Preparation of Papers in Two-Column Format For IJRISS

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Spirituality at Work as a Pathway to Enhance Employee Engagement
among Nurses in Malaysia

Rabiatul Adawiyah Ma’arof1, Umi Kartini Rashid2, Juzaimi Nasuredin3, Kartini Mat Rashid4, Hasmida
Mohd Noor5

1,4,5Universiti Teknologi MARA, Cawangan Terengganu Kampus Dungun, 23000 Sura Hujung Dungun,
Terengganu, MALAYSIA

2,3Faculty of Technology Management and Business, Universiti Tun Hussein Onn Malaysia, 86400 Parit Raja, Batu
Pahat, Johor, MALAYSIA

DOI: https://dx.doi.org/10.47772/IJRISS.2025.910000280

Received: 14 October 2025; Accepted: 21 October 2025; Published: 10 November 2025

ABSTRACT

Employee engagement is a key factor in the success of healthcare organizations in today's competitive
environment. However, nurses in Malaysia’s public hospitals often face heavy workloads and staff shortages,
which can lead to burnout and disengagement. Previous studies have shown that engagement is important for
service quality and employee performance, but few have examined how spirituality at work affects employee
engagement among nurses in Malaysia’s healthcare system. Spirituality at work includes aspects such as inner
life, meaningful work, and a sense of community is thought to help build psychological resources as well as
boost nurses’ energy, dedication, and focus on their roles. This paper aims to expand existing knowledge by
looking at the direct relationship between spirituality at work and employee engagement among nurses in
Malaysian public hospitals. This study will use a quantitative survey method with self-administered
questionnaires, and the collected data will be analyzed with SPSS software Version 26. A total of 375 nurses
from public hospitals across Malaysia will be chosen for the study. The research aims to provide valuable insights
for healthcare leaders and policymakers in Malaysia, suggesting potential strategies to foster spirituality at work
and maintain engagement, which can enhance workforce resilience and the quality of patient care.

Keywords: Spirituality at Work, Employee Engagement, Nurses, Self-Determination Theory, Malaysia
healthcare

INTRODUCTION

Corporate businesses consider engaged employees as a source of competitive advantage to achieve
organizational goals. Therefore, employee engagement has emerged as a central focus in healthcare research and
practice due to its strong association with patient safety, quality of care, staff retention, and organizational
performance (Schaufeli, Bakker, & Salanova, 2006). Employee engagement is commonly defined as a positive,
fulfilling, work-related state of mind characterized by vigour, dedication, and absorption (Schaufeli et al., 2006).
Empirical evidence consistently demonstrates that organizations that allocate resources to cultivating
engagement often experience superior outcomes across various performance indicators. For instance, Mustaffa,
Lajuma, and Wider (2022) reported that companies with high levels of employee engagement can achieve
earnings growth up to 2.6 times greater than those with lower levels of employee engagement. Similarly, a study
conducted among nurses in Malaysia found that employee engagement can improve the job performance of
nurses (Ma’arof & Mat, 2019). These findings highlight the strategic relevance of fostering employee
engagement, especially in labour-intensive industries like healthcare, where human capital is the major driver of
service quality.

Nevertheless, despite the importance of engagement in both global and Malaysian contexts, a recent report shows
that engagement remains low globally, with only 21% of employees reporting themselves as engaged (Gallup,
2024). In fact, findings from Ibrahim, Mohd Rodzi, and Mohd Zin (2021) indicate that employee engagement

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levels in Malaysia remain comparatively low within the Asia-Pacific region.

At the same time, the public healthcare sector in Malaysia is under severe strain. Nurses, who form the largest
group of the healthcare workforce and provide direct patient care (Russeng et al., 2020), are increasingly affected
by a growing shortage. This situation has been worsened by heavy workloads, burnout, and high turnover
intentions among nurses, leading to reduced quality of care and increased risk to patient safety (Thum, 2025).
Moreover, the Ministry of Health (MOH) has reported a substantial disparity in the number of people seeking
medical care between public and private hospitals. In 2020, public hospitals recorded a significant increase in
patient admissions, with a total of 2,284,303 cases, compared to only 916,294 admissions in private hospitals.
This imbalance further intensifies the pressure on public healthcare facilities and their staff.

Further, Malaysia has witnessed a growing trend of qualified and experienced nurses migrating to other countries
in search of better salaries, improved working conditions, and career advancement opportunities. For instance,
it has been reported that approximately 2,000 Malaysian nurses are currently employed in Saudi Arabia (Seng,
2021). The nurse-to-population ratio in Malaysia also remains below international standards, standing at 1:283
compared to the World Health Organization (WHO) recommended ratio of 1:225 (Murugesan, 2024). The
Ministry of Health (MOH) has further projected that Malaysia will face a significant nursing shortage by 2030,
which is expected to place an even greater burden on existing staff and further compromise the quality of
healthcare service. These challenges undermine morale, reduce commitment, and contribute to disengagement
among nurses, making it urgent to find effective strategies that can sustain their motivation, well-being, and
long-term commitment to the profession.

Mendes and Stander (2011) argued that nurses can demonstrate a positive attitude toward their work through
employee engagement. Similarly, Sharma and Dhar (2016) highlighted that meaningful engagement is important
for nurses, as the constant pressure and emotional demands they face while performing daily tasks lead to stress
and emotional exhaustion. When nurses are engaged, they tend to display a high level of energy and become
more productive in performing their duties (Ma’arof, Rashid, & Nasuredin, 2023). Besides, from a psychological
perspective, engagement is viewed to be the opposite of burnout (Maslach, Schaufeli, & Leiter, 2001), which
can promote positive emotions and increase the motivation of employees (Parker & Griffin, 2011). Moreover,
higher engagement levels among nurses contribute to improving patient safety and satisfaction, especially during
the global shortage of nurses (Almotawa & Shaari, 2019).

Similarly, several researchers have highlighted the importance of considering spirituality at work as a key
strategy for promoting a positive, healthy, and productive work environment, particularly in the healthcare sector
(Hisam & Sanyal, 2021; Garg & Rastogi, 2006). James, Miles, and Mullins (2011) further argued that spirituality
can function as an innate source and be used as one of the personal methods for individuals in managing stressful
situations. In the same line, Kouhdasht, Mahdian, Parmouz, and Moghadam (2019) and Reutter and Bigatti
(2014) found that higher levels of spirituality are associated with lower occupational stress and improved
psychological well-being. Therefore, Wei, Wu, Lee, and Tung (2020) noted that, in stressful situations,
promoting spirituality at work can encourage positive employee attitudes and behaviours that directly enhance
the quality of patient care and organizational outcomes.

On top of that, based on Self-Determination Theory, as proposed by Deci and Ryan (2000), people are
intrinsically motivated when their basic psychological needs for autonomy, competence, and relatedness are met.
In organization settings, when these needs are satisfied, employees will demonstrate high internal motivation,
positive attitudes, and improved performance (Ryan & Deci, 2000; Gagne & Deci, 2005). Within this framework,
spirituality at work, which comprises inner life, meaningful work, and a sense of community, serves as a key
driver of these needs. The inner life dimension promotes autonomy and authenticity at work by allowing
individuals to match their personal values with organizational objectives (Srivastava & Gupta, 2021).
Meaningful work enhances a sense of competence by helping people perceive their jobs as meaningful and
important, whereas a sense of community fosters relatedness through supporting relationships and a sense of
belonging (Vesal & Alam, 2025). Studies conducted by Sode and Chenji (2024) and Moon, Youn, and Hur
(2020) also claimed that spirituality at work can boost intrinsic motivation and engagement, which leads to
beneficial organizational outcomes, including increased commitment, creativity, and well-being.

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Nevertheless, although studies have shown that spirituality at work can improve employees’ attitudes and
behaviours by offering meaning, motivation, and a sense of belonging, Wei et al. (2020) claimed that studies
focused on spirituality at work in healthcare are lacking. Meanwhile, Amin, Lubis, and Putra (2020) suggested
that it is necessary to examine spirituality at work and determine whether the variable is linked to employee
attitudes and behaviours. In addition, Margaretha, Saragih, Zaniarti, and Parayow (2021) argued that studies on
the relationship between spirituality at work and employee engagement are limited, particularly in the healthcare
context. Therefore, there is a need for studies that specifically investigate how spirituality at work contributes to
employee engagement among nurses in Malaysian public hospitals.

LITERATURE REVIEW

This section provides a comprehensive discussion of the relationship between spirituality at work and employee
engagement.

Employee Engagement

In the current competitive landscape, the concept of employee engagement has gained significant attention due
to its role in fostering engaged employees and retaining skilled personnel. The concept was first introduced by
Kahn (1990), who described employee engagement as the integration of individuals into their work roles and
recognized three psychological conditions that support engagement, such as meaningfulness, safety, and
availability. Building upon this foundation, Maslach, Schaufeli, and Leiter (2001) conceptualized engagement
as “a persistent, positive affective-motivational state of fulfillment”, contrasting it with burnout. Similarly,
Schaufeli, Salanova, Gonzalez-Roma, and Bakker (2002) defined a different view of engagement, “a positive,
fulfilling, work-related state of mind characterized by vigor, dedication, and absorption. Later, Macey,
Schneider, Barbera, and Young (2009) broadened the concept, portraying engagement as an individual’s sense
of purpose and focused energy, evident to others in the display of personal initiative, adaptability, effort, and
persistence directed towards achieving organizational goals. Therefore, this study adopts the definition by
Schaufeli et al. (2002) as it is widely used in academic research, particularly in studies involving nurses (Keyko,
2014), and reflects a persistent and general affective-cognitive state not tied to specific events or individuals
(Simpson, 2009).

A recent study conducted by Wu (2025) among teachers showed that engaged teachers demonstrated higher
levels of motivation, commitment, and performance, leading to job retention. In the same line, Bhatti et al. (2018)
claimed that nurses who are engaged in their work get higher rankings from their employers and achieve higher
performance. These outcomes highlight the importance of maintaining engaged employees as a key driver of
organizational success.

Spirituality at Work

Spirituality at work has received extensive attention from scholars and practitioners in contemporary business
due to its potential to address employee-related issues as organizations and employees alike seek to create a more
meaningful, purposeful, and fulfilling work environment. Bharadwaj and Jamal (2020) argued that employees
desire an environment that supports their inner values and nurtures their spiritual needs. The concept of
spirituality at work has been defined and interpreted in various ways. In a seminal study by Mitroff and Denton
(1999), spirituality at work is defined as the process of finding purpose in one’s work, building positive and
meaningful connections, and aligning personal values with organizational goals. Similarly, Ashmos and Duchon
(2000) viewed spirituality at work as the recognition of employees’ inner life that flourishes through meaningful
work in a community setting. Meanwhile, Milliman Czaplewski, and Ferguson (2003) further conceptualized
spirituality at work as comprising three key aspects: meaningful work, sense of community, and alignment with
organizational values. In a comparable framework, Karakas (2010) divided spirituality at work into three
components, namely meaningful work, sense of community, and spiritual self. Belwalkar, Vohra, and Pandey
(2019) noted that most contemporary studies on spirituality consistently emphasize three core dimensions:
meaningful work, sense of community, and inner life.

Empirical studies also highlight that spirituality plays a significant role in creating a positive work environment,

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including lower occupational stress (Kouhdasht et al., 2019), increased organizational citizenship behaviour
(Jena & Pradhan, 2018), and improved organizational commitment (Hisam & Sanyal, 2021). Past researchers
suggest that spirituality at work provides meaning that can serve as a key indicator in enhancing engagement
(van der Walt, 2018; Roof, 2015; Saks, 2011). Similarly, Rashidin et al. (2019) suggested that spirituality at
work plays a key role in shaping employee engagement and job satisfaction. Indeed, Margaretha et al. (2021) in
a study among lecturers discovered that spirituality at work, which comprises inner life, meaningful work, and
a sense of community, has a significant and positive impact on employee engagement.

Research Framework

Based on the literature review and underpinning theory, this study proposes a research framework illustrated in
Figure 1. The framework examines the potential influence of spirituality at work on the dependent variable,
employee engagement. It is hypothesized that spirituality at work will have a significant relationship with
employee engagement. To satisfy the objective of this study, the following hypothesis may be summarized based
on prior discussion and the proposed framework:

Objective: To determine the relationship between spirituality at work and employee engagement among nurses
in Malaysia’s public hospitals.

H1: There is a significant relationship between spirituality at work and employee engagement among nurses in
Malaysia’s public hospitals.

Figure 1.1 Research Framework

METHODOLOGY

This study will utilize a quantitative research design to collect data from a targeted sample of respondents. As
highlighted by Sekaran and Bougie (2010), this method is suitable for testing hypotheses, making it appropriate
for examining the relationship between spirituality at work and employee engagement among nurses in
Malaysia’s public hospitals. Furthermore, Cavana, Delahaye, and Sekaran (2001) emphasized that quantitative
research is effective in validating hypotheses and ensuring high levels of reliability and validity.

Research Design

To accommodate respondents from various ethnic and educational backgrounds, this study will use a dual-
language questionnaire, English and Bahasa Malaysia. An English teacher and a practicing nurse were invited
to voluntarily review the content to ensure the clarity, relevance, and overall structure of the translated version.
The study will administer a survey anonymously to lower the social desirability bias, and all instruments will be
pilot tested before conducting the actual research to ensure clarity, cultural relevance, and content validity.
Before conducting the data collection, ethical approval will be obtained from the Malaysia Medical Research
and Ethics Committee (MREC). Two instruments will be used to measure the study variables. Specifically, the
employee engagement scale will be measured using nine shortened items derived by Schaufeli, Bakker, and
Salanova (2006) with a scale ranging from 1=never to 7=always. Meanwhile, the spirituality at work instrument
will be adapted from a well-established scale created by Ashmos and Duchon (2000) using a 7-point Likert Scale
ranging from 1=strongly disagree to 7=strongly agree. Data analysis will be conducted using Statistical Package
for the Social Sciences (SPSS) version 26, as it is more flexible and works well in analysing the survey data
(Quinlan, 2011).

Population and Sampling

This study focuses on nurses working in public hospitals across Malaysia, and the unit of analysis is the
individual. Public hospitals are chosen because they are the primary source of healthcare access for most

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Malaysians (Ma’arof, Rashid, & Nasuredin, 2024). Meanwhile, nurses are highlighted as the respondents of the
study because they represent the largest group of healthcare workers and play a critical role in delivering quality
care to patients compared to other healthcare professions in the sector (Murugesan, May 31, 2024). An estimated
total population of 12,514 nurses working in ten general public hospitals across Malaysia is considered, and a
sample size of 375 respondents is deemed appropriate, following the guidelines of Sekaran and Bougie (2010)
and Krejcie and Morgan (1970).

Due to the lack of access to a complete sampling frame, this study will adopt a purposive sampling technique.
Purposive sampling, as described by Cooper and Schindler (2014), involves selecting participants based on
specific characteristics, experiences, perspectives, or attitudes. While this non-probability sampling technique
does not support generalization, its strength lies in identifying a targeted group of individuals who are willing to
participate and capable of providing meaningful insights aligned with research objectives (Kumar, 2011). In this
study, nurses are considered the most appropriate respondents, as their direct involvement in patient care,
practical knowledge, and lived experiences make them central to the discussion of spirituality at work and
employee engagement among nurses in Malaysia’s public hospitals.

RESULTS AND DISCUSSION

The findings of this study are expected to demonstrate that spirituality at work has a significant impact on
employee engagement among healthcare professionals, particularly among nurses in Malaysia. Specifically, the
dimensions of spirituality at work, namely inner life, meaningful work, and sense of community, are likely to
emerge as important predictors of engagement. When nurses can nurture their inner life, perceive work as
meaningful, and experience a strong sense of community in their workplace, they are more likely to feel
energized, motivated, and fully engaged in their roles, which indirectly improves performance in patient care as
well as enhances their job performance (Ma’arof & Mat, 2019). Moreover, spirituality at work may also serve
as a protective factor against the challenges that nurses face, such as heavy workloads, burnout, and staffing
shortages. Nurses who can draw strength from their inner life and find meaning in their daily task activities are
likely to remain resilient and sustain a high engagement level even in stressful conditions. This is consistent with
past research, which shows that spirituality at work supports psychological well-being and reduces occupational
stress (Kouhdasht et al., 2019; Reutter & Bigatti, 2014).

The expected results are also in line with Self-Determination Theory (Deci & Ryan, 2000), which suggests that
individuals are motivated and engaged when their psychological needs for autonomy, competence, and
relatedness are fulfilled. The dimension of inner life allows nurses to connect personal values and beliefs with
their professional roles, fulfilling the need for autonomy. Meaningful work provides a sense of purpose and
achievement, satisfying the need for competence. Meanwhile, a sense of community fulfils the need for
relatedness by fostering supportive and collaborative relationships in the workplace. Therefore, by cultivating
environments that support employees’ inner life, emphasize the meaningfulness of their work, and strengthen
community bonds, hospital administrators can nurture higher engagement among staff, which can enhance the
overall quality of patient care and strengthen the resilience of Malaysia’s healthcare system.

CONCLUSION AND RECOMMENDATIONS

In conclusion, this study anticipates that spirituality at work, through its three core dimensions of inner life,
meaningful work, and sense of community, plays a significant role in fostering employee engagement among
healthcare professionals, particularly nurses in Malaysia. The implications of this study are both theoretical and
practical. From a theoretical standpoint, it contributes to the growing body of knowledge on spirituality at work
by linking its dimensions with employee engagement within the Malaysian healthcare context. Practically, the
findings emphasize the necessity of hospital administrators and policymakers to create an environment that
supports spiritual well-being at work. This can be achieved by encouraging reflective practices that nurture
employees’ inner life, designing work that emphasizes purpose and value to strengthen meaningfulness, and
implementing initiatives that promote teamwork to establish a strong sense of community. Therefore, it is
recommended that healthcare organizations in Malaysia should incorporate spirituality at work into their human
resource management strategies and leadership practices. Leaders should be trained to recognize the importance
of inner life and provide opportunities for employees to align their personal values with organizational goals.

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Human resource policies should support meaningful work through recognition programs, professional
development opportunities, and equitable task distribution. Furthermore, interpersonal connections can be
strengthened through community-building activities such as team-based care models, peer support groups, and
inclusive cultural events. Embedding these practices within the healthcare system is expected to not only increase
employee engagement but also reduce turnover intentions and improve the overall quality of patient care in the
long term.

ACKNOWLEDGMENT

We wish to acknowledge Universiti Teknologi MARA, Cawangan Terengganu Kampus Dungun, for their
support and resources that have facilitated this study. Institutional support, including access to academic
databases and research facilities, has been instrumental in carrying out this comprehensive information.

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