Journals / İktisadi İdari ve Siyasal Araştırmalar Dergisi / 2026 / Sayı: 29

The Relationship Between Total Quality Management and Occupational Burnout: An Analysis in Healthcare Institutions

Toplam Kalite Yönetimi ve Mesleki Tükenmişlik İlişkisi: Sağlık Kurumlarında Bir İnceleme

Ayhan Terzibaş(BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, YENİÇAĞA YAŞAR ÇELİK MESLEK YÜKSEKOKULU, PAZARLAMA VE DIŞ TİCARET BÖLÜMÜ)0000-0002-9738-5917
Pages
767–789
Publication Date
2026-09-10
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The results suggest that implementing TQM in ways that strengthen employee participation, feedback, and organizational support may contribute to employee well-being in healthcare institutions.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:This study aims to examine the relationships between the level of Total Quality Management (TQM) adoption perceived by healthcare professionals and the three dimensions of occupational burnout: emotional exhaustion, depersonalization, and personal failure.
📊
Key Findings & Data:The study was conducted using a correlational survey design, and data were collected between May 1 and June 20, 2025, from 322 healthcare professionals working in Düzce, Türkiye, who were reached through convenience sampling.
💡
Conclusion & Impact:The results suggest that implementing TQM in ways that strengthen employee participation, feedback, and organizational support may contribute to employee well-being in healthcare institutions.
🔬Design:Survey & Empirical Study
📍Scope:2025 Verileri
⚙️Variables:Mesleki Tükenmişlik · Toplam Kalite Yönetimi · Sağlık Çalışanları

Abstract

This study aims to examine the relationships between the level of Total Quality Management (TQM) adoption perceived by healthcare professionals and the three dimensions of occupational burnout: emotional exhaustion, depersonalization, and personal failure. The study was conducted using a correlational survey design, and data were collected between May 1 and June 20, 2025, from 322 healthcare professionals working in Düzce, Türkiye, who were reached through convenience sampling. Data were collected using the 28-item TQM Adoption Scale developed by Ramseook-Munhurrun et al. (2011) and the Maslach Burnout Inventory adapted into Turkish by Ergin (1992). The data were analyzed using descriptive statistics, reliability analyses, confirmatory factor analysis, Pearson correlation analysis, and hierarchical regression analysis. The findings showed that, after controlling for demographic variables, TQM adoption was significantly and negatively associated with emotional exhaustion (β = -0,316), depersonalization (β = -0,204), and personal failure (β = -0,293). The strongest relationship was observed for emotional exhaustion, whereas the weakest relationship was found for depersonalization. The results suggest that implementing TQM in ways that strengthen employee participation, feedback, and organizational support may contribute to employee well-being in healthcare institutions.

Özet

Bu araştırmada, sağlık çalışanlarının algıladığı toplam kalite yönetimi (TKY) benimsenme düzeyi ile mesleki tükenmişliğin duygusal tükenme, duyarsızlaşma ve kişisel başarısızlık hissi boyutları arasındaki ilişkilerin incelenmesi amaçlanmıştır. Araştırma ilişkisel tarama modelinde yürütülmüş; veriler 1 Mayıs–20 Haziran 2025 tarihleri arasında Düzce'de görev yapan ve kolayda örnekleme yöntemiyle ulaşılan 322 sağlık çalışanından toplanmıştır. Veri toplamada Ramseook-Munhurrun vd. (2011) tarafından geliştirilen 28 maddelik TKY Benimsenmesi Ölçeği ile Ergin (1992) tarafından Türkçeye uyarlanan Maslach Tükenmişlik Ölçeği kullanılmıştır. Veriler tanımlayıcı istatistikler, güvenirlik analizleri, doğrulayıcı faktör analizi, Pearson korelasyon analizi ve hiyerarşik regresyon analiziyle incelenmiştir. Bulgular, demografik değişkenler kontrol edildikten sonra TKY benimsenmesinin duygusal tükenme (β = -0,316), duyarsızlaşma (β = -0,204) ve kişisel başarısızlık hissi (β = -0,293) ile negatif ve anlamlı biçimde ilişkili olduğunu göstermiştir. İlişki en güçlü duygusal tükenme, en zayıf ise duyarsızlaşma boyutunda gözlenmiştir. Sonuçlar, sağlık kurumlarında TKY'nin çalışan katılımını, geri bildirimi ve örgütsel desteği güçlendirecek biçimde uygulanmasının çalışan refahını destekleyebileceğine işaret etmektedir.

🔖

Cite This Article

Terzibaş, A. (2026). The Relationship Between Total Quality Management and Occupational Burnout: An Analysis in Healthcare Institutions. İktisadi İdari ve Siyasal Araştırmalar Dergisi, Sayı: 29, 767–789. https://doi.org/10.25204/iktisad.1900095

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (63)

  1. Aguinis, H., Gottfredson, R. K., & Joo, H. (2013). Best-Practice Recommendations for Defining, Identifying, and Handling Outliers. Organizational Research Methods, 16(2), 270-301. https://doi.org/10.1177/1094428112470848
  2. Ahmed, A. O., Abdalla, A. M., & Ali, A. M. (2025). Investigating the impact of soft TQM practices on employees’ organizational commitment in governmental Sudanese petroleum organizations. International Journal of Quality & Reliability Management, 42(7), 1995-2010. https://doi.org/10.1108/IJQRM-04-2024-0113
  3. Ahola, K. (2007). Occupational burnout and health. http://hdl.handle.net/10138/19788
  4. Akkoç, İ., Okun, O., & Türe, A. (2021). The effect of role‐related stressors on nurses' burnout syndrome: The mediating role of work‐related stress. Perspectives in Psychiatric Care, 57(2), 583-596. https://doi.org/10.1111/ppc.12581
  5. Al Alwi, A., Almutair, R., Alyousef, L., Albahrani, H., Almotter, E., Owaynah, A. B., Almoaibed, H., Alfayez, A., Alqanbar, M., Alessa, R., Alawadh, S., & Aljaber, A. (2024). Nursing care delivery models and their impact on emotional exhaustion and practice environment: A cross-sectional study in Saudi Arabia. Journal of Healthcare Administration, 3(2), 149-165. https://doi.org/10.33546/joha.3536
  6. Amin, M., Aldakhil, A. M., Wu, C., Rezaei, S., & Cobanoglu, C. (2017). The structural relationship between TQM, employee satisfaction and hotel performance. International Journal of Contemporary Hospitality Management, 29(4), 1256-1278. https://doi.org/10.1108/IJCHM-11-2015-0659
  7. Amiri, S., Mahmood, N., Mustafa, H., Javaid, S. F., & Khan, M. A. (2024). Occupational risk factors for burnout syndrome among healthcare professionals: A global systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 21(12), 1583. https://doi.org/10.3390/ijerph21121583
  8. Bakker, A. B., & Demerouti, E. (2007). The job demands‐resources model: State of the art. Journal of managerial psychology, 22(3), 309-328. https://doi.org/10.1108/02683940710733115
  9. Becker, T. E. (2005). Potential Problems in the Statistical Control of Variables in Organizational Research: A Qualitative Analysis With Recommendations. Organizational Research Methods, 8(3), 274-289. https://doi.org/10.1177/1094428105278021
  10. Boon Ooi, K., Abu Bakar, N., Arumugam, V., Vellapan, L., & Kim Yin Loke, A. (2007). Does TQM influence employees' job satisfaction? An empirical case analysis. International Journal of Quality and Reliability Management, 24(1), 62-77. https://doi.org/10.1108/02656710710720330
  11. Bornstein, M. H., Jager, J., & Putnick, D. L. (2013). Sampling in developmental science: Situations, shortcomings, solutions, and standards. Developmental Review, 33(4), 357–370. https://doi.org/10.1016/j.dr.2013.08.003
  12. Cordes, C. L., & Dougherty, T. W. (1993). A review and an integration of research on job burnout. Academy of Management Review, 18(4), 621-656. https://doi.org/10.5465/amr.1993.9402210153
  13. Cropanzano, R., & Mitchell, M. S. (2005). Social exchange theory: An interdisciplinary review. Journal of management, 31(6), 874-900. https://doi.org/10.1177/0149206305279602
  14. Curtis, E. A., Comiskey, C., & Dempsey, O. (2016). Importance and use of correlational research. Nurse researcher, 23(6). https://doi.org/10.7748/nr.2016.e1382
  15. Dale, B. G., & Lascelles, D. M. (1997). Total quality management adoption: revisiting the levels. The TQM Magazine, 9(6), 418-428. https://doi.org/10.1108/09544789710186957
  16. Dubale, B. W., Friedman, L. E., Chemali, Z., Denninger, J. W., Mehta, D. H., Alem, A., Fricchione, G. L., Dossett M. L. & Gelaye, B. (2019). Systematic review of burnout among healthcare providers in sub-Saharan Africa. BMC Public Health, 19(1), 1247. https://doi.org/10.1186/s12889-019-7566-7
  17. Dursun Temiz, T. N., & Sivuk, D. (2022). Toplam kalite yönetimi uygulamaları ile hastane çalışanlarının iş tatmini, iş yaşam kalitesi ve işten ayrılma niyeti arasındaki ilişki. Verimlilik Dergisi, (1), 120-131. https://doi.org/10.51551/verimlilik.731664
  18. Eisenberger, R., Huntington, R., Hutchison, S., & Sowa, D. (1986). Perceived organizational support. Journal of Applied psychology, 71(3), 500-507. https://doi.org/10.1037/0021-9010.71.3.500
  19. Ergin, C. (1992, 22 Eylül). Doktor ve hemşirelerde tükenmişlik ve Maslach tükenmişlik ölçeğinin uyarlanması. VII. Ulusal Psikoloji Kongresi içinde (s. 143-154). Ankara, Türkiye.
  20. Escrig-Tena, A. B., Segarra-Ciprés, M., & García-Juan, B. (2025). Examining the dark side of quality management: Analysing work overload, exhaustion and managerial support using a moderated mediation approach. International Journal of Operations & Production Management, 45(6), 1276-1307. https://doi.org/10.1108/IJOPM-08-2023-0695
  21. Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American journal of theoretical and applied statistics, 5(1), 1-4. https://doi.org/10.11648/j.ajtas.20160501.11
  22. Fallah Ebrahimi, Z., Wei Chong, C., & Hosseini Rad, R. (2014). TQM practices and employees' role stressors. International Journal of Quality and Reliability Management, 31(2), 166-183. https://doi.org/10.1108/IJQRM-04-2013-0067
  23. Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.1177/002224378101800104
  24. Fuller, C. M., Simmering, M. J., Atinc, G., Atinc, Y., & Babin, B. J. (2016). Common methods variance detection in business research. Journal of Business Research, 69(8), 3192–3198. https://doi.org/10.1016/j.jbusres.2015.12.008
  25. Halawani, N., AlOmari, H. K., AlZamil, M. S., Almutairi, A. K., Alharthi, M. S., & Alluqmani, W. A. (2023). A systematic review of burnout among healthcare providers: Prevalence, causes, and impacts. International Journal of Development Research, 13(12), 64368-64372. https://tinyurl.com/39mzb4t9
  26. Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43, 115–135. https://doi.org/10.1007/s11747-014-0403-8
  27. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
  28. Ishikawa, K. (1985). What is total quality control? The Japanese way. Prentice Hall Direct.
  29. Jun, M., Cai, S., & Shin, H. (2006). TQM practice in maquiladora: Antecedents of employee satisfaction and loyalty. Journal of Operations Management, 24(6), 791-812. https://doi.org/10.1016/j.jom.2005.09.006
  30. Kanbay, Y., & Yalap, O. (2022). SPSS ile temel veri analizleri. Akademisyen Kitabevi.
  31. Karagöz, Y., & Kösterelioğlu, İ. (2008). İletişim becerileri değerlendirme ölçeğinin faktör analizi metodu ile geliştirilmesi. Dumlupınar Üniversitesi Sosyal Bilimler Dergisi, (21), 81-97. https://izlik.org/JA94XY86DR
  32. Karia, N., & Saleh, F. I. M. (2022). The effect of TQM practices on INGOs’ staff work-related attitudes. Benchmarking: An International Journal, 29(2), 596–621. https://doi.org/10.1108/BIJ-02-2021-0080
  33. Klein, K. J., & Kozlowski, S. W. J. (2000). From micro to meso: Critical steps in conceptualizing and conducting multilevel research. Organizational Research Methods, 3(3), 211–236. https://doi.org/10.1177/109442810033001
  34. Krejcie, R. V., & Morgan, D. W. (1970). Determining sample size for research activities. Educational and Psychological Measurement, 30(3), 607–610. https://doi.org/10.1177/001316447003000308
  35. Lance, C. E., Butts, M. M., & Michels, L. C. (2006). The sources of four commonly reported cutoff criteria: What did they really say? Organizational Research Methods, 9(2), 202-220. https://doi.org/10.1177/1094428105284919
  36. LeBreton, J. M., & Senter, J. L. (2008). Answers to 20 questions about interrater reliability and interrater agreement. Organizational Research Methods, 11(4), 815–852. https://doi.org/10.1177/1094428106296642
  37. Lee, H.-F., & Chang, Y.-J. (2022). The Effects of Work Satisfaction and Work Flexibility on Burnout in Nurses. Journal of Nursing Research, 30(6), e240. https://doi.org/10.1097/jnr.0000000000000522
  38. Liu, J., Zheng, J., Liu, K., Liu, X., Wu, Y., Wang, J., & You, L. (2019). Workplace violence against nurses, job satisfaction, burnout, and patient safety in Chinese hospitals. Nursing Outlook, 67(5), 558-566. https://doi.org/10.1016/j.outlook.2019.04.006
  39. Liu, N. C., & Liu, W. C. (2014). The effects of quality management practices on employees’ well-being. Total Quality Management and Business Excellence, 25(11–12), 1247–1261. https://doi.org/10.1080/14783363.2012.704285
  40. Lu, M. K., Moslehpour, M., Lin, P. K., & Chen, T. W. (2025). Impact of sustainable HRM practices on employee well-being in health organizations: The mediating role of perceived organizational support. American Journal of Health Behavior, 49(2), 78-92. https://doi.org/10.5993/AJHB.49.2.8
  41. Marsh, H. W., & Hocevar, D. (1985). Application of confirmatory factor analysis to the study of self-concept: First- and higher order factor models and their invariance across groups. Psychological Bulletin, 97(3), 562–582. https://doi.org/10.1037/0033-2909.97.3.562
  42. Maslach, C. (1978). Job burnout: How people cope. Public Welfare, 36(2), 56-58.
  43. Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2(2), 99-113. https://doi.org/10.1002/job.4030020205
  44. Maslach, C., Schaufeli, W. B. & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422. https://doi.org/10.1146/annurev.psych.52.1.397
  45. McNeish, D. (2018). Thanks coefficient alpha, we'll take it from here. Psychological methods, 23(3), 412–433. https://doi.org/10.1037/met0000144
  46. Meredith, L. S., Bouskill, K., Chang, J., Larkin, J., Motala, A., & Hempel, S. (2022). Predictors of burnout among US healthcare providers: a systematic review. BMJ Open, 12(8), e054243. https://doi.org/10.1136/bmjopen-2021-054243
  47. Mohamed, A. A. (2025). Nurses’ perception of organizational cynicism and its relation to their quality of work life in Port-Said hospitals. Port Said Scientific Journal of Nursing, 12(1), 388-415. https://doi.org/10.21608/pssjn.2025.355800.1346
  48. Mohanty, R. P., & Behera, A. K. (1996). TQM in the service sector. Work study, 45(3), 13-17. https://doi.org/10.1108/00438029610115479
  49. Nevanperä, N. J., Hopsu, L., Kuosma, E., Ukkola, O., Uitti, J., & Laitinen, J. H. (2012). Occupational burnout, eating behavior, and weight among working women. The American Journal of Clinical Nutrition, 95(4), 934-943. https://doi.org/10.3945/ajcn.111.014191
  50. Osayawe Ehigie, B., & McAndrew, E. B. (2005). Innovation, diffusion and adoption of total quality management (TQM). Management Decision, 43(6), 925-940. https://doi.org/10.1108/00251740510603646
  51. Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. The Journal of applied psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879
  52. Ramseook-Munhurrun, P., Munhurrun, V., & Panchoo, A. (2011). Total Quality Management adoption in a public hospital: evidence from Mauritius. Global Journal of Business Research, 5(3), 67-77. https://access.portico.org/stable?au=phx4jvxq1k7
  53. Raudenská, J., Steinerová, V., Javůrková, A., Urits, I., Kaye, A. D., Viswanath, O., & Varrassi, G. (2020). Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic. Best Practice and Research Clinical Anaesthesiology, 34(3), 553-560. https://doi.org/10.1016/j.bpa.2020.07.008
  54. Ross, J. E. (2017). Total quality management: Text, cases, and readings. Routledge. https://doi.org/10.1201/9780203735466
  55. Seeram, E. (2019). An overview of correlational research. Radiologic Technology, 91(2), 176-179. https://pubmed.ncbi.nlm.nih.gov/31685592/
  56. Spector, P. E., & Brannick, M. T. (2011). Methodological Urban Legends: The Misuse of Statistical Control Variables. Organizational Research Methods, 14(2), 287-305. https://doi.org/10.1177/1094428110369842
  57. Şanlı, Ö., & Tan, Ç. (2017). Öğretmenlerin tükenmişlik düzeylerinin çeşitli değişkenler açısından incelenmesi. Fırat Üniversitesi Sosyal Bilimler Dergisi, 27(2), 131-142. https://doi.org/10.18069/firatsbed.346496
  58. Talha, M. (2004). Total quality management (TQM): an overview. The bottom line, 17(1), 15-19. https://doi.org/10.1108/08880450410519656
  59. Taranu, S. M., Ilie, A. C., Turcu, A.-M., Stefaniu, R., Sandu, I. A., Pislaru, A. I., Alexa, I. D., Sandu, C. A., Rotaru, T.-S., & Alexa-Stratulat, T. (2022). Factors associated with burnout in healthcare professionals. International Journal of Environmental Research and Public Health, 19(22), 14701. https://doi.org/10.3390/ijerph192214701
  60. Tarcan, G. Y., Tarcan, M., & Top, M. (2017). An analysis of relationship between burnout and job satisfaction among emergency health professionals. Total Quality Management and Business Excellence, 28(11–12), 1339–1356. https://doi.org/10.1080/14783363.2016.1141659
  61. Tutar, H., Eryüzlü, H., Mutlu, H. T., & Nam, S. (2024). Bilimsel analiz teknikleri (Nicel, nitel, karma yöntem ve ekonometrik analiz teknikleri). Umuttepe Yayınları.
  62. Türkiye Cumhuriyeti Sağlık Bakanlığı. (2025). Sağlık istatistikleri yıllığı 2024. https://dosyamerkez.saglik.gov.tr/Eklenti/52859/0/siy2024tr31122025pdf.pdf
  63. Yazdani, B. (2022). TQM, employee outcomes and performance: the contingency effect of environmental uncertainty. International Journal of Quality and Reliability Management, 39(2), 647-672. https://doi.org/10.1108/IJQRM-04-2018-0090