Psychological Ownership Approaches to Understanding the Impact of Role Ambiguity on Healthcare Providers' Services in the Disability and Rehabilitation Field

Background/Purpose: With the rise of New Public Management reform, an important research stream in the third sector literature has been the consequences of purchase of service contracts (POSCs) and coping strategies. This issue is crucial in the Chinese context, as the strongly embedded POSCs model leads to role ambiguity for service providers. Meanwhile, even though psychological ownership can reduce role ambiguity, but the distinct roles of job-based psychological ownership (JPO) and collective psychological ownership (CPO) remain unclear.

This study aims to explore healthcare providers’ service impact in the context of POSCs in China with strong government embeddedness characteristics and examine the influences of psychological ownership in it, by developing a theoretical framework to compare a JPO model with a CPO model. We hypothesizes that role ambiguity would deteriorate service providers’ service impact and that the negative effects of role ambiguity could be mediated by both JPO and CPO of service providers.

Methods: Data come from the China Social Work Longitudinal Study conducted in 2019, which contains 1,153 social workers who were working in the disability and rehabilitation field. Out of the total interviewees, women accounted for 78.5% (n = 905), and the average age was 33 years old (SD = 8.38), 53.9% were married (n = 621), 55.2% were holders of bachelor’s degree or above (n = 636), and 13% possessed social work licensing (n = 150). The four items in our model were extracted from the existing literature, to ensure the construct validity of potential variables. And we conducted confirmatory factor analyses (CFAs) to guarantee scale validity and reliability.

Results: Our findings indicate that the role ambiguity induced by outsourcing practices has a detrimental impact on the service impact of Chinese HCPs, supporting the theoretical tenet that role ambiguity can lead to poor work performance. And this finding also broadens the current understanding of the relationship between role ambiguity and the service impact of disability services in the context of the purchase-of-service contracts. Meanwhile, we find that job-based psychological ownership exerts a greater influence than collective psychological ownership did among the Chinese HCPs who experienced role ambiguity. This finding revealed the dilemma of insufficient capacity of human service organizations under service contracting because the service organizations failed to effectively reduce the negative effects of role ambiguity.

Conclusions and Implications: Our model responds to previous calls to compare JPO and CPO, as well as to a more nuanced understanding of service contracts, expanding the understanding of service impact under POSCs. The findings are a wake-up call regarding public services for the disabled, alerting both human service organization managers and the government to the need for strengthening organizational capacity. Furthermore, we call on the POSCs in China to maintain a specific degree of consistency with the collectivist culture and the tradition of work-units, and to strengthen emerging service organizations, so that they can provide higher-quality services for their clients.