Internal Marketing and Employee Satisfaction and Loyalty: Cross-Cultural Scale Validation in Context of U.S. and German Nurses

Abstract

Frontline healthcare service providers’ job satisfaction and loyalty continues to remain a key global issue. Efforts to increase employee satisfaction and loyalty are antecedents to improving the service experience, customer (patient) satisfaction, and customer loyalty. This article develops and validates a parsimonious scale for internal marketing’s impact on employee satisfaction and loyalty within the nursing profession. A combination of exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and regression analyses are used in a staged-approach to assess face, content, predictive, and convergent validity. The resulting 14-item scale shows a high level of cross-country (U.S. and Germany) reliability and validity and provides strong evidence of the stability of the four underlying internal bonding dimensions (structural, nurse social, physician social, and financial bonds). The scale provides managerial insights on the relative priority of relational bonds internal marketing efforts should address to enhance employee satisfaction and loyalty.