Abstract

1. LITERATURE
It represents an understanding that unites all employees from organizational culture under an umbrella. For this reason, creating a common mission, vision, value and employees' participation in the management processes are among the primary issues in the organizational culture. In cases where the opinions and thoughts of the employees are ignored and they are perceived as people who only meet the specified job criteria, the organizational silence situation is likely to mature. In the concept of organizational silence, it can be expressed as that the employees hide their thoughts about a problem and do not express their solutions. It is inevitable that such a situation will cause many irreversible problems that threaten human health and irreversible before health institutions. The aim of this study is to examine the effect of organizational culture on organizational silence in health institutions.
In the literature review, in studies related to organizational culture and organizational silence; Yalçınsoy (2019) has a weak effect on organizational silence as a result of a survey applied to the health sector, the effect of organizational culture on organizational silence in the research carried out on Çavuşoğlu and Köse (2016) and Sholekar and Shoghi (2017) academics, Acaray (2014) organizational culture and organizational silence are closely related concepts, Yaman and Ruçlar (2014) and Woo and Lee (2018) have a moderate negative relationship between organizational culture and organizational silence. In this respect, it is important to study the concepts by comparing them with different assumption findings in the literature.
2. DESIGN AND METHOD
The universe of the research includes 760 health and administrative staff within the body of Bolu Province Public Hospitals Institution General and Izzet Baysal State Hospital. In line with the data obtained with convenience sampling method, 212 questionnaires were included in the research sample. The survey form consists of three parts. Organizational culture scale of Haris and Moran, organizational silence scale of Miliken et al. (2003) and demographic variable expressions are included. The 5-point Likert scale (1 = Strongly Agree, 5 = Strongly Disagree) was used from the scoring of statements to measure organizational culture and organizational silence perceptions.
SPSS 22.0 package program was used in the analysis of the data. Firstly, skewness and kurtosis values were examined to determine whether the expressions in organizational culture and organizational silence scales show a normal distribution. As a result of the Shapiro Wilk normality test, the skewness and kurtosis coefficients were found to be between ± 2. Accordingly, parametric tests were used to analyze the data. The relations between organizational culture and organizational silence scales were examined by Pearson Correlation analysis. Arithmetic mean and standard deviation values of the variables are also presented in the correlation table. In addition, regression analysis was used to determine the effect of organizational culture sub-dimensions on organizational silence sub-dimensions. Within the scope of the research, the hypotheses listed below were tested.
H1: Organizational culture sub-dimensions have a significant effect on the perception and attitude of top management, which is the organizational silence sub-dimension.
H2: The organizational silence sub-dimensions of organizational culture sub-dimensions have a significant effect on the attitude of the department managers towards different ideas and problem solving techniques.
H3: Organizational culture sub-dimensions have a significant impact on the level of organizational silence, communication level and information sharing.
3. FINDINGS AND DISCUSSION
According to the correlation table, it was determined that there was a positive and positive relationship between organizational silence and sub-dimensions, and organizational culture and its sub-dimensions. These results support the judgment of the participants, who perceive the organizational culture at a higher level, that organizational silence will be perceived more positively.
“Top Management Perception and Attitude” of organizational culture sub-dimensions (F = 37.93, p <0.05), “Attitude of Department Managers towards Different Ideas and Problem Solving Techniques” (F = 94.90, p <0.05) and the model established to measure its effect on “Communication Level and Information Sharing Dimension” was found to have a statistically valid and significant effect (F = 106.64, p <0.05). In the study conducted by the researchers of Alioglulları (2012) and Bayın, Yesilaydın and Esatoglu (2015), it was found that administrative and organizational attitudes were the highest average as the reason for silence. Ozturk (2019) states that people who prefer organizational silence affect their problem solving skills and therefore, their solution skills are low and managers have an important role. This result supports the conclusion reached in our research. In the study of Erigüc et al. (2014b), it is stated that the managers' attitude "I know the best" is an important factor in organizational silence.
In the research, findings were obtained that the organizational culture and organizational silence are related. When we look at the literature review, Acaray et al. (2015), Cavusoglu and Kose (2016), Parcham and Ghasemizad (2017) and Yalcınsoy (2019) stated in their research that there was a positive relationship between organizational culture and organizational silence. These results are findings similar to the relationship when we reach between organizational culture and organizational silence.
4. CONCLUSION, RECOMMENDATION AND LIMITATIONS
It is concluded that when the relations are conducted based on a fair rewarding system, communication opportunity and trust basis for the employees by the top management, the employees can express themselves more easily. When the effect of “Department Managers' Attitude towards Different Ideas and Problem Solving Techniques”, which is another dimension of organizational silence, is examined, the effect of “Supporting Participation”, “Effectiveness of Rewarding System”, “Effectiveness of Communication System” and “Support for Innovation and Creativity” dimensions have been identified. The sub-dimensions of the organizational culture “Supporting Participation”, “Effectiveness of Rewarding System”, “Effectiveness of Communication System”, “Level of Creation of Trust Environment” and “Support for Innovation and Creativity” have a significant effect on the last dimension, “Communication Level and Information Sharing”.
 In line with the probability that different concepts may have an effect on organizational silence, relations with intermediary or regulatory variables can be examined.
 In order for all employees working as health practitioners to gain an organizational identity, the mission, vision, purpose and goal unity must be determined by top management.
 It is important that all employees are offered equal opportunities in rewarding or punishing, and that they find practice in the principle of equality.
 Communication and sharing of ideas is an imperative for selecting the best medical treatment for the patient.
 Since the research is carried out in public health institutions, private sector employees are not included.
 Some participants were reluctant to be included in the questionnaire due to the presence of statements questioning their management attitude. This is likely to affect the responses to the items.
 The number of health personnel who could not participate in the survey due to intensive working conditions shows significant limitations.