Secure Workplace Attachment: A Qualitative Study of Relational, Social and Physical Contingencies

Background and Purpose: Much of health services research examines the role of patient behaviors in health outcomes (Walters et al., 2016).  In turn, researchers have overlooked the importance of worker security and organizational attachment.  Drawing from a capability perspective (Sen, 2009), this presentation explains how relational, social and physical contingencies enhance or diminish workplace attachment security.

Methods: Thirteen in-depth, semi-structured interviews were conducted with Veteran health care sector social workers.  Interview participants were mostly female (77% female; 23% male), direct practitioners (85% direct practitioners; 15% supervisors), in young to middle adulthood, and worked primarily in behavioral health (77% behavioral health; 23% medical/surgical).  Recruitment was conducted via announcement at staff meetings.  Interviews elicited participants’ perceptions of connection with their work with Veterans, including their motivation to work with this population, what makes them feel secure in their work, and times they felt particularly attached to their job.  Interviews were transcribed verbatim.  Data was analyzed using a combination of thematic and deductive qualitative analysis.  Findings were member checked for their accuracy and relevance (92% of interviewees participated). The protection of human subjects in this study was provided by the oversight of the [name redacted for blind review] Institutional Review Board.

Results: Data analysis revealed several contingencies that enhanced or diminished workplace attachment security.  Relational contingencies included the presence or absence of family members and/or friends with military experience as well as positive or challenging relationships with administrators, colleagues, supervisors and/or patients.  Organizational and patient culture, including their medical and paramilitary dimensions, as well as a robust or compromised professional identity and perceptions of “loyalties” that supported or interfered with the agency mission were social contingencies.  Bureaucratic policies that protected workers from being fired but also made them feel encumbered in their ability to meet patient need, enjoyable or unpleasant job tasks, the presence or absence of opportunities for career advancement, and the availability or inaccessibility of alternative employment opportunities were physical contingencies. 

Conclusions and Implications: Results reveal that workplace attachment security is linked to several relational, social and physical contingencies. Managers, supervisors and administrators would benefit from conducting an assessment of these contingencies to promote workers’ attachment security.  Further research should also measure the significance and relative effects of these contingencies on workplace attachment security.