Organizational silence pdf

The effects of organizational silence are not limited to the organization. These effects are represented in 1 the individual feeling unappreciated, as he does not contribute in earnest in the issues of the organization, reducing the importance and value of his presence, 2 lack of the individual's ability to control, reducing motivations at work and participation in the issues within the organization, and 3 the individual suffering from cognitive dissonance Hazen, Organizational silence does have implications and consequences on the climate of trust within the organization, because it leads to poor relations of trust between employees due to lack of dialogue between them Willman et al.

Organizational silence correlates negatively with organizational trust. This means that the more silence means less trust Nakolaous, et al. There are several implications of organizational silence, as silence is of a significant impact on individuals and the organization. In spite of that, the silence study results have little attention from the management literature. The employee's silence has considerable implications on the employee himself, the organization, and even the community.

This is because the silent employee, regarding labor issues, prevents the flow of new information. Silence leads, in some cases, to organizational failure Bogosian, Organizational Success ''Success'' in English, according to Webster, means end your access to what is best, or access to excel. In French, according to Robert, ''Reussite'' means getting a new result, and the means to reach or attain higher. With respect to organizational success, there is still some confusion and lack of clarity of methodological and procedural frameworks.

Growth is an indicator for measuring organizational success. It means efficiency or the organization's ability to achieve its objectives in the long term, through expansion, renovation and survival Whetten, Regarding success through financial performance, operational productivity and efficiency, profits, target return, improvement programs in total quality management framework, re-engineering of reference and comparison is a narrow view that does not define success in the long-term in light of competitive markets.

Success in the long-term lies in the organization's ability to do better things than competitors do. This is through owning distinct and fundamental capabilities that can not be imitated; besides ability to get on a competitive center of excellence Hill, Organizational success is the organization's ability to achieve long-term goals and balance between the goals and objectives of the organization of employees Kenny, There are two approaches for organizational success in all different organizations.

The first is the economic gateway. It is based on the competitive advantage stemming from the distinct market place. The first set for the performance of the organization is the external environment of the structure of the competition environment industry Ambrosini, This includes approaches of forces of competition Porter , innovation Schumpeter , and scenario analysis which is characterized by a vision of the future opportunities and environmental threats, besides forecasting analysis of the competitive advantages Grant, The second approach to organizational success is based on the relatively modern resources approach, which confirms the possibility of looking at the organization as a package of resources to enable them to get a sustainable competitive advantage Ambrosini, This approach is mainly based on a study Selznick, about the distinctive competencies, and Penrose that the organization is a collection of resources and their performance depends on their ability to use these resources.

This includes the approach of the value chain to analyze the strategic capabilities that can be converted into essential competencies that support competitive advantage analysis Hitt, Methodology 3. Research Model The proposed comprehensive conceptual model is presented in Figure 1. The diagram below shows that there is one independent variable of organizational silence. There is one dependent variable of organizational success.

It shows the rational links among the variables. The research model is as shown in figure 1. The research framework suggests that organizational silence has an impact on organizational success.

Organizational silence as measured consisted of support of the top management of silence, lack of communication opportunities, support of supervisor for silence, official authority, and subordinate's fear of negative reactions Schechtman, ; Brinsfield, Organizational success is measured in terms of organizational survival and organizational growth Simon et al. Research Questions and Hypotheses The researcher found the research problem through two sources. The first source is to be found in previous studies, and it turns out that there is a lack in the number of literature reviews that dealt with the analysis of the relationship between organizational silence and organizational success.

This called for the researcher to test this relationship in the Egyptian environment. The second source is the pilot study, which was conducted in an interview with 30 employees in order to identify the relationship between organizational silence and organizational success. The researcher found several indicators notably the important and vital role that could be played by organizational silence. As a result of the discussions given above, the research questions are as follows: Q1: What is the nature and extent of the relationship between organizational silence support of the top management of silence and organizational success at the Egyptian industrial companies in Sadat City.

Q2: What is the nature of the relationship between organizational silence lack of communication opportunities and organizational success at the Egyptian industrial companies in Sadat City. Q3: What is the statistically significant relationship between organizational silence support of supervisor for silence and organizational success at the Egyptian industrial companies in Sadat City. Q4: What is the nature and extent of the statistical relationship between organizational silence official authority and organizational success at the Egyptian industrial companies in Sadat City.

Q5: What is the nature of the relationship between organizational silence subordinate's fear of negative reactions and organizational success at the Egyptian industrial companies in Sadat City. There are studies in literature that study organizational silence and organizational success factors separately and within the frame of bilateral relation, but there is no study that examines these two factors collectively at the Egyptian environment.

This study aims to contribute to the literature by examining the research variables collectively and revealing the interaction between the research variables. As a result of the discussions given above, the following hypotheses were developed to test the effect of organizational silence on organizational success at the Egyptian industrial companies in Sadat City.

H1: Organizational silence support of the top management of silence of employees has no statistically significant effect on organizational success at the Egyptian industrial companies in Sadat City. H3: Organizational silence support of supervisor for silence of employees has no statistically significant influence on organizational success at the Egyptian industrial companies in Sadat City.

H4: Organizational silence official authority of employees has no statistically significant relationship with organizational success at the Egyptian industrial companies in Sadat City. H5: Organizational silence subordinate's fear of negative reactions of employees has no statistically significant impact organizational success at the Egyptian industrial companies in Sadat City. Population and Sample The population of the study included all employees at the Egyptian industrial companies in Sadat City.

The total population is employees. Determination of respondent sample size was calculated using the formula Daniel, as follows: The number of samples obtained by employees at the Egyptian industrial companies in Sadat City is presented in Table 1.

Ezz Company for Reinforcement Steel Arab Company for Steel Arco Steel 6. Horizon for Investment Geraneto Egyptian-American Steel Company Al Gawhara for Ceramics Egyptian Group for Investments Prima Table 2 provides more detailed information about the sample and the measures.

A survey research method was used to collect data. The questionnaire included three questions, relating to organizational silence, organizational success, and demographic information of employees at the Egyptian industrial companies in Sadat City.

Data collection took two months. Data Collection Tools 3. Organizational Silence Scale The researcher will depend on the scale developed by Schechtman, ; and Brinsfield, in measuring organizational silence, which has been divided into five elements support of the top management of silence, lack of communication opportunities, support of supervisor for silence, official authority, and subordinate's fear of negative reactions.

The item scale organizational silence section is based on Schechtman, ; and Brinsfield, There were five items measuring support of the top management of silence, six items measuring lack of communication opportunities, five items measuring support of supervisor for silence, five items measuring official authority, and six items measuring subordinate's fear of negative reactions.

The survey form is used as the main tool for data collection in measuring organizational silence at the Egyptian industrial companies in Sadat City. Organizational Success Scale The researcher will depend on the scale developed by Simon et al. The item scale organizational success section is based on Simon, et al.

There were five items measuring organizational survival and five items measuring organizational growth. The survey form has been used as a key tool to collect data to measure organizational success at the Egyptian industrial companies in Sadat City. All these tests are found in SPSS. Hypotheses Testing 4. Evaluating Reliability Before testing the hypotheses and research questions, the reliability of organizational silence and organizational success were assessed to reduce errors of measuring and maximizing constancy of these scales.

Table 3 shows the reliability results for organizational silence and organizational success. All items had alphas above 0. For support of the top management of silence, which consists of 5 items, is reliable because the ACC is 0.

Lack of communication opportunities, which consists of 6 items, is reliable because the ACC is 0. Furthermore, support of supervisor for silence which consists of 5 items, is reliable because the ACC is 0. For official authority, which consists of 5 items, is reliable because the ACC is 0. Subordinate's fear of negative reactions, which consists of 6 items, is reliable because the ACC is 0.

Thus, the internal consistency of organizational silence can be acceptable. According to Table 3 , the 10 items of organizational success are reliable because the ACC is 0. The organizational survival, which consists of 5 items, is reliable because the ACC is 0. The 5 items related to organizational growth are reliable because ACC is 0. Thus, the reliability of organizational success can be acceptable.

Accordingly, two scales were defined, organizational silence 27 variables , where ACC represented about 0. Variables Mean 1 2 3 4 5 6 Deviation 1. Support of the top management of 3. Lack of communication 3. Support of Supervisor for 3. Official 3. Subordinate's fear of negative 3.

Organizational 4. The researcher calculated means and standard deviations for each variable and created a correlation matrix of all variables used in hypothesis testing. Arithmetic mean and standard deviation values related to dependent and independent variables of this study and correlation coefficients between these variables are given in Table 4. In order to determine what reasons affect employees to remain silent at work.

Reasons were grouped under five factors. Based on Table 4 , the first issue examined was the different facets of organizational silence. The second issue examined was the different organizational success organizational survival, and organizational growth.

According to Table 4 , organizational silence dimensions have negative and significant relation with organizational success dimensions. The correlation between organizational silence support of the top management of silence and organizational success is 0. For organizational silence lack of communication opportunities and organizational success, the value is 0. For organizational silence official authority and organizational success, the value is 0.

Finally, Table 4 proves that there is a significant and negative correlation between organizational silence and organizational success. So our hypothesis is supported and it can be said that there is a significant and negative correlation between organizational silence and organizational success. Organizational Silence Support of the top Management of Silence and Organizational Success The relationship between organizational silence support of the top management of silence and organizational success at the Egyptian industrial companies in Sadat City is determined.

The first hypothesis to be tested is: There is no relationship between organizational silence support of the top management of silence and organizational success at the Egyptian industrial companies in Sadat City. Organization's management believes that its role is 0. The organization is not interested in encouraging employees to express their opinions or suggestions 0. Management of the organization does not tend to serious discussion of the views and suggestions of 0.

Management of the organization does not express gratitude to workers for their opinions and suggestions 0. I do not feel comfortable when management of the organization is involved in solving a problem 0. As a result of the value of R2, the 5 independent variables of support of the top management of silence can explain For the results of a structural analysis of the MRA, the direct effect of organizational silence support of the top management of silence and organizational success is obtained.

Because MCC is 0. Organizational Silence Lack of Communication Opportunities and Organizational Success The relationship between organizational silence lack of communication opportunities and organizational success at the Egyptian industrial companies in Sadat City is determined. The second hypothesis to be tested is: There is no relationship between organizational silence lack of communication opportunities and Organizational Success at the Egyptian industrial companies in Sadat City.

There is no exchange of information between various 0. The chances of communication between employees in 0. Management of the organization does not notify the staff 0. There is not enough channels of communication between 0. Management of the organization does not bother to hold 0. My superiors at work do not possess the good skills needed 0. This means that organizational success has been significantly explained by the 5 independent variables of lack of communication opportunities.

Furthermore, the R2 of 0. It is evident that the five independent variables justified Hence, Therefore, there is enough empirical evidence to reject the null hypothesis the null hypothesis. Organizational Silence Support of Supervisor for Silence and Organizational Success The relationship between organizational silence support of supervisor for silence and organizational success at the Egyptian industrial companies in Sadat City is determined.

The third hypothesis to be tested is: There is no relationship between organizational silence support of supervisor for silence and organizational success at the Egyptian industrial companies in Sadat City.

Table 7 proves that there is a relationship between organizational silence support of supervisor for silence and organizational success. As a result of the value of R2, the 5 independent variables of support of supervisor for silence can explain I hesitate to speak freely with my direct manager 0. My direct manager does not care about any negative 0. My direct manager sees any criticism against him a sort of 0.

My direct manager suspects the source of my information 0. My direct manager sees the difference in opinion on the 0. Organizational Silence Official Authority and Organizational Success The relationship between organizational silence official authority and organizational success at the Egyptian industrial companies in Sadat City is determined.

The fourth hypothesis to be tested is: There is no relationship between Organizational Silence official authority and organizational success at the Egyptian industrial companies in Sadat City. My direct manager depends mainly on the official 0. My direct manager draws on the method of threatening with punishment to guide the behavior of 0.

My direct manager accepts excuses of subordinates with difficulty when they commit negligence in their 0. My direct manager directs the behavior of subordinates through compliance with laws and 0. My direct manager complies with laws and regulations in force when solving problems of 0. As a result of the value of R2, the 5 independent variables of official authority can explain For the results of a structural analysis of the MRA, the direct effect of organizational silence official authority and organizational success is obtained.

Organizational Silence Subordinate's Fear of Negative Reactions and Organizational Success The relationship between organizational silence subordinate's fear of negative reactions and organizational success at the Egyptian industrial companies in Sadat City is determined. The fifth hypothesis to be tested is: There is no relationship between Organizational Silence subordinate's fear of negative reactions and organizational success at the Egyptian industrial companies in Sadat City. I feel afraid to inform my direct manager with the 0.

I don't tend to talking about the negative working 0. I prefer to stay silent in order to avoid conflicts or 0. I prefer to stay silent for fear of breaking my 0. I prefer to stay silent not to be considered a problem- 0.

My speaking of work problems could be harmful to my 0. This means that organizational success has been significantly explained by the 5 independent variables of subordinate's fear of negative reactions. It is evident that the six independent variables justified Therefore, there is enough empirical evidence to reject the null hypothesis. Research Findings The present study on analyzing the relationship between organizational silence support of the top management of silence, lack of communication opportunities, support of supervisor for silence, official authority, subordinate's fear of negative reactions and organizational success at the Egyptian industrial companies in Sadat City revealed the following results: 1.

There is a significant relationship between organizational silence and organizational success at the Egyptian industrial companies in Sadat City.

Organizational silence plays an important role in influencing organizational success. Also, organizational silence contributes significantly to organizational success.

This study concluded that the organizational silence was negatively related with organizational success at the Egyptian industrial companies in Sadat City. Hence, the top management should 1 coordinate between different departments and divisions within the organization, 2 provision of good channels of communication between the employees within the organization, and 3 developing effective communication channels which support exchange and transfer of ideas and information.

There is a negative relationship between organizational silence and organizational success of employees at the Egyptian industrial companies in Sadat City. In other words, organizational silence affects organizational success. So, top management should 1 pay attention to the moral of the employees within the organization, 2 provide of organizational support for the exchange of ideas associated to labor issues, 3 encourage employees to creative thinking within the organization, and 4 employ and attract talented employees, especially those who have high levels of organizational commitment.

This is because these employees have a high tendency to speak and participate in labor issues. Thus, organizational silence can be reduced or faced focusing on the selection and retention of this distinctive quality of the staff. Research Recommendations 1. Officials should work in the organization to create a culture that will encourage employees to speak, and not to keep silent regarding all critical business issues so that we can know their problems and try to resolve them.

Preparation and training of administrative leaders, as the training is the mainstay of administrative development. Hence, Managers should provide an opportunity for subordinates to participate in matters relating to their work and listen to and study their views, desires, needs and then execute the good ones. Heads should pay attention to each new initiative of the workers and convince them with the interest and desire of the administration in innovation and continuous improvement in the ways and methods of work.

It gives them the opportunity to participate in the administration as a kind of stimulus, encouraging participation and innovation through involvement in setting goals of the organization, the decision-making process, and determining the stage of their participation. The need to increase attention and action on the coherence of the organization group, as well as the professional commitment and procedural justice because of its inverse relationship to silent workers.

It has been found that the more these variables exit, the less workers keep silent. Improving leadership patterns requires a scientific approach to stimulate the administrative leaders for continual good performance. This requires adopting modern systems of management, such as management by goals which achieves flexibility and freedom in performance, besides saving management time in the planning and follow-up of work.

Add to this development of subordinates who are the second row capable of leadership. This is one of the important results. The need for increased attention on the part of senior management to support the exchange of information and ideas with employees in the organization process because its significant correlation effect is obvious to silence workers.

The civil servant who feels that his heads do not care about his views would be more silent. Encouraging personal initiative of the workers by offering rewards and incentives for new ideas that contribute to the treatment of problems of the organization and help in its development.

Formation of specialized committees to study the proposals and issues that relate to subordinates and commitment to their recommendations. Notes from the results of the study also showed significant correlation between the extent of adoption of the supervisors of the behavior of silence and silent workers. This means that supervisors ought to pay due attention to the opinions and suggestions of subordinates.

This is reflected in increased confidence of senior management personnel lowering their silence about the critical issues in the organization. Promote open-door policy by opening channels of communication to the subordinates to communicate their ideas to their heads, either through personal meetings, suggestion funds or regular meetings, as well as facilitating communication with higher heads in case direct head does not respond.

Research Implications The findings of the study should contribute to managers and practitioners becoming more aware of ES. In addition, management should encourage employees to express their relevant ideas, information and opinions. The cultural dimensions such as appreciating the individuals, orientation to detail, team orientation and competition may lead to silence breaking, as they urge people to actively participate in matters of the organization, which reduces the degree of silence O.

Reilly, It is not easy to break silence climate of employees and their managers. The behavioral cycles that maintain organizational silence will be hard to break in part because they are not subject to direct observation or discussion. To prevent silence from characterizing their organizations, leaders should not only permit, but reward, employees who come forward with sensitive or risky information, and should create formal mechanisms through which employees can speak up anonymously if they wish to do so Reichers, et al.

The nature of silence behavior makes it difficult to break. This may be due to the fact that organizational silence may be a result of lack of confidence in the organization.

It may be, then, difficult to restore that trust in a short period of time. ES behaviour can also create stress, cynicism, and dissatisfaction Tamuz, Breaking silence needs a vision which can provide a climate that helps in engagement and talking. Breaking silence is also possible through the administration's desire to hear the views and suggestions of staff about problems and issues of work which they face.

This is because the employee must feel safe when talking Milliken et al. Another way to encourage speaking up behaviour is to ensure communication opportunities and create formal systems for the transfer or exchange of information, concerns or ideas.

Employees who have ideas or suggestions for improvement who do not feel that they can bring these to their bosses, could submit them to a designated person who then presents the ideas for review Milliken et al.

Another way of breaking silence would be through the keenness of the leaders of organizations to fight or prevent any impediments to the transfer or exchange of upwards information relating to problems and issues of work Edmondson, Top managers and supervisors have to create a workplace where employees will feel safe to express their views and will be encouraged to offer their ideas and suggestions.

Therefore, top managers and supervisors should develop attitudes and engage in behaviours that would create a psychologically safety net for their employees. There are some tools that can be used for the purpose of breaking organizational silence.

Organizations today need not only to recruit but also to retain and motivate talented employees. Managers may consider organizational silence as an important variable when they explore organizational climate and culture or when they want to create an environment where talented people would choose to remain or wish to join.

Finally, employees are regarded as major sources of change, creativity, learning, and innovation, which are critical factors to the success of organizations. However, many employees choose not to voice their opinions and concerns about matters in their organizations Liu, et al. Limitations and Future Research There are some limitations of this study. They are 1 data was gathered from one private sector in Egypt. Therefore, the findings of this research need to be evaluated with this in mind.

The survey answers are related to the perception of employees at that moment, 2 the respondents are unwilling to answer the questionnaires accurately.

Therefore, before distributing questionnaires among respondents, we attempted to describe the positive effects of the results of this research on their work-life quality and satisfying their needs, 3 the current study is about cause and effect relationship among research variables; maybe there are other factors that affect research variables, which need to be identified. There are several areas for future research. If employee silence does occur, communication suffers and as a result harms the overall functioning of the organization.

This indicates how much an organization can suffer just because of a lack of proper communication. Over time silence within organizations causes some employees to be extremely indifferent. Indifferent employees cause the organization to lose money and function poorly. Unfortunately when major monetary losses are detected in organizations, managers tend to react by trying to recover the loss, overlooking the fact employees have become indifferent as a result of unaddressed employee silence.

More often than not employees who are not doing their share of the work are also not speaking up with the problems they see, leading to a perpetual cycle of employee silence Joinson, Effects on Employees Employee silence also has many effects on the employees themselves.

Organizational Silence In the book Moose on the Table by Jim Clemmer, Pete who is the main character of the book develops these types of health problems Clemmer, Most people assume that employee silence only hurts the organization, but realistically it hurts both the organization and the employees. The Development of Organizational Silence Figure 1 provides an overview of the organizational condition under which organizational silence is most likely to develop.

Managers' Fear of Negative Feedback One important factor that facilitates the creation of a climate of silence in organization is top managers' fear of receiving negative feedback, especially from subordinates.

Argyris and schone argue that many managers feel a strong need to avoid embarrassment, threat, and feeling of vulnerability or incompetence. One such belies is that employees are self-interested and untrustworthy. When an organization' top-level managers believe employees are self-interested and untrustworthy, they will then act in ways that discourage upward communication Redding, A second unstated belief is likely to create conditions conducive to organizational silence is the belief that management knows best about most issues of organizational importance.

If employees are self-interested, then they are unlikely to know about what is best for organization. A third unstated belief as a factor in creating a climate conducive to wide-spread silence is the belief that unity, agreement and consensus are sings of organizational health, whereas disagreement and dissent should be avoided. Burrell and Morgan describe this belief as part of the "unitary view" of organizations, which stands in stark contrast to a "pluralistic view", in which dissent is regarded as normal and conflict as potentially healthy.

Conditions Fostering Managers' Implicit Beliefs: top management team characteristics and organizational and environmental characteristics. Further, the more homogeneous the top management team is with respect to functional training and experience. Also impact of functional background will be intensified when the composition of the top management team is stable over time. The longer top managers have been together, the more entrenched their shared assumptions will tend to be and the less likely the members will be to question those assumption Pfeffer, The cultural background of the top management team also may affect the beliefs that its members hold about employees.

For example, if the top management team is composed of individuals who all come from high power distance cultures, these managers especially will be likely to believe that they know best. In high power distance cultures, individuals are much more likely to believe that the boss is right merely because he or she is the boss.

Organization-level and environmental variables are also likely to affect the likelihood that silence-fostering beliefs will be held by top management. In order to survive, organizations in high-velocity environment need to become adept at considering alternatives and responding to changes in their environment.

High vertical differentiation is also likely to reinforce silence- creating beliefs. Also within tall organizational structures, top managers will be less likely to interact with employees. In addition, firm that brings in top managers from the outside may be more likely to create a gap between top management and the rest of the organization. Top managers will view employees as untrustworthy.

Finally, heavy reliance on contingent workers is likely to foster the managerial belief. Organizational Structures, Policies, and Practices When the unspoken yet dominant ideology within an organization is that 1 employees are self-interested, 2 management knows best, and 3 disagreement is bad, then management will erect structures and policies that either does not facilitate or that discourage upward information flow.

Two common structural features of organizations dominated by these beliefs will be high centralization of decision making and lack of formal upward feedback mechanisms. If the dominant belief in an organization is that employees are opportunistic and not knowledgeable about what's best for the organization, then it is reasonable for managers not to involve them in decision-making processes.

Decentralized decision making, as well as other participative forms of management, will be seen by managers as not worth the time and effort they require. The Creation of Shared Perceptions via Collective Sense Making The term organizational climate refers to shared and enduring perceptions of psychologically important aspects of a particular work environment.

Researcher have emphasized that work setting have numerous climates, each pertaining to a particular type of activity. A climate of silence as one is characterized by two shared beliefs: 1 speaking up about problems in the organization is not worth the effort, and 2 voicing one's opinion and concerns is dangerous. Schneider and Reichers proposed an interactions perspective.

In this perspective it is argued that climate originates from a process of collective sense making, whereby employees together try to derive meaning about their workplace.

Through social interaction that employees share their perceptions and experiences and derive a common understanding of the meaning of various aspects of their work context. Because individuals have a strong need to evaluate their beliefs and perceptions, they compare them with those of others.

Through this process people "triangulate on a single set of perceptions and meanings". This perspective is similar to the notion that reality within organization is socially constructed.

Thus a climate of silence is rooted not only in objective features of the workplace but also in social interactions that contribute to a subjective process of sense making. A process of collective sense making moderates the relationship between organizational structures and managerial practices on the one hand and climate on the other.

Hence, to understand how a climate of silence develops within an organization, it is necessary to understand this sense making process and the factor that makes it more likely to occur. Social network research has indicated that the following variables facilitate contact and communication and hence, increase the likelihood of a strong climate of silence developing.

Similarity, stability, workflow interdependence, and informal social networks are dense and composed of strong ties. Demographic Dissimilarity Demographic dissimilarity between top managers and lower-level employees was a factor that we hypothesized would increase the likelihood of management holding beliefs that contribute to silence.

This variable is also likely to contribute more directly to a climate of silence by affecting the perceptions and beliefs of lower-level employees.

It is one that places a high value on understanding system complexity and does not take comfort in organizational silence or in simple explanations.

It focuses on the interdependencies and not just the components. It values dissent and multiple perspectives as signs of organizational health, and questions agreement, consensus and unity when they are too readily achieved.

It is a role that is sensitive to the hidden pitfalls of the availability heuristic, self-serving bias, and the status quo. It understands the impact of social factors on group behavior and the potentially harmful consequences of conformity, diffusion of responsibility, and microclimates of distrust. It does not allow prevailing beliefs to go unchallenged, it thinks differently about what it means to be a good provider, and it is mindful of the frequently neglected interdependencies of care.