Motivating Human Resources for Health at Govt Medical Colleges: The leaders' Way.

Bansal RN

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OJHAS Vol. 15, Issue 3: (July-September 2016)

Original Article
Motivating Human Resources for Health at Govt Medical Colleges: The leaders' Way

Author
Ravinder Nath Bansal, Deputy Medical Superintendent, GGS Medical College Hospital, Faridkot, Punjab, India,
Meenakshi Malhotra, Professor and Head, University Business Schools, Punjab University, Chandigarh, India

Address for Correspondence
Ravinder Nath Bansal,
H.No 86, Medical Campus,
GGS Medical College,
Faridkot,
Punjab, India.
E-mail: rnbansal@gmail.com

Citation
Bansal RN, Malhotra M. Motivating Human Resources for Health at Govt Medical Colleges: The leaders' Way. Online J Health Allied Scs. 2016;15(3):2. Available at URL: http://www.ojhas.org/issue59/2016-3-2.html

Open Access Archives
http://cogprints.org/view/subjects/OJHAS.html
http://openmed.nic.in/view/subjects/ojhas.html

Submitted: Aug 4, 2016; Accepted: Oct 2, 2016; Published: Oct 25, 2016

This work is licensed under a Creative Commons Attribution-No Derivative Works 2.5 India License

This Article

Abstract: Public sector organisations have limited scope for incentives, performance based pay and promotions. Leaders can influence public service motivation through several mechanisms including engaging employees existing values, infusing jobs with meaning and highlighting and rewarding public service values. Current research was aimed to study the impact of leader behaviour aspects on motivation levels of different types of personnel working at a non-profit making teaching medical college. Results suggested that impact of leaders behaviour must be studied separately for different professional groups. Approach to motivating different category of professionals needs to be different. Not all leader behaviour aspects have similar impact on motivation of different professional groups and organsiations. Government sector organisations having limited scope for external motivation and must look at creating provisions for contingent rewards. Nursing professionals need immediate management focus for better patient care.
Key Message: Management in Public Sector healthcare institutions with limited options to exercise external motivation must actively look for other options like focusing on leader behaviour and creating healthy work environments.
Key Words: Hospital, Healthcare, Medical College, Public Sector, Motivation, Leader Behaviour

Introduction:

Leaders primary task according to Irum et al¹ (2012) is to motivate followers to exhibit high performance level in an organisation, it is therefore prudent that a leader is aware of how to motivate his/her followers to enhance performance, and advance the concept of accountability in the organization. Amorose and Horn² (2000) found that coaches who exhibit a leadership style characterized by low levels of autocratic behavior and who provide high frequencies of positive, encouraging and informationally based feedback and low frequencies of ignoring players successes and failures may create an environment that facilitates the development of intrinsic motivation in their athletes. Research carried out in the past to determine the most effective leadership style in specific situations show that leader behaviour high in either consideration or initiating or both is most effective is the best form of leadership. Contingent factors such as behaviour, situations and others have been examined with a considerable amount of research devoted to identifying moderator variables, as research has shown the relationship of leadership styles to worker motivation.^3-6 Public sector organisation have limited scope for incentives, performance based pay and promotions. Leaders can influence motivation of public sector personnel through several mechanisms including engaging employees existing values, infusing jobs with meaning, highlighting and rewarding public service values.⁷

Hospitals being manpower intensive industries; performance of their system depends on the motivational levels of its personnel, translating into productivity and quality of output.⁸ On review of literature it was found that many studies have been done on assessing the impact of leader behaviour on motivation levels but in non-healthcare organisations. Very few studies have been done in healthcare setups in public sector and that too mostly in non-teaching hospital. Aim of this study was to find impact of leader behaviour on motivation of different types of personnel working at a non-profit making teaching medical college and hospital, trying to identify key behaviour aspects which have higher impact on various categories of work groups.

Objectives

The objectives of this study were:

To assess the impact of leader's behavior aspects on motivation in the organization under study
To identify the key leader behavior aspect that have maximum impact on motivation
To identify the key behavior aspects that lead to de-motivation / amotivation
To recommend suggestions to improve the motivation of personnel in the selected organisation

Materials and Methods

For the purpose of study, a non-profit making medical college, in Punjab was selected. This institute was established more than 35 years ago and currently has an average OPD of more than 1800 patients per days with more than 36000 admissions per year supported by 700 plus beds and being manned by 1000 plus personnel including 275 doctors, 282 nurses, 143 paramedicos, 96 non-medicos and 250 plus class IV staff

H₀1: r=0 that is there is no significant relationship between leaders behavior aspects and motivation of personnel working in the selected organization under study.

H₀2 r=0 that is there is no significant correlation between Leader behavior aspects and motivation levels of professionals of different categories (Doctors, Nurses, Para-medics and Non-Medicos). H₀2_Doctorsr=0, H₀2_Non-medicos r=0, H₀2_Nursesr=0, H₀2_Para-Medicsr=0

Study instrument: It consisted of three parts namely: personnel profile of the respondent, component of assessment of leader behaviour and component of the assessment of Motivation. Leader Behaviour Description Questionnaire (LBDQ) Form XII by Stodgil (1963) and Motivation at Work Scale (MAWS) developed by Gagne (2010) was used. LBDQ describes twelve aspects of leader behaviour namely Representation, Demand Reconciliation, Tolerance of Uncertainty, Persuasiveness, Initiation of Structure, Tolerance and Freedom, Role Assumption, Consideration, Production Emphasis, Predictive Accuracy, Integration, Superior Orientation and MAWS assess 4 type of motivation namely internal motivation, identified regulation, introjected regulation and External motivation. Internal consistency of the scale was checked and found to be adequate with Cronbachs's alpha found to be 0.948 for LBDQ and 0.910 for MAWS, testifying the strong reliability of the scale.

Sample size and sampling: For the purpose of this study all doctors, nurses, paramedics and non-medicos personnel (Class III and above) were selected and a cross sectional study was performed. Questionnaire was distributed to 796 eligible personnel as per the above criterion. They were met either in small groups or individually. Objectives of the study were explained at each meeting and confidentially of responses was assured.

Statistical Analysis: Each of the leader behaviour aspects were tested using 5 to 10 questions for each aspect on a 5 point Likert scale with always practised at score 1 to never practised with score 5. Negatively worded items were reverse scored using Microsoft Excel software. Motivational factors were tested using 3 questions for each factor on a 7 point Likert scale based scale ranging from non-agreement at score 1 to exact agreement with score 7. Further analysis was done applying Pearson's correlation and regression analysis using statistical package (SPSS, Ver.20).

Results

Distribution of respondents: 621 respondents completed their questionnaire. The sex ratio of respondents was in favour of females (66:34). 71% of the respondents were regular employees and the rest were contractual staff members. Study group respondents included 33% Doctors, 39% Nurses, 16% Paramedics and 12% Non-medicos.

Table 1: Correlation between leader behavior and motivation levels of all the employees under study.
Leaders behavior	Intrinsic Motivation	Identified regulation	Introjected regulation	Extrinsic regulation	Total Motivation
Consideration	.163^**	.140^**	.107^**		.098^*
Demand Reconciliation	.168^**	.172^**	.151^**		.130^**
Integration	.156^**	.142^**	.120^**		.105^**
Predictive Accuracy	.127^**	.132^**	.103^*		.082^*
Initiation of Structure	.120^**	.107^**
Persuasiveness	.191^**	.197^**	.150^**		.158^**
Production Emphasis	.089^*	.142^**	.110^**		.083^*
Representation	.112^**	.095^*
Role Assumption				-.094^*
Superior Orientation	.147^**	.164^**	.137^**		.129^**
Tolerance and Freedom	.169^**	.150^**	.083^*		.100^*
Tolerance of Uncertainty	.108^**	.079^*
Pearson's Correlation: Correlation values of only significantly correlating values are shown in the above table. . Correlation is significant at the 0.05 level (2-tailed). *. Correlation is significant at the 0.01 level (2-tailed).

Graph 1: Graphical representation of significant correlation values between leader behavior and motivation levels of all personnel.

Motivation factors on x-axis and values of significant correlation on y axis for four categories of employees

Only Significant valve have been plotted. Value not significant are not plotted

To find out the relationship between variables of interest, correlation (Pearson's correlation (r)) analysis was performed. Persuasive behaviour (Table 1) of leader had maximum association with intrinsic motivation (r=0.191, p<0.01), identified regulation (r=0.197, p=<0.01) and total motivation (r=0.158, p=<0.01). Demand reconciliation (r=0.151, p=<0.01) and persuasiveness (r=0.150, p<0.01) had higher association with introjected regulation. While overall persuasive behaviour had higher association with total motivation, it had no significant association with extrinsic regulation. Only role assumption behaviour out of twelve leader behaviour aspects was found to have significant but weak negative association (r=-0.094, p=<0.01) with extrinsic regulation. Except for role assumption behaviour all the other leader behaviour aspects had significant association with intrinsic motivation and identified regulation. Since most of the variables have significant correlation, null hypothesis H₀1 is rejected.

Work profile, working conditions, unmet needs, leaders and hierarchy of leaders differ for different professional. Considering this personnel working at this organisation were divided into 4 professional groups namely Doctors, Nurses, Paramedics and Non-medicos and the relationship between leader behaviour (of respective leaders) and perceived motivation was assessed using Pearson's correlation analysis (r) and regression analysis.

Table 2: Correlation between leader behavior and motivation of doctors
Leaders Behavior	Intrinsic Motivation	Identified Regulation	Introjected Regulation	Extrinsic Regulation	Total Motivation
Consideration	.152^*	.183^**	.166^*		.136^*
Demand Reconciliation				-.171^*
Initiation of Structure		.139^*
Integration	.145^*		.145^*
Persuasiveness	.151^*	.241^**	.160^*		.155^*
Predictive Accuracy		.139^*
Production Emphasis		.194^**
Representation
Role Assumption				-.185^**
Superior Orientation			.166^*
Tolerance and Freedom	.136^*
Tolerance of Uncertainty
Pearson's Correlation: Correlation values of only significantly correlating values are shown in the above table. . Correlation is significant at the 0.05 level (2-tailed). *. Correlation is significant at the 0.01 level (2-tailed).

Graph 2: Graphical representation of significant correlation values between leader behavior and motivation levels of Doctors

Motivation factors on x-axis and values of significant correlation on y axis for four categories of employees

Only Significant valve have been plotted. Value not significant are not plotted

For doctors, consideration behaviour had maximum association with intrinsic motivation (r=0.152, p<0.05, R²=0.023) explaining for 2.3% variance (Table 2, Table 6-9, Graph 2) in the same. Further persuasive behaviour had maximum association with identified regulation (r=0.241, p=<0.01, R²=0.058) explaining for 5.8% of variance in the same. Consideration had maximum association with introjected regulation (r=0.166, p<0.05, R²=0.028) explaining for 2.8% variance. On the other hand role assumption (r=-0.185, p<0.01) and demand reconciliation (r=-0.171, p<0.05) had weak negative association with external regulation. Regression analysis indicated 8% variance in external regulation jointly explained by role assumption (β= -0.271), persuasiveness (β= -0.373) and Integration behaviour (β= -0.242). Since most of the variables had significant correlation, null hypothesis H₀2_doctorswas established as rejected.

Table 3: Correlation between leader behavior and motivation of non-medicos
Leaders Behavior	Intrinsic Motivation	Identified Regulation	Introjected Regulation	Extrinsic Regulation
Consideration	.291^*
Demand Reconciliation
Initiation of Structure
Integration
Persuasiveness
Predictive Accuracy
Production Emphasis
Representation
Role Assumption
Superior Orientation		.270^*		.301^*
Tolerance and Freedom	.306^**	.325^**
Tolerance of Uncertainty			-.337^**	-.346^**
Pearson’s Correlation: Correlation values of only significantly correlating values are shown in the above table. . Correlation is significant at the 0.05 level (2-tailed). *. Correlation is significant at the 0.01 level (2-tailed).

Graph 3: Graphical representation of significant correlation values between leader behavior and motivation levels of non-medicos

Motivation factors on x-axis and values of significant correlation on y axis for four categories of employees

Only Significant valve have been plotted. Value not significant are not plotted

For non-medicos tolerance of freedom behaviour (Table 3, Table 6-9, Graph 3) had maximum association with intrinsic motivation (r=0.306, p<0.01, R²=0.094) explaining for 9.4% variance and identified regulation (r=0.325, p<0.01, R²=0.106) explaining for 10.6% variance. On the other hand tolerance of uncertainty had negative association with introjected regulation (r=-0.337, p<0.01, R²=0.113) explaining for 11.3% variance and external regulation (r= -0.346, p=<0.01). Eight of the twelve leader behaviour aspects had no significant association with motivation of non-medicos. Regression analysis indicates 26.4% variance in external regulation jointly explained by tolerance of uncertainty (β= -0.374), superior orientation (β= 0.562) and representation behaviour (β= -0.301). Since four of variables have significant correlation, null hypothesis H₀2_non-medicos is partly rejected.

Table 4: Correlation between leader behavior and motivation of nurses
Leaders Behavior	Intrinsic Motivation	Identified Regulation	Introjected Regulation	Extrinsic Regulation	Total Motivation
Consideration				-.163^*
Demand Reconciliation
Initiation of Structure				-.139^*
Integration
Persuasiveness
Predictive Accuracy				-.128^*
Production Emphasis
Representation				-.156^*
Role Assumption				-.149^*
Superior Orientation
Tolerance and Freedom
Tolerance of Uncertainty
Pearson's Correlation: Correlation values of only significantly correlating values are shown in the above table. . Correlation is significant at the 0.05 level (2-tailed). *. Correlation is significant at the 0.01 level (2-tailed).

Graph 4: Graphical representation of significant correlation values between leader behavior and motivation levels of nurses
Motivation factors on x-axis and values of significant correlation on y axis for four categories of employees
Only Significant valve have been plotted. Value not significant are not plotted

For nurses consideration (r=-0.163, p<0.05) behaviour had maximum but negative association with extrinsic motivation of nurses (Table 4, Table 6-9, Graph 4). There was no significant association between intrinsic motivation, identified regulation, introjected regulation and leader behaviour aspects. Regression analysis indicated 4% variance in external regulation jointly explained by integration (β= 0.327) and consideration (β= -0.409) behaviour. Only five (consideration, initiation of structure, predictive accuracy, representation and role assumption) of the twelve leader behaviour aspects had significant association with motivation, however all these aspects negatively influenced their motivation. Since most of the variables had significant correlation, null hypothesis H₀2_nurses is partly rejected.

For paramedics (Table 5, Table 6-9) superior orientation behaviour had strong positive association with motivational factors intrinsic motivation (r=0.456, p<0.01, R²=0.208), identified regulation (r=0.557, p<0.01, R²=0.310), introjected regulation (r=0.587, p<0.01, R²=0.344) and external motivation (r=0.408, p<0.01, R²=0.167). Superior orientation behaviour explained for 20.8% variance in internal motivation, 31% in identified regulation, 34.4% in introjected regulation and 16.7% variance in external motivation. Since most of the variables have significant correlation, null hypothesis H₀2_paramedics is rejected.

Table 5: Correlation between leader behavior and motivation of paramedics
	Intrinsic Motivation	Identified Regulation	Introjected Regulation	Extrinsic Regulation	Total Motivation
Consideration	.447^**	.501^**	.544^**	.305^**	.534^**
Demand Reconciliation	.415^**	.501^**	.518^**	.363^**	.536^**
Initiation of Structure	.257^*	.340^**	.253^*		.293^**
Integration	.413^**	.467^**	.426^**	.312^**	.485^**
Persuasiveness	.349^**	.386^**	.308^**	.207^*	.367^**
Predictive Accuracy	.342^**	.418^**	.368^**	.297^**	.418^**
Production Emphasis		.303^**	.256^*	.219^*	.239^*
Representation	.420^**	.499^**	.475^**	.341^**	.528^**
Role Assumption
Superior Orientation	.456^**	.557^**	.587^**	.408^**	.614^**
Tolerance and Freedom	.432^**	.373^**	.397^**	.226^*	.431^**
Tolerance of Uncertainty
Pearson's Correlation: Correlation values of only significantly correlating values are shown in the above table. . Correlation is significant at the 0.05 level (2-tailed). *. Correlation is significant at the 0.01 level (2-tailed).

Graph 5: Graphical representation of significant correlation values between leader behavior and motivation levels of paramedics
Motivation factors on x-axis and values of significant correlation on y axis for four categories of employees
Only Significant valve have been plotted. Value not significant are not plotted

Table 10 summarises the R² values for leader behaviours aspects and motivational factors for each of the professional category of personnel. It was found that maximum association of leader behaviour with motivation was different for each of the professional group and there is a wide variation in the same.

Table 6: Impact of leader behavior on intrinsic motivation of various categories of the employees under study
Dependent Variable: Intrinsic Motivation		r	Beta	t-value	Sig.	Tolerance	VIF
Non Medico	(Constant)	3.922		.974	.333
Non Medico	Tolerance and Freedom	.261	.306	2.693	.009	1.000	1.000
R=.306, R²=.094, Adjusted R²=.081, F=7.255, Significance=0.009
Doctor	(Constant)	10.220		4.617	.000
Doctor	Consideration	.120	.152	2.208	.028	1.000	1.000
R=.152, R²=.023, Adjusted R²=.018, F=4.877, Significance=0.028
Para Medic	(Constant)	3.391		1.457	.148
Para Medic	Superior Orientation	.283	.456	5.045	.000	1.000	1.000
R=.456, R²=.208, Adjusted R²=.200, F=25.454, Significance=0.000
Nurses: No variables were entered into the equation for Nurse

Table 7: Impact of leader behavior on Identified Regulation of various categories of the employees under study
Dependent Variable: Identified Regulation		B	Beta	t-value	Sig.	Tolerance	VIF
Non Medico	(Constant)	2.080		.448	.655
Non Medico	Tolerance and Freedom	.322	.325	2.874	.005	1.000	1.000
R=.325, R²=.106., Adjusted R²=.093, F=8.262, Significance=0.005
Doctor	(Constant)	7.603		3.064	.002
Doctor	Persuasiveness	.212	.241	3.561	.000	1.000	1.000
R=.241, R²=.058, Adjusted R²=.054, F=12.683, Significance=0.000
Para Medic	(Constant)	2.010		.844	.401
Para Medic	Superior Orientation	.380	.557	6.608	.000	1.000	1.000
R=.557, R²=.310, Adjusted R²=.303, F=43.671, Significance=0.000
Nurses: No variables were entered into the equation for Nurse

Table 8: Impact of leader behavior on Introjected Regulation of various categories of the employees under study
Dependent Variable: Introjected Regulation		B	Beta	t-value	Sig.	Tolerance	VIF
Non Medico	(Constant)	29.532		7.820	.000
Non Medico	Tolerance of Uncertainty	-.334	-.337	-2.993	.004	1.000	1.000
R=.337, R²=.113, Adjusted R²=.101, F=8.960, Significance=0.004
Doctor	(Constant)	10.751		4.713	.000
Doctor	Consideration	.135	.166	2.403	.017	1.000	1.000
R=.166, R²=.028, Adjusted R²=.023, F=5.773, Significance=0.17
Para Medic	(Constant)	2.524		1.110	.270
Para Medic	Superior Orientation	.392	.587	7.138	.000	1.000	1.000
R=.587, R²=.344, Adjusted R²=.338, F=50.952, Significance=0.000
Nurses: No variables were entered into the equation for Nurse

Table 9: Impact of leader behavior on External Regulation of various categories of the employees under study
Dependent Variable: Extrinsic Regulation		B	Beta	t-value	Sig.	Tolerance	VIF
Non Medico	(Constant)	7.416		1.280	.205
	Tolerance of Uncertainty	-.390	-.374	-3.601	.001	.963	1.038
	Superior Orientation	.644	.562	4.033	.000	.535	1.869
	Representation	-.381	-.301	-2.144	.036	.528	1.895
R=.543, R²=.295, Adjusted R²=.264, F=9.470, Significance=0.000
Doctor	(Constant)	14.253		5.906	.000
	Role Assumption	-.221	-.271	-3.142	.002	.599	1.671
	Persuasiveness	.300	.373	3.626	.000	.423	2.364
	Integration	-.319	-.242	-2.420	.016	.447	2.238
R=.306, R²=.094, Adjusted R²=.080, F=6.995, Significance=0.000
Nurse	(Constant)	15.593		9.117	.000
	Integration	.327	.286	2.336	.020	.264	3.786
	Consideration	-.293	-.409	-3.337	.001	.264	3.786
R=.220, R²=.048, Adjusted R²=.040, F=6.092, Significance=0.003
Para Medic	(Constant)	2.109		.780	.437
	Superior Orientation	.288	.408	4.405	.000	1.000	1.000
R=.408, R²=.167, Adjusted R²=.158, F=19.405, Significance=0.000

Table 10: Maximum R² values for association between leader behaviour and motivational factors for different professional categories
	Intrinsic Motivation	Identified Regulation	Introjected Regulation	Extrinsic Regulation
Non-medicos	0.094	0.106	0.113	0.295
Doctor	0.023	0.058	0.028	0.094
Nurses				0.048
Paramedics	0.208	0.310	0.344	0.167

Discussion

Studies in the past show signification correlation between leader behaviour and employee outcomes. Different leader behaviour characteristics have shown to have varying relationship with employee motivation in the organisations/population's being studied by various researchers. Voon⁹ found contingent rewards and active management to have significant positive correlation and passive management by exception to have negative outcomes.

The inference drawn from pair wise multiple comparison in the organization under study is that different leader behaviour aspects have varying levels of correlation with various motivational factors. Leader behaviour aspect having maximum impact on motivational levels among employees was persuasiveness, thus this behaviour of leader can lead to higher motivational levels of employees. Long¹⁰ in a government organisation found positive correlation for consideration behaviour and that not all transformational characterises have positive effect.

Working personnel were split into four professional groups i.e., doctors, nurses, paramedics and non-medicos. From multiple comparison it can be inferred that if perceived appropriate, different leader behaviour aspects increase intrinsic motivation, indentified regulation, introjected regulation levels in different categories of personnel except for tolerance of uncertainty behaviour of leader with negatively influence on introjected motivation of non-medicos.

The results of this study clearly indicate that correlation analysis for assessing the association between leader behaviour and motivation for the personnel working in any organisation as a whole may not be representative of the individual professional category. Thus the impact of leader behaviour on employee's motivation must be analysed separately for individual professional groups. This difference can be attributed partly due to the fact that leaders of different professional groups have different hierarchy in the organisation and partly to the fact the personnel in different professional groups are likely to have achieved different levels as per Maslow theory of hierarchy of needs.

Leaders of doctors must practice individualised consideration and persuasive behaviour to enhance the motivation of their subordinates. Contrary to expected, role assumption and integration behaviour of the leader negatively influences motivation of doctors. This may mean that doctors do not like to be led by leaders who maintain a closely knit organization; resolves inter-member conflicts and actively exercises the leadership role rather that surrendering leadership to others. Doctors probably look for more freedom and independence in work. No similar study was found for doctors. Considering doctors as teachers, similar studies on teachers in past^11,12 found consideration behaviour having significant positive correlation which corroborate with our findings.

Leaders of non-medicos must allows them for taking initiative, decision making and be preferably having better superior orientation which in-return is likely to provide opportunities for initiative and decision making. On the other hand tolerance of uncertainty, postponement without anxiety and representative behaviour negatively influences motivational levels of the non-medico employees. Thus leaders of non-medicos must provide freedom to their subordinates and reduce their tolerance of uncertainty. Considering job of non-medicos similar to office workers, contrary^12,13to findings of this study, positive correlation was found for transformational leader behaviour and motivation

For para-medics single most important factor that motives them is orientation of their leader with his/her superiors. Cordial relations of their leader with (leaders) superiors; may be enabling them to influence them indirectly and possibly providing opportunities for benefits to non-medicos. No similar study was found on paramedics.

Surprisingly none of the leader behaviour aspects had impact on motivation factors; internal motivation, identified regulation and introjected regulation of the nurses. Further consideration behaviour negatively influenced external motivation. Sole behaviour of leader that influences external motivation positively but weakly is integration of the leader. This means that in the current organisation steps need to be taken to train the leaders of nurses to be able to maintains a closely knit organization and actively work to resolves inter-member conflicts. Further study is needed to understand reason behind such difference in perception of nurses in contrast to other three groups. Earlier studies had shown lower motivational levels⁸and job satisfaction.^14,15 Earlier studies found that career development program¹⁶, better working environment had positive effects on nurses.

Leaders unable to externally motivate personnel working therein, correlates to the fact that being a non-profit public sector organisation have limited rather no scope of incentives for workers.⁸ Contrary to this, negative relation with external motivation is surprising which may mean that there are some incentives which may get reduced if the leaders actively exercise their roles. This could be partly explained by assumption that 1. all promotions and increments are time bound, 2. management of the work environment has not been there for long time which may create sense of threat in the system if leader exercise his / her role.

Further differences in impact of leader behaviour between various professional categories could be understood by Maslow's Hierarchy of Needs. Personnel in different professional categories are likely to have achieved certain levels of the needs and are striving for next level to be achieved, which is different for different category of personnel.

Due to the limited scope and limitations of the study, the researcher recommends that further research on the other factors affecting motivation of personnel including for working conditions, communication channels, involvement in decision making, job stress, defined jobs, supervisory systems and inter-departmental channels. Further work up will also be required for assessing the reason for difference in various professional categories. This will help authorities to align their policies for better performance of staff and eventually improve the performance of the services provided by the organisation. Further studies are also required to understand why there is such difference in perception of nurses as compared to that of other three groups.

Conclusion: Impact of leader behaviours must be studied separately for different professional groups. Approach to motivating different category of professionals needs to be different. Not all leader behaviour aspects have similar impact on motivation of different professional groups and organisations. Government sector organisations have limited scope for external motivation and must look at creating provision for contingent rewards. Nursing professionals need immediate focus of the management to improve patient care.

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