What’s Love Got to Do With It?:

A Longitudinal Study of the

Influence of a Culture of

Companionate Love on Employee

and Client Outcomes in the Long-term Care

Industry

Sigal Barsade & Olivia (Mandy) O’Neill

Wharton School School of Management

University of Pennsylvania George Mason University

Early Management Theorists …

“I have left to the last what seems to me the chief function, the real service, of business: to give an opportunity for individual development through the better organization of human relationships. . . .I think it offers a larger opportunity than any single profession in the possibilities of those intimate human interweavings through which all development of man must come.” Mary Parker Follett, 1925, p. 113 

An “Other-focused” vs. “Ego-focused” emotion (Markus and Kitayama, 1991) Compassion (Shaver et al., 1987) Affection (Lazarus, 1991) Caring (Fehr, 1988; Walster & Walster, 1978) Tenderness (Fehr & Russell, 1991)

A basic emotion – Fundamental to human experience (Hatfield, Rapson & Martel, 1993 ; Reis & Aron, 2008).

Helps keep people connected and committed (Reis & Aron, 2008)

It doesn’t stop at the office door - and it can live in long-term relationships, and in short “moments”

What is companionate love?

Link

Companies are also beginning to recognize

the importance of companionate love as part of their culture Pepsi – “Caring” is the

first guiding principles MagnaPowerTrain –

“Caring as a key value” Zappos – “We watch out

for each other, care for each other, and go above and beyond for each other”- CEO Tony Hsieh

“Love” is first of Whole Food’s management. principles

Companionate Love is a social emotion – and could have particularly relevant outcomes at the collective, cultural, level.

Organizational culture has been shown to be related to motivation, commitment, turnover, leadership, demography, cooperativeness, and performance (Carroll & Harrison, 1998; Chatman & Barsade, 1995; Denison and Mishra, 1995; O’Reilly, Chatman, and Caldwell, 1991; Ott, 1989; Schein, 2004; van Maanen & Schein, 1979; Wilkins and Ouchi, 1983)

BUT…. Organizational culture research has

ignored the construct of emotional culture, focusing only on shared cognitions, or cognitive culture.

The Intersection of Companionate Love and Organizational

Culture

A Culture of Companionate Love:

Visible norms and artifacts, underlying values and assumptions, reflecting degree of perceived appropriateness and actual expression or suppression of affection, caring, compassion and tenderness within a social unit.

. Relies heavily on non-verbal expression. Varies from weak to strongOperates through “feeling mechanisms” – nonverbal manifestations through facial expression and body language are critical (Haviland, 1982)Operates through “normative enactments” which keep members conforming and committed to the group (Durkheim, 1912; Ekman, 1973; van Maanen, 1991; Hochschild, 1983). Can be strategic and intentional.

“If you came to work at this place and you weren’t as compassionate a person as others . . .I think it just becomes a part of your norm if it wasn’t before. If you practice it enough, it becomes the norm” (Lilius et al., 2011, p. 881).

What is the missing piece? Emotional

Culture – A Culture of

Companionate Love

Long-term care settings - “a world of emotions” (Ruckdeschel and Van Haitsma, 2004)

Health-care organizations characterized as “ecologies of compassion” (Miller, 2007)

There are issues in long-term care that a culture of companionate love could help address Healthcare workers display some of

the highest levels of employee dissatisfaction (Aiken et al., 2001)

Turnover ranging from 48% nurses to as high as 119% for Certified Nursing Assistants (Castle, 2006)

Why Study the Culture of Companionate Love in a Long-term Care

Setting?

Sample comes from a large not-for-profit long-term healthcare facility in a metro city in the Northeast. 185 employees, 108 patients and 42 families across 13 units in the geographic sites.

Multiple ratings of a culture of companionate love: outside research observers, employees, and patients’ families

Multiple measures of employee, patient and family outcomes spanning the attitudinal, emotional, behavioral, and health domains. Includes ratings of patient mood, objective patient health care outcomes, and employee absenteeism.

Longitudinal: Predictor variables were gathered at Time 1 and all dependent variables were collected 16 months later (Time 2)

Method

“How frequently did employees on the unit express the following emotions?” Caring, compassion, affectionate, and tenderness (1=Never through 5=Very Often).

Trained research assistants (M = 3.35, s.d=.97) Rated affective culture of caring and

compassion for unit visits > 20 minutes Avg. # of visits = 7.98 (s.d. = 4.10), ICC = .73

Employee Ratings (M = 3.97, s.d. = .70, α = .73)

Family Ratings (M = 3.94, s.d.=.93, α = .91)

Culture of Companionate Love:

Multiple Ratings of Companionate Love

Employee outcomesTeamworkSatisfactionEmotional exhaustionAbsenteeism

The Influence of a Culture of Companionate Love on Employee, Patient and Family Outcomes

Patient outcomesSatisfactionQuality of LifeMood (rated by CNAs)

Health (objective measures)

Patient family outcomesSatisfactionWillingness to Recommend Facility

“I would like to add that [this organization] has not only been a home for the patients, it has been a home for me. My co-workers have been a family. They have watched me grow. Since I started coming here they’ve been cooperative, compassionate and moreover, loving.” Comment from Nurse My co-workers are “caring,

compassionate people…” Nurse “The staff genuinely cares and feels

the loss, which shows their compassion.” Family member commenting on how employees deal with patient death on the units “I love them all.” Family Member

Qualitative Comments: Strong Culture of

Companionate Love

“[People] need to have love and [a] caring spirit.” Suggestion from employee about other employees

A small minority of the staff was “particularly empathetic and caring—they should be encouraged.” Family Member

Staff members described as less than satisfactory specifically because they are “the ‘opposite’ of ‘very caring’.” Family Member

Qualitative Comments: Weak or Mixed Culture of

Companionate Love

A culture of companionate love positively impacts employees, patients and their families

Leaders need to consider and manage emotional culture as well as cognitive culture Leaders own emotions influence the

culture – emotional contagion Leaders coaching others in

companionate love can help their own health

Create organizational structures and procedures to support a culture of love

Conclusion

Questions?

Thank you!

Appendix Slides

Illustrative examination of culture of companionate love among 3,201 employees in 17 organizations within 7 industries (Biopharmaceutical, Engineering, Financial Services, Higher Education, Real Estate, Travel & Utilities)

“In general how frequently do other employees in your division/organization express the following emotions (affection, caring, compassion and tenderness) at work? Mean = 2.93 (s.d.=.76, Cronbach Alpha = .77) Public Utility lowest (M=2.59, s.d.=.81) & Real

Estate highest (M=3.26, s.d.=.80)

Does a Culture of Companionate Love Matter in

Other Industries?

Relationship between of Culture of Companionate Love and: Employee Job Satisfaction (r=.23, p

< .001) Employee commitment to the

organization (r=.23, p < .001) Accountability for individual work

performance (r =.07, p < .01)

Does a Culture of Companionate Love Matter in

Other Industries? Relationship to Employee Attitudes

The attitudinal and behavioral outcomes of higher trait positive affect employees will be more strongly influenced by a culture of companionate love than those of lower trait positive affect employees.

Individual Difference Moderator:

Trait Positive Affect

Time 1 Predictor Variables Time 2EmployeeTeamworka

Time 2EmployeeSatisfactionb

Time 2EmployeeEmotional Exhaustiona

Time 2EmployeeAbsenteeismc

Site 1 -.00 .02 -.18 -.47•Site 2 .29 .23 -.32 -.22Male .31• .24 -.22 .02Tenure .00 .00 .00• .00Certified nursing assistant .08 -.11 .05 .55••Trait positive affectivity .05 .05 -.28• -.02Social desirability 1.39•• 1.49•• -1.78•• -.34Culture of companionate love – Outsider raters’ observations

.56• .51•• -.40• -.21•

Pseudo R2 .05 .11 .07 .08*Unstandardized coefficients are reported. Time 2 measures collected 16 months later. a n = 156 observations nested in 13 units; b n = 137 observations nested in 13 units. cn = 120 observations nested in 13 units•p < .05, ••p< .01, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Longitudinal Models Predicting Employee Engagement and Withdrawal at Time 2 from Outside Raters’ Observations of Culture of

Companionate Love at Time 1*

Time 1 Predictor Variables

Time 2EmployeeTeamworka

Time 2EmployeeSatisfactionb

Time 2EmployeeEmotional Exhaustiona

Time 2EmployeeAbsenteeismc

Site 1 .07 .05 -.15 -.66•Site 2 .01 -.02 -.13 -.12Male .29• .28 -.29 .02Tenure .00 -.00 .00•• .00Certified nursing assistant

.08 -.09 .02 .56••

Trait positive affectivity .05 .08 -.37•• .02Social desirability 1.37•• 1.40•• -1.70•• -.47Culture of companionate love – Employees’ observations

.29••• .27••• -.07 -.14•

Culture of companionate love * Trait positive affectivity

.25• .41••• -.30• .08

Pseudo R2 .15 .21 .08 .00

*Unstandardized coefficients are reported. Trait affectivity, social desirability, culture of companionate love, and interaction terms all grand-mean centered. Time 2 measures collected 16 months later. a n = 137 observations nested in 13 units; b n = 156 observations nested in 13 units. cn = 120 observations nested in 13 units•p < .05, ••p< .01, •••p< .001, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Longitudinal Models Predicting Employee Engagement and Withdrawal at Time 2 from

Employees’ Observations of Culture of Companionate Love at Time 1*

Figure 1: Interaction of a Culture of Companionate Love and Trait Positive Affect

on Employee Satisfaction.

Figure 2: Interaction of a Culture of Companionate Love and Trait Positive Affect

on Employee Teamwork.

Figure 3: Interaction of a Culture of Companionate Love and Trait Positive Affect

on Employee Emotional Exhaustion.

Predictor Variables Time 2 Resident Pleasant Mood (as rated by primary Certified Nursing Assistants) a

Poor health (Time 2) -.01Cognitive impairment (Time 2) -.14••Poor physical functioning (Time 2)

-.02

Culture of companionate love – Outside raters’ observations

.46•

Pseudo R2 .10

*Unstandardized coefficients are reported. Time 2 measures collected 16 months later. a n = 109 observations nested in 13 units.•p < .05, ••p< .01, •••p< .001, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Longitudinal Models Predicting Resident Mood at Time 2 from Outside Raters’

Observations of Culture of Companionate Love at Time 1*

*Unstandardized coefficients are reported. Time 2 measures collected 16 months later. a n = 32 observations nested in 13 units; bn = 39 observations nested in 13 units. •p < .05, ••p< .01, •••p< .001, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Predictor VariablesTime 2ResidentSatisfaction

a

Time 2ResidentQuality of Life - Dignity b

Time 2ResidentQuality of Life – Good Relationships b

Poor health (Time 2) -.06 .19 -.28•Cognitive impairment (Time 2)

.33• .65••• .14

Poor physical functioning (Time 2)

-.30• -.44•• -.05

Culture of companionate love – Outside raters’ observations

.60•• .75• .57•

Pseudo R2 .04 .18 .10

Longitudinal Models Predicting Resident Satisfaction and Quality of Life at Time 2

from Outside Raters’ Observations of Culture of Companionate Love at Time 1*

Longitudinal Models Predicting Resident Health Outcomes at Time 2 from Outside

Raters’ Observations of Culture of Companionate Love at Time 1*

Predictor Variables

Time 2ResidentWeight Gain a

Time 2ResidentFewer Trips to Emergency Room a

Time 2ResidentLower Incidence of Ulcers b

Poor health (Time 2) -.21 .25 -.31Cognitive impairment (Time 2)

-.42 .07 -.19

Poor physical functioning (Time 2)

.16 -.04 -1.16•••

Culture of companionate love – Outside raters’ observations

.57 1.61• .20

Pseudo R2 .00 .02 .09*Unstandardized coefficients are reported. Time 2 measures collected 16 months later.a n = 114 observations nested in 13 units; b n = 111 observations nested in 13 units. •p < .05, ••p< .01, •••p< .001, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Time 1 Predictor Variables Time 2Family Member Satisfaction a

Time 2Family Member Would Recommend to Othersa

Site 1 -.18 -.32Site 2 .38 .19Poor health (Time 2) .26• .31••Cognitive impairment (Time 2)

-.43•• -.47•••

Poor physical functioning (Time 2)

.17 .11

Culture of companionate love – Outsider raters’ observations

.32 .29

Pseudo R2 .16 .20

*Unstandardized coefficients are reported. Time 2 measures collected 16 months later. Poor health, cognitive impairment, and poor physical functioning measures are for the family member in the hospital. a n = 91 observations nested in 13 units.•p < .05, ••p< .01, •••p< .001, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Longitudinal Models Predicting Family Attitudes at Time 2 from Outsider Raters’ Observations of Culture of Companionate

Love at Time 1*

Time 1 Predictor Variables Time 2Family Member Satisfactiona

Time 2Family Member would Recommend to Othersa

Site 1 .59 .52Site 2 .52 .46Poor health (Time 2) -.01 .02Cognitive impairment (Time 2)

-.39• -.42•

Poor physical functioning (Time 2)

.29 .26

Culture of companionate love – Family observations

.41••• .49•••

Pseudo R2 .07 .19

*Unstandardized beta coefficients. Time 2 measures collected 16 months later. Poor health, cognitive impairment, and poor physical functioning measures are for the family member in the hospital.a n = 47 observations nested in 13 units.•p < .05, ••p< .01, •••p< .001, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Longitudinal Models Predicting Family Attitudinal Variables at Time 2 from Family Observations of Culture of Companionate

Love at Time 1*

Time 1 Predictor Variables Time 2Employee Teamworka

Time 2EmployeeSatisfactionb

Time 2Employee Emotional Exhaustionb

Time 2Employee Absenteeism

Site 1 .91• .35 -.95• -1.08•Site 2 .69• .76• -.72• -.62Male .35• .32• -.30 -.01Tenure .00 .00 .00 .00Certified nursing assistant .11 -.06 .01 .51••Trait positive affectivity .05 .06 -.29• -.04Social desirability 1.31•• 1.40•• -1.68•• -.24Culture of companionate love – Artifacts

.55••• .44••• -.48••• -.38••

Pseudo R2 .05 .10 .08 .09

*Unstandardized coefficients are reported. Time 2 measures collected 16 months later. a n = 156 observations nested in 13 units; b n = 137 observations nested in 13 units. n = 120 observations nested in 13 units•p < .05, ••p< .01, •••p< .001, two-tailed tests (control variables), one-tailed test (culture of companionate love).

Table 10: Longitudinal Models Predicting Employee Engagement and Withdrawal at Time 2 from Culture of Companionate Love

Artifacts at Time 1*

Prototype Approach to Emotions

Source: Shaver, Schwartz, Kirson, & O’Connor, 1987

link

General Model of Emotional Culture

Emotional culture• Emotional artifacts &

norms• Emotional values - Prescriptive - Descriptive• Emotional

assumptions

Normative response• Social exchange• Conformity• Surface acting

Feeling the emotion• Self-generated emotion • Facial feedback• Emotional contagion• Deep acting

Individual attitudes and behaviors

Group dynamics and effectiveness

Organizational survival & effectiveness

Mechanisms

Consequences

Construct

Individual Differences• Trait affect• Emotional intelligence• Propensity towards

Emotional Contagion• Big-5 Personality Variable