
 66

subjective norms was very high for the ancillary services (6.20), while for the other three groups of services, administration and

support services (5.78); the nursing services (5.55); medical services (5.46) were high.

The above findings imply that healthcare workers are highly motivated to share their knowledge in the workplace because of

the people in the organization, especially those in higher position valuing their knowledge sharing contribution and collaboration, thus

they want to share their knowledge to deliver the expectations of other members of the organization, particularly the leaders. Hence, it

further implies that the higher the motivation of healthcare workers from among their colleagues, the higher their intention to share

their knowledge. Moreover, it was evident that among the four groups of healthcare workers, ancillary services manifest the most

appreciation of collaborative activities compared to other groups of healthcare workers. The expectations of leaders with regards to

knowledge sharing are the motivations of nursing services, ancillary services, and the administration and support services, which

further mean that it is important to them to deliver what is expected of them, particularly in knowledge sharing by the leaders of the

groups. However, the ancillary services in general perspective are the most motivated to deliver the expectations of the leaders in

knowledge sharing.

The above results were supported by the Theory of Planned Behavior (TPB) specifying individual’s intention to perform a

given behavior, wherein effort and willingness to perform the behavior are perceived in their intentions. Hence, the behavior of the

respondents toward knowledge sharing and knowledge sharing behavior was grounded from the assumption that the stronger the
 67

intention, attitude, subjective norms, intention to knowledge sharing, and knowledge sharing behavior to engage in behaviour, the

more likely should be its performance (Ajzen, 1991).

In addition, according to Lee and Hong (2014), in a hospital setting, motivation among employees to adopt and continually

place knowledge sharing into practice is important. This was furthermore supported by Nilsen, et. al. (2020) suggesting that clear and

communicated information among staff instigates the chances to achieve success. Sabeeh, et. al. (2017) on the other hand, reflected

that the shared knowledge of medical workers and practitioners has direct impact on the quality of healthcare delivery and services. It

was revealed in a research conducted by Sabeeh, et. al. (2017) that the recognition of knowledge sharing should be taken into account

to achieve organizational success in healthcare organization.

Bavel, et. al. (2020) provides that social norms influence individual’s behavior. However, even though people are affected by

norms, most of the times, their perceptions are inaccurate. The provision of precise information pertaining to, what the majority of

individuals are doing most likely are helpful provided that what these people are doing is desirable. It is significant to note that

perceived norms considered influential when specific to particular individuals with whom common identities are shared. Hence,

messages and information that offers in-group representation for norms are considered effective.

Moreover, teams bids promising accomplishment compared to any individual could attain working alone. Thus, it is essential

to benefit from the variety of skills, abilities, and knowledge that are available. The significance of team work, collaborative planning,

wherein members consider recognize the knowledge of every member facilitate acknowledgement of their own knowledge, of which
 68

such recognition enhances team members’ capability to make use of their knowledge. In addition, establishment of group norms for

critical thinking heads the group towards engagement in a more effective knowledge sharing. Such behavior furthermore leads to a

dynamic eliciting of knowledge and information from other members of the team. Inclusive behaviors likewise encompass

appreciation and constructive responses of members’ contributions (Tamayo & Wooley, 2016).

Knowledge Sharing Attributes as Perceived by Healthcare Workers—Self-efficacy

Table 3 presents the data on the knowledge sharing attributes as perceived by healthcare workers in terms of self-efficacy.

Table 3

Knowledge Sharing Attributes as Perceived by Healthcare Workers—Self Efficacy

Administration and
Medical Service Nursing Services Ancillary Services Overall
Support Services
(n=50) (n=50) (n=50) (n=200)
(n=50)
Attribute Mean Mean Mean Mean Mean
SD Int SD Int SD Int SD Int SD Int
score score score score score
Self-efficacy (SE)
1. I feel that I am
able to share my
0.9
knowledge with 5.04 SH 4.70 1.67 SH 5.20 1.34 SH 5.66 1.06 H 5.15 1.31 SH
0
colleagues who
are very critical.
2. I feel able to 4.92 0.9 SH 2.83 0.95 L 3.66 1.14 M 3.14 1.26 L 3.65 1.33 M
share my 4
knowledge with
people who have
a higher level in
 69

the hierarchy
within the
organization.
3. I feel able to
share my
knowledge with 0.8
4.82 SH 2.16 0.89 SL 2.92 1.16 L 2.62 1.47 SL 3.13 1.51 L
people who are 7
more expert than
I am.
4. I feel able to
share my 1.0
4.80 SH 4.42 1.50 M 4.90 1.28 SH 4.80 1.51 SH 4.73 1.34 SH
knowledge in 1
large groups.
Factor mean 0.8
4.90 SH 3.54 0.98 L 4.17 0.90 M 4.06 0.69 M 4.16 0.98 M
4
Legend: 1.00 – 1.86 is very low; 1.87 – 2.72 is somewhat low; 2.73 – 3.58 is low; 3.59 – 4.44 is moderate; 4.45 – 5.30 is somewhat high; and 5.31 – 6.16 is high;
and 6.17 - 7.00 is very high.

All groups had a somewhat high level on being able to share their knowledge with colleagues who were very critical, except

for the administration and support services where they were high on this aspect. The medical services was somewhat high on being

able to share their knowledge with people who have a higher level in the hierarchy within the organization while the ancillary services

was moderate and both the nursing services and the administration and support group as low. The medical services was somewhat

high on being able to share their knowledge with people who are more expert than them while the ancillary services was low and both

the nursing services and the administration and support group as somewhat low. The three groups of medical services, ancillary

services, and the administration and support services were somewhat high on being able to share their knowledge in large groups
 70

while the nursing services was moderate only. Overall, the medical services scored the highest on the knowledge sharing

attribute on self-efficacy as somewhat high (4.90). They were followed by the ancillary services being moderate (4.17) and the

administration and support services, which were also, moderate (4.06). The nursing services consistently perceived themselves to have

low self-efficacy in all of the attribute statements provided which had them the lowest in overall with an interpretation of low (3.54).

The implication of the results suggests that the healthcare workers are willing to share their knowledge, particularly to their

colleagues whom they identified needed their guidance, especially the administrative and support group. The healthcare workers also

possess confidence and willingness to share their knowledge regardless of the hierarchy, expertise, and the attendees for as long as

they possess the knowledge that is needed to share. The results further explain that medical services group manifested more

knowledge sharing attribute in terms of self-efficacy apparently of their professional knowledge in the field.

The above results were supported by the self-efficacy theory, specifying that self-efficacy can influence the individual

willingness and unwillingness to choose the activities, prepare them to participate, and influence their effort to the performance. It

was evident that the participants of the present research showed willingness in knowledge sharing as attribute in terms of self-efficacy

(Bandura, 1991).

Memba (2018) suggests that self-efficacy reflects confidence in a person’s capability to perform behaviors that entail to

produce specific performance objectives. It also reflects confidence in the ability to exert control over one’s own emotion, behavior,
 71

and also social environment. Apparently, people with pronounced self-efficacy are most likely to possess higher level of commitment,

especially in completing tasks once they were delegated to them.

In a study conducted by Chhajer, et. al. (2018), it was revealed that higher levels of self-efficacy as well as optimism predict

higher levels of cognitive, emotional, and physical engagement. In the same manner that the higher levels of cognitive, emotional,

and physical engagement significantly predict performance.

At this time, wherein pandemic continues to evolve, Abou-Abbas, et. al. (2020) suggest that it is crucial for the medical

specialists to possess adequate knowledge, proficiencies pertaining to the preventive measures, and confidence in diagnosing and

providing of treatment, particularly among COVID-19 patients. Thus, medical doctors play a significant role, especially in sharing of

knowledge. Hence, continued professional education and training are further suggested in order to foster empowerment among

physicians by supporting their ability to acquire, use, and share evidence-based information.

Knowledge Sharing Intention of the Healthcare Workers

Table 4 presents the data on the perceptions of the healthcare workers on the knowledge sharing intention.

Table 4

Knowledge Sharing Intention of the Healthcare Workers

Administration and
Medical Service Nursing Services Ancillary Services Overall
Support Services
(n=50) (n=50) (n=50) (n=200)
(n=50)
 72

Items Mea SD Int Mean SD Int Mean SD Int Mean SD Int Mea SD Int
n score score score n
score score
1. If I had the
chance, I
would share
work
experiences 1.0 0.7
5.54 H 5.66 0.80 H 6.30 0.89 VH 6.06 H 5.89 0.92 H
with my 1 7
colleagues
that could
enrich their
work.
2. If I had the
chance, I
would share
ideas with
1.0 0.7
my 5.60 H 5.66 0.80 H 6.30 0.89 VH 6.08 H 5.91 0.94 H
9 8
colleagues
so that they
could do
better work.
3. If I had the
chance, I
would share
documents
1.0 0.7
with my 5.50 H 5.66 0.80 H 6.24 0.87 VH 6.08 H 5.87 0.92 H
4 8
colleagues
that may be
useful to
them.
 73

4. If I had the
chance, I
would share
specific
knowledge
1.0 0.7
with my 5.44 H 5.66 0.80 H 6.28 0.88 VH 6.08 H 5.87 0.94 H
5 8
colleagues
that I have
learned in
academic
activities.
Grand Mean 0.9 0.7
5.52 H 5.66 0.80 H 6.28 0.87 VH 6.08 H 5.88 0.91 H
9 7
Legend: 1.00 – 1.86 is very low; 1.87 – 2.72 is somewhat low; 2.73 – 3.58 is low; 3.59 – 4.44 is moderate; 4.45 – 5.30 is somewhat high; and 5.31 – 6.16 is high;
and 6.17 - 7.00 is very high.

The ancillary services were very high in terms of knowledge sharing intention, while the rest of the three groups were only

high. The staffs from the ancillary service were very high in terms of wanting to share work experiences with their colleagues that

could enrich their work and wanting to share ideas with their colleagues so that they could do better work. They were also very high in

terms of wanting to share documents with their colleagues that may be useful to them and in wanting to share specific knowledge with

their colleagues that they have learned in academic activities. The three other groups were only high in all aspects where the ancillary

services were very high. Further, based on the cross tabulation, the group that scored the highest is the ancillary services followed by

the administration and support services then by the nursing services with the medical services being the lowest.
 74

The findings imply that healthcare workers showed their positive intention in sharing their knowledge for the interest of

quality performance of the organization, particularly the ancillary services. The ancillary services also showed collaborative intention

towards knowledge sharing above other groups of healthcare workers. Moreover, the ancillary services are perceived to be more open

in terms of their intention to share their knowledge, particularly on what they have obtained academically in order for the group to

effectively perform their function. It was also evident that when opportunity comes, their intention to share knowledge remains.

Thus, although the three other healthcare groups are perceived with high intention on knowledge sharing, it was evident that the

ancillary group manifested very high intention on knowledge sharing. This further explains that different groups face distinct

functionalities and responsibilities affecting their respective intention in knowledge sharing. Medical physicians, for instance may

have their own way of sharing information, of which cannot be shared among other groups because of technical and professional

aspects that require specific expertise. In most cases, the information shared by medical services is about patient care to include

nurses.

Above results, in consideration of different functionalities affecting intention towards knowledge sharing is supported by a

study conducted by Alsaqqa (2020), imparting that hospital setting is composed of various roles along with different skills. However,

all of the expertise is essential in the professional care provided to the patients. Hence, knowledge along with varied approaches is

developed in every department in order to persuade hospital players in various means that shall meet the needs of the patients.

Moreover, the hospital organization is entailed to understand the important factors of the organization, primarily the overall system,
 75

the structure and culture of the organization, in order to successfully facilitate the knowledge sharing activities in consideration of the

responsibilities of each individual or group, of which different functionality provides diverse intention in sharing of knowledge.

Additionally, knowledge management was found a crucial component in forming the knowledge intention among various departments

in healthcare organization.

Furthermore, Danared and Löfgren (2017) also support that healthcare delivery is multifaceted, which involve various units

within the organization organized in accordance to medical skills or area of specializations, of which boundaries are not reflected

within which value is created. The disintegration directs to an insufficient view of the value-creating actions within the process of

care delivery. For these reasons, healthcare organizations bring into alignment along with integration of care process horizontally

such as movement from functional and hierarchical structures heading to more patient-centered processes. Thus, there is likewise a

necessity to establish coordination from different actors in the hospital involved and accountable for the scope of the creation of

knowledge sharing activities.

Considering the intention of ancillary services towards knowledge sharing, Wu and Li (2020) explicate that when employees

possess adequate resources, it is then easier for them to become associated in sharing of knowledge activities. In addition, employees

that are engaged in knowledge sharing obtain further self-affirmation and enhance their interpersonal relationships with their

colleagues.
 76

Most of the ancillary services and functions had resources that were redirected to activities related to COVID-19. The

ancillary services play significant part during the pandemic health emergencies. Thus, knowledge shared is significant. Facing the

challenges of the COVID-19 pandemic, it is a very important time to additionally enhance relationships and alliances between

healthcare organizations and independent care providers and groups in the continuum of care (American Hospital Association, 2020).

Knowledge Sharing Behavior of the Healthcare Workers

Table 5 presents the data on the perceptions of the healthcare workers on the knowledge sharing behavior.

Table 5

Knowledge Sharing Behavior of the Healthcare Workers

Administration and
Medical Service Nursing Services Ancillary Services Overall
Support Services
(n=50) (n=50) (n=50) (n=200)
(n=50)
Items Mean Mean Mean Mean Mean
SD Int SD Int SD Int SD Int SD Inter
score score score score score
1. Nowadays, I
share work
experiences
1.1 1.1 0.8
with my 5.22 SH 5.04 0.97 SH 5.48 H 5.66 H 5.35 1.04 H
5 1 2
colleagues that
could enrich
their work.
2. Nowadays, I 5.20 1.2 SH 5.02 0.98 SH 5.46 1.0 H 5.68 0.8 H 5.34 1.06 H
share ideas 1 9 4
with my
colleagues so
 77

that they can

do better
work.
3. Nowadays, I
share
documents
1.2 1.1 1.0
with my 5.10 SH 4.88 0.92 SH 5.24 SH 5.50 H 5.18 1.12 SH
7 3 9
colleagues that
may be useful
for them.
4. Nowadays, I
share specific
knowledge
with my 1.1 1.0 1.0
5.26 SH 4.94 0.93 SH 5.42 H 5.50 H 5.28 1.07 SH
colleagues that 2 7 9
I have learned
in academic
activities.
Grand mean 1.1 1.0 0.8
5.20 SH 4.97 0.93 SH 5.40 H 5.59 H 5.29 1.02 SH
1 7 8
Legend: 1.00 – 1.86 is very low; 1.87 – 2.72 is somewhat low; 2.73 – 3.58 is low; 3.59 – 4.44 is moderate; 4.45 – 5.30 is somewhat high; and 5.31 – 6.16 is high;
and 6.17 - 7.00 is very high.

Both the medical and nursing services were somewhat high in terms of sharing their work experiences with their colleagues

that could enrich their work; sharing ideas with their colleagues so that they can do better work; sharing documents with their

colleagues that may be useful for them; and sharing specific knowledge with their colleagues that they have learned in academic

activities. Also, both ancillary and administrative and support services were high on of sharing their work experiences with their
 78

colleagues that could enrich their work; sharing ideas with their colleagues so that they can do better work; and sharing specific

knowledge with their colleagues that they have learned in academic activities. However, the ancillary group was somewhat high in

sharing documents with their colleagues that may be useful for them while administrative and support services was high. The

administrative and support services scored the highest followed by the ancillary services, then the medical services and lastly by the

nursing services.
 79

The above results explain that administration and support manifested the higher

motivation to support knowledge sharing because of the nature of their work that requires

them to further disseminate knowledge and information to have the work done as easy

and faster as they could. Most of the administrative and support staff do paper works,

which also include the information technology aspect as their tool. On the other hand,

nursing services have their own process of knowledge sharing, which depends on what

the medical services require and in compliance to the direction provided by the medical

services. This further means that knowledge sharing behavior of nurses is controlled for

the most part by the medical services assisting them on several aspects of health care and

maintenance of the patients. This further suggests that knowledge sharing behavior

among medical and nursing services are equally evident and crucial however, the

differences manifest on the level of knowledge and the gravity of functions and

accountabilities in performance of their duties.

In support, Lee and Hong (2014) emphasized the importance of behavior

of employee, particularly in knowledge sharing as part of innovation, which further

specify that behavior is considered as crucial element in as far as growth and survival of

organizations, especially hospital organizations are concern.

The findings also agree with the literature, specifically on issue of trust, wherein

Harrison (2020) specified that trust allows individuals to have faith or belief to others

without the feeling of being compelled for their own protection with legal provisions at

every aspect. It was furthermore insinuated that in organizational context, trust is even

developed when behavior goes with that of the expectations.

 80

The above results further connect with the importance of the administration and

support, which consist primarily of the IT department that played a crucial role in

addressing the COVID-19 through sharing of information and pertinent data to concern

departments and individuals. The departments have redirected resources in order to meet

the COVID-19 necessities for enhanced tele-health, provisional sites of service, the

needed and on-time submission of reports, and intensifying needs for contact tracing and

testing.

Knowledge Sharing Attributes Predicting Knowledge Sharing Intention

Table 6 presents the data on the prediction of the knowledge sharing intention by

the different knowledge sharing attributes.

Table 6

Knowledge Sharing Attributes Predicting Knowledge Sharing Intention

Knowledge sharing Beta T p value Decision Interpretation
attributes value value
Constant -.073 -.114
Perceived .193 1.371 .172 Failed to reject the Not Significant
organization null hypothesis
support (POS)
Subjective norms .587 8.776 .000 Reject the null Significant
(SN) hypothesis
Self-efficacy (SE) .289 4.813 .000 Reject the null Significant
hypothesis
Note: Knowledge Sharing Intention (dependent variable). R squared value is .593.
Legend: If R-squared value < 0.3 this value is generally considered a None or Very weak effect size, if R-
squared value 0.3 < r < 0.5 this value is generally considered a weak or low effect size,if R-squared value
0.5 < r < 0.7 this value is generally considered a Moderate effect size, and if R-squared value r > 0.7 this
value is generally considered strong effect size,
Significant if p value is < .05.
The table 6 shows that the p values for knowledge sharing attributes predicting

knowledge sharing intention in terms of SN and SE were lesser that .05, showing their

significance and leading to the decision of rejecting the null hypothesis, thus SN and SE
 81

predict knowledge sharing intention. The results furthermore indicate that prediction is

positive since the t values for SN (8.776) and SE (4.813) are also positive. This means

that for one unit increase in the SN, knowledge sharing intention increases by .587. The

same with SE, for every one unit increase in the SE, knowledge sharing information

intention increases by .289 unit. This also means that when SN and SE are increased, the

level of psychological well-being also increases. Further, the POS do not predict

knowledge sharing intention and therefore do not influence it at all. The findings explain

that POS is less likely to affect healthcare workers’ intention towards knowledge sharing.

The POS is perceived important aspect in the implementation of knowledge sharing, of

which in the findings, healthcare workers appreciate the imparted care of the

organization, however based on the results healthcare workers’ intention to contribute

towards the success of knowledge sharing does not significantly affect by the POS but by

the SN and SE. Furthermore, reciprocity and trust needed to be basically established

prior to the intention towards knowledge sharing is generated from among the healthcare

workers. On the other hand, SN and SE are significant of their effects on knowledge

sharing intention. It was shown that healthcare workers are perceived of their willingness

to share their knowledge to their colleagues, extending due importance to those who

predominantly needed to be shared the knowledge with and that they perceived that their

colleagues expect them to share their knowledge and capable in doing so. The SE is also

significant of its effect on knowledge sharing intention because the findings show that

healthcare workers are confident that they are able to share their knowledge regardless of

the hierarchy and number of colleagues. Thus, their intention is evident because they

know they have the capacity in sharing their knowledge for mutual interest of the
 82

organization and the employees. The greater knowledge healthcare workers possess, the

greater intention they present.

Based on the findings, the regression equation derived from the statistical

treatment on regression revealed that:

KSI = -.114 + (.587) SN + (.289) SE

The equation can be explained in such a way that KSI is the sum of the constant

value of -.114 plus .587 of SN plus .289 of SE. Based on the model summary, the r

squared value was .593. This means that the confidence that the variable of SN and SE

predict KSI is moderate. Thus, the prediction model is moderate only despite the

significant prediction or correlation.

The above results agree with the literature suggested by Castaneda and Rios

(2013), of which accordingly that perceived organizational support forms sense of

reciprocity in an employee, particularly in his contribution to the organizational

objectives, of which is also perceived as significant association in the concept of

organizational commitment, quality job performance, as well as less rotation. In addition,

if perceived organizational support tends to produce awareness of reciprocity, hence it

could be anticipated that an employee shares his knowledge. The literature additionally

that varied support of top management could be in different forms which include,

extending help to teams in dealing with hurdles, exhibiting commitment to work, or

motivating the people in the organization (Khan, et. al., 2014)

The Theory of Reasoned Action Ajzen (1985) supports the above results

pertaining to knowledge sharing attributes predicting knowledge sharing intention in

terms of subjective norms. The TRA states that the nearest behavior determinant is
 83

intention, wherein cognitive representation of the disposition of an individual to perform

a behavior is emphasized. Additionally, herein attitude of individuals is defined

predominantly as disposition in responding either favorably or unfavorably to the self,

including others, and the surrounding environment.

The above results further agree on Bock, et. al. (2005) pertaining fundamentally

on the concept of TRA, which pointed out that the individual intention to perform a

certain behavior is influenced by optimistic attitude as well as social norms, of which is

moreover identified as the degree to which an individual perceives how other individuals

support the other individual’s involvement in a particular behavior.

In terms of self-efficacy, the study conducted by Zhang and Ng (2013) revealed

that knowledge sharing is positively influenced by perceptions of knowledge self-

efficacy. The study of Zhang and Ng (2013) likewise emphasized the significance of

information and communication technology (ICT) having significance on individuals’

perceived behavioral control and knowledge sharing.

On theoretical standpoint, Bandura’s extension of TRA, which is the TPB,

supports the above results on knowledge sharing attributes predicting knowledge sharing

intention in terms of self-efficacy, elucidating the intention should be clear as to the need

to recognize the direction of what the individual wants to acquire and reflects to the

individual behavior decided to perform in what ways.

Knowledge Sharing Attributes Predicting Knowledge Sharing Behavior

Table 7 presents the data on the prediction of the knowledge sharing behavior by

the different knowledge sharing attributes.

Table 7
 84

Knowledge Sharing Attributes Predicting Knowledge Sharing Behavior

Knowledge sharing B T p value Decision Interpretation
attributes value value
Constant .349 .697
Perceived .252 2.302 .022 Reject the null Significant
organization hypothesis
support (POS)
Subjective norms .763 14.693 .000 Reject the null Significant
(SN) hypothesis
Self-efficacy (SE) .030 .644 .520 Failed to reject the Not significant
null hypothesis
Note: Knowledge Sharing Behavior (dependent variable). R squared value is .467.
Legend: If R-squared value < 0.3 this value is generally considered a None or Very weak effect size, if R-
squared value 0.3 < r < 0.5 this value is generally considered a weak or low effect size,if R-squared value
0.5 < r < 0.7 this value is generally considered a Moderate effect size, and if R-squared value r > 0.7 this
value is generally considered strong effect size,
Significant if p value is < .05.

The table 7 shows that the p values for knowledge sharing attributes predicting

knowledge sharing behavior in terms of POS and SN were lesser that .05, thus showing

their significance and leads to the decision of rejecting the null hypothesis, hence POS

and SN predict knowledge sharing behavior. The results furthermore indicate that

prediction is positive since the t values for POS (2.302) and SN (14.694) are also

positive. This means that for one unit increase in the POS, knowledge sharing behavior

increases by .252. Also, with SN, which showed that for every one unit increase in the

SN, knowledge sharing behavior increases by .763 unit. This also means that when POS

and SN are increased, the level of psychological well-being also increases. Further, the

SE does not predict knowledge sharing behavior and therefore does not influence it at all.

The findings explain that when POS and SN are perceived, healthcare workers are

evident of their behavior towards knowledge sharing. The reciprocity as shown in the

care of the organization to the healthcare workers along with the acknowledgement of
 85

the efforts imparted by them motivate them to commit and take part on the objectives of

the organization towards knowledge sharing. Thus, with the appreciation of the

organizational support, healthcare workers behavior on knowledge sharing is affected by

POS. On the other hand, SN is evident of its significance because the healthcare workers

willingness to support the knowledge sharing is expected by their colleagues along with

the beliefs of the colleagues on their capacity to share their knowledge. Thus, the

healthcare workers’ behavior to meet the expectations of other members of the

organization, which include the leaders and managers affect their decision and

willingness to take part in knowledge sharing activities. However, SE apparently of no

significance to the knowledge sharing behavior because although confidence and

willingness are manifested by the healthcare workers, the process and limitations of

knowledge sharing should be defined, particularly to whom and how knowledge sharing

should be conducted in parallel of the knowledge that the healthcare workers possess.

Based on the outcomes, the regression equation derived from the statistical

treatment on regression revealed that:

KSB = -.697 + (.252) POS + (.763) SN

The equation can be explained as KSB is the sum of the constant value of -.697

plus .252 of POS plus .763 of SN. Based on the model summary, the r squared value was

.593. This means that the confidence that the variable of POS and SN predict KSB is

moderate. Thus, the prediction model is only moderate despite the significant prediction

or correlation.

The above findings were supported by a literature provided by Huda and Othman

(2014) indicating that organization’s motivation influences individuals to share their

 86

knowledge. There had been identified motivators that influence successful sharing of

knowledge, which include trust and reputation as major motivating factors. The above

findings and literature support therefore justify the importance of organizational support

as motivational factor in the successful implementation of knowledge sharing. The study

also calls for organizational motivation as paramount objective in realizing the

effectiveness of knowledge sharing.

The above results however rejected by Sihombing (2011) stating that no

relationship is found between subjective norms and behavioral intention, which indicates

that respondents’ intention in knowledge sharing was not in association with perceived

social pressure from significant referents. However, Sihombing (2011) deems that this

particular result in her conducted study was inconsistent with previously conducted

studies having TPB as foundation in understanding knowledge sharing behavior. This

clearly indicates that as perceived on the concept and as embedded by the TPB,

knowledge sharing predicts knowledge sharing behavior in terms of subjective norms.

The above findings also reject the literature provided by Olowodunote (2015),

which showed that knowledge behavior is determined by self-efficacy of an individual.

However, it was furthermore stressed that self-efficacy may be enhanced through

engagement in knowledge sharing behavior. It was also explained that the disposition

and response of the employees to matters that concern the organization is perceived as

function of organizational justice as well as of equality from the viewpoint of the

individual employees. It may not be recognized as written policy within the organization,

nevertheless it may be considered as strong determinants of employees’ commitment

towards knowledge sharing behavior.

 87

A literature indicates the importance of enhancing self-efficacy as supported by

organization, particularly in providing motivation for the employees in realization of

knowledge sharing objective. It was moreover substantiated that organizational support

is a significant tool in guiding the employees in building their self-efficacy through

practices that shall encourage such. Accordingly, individuals having a high level of self-

efficacy may be prone and at the same time useful to the organization, particularly in

knowledge sharing, of which in the same way help the individuals to overcome hoarding

of knowledge in a particular organization (Olowodunote, 2015).

Significant Relationship between the Knowledge Sharing Intention and Knowledge

Sharing Behavior

Table 8 presents the data on the relationship of knowledge sharing intention and

knowledge sharing behavior.

Table 8

Significant Relationship between the Knowledge Sharing Intention and Knowledge

Sharing Behavior
Variables
r value p value Decision Interpretation
Knowledge sharing
intention (independent
variable) vs Reject the null
.694 .000 Significant
Knowledge sharing hypothesis
behavior (dependent
variable)
Significant if p value is < .05.
The above findings explicate that the attributes enfolding the intention to share

knowledge are of significance on individuals’ behavior towards sharing of knowledge.

Although intention and behavior, particularly in as far as knowledge sharing is concern

are diverse of their implications and merits, nonetheless they are deemed as equally

important predictors and elements of knowledge sharing. The organizational support is

perceived as predominant factor of motivation towards an employee’s decision to share

 88

knowledge. Hence, as individual is motivated, his/her behavior towards knowledge

sharing is in the same way amplifies. His/her willingness to share knowledge is likewise

when an employee is perceived well geared with appropriate and sufficient knowledge

like, sufficient training, awareness, and innovative facet, his/her behavior towards

knowledge sharing intensifies.

According to Reychav and Weisberg (2014), the intention in sharing explicit

knowledge influences explicit knowledge-sharing behavior to an equal extent both

directly and indirectly. Consequently, Reychav and Weisberg (2014) highlighted that in

any organizational types, a competitive advantage is obtained from individuals having

specific knowledge and the organization’s capability to influence this knowledge to its

benefit. Most importantly, implementation, management, and sustainability of

knowledge sharing systems generate better decision-making concept, more rapidly

turnaround times, augmented organizational communications, along with a higher level

of interaction and collaboration among members of the organization.

Usman and Musa (2016) provide the impact of motivation towards employees’

knowledge sharing behavior. The fact that the organization is also benefited of the

knowledge sharing activities among employees, knowledge sharing also provides the

various forms of knowledge stores within the organization that flow from the employees

to the whole organization department, it is evident that the employees equally share the

advantages that knowledge sharing offers. Thus, increasing the exchange and

communication among the employees will improved the employees’ knowledge and the

rate of productivity of organization. Therefore, the motivation provided by the

organization reflects as crucial factor in the success of knowledge sharing.

 89

In a study conducted by Castaneda, et. al. (2016), it was showed that KSI and

KSB. Accordingly, the said finding was supported by reasoned action theory, pointing

out that the closest determinant of behavior is intention, which is understood as a

cognitive representation of the disposition of an individual to perform a behavior. It was

further explicated that intention is a good predictor of behavior. Having these

explanations, it was illustrated that if a person has the KSI, there is a probability that the

person will share knowledge in practice, as further reported in some studies.

Significant difference on Knowledge Sharing Attributes among Healthcare Workers

– Perceived Organizational Support

Table 9 presents the data on the difference in the knowledge sharing attributes

among health care workers in terms of perceived organizational support.

Table 9

Significant difference on Knowledge Sharing Attributes among Healthcare Workers –

Perceived Organizational Support
Mean F p
square value value
Group mean Decision Interpretation
Medical services Between 1.308 10.194 .000 Reject the null Significant
– 4.06 Groups hypothesis

Nursing services Within .128

– 3.93 Groups
Ancillary
services – 4.06
Administration
and support
services – 4.31
Significant if p value is < .05.
Note: Post Hoc (Tukey): p values: Medical services vs. Nursing service = .230; Medical services vs.
Ancillary services = 1.000; Medical services vs. Administrative and support services = .003; Nursing
services vs. Ancillary services = .239; Nursing services vs. Administrative and support services = .000; and
Ancillary services vs. Administrative and support services = .003.
 90

Based on the post hoc Tukey, the p values for medical services vs. administrative

and support services; nursing services vs. administrative and support services; and

ancillary services vs. administrative and support services were lesser than .05 which was

interpreted as significant which means that the difference in the mean scores was

significant. Basing on the mean scores, the significant difference was seen between the

medical services vs. administrative and support services; nursing services vs.

administrative and support services; and ancillary services vs. administrative and support

services. The medical services were lesser than administrative and support services and

the nursing services was lesser than administrative and support services. Also, the

ancillary services were lesser than administrative and support services. However, p

values for the medical services vs. nursing service; medical services vs. ancillary

services; and nursing services vs. ancillary services were greater than .05 which were

interpreted as not significant, which means that despite the differences in the mean scores

between the groups the differences were not significant.

The above findings further suggest that every group of healthcare workers is

apparent of the differences pertaining to knowledge sharing attributes in terms of POS.

This also implies that their functions and responsibilities call for a particular behavior

they manifest in terms of organizational support, which affect their behaviors as well as

motivation in knowledge sharing. Thus, these group differences along with their specific

functions and accountabilities were found affecting knowledge sharing behavior,

particularly on the POS, particularly in terms of reciprocity, trust, and motivation.

The importance of organizational support towards the knowledge sharing

behavior was elucidated by Ogbonnaya (2018), specifying that the POS is linked with a
 91

quantity of significant outcomes, which include job satisfaction and work engagement.

Nonetheless, the characteristics of these outcomes towards knowledge sharing behavior

may differ on the source of support.

On the other hand, in a study conducted by Muneer, et. al. (2017) showed that

organizational commitment fully mediates the relationships between POS and knowledge

sharing behavior and between organizational trust and knowledge sharing behavior.

Additionally, the study further showed that POS positively correlates with organizational

trust. Apparently, employees of high level of POS are seen more willing to stay with that

particular organization as well as on the particular job responsibilities they are assigned,

of which performance is satisfactorily.

Significant difference on Knowledge Sharing Attributes among Healthcare Workers

– Subjective Norms

Table 10 presents the data on the difference in the knowledge sharing attributes

among health care workers in terms of subjective norms.

Table 10

Significant difference on Knowledge Sharing Attributes among Healthcare Workers –

Subjective Norms
Mean F p
square value value
Group mean Decision Interpretation
Medical services Between 5.720
– 5.43 Groups Reject the null Significant
8.184 .000 hypothesis

Nursing services Within .699

– 5.55 Groups
Ancillary
services – 6.20
Administration
and support
services – 5.78
 92

Significant if p value is < .05.

Note: Post Hoc (Tukey): p values: Medical services vs. Nursing service = .872; Medical services vs.
Ancillary services = .000; Medical services vs. Administrative and support services = .148; Nursing
services vs. Ancillary services = .001; Nursing services vs. Administrative and support services = .521; and
Ancillary services vs. Administrative and support services = .066.

Based on the post hoc Tukey, the p values for medical services vs. ancillary

services and the nursing services vs. ancillary services were lesser than .05 which was

interpreted as significant which means that the difference in the mean scores was

significant. Basing on the mean scores, the significant difference was seen between the

medical services vs. ancillary services and the nursing services vs. ancillary services. The

medical services were lesser than ancillary services and the nursing services were lesser

than the ancillary services. However, p values for the medical services vs. nursing

service; medical services vs. administrative and support services; nursing services vs.

administrative and support services; and ancillary services vs. administrative and support

services were greater than .05 which were interpreted as not significant, which means that

despite the differences in the mean scores between the groups the differences were not

significant.

The above results imply that each group of healthcare workers has varied

differences among any other groups of healthcare workers. However, the differences

have no effect in terms of subjective norms attributes in knowledge sharing. The

differences on the level of technical knowledge, level of accountabilities, innovative

skills, and number of years in the field of specialization are factors affecting the behavior

on knowledge sharing among the four groups of healthcare workers.

Lee and Hong (2014) revealed that individual factors, which include subjective

norms significantly, influenced knowledge sharing behavior. The increase in the level of

education, position, as well as work experience the innovative behavior tends to be higher
 93

as well. It was further showed that the pressure to share knowledge coming from

significant people in the organization affects workers' behavior. In this particular

research, SN was the best predictor of KSB in leaders and collaborators.

Significant Difference on Knowledge Sharing Attributes among Healthcare

Workers – Self-efficacy

Table 11 presents the data on the difference in the knowledge sharing attributes

among health care workers in terms of self-efficacy.

Table 11

Significant difference on Knowledge Sharing Attributes among Healthcare Workers –

Self-efficacy
Mean F p
Group mean square value value Decision Interpretation
Medical services Between 15.699
– 4.90 Groups Reject the null Significant
21.260 .000 hypothesis

Nursing services Within .738

– 3.54 Groups
Ancillary
services – 4.17
Administration
and support
services – 4.06
Significant if p value is < .05.
Note: Post Hoc (Tukey): p values: Medical services vs. Nursing service = .000; Medical services vs.
Ancillary services = .000; Medical services vs. Administrative and support services = .000; Nursing
services vs. Ancillary services = .002; Nursing services vs. Administrative and support services = .015; and
Ancillary services vs. Administrative and support services = .909.

Based on the post hoc Tukey, the p values for medical services vs. nursing

services; medical services vs. ancillary services; medical services vs. administrative and

support services; nursing services vs. ancillary services; and nursing services vs.

administrative and support services were lesser than .05 which was interpreted as

significant which means that the difference in the mean scores was significant. Basing on
 94

the mean scores the significant difference was seen between the medical services vs.

nursing services; medical services vs. ancillary services; medical services vs.

administrative and support services; nursing services vs. ancillary services; and nursing

services vs. administrative and support services. The medical services were greater than

the nursing services and the medical services were greater than ancillary services.

Further, the medical services were greater than administrative and support services.

Furthermore, the nursing services were lesser than ancillary services. However, p values

for the ancillary services vs. administrative and support services was greater than .05

which was interpreted as not significant, which means that despite the differences in the

mean scores between the groups the difference was not significant.

Above findings imply that despite the importance of self-efficacy different groups

are perceived of their distinct attribute in terms of self-efficacy towards knowledge

sharing. Nevertheless, these differences do not affect each group’s behavior towards

knowledge sharing. Considering further that each group focus on their specific functions

and responsibilities that are diverse to other groups of healthcare workers.

Moreover, Castaneda (2015) provides that efficacy beliefs influence individual

persons’ focus on opportunities along with impediments in the perspective. Evidently,

individuals having high self-efficacy focus on opportunities, thus minimizing the value of

obstacles.

Significant Difference on Knowledge Sharing Intention among Healthcare Workers

Table 12 presents the data on the difference in the knowledge sharing intention

among health care workers.

Table 12
 95

Significant Difference on Knowledge Sharing Intention among Healthcare Workers

Mean F p
square value value
Group mean Decision Interpretation
Medical services Between
– 5.52 Groups 6.266 Reject the null Significant
8.342 .000 hypothesis

Nursing services Within

.744
– 5.66 Groups
Ancillary
services – 6.28
Administration
and support
services – 6.08
Significant if p value is < .05.
Note: Post Hoc (Tukey): p values: Medical services vs. Nursing service = .849; Medical services vs.
Ancillary services = .000; Medical services vs. Administrative and support services = .008; Nursing
services vs. Ancillary services = .002; Nursing services vs. Administrative and support services = .079; and
Ancillary services vs. Administrative and support services = .635.

Based on the post hoc Tukey – the p values for medical services vs. ancillary

services; medical services vs. administrative and support services; and nursing services

vs. ancillary services were lesser than .05 which was interpreted as significant which

means that the difference in the mean scores was significant. Basing on the mean scores

the significant difference was seen between the medical services vs. ancillary services;

medical services vs. administrative and support services; and nursing services vs.

ancillary services. The medical services were lesser than ancillary services. Further, the

medical services were lesser than administrative and support services. Furthermore, the

nursing services were lesser than ancillary services. However, p values for medical

services vs. nursing services; nursing services vs. administrative and support services and

the ancillary services vs. administrative and support services were greater than .05 which

were interpreted as not significant, which means that despite the differences in the mean

scores between the groups the differences were not significant.

 96

The above results showed the apparent difference on knowledge sharing intention

between healthcare workers. Nonetheless, these differences do not affect their intention

towards knowledge sharing. Thus, the difference with regards to intention focuses on a

particular group considering further of the difference functions and responsibilities.

The above results were supported by Lee and Hong (2015), which elucidate that

the reasons of the hospital organizations consisting of medical professionals have

differing functions as well as skills and proficiencies. This means that diverse groups or

departments in the hospital organization entail to attain new knowledge along with the

needed strategies and systems in order to persuade workers in various approaches.

Hospital organizations possess a vast of information, skills, knowledge as well as

complex aspects of decision-making, processes, and networks.

Significant difference on Knowledge Sharing Behavior among Healthcare Workers

Table 13 presents the data on the difference in the knowledge sharing behaviors

among health care workers.

Table 13

Significant difference on Knowledge Sharing Behavior among Healthcare Workers

Mean F p
square value value
Group mean Decision Interpretation
Medical services Between 3.509
– 5.20 Groups Reject the null Significant
3.481 .000 hypothesis

Nursing services Within 1.008

– 4.97 Groups
Ancillary
services – 5.40
Administration
and support
services – 5.59
 97

Significant if p value is < .05.

Note: Post Hoc (Tukey): p values: Medical services vs. Nursing service = .677; Medical services vs.
Ancillary services = .737; Medical services vs. Administrative and support services = .214; Nursing
services vs. Ancillary services = .144; Nursing services vs. Administrative and support services = .013; and
Ancillary services vs. Administrative and support services = .793.

Based on the post hoc Tukey – the p value for nursing services vs. administrative

and support services was lesser than .05 which was interpreted as significant which

means that the difference in the mean scores was significant. Basing on the mean scores

the significant difference was seen between the nursing services and the administrative

and support services. The nursing services were lesser than the administrative and

support services. However, p values for medical services vs. nursing service; medical

services vs. ancillary services; medical services vs. administrative and support services;

nursing services vs. ancillary services; and ancillary services vs. administrative and

support services were greater than .05 which were interpreted as not significant, which

means that despite the differences in the mean scores among the groups the difference

were not significant.

The above findings explain the difference with regards to knowledge sharing

behavior among four groups of healthcare. It was evident that the four groups of

healthcare workers are different in terms of their behavior in knowledge sharing. This

further implies that their responsibilities and motivational factors affect their knowledge

sharing behavior. However, collaboration with other groups of healthcare workers is

necessary in order to attain success in knowledge sharing.

The above outcomes were supported by Appel-Meulenbroek, et. al. (2017),

specifying the importance of interaction between members of the organization, of which

commitment towards knowledge sharing is important. Furthermore, in the interactions,

right people are of parallel importance to optimize the tacit knowledge sharing. On the
 98

concept of behavioral element of knowledge sharing process, collaboration, coordination,

and interaction are crucial components.

In a study conducted by Asemahagn (2014), it was revealed that a majority of

healthcare workers express willingness to share their knowledge and experiences to their

colleagues. The determinants of the knowledge sharing behavior of healthcare workers

include knowledge, motivation, support of the leaders, job satisfaction, awareness, and

allocation of resource.

Generalization

The POS positively influences KSI and KSB. This further means that combined

beliefs of the four groups of healthcare workers about knowledge sharing, influence

knowledge sharing intention as well as knowledge sharing behavior. The POS include

the appreciation of employees’ contribution and extra efforts and the organizations care

of employees’ wellbeing. The employees’ job satisfaction also contributes to their

knowledge sharing behavior and knowledge sharing intention.

On the other hand, the SN positively influences the KSI and KSB. The behavior

is apparently guided by individual beliefs about the normative expectations of people

who are important to individual as well as the motivation he has to perform. The SN

when it comes to organizational level was also found influencing the knowledge sharing

intention. These SN attributes that influence KSI and KSB among the four groups of

healthcare workers include, the expectation of leaders pertaining to collaborations and

knowledge sharing, wherein the four groups of healthcare workers intend to meet the

expectations of the leaders, which further means that the four groups of healthcare

workers are motivated to share their knowledge. Moreover, the four groups of healthcare
 99

workers intention to share knowledge also because of the important people believing that

they should share their knowledge to others and they want to perform what is expected of

them. Their colleagues are also important for the four groups of healthcare workers, of

which their behavior and intention in knowledge sharing were influenced by them.

The KSI and KSB although of different views in knowledge sharing, nonetheless

both positively influence knowledge sharing. The TRA explains the cognitive decision

making, which aims to clarify human behavior resulting from rational psychological

processes. TRA further assumes a person’s logical and rational choice to either perform

or not to perform a certain act. On the other hand, TRA views the choice as a function of

the individual’s attitude pertaining to that action as well as his perception of social norms

or sense of social support for a particular behavior. In the foregoing results, the four

groups of healthcare workers are positively influenced KSI and KSB in sharing their

knowledge among their colleagues and for the benefit of the organization.

The significant difference on KS attributes among the four groups of healthcare

workers in terms of POS shows that each and every group has significant differences

when compared with other groups, particularly on the perceptions and degree in terms of

the POS. However, despite the differences among the four groups of healthcare workers

in this aspect, their differences are not significant on knowledge sharing.

Moreover, difference on KS attribute among the four groups of healthcare

workers in terms of SN indicates significant differences, particularly on the perceptions

and degree in terms of the SN. However, these differences among the four groups of

healthcare workers pertaining to KS attribute, particularly on SN, their differences are not

significant on KS.
 100

Finally, the difference on KS attribute in terms of SE among the four groups of

healthcare workers reveals significant differences, particularly on the perceptions and

degree in terms of the SE. However, these differences among the four groups of

healthcare workers pertaining to KS attribute, particularly on SE, their differences are not

significant on KS.

Definition of Terms

Perceived Organizational Support (POS) is the overall level of employees’ belief

of the value that the organization recognizes, particularly on the contribution of the

employees to the organization, and that the organization shows cares about the

employees’ wellbeing in return.

Subjective Norms (SN) pertains to the perceived expectations from others

influencing a user to perform a specific behavior. It is also the level to which an

individual perception that most people who are important to him think that he should

perform or not perform a particular behavior.

Self-Efficacy (SE) is a person’s belief pertaining to his capacity to perform

behaviors that are essential to produce particular performance attainments. It is also a

reflection of confidence in the ability to exert control over one’s own motivation,

behavior, as well as the social environment.

Knowledge Sharing Intention (KSI) refers to the amount of favor that a person

has for knowledge sharing.

Knowledge Sharing Behavior (KSB) pertains to a set of individual behaviors,

which involve sharing one’s work-related knowledge and expertise with other members

of the organization. It is also a cognitive behavioral process, which involve individuals.

 101

Medical Services are those rendering healthcare-related service, which include

internal medicine, cardiology, emergency medicine, family practice, nephrology,

neurology, pediatrics, pulmonary medicine, orthodontics, and psycho analysis.

Nursing Services are integral part of the healthcare system, which include

promotion of health, prevention of illness, and care of physically ill, mentally ill, and

disabled people of all ages, and in all healthcare and community settings.

Administration and Support is responsible for organizing as well as overseeing

the health services along with daily routines and activities of a hospital or healthcare

facility.

Ancillary Services are medical services or supplies that are not provided by acute

care hospitals, doctors, or healthcare professionals.

Assumptions

The following assumptions were raised:

In terms of POS as KS attribute perceived by the four groups of healthcare

workers, the administration and support perceived that POS is significant to KS.

The KS in terms of SN attribute, ancillary services perceived that SN is

significant to KS.

In terms of SE as KS attribute, the medical services perceived that SE is

significant to KS.

Among the four groups of healthcare workers, the ancillary services are perceived

of highest KSI.

Among the four groups of healthcare workers, the administration and support are

perceived of highest KSB.

 102

There is significant difference on KS attributes in terms of POS among four

groups of healthcare workers.

There is significant difference on KS attributes in terms of SN among four groups

of healthcare workers.

There is significant difference on KS attributes in terms of SE among four groups

of healthcare workers.

Knowledge sharing intention and knowledge sharing behavior influence

knowledge sharing among the four groups of healthcare workers.

Discussion

In terms of POS as attribute to KS, the administration and support among the four

groups of healthcare workers perceived primarily that POS is significant to KS because it

is apparent that most of their responsibilities and functions are directly linked to the

hospital administrative tasks. Thus, the motivation and appreciation of their

contributions and efforts are predominantly recognized by the administration and support.

Eisenberger, et. al. (2016) provide that POS is soundly steered by leadership,

constructive Human Resource practices, work environment that is desirable, and fair

treatment. Castaneda and Rios (2013) additionally suggest that POS supports the

construction of reciprocity in an employee, most specifically in his contribution to the

organizational objectives, wherein significant relationship in the concept of

organizational commitment was also perceived, along with quality of work. Accordingly,

whenever POS tends to produce awareness of reciprocity, it could probably be

predictable that an employee would be sharing his knowledge.

 103

The SN in terms of KS attribute showed that ancillary services perceived that SN

is significant to KS. This result was raised given that ancillary services are more concern

of the expectations of other groups of healthcare workers because their functions are

pertaining to the provision of supplies and other pertinent needs of the hospitals,

especially the physicians and healthcare professionals. Therefore, their efficiency to

perform the function motivates them to further coordinate among the members of the

group given further, that other groups of healthcare workers anticipate of their

contribution to the process of rendering services to the patients.

The notion how a person wants people to behave is likely diverse for different

group of people. Thus, the motives to submit what is normal for a specific group will

most likely be the strongest. The aggregation of the beliefs therefore is the normal

expectation and the desire to comply turns out to be as the subjective norm. Accordingly,

to create the needed and appropriate subjective norms rests in the hands of leaders

(Change Factory, 2020).

In terms of SE as KS attribute, it is apparent that the medical services perceived

the significance of SE to KS. Considering that the crucial accountabilities of medical

services, they value the significance of SE towards knowledge sharing.

The reproduction of expertise is an important element that is for the most part

dependent on the self-efficacy and job tenure of the workers. Moreover, self-efficacy is

about an employee’s judgment of his/her capability to organize and execute a certain

course of action (Olowodunoye, 2015).

Memba (2018) provides that people having pronounced self-efficacy are most

likely to possess higher level of commitment, significantly in the completion and

 104

realization of tasks delegated to them. Moreover, it was shown that concept of self-

efficacy provides guidance in shedding light to people searching and trying new

experiences in a more philosophical manner. Self-efficacy is also believed as an

approach in organizing groups and teams that provides managers of individual employees

a framework in the establishment of standards of behavior as well as success in

organizations. Thus, those employees with have high level of self-efficacy are perceived

to be more involved in activities as compared to those having low self-efficacy

(Olowodunoye, 2015).

The ancillary services are perceived of highest KSI among the four groups of

healthcare workers. This is because the functions of ancillary services providing support

to other groups of healthcare workers require them to be more concern on the

expectations of other groups of healthcare worker.

Cherry (2020) states that reciprocity is described as a process that focuses towards

mutual benefits through exchanging of things with other people. The rule of reciprocity

is regarding social norm, wherein, if someone does some favor to you, you are in the

same manner obliged to return the good gesture. Reciprocity also takes a vital role,

especially in persuading others to adopt a particular belief or behaviors. Types of

reciprocity comprise of generalized, balanced, as well as negative. Taking a closer look

to reciprocity norm, many cases will actually signify the good return of reciprocity; as it

guides individuals to engage and commit in social give and take process.

The administration and support are perceived of highest KSB among the four

groups of healthcare workers. This is because the functions of the administration and

support require them to acquire work-related knowledge and expertise pertaining to the
 105

administrative tasks and IT concerns that connect to other groups of healthcare workers,

of which knowledge sharing is essential.

Knowledge sharing behavior was also believed significantly related to various

antecedents of knowledge sharing. This indicates that identifying responsibilities and

functions of every department and each individual employee would generate more

employee involvement and tacit knowledge sharing rather than steering on group’s

structure (Appel-Meulenbroek, et. al., 2018).

There is significant difference on KS attributes in terms of POS among four

groups of healthcare workers. This is because every group has different functionalities

and perception towards the support of the organization and knowledge sharing, of which

trust and confidence are significant factors.

Huda and Othman (2014) elucidate that organization’s motivation influences

employees’ sharing of knowledge. Trust and reputation on the other hand were also

identified motivators that influence successful sharing of knowledge. Thus, the

importance of organizational support as motivational factors justifies the success of the

employment and implementation of knowledge sharing.

There is significant difference on KS attributes in terms of SN among four groups

of healthcare workers. This is in consideration of every group’s different responsibility

and perception, of which the groups of healthcare workers are concern of the expectations

of other groups.

Punniyamoorthy and Asumptha (2019) suggest the different functions of each

group, of which the significance of the SN to the attitude path emphasizing what the

members of the group feel with regards to knowledge sharing as a result of social
 106

pressure, which furthermore indicates the causal path created from SN to perceived

behavioral control revealing that behavior in knowledge sharing depends on the

individual feelings pertaining to how others viewed them.

There is significant difference on KS attributes in terms of SE among four groups

of healthcare workers. This is because every group has different functionalities and

perception towards the importance of cognitive and experience in knowledge sharing.

However, the medical services are found to possess the higher level of self-efficacy in

hospital setting.

According to Olowodunoye (2015), those employees with have high level of self-

efficacy are perceived to be more involved in activities as compared to those having low

self-efficacy. In essence, knowledge sharing behavior may be determined by self-

efficacy of individual employee, in the same manner as self-efficacy may be developed

through engaging in knowledge sharing behavior.

Knowledge sharing intention and knowledge sharing behavior influence

knowledge sharing among the four groups of healthcare workers. This influence is

resulting from the knowledge and experiences that made the decision and motivation

towards knowledge sharing.

Punniyamoorthy and Asumptha (2019) suggest that the behavior over knowledge

sharing is established in which an owner of knowledge actually shares their knowledge

with other members of their organization, while intention studies an employee’s

willingness to connect with knowledge sharing. It was furthermore emphasized that both

human and technical perspectives are of equal importance to knowledge sharing.

 107

The knowledge management framework illustrates POS as KS attribute perceived

by the four groups of healthcare workers, of which the administration and support among

the groups has the highest perceived KS attribute in terms of POS. On the other hand, the

KS in terms of SN attribute perceived by the four groups of healthcare workers showed

that ancillary services got the highest perception KS in terms of SN. Moreover, the

medical services among the four groups of healthcare workers should higher perception

in terms KS in terms of SE. In terms of KSI, the ancillary services are perceived of

highest intention among the four groups of healthcare workers. On the other hand, the

administration and support are perceived of highest KSB among the four groups of

healthcare workers. Furthermore, significant difference on KS attributes in terms of POS

among four groups of healthcare workers is shown. There is also significant difference

on KS attributes in terms of SN among four groups of healthcare workers. There is

significant difference on KS attributes in terms of SE among four groups of healthcare

workers. Knowledge sharing intention and knowledge sharing behavior influence

knowledge sharing among the four groups of healthcare workers.

KNOWLEDGE MANAGEMENT FRAMEWORK

 108

Perceived Organizational Support Medical < Admin and Support

Nursing < Admin and Support
Ancillary < Admin and Support

Medical < Ancillary Knowledge Knowledge Nursing < Admin and Support
Medical < Admin and
Support Sharing Sharing
Nursing < Ancillary
Intention Behavior

Medical < Ancillary Subjective Norms

Nursing<Ancillary

Self-efficacy Medical >Nursing

Medical > Ancillary
Medical >Admin and Support
Nursing< Admin and Support
 109

KNOWLEDGE SHARING ENHANCEMENT PLAN

Rationale
Knowledge sharing in an organization, predominantly connotes passing of what

the employees know on to other members of the organization, of which those employees

become assets that everyone can draw from, into collective knowledge that every single

employee can apply to their specific role in the organization. Proper management of

knowledge sharing on the other hand is of parallel magnitude, especially in realization of

shared objectives. Knowledge sharing is also recognized of its association with decision

making abilities, building of learning process, and also in the establishment of cultural

change as well as innovation, of which is considered inevitable, particularly in an

organization. Nevertheless, findings of the present study entail identification of

appropriate management of knowledge sharing, which include establishment of

procedures, proper channelling and communication, along with the necessary training and

further education about knowledge sharing. Having those significant perspectives, the

following plan is proposed.

General Objectives

The foregoing knowledge sharing enhancement plan is conceptualized to enhance

the system and management of knowledge sharing. Furthermore, the knowledge sharing

enhancement plan is endeavoured to instil the beneficial outcome of sustainable

employment and practice of knowledge sharing in an organizational environment aligned

with the organization goals.

 110

Specific Objectives

The following specific objectives of the knowledge sharing plan are presented

with an effort to realize the significance of knowledge sharing in meeting the

organizational goals:

1. To build awareness among members of the organization of the significance of

knowledge sharing in the achievement of organizational objectives.

2. To motivate members of the organization and acknowledge that their

collaboration and contribution are imperative.

3. To convey support of the organization in building knowledge sharing procedures

and systematic approaches.

4. To systematically position every member of the organization to where their

crucial roles are necessary along with the knowledge sharing processes.

5. To identify from among the members of the organization need to gather and

transfer knowledge.

6. To develop learning approaches through conceptualization of appropriate training

needs.

7. To create records management to monitor the progress of the knowledge sharing

system.

8. To measure and conduct evaluation of the plan for continual improvement.

111
 112

PARTICULAR OBJECTIVES ACTIVITIES PERSONNEL RESOURCES TARGET SUCCESS

AREAS OF ASSIGNED DATES INDICATION
CONCERN
Perceived  To motivate  Allocate a specific Administration Php 10,000.00 Upon approval of  The healthcare
Organizational every member area where meetings Department or the plan. workers are
Support (POS) of the and conversations can Human Resource more aware of
organization of be undertaken. Department the new
the  Make a positive and environment
organizational conducive and sensible of
support atmosphere in the the effort of the
meeting room. organization/
 Provide a space for management.
coffee, aside from the  A developed
pantry. system that
provides
support and
recognition of
efforts among
healthcare
personnel.

 To recognize the  Recognize knowledge Human Resource Php 5,000.00, 3 months  Established
efforts of the sharing efforts Department printer subsequent sense of
employees in through writing approval of the recognition.
knowledge names of employees plan and  Established
sharing on the bulletin board quarterly systematic
collaboration. or disseminate thereafter. criteria on
information on emails awards and
and social media recognitions.
accounts or website
of the organization.
 Award a certificate of
recognition for
continuous
collaboration on
knowledge sharing.
 113

 Provide annual Human Resource Php Yearly

monetary rewards to Department 5,000/employee
exemplary
contribution to
knowledge sharing.

Subjective Norms  To inculcate  Conduct leadership Human Resource Php 30,000.00, 2 months  Certificate of
the importance and mentoring Department laptop, projector, subsequent attendance and
of leadership training/seminar. (Training & sound system, approval of the participation on
and  Evaluate the seminars Development) printer plan. the seminars.
subordination to analyse their  Developed
in the effectiveness. personal and
achievement of professional
knowledge skills.
sharing.

 To promote  Promote various Human Resource Php 20,000.00 3 months  Improved open
knowledge forms of knowledge Department along subsequent communication
sharing sharing like: allocate with the approval of the  Established
collaboration. time for face-to-face Department plan. awareness of
 To enhance collaboration; Heads/Managers. functions and
awareness on schedule off-site knowledge
functions and events and meetings. sharing
process of associations
knowledge  Conduct annual Top Management, Php 50,000.00, December with specific
sharing. conference to gather Human Resource laptop, projector, persons and/or
 To enhance and promote Department, along printer departments.
knowledge knowledge sharing. with the  Developed new
sharing Department ideas and
content. Heads/Managers. contents.
 Certificate of
participation
 Established
continual
improvement
of Knowledge
 114

Sharing.
Self-Efficacy  To further  Evaluate the need for Human Resource Php 5,00.00 Upon approval of  Enhanced
enhance training relative to Department, along the plan. knowledge on
knowledge on knowledge sharing. with the specific
specific  Identify specific areas Department function and
function and of concern and Heads/Managers. field of
field of formulate process of specialization.
specialization. knowledge  Preparedness
 To prepare sharing/transfer on innovation
members of the  Conceptualize and
organization training needs transformation.
for the plan/program.  Developed
imminent  Evaluate every confidence on
innovative training/seminar to knowledge
transformation. assess their sharing.
 To develop effectiveness and  Enhanced
confidence propose further professional
among improvement. effectiveness.
members of the
organization.

Medical services  To identify the  Create a system that Human Resource Php 5,000.00 Upon approval of  Improved
on knowledge knowledge shall identify the Department, along the plan. system and
sharing sharing process process of knowledge with the process of
among medical sharing: obtain Department Heads. communication
services group. consensus from and sharing of
medical practitioners knowledge.
through setting up  Well rounded
meetings. collaborative
system among
medical
practitioners.

Nurses on  To identify the  Create a system that Human Resource Php 5,000.00 Upon approval of  Improved
knowledge sharing knowledge shall identify the Department, along the plan. system and
sharing process process of knowledge with the Nursing process of
 115

among nurses. sharing: obtain Heads. communication

consensus from and sharing of
nurses through knowledge.
meetings. Formulate  Improved
a system to identify system of
from whom communication
knowledge should be and
obtained and collaborative
transferred. activities on
knowledge
sharing.
Admin and  To identify the  Create a system that Human Resource Php 5,000.00 Upon approval of  Improved
support services specific shall identify the Department, along the plan. system and
on knowledge knowledge process of knowledge with the process of
sharing sharing process sharing, which Heads/Managers. communication
among admin include the and sharing of
and support communication knowledge.
staff. process, the role of
IT, process of
procurement, and
other important
aspect of support.

Ancillary services  To identify the  Create a system that Human Resource Php 5,000.00 Upon approval of  Improved
on knowledge specific shall identify the Department, along the plan. system and
sharing knowledge process of knowledge with the process of
sharing process sharing among Heads/Managers. communication
among ancillary personnel. and sharing of
ancillary Formulate a system to knowledge.
personnel. identify from whom
knowledge should be
obtained and
transferred.
 116

Maria Divina M. Joriza Dr. Resty L. Picardo, DM, JD, MAN, DPE

Researcher Research Adviser

 117

CHAPTER V
SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

This chapter presents the research summary of findings, along with the

conclusions, and recommendations.

Summary of Findings:

The summary of findings were revealed as results of the prediction were also

discovered in the analysis of the study.

As for the knowledge sharing attributes, the perceived organizational support was

moderate, the subjective norm was high, and the SE was moderate. The knowledge

sharing intention of the respondents on the other hand was high. Consequently, the

knowledge sharing behavior of the respondents was somewhat high.

Both the SN and SE showed their significance to KSI, thus SN and SE predict

KSI. The SN and SE resulted to a positive influence, illustrating that for one unit

increase in the SN, knowledge sharing intention increases. On the other hand, POS does

not influence KSI. The confidence that the variables of SN and SE predict KSI was

moderate.

Moreover, POS and SN predict knowledge sharing behavior. It further illustrates

that for one unit increase in the POS, knowledge sharing behavior increases. With

regards to SN, for every one unit increase in the SN, knowledge sharing behavior

increases, which means that when POS and SN are increased, the level of intention also

increases. Further, the SE does not influence knowledge sharing behavior and therefore

does not influence KB at all.

 118

The findings conversely showed the positive significant relationship between KSI

and KSB.

There was a varying difference among the four groups in the POS, which further

differed between knowledge sharing attributes in terms of POS among healthcare

workers, of which Administration and Support got the highest score. On the other hand,

there was a varying difference among the four groups in the SN, of which Ancillary

Services got the highest score. There were varying differences between knowledge

sharing intention among the four groups of healthcare workers in terms of SE, of which

Medical Services got the highest score.

There was a varying difference in the knowledge sharing intention among the four

groups of healthcare workers with the Administration and Support services being the

highest. There was a varying difference between knowledge sharing behavior among

healthcare workers. Moreover, there was a varying difference among the four groups in

the KSI.

Conclusion

To conclude, the SN and SE were found positively influenced KSI, showing that

for one unit increase in the SN, knowledge sharing intention increases. For every one

unit increase in SE, knowledge sharing information intention increases. Therefore, when

SN and SE are increased, the level of intention also increases. POS was not perceived of

its influenced to knowledge sharing intention, thus POS do not influence KSI at all. The

confidence that the variables of SN and SE predict KSI was moderate. Therefore, the

prediction model is only moderate regardless of the varying influence.

 119

POS and SN showed significance in terms of knowledge sharing attributes

predicting knowledge sharing behavior. Furthermore, influence is positive. Therefore,

for one unit increase in the POS, knowledge sharing behavior increases. With regards to

SE, for every one unit increase in the SN, knowledge sharing behavior increases, which

means that when POS and SN are increased, the level of intention also increases. The SN

does not influence knowledge sharing behavior and therefore does not influence KB at

all. The confidence that the variables of POS and SN influence KSB is moderate.

Hence, the prediction model is only moderate despite the varying difference.

Relationship between KSI and KSB was also shown positive.

There was significant difference between knowledge sharing attributes in terms of

POS among the four groups of healthcare workers, of which Administration and Support

got the highest score. There was also a varying difference among the four groups in the

SN attributes among healthcare workers, of which Ancillary Services got the highest

score. There was a varying difference among the four groups of healthcare workers in

terms of SE, of which Medical Services got the highest score.

There was a varying difference between knowledge sharing intention among

healthcare workers. There was also a varying difference between knowledge sharing

intention among the four groups of healthcare workers. There was also a varying

difference between knowledge sharing behavior among the four groups of healthcare

workers. Moreover, there was varying difference among the four groups of healthcare

workers in the KSI and KSB.

The output model exhibited that a positive effect on knowledge sharing behavior

was perceived through attitude toward KS and subjective norms The findings indicated
 120

that the that the stronger the intention, attitude, subjective norms, intention to knowledge

sharing, and knowledge sharing behavior to engage in behavior, the more likely should

be its performance were shown in the foregoing results.

Recommendations

Based on the findings, the following recommendations are provided:

1. Findings of the present paper will be presented to different hospitals in the City of

Ormoc in order for them to assess their own organization and consider the present

study as basis in the enhancement or employment of knowledge sharing.

2. The researcher also deems that medical field is not the only area that will be

benefitted of the present research on knowledge sharing, hence, this paper will be

shared to anyone that finds this study significant.

3. This paper will also be shared to the Department of Health that they may consider

reviewing the existing knowledge sharing procedures, especially for public

hospitals and other healthcare services.

4. The Knowledge Sharing Plan will be shared to city government of Ormoc as

contribution to their respective health programs, of which knowledge sharing

management plays a significant part.

5. Training and seminars on knowledge sharing management is highly

recommended to further augment the confidence of the employees in knowledge

sharing, also in conceptualizing additional contents pertaining to knowledge

sharing.
 121

6. The proposed plan for the enhancement of knowledge sharing will also be shared

to the hospital wherein the proponent is currently employed. Having studied the

importance of knowledge sharing, the researcher will propose the employment of

the proposed plan for the enhancement of knowledge sharing.

7. Policies pertaining to the implementation and sustainability of knowledge sharing

in hospital setting are recommended, particularly to the policy makers and the

Department of Health.

8. Enhancement of organizational support through establishment of effective system

that shall promote the knowledge sharing activities among healthcare workers is

highly recommended.

9. Further research is recommended about The Role of Information and Technology

in the Successful Implementation of Knowledge Sharing Management.

10. A study on Strategies and Effectiveness: Approaches on Knowledge Sharing

Management and Continual Improvement is highly recommended.

11. Knowledge Sharing Predictors: Basis of Strategic Knowledge Sharing

Management is also recommended for further research.

 122

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 123

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APPENDICES
 131

APPENDIX A
TRASNMITTAL LETTER TO THE DEAN OF THE COLLEGE OF NURSING

October 12, 2020

MS. YVONNE M. SEVILLA, RN, RM, MAN

Dean, College of Nursing
University of the Visayas
Mandaue City

Ma’am:

Good day!

The undersigned respectfully request your permission to conduct a study entitled

“DETERMINANTS OFKNOWLEDGE SHARING BEHAVIOR AMONG
HEALTHCARE PROFESSIONALS”.The educational research is in compliance with
the requirements of my Doctor of Health Care Management degree of which,
confidentiality with regards to gathering of data shall be observed.

Your favorable response is highly appreciated.

Respectfully yours,

MARIA DIVINA M. JORIZA, MAN

Researcher

Noted by:

RESTY L PICARDO, DM, JD, MAN, DPE

Adviser
 132

APPENDIX B
TRASNMITTAL LETTER TO THE CHIEF OF HOSPITAL

October 12, 2020

____________________________
Medical Director
____________________________
____________________________

Dear _______________________:

Good day!

I am currently working on a study entitled “DETERMINANTS OFKNOWLEDGE

SHARING BEHAVIOR AMONG HEALTHCARE PROFESSIONALS,” in
compliance to the final requirement for my Doctor of Health Care Management degree.
The purpose of this undertaking is to determine the significance of Knowledge Sharing
towards Innovative Healthcare Systems in order to develop Knowledge Sharing
Enhancement Plan and Knowledge Management Framework/Model. This will be done
through survey method.

In connection to this, may I request from your good office the permission to interview the
healthcare staff in your institution, which will be determined through simple random
sampling. Rest assured that gathered data will be treated with utmost confidentiality and
ethical standards.

Thank you very much in anticipation of your kind approval regarding the matter.

Respectfully yours,

MARIA DIVINA M. JORIZA, MAN

Researcher

Noted by:

RESTY L PICARDO, DM, JD, MAN, DPE

Adviser
 133

APPENDIX C
QUESTIONNAIRE

I understand that I am being asked to participate in a research study at Ormoc City. This research
study will to assess the relationship between knowledge sharing intention and knowledge
sharing behavior. This study further assesses whether the knowledge sharing attributes
predict knowledge sharing intention and knowledge sharing behavior among healthcare
workers in the private healthcare institutions in Ormoc City, for the third quarter of 2020.
If I agree to participate in the study, I will be asked to answer a questionnaire for
approximately 10 – 15 minutes about my perceptions on the attributes, intention and
behavior on knowledge sharing. The answering of the questionnaire will take place in an
area most convenient to the respondent. No identifying information will be included after
the data gathering. I understand I will not receive any monetary consideration for
participating in the study. I do not anticipate any risks from participating in this research
study. My participation in the study will not cause physical nor psychological harm. The
study will be beneficial to the respondents and the community because the findings of
this study will ensure a knowledge sharing enhancement plan.

I realize that the knowledge gained from this study may help either me, the clients or
other healthcare team members to know more about knowledge sharing in the health care
setting.

I realize that my participation in this study is entirely voluntary, and I may withdraw from
the study at any time I wish. If I decide to discontinue my participation in this study, I
will continue to be treated in the usual and customary fashion.

I understand that all the data will be kept confidential. However, this information may be
used in publication or presentations.

I understand that in the event that any research related activities result to cause harm. I
will not be automatically compensated by the hospital. If I have any questions or
concerns regarding my right as respondent in this study I can contact the UV-IRB Ethics
Office, UV Main Colon St. Cebu City Tel no. 032-4169607 or email at
uvirb2017@gmail.com.

The study has been explained to me, I have read and understand the consent forms, all of
my questions have been answered and I agree to participate, I understand that I will be
given a copy of the signed consent form.

___________________________________
Signature of Respondents and Date
 134

Witnesses:
_______________________________ ____________________________
Signature and Date Signature and Date

Directions:Please indicate your responses by placing on the boxes provided using the
following 7-point scale:
1 – Strongly Disagree
2 – Disagree
3 – Somewhat Disagree
4 – Neither Agree or Disagree
5 – Somewhat Agree
6 – Agree
7 – Strongly Agree

1 2 3 4 5 6 7
PERCEIVED ORGANIZATIONAL
SUPPORT (POS)
9. The organization values my contribution
to its well-being.
10. The organization fails to appreciate any
extra effort from me.
11. The organization would ignore any
complaint from me.
12. The organization really cares about my
well-being.
13. Even if I did the best job possible, the
organization would fail to notice.
14. The organization cares about my general
satisfaction at work.
15. The organization shows very little concern
for me.
16. The organization takes pride in my
accomplishments at work.
SUBJECTIVE NORMS (SN)
8. In the organization I work for, leaders
expect that collaborators share knowledge
with each other.
9. With respect to knowledge sharing, I want
to do what leaders expect.
10. I am motivated to share my knowledge.
11. People who are important to me believe
that I should share my knowledge with
others.
12. With respect to knowledge sharing, I want
 135

to do what is expected of me by important

people.
13. In the organization I work for, my
colleagues expect that I share my
knowledge with them.
14. With respect to knowledge sharing, I want
to do what my colleagues expect.
SELF-EFFICACY (SE)
5. I feel that I am able to share my
knowledge with colleagues who are very
critical.
6. I feel able to share my knowledge with
people who have a higher level in the
hierarchy within the organization.
7. I feel able to share my knowledge with
people who are more expert than I am.
8. I feel able to share my knowledge in large
groups.
KNOWLEDGE SHARING INTENTION
(KSI)
5. If I had the chance, I would share work
experiences with my colleagues that could
enrich their work.
6. If I had the chance, I would share ideas
with my colleagues so that they could do
better work.
7. If I had the chance, I would share
documents with my colleagues that may
be useful to them.
8. If I had the chance, I would share specific
knowledge with my colleagues that I have
learned in academic activities.
KNOWLEDGE SHARING BEHAVIOR
(KSB)
5. Nowadays, I share work experiences with
my colleagues that could enrich their
work.
6. Nowadays, I share ideas with my
colleagues so that they can do better work.
7. Nowadays, I share documents with my
colleagues that may be useful for them.
8. Nowadays, I share specific knowledge
with my colleagues that I have learned in
academic activities.
 136

APPENDIX D
NOTICE TO PROCEED
137
 138

APPENDIX E
PLAGIARISM CERTIFICATE
 139

APPENDIX F
GRAMMARIAN CERTIFICATE
 140

APPENDIX G
POST HOC (TUKEY) RESULTS

Knowledge Sharing Attributes – Perceived Organizational Support

Groups p value Significant
Medical services vs. Nursing service .230 No
Medical services vs. Ancillary services 1.00 No
Medical services vs. Administrative and Yes (Medical services <
.003
support services Administrative and support services
Nursing services vs. Ancillary services .239 No
Nursing services vs. Administrative and Yes (Nursing services <
.000
support services Administrative and support services
Ancillary services vs. Administrative Yes (Ancillary services <
.003
and support services Administrative and support services

Knowledge Sharing Attributes – Subjective Norms

Groups p value Significant
Medical services vs. Nursing service .872 No
Yes (Medical services < Ancillary
Medical services vs. Ancillary services .000
services)
Medical services vs. Administrative and
.148 No
support services
Yes (Nursing services < Ancillary
Nursing services vs. Ancillary services .001
services)
Nursing services vs. Administrative and
.521 No
support services
Ancillary services vs. Administrative
.066 No
and support services

Knowledge Sharing Attributes – Self-efficacy

Groups p value Significant
Yes (Medical services > Nursing
Medical services vs. Nursing service .000
services)
Yes (Medical services > Ancillary
Medical services vs. Ancillary services .000
services)
Yes (Medical services >
Medical services vs. Administrative and
.000 Administrative and support
support services
services)
Yes (Nursing services < Ancillary
Nursing services vs. Ancillary services .002
services)
Yes (Nursing services <
Nursing services vs. Administrative and
.015 Administrative and support
support services
services)
Ancillary services vs. Administrative
.909 No
and support services
 141

Knowledge Sharing Intention

Groups p value Significant
Medical services vs. Nursing service .849 No
Yes (Medical services < Ancillary
Medical services vs. Ancillary services .000
services)
Yes (Medical services <
Medical services vs. Administrative and
.008 Administrative and support
support services
services)
Yes (Nursing services < Ancillary
Nursing services vs. Ancillary services .002
services)
Nursing services vs. Administrative and
.079 No
support services
Ancillary services vs. Administrative
.635 No
and support services

Knowledge Sharing Behavior

Groups p value Significant
Medical services vs. Nursing service .677 No
Medical services vs. Ancillary services .737 No
Medical services vs. Administrative and
.214 No
support services
Nursing services vs. Ancillary services .144 No
Yes (Nursing services <
Nursing services vs. Administrative and
.013 Administrative and support
support services
services)
Ancillary services vs. Administrative
.793 No
and support services
 MARIA DIVINA M. JORIZA
142
RN, MAN, HAAD-RN

EXPERIENCE

Nurse Supervisor Oct 2018-Present

ClinicaGatchalian and Hospital
Kangleon Street, Ormoc City, Leyte
(053) 255 2203

Head Nurse  Mar 2016- Oct 2018

ClinicaGatchalian and Hospital
Kangleon Street, Ormoc City, Leyte
(053) 255 2203

Staff Nurse Aug 2011- Mar 2016

ClinicaGatchalian and Hospital
 Kangleon Street, Ormoc City, Leyte
 (053) 255 2203
CURRICULUM
Private Duty Nurse Nov 2010- Jun 2011
Cebu City VITAE

Nurse Volunteer Mar 2010- Sep

2010
 Ormoc District Hospital
 Ormoc City, Leyte

Nurse Trainee and Employee Apr 2009- Sep 2009

Training & Employment Program
of Project N.A.R.S
(Nurses Assigned in Rural Services)
 Ormoc City, Leyte

School Nurse                                Jul 2008- Dec

2008
Concord Technical Institute
Cabreros Street, Basak San Nicolas, Cebu City
416 – 8172 / 418-9503

EDUCATION

Graduate Studies: University of Visayas, Cebu City

Master of Arts in Nursing-Nursing Management
Thesis: Job Satisfaction and Quality of Care
among Nurses in a Twelve Hour Shift
(May 2018)