Research design and method

4.1.1 Research design

The purpose of this study was to explain the relationship between organisational culture, leadership behaviour, and job satisfaction for PHC professionals in the Asir region PHCCs.

The literature review demonstrated a dearth of research in the study area, Saudi Arabia. A mixed methods approach was implemented, using an explanatory sequential design. The design was applied in two phases: the first phase involved the collection and analysis of the quantitative data; the second phase involved the collection of the qualitative data (Creswell &

Plano Clark, 2011; Teddlie & Tashakkori, 2009).

An explanatory sequential design was chosen for two reasons. First, the research problem was quantitatively-oriented; a reliable quantitative instrument was used to measure the constructs of organisational culture, leadership behaviour, and job satisfaction (Lok, 1997).

Second, the results of the qualitative research was thought to help explain, and gain insights into, the quantitative results (Creswell & Plano Clark, 2011). According to Creswell and Plano-Clark (2011), using a combination of quantitative and qualitative approaches provides a more complete understanding of the research problem than the use of only one method.

Although the quantitative method may identify the variables that are systematically or statistically related, the method may fail to provide insights into why the variables are related.

A qualitative explication can help to clarify the important concepts and to corroborate the findings from the statistical analysis; it may also give guidance that facilitates the interpretation of the results (Polit & Beck, 2008). Johnson, Onwuegbuzie and Turner (2007) defined this type of approach as a quantitative dominant mixed method research design (QUAN-qual). Using this method the researcher relied mainly on a quantitative, postpositivist view of the process, concurrently the researcher recognized that the addition of the qualitative data would benefit the research. Combining the quantitative and qualitative methods enables them to complement each other. This integration of the two methods provides a far richer understanding of the research problem than by either method alone (Tashakkori & Teddlie, 2010).

For this reason the questionnaire survey was complemented by interviews so that the researcher could assess the relationship between the variables. As this method is applicable in the social and health disciplines, the method was deemed as appropriate for assessing the relationships between the variables that influence job satisfaction for PHCC professionals (Creswell & Plano Clark, 2011). In addition, to complement the findings from the

quantitative data and to confirm the validity of the method, the qualitative data was able to provide a detailed understanding of the problem (Hansen, 2006; Morell & Tan, 2009).

In summary, the sequential explanatory mixed methods approach provided an explanation of the findings identified in the quantitative phase, by a sub set of the same participants, using semi structured interviews. Such data enabled a richer understanding of the relationship between job satisfaction, leadership behaviour, and organisational culture for PHCCs in Saudi Arabia. The findings were expected to make a significant contribution to the management literature generally and, more particularly, to the literature about the management of health service professionals (Tashakkori & Teddlie, 2003).

The fourth objective of the current study involved designing a managerial framework to provide a blue print solution for the Saudi MOH. To this end, in the focus group, the researcher outlined the result of the mixed methods approach to the PHC leaders in the Asir region. This instructional session provided an opportunity for a discussion of the findings, which provided a greater explanation about the research problem, and assisted the researcher in designing the managerial framework. Figure 4.1 gives an overview of the study’s direction, from the targeted population to the sequence of the data collection, followed by the completed managerial framework. To help achieve the goals of the study, the research was divided into four parts: Part 1: quantitative research; Part 2: qualitative research (semi-structured review); Part 3: qualitative research (focus group); and Part 4: managerial framework design (see Figure 4.1).

Figure 4.1 Study direction framework Primary Health Care Centre Environment in Asir Region Organisational culture Leadership behaviour

Primary Health Care Professional Satisfaction Study Population: 1856 PHC Professionals in 227 PHCCs

Pilot Study: 35 PHC Professional participants

Mixed Method Explanatory Sequential Design Quantitative Data = Questionnaire

(N = 550) PHCC professionals Study 1

Qualitative Data = Semi structured interview Study 2

Design Managerial Framework Focus group for PHC leaders of Asir region Study 3

Study 4

4.1.1.1 Part 1: Quantitative research

Part 1, the first phase, was a cross-sectional survey; it involved the administration of a self-report instrument with established properties of validity and reliability.

4.1.1.2 Part 2: Qualitative research (semi structured interview)

Part 2, the second phase, was a follow up to the quantitative study; it uses qualitative methods to provide more insight and to help explain the quantitative outcomes (Creswell & Plano Clark, 2011). The method used for the qualitative study was the semi-structured interviews with the PHCC professionals (physician, nurses, allied health) as frontline staff. The data from these interviews assisted the researcher in understanding how the PHCC professionals clarified and explored the problem and to validate the result of part one.

4.1.1.3 Part 3: Qualitative research (Focus Group)

Part 3, the third phase, involved the focus group, a set of high authority PHC leaders; the results of the mixed methods approach were outlined. The aim of this discussion of the results with the PHC leaders was to assist and validate the result, and also to draw practical solutions that fall within the Saudi Arabian rules and regulations. The focus group approach was the most appropriate qualitative method. The discussion with the leaders, who have similar roles and responsibilities, helped the researcher to explore and develop relevant solutions that had been used as the base for designing the managerial framework (Hansen, 2006; Ulin, Robinson, & Tolley, 2005).

4.1.1.4 Part 4: Managerial Framework Design

Part 4, the final stage of the study, followed the collection and analysis of the data. It culminated in the design of a managerial framework that could be applied to the PHCCs in Saudi Arabia to improve individual satisfaction and organisational performance.