Humans are one of the resources needed to run an organization or company. As the main factor that runs the organization system, humans hold the role of crisis (crucial factor) which will determine the success or failure of a company. In a hospital industry, health workers are human resources who play an important role. A hospital, with abundant capital accompanied by sophisticated technology will not be able to advance without being run by qualified health personnel and having a strong commitment in running every his duty.
The commitment of health personnel organizations is one of the key factors that determine the success or failure of a hospital to achieve its goals. Health personnel who have a commitment to the organization usually show a work attitude that is attentive to their duties, has the responsibility to carry out tasks and is very loyal the institution where he works. The existence of a high organizational commitment to health workers will make them avoid negative organizational behaviors such as defaulters, moving to another hospital, leaving work hours and so on.
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According to Kaswan (2012), organizational commitment is a measure of the willingness of employees to stay with a company in the future. Whereas according to Robbins and Judge (2015), organizational commitment is the level at which a worker identifies an organization, its goals and expectations to remain a member. In carrying out work, often health workers face many demands for work. High job demands certainly have an impact on the personal life of the health worker in question. For health workers who have a family, the high demand for work can certainly have an impact on the neglect of tasks that must be done for the family that can trigger the emergence of conflict in the family. As one part of the family, a health worker must be able to manage the time he has.
Conflict between work and family can occur in both women and men. According to Apperson's study, et al in Buhali and Margaretha (2013), there are several levels of role conflict between men and women, that women experience role conflict at a higher level than men. This is because women view family as their main obligation and must get more attention than the role of their workers. Whereas according to Martins et al, in Amelia (2010), work-family conflict is a condition that occurs when one's work affects or disrupts his family's life. Stress can be interpreted as something that makes us experience mental stress or the burden of life, an force that is urgent or gripping, disrupts balance due to problems or demands of adjustment. According to Mangkunegara (2007), work stress is a feeling of distress experienced by employees in the face of work. Excessive stress will adversely affect individuals to deal with their environment normally. As a result, their performance is bad and indirectly affects the organization where they work.
In dealing with various problems in the world of work, every employee in this case the health worker should recall his role as a human being created by God to serve Him in a way that has been determined in accordance with his beliefs. Every human being has religious values that make him always feel close to his God and believe that everything that applies to him is a provision from God. This made him believe that every problem in the world of work must have a way out for God's help. Religiosity is the internalization of religious values in a person. This internalization is then actualized in daily actions and behavior, including work. In Islam, for example, work is an inseparable whole, starting from the intention to work that is not only seeking material abundance in the world but also seeking rewards to end later. Nashori and Mucharam (2002) in Rohayati (2014) conclude religiosity as how far knowledge , how firm is the belief, how the worship is carried out and the rules and how deep the appreciation of the religion they embrace.
Latersia Binjai Hospital is one of the private public hospitals in the city of Binjai, and the only General Hospital in East Binjai District, stands on an area of 29 x 146 m2. Latersia Binjai Hospital starts from the General Clinic which was founded by Dr. Robinson Sembiring on June 19, 2004 and since March 13, 2012 the Ministry of Health of the Republic of Indonesia has established Binjai Latersia Hospital as a Type C Hospital. As a general hospital that is still categorized as a new one, Latersia Binjai Hospital always strives to provide the best service to patients starting from the physical facilities of hospitals and qualified health personnel. Health personnel are those who are devoted to the health sector and have knowledge and skills through education. in the health sector, which for certain types requires authority to carry out health efforts. Based on Law No. 36 of 2014 which is meant by health personnel consisting of medical personnel including doctors, specialists, dental doctors; nursing staff includes various types of nurses; midwifery staff; pharmacy staff includes pharmacists and pharmaceutical technical personnel; and others.
In hospital operations, all health workers have an important role in handling patients. In addition to adequate hospital facilities, doctors who are reliable in handling patient complaints, the role of nurses in serving patients, especially hospitalized patients, is the reason for patients to choose hospitals (interviews with hospital patients, 31 July 2018). So, the role of health workers in the progress of a hospital must be of particular concern by the management of the Hospital. Health workers are also expected to have a good commitment in carrying out each of their duties. One form of organizational commitment by health workers can be seen from the loyalty of health workers to survive and become part of the hospital where they work. The following is a table that shows the development of the number of health workers at Latersia Binjai Hospital in the period 2013 to July 2018.
This research is descriptive causal, namely a study conducted to investigate the causal relationship by observing the consequences and the possible factors (causes) that cause these effects. The study was conducted at Latersia General Hospital located on Jl. Soekarno Hatta Km.18 No.451 Binjai. Population is a generalization area consisting of objects and subjects that have certain qualities and characteristics determined by the researcher to be studied, then drawn conclusions. The population in this study is all health personnel of Latersia Binjai Hospital consisting of general practitioners, specialist doctors, dentists, pharmacists , there are 66 nurses, midwives, laboratories, nutritionists, radiologists and pharmacists.
Determination of sampling is as follows: if less than 100 is better taken all until the research is population research. If the number of large subjects can be taken between 10-15% or 20-25% or more, (Arikunto, 2013). Based on the explanation above, because the population is less than 100, this study uses the census method, which is the entire population into the study sample.This study used a questionnaire (questionnaire) which was distributed as many as 66 copies of the questionnaire with the number of samples being respondents in this study as many as 66 people. Questionnaire statements were all answered by respondents consisting of five statements for work-family conflict (X) variables, nine statements for organizational commitment (Y2), eight statements for work stress variables (Y1) and eight statements for religiosity (Z) variables.
Data collection techniques are ways that can be used by researchers to collect data. The data collection techniques used in this study were interviews, questionnaires / questionnaires and documentation studies. In this study data collection used a Likert scale. The Likert scale is a scale to measure an attitude where the respondent is faced with a statement and can choose one of the five alternative answers 'strongly agree, agree, doubt, disagree, and strongly disagree'.
Work-Family Conflict Has Positive and Significant Effects on Stress Work
Based on the research, the results show that work-family conflict has a positive and significant effect on work stress. This means that work-family conflicts will have an impact on work stress. The more problems in the household that trigger conflict will increase work stress on health care in the hospital.
As many as 79% of the respondents in this study were women. It is known that women are creatures that prioritize emotions. Based on the results of several studies it is also known that women tend to experience stress more easily than men because the differences in hormones and genetics that women and men have differ. Job demands that make women undergo several roles will also trigger stress. In the family, women have a very important role, namely as a wife who serves the needs of a husband and a mother who regulates the needs of all family members, especially in the care of children. Women workers must be able to share time and attention between family and work. When both roles require him at the same time, he must be able to choose and make a priority scale. Therefore, the role and support of the extended family is very important. The inability of women to share roles well can lead to work-family conflicts. The inability to manage conflict properly results in a woman who experiences conflict will tend to experience work stress.
Age and age of marriage is also a factor of health workers who experience work-family conflict experiencing work stress. Most of the respondents in this study were young. As many as 51% of respondents aged 26-30 years with the most dominant marriage age between 1-5 years were 62% of respondents. Ages 26-30 years are included in the category of early adults where they are not yet in the mature enough age category. At that age, generally a person still prioritizes emotions and ambitions, hard on principles and ideology. At the age of 1 to 5 years of marriage, generally a person is still going through times to get to know their spouse and extended family. So at a young age and marriage age that still tends to be young, every couple generally will encounter several conflicts in the early life of marriage. In-family conflicts can occur due to several reasons, one of which is role conflict caused by the imbalance of the roles undertaken by husband or wife in work and family life. The inability to manage work-family conflict for young couples will cause work stress.
As health workers who have sworn to professionals in work, namely by prioritizing the interests of patients, they are required to understand the importance of the presence of health workers in handling patients in any difficult conditions. The professional demands of the health workforce should also be known by the extended family of health workers. In this study, for example, the most respondents were nurses and midwives who had work shifts that always changed from time to time. Likewise in the profession of specialists who must be prepared to carry out emergency operations that can come at any time until they must be willing to leave the family to prioritize patient safety. Families who are not prepared for this condition can cause conflict within the family and cause work stress for health workers if it cannot be managed properly.
The length of work of health workers is also a factor in work-family conflict influences work stress. As many as 77% of the respondents from this study were health workers who had just worked for a period of 1-5 years at Binjai Latersia Hospital. The longer a person works as a health worker, generally the more accustomed to undergoing a profession with high work mobility and many job demands. Conversely, a short period of work may be the reason why health workers are not yet familiar with various conflicts that arise in work and family to cause work stress. Therefore, the initial period of working as a health worker in a hospital is a period of adaptation in working and managing conflict in work.
From respondents' answers regarding work-family conflict, 37.9% of respondents felt they did not have time with family and as many as 10.6% felt they had very little time with family. Reduced time with family can cause a lack of interaction with family. As many as 34.9% of respondents also answered tiredly after work causing them to have less time to interact with their families. Lack of interaction with the family can cause a lack of relationship between family members, this is due to the lack of interaction that can lead to prejudice and distrust among family members to cause conflict.
Conflict experienced by a health worker can increase work stress, so the higher the conflict experienced by a health worker, the higher the stress of work. This research is in accordance with the results of research conducted by Sihaloho (2016); Nart and Batur (2014), Jamadin et al (2015), Siahaan (2018), and Rusmewahni, et al (2018) which states that work family to conflict has a positive and significant effect on work stress. While the results of this study contradict the research conducted by Agustina and Gde (2018) which states that work family to conflict does not significantly influence work stress.
Work-Family Conflict Has Negative and Significant Effects on Organizational Commitment
Based on the research, the results show that work-family conflict has a negative and significant effect on organizational commitment. This means that conflicts in the family will have an impact on decreasing organizational commitment. The more problems in the household that trigger conflict will reduce the commitment of health personnel organizations. Health workers who experience work-family conflict will find it difficult to harmonize their role in the family and at work and will lead to a lack of commitment to the hospital where they work.
When compared between women and men in prioritizing family interests, women will be more concerned with family. This is because women have a major role in taking care of domestic household needs, while men have more to fulfill family needs in terms of responsibility as the main breadwinner by working. Women, even though they have obligations as workers, still have to take care of the needs of family members consisting of husbands, children and personal selves. Her presence as a mother who is the primary caregiver for her children also cannot be replaced by anyone. Therefore, when experiencing work-family conflict, women generally will prioritize their family's interests which impact on the organization's commitment to work. Higher work-family conflicting experiences will reduce organizational commitment.
In health workers who are generally young at the age of marriage who are also still young, undergoing roles as family members and health workers need good adaptation to avoid conflict. This is because health workers have high work mobility, so they often leave their families. In the statement 'I don't have enough time to be with family', the average respondent answered in doubt with the details 10.6% felt very agree, 37.9% agreed and 6.1% doubted. Lack of time with family can be one of the causes of work-family conflicts that can result in decreased organizational commitment.
From the respondents' answers to work-family conflict, as many as 18.2% of the respondents felt that working hours made them rush to finish their homework, as many as 12.1% of respondents also felt strongly in agreement with the statement. This shows that there are still health workers who have not been able to condition their home tasks so they are not in a hurry to enter work during predetermined working hours. The inability to complete domestic domestic tasks properly can lead to conflicts within the family and will impact on their commitment in the organization they work for.
This research is in accordance with the results of research conducted by Sihaloho (2016); Puspitasari (2012); Isnaini (2018); Nart & Batur (2014); Malik, et al (2015); Li, et al. (2013) and Hatam (2016) which state that WFC has a significant effect on organizational commitment. However, the results of this study contradict the research conducted by Rantika & Sunjoyo (2015) and Nwuggballa (2016) which stated that WFC had no significant effect on organizational commitment.
Stress Work Has Positive Impact Not Significant towards Organizational Commitment
Based on the research results obtained stating that work stress has a positive and not significant effect on organizational commitment. This means that work stress does not trigger a decrease in organizational commitment to health workers at Latersia Binjai Hospital.
In this study the results showed that the average of the respondents consisting of health workers Latersia Binjai Hospital did not experience work stress. If there are respondents who experience work stress then it is still categorized as light work stress. In general respondents did not experience symptoms of work stress, physical symptoms consisting of headaches, rising blood pressure, and stomach pain. Respondents generally did not experience psychological symptoms such as anxiety, depression, and decreased job satisfaction. Respondents in general also did not experience behavioral symptoms of work stress such as decreased performance, low motivation, absenteeism, and movement.
The insignificant effect of work stress on organizational commitment can also be caused by health workers being a profession that gets high work pressure every day. Health workers are accustomed to or accustomed to facing various work pressures in hospitals, facing various patient complaints, to face various failures to save patients' lives. All work stresses that involve emotions are usually faced professionally in accordance with the profession oath. Because of that, no matter how heavy the work pressure in the hospital that results in work stress can be overcome because it must commit to save the lives of patients, also to be able to continue the next work that has been awaited. Choosing a profession as a health worker must be packaged with mental readiness facing the pressure of work coming and going quickly in order to maintain commitment.
Chong in Khan (2014) states that employees with high organizational commitment will be happy to be in the organization. One reason for the high commitment of the organization is the low work stress. High levels of work stress will trigger employees to get bored in work and over time will find other jobs that are more comfortable. However, the stress level will have no effect if the employee can control himself in his attitude at work. The need for work is also a consideration to remain in a workload that is prone to stress. There are only 9 hospitals in the city of Binjai, and RSU Latersia is the only hospital in East Binjai District. The reason for domicile is a consideration for health workers who have married, especially women, to remain committed and stay in Latinoia Binjai Hospital.
This research is consistent with the research conducted by Viktorius (2013) which shows that work stress does not have a direct and significant effect on organizational commitment. The research was conducted at the RSUD dr. Soedarso Pontianak. Lazarus and Folkman in Viktorius (2013) stated that stress arises due to the relationship between individuals and their environment, which individuals perceive as exceeding resources and endangering health. Individual ability to overcome problems, whether stress occurs or formed coping, depending on how to interpret or perceive and measure with environmental events. Perception is an individual reaction to a potential source of stress that can cause stress. This study contrasts with the results of research conducted by Sihaloho (2016) and Nart & Batur (2014) which show that work stress has a negative effect on organizational commitment.
Work-Family Conflict Influences Organizational Commitment through Stress Work
Based on the research, the results show that work-family conflict directly influences organizational commitment. In this study work stress variables do not function as intervening variables, which cannot mediate the influence of work-family conflict on organizational commitment. This is because in the partial test the results show that work stress has a positive and insignificant effect on the commitment of the organization of health workers at Latersia Binjai Hospital.
In this study it was stated that work-family conflict had a negative and significant effect on organizational commitment. Health workers who experience work-family conflicts will directly reduce their organizational commitment without having to experience work stress first. This is contrary to the research of Sihaloho (2016) and Divara and Agoes (2016), but according to Isnaini's research (2018).
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