change management literature review

Reactions towards organizational change: a systematic literature review

• Published: 13 April 2022
• Volume 42 , pages 19137–19160, ( 2023 )

Cite this article

• Khai Wah Khaw 1 ,
• Alhamzah Alnoor   ORCID: orcid.org/0000-0003-2873-2054 1 , 2 ,
• Hadi AL-Abrrow 3 ,
• Victor Tiberius 4 ,
• Yuvaraj Ganesan 5 &
• Nadia A. Atshan 2  

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Regardless of the prevalence and value of change initiatives in contemporary organizations, these often face resistance by employees. This resistance is the outcome of change recipients’ cognitive and behavioral reactions towards change. To better understand the causes and effects of reactions to change, a holistic view of prior research is needed. Accordingly, we provide a systematic literature review on this topic. We categorize extant research into four major and several subcategories: micro and macro reactions. We analyze the essential characteristics of the emerging field of change reactions along research issues and challenges, benefits of (even negative) reactions, managerial implications, and propose future research opportunities.

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Introduction

During the past two decades, many studies have been conducted that have been interested in organizational change and the mechanisms that promote that process smoothly (Benford & Snow, 2000 ; Bouckenooghe, 2010 ; Caldwell et al., 2009 ; Pettigrew et al., 2001 ). Despite that wide interest in the process of organizational change, these studies reported negative results, as most of those efforts ended with an unsuccessful implementation of the process of organizational change and ultimately failure (Beer & Nohria, 2000 ; Meaney and Pung, 2008; Hussain et al., 2018 ). This is because the focus was on many secondary variables and ignored the most important factor of individual and organizational reactions towards organizational change in those studies (Oreg et al., 2011 ; Penava and Sˇehic, 2014). Herold et al., 2008 ; Holten and Brenner, 2015; Oreg & Berson, 2011 ; Alnoor et al., 2021 ).

A reaction towards a change is a cognitive and behavioral response based on an adaptation and a comprehensive understanding of how to react towards a change (AL-Abrrow et al., 2019b ; Peng et al, 2020 ). This largely depends on how managers introduce a change and on the extent to which others respond. Usually, a negative reaction towards change happens when it is expected to result into more workload, uncertainty, and fatigue, especially when change is rapid and spans the whole organization or large parts of it (Beare et al., 2020 ; Li et al., 2017 ). Individuals’ reactions towards organizational change are expected to be dependent on the individual’s perception and assessment of the change effects on the individual. This suggests that a reaction towards a change is developed through the interactions between attitudes, beliefs, and feelings of an individual towards a change. A successful implementation of a change depends on how individuals interact with organizational change (Oreg et al, 2011 ; Shura et al., 2017 ). Participation in the change process is closely related with reactions towards a change. Practitioners are likely to be able to effectively diagnose and improve the willingness to change when they understand the need for change (Albrecht et al., 2020 ). Besides, people are more inclined to commit to a change if they perceive the change in alignment with their expectations and the resistance to change would be minimal (Helpap, 2016 ).

A positive reaction allows individuals to be more job focused and hence less resistance to change can be expected (Gardner et al., 1987 ). Similarly, a negative reaction towards change often generates a strong resistance to change. This happens if change is perceived as harming. Moreover, individuals’ resort to negative reactions when work relationships are threatened because of a change in a way that causes them to quit their job (Michela & Vena, 2012 ). However, some individuals are indecisive in their reactions towards a change, especially when future outcomes are unpredictable. This results into disruption and anxiety for both organizations and individuals, and thus reactions serve as the method aimed at dealing and engaging with change (Blom, 2018 ).

These considerations suggest that individuals react differently towards organizational change, depending on their respective perceptions. This invites a comprehensive study to understand the differences in reactions and to explain the main role that reactions play towards organizational change. Based on a systematic literature review, we provide a comprehensive framework that can help get an in-depth understanding of the reactions on organizational change. Earlier studies on precedents and consequences of change have been more concerned about reactions to organizational change (Akhtar et al., 2016 ). Despite the need of organizational change, many change initiatives fail (Beer & Nohria, 2000 ), mainly because of differences in individuals’ interactions in the change process (Oreg et al., 2011 ). Rafferty et al. ( 2013 ), developed a model to study individual level willingness to change. It was found that change based on interactions, homogeneous attitudes, and feelings are successful, and vice versa. Still, there is need to present a broader and more comprehensive theoretical framework based on earlier studies to better understand reactions towards change at different levels, i.e., micro and macro level. Although many researchers have contributed to conducting many studies to try to analyze the nature of cognitive and behavioral responses, for example, job satisfaction, individual performance, emotional intelligence, readiness for organizational creativity, and leadership abilities of all kinds (Malik and Masood, 2015; Malik and Masood, 2015). There are rare studies that dealt with reactions to organizational change at all levels, micro and macro (Khan et al., 2018 ). Thus, the number of studies that investigated reactions to change has increased, but the different types of study cases are still unknown to allocate the most critical determinants that contribute to positive and negative reactions to change. Hence, further investigation is needed. This systematic analysis seeks to provide useful insights into contexts of change reactions and to assist the authors in identifying current options and gaps in this type of study. Accordingly, our research meets the stated literary need. Our focus is to find how the subject of reactions towards change has been studied so far. The main goal is to provide a detailed methodological framework based on earlier studies, which explains the differences and trends in prior research. Additionally, we critically assess methodological issues and challenges found in previous research on reactions to organizational change, which can be overcome in future research. We plead for a changed perspective, which disentangles negative employee reactions to change from negative change outcomes. Rather, we argue that negative reactions can be interpreted as constructive criticism, which can improve the outcome process.

Methodology

To archive our research goal, we conducted a systematic literature review. We used ‘reactions to change’ as the main key word to search relevant articles in four databases. We considered only those articles written in English, which is considered to be the predominant scientific language. Only peer-reviewed articles and conference papers were included. The current study was accomplished according to the ‘Preferred Reporting Items for Systematic reviews and Meta Analyses’ (PRISMA) criterions (Moher et al., 2015 ). For systematic reviews, PRISMA suggests that counting on a single database search for literature should be avoided; no single database is likely to contain all relevant references. Therefore, extensive searching is recommended (Berrang-Ford et al., 2015 ; Monroe et al., 2019 ).

In particular, we used four major databases to assemble the literature sample: IEE Xplore, Science Direct, Scopus, and Web of Science. These databases were selected based on their academic reliability and wider availability of relevant articles to discover the research gap and provide critical practical and theoretical implications (Aria & Cuccurullo, 2017 ; Knobloch et al., 2011 ).

The selection process consisted of two phases of screening and filtration. First, duplicate articles found through matching of titles and abstracts were excluded. Second, articles were filtered after reading the entire article. This resulted in 79 articles (Fig.  1 ). Then, the main findings of the remaining articles were extracted and categorized.

Systematic review protocol

Results and discussion

A critical overview of the change reactions literature.

Previous studies of organizational change attempted to reach an increase in organizational effectiveness by focusing on organizational change and how change is implemented (Oreg & Berson, 2011 ; Oreg et al., 2011 ; Tavakoli, 2010 ; Tyler & De Cremer, 2005 ; Vakola et al., 2013 ; Van Dick et al., 2018 ; Walk & Handy, 2018 ; Whelan-Barry et al., 2003 ). The basic logic of such studies is based on the main assumption the positive or negative organizational consequences depend primarily on the extent to which individuals accept organizational change and their reactions to that change. Such a hypothesis is supported by many recent studies (Alfes et al., 2019 ; Borges & Quintas, 2020 ; Beare et al., 2020 ). Through the growing interest in researching the reactions of individuals towards organizational change. For example, the role of individuals’ reactions and how they interact with organizational change was examined within a time frame that spanned six decades from the end of the forties to 2022. A model was built on the basis of this research showing the relationship between the three main axes in the change process represented by the precedents of individuals’ reactions to change and responses to Their public actions and the consequences of that change (Oreg et al., 2011 ).

The vast majority of the total 79 studies relied on the longitudinal design in the research, and the other studies varied, including in adopting the type of design from transverse design to experimental studies, and 90% of those studies relied on data collection on self-reports of the study variables. Three main axes were discussed in terms of their relationship to the process of organizational change and the potential resistance that individuals come up with towards that change. Such three axes were represented by the cognitive axis, which is analyzed based on how individuals think about organizational change. The emotional axis by understanding and measuring the positive or negative feelings of individuals toward organizational change. The behavioral axis through which the extent to which the individual accepts or rejects organizational change appears (Bhatti et al., 2020 ; Constantino et al., 2021 ; Kashefi et al., 2012 ).

In recent years, factors such as the extent to which individuals accept organizational change and reactions to organizational change were the basic logic of previous studies that grew interested in researching the reactions of individuals towards organizational change (i.e., Roczniewska, & Higgins, 2019 ; Borges & Quintas, 2020 ; Du et al., 2020 ; Peng et al., 2020 ; Li et al., 2021 ). Prior studies have been focused on topics such as the psychodynamic explication of emotion, perception, behavior, and learning (Armenakis & Harris, 2009 ; Reiss et al., 2019 ; Tang & Gao, 2012 ; Al-Abrrow et al., 2019a ; Borges & Quintas, 2020 ), the behavior of leadership (Fugate, 2012 ; Matthew, 2009 ; Alnoor et al., 2020 ), the focus of attention (Gardner et al., 1987 ), internal communication (Men & Stacks, 2014 ; Li et al., 2021 ), individual attitudes (Akhtar et al., 2016 ; Jacobs & Keegan, 2018 ; Liu & Zhang, 2019 ; McElroy & Morrow, 2010 ; Sanchez de Miguel et al., 2015 ), openness to change (Straatmann et al., 2016 ), and information systems (Bala & Venkatesh, 2017 ; Beare et al., 2020 ; Thirumaran et al., 2013 ). Figure  2 simplifies the determinants of reactions to change explored and investigated by the previous literature.

Determinants of reactions to change

Taxonomy of reactions to organizational change

The remaining 79 articles were divided into four categories (Fig.  3 ) regarding the level of reactions towards change i.e., micro and macro level. There were 39 articles relating to micro reactions to change and 40 articles on macro reactions. Hence, these major categories were linked to their corresponding subcategories as shown in Fig.  3 , depending on the frequency of relevance to ‘reactions to change’.

Taxonomy of reactions to change

Micro-level reactions

Antecedents of micro-level reactions.

In this category, the research articles discuss aspects the antecedents of individuals’ reactions to organizational change. The subcategory contains major topics where reactions to organizational change was adopted with regards to (1) Emotional, cognitive, and behavioral therapy, (2) Communication between employees, (3) Leadership style, (4) Individual attitude, (5) Openness to change, and (6) Information systems.

Cognitive behavioral therapy

At the individual level, aims to help human resource to relieve emotional stress and reduce the need for associated dysfunctional coping behaviors. Hence, this set of studies discusses reactions to organizational change with psychodynamic perspective and include 19 studies. Four studies (Antonacopoulou & Gabriel, 2001 ; Armenakis & Harris, 2009 ; Reiss et al., 2019 ; Tang & Gao, 2012 ) discuss emotional and motivational responses to organizational change and strategies to overcome these emotional and motivational challenges. The other nine studies discuss perceptions about organizational change. Beside this, to present a systematic analysis of positive psychology, one of the studies emphasized the relationship between perceptions about organizational support and resistance to change (Ming-Chu & Meng-Hsiu, 2015 ; Al-Abrrow et al., 2019a ; Abbas et al., 2021b ). According to Albrecht et al. ( 2020 ) and Hatjidis and Parker ( 2017 ) change engagement influences employees’ perceptions of organizational change. Thus, employees’ cognitive and behavioral reactions influence their perceptions of organizational change (Borges & Quintas, 2020 ). Endrejat et al. ( 2020 ) and Helpap ( 2016 ) argue that organizational communication reinforces employees’ positive perceptions of organizational change and affects their psychological mechanisms. Contrary to this, a negative awareness about organizational change causes psychological withdrawal or distancing from organization (Michela & Vena, 2012 ). Belschak et al. ( 2020 ) found that the Machiavellianism leads to negative perceptions and negative reactions to change. Organizational efforts to induce change are much consistent when employees are more concerned with change target (Gardner et al., 1987 ; Hadi et al., 2018 ). Six studies discuss two aspects of personality and health regarding employees’ reactions towards change. We found two articles, which describe that organizational justice and culture significantly influence employees’ personality. Additionally, job satisfaction, once change occurs, is critical to personality development (Bailey & Raelin, 2015 ; Caldwell & Liu, 2011 ). The remaining four articles encompass employees’ health related concern in relation to organizational change in health sector (Abbas et al., 2020 ; Fournier et al., 2021 ). It was found that organizational change is perceived as causing fear of job insecurity and health and safety issues among doctors, which resulted into less job satisfaction and reduced level of motivation (Størseth, 2006 ; Tavakoli, 2010 ; Al-Abrrow et al., 2021 ).

Communication between employees

Communication between employees originated from the concept of organizational transparency. Communication provides positive and negative information to employees in a timely manner. Furthermore, communication between employees enhances the organizational capacity of employees and holds organizations accountable for practices and policies (Li et al., 2021 ). Communication between employees includes transparency, accountability, participation, and informatics (Men & Stacks, 2014 ). The change can be planned or unplanned. Planned change is the discovery of problems that need improvement in a proactive manner. Unplanned change is imposed by external forces. Therefore, organizations must react flexibly and quickly to survive (Seeger et al., 2005 ; Alnoor et al., 2020 ). However, the lack of communication between employees creates barriers and threats to organizations towards increasing negative reactions to change. Planned and unplanned changes increase people's confusion and uncertainty. Therefore, employees' understanding of changes through communication between them is critical to the success of change (Gillet et al., 2013 ).

Leadership style

Leadership contributes 71% of the success of change amongst employees. Therefore, leadership and leadership traits were critical factors for change reactions for employees (Fugate, 2012 ). The openness of the leader increases the positive reactions to change. However, the resistance of the leader stimulates negative reactions to change from the employees (Matthew, 2009 ). Relationships with employees by leaders are critical determinants of successful change leadership (Alnoor et al., 2020 ). Leadership style affects employees in different ways, such as credibility and trust are important drivers of change for leaders to certify employee interests are considered. The literature confirms the leader-member exchange theory increases the negative reactions of employees to the change linked with corporate merger (Fugate, 2012 ). On the other hand, creative leadership and transformational leadership inspire employees and increase positive employee reactions. Change leaders are creative and transformative leaders (Matthew, 2009 ). In addition, practical leadership reduces employee resistance to change and increases individual interest in implementing change (Herold et al., 2008 ; Khaw et al., 2021 ).

Individual attitude

This set of studies discusses reactions to organizational change in relation to different individual attitude and included eight studies. Two studies discuss gender attitude, especially the reactions of female employees towards organizational change (Sanchez de Miguel et al., 2015 ). Similarly, employees differ in their attitude of reactions to organizational change depending on their age. Additionally, cultural and attitude differences cause numerous employee reactions towards organizational change (McElroy & Morrow, 2010 ). Three studies discussed the influence of employees’ respective experiences on their attitude of reactions towards organizational change. These studies assert that employees’ previous experiences are important to influence employees’ reactions to organizational change (Alas, 2007 ). A frequent exposure to organizational change causes change fatigue and cynicism and accordingly produce employees’ reactions to organizational change (Stensaker & Meyer, 2012 ). Thus, there is a relationship between the frequency of change and the reactions to change represented by exit, voice, loyalty, and neglect (Akhtar et al., 2016 ). On the other hand, the attitude of employees’ reactions towards organizational change in the public sector differs from the private sector in many ways, because the various processes of logistics and implementation. Therefore, the reactions of employees in the public sector are different compared to those in private sector. For this, the attitude of employees’ reactions in South African prisons to transformative changes in leadership were studied (Mdletye et al., 2013 ). In a policing context, 23 interviews were conducted, and it was concluded that the employees’ feedback began with three foci (me, colleagues, and organization) to assess change (Jacobs & Keegan, 2018 ). Moreover, a relationship between employees’ attitude in public service and their commitment to change was found (Liu & Zhang, 2019 ).

Openness to change

Four studies discussed employees’ openness to change in change and suggested that employability is related to positive emotions and higher level of employees’ openness to change in organizational changes (Fugate & Kinicki, 2008 ). Employees’ (dis) openness to change influences their emotional responses to organizational change (Saunders & Thornhill, 2011 ). It was found that the size and age of a company as well as employees’ expectations boost employees’ openness to change for the successful implementation of change (Lines et al., 2015 ). It is common that employees react whenever a new system is introduced. Yan and Jacobs ( 2008 ) studied employees’ trust and openness to change in relation to organizational change under the lean enterprise system. Two studies discuss diagnostic assessments, which are important during change implementation to deal with employees’ reactions to organizational change (Straatmann et al., 2016 ). Hence, creating interpersonal consensus promotes positive perceptions of change (Dickson & Simmons, 1970 ).

Information systems

This set of studies discusses reactions to organizational change in form of Information systems adoption and included six studies. For example, employees’ cognitive evaluation in reaction to Information systems implementation initiatives was discussed, which provided a deeper understanding of employees' feelings and perceptions of change (Kashefi et al., 2012 ). The authors claimed that a system can be designed to measure the feelings of individuals and customers towards the change implementation (Thirumaran et al., 2013 ). In another study, individuals' reactions to changes within supply chains were measured through the implementation of interorganizational business process standards (Bala & Venkatesh, 2017 ). Moreover, another study presented reactions of employees to digitally enabled work events and how digital technology affects employees ‘emotions (Beare et al., 2020 ). Lilly and Durr ( 2012 ), discussed the effect of implementing new technology on increasing the anxiety and stress among employees. Similarly, employees’ reactions towards technological change implemented in a bank were analyzed (Vakola, 2016 ).

Outcomes of micro-level reactions to organizational change

The change reaction leads to many outcomes and at different organizational levels. The range of literature examining employees' reaction to change is wide. Furthermore, the results of the literature review identified four vital categories: Voice behavior, exit behavior, neglect behavior, and loyalty behavior.

Individual voice behavior

Voice behavior is a type of organizational citizenship behavior differs from altruism, conscientiousness, and sportsmanship because such behavior is costly (Chou & Barron, 2016 ). Voice behavior is discussing problems with the administrator or staff, suggesting solutions, solve problems, and whistleblowing (Farrell & Rusbult, 1992 ). There is a high perceived risk of employee voice behavior. Nevertheless, organizations invest in voice behavior to make efficient management decisions and solve problems (Akhtar et al., 2016 ). The change literature has shown one of the consequences of change reactions is the voice behavior (Abdullah et al., 2021 ; Barner, 2008 ; Svendsen & Joensson, 2016 ). According to Ng and Feldman ( 2012 ) the higher employee voice behavior increases creativity, performance, exploration, and exploitation of ideas. Therefore, the voice behavior reduces anxiety and fatigue of individual toward organizational change. Previous literature has demonstrated voice behavior due to change increases employee turnover (Bala & Venkatesh, 2017 ). Individual voice behavior leads to undesirable results. In this context, change affects the social exchange and social relations between employees. Hence, organizational change reduces the quality of social exchange. Employees feel unappreciated and involved, which increases resistance to change (Zellars & Tepper, 2003 ). From a psychological perspective, the reaction to change is crucial for employees to express their opinions (Bhatti et al., 2020 ). Therefore, the voice behavior should be considered as a positive behavior that solves problems rather than identifying them (Whiting et al., 2012 ).

Individual exit behavior

Exit behavior is transferring, thinking about quitting, searching for a different job, and sabotage (Farrell & Rusbult, 1992 ). Most of the literature on reactions to change confirmed the main reason for employees to exit work is change (Akhtar et al., 2016 ; Bryant, 2006 ; Šedžiuvienė & Vveinhardt, 2018 ). However, there are two types of exit behavior, vertical and horizontal. Vertical mobility is moving upwards in the same organization. Horizontal mobility is the employee’s turnover of the organization (Davis & Luthans, 1988 ). Many firms view employee turnover negatively. The literature confirmed the employee turnover can be positive because it renews blood and increases the recruitment of skilled human resources (Elfenbein & Knott, 2015 ). Negative change reactions cause an increase in employee turnover. In this context, many human resources are transferred to other organizations. Such human resources bringing with them competitive advantages that increase innovation and creativity (Walk & Handy, 2018 ). Therefore, the literature confirms organizational inertia reduces organizational development. Hence, turnover allows work to correct organizational errors and provides further improvement for tasks (Piderit, 2000 ). Horizontal mobility due to change reduces organizational loyalty of employees caused by increased desire to search for new work (Carnall, 1986 ). In conclusion the reactions to organizational change contribute to the withdrawal of employees from the organization. However, employee turnover may promote to superior performance.

Individual neglect behavior

The literature indicates that one of the outcomes of micro-level reactions to organizational change is neglectful behavior (Akhtar et al., 2016 ). Employees who experience negative reactions to change contribute less organizational effort (Vantilborgh, 2015 ). Hence, individual neglect behavior is chronic lateness, reduced interest, increased error rate, and using firm time for personal business (Farrell & Rusbult, 1992 ). The change increases uncertainty due to several employees loses their jobs and positions. In this context, many employees underestimate the seriousness of their work (Svendsen & Joensson, 2016 ). Previous studies on organizational change have argued employees' reactions to change are a decisive factor in reducing efforts, decreasing work quality, and increasing absenteeism (Chou & Barron, 2016 ; Withey & Cooper, 1989 ). Therefore, negative reactions to change are negatively related to the time spent by the employee and the efforts made at work (Alnoor et al., 2022 ; McLarty et al., 2021 ).

Individual loyalty behavior

Loyalty behavior is waiting and hoping for improvement, giving support to the organization, being a good soldier, and trusting the organization to do the right thing (Farrell & Rusbult, 1992 ). Organizational change that maintains working relationships and psychological contracts with employees is likely to increase the strength of individuals’ loyalty due to the rule of reciprocity (Davis & Luthans, 1988 ). Individual realization that organizational change fulfills organizational commitment to individuals, strengthens the relationship amongst the organization and the individual (McElroy & Morrow, 2010 ). Negative employee reactions to change reduce individual loyalty (Constantino et al., 2021 ). Individual loyalty is the employee's readiness to maintain affiliation in the organization by giving attention to the goals and values of the organization (Aljayi et al., 2016 ). Individual loyalty receives outstanding consideration in the change literature because individual reactions to change can be a fundamental determinant of individual loyalty to the organization (Akhtar et al., 2016 ). Hence, job satisfaction and a positive reaction to change increase the emotional and mental connection of individuals to the organization (Milton et al., 2020 ).

Macro-level reactions

Antecedents of macro-level reactions.

This category included 40 research articles, which discuss macro-level related aspects of reactions towards organizational change. In this category, the research articles consider aspects the antecedents of macro-level reactions. Major topics are (1) Organizational emotional, cognitive, and behavioral, (2) Organizational communication, (3) Leadership style, (4) Organizational attitude, (5) Organizational openness to change, and (6) Organizational information systems.

Organizational emotional, cognitive, and behavioral

Organizational reactions towards organizational change are informed by emotional, cognitive, and behavioral therapy of strategic changes such as mergers and strategic alliance. Strategic mergers can influence stakeholders’ decisions, which may result into negative reactions towards such merger (Basinger & Peterson, 2008 ; Bowes, 1981 ). This negative reaction is expressed through heightened anxiety levels and reduced emotional attachment (Rafferty and Jimmieson, 2010 ). Such a strategic change can lead to organizational exit (Schilling et al., 2012 ). Moreover, the effect of changes introduced by cross-border processes on organizational reactions was studied and it was found that there is an effect of dynamic cultures on organizational reactions towards change (Chung et al., 2014 ; Khaw et al., 2022 ).

Organizational communication

The second set of studies discusses reactions to organizational change regarding organizational communication. The lack of organizational communication caused organizational imbalances that negatively affected reactions towards organizational change in a way that tends to follow negative reactions such as an exit (Kruglanski et al., 2007 ). Weakness in organizational communication caused tension among employees and resulted into negative reactions towards change (Li et al., 2021 ). In this context, numerous environmental changes and crises have led to weak organizational communication during the change. For example, the recent Covid-19 pandemic that caused many barriers in organizational communication (Milton et al., 2020 ). Hence, when there is an abrupt change due to unexpected circumstances the organizational negative reactions would be increased towards change due to the lack of organizational communication (Fadhil et al., 2021 ).

Transformational leaders’ reactions are affected by organizational change in a way that enhances their readiness for change and motivates them for increased participation and performance to support change (Faupel, & Süß, 2019 ). It was also found transformational leaders and their reactions are significantly related to change. Transformational leaders are committed and willing to bring change and react in a way to defuse resistance to change (Peng, et al., 2020 ). Transformational leadership facilitates a successful implementation of a change (Islam et al., 2021 ; Thomson et al., 2016 ). There is an influence of transformational leaders in supporting the change processes which commensurate with their positive reactions towards change (Bayraktar & Jiménez, 2020 ). Transformational leaders play an important role in shaping positive reactions towards organizational change and supporting the changes process (Busari et al., 2019 ). On the other hand, the success of a change process depends on leaders’ competency in inducing change, and transactional leadership can provide such competency. Transactional leadership encourages critical thinking and participation to ensure success of a change process (Khan, et al., 2018 ). As transactional leadership is supportive to change, it is helpful to reduce resistance to change (Oreg & Berson, 2011 ). Therefore, managers use their authority to support organizational change (Tyler & De Cremer, 2005 ). Organizational confidence in managers is a critical factor that generates positive managerial reactions towards organizational change (Du et al., 2020 ; Harley et al., 2006 ). However, change may generate negative managerial reactions of non-acceptance of change (Huy et al., 2014 ). The magnitude of managers response and their reactions depends on the degree and intensity of a change (Bryant, 2006 ).

Organizational attitude

There is an agreement between leadership and organizational change such that organizational attitude is employed in a way that reflects positive reactions towards organizational change (Fugate, 2012 ). It was found that, acceptance or rejection of change depends on the existing organizational attitude and measures taken to implement change (Bin Mat Zin, 2009 ). Hence, organizational wellness is positively related to the ability to deal with change. Moreover, leaders provide insight about how change affects the organization’s procedures, and this may help to overcome resistance to change (Alfes et al., 2019 ). Although change is inevitable, individuals struggle with change when their vision is unclear, which causes turmoil and increased anxiety. Additionally, individuals find it difficult to engage in organizational change when the organizational policies develop feelings of fear among individuals, and this causes resistance to change (Blom, 2018 ). Firms’ responses to organizational change requires confidence and adaptation necessary to engage with change, and this depends on the self-evaluation and the extent of accept the changes. Therefore, leaders highlight the change and call for a commitment to it (Judge & Kammeyer-Mueller, 2011 ; Rizzuto et al., 2014 ). Reactions towards change are dependent on firms' belief about change. Organizational actions and beliefs induce constructive change (Vakola et al., 2013 ).

Organizational openness to change

The literature found reactions pose a challenge for organization towards change when there is a lack of organizational openness to change. Therefore, employees have negative reactions towards change, while leaders have positive reactions that support the change process and help to get change accepted (Walk & Handy, 2018 ). Individual employees understand that change can create a complex situation, which can give rise to issues for employees, and they refute change. In contrast, leaders perceive change as beneficial to the organization and they support it. Leaders see change as one major requirement for the development of organization. Therefore, they encourage openness to change. Whereas individual employees are not opened to change because they perceive change will create organizational instability. Leaders encourage organizational activities, which facilitate change. In contrast, individuals express lower level of openness and acceptance to change (Rechter & Sverdlik, 2016 ). Leaders see the attainment of organizational and personal goal through change. Contrary to this, the lack of opened to accept change create incompatibility between the organizational goals and the change initiative (Roczniewska & Higgins, 2019 ). Explicit reactions to change can be interpreted in many ways, some of which involve the benefits of change, while others are related to the negative consequences of change (Oreg et al., 2011 ). Thus, employees do not show a stronger commitment to accept change, but leaders tend to understand a change (Mangundjaya et al., 2015 ).

Organizational information systems

Organizational information systems are a vital and significant resource for companies. Consequently, the huge development in information and communication systems led to taking proactive steps towards adopting innovative and modern technology (Hadid & Al-Sayed, 2021 ). The adoption of modern information systems has contributed to increasing organizational anxiety due to fear of change (Paterson & Cary, 2002 ). However, interest in new technology development by companies increases the potential for long-term downtime. Therefore, context conditions must be created to encourage organizational changes (Walk & Handy, 2018 ). Digital technologies have penetrated companies tremendously and rapidly. Rapid technological changes have transformed organizational work designs by increasing flexibility and empowerment (Beare et al., 2020 ). However, digital technologies have negatively affected the organization by not separating personal and work life (Chen & Karahanna, 2014 ). Digital technologies have created enormous social challenges through the constant bombardment of social media messages and emails (Vakola, 2016 ). Therefore, the working hours of employees have increased because they are sometimes obligated to respond. Furthermore, organizational information systems enhanced emotional reactions by increasing feelings of anger, unhappiness, and frustration (Andrade & Ariely, 2009 ).

In conclusion, the level-specific study offers an examination of the antecedents, associations, and implications of reactions to organizational change at the individual and organizational level. However, multilevel theories, methods, and analyses have gained popularity in recent years (Walk & Handy, 2018 ), and the reactions to organizational change have been studied in this manner. Several studies examine how reactions to organizational change operates across levels, while others use cross-level designs to examine how reactions to organizational change is concurrently influenced by variables at different levels. Exemplary studies for both kinds are discussed below and are arranged according to the main predictor variable (or variables) from the preceding categories.

Outcomes of macro-level reactions to organizational change

The change reaction indicates to various consequences at macro-level. Hence, the frequency of macro-level reactions to change, relating to the reaction typology suggested by Akhtar et al. ( 2016 ). Apart from voice, exit, loyalty, and neglect, we added social identity as the most frequently mentioned reaction type at the macro level.

Organizational voice

A positive organizational change results into a voice behavior where employees accept organizational change (Barner, 2008 ). However, change is without organizational support led in negative voice behavior such as employees’ resistance (Peachey & Bruening, 2012 ). Directing organizations has the enormous leadership task of listening to the voices of managers and employees about strategies for change (O'Neill & Lenn, 1995 ). The literature indicates responses to change, such as organizational voice behavior, leave managers stuck between fear of the future and respect for the past (Stylianou et al., 2019 ). Organizational voice behavior affects the professional and personal lives of managers and employees. Consequently, the practice of organizational changes causes the loss of many jobs, which is reflected on the feelings of managers and employees and causes ridicule, anger, anxiety, resentment, and organizational surrender (O'Neill & Lenn, 1995 ). Organizational voices due to change exacerbate organizational problems because of constant blaming of the chief executive officer. Organizational concerns are heightened by the difficulty of expressing opinions. In this context, organizational voices turn into sources of organizational mopping throughout the organization except perhaps the chief executive office (Barner, 2008 ). As a result, the negative reactions cause feelings of organizational anger and anxiety by increasing the difficulty of articulate the organizational voice.

Organizational exit

The literature shows negative reactions to change increase workplace bullying (Barner, 2008 ; Peachey & Bruening, 2012 ). Thus, reactions to organizational procedures encourage behavioral responses to organizational exit (Akhtar et al., 2016 ). Negative responses to organizational change are likely to be stronger in the exit behavior comparative with voice behavior (Balabanova et al., 2019 ). Because exit behavior is an assertive reaction that is associated with change and is not bound by organizational conditions (Farrell & Rusbult, 1992 ). Hence, exit behavior is risky because such behavior increases organizational disruption and stimulates harmful work behavior (Ng et al., 2014 ). Unexpected change leads to the organization's exit from the entrepreneurial work. In this context, organizations leave the entrepreneurial profession. Exiting creative and entrepreneurial businesses affects the company and the economy in general (Shahid and Kundi, 2021b ). Negative reactions to change reduces motivation and self-efficacy, which increases organizational fatigue, impedes the implementation of organizational tasks, and causes exit (Surdu et al., 2018 ).

Organizational loyalty

Panchal and Catwright ( 2001 ) argued that organizational change is a complex process that makes it difficult for employees to accept such a process. Because routine work and many tasks affect change. Employees are significantly affected by frequent organizational change and are reflected in the practice of exit and neglect behaviors and low level of loyalty (Akhtar et al., 2016 ). Adopting successful organizational change increases positive reactions. However, most of the change literature confirms numerous change programs erupt and increase the negative reactions that occur through the practice of neglectful behaviors and lack of organizational loyalty (Bartunek et al., 2006 ). Organizational change increases stress, decreases commitment, and decreases loyalty. Frequent and ineffective changes produce negative responses and cause a decrease in job security. Consequently, the organization will suffer from low loyalty (Guzzo et al., 1994 ). Organizational loyalty decreases due to frequent changes lead to employees rethinking that continuing in this organization is not beneficial (Reiss et al., 2019 ). Such changes create uncertainty and cause organizational mopping (Constantino et al., 2021 ). Organizational change is a critical cause of low loyalty because inefficient changes increase negative organizational perceptions regarding social atmosphere, perceived promise, job content, and rewards (Van der Smissen et al., 2013 ). Therefore, increased negative reactions to change due to frequent and ineffective changes raises organizational perceptions of low loyalty and decreases organizational loyalty.

Organizational neglect

Hirschman ( 1970 ) proposed the employees' enactment of exit, voice, loyalty, and neglect model and was expanded by (Farrell, 1983 ; Rusbult et al., 1988 ). The employees' enactment of exit, voice, loyalty, and neglect model refer the decline of the organization creates many negative reactions that increase the deterioration in performance and reduce efficiency and learning, involving exit, voice, loyalty, and neglect. Reactions contributes to identifying failures and correcting tracks. Therefore, adverse behaviors assist the organization to deal with unfavorable situations, because the behavior of neglect and tardiness for work represents a communication strategy for the members of the organization (Meyers, 2020 ). Organizational neglect represents dishonorable behavior and organizational leniency. Organizational neglect behaviors include reduced attention and delay, reduced effort, increased absenteeism, increased error rates, and concern for personal issues at work (Lee & Varon, 2020 ). Unsuccessful organizational change is a major source of social loafing. Social loafing is the tendency of people to neglect work (Murphy et al., 2003 ). Thus, the reactions of employees at the organizational level contribute to reducing performance and increasing organizational failure (Abbas et al., 2021a ; Akhtar et al., 2016 ).

Social identity

A fantastic reaction is generated by the members of the organization to protect and prove the social identity of the organization. Therefore, managing stability is as important as managing change in the context of social identity (Dutton et al., 1994 ). Organizational change affects some basic features of employees’ social identity, which leads to an imbalance in reactions towards change and causes uncertainty among individuals (Jacobs et al., 2008 ). The intense reactions of the members of the organization highlight the importance of organizational identity. Social identity is useful to understand and analyze reactions to deal positively with organizational change. For example, a weak social identity may lead to a negative reaction towards organizational change, such as disloyalty. Flexible social identity helps to give a quick response to organizational change and facilitates an anticipation of reactions towards change (Aggerholm, 2014 ). The success of organizational change and positive reaction is linked to the recognition of organizational identity based on the intention to remain in the organization and job satisfaction. Developing social identity in change programs reduces negative reactions to change (Clark et al., 2010 ). Łupina-Wegener et al. ( 2015 ) argued shared identity positively influences employees' perceptions of accepting change. Because the shared identity stimulates the transfer of organizational practices between units and departments after the post-change. Therefore, the organization must give employees a sense of continuity for the organization's bright future to practice transferring positive behaviors after implementing change programs (Jacobs et al., 2008 ).

Research issues and challenges

Previous research on reactions to organizational change is subject to several methodological issues and challenges. In the following, we asses methodological issues relating to research design, sector, country, research sample, techniques, and variables (Table 1 ). Compared to a multitude of other management subjects, research on reactions to organizational change shows both its strengths and limitations. Furthermore, it seems that similar problems are relevant at different levels of analysis. To a certain extent, a reaction to organizational change literature advances systematically, while other subject areas have not progressed as much.

Reactions to organizational change as a multidimensional construct

Evidence has collected that a five-factor multi-indicator CFA model fits Akhtar et al. ( 2016 ) and Van Dick et al. ( 2018 ) reactions to organizational change measure at the individual levels of analysis (e.g., Exit, neglect, loyalty, voice, and social identity). Using first-order CFA, Akhtar et al. ( 2016 ) found an “modest fit” with one sample. Elsewhere, both Bryant ( 2006 ) and Šedžiuvienė and Vveinhardt ( 2018 ) found satisfactory fit for a two-factor (i.e., Exit and voice) latent model. Divergent validity of the five-dimensional reactions to organizational change scale was shown by Akhtar et al. ( 2016 ) who discovered that it was different from a single order factor. It should be noted that in addition to obtaining evidence supporting the discriminant validity of the reactions to organizational change dimensions from negative affectivity, job satisfaction, and psychological climate Van Dick et al. ( 2018 ) examined the relationships between social identity and voice behavior. Researcher Aggerholm ( 2014 ) was able to show the discriminant and convergent validity of reactions to organizational change, namely, the capacity to increase organizational misbehavior, working relationship with a supervisor, decrease trust in one's supervisor, and work performance, with unrespect to work engagement and job satisfaction.

There has been relatively little team-level CFA work done as compared to work done at the individual level. It should be clear that this fact comes from the truth that it is very difficult to sample enough teams to do studies for this kind of analyses. Although CFA models have been applied to the Walk and Handy ( 2018 ) individual and organizational outcomes but without respect multilevel model. This produces a discontinuity between the amount of investigation and the amount of theory used (Maynard et al., 2012 ). While we believe this is a promising approach, we encourage researchers to use multilevel CFA methods when conducting analyses that seek to elucidate the construct validity of aggregate variables, with the goal of the study being the total number of teams in the focus population. Concurrently, there is no published research on whether two- and four-dimensional forms of reactions to organizational change provide equivalent criterion-related validity. Here, future studies could compare the two measures, determine whether there are important changes between the various versions, and investigate if the various conceptualizations maintain validity and stability through time and cultures by respecting the assessment of measurement model. In addition, we think that these problems offer valuable topics for future study. In this context, there was vital issue which is related to assessment of structural model. Moreover, there is no study combination of structural equation modeling and artificial neural network. Hence, they did not consider the two mains of benefits the combination of structural equation modeling and artificial neural network is that the use of multi-analytical two-phases SEM–ANN method tool up two vital benefits. First, it allows for further validation of the SEM analysis findings. Second, this approach captures not just linear but also dynamic nonlinear interactions between antecedents and dependent variables and a more accurate measure of each predictor's relative power as well. Furthermore, the potential future work can use SEM-ANN model to determine the reactions to organizational change by adopting multilevel model.

Mono-method issues

At the individual and team levels, most research done on reactions to organizational change consists of questionnaires asking workers about antecedents, correlates, and consequences of such reactions. Any common measurement or percept-percept biases will increase observed associations (Maynard et al., 2012 ). These biases are intensified if both variables are measured at the same time. Three percent of the individual-level research utilized a different source, whereas 97 percent used self-reported criteria measures. Individual-level reactions to organizational change are more likely to be biased by monothiol bias, resulting in inflated correlations, while team-level relationships are less likely to be distorted by monothiol bias. In keeping with this result, Mangundjaya et al. ( 2015 ) showed that task performance correlated more strongly with the reactions of individuals when responses were obtained through self-report measures than when responses were collected by other means. Reactions to organizational change have been operationalized in different ways throughout the literature at each level of study. Reactions to organizational change, as measured and studied at both the individual and team levels, are each shown in the literature as being in two-dimensional, four-dimensional, and aggregated forms. However, yet, there has been no study to account for the disparate measuring methods that may influence the correlations shown in studies like this. Therefore, we believe future studies should examine how measuring approaches influence such correlations.

Mediator and moderator inferences

As mentioned before and shown in Fig.  2 , reactions to organizational change are usually regarded as a mediator between the characteristics of people and environments and outcomes, regardless of the substantive level of study. The validity of mediational effects is contingent on a variety of variables, most notably the accuracy of the assumed causal chain connecting antecedents to reactions to organizational change and to outcomes (Chung et al., 2014 ; Li et al., 2021 ). As shown in the contribution section, 49% of individual-level studies and 16% of team-level studies used cross-sectional designs. The studies conducted so far have shown nothing in the way of causation or association between organizational change and reactions at the level of analysis. Additional work exploring how direct impacts are mediated and/or studying variables that may mitigate such direct effects appears to hold across different levels of analysis in which reactions to organizational change have been examined. Researchers to date have mostly examined things that serve as antecedents to reactions and results that are influenced by reactions to organizational change. According to the authors of the paper Walk and Handy ( 2018 ), job crafting acts as a mediator in explaining the connection between the perceived effect of change and people's reactions to organizational change. Hence, there are many additional possible mediators that have not yet been studied. In fact, the few research that investigate how specific connections within the reactions to organizational change influence other possible moderators are found at different levels of analysis. And thus, we believe that it is the appropriate moment for those interested in the influences that mediate and moderate reactions to organizational change to investigate many facets that are intricately intertwined in these responses.

Research design

Research design refers to a general strategy chosen to integrate various components of a study in a coherent and logical manner. It is always challenging to choose an appropriate research design because sometimes a chosen design does not align with the data. For example, a longitudinal design often used in qualitative studies can be time consuming due to nature of data (Bayraktar & Jiménez, 2020 ; Faupel & Süß, 2019 ; Liu & Zhang, 2019 ). Similarly, the descriptive design may not generate the required results due to inability to control the tendencies of the individuals involved in data collection (Barner, 2008 ; Bin Mat Zin, 2009 ). Some of the studies that have been covered focus on cross-sectional or one-way design, but they are not generalizable because they may be biased (Vakola et al., 2013 ). In addition, future studies should use longitudinal designs that allow tracking of changes at organizational levels and aim to collect data from multiple sources (Barner, 2008 ; Chung et al., 2014 ; Fournier et al., 2021 ; Kashefi et al., 2012 ; Oreg et al., 2011 ), while other studies called to follow the method of interviews that extract information and provide insight into the nature of change processes in organizations (Jacobs & Keegan, 2018 ; Saunders & Thornhill, 2011 ). An improved understanding of the long-term consequences of organizational transformation might enhance the reactions to such studies. Gerwin ( 1999 ) proposed managers could empower teams throughout the life cycle, for example, while the teams are forming, maturing, and growing. According to Gerwin ( 1999 ), organizational change may take place as a cycle, and it is the role of reactions to these changes to push the cycle in one direction or another.

The sector refers to research site where the study is to be conducted and can be public or private organization as per the study requirements. Choosing a public sector as study site may be problematic for change related studies because public sector employees resist change and can generate biasness in responses (Borges & Quintas, 2020 ; Kennedy-Clark, 2010 ; Santos Policarpo et al., 2018 ; Milton et al., 2020 ). Studies conducted in industrial organizations do not allow generalization of the results because these organizations require changes in terms of organizational structures, strategy, and operating procedures, but they are not on a large scale. Thus, results could not be generalized, and such studies should be conducted in other organizations (Mangundjaya et al., 2015 ). Studies in service sector (hotels, hospitals) give great importance to adopting actual change (Hatjidis & Parker, 2017 ). As a result, it must be considered when generalizing to all other service organizations, as there may be fundamental differences between organizations. Future research should focus on other service sectors such as banking (Vakola, 2016 ). Regarding security issues, the effect of the organizational identity on the change processes of national security institutions has been verified, and the results of these studies cannot be generalized because the changes that are made may lead to imbalances with the organizational culture in other organizations (Belschak et al., 2020 ; Jacobs et al., 2008 ). In addition, researchers can focus on industrial companies such as technological industries, digital technologies, wired and wireless communication companies (Tang & Gao, 2012 ).

Countries differ from one another in many ways. Hence, the result of a study conducted in one country may not be generalized to other countries. Similarly, economic, social, and political restrictions among countries may reduce the possibility of generalization of research findings across countries (Fournier et al., 2021 ; Lines et al., 2015 ; Tang & Gao, 2012 ). Some studies focused on one country without considering the role of the social and political factors of other countries, Therefore, the results of these studies cannot be generalized to other countries (Kashefi et al., 2012 ; Mangundjaya et al., 2015 ). As a result, future studies are encouraged to use data from other countries to conduct comparative analyzes, which may allow generalization (Fournier et al., 2021 ; Straatmann et al., 2016 ). A study of Blom ( 2018 ) in manufacturing industries of South Africa, which included a sample of companies interconnected with the parent company, and thus studied the opinions of employees from other countries. As for studies conducted in developing countries, their results are not generalizable, as the behavioral responses in these countries differ from those in European countries (Busari et al., 2019 ; Li et al., 2021 ). Consequently, the country differs in many ways in terms of productive and social capabilities, and this may be a limitation in several countries (Huy et al., 2014 ; McElroy & Morrow, 2010 ).

Research sample

A sample represents a component of population chosen to provide the required data. There is problem when sample size is too small to generalize the result to larger population (Šedžiuvienė & Vveinhardt, 2018 ; Yan & Jacobs, 2008 ). Similarly, a larger sample may provide the data which may not be relevant to the study objectives (Rizzuto et al., 2014 ; Stensaker & Meyer, 2012 ). Most of the studies discussed focused on collecting data from individuals working in different organizations. However, there is a strong tendency to conduct more studies that enable data collection in other contexts to highlight the roles of leaders and managers to participate in providing support for change processes (Antonacopoulou & Gabriel, 2001 ; Barner, 2008 ; Jacobs & Keegan, 2018 ). Moreover, the choice of the sample determines the fate of the study, whether it is possible to generalize or not. The larger sample size, the greater the possibility of generalization (Šedžiuvienė and Vveinhardt, 2018 ; Yan and Jacobs, 2008 ). Sample selection was problematic during the pandemic period because there were difficulties in collecting data and accessing responses (Li et al., 2021 ). In addition, some authors have dealt with specific groups in state-owned organizations, but such studies were hard to generalize as they need more verification and other opinions to prevent bias (Lines et al., 2015 ). More studies shed light on urging researchers to survey the opinions of users and beneficiaries at all organizational levels to reach the results. The researchers were also urged to take into consideration the age composition of the polarized sample before embarking on organizational change initiatives (McElroy & Morrow, 2010 ).

Among the other challenges that some studies faces are the choice of statistical methods to analyze the data because the chosen methods may be not suitable for data and the results are less convincing (Bin Mat Zin, 2009 ; Chung et al., 2014 ). Many researchers have used exploratory studies, which are of great importance in drawing conclusions. However, previous studies focused on use such design in one context and limits the possibility of generalization (Jacobs & Keegan, 2018 ; Vakola et al., 2013 ). Researchers also used interviews for a specific number of employees, which caused biasness in reactions (Jacobs & Keegan, 2018 ; Saunders & Thornhill, 2011 ). Therefore, focusing on other methods such as observation to see the impact of reactions to change will provide motivational cases and ideas worth sharing (Kruglanski et al., 2007 ). Some studies used structural equation modeling, which revealed the suitability of this technique for experimental research (Borges & Quintas, 2020 ; Faupel & Süß, 2019 ; Gardner et al., 1987 ). Likewise, some studies used a questionnaire and performed analysis, such as multiple regression and content analysis, which is considered a qualitative method in analyzing data and interpreting its meaning and provides an opportunity for researchers to choose different issues (Alas, 2007 ; Busari et al., 2019 ; Chung et al., 2014 ; Tavakoli, 2010 ). Although these analyses have proven their worth in extracting results, it requires researchers to use deep statistical analysis to reach generalizable results (Hatjidis & Parker, 2017 ; Huy et al., 2014 ). The researchers urged for future studies to use surveys and conduct comparative analysis between groups that would reduce time bias in the data (McElroy & Morrow, 2010 ).

The selection of incorrect variables may generate the biased result, or the variables may not be able to sufficiently serve the purpose of study and researchers need to add more variable to get rich data (Albrecht et al., 2020 ; Tyler & De Cremer, 2005 ). Table 1 . Explain the issues and challenges of reactions organizational change in this regard. One of the limitations that some studies faced is they did not examine the personal characteristics of individuals, such as the influence of traits and the role of personality in directing reactions, as individuals with a high degree of negative influence of traits tend to follow the opposite reactions, neglecting this aspect may cause bias (Huy et al., 2014 ). It was also noted the studies discussed focused on the pace of change and trust in management and still there is necessity to discuss other variables that are highly related to change such as organizational culture, employee communication, commitment, fairness, job characteristics, resistance to change, psychological context, individual incentives, and anxiety of change (Busari et al., 2019 ; Lines et al., 2015 ; Oreg et al., 2011 ). Given the behavioral aspect is very important in human studies, addressing the use of behavioral support for organizational performance contributes to improving the reaction to change processes (Fournier et al., 2021 ). Moreover, considering technological development and intense competition between current organizations, the use of management information system will reduce behavioral and organizational problems (Dickson & Simmons, 1970 ). Researchers called for attention to the problem of studying the planned organizational change on a large scale in a place where employees do not have a voice, and the opportunities for participation are limited and the resistance to change is extreme (Fugate, 2012 ; Jacobs & Keegan, 2018 ). As a result, the changing organizations face huge challenges and spend massive amounts of resources on training and developing their employees (Antonacopoulou & Gabriel, 2001 ).

Benefits of (Even Negative) reactions to organizational change

The purpose of this systematic review is to expand theory and the understanding on reactions to organizational change by incorporating ideas from several disciplines (e.g., psychology, sociology, complexity sciences, and institutional perspectives). Many studies on organizational change reactions have concentrated on the causes or outcomes of these reactions, with a specific focus on resistance and, therefore, rather negative outcomes. Organizational change is often a necessity caused by external threats, such as intense competition (Oreg et al., 2011 ; Tavakoli, 2010 ). To implement change, the cooperation of employees is required (Antonacopoulou & Gabriel, 2001 ; Hatjidis & Parker, 2017 ; Peng et al., 2020 ). However, a mixture of psychological, social, emotional, and cultural dimensions in employees’ reactions can negatively interfere with the process of organizational change itself (Armenakis & Harris, 2009 ).

In this section, we attempt to change this perspective and, based on the findings in Sect. 3.1, formulate several propositions, which may enable organizations to overcome negative reactions and transform them into positive change outcomes. Basically, we argue that (1) negative reactions can be seen as a source of constructive criticism, (2) which can be used to improve the change process. Employees can be viewed as a critical authority in an organization, which might evoke new perspectives on the change process. The provided constructive criticism points to issues that require further attention by the organization. The antecedents, process, and outcomes of the change process are more thoroughly analyzed regarding possible weaknesses and strengths, which can improve the whole change process (Fournier et al., 2021 ; Straatmann et al., 2016 ). In particular, this encourages those in charge to address shortcomings and help facilitate change processes (Jacobs & Keegan, 2018 ). It can also help increase communication between members of the organization during various stages of organizational change (Li et al., 2021 ). Listening to employees’ objections might reduce the complexity of change (Chung et al., 2014 ; Fugate, 2012 ; Reiss et al., 2019 ) and can motivate and empower them to contribute to the success of change processes (Casey et al., 1997 ; Kruglanski et al., 2007 ; Tavakoli, 2010 ).

Theoretical recommendation

The results of this review revealed several critical variables and factors that had been investigated in previous research on change responses. There are many challenges and benefits that academics should take into consideration. Hence, understanding the negative and positive effects of change reactions can be an essential key concept to the successful implementation of organizational change. The results of an extensive literature review show allowing human resources to participate and rush into change programs increases the likelihood of successful implementation of planned and unplanned change. The leadership style has a strong and significant role in adopting change. Theoretically, the literature has proven the transformational and transactional leadership style are vital leadership styles that raise positive reactions to organizational change (e.g., Bayraktar & Jiménez, 2020 ; Busari et al., 2019 ; Faupel, & Süß, 2019 ; Khan, et al., 2018 ; Oreg & Berson, 2011 ; Peng, et al., 2020 ; Thomson et al., 2016 ). The leadership aspect is of fantastic importance in the success of implementing change because the leader has ability to inspire employees towards increasing levels of motivation and deliver the message of change with the lowest level of negative reactions. Because leadership styles achieve mutual gain between individuals by giving individuals a sense of power to adjust or accept the changes that occur in the organization. This review expanded the communication's vision of change by identifying reactions in four integrated behaviors (i.e., Exit, voice, loyalty, and neglect) that explain why individuals reject, resist, accept and embrace change.

Understanding reactions to change plays a critical role in enhancing individuals' cognitive, emotional experiences, and perceptions of changes. The results of this study shed light on the implementation of change during crises. The results prove epidemics and sudden consequences lead to lack of resources and loss of market share. There is huge benefit in adopting and responding to change programs amid crises, especially in the aftermath of unexpected crises, such as the COVID-19. Although crises add a significant burden to organizations in implementing change, it is necessary to face crises with a fantastic deal of courage, confidence, and communication to reduce exit reactions and disloyalty amongst employees. Supporting human resources and creating a work context with less organizational mopping leads to positive results and increases the success of organizational change adoption (Barner, 2008 ; Qin et al., 2019 ). Adopting organizational change is an emotional process based on individuals' feelings and perceptions of change. Organizational change causes high levels of anxiety and tension. Because the individual adversely interferes with aspects of organizational change in a manner that creates the feeling of anxiety increased and loss of identity. However, reactions to organizational change are varied and may be positive by increasing job satisfaction and granting of responsibility. In this context, the reactions toward change may be negative also by increasing the likelihood of unsuitability of change with the organizational work. Furthermore, academics and practitioners should be concerned with the sensory and emotional aspects of how individuals react to organizational change. Because the organizational changes that include providing importance to the emotions and feelings of staff as part of the change process can encourage employees to change the attitude towards change and cooperate with current events (Beare et al., 2020 ).

Organizational communication is important for understanding people's emotions and perceptions of change. Communication before and post organizational change provides people with suitable and timely information, creates a sense of delegation of responsibility for change, and mitigates negative responses to organizational change (e.g., Basinger & Peterson, 2008 ). Academics can use the results of this review to understand change reactions from an organizational and individual perspective and to highlight challenges and barriers to implementing change. Analyzing and examining organizational elements such as organizational communication and organizational attitudes provides solutions while implementing change. Additionally, sharing responsibilities and integrating roles between participants in the change increases the results achieved from adopting organizational change. This review confirms there is a dearth of investigation into the influence of psychological context factors such as individual incentives, change anxiety, and organizational mopping on post change results at the individual and organizational level. Studying reactions to organizational change at different organizational levels contributes to identifying differences and similarities to reactions at multiple organizational levels. In this context, using the results of this review by academics and practitioners contributes to reducing negative reactions and increases the chances of successful implementation of change programs.

Many studies highlight the importance of change efforts in contemporary organizations to address external threats. However, employees’, i.e., change recipients’, cognitive and behavioral responses to change often result in resistance. A comprehensive perspective of past research is required to have a clear understanding of the causes and consequences of responses to change. For this reason, we have conducted a systematic literature review on this subject. Much of what has been discovered before may be categorized into these four levels: micro and macro level responses. An in-depth analysis of the literature helped identify the antecedents, effects, benefits, challenges, and recommendations associated with reactions to organizational change.

Our findings have managerial implications. Based on the literature review, we derive recommendations for change agents to facilitate the issues experienced by researchers whilst studying reactions to organizational change. Insights from our literature review highlighted both positive and negative aspects of reactions towards change. Accordingly, we divided these studies into two groups discussing positive and negative aspects. The positive aspects highlight the importance of reactions in supporting change and broadening the view of the motives for change (Armenakis & Harris, 2009 ; Gardner et al., 1987 ; Mangundjaya et al., 2015 ). This increases employees’ participation and positively affects their perceptions of change (Faupel & Süß, 2019 ; Straatmann et al., 2016 ; Paterson & Cary, 2002 ; Bin Mat Zin, 2009 ). In addition, there is a significant correlation between reactions, emotional commitment, self-respect, and optimism (Fugate & Kinicki, 2008 ; Liu & Zhang, 2019 ; Vakola, 2016 ), and this depends on administrative support to reduce the negative feelings towards change implementation. The stronger communication between individuals, the more it has a positive effect towards improving reactions to change (Tang & Gao, 2012 ). The leadership plays a big role in directing reactions by providing opportunities to participate in decision-making, build confidence, and give individuals compensation opportunities (Khan et al., 2018 ). Likewise, individuals’perception of change depends on their reactions and behaviors (Hatjidis & Parker, 2017 ; Rechter & Sverdlik, 2016 ; Saunders & Thornhill, 2011 ). As the human being consists of a group of elements (emotional, mental, spiritual, and physical), when one of these elements is disrupted, it affects the other elements, which requires equal attention to these elements in order have a coherence and non-conflicting reactions (Blom, 2018 ).

Negative feelings towards change can occur due to increased fear of losing jobs and lower level of employees’ participation in change process (Barner, 2008 ; Rizzuto et al., 2014 ). When thinking about change, resistance is often the first thing that comes to mind (Walk & Handy, 2018 ). This is because individuals think of change as a shock that inversely affect them to think of negative consequences of change and hence, they resist change or develop an uncertainty about change processes (Størseth, 2006 ). There is also a perception that a poorly planned or poorly implemented change initiatives, in a way that does not consider the organizational or social conditions of individuals, increase stress levels (Blom, 2018 ). Likewise, changes frequently conflict with the organizational identity, which creates an unpleasant impression on individuals, and this leads to distort the intended purpose of the change and exposes the organizational identity to danger (Mdletye et al., 2013 ). It is imperative for practitioners and researchers to adopt broader, more accurate, and positive perspectives on how reactions affect organizational change (Belschak et al., 2020 ; McElroy & Morrow, 2010 ). In addition, some contradictory reactions lead to the deterioration of an organization (Fugate, 2012 ; Ming-Chu & Meng-Hsiu, 2015 ). This is because individuals have resistance to change and ridicule change, which generates internal conflict that negatively affects organization work processes (Jacobs & Keegan, 2018 ; Mdletye et al., 2013 ; Tavakoli, 2010 ). This happens because employees see change as a threat to their survival in organization (Huy et al., 2014 ; Paterson & Cary, 2002 ).

Our findings suggest steps aimed at addressing reactions should be initiated early on in a change process, to prevent negative attitudes from escalating into a desire to leave the organization. Organizations should also be aware that employees’ beliefs about ongoing change play an important role in shaping their work engagement and turnover intentions. Carefully monitoring and managing collective beliefs about a change during the full implementation phase—for instance, through employee participation and careful and timely communication. Therefore, help to avoid a loss in change momentum. Facilitating the change process and reducing the social and organizational costs of change.

This study also shows the theoretical contributions of previous studies by contributing to the development of the context of reactions towards organizational change at the individual, collective, and leadership levels, and using many of the above-mentioned scales at each level, which helps in accurately determining the impact at each level towards organizational change. This study, through its multi-level approach, attempted to cover as much as possible the reasons that may promote positive or negative reactions towards organizational change smoothly, which have not been extensively examined in previous studies. The results of the study found that the reactions towards organizational change within the cognitive and behavioral response were affected differently at each of the levels. For example, at the individual level by influencing the emotional side of working individuals, which affects their perceptions and thus their cognitive response to change and their behavior in terms of dealing with it (Hatjidis and Parker, 2020; Borges & Quintas, 2020 ), as both negative perception and the stimulation of negative emotions have A clear effect on the resistance reactions to organizational change in general (Belschak et al., 2020 ). The micro level, based on the criteria for strategic change, the pandemic, social identity, and vocal behavior, showed the negative effects of resistance reactions to organizational change resulting in most cases from negative perceptions and negative emotions towards change (Li et al., 2021 ; Milton et al., 2020 ; Van et al., 2018). The macro level by reviewing the types of leadership and the way each of them affects the reactions towards organizational change, as transformational leadership and transactions, as well as the response of managers, showed a prominent positive role in reducing the standing towards organizational change, promoting it and participating in it (Faupel & Süß, 2019 ; Peng et al., 2020 ; Du et al., 2020 ). The macro levels depended on a set of important factors represented in education, human resources, explicit feedback, and self-evaluations. Organizational attitude is behind the disruption of positive and negative reactions based on individuals' perception of information in a positive or negative way, or rather in an optimistic or pessimistic manner (Roczniewska & Higgins, 2019 ). While the impact of human resources appears in the reactions towards organizational change, positively or negatively, depending on the system that has been adopted and the methods used to implement the change (Bin Mat Zin, 2009 ; Blom, 2018 ). The effect of explicit reactions appears depending on a rule from which individuals start in their behavior, which is the belief about change and a factor directing that behavior towards accepting change through the leader’s behavior as a role model to deal with change and clarifying the impact of change in the minds of individuals (Vakola et al., 2013 ). Finally, it seems that individuals' self-assessment about change is often based on the principle of maintaining the status quo and unwillingness to change, which shows resistance behavior (Rizzuto et al., 2014 ). Therefore, the study recommends in some variables for future research, which is the study of personality traits because there are some underlying factors of emotions and openness to change and other factors that may significantly affect reactions towards organizational change. It also recommends taking other types of leadership, for example, participatory leadership and knowing its impact in reactions.

The review also revealed research gaps to be addressed in future research. Regardless of the prevalence and value of reform initiatives in contemporary organizations, change initiatives often struggle to achieve desired goals. It has been argued employees are at the heart of the change initiative and major determinants of the degree to which any change will succeed. Despite many challenges, organizational change is relevant for firm survival and performance, which needs to be further investigated. Specific patterns can be drawn from different organization types where reactions towards organizational change have been studied. Further research gaps relate to the level of application, conceptual model, and sector. The literature made some recommendations to increase strategic performance as well as achieve marketing differentiation in addition to high customer satisfaction. This helps to reduce risks, respond to uncertainties and to achieve high flexibility under changing environmental conditions. These recommendations can address the challenges to organizational change and open more opportunities for future research. Because of the fierce competition, companies will continue to develop more sophisticated competitive advantages, and thus researchers must identify emerging trends and strategies of organizational change. Based on the research that is shown throughout this review, there is a wealth of work in different settings and at various levels of analysis that considers reactions to organizational change during the prior two decades.

The current study is not without some limitations like any other study. As the current study was limited to focusing on the leadership level on direct leadership instead of focusing on the leadership team, as the former appears as a representative of the interests of the organization and transfers its goals and defines tasks to working individuals, while the latter is concerned with clarifying the objectives and reasons behind the organizational change in a way that enhances acceptance of change and participation in it. by working individuals. In addition, when studying the variables that were adopted in the study and their impact on reactions to organizational change, that study did not control some of the variables that could have a very big role in explaining the nature of the results that were reached, which are individual differences and personal traits. Finally, the study neglects the cultural context, which often has a significant role in influencing the nature of the interrelationships between variables at the individual, collective, and leadership levels, and between the nature of reactions towards organizational change, which appears more clearly when the study sample is diverse in different countries able to reflect the nature of cultures change.

Data availability

The data of the paper, which support the analysis and results of this paper, are available with the corresponding author and the data can be obtained from the authors upon request.

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This work is funded by Universiti Sains Malaysia, Short Term Grant [Grant Number: 304/PMGT/6315513], for the Project entitled "The Efficiency of Variable Sampling Interval Scheme for the Multivariate Coefficient of Variation in Short Production Runs".

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Khaw, K.W., Alnoor, A., AL-Abrrow, H. et al. Reactions towards organizational change: a systematic literature review. Curr Psychol 42 , 19137–19160 (2023). https://doi.org/10.1007/s12144-022-03070-6

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Reactions towards organizational change: a systematic literature review

Khai wah khaw.

1 School of Management, Universiti Sains Malaysia, 11800 Gelugor Pulau Pinang, Malaysia

Alhamzah Alnoor

2 Management Technical College, Southern Technical University, Basrah, Iraq

Hadi AL-Abrrow

3 Department of Business Administration, College of Administration and Economic, University of Basrah, Basrah, Iraq

Victor Tiberius

4 Faculty of Economics and Social Sciences, University of Potsdam, Potsdam, Germany

Yuvaraj Ganesan

5 Graduate School of Business, Universiti Sains Malaysia, 11700 Gelugor Penang, Malaysia

Nadia A. Atshan

Associated data.

The data of the paper, which support the analysis and results of this paper, are available with the corresponding author and the data can be obtained from the authors upon request.

Regardless of the prevalence and value of change initiatives in contemporary organizations, these often face resistance by employees. This resistance is the outcome of change recipients’ cognitive and behavioral reactions towards change. To better understand the causes and effects of reactions to change, a holistic view of prior research is needed. Accordingly, we provide a systematic literature review on this topic. We categorize extant research into four major and several subcategories: micro and macro reactions. We analyze the essential characteristics of the emerging field of change reactions along research issues and challenges, benefits of (even negative) reactions, managerial implications, and propose future research opportunities.

Introduction

During the past two decades, many studies have been conducted that have been interested in organizational change and the mechanisms that promote that process smoothly (Benford & Snow, 2000 ; Bouckenooghe, 2010 ; Caldwell et al., 2009 ; Pettigrew et al., 2001 ). Despite that wide interest in the process of organizational change, these studies reported negative results, as most of those efforts ended with an unsuccessful implementation of the process of organizational change and ultimately failure (Beer & Nohria, 2000 ; Meaney and Pung, 2008; Hussain et al., 2018 ). This is because the focus was on many secondary variables and ignored the most important factor of individual and organizational reactions towards organizational change in those studies (Oreg et al., 2011 ; Penava and Sˇehic, 2014). Herold et al., 2008 ; Holten and Brenner, 2015; Oreg & Berson, 2011 ; Alnoor et al., 2021 ).

A reaction towards a change is a cognitive and behavioral response based on an adaptation and a comprehensive understanding of how to react towards a change (AL-Abrrow et al., 2019b ; Peng et al, 2020 ). This largely depends on how managers introduce a change and on the extent to which others respond. Usually, a negative reaction towards change happens when it is expected to result into more workload, uncertainty, and fatigue, especially when change is rapid and spans the whole organization or large parts of it (Beare et al., 2020 ; Li et al., 2017 ). Individuals’ reactions towards organizational change are expected to be dependent on the individual’s perception and assessment of the change effects on the individual. This suggests that a reaction towards a change is developed through the interactions between attitudes, beliefs, and feelings of an individual towards a change. A successful implementation of a change depends on how individuals interact with organizational change (Oreg et al, 2011 ; Shura et al., 2017 ). Participation in the change process is closely related with reactions towards a change. Practitioners are likely to be able to effectively diagnose and improve the willingness to change when they understand the need for change (Albrecht et al., 2020 ). Besides, people are more inclined to commit to a change if they perceive the change in alignment with their expectations and the resistance to change would be minimal (Helpap, 2016 ).

A positive reaction allows individuals to be more job focused and hence less resistance to change can be expected (Gardner et al., 1987 ). Similarly, a negative reaction towards change often generates a strong resistance to change. This happens if change is perceived as harming. Moreover, individuals’ resort to negative reactions when work relationships are threatened because of a change in a way that causes them to quit their job (Michela & Vena, 2012 ). However, some individuals are indecisive in their reactions towards a change, especially when future outcomes are unpredictable. This results into disruption and anxiety for both organizations and individuals, and thus reactions serve as the method aimed at dealing and engaging with change (Blom, 2018 ).

These considerations suggest that individuals react differently towards organizational change, depending on their respective perceptions. This invites a comprehensive study to understand the differences in reactions and to explain the main role that reactions play towards organizational change. Based on a systematic literature review, we provide a comprehensive framework that can help get an in-depth understanding of the reactions on organizational change. Earlier studies on precedents and consequences of change have been more concerned about reactions to organizational change (Akhtar et al., 2016 ). Despite the need of organizational change, many change initiatives fail (Beer & Nohria, 2000 ), mainly because of differences in individuals’ interactions in the change process (Oreg et al., 2011 ). Rafferty et al. ( 2013 ), developed a model to study individual level willingness to change. It was found that change based on interactions, homogeneous attitudes, and feelings are successful, and vice versa. Still, there is need to present a broader and more comprehensive theoretical framework based on earlier studies to better understand reactions towards change at different levels, i.e., micro and macro level. Although many researchers have contributed to conducting many studies to try to analyze the nature of cognitive and behavioral responses, for example, job satisfaction, individual performance, emotional intelligence, readiness for organizational creativity, and leadership abilities of all kinds (Malik and Masood, 2015; Malik and Masood, 2015). There are rare studies that dealt with reactions to organizational change at all levels, micro and macro (Khan et al., 2018 ). Thus, the number of studies that investigated reactions to change has increased, but the different types of study cases are still unknown to allocate the most critical determinants that contribute to positive and negative reactions to change. Hence, further investigation is needed. This systematic analysis seeks to provide useful insights into contexts of change reactions and to assist the authors in identifying current options and gaps in this type of study. Accordingly, our research meets the stated literary need. Our focus is to find how the subject of reactions towards change has been studied so far. The main goal is to provide a detailed methodological framework based on earlier studies, which explains the differences and trends in prior research. Additionally, we critically assess methodological issues and challenges found in previous research on reactions to organizational change, which can be overcome in future research. We plead for a changed perspective, which disentangles negative employee reactions to change from negative change outcomes. Rather, we argue that negative reactions can be interpreted as constructive criticism, which can improve the outcome process.

Methodology

To archive our research goal, we conducted a systematic literature review. We used ‘reactions to change’ as the main key word to search relevant articles in four databases. We considered only those articles written in English, which is considered to be the predominant scientific language. Only peer-reviewed articles and conference papers were included. The current study was accomplished according to the ‘Preferred Reporting Items for Systematic reviews and Meta Analyses’ (PRISMA) criterions (Moher et al., 2015 ). For systematic reviews, PRISMA suggests that counting on a single database search for literature should be avoided; no single database is likely to contain all relevant references. Therefore, extensive searching is recommended (Berrang-Ford et al., 2015 ; Monroe et al., 2019 ).

In particular, we used four major databases to assemble the literature sample: IEE Xplore, Science Direct, Scopus, and Web of Science. These databases were selected based on their academic reliability and wider availability of relevant articles to discover the research gap and provide critical practical and theoretical implications (Aria & Cuccurullo, 2017 ; Knobloch et al., 2011 ).

The selection process consisted of two phases of screening and filtration. First, duplicate articles found through matching of titles and abstracts were excluded. Second, articles were filtered after reading the entire article. This resulted in 79 articles (Fig.  1 ). Then, the main findings of the remaining articles were extracted and categorized.

Systematic review protocol

Results and discussion

A critical overview of the change reactions literature.

Previous studies of organizational change attempted to reach an increase in organizational effectiveness by focusing on organizational change and how change is implemented (Oreg & Berson, 2011 ; Oreg et al., 2011 ; Tavakoli, 2010 ; Tyler & De Cremer, 2005 ; Vakola et al., 2013 ; Van Dick et al., 2018 ; Walk & Handy, 2018 ; Whelan-Barry et al., 2003 ). The basic logic of such studies is based on the main assumption the positive or negative organizational consequences depend primarily on the extent to which individuals accept organizational change and their reactions to that change. Such a hypothesis is supported by many recent studies (Alfes et al., 2019 ; Borges & Quintas, 2020 ; Beare et al., 2020 ). Through the growing interest in researching the reactions of individuals towards organizational change. For example, the role of individuals’ reactions and how they interact with organizational change was examined within a time frame that spanned six decades from the end of the forties to 2022. A model was built on the basis of this research showing the relationship between the three main axes in the change process represented by the precedents of individuals’ reactions to change and responses to Their public actions and the consequences of that change (Oreg et al., 2011 ).

The vast majority of the total 79 studies relied on the longitudinal design in the research, and the other studies varied, including in adopting the type of design from transverse design to experimental studies, and 90% of those studies relied on data collection on self-reports of the study variables. Three main axes were discussed in terms of their relationship to the process of organizational change and the potential resistance that individuals come up with towards that change. Such three axes were represented by the cognitive axis, which is analyzed based on how individuals think about organizational change. The emotional axis by understanding and measuring the positive or negative feelings of individuals toward organizational change. The behavioral axis through which the extent to which the individual accepts or rejects organizational change appears (Bhatti et al., 2020 ; Constantino et al., 2021 ; Kashefi et al., 2012 ).

In recent years, factors such as the extent to which individuals accept organizational change and reactions to organizational change were the basic logic of previous studies that grew interested in researching the reactions of individuals towards organizational change (i.e., Roczniewska, & Higgins, 2019 ; Borges & Quintas, 2020 ; Du et al., 2020 ; Peng et al., 2020 ; Li et al., 2021 ). Prior studies have been focused on topics such as the psychodynamic explication of emotion, perception, behavior, and learning (Armenakis & Harris, 2009 ; Reiss et al., 2019 ; Tang & Gao, 2012 ; Al-Abrrow et al., 2019a ; Borges & Quintas, 2020 ), the behavior of leadership (Fugate, 2012 ; Matthew, 2009 ; Alnoor et al., 2020 ), the focus of attention (Gardner et al., 1987 ), internal communication (Men & Stacks, 2014 ; Li et al., 2021 ), individual attitudes (Akhtar et al., 2016 ; Jacobs & Keegan, 2018 ; Liu & Zhang, 2019 ; McElroy & Morrow, 2010 ; Sanchez de Miguel et al., 2015 ), openness to change (Straatmann et al., 2016 ), and information systems (Bala & Venkatesh, 2017 ; Beare et al., 2020 ; Thirumaran et al., 2013 ). Figure  2 simplifies the determinants of reactions to change explored and investigated by the previous literature.

Determinants of reactions to change

Taxonomy of reactions to organizational change

The remaining 79 articles were divided into four categories (Fig.  3 ) regarding the level of reactions towards change i.e., micro and macro level. There were 39 articles relating to micro reactions to change and 40 articles on macro reactions. Hence, these major categories were linked to their corresponding subcategories as shown in Fig.  3 , depending on the frequency of relevance to ‘reactions to change’.

Taxonomy of reactions to change

Micro-level reactions

Antecedents of micro-level reactions.

In this category, the research articles discuss aspects the antecedents of individuals’ reactions to organizational change. The subcategory contains major topics where reactions to organizational change was adopted with regards to (1) Emotional, cognitive, and behavioral therapy, (2) Communication between employees, (3) Leadership style, (4) Individual attitude, (5) Openness to change, and (6) Information systems.

Cognitive behavioral therapy

At the individual level, aims to help human resource to relieve emotional stress and reduce the need for associated dysfunctional coping behaviors. Hence, this set of studies discusses reactions to organizational change with psychodynamic perspective and include 19 studies. Four studies (Antonacopoulou & Gabriel, 2001 ; Armenakis & Harris, 2009 ; Reiss et al., 2019 ; Tang & Gao, 2012 ) discuss emotional and motivational responses to organizational change and strategies to overcome these emotional and motivational challenges. The other nine studies discuss perceptions about organizational change. Beside this, to present a systematic analysis of positive psychology, one of the studies emphasized the relationship between perceptions about organizational support and resistance to change (Ming-Chu & Meng-Hsiu, 2015 ; Al-Abrrow et al., 2019a ; Abbas et al., 2021b ). According to Albrecht et al. ( 2020 ) and Hatjidis and Parker ( 2017 ) change engagement influences employees’ perceptions of organizational change. Thus, employees’ cognitive and behavioral reactions influence their perceptions of organizational change (Borges & Quintas, 2020 ). Endrejat et al. ( 2020 ) and Helpap ( 2016 ) argue that organizational communication reinforces employees’ positive perceptions of organizational change and affects their psychological mechanisms. Contrary to this, a negative awareness about organizational change causes psychological withdrawal or distancing from organization (Michela & Vena, 2012 ). Belschak et al. ( 2020 ) found that the Machiavellianism leads to negative perceptions and negative reactions to change. Organizational efforts to induce change are much consistent when employees are more concerned with change target (Gardner et al., 1987 ; Hadi et al., 2018 ). Six studies discuss two aspects of personality and health regarding employees’ reactions towards change. We found two articles, which describe that organizational justice and culture significantly influence employees’ personality. Additionally, job satisfaction, once change occurs, is critical to personality development (Bailey & Raelin, 2015 ; Caldwell & Liu, 2011 ). The remaining four articles encompass employees’ health related concern in relation to organizational change in health sector (Abbas et al., 2020 ; Fournier et al., 2021 ). It was found that organizational change is perceived as causing fear of job insecurity and health and safety issues among doctors, which resulted into less job satisfaction and reduced level of motivation (Størseth, 2006 ; Tavakoli, 2010 ; Al-Abrrow et al., 2021 ).

Communication between employees

Communication between employees originated from the concept of organizational transparency. Communication provides positive and negative information to employees in a timely manner. Furthermore, communication between employees enhances the organizational capacity of employees and holds organizations accountable for practices and policies (Li et al., 2021 ). Communication between employees includes transparency, accountability, participation, and informatics (Men & Stacks, 2014 ). The change can be planned or unplanned. Planned change is the discovery of problems that need improvement in a proactive manner. Unplanned change is imposed by external forces. Therefore, organizations must react flexibly and quickly to survive (Seeger et al., 2005 ; Alnoor et al., 2020 ). However, the lack of communication between employees creates barriers and threats to organizations towards increasing negative reactions to change. Planned and unplanned changes increase people's confusion and uncertainty. Therefore, employees' understanding of changes through communication between them is critical to the success of change (Gillet et al., 2013 ).

Leadership style

Leadership contributes 71% of the success of change amongst employees. Therefore, leadership and leadership traits were critical factors for change reactions for employees (Fugate, 2012 ). The openness of the leader increases the positive reactions to change. However, the resistance of the leader stimulates negative reactions to change from the employees (Matthew, 2009 ). Relationships with employees by leaders are critical determinants of successful change leadership (Alnoor et al., 2020 ). Leadership style affects employees in different ways, such as credibility and trust are important drivers of change for leaders to certify employee interests are considered. The literature confirms the leader-member exchange theory increases the negative reactions of employees to the change linked with corporate merger (Fugate, 2012 ). On the other hand, creative leadership and transformational leadership inspire employees and increase positive employee reactions. Change leaders are creative and transformative leaders (Matthew, 2009 ). In addition, practical leadership reduces employee resistance to change and increases individual interest in implementing change (Herold et al., 2008 ; Khaw et al., 2021 ).

Individual attitude

This set of studies discusses reactions to organizational change in relation to different individual attitude and included eight studies. Two studies discuss gender attitude, especially the reactions of female employees towards organizational change (Sanchez de Miguel et al., 2015 ). Similarly, employees differ in their attitude of reactions to organizational change depending on their age. Additionally, cultural and attitude differences cause numerous employee reactions towards organizational change (McElroy & Morrow, 2010 ). Three studies discussed the influence of employees’ respective experiences on their attitude of reactions towards organizational change. These studies assert that employees’ previous experiences are important to influence employees’ reactions to organizational change (Alas, 2007 ). A frequent exposure to organizational change causes change fatigue and cynicism and accordingly produce employees’ reactions to organizational change (Stensaker & Meyer, 2012 ). Thus, there is a relationship between the frequency of change and the reactions to change represented by exit, voice, loyalty, and neglect (Akhtar et al., 2016 ). On the other hand, the attitude of employees’ reactions towards organizational change in the public sector differs from the private sector in many ways, because the various processes of logistics and implementation. Therefore, the reactions of employees in the public sector are different compared to those in private sector. For this, the attitude of employees’ reactions in South African prisons to transformative changes in leadership were studied (Mdletye et al., 2013 ). In a policing context, 23 interviews were conducted, and it was concluded that the employees’ feedback began with three foci (me, colleagues, and organization) to assess change (Jacobs & Keegan, 2018 ). Moreover, a relationship between employees’ attitude in public service and their commitment to change was found (Liu & Zhang, 2019 ).

Openness to change

Four studies discussed employees’ openness to change in change and suggested that employability is related to positive emotions and higher level of employees’ openness to change in organizational changes (Fugate & Kinicki, 2008 ). Employees’ (dis) openness to change influences their emotional responses to organizational change (Saunders & Thornhill, 2011 ). It was found that the size and age of a company as well as employees’ expectations boost employees’ openness to change for the successful implementation of change (Lines et al., 2015 ). It is common that employees react whenever a new system is introduced. Yan and Jacobs ( 2008 ) studied employees’ trust and openness to change in relation to organizational change under the lean enterprise system. Two studies discuss diagnostic assessments, which are important during change implementation to deal with employees’ reactions to organizational change (Straatmann et al., 2016 ). Hence, creating interpersonal consensus promotes positive perceptions of change (Dickson & Simmons, 1970 ).

Information systems

This set of studies discusses reactions to organizational change in form of Information systems adoption and included six studies. For example, employees’ cognitive evaluation in reaction to Information systems implementation initiatives was discussed, which provided a deeper understanding of employees' feelings and perceptions of change (Kashefi et al., 2012 ). The authors claimed that a system can be designed to measure the feelings of individuals and customers towards the change implementation (Thirumaran et al., 2013 ). In another study, individuals' reactions to changes within supply chains were measured through the implementation of interorganizational business process standards (Bala & Venkatesh, 2017 ). Moreover, another study presented reactions of employees to digitally enabled work events and how digital technology affects employees ‘emotions (Beare et al., 2020 ). Lilly and Durr ( 2012 ), discussed the effect of implementing new technology on increasing the anxiety and stress among employees. Similarly, employees’ reactions towards technological change implemented in a bank were analyzed (Vakola, 2016 ).

Outcomes of micro-level reactions to organizational change

The change reaction leads to many outcomes and at different organizational levels. The range of literature examining employees' reaction to change is wide. Furthermore, the results of the literature review identified four vital categories: Voice behavior, exit behavior, neglect behavior, and loyalty behavior.

Individual voice behavior

Voice behavior is a type of organizational citizenship behavior differs from altruism, conscientiousness, and sportsmanship because such behavior is costly (Chou & Barron, 2016 ). Voice behavior is discussing problems with the administrator or staff, suggesting solutions, solve problems, and whistleblowing (Farrell & Rusbult, 1992 ). There is a high perceived risk of employee voice behavior. Nevertheless, organizations invest in voice behavior to make efficient management decisions and solve problems (Akhtar et al., 2016 ). The change literature has shown one of the consequences of change reactions is the voice behavior (Abdullah et al., 2021 ; Barner, 2008 ; Svendsen & Joensson, 2016 ). According to Ng and Feldman ( 2012 ) the higher employee voice behavior increases creativity, performance, exploration, and exploitation of ideas. Therefore, the voice behavior reduces anxiety and fatigue of individual toward organizational change. Previous literature has demonstrated voice behavior due to change increases employee turnover (Bala & Venkatesh, 2017 ). Individual voice behavior leads to undesirable results. In this context, change affects the social exchange and social relations between employees. Hence, organizational change reduces the quality of social exchange. Employees feel unappreciated and involved, which increases resistance to change (Zellars & Tepper, 2003 ). From a psychological perspective, the reaction to change is crucial for employees to express their opinions (Bhatti et al., 2020 ). Therefore, the voice behavior should be considered as a positive behavior that solves problems rather than identifying them (Whiting et al., 2012 ).

Individual exit behavior

Exit behavior is transferring, thinking about quitting, searching for a different job, and sabotage (Farrell & Rusbult, 1992 ). Most of the literature on reactions to change confirmed the main reason for employees to exit work is change (Akhtar et al., 2016 ; Bryant, 2006 ; Šedžiuvienė & Vveinhardt, 2018 ). However, there are two types of exit behavior, vertical and horizontal. Vertical mobility is moving upwards in the same organization. Horizontal mobility is the employee’s turnover of the organization (Davis & Luthans, 1988 ). Many firms view employee turnover negatively. The literature confirmed the employee turnover can be positive because it renews blood and increases the recruitment of skilled human resources (Elfenbein & Knott, 2015 ). Negative change reactions cause an increase in employee turnover. In this context, many human resources are transferred to other organizations. Such human resources bringing with them competitive advantages that increase innovation and creativity (Walk & Handy, 2018 ). Therefore, the literature confirms organizational inertia reduces organizational development. Hence, turnover allows work to correct organizational errors and provides further improvement for tasks (Piderit, 2000 ). Horizontal mobility due to change reduces organizational loyalty of employees caused by increased desire to search for new work (Carnall, 1986 ). In conclusion the reactions to organizational change contribute to the withdrawal of employees from the organization. However, employee turnover may promote to superior performance.

Individual neglect behavior

The literature indicates that one of the outcomes of micro-level reactions to organizational change is neglectful behavior (Akhtar et al., 2016 ). Employees who experience negative reactions to change contribute less organizational effort (Vantilborgh, 2015 ). Hence, individual neglect behavior is chronic lateness, reduced interest, increased error rate, and using firm time for personal business (Farrell & Rusbult, 1992 ). The change increases uncertainty due to several employees loses their jobs and positions. In this context, many employees underestimate the seriousness of their work (Svendsen & Joensson, 2016 ). Previous studies on organizational change have argued employees' reactions to change are a decisive factor in reducing efforts, decreasing work quality, and increasing absenteeism (Chou & Barron, 2016 ; Withey & Cooper, 1989 ). Therefore, negative reactions to change are negatively related to the time spent by the employee and the efforts made at work (Alnoor et al., 2022 ; McLarty et al., 2021 ).

Individual loyalty behavior

Loyalty behavior is waiting and hoping for improvement, giving support to the organization, being a good soldier, and trusting the organization to do the right thing (Farrell & Rusbult, 1992 ). Organizational change that maintains working relationships and psychological contracts with employees is likely to increase the strength of individuals’ loyalty due to the rule of reciprocity (Davis & Luthans, 1988 ). Individual realization that organizational change fulfills organizational commitment to individuals, strengthens the relationship amongst the organization and the individual (McElroy & Morrow, 2010 ). Negative employee reactions to change reduce individual loyalty (Constantino et al., 2021 ). Individual loyalty is the employee's readiness to maintain affiliation in the organization by giving attention to the goals and values of the organization (Aljayi et al., 2016 ). Individual loyalty receives outstanding consideration in the change literature because individual reactions to change can be a fundamental determinant of individual loyalty to the organization (Akhtar et al., 2016 ). Hence, job satisfaction and a positive reaction to change increase the emotional and mental connection of individuals to the organization (Milton et al., 2020 ).

Macro-level reactions

Antecedents of macro-level reactions.

This category included 40 research articles, which discuss macro-level related aspects of reactions towards organizational change. In this category, the research articles consider aspects the antecedents of macro-level reactions. Major topics are (1) Organizational emotional, cognitive, and behavioral, (2) Organizational communication, (3) Leadership style, (4) Organizational attitude, (5) Organizational openness to change, and (6) Organizational information systems.

Organizational emotional, cognitive, and behavioral

Organizational reactions towards organizational change are informed by emotional, cognitive, and behavioral therapy of strategic changes such as mergers and strategic alliance. Strategic mergers can influence stakeholders’ decisions, which may result into negative reactions towards such merger (Basinger & Peterson, 2008 ; Bowes, 1981 ). This negative reaction is expressed through heightened anxiety levels and reduced emotional attachment (Rafferty and Jimmieson, 2010 ). Such a strategic change can lead to organizational exit (Schilling et al., 2012 ). Moreover, the effect of changes introduced by cross-border processes on organizational reactions was studied and it was found that there is an effect of dynamic cultures on organizational reactions towards change (Chung et al., 2014 ; Khaw et al., 2022 ).

Organizational communication

The second set of studies discusses reactions to organizational change regarding organizational communication. The lack of organizational communication caused organizational imbalances that negatively affected reactions towards organizational change in a way that tends to follow negative reactions such as an exit (Kruglanski et al., 2007 ). Weakness in organizational communication caused tension among employees and resulted into negative reactions towards change (Li et al., 2021 ). In this context, numerous environmental changes and crises have led to weak organizational communication during the change. For example, the recent Covid-19 pandemic that caused many barriers in organizational communication (Milton et al., 2020 ). Hence, when there is an abrupt change due to unexpected circumstances the organizational negative reactions would be increased towards change due to the lack of organizational communication (Fadhil et al., 2021 ).

Transformational leaders’ reactions are affected by organizational change in a way that enhances their readiness for change and motivates them for increased participation and performance to support change (Faupel, & Süß, 2019 ). It was also found transformational leaders and their reactions are significantly related to change. Transformational leaders are committed and willing to bring change and react in a way to defuse resistance to change (Peng, et al., 2020 ). Transformational leadership facilitates a successful implementation of a change (Islam et al., 2021 ; Thomson et al., 2016 ). There is an influence of transformational leaders in supporting the change processes which commensurate with their positive reactions towards change (Bayraktar & Jiménez, 2020 ). Transformational leaders play an important role in shaping positive reactions towards organizational change and supporting the changes process (Busari et al., 2019 ). On the other hand, the success of a change process depends on leaders’ competency in inducing change, and transactional leadership can provide such competency. Transactional leadership encourages critical thinking and participation to ensure success of a change process (Khan, et al., 2018 ). As transactional leadership is supportive to change, it is helpful to reduce resistance to change (Oreg & Berson, 2011 ). Therefore, managers use their authority to support organizational change (Tyler & De Cremer, 2005 ). Organizational confidence in managers is a critical factor that generates positive managerial reactions towards organizational change (Du et al., 2020 ; Harley et al., 2006 ). However, change may generate negative managerial reactions of non-acceptance of change (Huy et al., 2014 ). The magnitude of managers response and their reactions depends on the degree and intensity of a change (Bryant, 2006 ).

Organizational attitude

There is an agreement between leadership and organizational change such that organizational attitude is employed in a way that reflects positive reactions towards organizational change (Fugate, 2012 ). It was found that, acceptance or rejection of change depends on the existing organizational attitude and measures taken to implement change (Bin Mat Zin, 2009 ). Hence, organizational wellness is positively related to the ability to deal with change. Moreover, leaders provide insight about how change affects the organization’s procedures, and this may help to overcome resistance to change (Alfes et al., 2019 ). Although change is inevitable, individuals struggle with change when their vision is unclear, which causes turmoil and increased anxiety. Additionally, individuals find it difficult to engage in organizational change when the organizational policies develop feelings of fear among individuals, and this causes resistance to change (Blom, 2018 ). Firms’ responses to organizational change requires confidence and adaptation necessary to engage with change, and this depends on the self-evaluation and the extent of accept the changes. Therefore, leaders highlight the change and call for a commitment to it (Judge & Kammeyer-Mueller, 2011 ; Rizzuto et al., 2014 ). Reactions towards change are dependent on firms' belief about change. Organizational actions and beliefs induce constructive change (Vakola et al., 2013 ).

Organizational openness to change

The literature found reactions pose a challenge for organization towards change when there is a lack of organizational openness to change. Therefore, employees have negative reactions towards change, while leaders have positive reactions that support the change process and help to get change accepted (Walk & Handy, 2018 ). Individual employees understand that change can create a complex situation, which can give rise to issues for employees, and they refute change. In contrast, leaders perceive change as beneficial to the organization and they support it. Leaders see change as one major requirement for the development of organization. Therefore, they encourage openness to change. Whereas individual employees are not opened to change because they perceive change will create organizational instability. Leaders encourage organizational activities, which facilitate change. In contrast, individuals express lower level of openness and acceptance to change (Rechter & Sverdlik, 2016 ). Leaders see the attainment of organizational and personal goal through change. Contrary to this, the lack of opened to accept change create incompatibility between the organizational goals and the change initiative (Roczniewska & Higgins, 2019 ). Explicit reactions to change can be interpreted in many ways, some of which involve the benefits of change, while others are related to the negative consequences of change (Oreg et al., 2011 ). Thus, employees do not show a stronger commitment to accept change, but leaders tend to understand a change (Mangundjaya et al., 2015 ).

Organizational information systems

Organizational information systems are a vital and significant resource for companies. Consequently, the huge development in information and communication systems led to taking proactive steps towards adopting innovative and modern technology (Hadid & Al-Sayed, 2021 ). The adoption of modern information systems has contributed to increasing organizational anxiety due to fear of change (Paterson & Cary, 2002 ). However, interest in new technology development by companies increases the potential for long-term downtime. Therefore, context conditions must be created to encourage organizational changes (Walk & Handy, 2018 ). Digital technologies have penetrated companies tremendously and rapidly. Rapid technological changes have transformed organizational work designs by increasing flexibility and empowerment (Beare et al., 2020 ). However, digital technologies have negatively affected the organization by not separating personal and work life (Chen & Karahanna, 2014 ). Digital technologies have created enormous social challenges through the constant bombardment of social media messages and emails (Vakola, 2016 ). Therefore, the working hours of employees have increased because they are sometimes obligated to respond. Furthermore, organizational information systems enhanced emotional reactions by increasing feelings of anger, unhappiness, and frustration (Andrade & Ariely, 2009 ).

In conclusion, the level-specific study offers an examination of the antecedents, associations, and implications of reactions to organizational change at the individual and organizational level. However, multilevel theories, methods, and analyses have gained popularity in recent years (Walk & Handy, 2018 ), and the reactions to organizational change have been studied in this manner. Several studies examine how reactions to organizational change operates across levels, while others use cross-level designs to examine how reactions to organizational change is concurrently influenced by variables at different levels. Exemplary studies for both kinds are discussed below and are arranged according to the main predictor variable (or variables) from the preceding categories.

Outcomes of macro-level reactions to organizational change

The change reaction indicates to various consequences at macro-level. Hence, the frequency of macro-level reactions to change, relating to the reaction typology suggested by Akhtar et al. ( 2016 ). Apart from voice, exit, loyalty, and neglect, we added social identity as the most frequently mentioned reaction type at the macro level.

Organizational voice

A positive organizational change results into a voice behavior where employees accept organizational change (Barner, 2008 ). However, change is without organizational support led in negative voice behavior such as employees’ resistance (Peachey & Bruening, 2012 ). Directing organizations has the enormous leadership task of listening to the voices of managers and employees about strategies for change (O'Neill & Lenn, 1995 ). The literature indicates responses to change, such as organizational voice behavior, leave managers stuck between fear of the future and respect for the past (Stylianou et al., 2019 ). Organizational voice behavior affects the professional and personal lives of managers and employees. Consequently, the practice of organizational changes causes the loss of many jobs, which is reflected on the feelings of managers and employees and causes ridicule, anger, anxiety, resentment, and organizational surrender (O'Neill & Lenn, 1995 ). Organizational voices due to change exacerbate organizational problems because of constant blaming of the chief executive officer. Organizational concerns are heightened by the difficulty of expressing opinions. In this context, organizational voices turn into sources of organizational mopping throughout the organization except perhaps the chief executive office (Barner, 2008 ). As a result, the negative reactions cause feelings of organizational anger and anxiety by increasing the difficulty of articulate the organizational voice.

Organizational exit

The literature shows negative reactions to change increase workplace bullying (Barner, 2008 ; Peachey & Bruening, 2012 ). Thus, reactions to organizational procedures encourage behavioral responses to organizational exit (Akhtar et al., 2016 ). Negative responses to organizational change are likely to be stronger in the exit behavior comparative with voice behavior (Balabanova et al., 2019 ). Because exit behavior is an assertive reaction that is associated with change and is not bound by organizational conditions (Farrell & Rusbult, 1992 ). Hence, exit behavior is risky because such behavior increases organizational disruption and stimulates harmful work behavior (Ng et al., 2014 ). Unexpected change leads to the organization's exit from the entrepreneurial work. In this context, organizations leave the entrepreneurial profession. Exiting creative and entrepreneurial businesses affects the company and the economy in general (Shahid and Kundi, 2021b ). Negative reactions to change reduces motivation and self-efficacy, which increases organizational fatigue, impedes the implementation of organizational tasks, and causes exit (Surdu et al., 2018 ).

Organizational loyalty

Panchal and Catwright ( 2001 ) argued that organizational change is a complex process that makes it difficult for employees to accept such a process. Because routine work and many tasks affect change. Employees are significantly affected by frequent organizational change and are reflected in the practice of exit and neglect behaviors and low level of loyalty (Akhtar et al., 2016 ). Adopting successful organizational change increases positive reactions. However, most of the change literature confirms numerous change programs erupt and increase the negative reactions that occur through the practice of neglectful behaviors and lack of organizational loyalty (Bartunek et al., 2006 ). Organizational change increases stress, decreases commitment, and decreases loyalty. Frequent and ineffective changes produce negative responses and cause a decrease in job security. Consequently, the organization will suffer from low loyalty (Guzzo et al., 1994 ). Organizational loyalty decreases due to frequent changes lead to employees rethinking that continuing in this organization is not beneficial (Reiss et al., 2019 ). Such changes create uncertainty and cause organizational mopping (Constantino et al., 2021 ). Organizational change is a critical cause of low loyalty because inefficient changes increase negative organizational perceptions regarding social atmosphere, perceived promise, job content, and rewards (Van der Smissen et al., 2013 ). Therefore, increased negative reactions to change due to frequent and ineffective changes raises organizational perceptions of low loyalty and decreases organizational loyalty.

Organizational neglect

Hirschman ( 1970 ) proposed the employees' enactment of exit, voice, loyalty, and neglect model and was expanded by (Farrell, 1983 ; Rusbult et al., 1988 ). The employees' enactment of exit, voice, loyalty, and neglect model refer the decline of the organization creates many negative reactions that increase the deterioration in performance and reduce efficiency and learning, involving exit, voice, loyalty, and neglect. Reactions contributes to identifying failures and correcting tracks. Therefore, adverse behaviors assist the organization to deal with unfavorable situations, because the behavior of neglect and tardiness for work represents a communication strategy for the members of the organization (Meyers, 2020 ). Organizational neglect represents dishonorable behavior and organizational leniency. Organizational neglect behaviors include reduced attention and delay, reduced effort, increased absenteeism, increased error rates, and concern for personal issues at work (Lee & Varon, 2020 ). Unsuccessful organizational change is a major source of social loafing. Social loafing is the tendency of people to neglect work (Murphy et al., 2003 ). Thus, the reactions of employees at the organizational level contribute to reducing performance and increasing organizational failure (Abbas et al., 2021a ; Akhtar et al., 2016 ).

Social identity

A fantastic reaction is generated by the members of the organization to protect and prove the social identity of the organization. Therefore, managing stability is as important as managing change in the context of social identity (Dutton et al., 1994 ). Organizational change affects some basic features of employees’ social identity, which leads to an imbalance in reactions towards change and causes uncertainty among individuals (Jacobs et al., 2008 ). The intense reactions of the members of the organization highlight the importance of organizational identity. Social identity is useful to understand and analyze reactions to deal positively with organizational change. For example, a weak social identity may lead to a negative reaction towards organizational change, such as disloyalty. Flexible social identity helps to give a quick response to organizational change and facilitates an anticipation of reactions towards change (Aggerholm, 2014 ). The success of organizational change and positive reaction is linked to the recognition of organizational identity based on the intention to remain in the organization and job satisfaction. Developing social identity in change programs reduces negative reactions to change (Clark et al., 2010 ). Łupina-Wegener et al. ( 2015 ) argued shared identity positively influences employees' perceptions of accepting change. Because the shared identity stimulates the transfer of organizational practices between units and departments after the post-change. Therefore, the organization must give employees a sense of continuity for the organization's bright future to practice transferring positive behaviors after implementing change programs (Jacobs et al., 2008 ).

Research issues and challenges

Previous research on reactions to organizational change is subject to several methodological issues and challenges. In the following, we asses methodological issues relating to research design, sector, country, research sample, techniques, and variables (Table ​ (Table1). 1 ). Compared to a multitude of other management subjects, research on reactions to organizational change shows both its strengths and limitations. Furthermore, it seems that similar problems are relevant at different levels of analysis. To a certain extent, a reaction to organizational change literature advances systematically, while other subject areas have not progressed as much.

Issues and challenges of research on reactions to organizational change

Reactions to organizational change as a multidimensional construct

Evidence has collected that a five-factor multi-indicator CFA model fits Akhtar et al. ( 2016 ) and Van Dick et al. ( 2018 ) reactions to organizational change measure at the individual levels of analysis (e.g., Exit, neglect, loyalty, voice, and social identity). Using first-order CFA, Akhtar et al. ( 2016 ) found an “modest fit” with one sample. Elsewhere, both Bryant ( 2006 ) and Šedžiuvienė and Vveinhardt ( 2018 ) found satisfactory fit for a two-factor (i.e., Exit and voice) latent model. Divergent validity of the five-dimensional reactions to organizational change scale was shown by Akhtar et al. ( 2016 ) who discovered that it was different from a single order factor. It should be noted that in addition to obtaining evidence supporting the discriminant validity of the reactions to organizational change dimensions from negative affectivity, job satisfaction, and psychological climate Van Dick et al. ( 2018 ) examined the relationships between social identity and voice behavior. Researcher Aggerholm ( 2014 ) was able to show the discriminant and convergent validity of reactions to organizational change, namely, the capacity to increase organizational misbehavior, working relationship with a supervisor, decrease trust in one's supervisor, and work performance, with unrespect to work engagement and job satisfaction.

There has been relatively little team-level CFA work done as compared to work done at the individual level. It should be clear that this fact comes from the truth that it is very difficult to sample enough teams to do studies for this kind of analyses. Although CFA models have been applied to the Walk and Handy ( 2018 ) individual and organizational outcomes but without respect multilevel model. This produces a discontinuity between the amount of investigation and the amount of theory used (Maynard et al., 2012 ). While we believe this is a promising approach, we encourage researchers to use multilevel CFA methods when conducting analyses that seek to elucidate the construct validity of aggregate variables, with the goal of the study being the total number of teams in the focus population. Concurrently, there is no published research on whether two- and four-dimensional forms of reactions to organizational change provide equivalent criterion-related validity. Here, future studies could compare the two measures, determine whether there are important changes between the various versions, and investigate if the various conceptualizations maintain validity and stability through time and cultures by respecting the assessment of measurement model. In addition, we think that these problems offer valuable topics for future study. In this context, there was vital issue which is related to assessment of structural model. Moreover, there is no study combination of structural equation modeling and artificial neural network. Hence, they did not consider the two mains of benefits the combination of structural equation modeling and artificial neural network is that the use of multi-analytical two-phases SEM–ANN method tool up two vital benefits. First, it allows for further validation of the SEM analysis findings. Second, this approach captures not just linear but also dynamic nonlinear interactions between antecedents and dependent variables and a more accurate measure of each predictor's relative power as well. Furthermore, the potential future work can use SEM-ANN model to determine the reactions to organizational change by adopting multilevel model.

Mono-method issues

At the individual and team levels, most research done on reactions to organizational change consists of questionnaires asking workers about antecedents, correlates, and consequences of such reactions. Any common measurement or percept-percept biases will increase observed associations (Maynard et al., 2012 ). These biases are intensified if both variables are measured at the same time. Three percent of the individual-level research utilized a different source, whereas 97 percent used self-reported criteria measures. Individual-level reactions to organizational change are more likely to be biased by monothiol bias, resulting in inflated correlations, while team-level relationships are less likely to be distorted by monothiol bias. In keeping with this result, Mangundjaya et al. ( 2015 ) showed that task performance correlated more strongly with the reactions of individuals when responses were obtained through self-report measures than when responses were collected by other means. Reactions to organizational change have been operationalized in different ways throughout the literature at each level of study. Reactions to organizational change, as measured and studied at both the individual and team levels, are each shown in the literature as being in two-dimensional, four-dimensional, and aggregated forms. However, yet, there has been no study to account for the disparate measuring methods that may influence the correlations shown in studies like this. Therefore, we believe future studies should examine how measuring approaches influence such correlations.

Mediator and moderator inferences

As mentioned before and shown in Fig.  2 , reactions to organizational change are usually regarded as a mediator between the characteristics of people and environments and outcomes, regardless of the substantive level of study. The validity of mediational effects is contingent on a variety of variables, most notably the accuracy of the assumed causal chain connecting antecedents to reactions to organizational change and to outcomes (Chung et al., 2014 ; Li et al., 2021 ). As shown in the contribution section, 49% of individual-level studies and 16% of team-level studies used cross-sectional designs. The studies conducted so far have shown nothing in the way of causation or association between organizational change and reactions at the level of analysis. Additional work exploring how direct impacts are mediated and/or studying variables that may mitigate such direct effects appears to hold across different levels of analysis in which reactions to organizational change have been examined. Researchers to date have mostly examined things that serve as antecedents to reactions and results that are influenced by reactions to organizational change. According to the authors of the paper Walk and Handy ( 2018 ), job crafting acts as a mediator in explaining the connection between the perceived effect of change and people's reactions to organizational change. Hence, there are many additional possible mediators that have not yet been studied. In fact, the few research that investigate how specific connections within the reactions to organizational change influence other possible moderators are found at different levels of analysis. And thus, we believe that it is the appropriate moment for those interested in the influences that mediate and moderate reactions to organizational change to investigate many facets that are intricately intertwined in these responses.

Research design

Research design refers to a general strategy chosen to integrate various components of a study in a coherent and logical manner. It is always challenging to choose an appropriate research design because sometimes a chosen design does not align with the data. For example, a longitudinal design often used in qualitative studies can be time consuming due to nature of data (Bayraktar & Jiménez, 2020 ; Faupel & Süß, 2019 ; Liu & Zhang, 2019 ). Similarly, the descriptive design may not generate the required results due to inability to control the tendencies of the individuals involved in data collection (Barner, 2008 ; Bin Mat Zin, 2009 ). Some of the studies that have been covered focus on cross-sectional or one-way design, but they are not generalizable because they may be biased (Vakola et al., 2013 ). In addition, future studies should use longitudinal designs that allow tracking of changes at organizational levels and aim to collect data from multiple sources (Barner, 2008 ; Chung et al., 2014 ; Fournier et al., 2021 ; Kashefi et al., 2012 ; Oreg et al., 2011 ), while other studies called to follow the method of interviews that extract information and provide insight into the nature of change processes in organizations (Jacobs & Keegan, 2018 ; Saunders & Thornhill, 2011 ). An improved understanding of the long-term consequences of organizational transformation might enhance the reactions to such studies. Gerwin ( 1999 ) proposed managers could empower teams throughout the life cycle, for example, while the teams are forming, maturing, and growing. According to Gerwin ( 1999 ), organizational change may take place as a cycle, and it is the role of reactions to these changes to push the cycle in one direction or another.

The sector refers to research site where the study is to be conducted and can be public or private organization as per the study requirements. Choosing a public sector as study site may be problematic for change related studies because public sector employees resist change and can generate biasness in responses (Borges & Quintas, 2020 ; Kennedy-Clark, 2010 ; Santos Policarpo et al., 2018 ; Milton et al., 2020 ). Studies conducted in industrial organizations do not allow generalization of the results because these organizations require changes in terms of organizational structures, strategy, and operating procedures, but they are not on a large scale. Thus, results could not be generalized, and such studies should be conducted in other organizations (Mangundjaya et al., 2015 ). Studies in service sector (hotels, hospitals) give great importance to adopting actual change (Hatjidis & Parker, 2017 ). As a result, it must be considered when generalizing to all other service organizations, as there may be fundamental differences between organizations. Future research should focus on other service sectors such as banking (Vakola, 2016 ). Regarding security issues, the effect of the organizational identity on the change processes of national security institutions has been verified, and the results of these studies cannot be generalized because the changes that are made may lead to imbalances with the organizational culture in other organizations (Belschak et al., 2020 ; Jacobs et al., 2008 ). In addition, researchers can focus on industrial companies such as technological industries, digital technologies, wired and wireless communication companies (Tang & Gao, 2012 ).

Countries differ from one another in many ways. Hence, the result of a study conducted in one country may not be generalized to other countries. Similarly, economic, social, and political restrictions among countries may reduce the possibility of generalization of research findings across countries (Fournier et al., 2021 ; Lines et al., 2015 ; Tang & Gao, 2012 ). Some studies focused on one country without considering the role of the social and political factors of other countries, Therefore, the results of these studies cannot be generalized to other countries (Kashefi et al., 2012 ; Mangundjaya et al., 2015 ). As a result, future studies are encouraged to use data from other countries to conduct comparative analyzes, which may allow generalization (Fournier et al., 2021 ; Straatmann et al., 2016 ). A study of Blom ( 2018 ) in manufacturing industries of South Africa, which included a sample of companies interconnected with the parent company, and thus studied the opinions of employees from other countries. As for studies conducted in developing countries, their results are not generalizable, as the behavioral responses in these countries differ from those in European countries (Busari et al., 2019 ; Li et al., 2021 ). Consequently, the country differs in many ways in terms of productive and social capabilities, and this may be a limitation in several countries (Huy et al., 2014 ; McElroy & Morrow, 2010 ).

Research sample

A sample represents a component of population chosen to provide the required data. There is problem when sample size is too small to generalize the result to larger population (Šedžiuvienė & Vveinhardt, 2018 ; Yan & Jacobs, 2008 ). Similarly, a larger sample may provide the data which may not be relevant to the study objectives (Rizzuto et al., 2014 ; Stensaker & Meyer, 2012 ). Most of the studies discussed focused on collecting data from individuals working in different organizations. However, there is a strong tendency to conduct more studies that enable data collection in other contexts to highlight the roles of leaders and managers to participate in providing support for change processes (Antonacopoulou & Gabriel, 2001 ; Barner, 2008 ; Jacobs & Keegan, 2018 ). Moreover, the choice of the sample determines the fate of the study, whether it is possible to generalize or not. The larger sample size, the greater the possibility of generalization (Šedžiuvienė and Vveinhardt, 2018 ; Yan and Jacobs, 2008 ). Sample selection was problematic during the pandemic period because there were difficulties in collecting data and accessing responses (Li et al., 2021 ). In addition, some authors have dealt with specific groups in state-owned organizations, but such studies were hard to generalize as they need more verification and other opinions to prevent bias (Lines et al., 2015 ). More studies shed light on urging researchers to survey the opinions of users and beneficiaries at all organizational levels to reach the results. The researchers were also urged to take into consideration the age composition of the polarized sample before embarking on organizational change initiatives (McElroy & Morrow, 2010 ).

Among the other challenges that some studies faces are the choice of statistical methods to analyze the data because the chosen methods may be not suitable for data and the results are less convincing (Bin Mat Zin, 2009 ; Chung et al., 2014 ). Many researchers have used exploratory studies, which are of great importance in drawing conclusions. However, previous studies focused on use such design in one context and limits the possibility of generalization (Jacobs & Keegan, 2018 ; Vakola et al., 2013 ). Researchers also used interviews for a specific number of employees, which caused biasness in reactions (Jacobs & Keegan, 2018 ; Saunders & Thornhill, 2011 ). Therefore, focusing on other methods such as observation to see the impact of reactions to change will provide motivational cases and ideas worth sharing (Kruglanski et al., 2007 ). Some studies used structural equation modeling, which revealed the suitability of this technique for experimental research (Borges & Quintas, 2020 ; Faupel & Süß, 2019 ; Gardner et al., 1987 ). Likewise, some studies used a questionnaire and performed analysis, such as multiple regression and content analysis, which is considered a qualitative method in analyzing data and interpreting its meaning and provides an opportunity for researchers to choose different issues (Alas, 2007 ; Busari et al., 2019 ; Chung et al., 2014 ; Tavakoli, 2010 ). Although these analyses have proven their worth in extracting results, it requires researchers to use deep statistical analysis to reach generalizable results (Hatjidis & Parker, 2017 ; Huy et al., 2014 ). The researchers urged for future studies to use surveys and conduct comparative analysis between groups that would reduce time bias in the data (McElroy & Morrow, 2010 ).

The selection of incorrect variables may generate the biased result, or the variables may not be able to sufficiently serve the purpose of study and researchers need to add more variable to get rich data (Albrecht et al., 2020 ; Tyler & De Cremer, 2005 ). Table ​ Table1. 1 . Explain the issues and challenges of reactions organizational change in this regard. One of the limitations that some studies faced is they did not examine the personal characteristics of individuals, such as the influence of traits and the role of personality in directing reactions, as individuals with a high degree of negative influence of traits tend to follow the opposite reactions, neglecting this aspect may cause bias (Huy et al., 2014 ). It was also noted the studies discussed focused on the pace of change and trust in management and still there is necessity to discuss other variables that are highly related to change such as organizational culture, employee communication, commitment, fairness, job characteristics, resistance to change, psychological context, individual incentives, and anxiety of change (Busari et al., 2019 ; Lines et al., 2015 ; Oreg et al., 2011 ). Given the behavioral aspect is very important in human studies, addressing the use of behavioral support for organizational performance contributes to improving the reaction to change processes (Fournier et al., 2021 ). Moreover, considering technological development and intense competition between current organizations, the use of management information system will reduce behavioral and organizational problems (Dickson & Simmons, 1970 ). Researchers called for attention to the problem of studying the planned organizational change on a large scale in a place where employees do not have a voice, and the opportunities for participation are limited and the resistance to change is extreme (Fugate, 2012 ; Jacobs & Keegan, 2018 ). As a result, the changing organizations face huge challenges and spend massive amounts of resources on training and developing their employees (Antonacopoulou & Gabriel, 2001 ).

Benefits of (Even Negative) reactions to organizational change

The purpose of this systematic review is to expand theory and the understanding on reactions to organizational change by incorporating ideas from several disciplines (e.g., psychology, sociology, complexity sciences, and institutional perspectives). Many studies on organizational change reactions have concentrated on the causes or outcomes of these reactions, with a specific focus on resistance and, therefore, rather negative outcomes. Organizational change is often a necessity caused by external threats, such as intense competition (Oreg et al., 2011 ; Tavakoli, 2010 ). To implement change, the cooperation of employees is required (Antonacopoulou & Gabriel, 2001 ; Hatjidis & Parker, 2017 ; Peng et al., 2020 ). However, a mixture of psychological, social, emotional, and cultural dimensions in employees’ reactions can negatively interfere with the process of organizational change itself (Armenakis & Harris, 2009 ).

In this section, we attempt to change this perspective and, based on the findings in Sect. 3.1, formulate several propositions, which may enable organizations to overcome negative reactions and transform them into positive change outcomes. Basically, we argue that (1) negative reactions can be seen as a source of constructive criticism, (2) which can be used to improve the change process. Employees can be viewed as a critical authority in an organization, which might evoke new perspectives on the change process. The provided constructive criticism points to issues that require further attention by the organization. The antecedents, process, and outcomes of the change process are more thoroughly analyzed regarding possible weaknesses and strengths, which can improve the whole change process (Fournier et al., 2021 ; Straatmann et al., 2016 ). In particular, this encourages those in charge to address shortcomings and help facilitate change processes (Jacobs & Keegan, 2018 ). It can also help increase communication between members of the organization during various stages of organizational change (Li et al., 2021 ). Listening to employees’ objections might reduce the complexity of change (Chung et al., 2014 ; Fugate, 2012 ; Reiss et al., 2019 ) and can motivate and empower them to contribute to the success of change processes (Casey et al., 1997 ; Kruglanski et al., 2007 ; Tavakoli, 2010 ).

Theoretical recommendation

The results of this review revealed several critical variables and factors that had been investigated in previous research on change responses. There are many challenges and benefits that academics should take into consideration. Hence, understanding the negative and positive effects of change reactions can be an essential key concept to the successful implementation of organizational change. The results of an extensive literature review show allowing human resources to participate and rush into change programs increases the likelihood of successful implementation of planned and unplanned change. The leadership style has a strong and significant role in adopting change. Theoretically, the literature has proven the transformational and transactional leadership style are vital leadership styles that raise positive reactions to organizational change (e.g., Bayraktar & Jiménez, 2020 ; Busari et al., 2019 ; Faupel, & Süß, 2019 ; Khan, et al., 2018 ; Oreg & Berson, 2011 ; Peng, et al., 2020 ; Thomson et al., 2016 ). The leadership aspect is of fantastic importance in the success of implementing change because the leader has ability to inspire employees towards increasing levels of motivation and deliver the message of change with the lowest level of negative reactions. Because leadership styles achieve mutual gain between individuals by giving individuals a sense of power to adjust or accept the changes that occur in the organization. This review expanded the communication's vision of change by identifying reactions in four integrated behaviors (i.e., Exit, voice, loyalty, and neglect) that explain why individuals reject, resist, accept and embrace change.

Understanding reactions to change plays a critical role in enhancing individuals' cognitive, emotional experiences, and perceptions of changes. The results of this study shed light on the implementation of change during crises. The results prove epidemics and sudden consequences lead to lack of resources and loss of market share. There is huge benefit in adopting and responding to change programs amid crises, especially in the aftermath of unexpected crises, such as the COVID-19. Although crises add a significant burden to organizations in implementing change, it is necessary to face crises with a fantastic deal of courage, confidence, and communication to reduce exit reactions and disloyalty amongst employees. Supporting human resources and creating a work context with less organizational mopping leads to positive results and increases the success of organizational change adoption (Barner, 2008 ; Qin et al., 2019 ). Adopting organizational change is an emotional process based on individuals' feelings and perceptions of change. Organizational change causes high levels of anxiety and tension. Because the individual adversely interferes with aspects of organizational change in a manner that creates the feeling of anxiety increased and loss of identity. However, reactions to organizational change are varied and may be positive by increasing job satisfaction and granting of responsibility. In this context, the reactions toward change may be negative also by increasing the likelihood of unsuitability of change with the organizational work. Furthermore, academics and practitioners should be concerned with the sensory and emotional aspects of how individuals react to organizational change. Because the organizational changes that include providing importance to the emotions and feelings of staff as part of the change process can encourage employees to change the attitude towards change and cooperate with current events (Beare et al., 2020 ).

Organizational communication is important for understanding people's emotions and perceptions of change. Communication before and post organizational change provides people with suitable and timely information, creates a sense of delegation of responsibility for change, and mitigates negative responses to organizational change (e.g., Basinger & Peterson, 2008 ). Academics can use the results of this review to understand change reactions from an organizational and individual perspective and to highlight challenges and barriers to implementing change. Analyzing and examining organizational elements such as organizational communication and organizational attitudes provides solutions while implementing change. Additionally, sharing responsibilities and integrating roles between participants in the change increases the results achieved from adopting organizational change. This review confirms there is a dearth of investigation into the influence of psychological context factors such as individual incentives, change anxiety, and organizational mopping on post change results at the individual and organizational level. Studying reactions to organizational change at different organizational levels contributes to identifying differences and similarities to reactions at multiple organizational levels. In this context, using the results of this review by academics and practitioners contributes to reducing negative reactions and increases the chances of successful implementation of change programs.

Many studies highlight the importance of change efforts in contemporary organizations to address external threats. However, employees’, i.e., change recipients’, cognitive and behavioral responses to change often result in resistance. A comprehensive perspective of past research is required to have a clear understanding of the causes and consequences of responses to change. For this reason, we have conducted a systematic literature review on this subject. Much of what has been discovered before may be categorized into these four levels: micro and macro level responses. An in-depth analysis of the literature helped identify the antecedents, effects, benefits, challenges, and recommendations associated with reactions to organizational change.

Our findings have managerial implications. Based on the literature review, we derive recommendations for change agents to facilitate the issues experienced by researchers whilst studying reactions to organizational change. Insights from our literature review highlighted both positive and negative aspects of reactions towards change. Accordingly, we divided these studies into two groups discussing positive and negative aspects. The positive aspects highlight the importance of reactions in supporting change and broadening the view of the motives for change (Armenakis & Harris, 2009 ; Gardner et al., 1987 ; Mangundjaya et al., 2015 ). This increases employees’ participation and positively affects their perceptions of change (Faupel & Süß, 2019 ; Straatmann et al., 2016 ; Paterson & Cary, 2002 ; Bin Mat Zin, 2009 ). In addition, there is a significant correlation between reactions, emotional commitment, self-respect, and optimism (Fugate & Kinicki, 2008 ; Liu & Zhang, 2019 ; Vakola, 2016 ), and this depends on administrative support to reduce the negative feelings towards change implementation. The stronger communication between individuals, the more it has a positive effect towards improving reactions to change (Tang & Gao, 2012 ). The leadership plays a big role in directing reactions by providing opportunities to participate in decision-making, build confidence, and give individuals compensation opportunities (Khan et al., 2018 ). Likewise, individuals’perception of change depends on their reactions and behaviors (Hatjidis & Parker, 2017 ; Rechter & Sverdlik, 2016 ; Saunders & Thornhill, 2011 ). As the human being consists of a group of elements (emotional, mental, spiritual, and physical), when one of these elements is disrupted, it affects the other elements, which requires equal attention to these elements in order have a coherence and non-conflicting reactions (Blom, 2018 ).

Negative feelings towards change can occur due to increased fear of losing jobs and lower level of employees’ participation in change process (Barner, 2008 ; Rizzuto et al., 2014 ). When thinking about change, resistance is often the first thing that comes to mind (Walk & Handy, 2018 ). This is because individuals think of change as a shock that inversely affect them to think of negative consequences of change and hence, they resist change or develop an uncertainty about change processes (Størseth, 2006 ). There is also a perception that a poorly planned or poorly implemented change initiatives, in a way that does not consider the organizational or social conditions of individuals, increase stress levels (Blom, 2018 ). Likewise, changes frequently conflict with the organizational identity, which creates an unpleasant impression on individuals, and this leads to distort the intended purpose of the change and exposes the organizational identity to danger (Mdletye et al., 2013 ). It is imperative for practitioners and researchers to adopt broader, more accurate, and positive perspectives on how reactions affect organizational change (Belschak et al., 2020 ; McElroy & Morrow, 2010 ). In addition, some contradictory reactions lead to the deterioration of an organization (Fugate, 2012 ; Ming-Chu & Meng-Hsiu, 2015 ). This is because individuals have resistance to change and ridicule change, which generates internal conflict that negatively affects organization work processes (Jacobs & Keegan, 2018 ; Mdletye et al., 2013 ; Tavakoli, 2010 ). This happens because employees see change as a threat to their survival in organization (Huy et al., 2014 ; Paterson & Cary, 2002 ).

Our findings suggest steps aimed at addressing reactions should be initiated early on in a change process, to prevent negative attitudes from escalating into a desire to leave the organization. Organizations should also be aware that employees’ beliefs about ongoing change play an important role in shaping their work engagement and turnover intentions. Carefully monitoring and managing collective beliefs about a change during the full implementation phase—for instance, through employee participation and careful and timely communication. Therefore, help to avoid a loss in change momentum. Facilitating the change process and reducing the social and organizational costs of change.

This study also shows the theoretical contributions of previous studies by contributing to the development of the context of reactions towards organizational change at the individual, collective, and leadership levels, and using many of the above-mentioned scales at each level, which helps in accurately determining the impact at each level towards organizational change. This study, through its multi-level approach, attempted to cover as much as possible the reasons that may promote positive or negative reactions towards organizational change smoothly, which have not been extensively examined in previous studies. The results of the study found that the reactions towards organizational change within the cognitive and behavioral response were affected differently at each of the levels. For example, at the individual level by influencing the emotional side of working individuals, which affects their perceptions and thus their cognitive response to change and their behavior in terms of dealing with it (Hatjidis and Parker, 2020; Borges & Quintas, 2020 ), as both negative perception and the stimulation of negative emotions have A clear effect on the resistance reactions to organizational change in general (Belschak et al., 2020 ). The micro level, based on the criteria for strategic change, the pandemic, social identity, and vocal behavior, showed the negative effects of resistance reactions to organizational change resulting in most cases from negative perceptions and negative emotions towards change (Li et al., 2021 ; Milton et al., 2020 ; Van et al., 2018). The macro level by reviewing the types of leadership and the way each of them affects the reactions towards organizational change, as transformational leadership and transactions, as well as the response of managers, showed a prominent positive role in reducing the standing towards organizational change, promoting it and participating in it (Faupel & Süß, 2019 ; Peng et al., 2020 ; Du et al., 2020 ). The macro levels depended on a set of important factors represented in education, human resources, explicit feedback, and self-evaluations. Organizational attitude is behind the disruption of positive and negative reactions based on individuals' perception of information in a positive or negative way, or rather in an optimistic or pessimistic manner (Roczniewska & Higgins, 2019 ). While the impact of human resources appears in the reactions towards organizational change, positively or negatively, depending on the system that has been adopted and the methods used to implement the change (Bin Mat Zin, 2009 ; Blom, 2018 ). The effect of explicit reactions appears depending on a rule from which individuals start in their behavior, which is the belief about change and a factor directing that behavior towards accepting change through the leader’s behavior as a role model to deal with change and clarifying the impact of change in the minds of individuals (Vakola et al., 2013 ). Finally, it seems that individuals' self-assessment about change is often based on the principle of maintaining the status quo and unwillingness to change, which shows resistance behavior (Rizzuto et al., 2014 ). Therefore, the study recommends in some variables for future research, which is the study of personality traits because there are some underlying factors of emotions and openness to change and other factors that may significantly affect reactions towards organizational change. It also recommends taking other types of leadership, for example, participatory leadership and knowing its impact in reactions.

The review also revealed research gaps to be addressed in future research. Regardless of the prevalence and value of reform initiatives in contemporary organizations, change initiatives often struggle to achieve desired goals. It has been argued employees are at the heart of the change initiative and major determinants of the degree to which any change will succeed. Despite many challenges, organizational change is relevant for firm survival and performance, which needs to be further investigated. Specific patterns can be drawn from different organization types where reactions towards organizational change have been studied. Further research gaps relate to the level of application, conceptual model, and sector. The literature made some recommendations to increase strategic performance as well as achieve marketing differentiation in addition to high customer satisfaction. This helps to reduce risks, respond to uncertainties and to achieve high flexibility under changing environmental conditions. These recommendations can address the challenges to organizational change and open more opportunities for future research. Because of the fierce competition, companies will continue to develop more sophisticated competitive advantages, and thus researchers must identify emerging trends and strategies of organizational change. Based on the research that is shown throughout this review, there is a wealth of work in different settings and at various levels of analysis that considers reactions to organizational change during the prior two decades.

The current study is not without some limitations like any other study. As the current study was limited to focusing on the leadership level on direct leadership instead of focusing on the leadership team, as the former appears as a representative of the interests of the organization and transfers its goals and defines tasks to working individuals, while the latter is concerned with clarifying the objectives and reasons behind the organizational change in a way that enhances acceptance of change and participation in it. by working individuals. In addition, when studying the variables that were adopted in the study and their impact on reactions to organizational change, that study did not control some of the variables that could have a very big role in explaining the nature of the results that were reached, which are individual differences and personal traits. Finally, the study neglects the cultural context, which often has a significant role in influencing the nature of the interrelationships between variables at the individual, collective, and leadership levels, and between the nature of reactions towards organizational change, which appears more clearly when the study sample is diverse in different countries able to reflect the nature of cultures change.

Acknowledgements

This work is funded by Universiti Sains Malaysia, Short Term Grant [Grant Number: 304/PMGT/6315513], for the Project entitled "The Efficiency of Variable Sampling Interval Scheme for the Multivariate Coefficient of Variation in Short Production Runs".

Data availability

Declarations.

All the procedures adopted by the study, involving human participants, were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants of the study.

All the authors of this paper declare existence of no mutual conflict of interests.

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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• Volume 83, Issue 6
• EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update
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• http://orcid.org/0000-0003-0920-888X Tuva Moseng 1 ,
• http://orcid.org/0000-0001-6322-3859 Theodora P M Vliet Vlieland 2 ,
• Simone Battista 3 ,
• David Beckwée 4 ,
• Vladimira Boyadzhieva 5 ,
• http://orcid.org/0000-0002-3478-5665 Philip G Conaghan 6 ,
• Daniela Costa 7 ,
• Michael Doherty 8 ,
• Andrew G Finney 9 , 10 ,
• Tsvetoslav Georgiev 11 ,
• Milena Gobbo 12 ,
• Norelee Kennedy 13 ,
• Ingvild Kjeken 1 ,
• http://orcid.org/0000-0002-8940-0582 Féline P B Kroon 14 , 15 ,
• http://orcid.org/0000-0002-5424-9448 L Stefan Lohmander 16 ,
• Hans Lund 17 ,
• Christian D Mallen 18 ,
• Karel Pavelka 19 ,
• Irene A Pitsillidou 20 ,
• Margaret P Rayman 21 ,
• Anne Therese Tveter 1 ,
• http://orcid.org/0000-0003-4783-8663 Johanna E Vriezekolk 22 ,
• Dieter Wiek 23 ,
• Gustavo Zanoli 24 ,
• http://orcid.org/0000-0001-8602-342X Nina Østerås 1
• 1 Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY) , Diakonhjemmet Hospital , Oslo , Norway
• 2 Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center (LUMC) , Leiden , Netherlands
• 3 University of Genoa Department of Neuroscience Ophthalmological Rehabilitation Genetics and Mother and Child Health , Genova , Italy
• 4 Rehabilitation Research Department , Vrije Universiteit Brussel , Brussel , Belgium
• 5 UMHAT “St. Iv. Rilski” Clinic of Rheumatology, Medical University Sofia , Sofia , Bulgaria
• 6 Leeds Institute of Rheumatic and Musculoskeletal Medicine , University of Leeds and NIHR Leeds Biomechanical Reserch Centre , Leeds , UK
• 7 Comprehensive Health Research Center (CHRC) , Universidade Nova de Lisboa , Lisboa , Portugal
• 8 Department of Academic Rheumatology , University of Nottingham , Nottingham , UK
• 9 Research Institute for Primary Care and Health Sciences , Keele University School of Medicine , Keele , UK
• 10 School of Nursing and Midwifery , Keele University , Keele , UK
• 11 Clinic of Rheumatology, University Hospital St. Marina, First Department of Internal Medicine , Medical University Varna , Varna , Bulgaria
• 12 Positivamente Centro de Psicología , Madrid , Spain
• 13 School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute , University of Limerick , Limerick , Ireland
• 14 Department of Rheumatology , Leiden University Medical Center (LUMC) , Leiden , The Netherlands
• 15 Department of Rheumatology , Zuyderland Medical Centre Heerlen , Heerlen , The Netherlands
• 16 Department of Clinical Sciences Lund, Orthopaedics , Lund University , Lund , Sweden
• 17 Centre for Evidence-Based Practice , Western Norway University of Applied Sciences , Bergen , Norway
• 18 Keele University School of Medicine , Keele , UK
• 19 Institute of Rheumatology, Department of Rheumatology , Charles University First Faculty of Medicine , Praha , Czech Republic
• 20 EULAR Patient Research Partner , Cyprus League Against Rheumatism , Nicosia , Cyprus
• 21 Department of Nutritional Sciences , University of Surrey Faculty of Health and Medical Sciences , Guildford , UK
• 22 Research & Innovation , Sint Maartenskliniek , Nijmegen , The Netherlands
• 23 EULAR Patient Research Partner , Deutsche Rheuma-Liga , Bonn , Germany
• 24 Orthopaedic Ward , Casa di Cura Santa Maria Maddalena , Novara , Italy
• Correspondence to Dr Tuva Moseng, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; tuva.moseng{at}diakonsyk.no

Introduction Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed.

Methods The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed.

Results The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0–10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work.

Conclusions The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.

• Osteoarthritis, Knee
• Osteoarthritis
• Rehabilitation
• Physical Therapy Modalities
• Therapeutics

This is an open access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0). See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/ard-2023-225041

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Introduction

Osteoarthritis (OA) is the most common joint disease worldwide, 1 with an increasing global burden of disability and healthcare utilisation. 2 The number of people with OA globally rose by 28% from 2010 to 2019, affecting over 500 million people, and about 6%, worldwide. 3 Due to an ageing population, increasing obesity and sport-related joint injuries, the disease will become even more prevalent in the forthcoming years. 2 In 2019, OA was the 15th highest-ranked cause of years lived with disability (YLDs) worldwide and was responsible for 2% of the total global YLDs. 3 OA is regarded as a severe disease, and serious condition and people with OA commonly experience pain, stiffness and associated functional loss. 4 Optimal management of hip and knee OA has important implications for the individual and society through the potential for improving individual health, work participation and utilisation of healthcare services. However, most people with OA do not receive optimal management. 5 6 In order to reduce the evidence-to-practice gap and the future burden 7 of this disease, the healthcare services’, policy-makers’ and the population awareness of the importance and benefits of evidence-based management of OA must be improved.

EULAR recommendations, including priorities for implementation and future research, can play a role in increasing awareness and uptake of best evidence care. In 2013, an EULAR Task Force (TF) developed recommendations for the non-pharmacological core management of hip and knee OA. 8 Since then there remains no cure in sight for OA, and effective disease-modifying drugs are lacking. 2 Therefore, non-pharmacological approaches are still considered a core treatment for people with hip and knee OA, aiming to alleviate symptoms and improve or maintain physical function. Since the publication of the 2013 recommendations, a large number of studies on the effectiveness of core non-pharmacological treatment modalities and new methods for delivery and follow-up of such treatments have been published. An update of these recommendations would potentially have implications for the level of evidence (LoE) categories and could lead to revisions of the recommendations and formulation of new recommendations with important implications for OA management.

The main aim of this TF process was to update the 2013 evidence-based recommendations for non-pharmacological core management, provide additional details on effectiveness, safety and cost-effectiveness, and formulate research and educational agendas and priorities for implementation activities. The target groups for the updated recommendations are people with hip or knee OA, all healthcare providers involved in the delivery of non-pharmacological interventions in OA care, researchers in the field of OA, officials in healthcare governance and reimbursement agencies and policy-makers.

The Standardised Operating Procedures for EULAR-endorsed Recommendations 9 were used as a framework for this project. The structure of the manuscript is guided by the Appraisal of Guidelines, Research and Evaluation instrument. 10

To pursue the task of updating the 2013 recommendations, a multidisciplinary TF with in-depth knowledge of non-pharmacological OA care was established. The TF consisted of 25 members from 14 European countries and included 9 physiotherapists, 6 rheumatologists, 2 orthopaedic surgeons, 2 psychologists, 2 patient research partners, 1 occupational therapist, 1 nurse, 1 general practitioner and 1 nutrition expert. A steering group, including a convenor (NØ), a methodologist (TPMVV) and a research fellow (TM), managed the process.

During the first digital TF meeting, the rationale for the update of the recommendations was presented, and the definition of core non-pharmacological management was clarified. The TF agreed on 11 research questions based on the research propositions from the 2013 recommendation. For the subsequent systematic literature review (SLR), the research questions were organised according to the population, intervention, control and outcome (PICO) format with associated search terms ( online supplemental file 1 ). The new search terms added to the previous search strategy were related to the following topics: remote care, shared decision-making, psychological interventions/cognitive behaviour therapy (CBT)-based interventions and specific exercise modalities (eg, strength training and aerobic exercise). Due to the expected large body of published literature since the previous literature review from 2012, combined with the available resources and strict timeline for this update, it was decided that this SLR should primarily focus on evidence from systematic reviews (SRs) and meta-analyses of randomised controlled trials (RCTs) and secondarily on evidence from single RCTs. As this SLR was an update of a previously unpublished SLR, along with its pragmatic approach, it was decided that the details were best presented as online supplemental file 1 rather than a publication of its own.

Supplemental material

The SLR was conducted by the fellow and convenor in close collaboration with an experienced librarian (HIF) and with support from the methodologist. Three main literature searches were conducted in the databases Medline (Ovid), Embase (Ovid), AMED (Ovid), Cochrane Library (Cochrane TRIALS), CINAHL (Ebsco) and Epistemonikos (SR search only).

The primary literature search aimed at identifying relevant SRs of RCTs investigating the effectiveness of core non-pharmacological management strategies as specified in the PICOs. The search was conducted from 2012 (the end year of the previous search) until 17 February 2022 and later updated until 27 May 2022 ( online supplemental file 1 ). Based on the PICOs, two authors (TM and NØ) independently screened titles and abstracts. Potentially relevant studies were read and evaluated in full text. Studies were included if they were SRs, including a meta-analysis of two or more RCTs on people diagnosed with hip or knee OA or with persisting knee pain in people 45 years or older and investigating non-pharmacological core management strategies. Relevant comparisons were no intervention, usual care or any other intervention. Relevant outcomes were pain, physical function, quality of life (QoL), patient global assessment of target joint, adverse effects or cost-effectiveness. The included studies were categorised under the 11 research questions. If relevant, one study could inform multiple research questions. The quality of the included SRs was evaluated with A MeaSurement Tool to Assess systematic Reviews (AMSTAR II). 11 The assessments were conducted independently by three assessors (GS, EAB and IS), working in pairs independent of the TF, with experience in quality assessment of SRs and RCTs. Disagreements between the assessors were resolved through discussion.

A second literature search with a comparable search strategy was conducted to identify newer RCTs not included in the latest published SR on the same topic, or relevant RCTs not included in any SRs, or RCTs on research questions for which no relevant SRs were identified. To identify such RCTs published in the past four to 5 years, the search was conducted from 1 January 2018 to 27 May 2022.

A third literature search was conducted with a similar search strategy from 1 January 2012 to 31 December 2017, aiming to identify relevant RCTs specifically on the research questions for which no relevant SRs had been identified. The two last searches were screened independently by the same two authors, and relevant studies were read and evaluated in full text. Studies were included if they were RCTs relevant to the PICOs. The quality of the included RCTs was assessed with the Cochrane Risk of Bias tool 2 (RoB2) 12 independently by two researchers (EAB and IS) independent of the TF. Disagreements between the assessors were resolved through discussion.

In the period before the second TF meeting, five digital subgroup meetings were arranged. Groups of 4–5 TF members and the steering group participated in each meeting. The purpose of the subgroup meetings was to go through the relevant results from the SLR and to discuss and prepare preliminary suggestions for revisions and updates of the recommendations to guide the discussion at the second TF meeting. The group discussed between 1 and 3 of the previous 11 recommendations in each subgroup meeting. This method was implemented to allow all TF members to express their opinions in smaller forums and potentially to reduce the workload of the second TF meeting.

During the second digital TF meeting, the results from the SLR, along with the proposed updates from the subgroups, were presented to the whole TF. The previous recommendations and the proposed updates were then discussed in light of the SLR and the expertise of the group. After the discussions and revisions, the TF members voted for consensus on each revised overarching principle and recommendation (defined as 75% or more in favour of the suggested updates). After the meeting, the updated list of recommendations was collated and emailed to the TF members in a digital survey to rate the level of agreement (LoA) on a 0–10 point scale (0=totally disagree, 10=totally agree). Further, the TF voted on the prioritised order of the recommendations for implementation activities. The TF also formulated a research agenda based on identified gaps in the evidence. The steering group defined the LoE and strength of each recommendation in accordance with the Oxford Levels of Evidence. 13 The steering group also formulated the educational agenda on behalf of the TF.

The three systematic literature searches yielded a total of 6816 references after the removal of duplicates ( figure 1 ). From these, 67 SRs and 31 RCTs were initially considered relevant for the SLR. However, we chose to extract data from 36 of the SRs due to reasons elaborated in online supplemental file 1, p.49 ,. The most frequent reason was that the interventions under study were not considered relevant for this review. The quality of the included SRs was generally poor, with 35 of 36 studies being rated with an overall low or critically low quality by the AMSTAR II tool ( online supplemental file 1 ). The critical items that most often contributed to the overall low quality of the studies were: the lack of an explicit statement that the review methods were established prior to the conduct of the review; the lack of the use of a comprehensive literature search strategy; and lack of a list of excluded studies with reasons for exclusion. There was large variation in the overall quality of the included RCTs as assessed by the RoB2 tool ( online supplemental file 1 ). Most studies with a low risk of bias were on exercise interventions and delivery, whereas there were higher concerns related to the studies on, for example, lifestyle-related interventions. Most commonly, these concerns were related to the elements of measurement of the outcome (eg, the lack of a blinded outcome assessor).

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PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

The main updates to the recommendations are summarised in box 1 . The TF agreed to rephrase and change two previous recommendations into overarching principles. These were the recommendations on: (1) the use of a biopsychosocial approach in the initial assessment and (2) the recommendation on individualisation of treatment. It was decided that these were generic statements used to inform the basis for management rather than specific treatment recommendations. Inherent to the nature of these statements, relevant studies were absent from the SLR. 14

What is new?

The updated recommendations have been reorganised into two overarching principles and eight treatment recommendations.

The wording of each recommendation is condensed.

The level of agreement is above 9 for all recommendations.

The level of evidence is 1a/1b for seven of the eight recommendations.

It was further decided to revise the nine previous recommendations into eight updated recommendations by merging the recommendations on footwear and walking aids, other assistive devices and adaptations. Moreover, to improve readability the previous recommendations were shortened, and subsections were rewritten and moved to the explanatory text. In addition, the TF also discussed the order for the presentation of the recommendations and decided to change this into a more logical sequence.

High LoAs were achieved for all eight recommendations, and seven recommendations were graded with LoE 1a/1b and strength level A. Recommendation 2—on delivery of information, patient education and self-management—was ranked by the TF as having the highest priority for implementation. Table 1 summarises the updated overarching principles, recommendations, LoA, LoE, strength of recommendation and priority for implementation.

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Overarching principles and specific recommendations for the non-pharmacological core management of hip and knee osteoarthritis

Recommendation 1

People with hip or knee OA should be offered an individualised, multicomponent management plan that includes the recommended core non-pharmacological approaches.

This recommendation deals with the provision of an integrated package of care rather than single treatments alone or in succession. The majority of new, relevant SRs and RCTs informing this recommendation investigated the effectiveness of the combination of patient education and exercise or the combination of patient education, exercise and diet or the combination of behaviour change techniques/pain-coping skills training and exercise, compared with information or one of the treatments alone. 15–18 The updated evidence shows that combining treatments leads to larger effects on pain and function compared with providing the treatments separately, thereby providing a rationale for combining different treatment modalities. The combination of education, exercise and dietary weight management was also considered cost-effective compared with physician-delivered usual care investigated in five healthcare systems. 19 The TF discussed that, although not all potential combinations of treatments are investigated in meta-analyses or newer RCTs, the results of available studies are likely to be generalisable to different combinations. Thus, the TF agreed on the general consideration of multicomponent treatments from a broader spectrum of potential combinations based on an assessment of a patient’s individual needs and preferences.

Through the SLR, no specific evidence was retrieved with regard to the effects of pacing and maintenance of activity. This specific element was therefore removed from the recommendation.

Recommendation 2

People with hip or knee OA should be offered information, education and advice on self-management strategies (considering available modes of delivery) and these should be included and reinforced at subsequent clinical encounters.

Recommendation 2 concerns the delivery of information, education and advice on self-management strategies. New evidence from the SLR showed zero to small significant effects on pain and function from patient education as a single intervention in the short term, which is in line with the previous recommendation. 15 20 In 2013, this recommendation focused on how education and information should be delivered in terms of being individualised, being included in every aspect of management, and specifically addressing the nature, causes, consequences and prognosis of OA. Moreover, it was stated that this should be reinforced and developed, supported by written or other types of material, including partners or carers of the individual, if relevant. The current TF acknowledged the importance of these aspects to ensure the effective delivery of information and education for people with hip and knee OA. However, none of the studies from the SLR could provide specific evidence for any of these aspects, except with regard to delivery method. One SR reported the effects of patient education delivered through telephone when compared with usual care, but the results were not significant for pain or disability. 20 The TF further chose to add self-management to the updated recommendation. Evidence from two SRs, including seven RCTs, compared structured self-management programmes against a large range of control interventions. Zero to small favourable effects were found for self-management, delivered face to face or digitally, compared with routine/usual care. 21 22 Despite the limited effects reported in the literature, the TF agreed that self-management is a concept closely related both to the delivery of information and education in a clinical setting and to the uptake of other relevant treatment modalities.

Recommendation 3

All people with hip or knee OA should be offered an exercise programme (eg, strength, aerobic, flexibility or neuromotor) of adequate dosage with progression tailored to their physical function, preferences and available services.

The body of literature investigating the effects of different types of exercise regimes was already large when the 2013 recommendations were published. Aiming to progress the knowledge on the effects of exercise for hip and knee OA, the current SLR did not focus on studies investigating the effects of general exercise on hip and knee OA as these effects were well established previously. 23 24 The aim was rather to identify studies investigating the effects of well-defined exercise modalities, as well as studies looking more specifically into exercise dosage.

For hip OA, one SR summarised the effects of supervised, progressive resistance training, which reported beneficial effects on pain, function and QoL. The effect sizes, however, were small with large CIs. 25

For knee OA, four SRs and five additional RCTs were identified on the exercise 26–28 modalities Tai Chi, yoga, stationary cycling, proprioceptive training, weight-bearing and non-weight bearing exercise, and neuromuscular exercise combined with strength training. 29–33 Overall, the results showed small to moderate positive effects on pain and function for all these exercise modalities compared with no-exercise control (no intervention, waiting list or non-exercise interventions). Still, the results were less clear in head-to-head comparisons of different exercise types, modalities or doses.

In summary, results showed that a variety of exercise modalities might lead to improved pain and function for people with hip or knee OA, making it difficult to recommend one type of exercise over another. The optimal exercise dosage is also difficult to establish, with evidence from 1 SR on hip OA (including 12 RCTs) and 1 SR on knee OA (including 45 RCTs) providing some evidence that exercise in line with dose recommendations from the American College of Sports Medicine provided larger improvements in pain compared with non-compliant exercise programmes. 34–36 The differences, however, were small, and the clinical relevance is debatable. Two newer RCTs on knee OA, comparing high-intensity to low-intensity resistance training or no-exercise control, found no or only small between-group differences with regard to pain and function, 37 38 thus making it difficult to make explicit recommendations on exercise dosage.

With respect to safety, adverse events in exercise studies for hip and knee OA were investigated in two SRs. 39 40 The two studies concluded that, although the report of adverse events in exercise studies was inconsistent and some patient drop-outs were potentially misclassified, adverse events were generally uncommon and non-serious, and that exercise seemed to be associated with minimal risk of harm. Concerning the economic aspects of exercise, one SR on cost-effectiveness found that in the majority of the 12 included studies, exercise for hip and knee OA showed cost-effectiveness at conventional willingness-to-pay thresholds. 19

The TF chose to update this recommendation, highlighting that the choice of exercise should be based on individual function, patient preferences and available services. 41 Overall, exercise is by far the most studied and strongly recognised non-pharmacological core management treatment option and this recommendation has the strongest evidence base. The TF also expressed the importance of maintaining exercise over time for the positive effects to persist.

Recommendation 4

The mode of delivery of exercises (eg, individual or group sessions, supervised or unsupervised, face to face or by using digital technology, land-based or aquatic exercise) should be selected according to local availability and patient preferences. The exercises preferably should be embedded in an individual plan for physical activity.

As established in the description of recommendation 3, there is convincing evidence for the effectiveness of various exercise modalities on pain and function in hip and knee OA. However, the delivery method of exercise programmes varies largely across studies and may influence study outcomes.

One SR found superior effects from technology-supported exercise compared with control with non-technological or no care services on pain, function and QoL, 42 whereas another SR found superior effects from telehealth-based exercise compared with no-telehealth exercise control for pain but not for function or QoL. 43 The reported effect sizes were small. One additional RCT found a small, significant effect on function at 6 months follow-up for an education combined with strengthening exercise follow-up through telephone calls compared with education alone, but no other between-group differences in pain and function were detected after 6 and 12 months. 44 Another RCT comparing access to an educational website combined with exercise supported by automated behaviour change text messages to access to the educational website alone found significant superior effects of the combined first intervention on pain and function after 24 weeks. 45 For aquatic exercise, one SR reported small short-term beneficial effects for pain and function compared with no intervention or usual care. However, another SR comparing aquatic exercise to land-based exercise did not find any of these modes superior to the other. 46 47 One RCT of a three-stage stepped care exercise programme compared with educational materials found beneficial, although not clinically relevant, effects of the stepped care programme on pain and function at 3 and 9 months, but not at 6 months. 48 Analyses of the cost-effectiveness of the same stepped-care intervention concluded that there is a high probability of short-term cost-effectiveness. 49

The new evidence adds information on technology-supported delivery of exercise, aquatic exercise and a stepped care strategy for exercise delivery. The results from these studies show a wide variety of potentially effective delivery methods for exercise, which in clinical practice should be aligned with patient preferences and the availability of local services. The TF also underlined the importance of the exercise programme being embedded in an individual plan for physical activity. Such plans should be set up in accordance with well-recognised recommendations for physical activity, such as from the WHO or EULAR. 41 50 General physical activity has multiple health benefits and is also important for the management of common comorbidities associated with OA, such as cardiovascular disease and diabetes. 51 52

Recommendation 5

People with hip or knee OA should be offered education on the importance of maintaining a healthy weight. Those overweight or obese should be offered support to achieve and maintain weight loss.

In the updated SLR, three SRs were identified, including one network meta-analysis investigating the effects of weight loss interventions. Two were on studies of knee OA, 19 53 whereas the third included studies of both hip and knee OA, although only 2 of the 19 trials included in that study were conducted on a mixed hip and knee OA population. 54 The results from this SR showed beneficial effects, compared with minimal care, of both diet and multifocused weight-loss interventions (combining diets, telephone coaching, psychological pain-coping interventions/CBT, specialist referral education and exercise) on pain and disability, with the largest effect size on pain for multifocused interventions. Further, it was reported that when comparing weight-loss-focused interventions (diets) to exercise, no between-group differences were detected for pain or disability. When comparing combined interventions of dietary weight loss and exercise to dietary weight loss or exercise alone, small effects were found in favour of the combined intervention.

In the network meta-analysis, bariatric surgery was the most effective pain-reducing intervention, followed by a low-calorie diet combined with exercise intervention. 53 The last SR on knee OA used cost-effectiveness as an outcome and reported that an intensive 18-month diet and exercise intervention with the goal of 5% weigth loss was likely to be an efficient use of healthcare resources compared with a healthy lifestyle control. 19

The above-mentioned studies made it clear that there is increasing evidence supporting multifocused weight loss interventions as beneficial for OA pain and disability. Therefore, the TF recommended that people with overweight or obesity and OA should be offered support to achieve and maintain weight loss. The TF notes that the amount of evidence mainly stems from studies on knee OA. As overweight and obesity are strong risk factors for the development and progression of OA, and in particular knee OA, 2 the TF also wanted to add to the recommendation the importance of education on the benefits of maintaining a healthy weight.

Recommendation 6

For people with hip or knee OA, consider walking aids, appropriate footwear, assistive devices and adaptations at home and at work to reduce pain and increase participation.

Through the SLR, four SRs investigating the effects on knee OA of lateral wedge insoles compared with other types of insoles, including flat/neutral insoles or knee braces, were retrieved. These studies did not report any between-group differences for any comparisons on pain or function. 55–58 On the other hand, one RCT reported a small between-group difference in favour of lateral wedge insoles compared with neutral insoles on a single pain scale in people prescreened to knee adduction moment improvements (but not on other pain scales, function or QoL). 59 For footwear, one RCT found positive effects of biomechanical footwear with individually adjustable external convex pods attached to the outsole compared with control footwear. 60 Another RCT found small effects after 6 months on pain, but not on function, from wearing stable, supportive shoes over flat flexible shoes for at least 6 hours per day. 61

Summarised, most evidence did not support the use of any lateral wedged or other insoles to affect pain or function in knee OA. The results from one RCT provided some support for the use of stable, supportive shoes. The TF wanted to add that from a clinical perspective, the use of comfortable shoes, big enough to give ample space for the toes when weight-bearing, is still a general recommendation for people with hip and knee OA.

For other types of assistive aids and devices, two RCTs comparing the use of canes to the non-use of auxiliary gait devices were identified. The results were contradictory, and conclusions on the effect of cane were difficult to draw from the available evidence. 62 63 No studies were retrieved for other types of assistive devices or home adaptations. Based on the expert knowledge of the group, it was argued that such devices could still be useful to some people with hip or knee OA in terms of reducing pain, undertaking daily activities and improving participation. The TF wanted to emphasise that improving participation is an important aspect underpinning this specific recommendation. Assistive devices may serve as means to reduce pain and improve participation both at home and at work and should, therefore, be considered in that context. Examples of such devices might be devices to aid dressing, height-adjustable chairs, raised toilet seats, handrails in staircases or the use of appropriate walking aids.

Recommendation 7

People with hip or knee OA with or at risk of work disability should be offered timely advice on modifiable work-related factors and, where appropriate, referral for expert advice.

OA is one of the leading causes of reduced work participation, and the disease may critically affect the number of sick days and, ultimately, the extension of a person’s work career. 64 Although there are well-known occupational risk factors, such as heavy lifting and knee straining activities associated with the development of knee OA, 65 it was noted that there is a lack of studies on vocational rehabilitation for people with hip or knee OA. In the current update, only one relevant RCT was retrieved. This study used workability as an outcome, whereas the study intervention in both groups focused on self-management with the addition of an activity tracker in the intervention group. In this study, no between-group differences were reported for workability. 66

Although little research has been conducted, the TF considered that appropriate interventions to increase work participation for people with hip and knee OA are highly relevant. A proper assessment of the individual work situation may have a large impact and should receive attention during consultations. 67 Health professionals, in cooperation with the employer, should be able to offer timely advice on modifiable work-related factors such as working from home, the use of height-adjustable desks and office chairs, the possibility of changing work tasks, commuting to/from work, use of assistive technology, and receiving support from management, colleagues and family towards employment. The TF also noted that adaptations to improve workability might be considered and applied not only at the workplace but also in the home.

Recommendation 8

Consider employing elements of behaviour change techniques when lifestyle modifications are needed (eg, physical activity, weight loss) for people with hip or knee OA.

This recommendation concerns the potential need for lifestyle change in people with hip and knee OA. It focuses specifically on physical activity and weight loss as part of a healthy lifestyle since these aspects are specifically relevant for people with hip or knee OA. One SR and eight additional RCTs were identified on various interventions to enhance a healthy lifestyle, mainly through maintaining physical activity over time. The SR reported small to moderate effects of adding booster sessions to exercise programmes to improve mid-term to long-term adherence to exercise. 68 Furthermore, one RCT reported statistically significant improvements in pain and function from a combined programme of pain coping skills training and lifestyle behavioural weight management lasting 24 weeks compared with these interventions alone or standard care. 69 Interventions from the other RCTs aiming to support people with OA to improve their lifestyle and sustain such changes over time, included interventions of behaviour-graded activity, improving exercise adherence with telephone counselling, an app to enhance a healthy lifestyle, physical activity with telephone follow-up and a self-management lifestyle intervention. 70–72 However, when the effects on pain and function of these interventions were compared with standard care or other minimal interventions, none to very small between-group differences were observed for the comparisons. The TF wanted to enhance the importance of long-term follow-up on health behaviour change and not just recommend lifestyle change as a single intervention. The TF also discussed that the EULAR recommendation on core competencies for health professionals in rheumatology underlines that health professionals should be able to provide the principles of behaviour change techniques in the management of people with rheumatic and musculoskeletal disorders. 73

Research and educational agendas

The proposed research agenda ( table 2 ) was based on gaps identified in the literature and on topics which emerged during discussions among the TF members.

Research agenda for the non-pharmacological core management of people with hip and knee osteoarthritis

The education agenda ( table 3 ) highlights activities relevant to promote appropriate management of people with hip and knee OA.

Educational agenda for the non-pharmacological core management of people with hip and knee OA

Through this update, the recommendations for the non-pharmacological core management of hip and knee OA have been revised into two overarching principles and eight treatment recommendations. The revisions are based on research evidence, expert discussions and consensus. Since the publication of the 2013 recommendations, a number of new studies have been published on non-pharmacological treatment modalities and their methods of delivery. The updates to the recommendations are thus well anchored in evidence from research and the perspectives of the TF members, representing different professional, cultural and personal backgrounds, including the perspective of people with OA. The process led to a broad consensus within the TF on the updated principles and recommendations, reflected by the high LoA for all the revised recommendations. Such strong consensus gives reason to believe that the recommendations are suitable for use and implementation across European healthcare systems. These recommendations are also in line with recently published treatment recommendations for hip and knee OA by other societies. 74–76

The number of relevant SRs and RCTs retrieved through the SLR was high, especially for the research questions concerning exercise and delivery of exercise, with data drawn from a total of 15 SRs and 11 additional RCTs. The number of new studies led to an upgrade of the LoE for most of the recommendations, and seven of eight recommendations are now supported by level 1a or 1b evidence. However, it should be noted that the stated LoE does not necessarily involve all aspects of every recommendation and does not distinguish between hip and knee OA. The number of studies on hip OA was markedly lower than those on knee OA for all the treatment modalities. Therefore, the recommendations are generally weaker for hip OA than knee OA. There is an increasing recognition of differences between hip and knee OA, which heightens the need for more hip OA-specific studies to improve outcomes for this group specifically. 77 This is also highlighted in the proposed research agenda ( table 2 ). Further, as the aim was to address relevant non-pharmacological core management strategies, the recommendations do not specifically advise the management of subgroups of the OA population, for instance, younger adults or adults with a high burden of comorbidities. The authors are also aware of a number of ongoing studies addressing a range of innovative digital programmes in OA care. Such approaches will likely receive further attention in future updates of these recommendations. 78–81

With regard to outcomes, most of the included studies reported effects primarily on pain and physical function. To follow the recommendations on prioritised outcomes in OA research, 82 more studies investigating the effects of interventions on QoL and patients’ global assessment of the target joint may have provided additional relevant information. Workability and cost-effectiveness are two other outcomes of increasing interest when investigating the effect of interventions from a broader perspective. This SLR identified some studies including these outcomes, thus adding new and important knowledge to the recommendations. Nevertheless, additional studies with a focus on interventions to prevent the decline in workability and studies examining cost-effectiveness are still needed as such knowledge is important for healthcare governance and policy-makers when planning and prioritising effective OA care. Another relevant aspect of this update is the inclusion of studies investigating potential harm or adverse events from the interventions under study. Only two SRs specifically looking into this subject were identified. Still, the results add new knowledge to this important, although understudied, aspect of non-pharmacological interventions. 83

The challenges of implementing recommended care for people with hip and knee OA are well documented. 84 It is also apparent that developing recommendations is not sufficient on its own to influence practice. 85 Therefore, efforts have been made to address the impact and to develop strategies for the implementation of treatment recommendations. For future implementation, collaboration with other organisations focusing on OA care, such as The Osteoarthritis Research Society International, must be considered. EULAR highlights that implementing all recommendations at once is probably not feasible in practice. 86 The TF voted that the recommendation on information, education and self-management was ranked as the recommendation with the highest priority for implementation. This recommendation may play an important role as a basis for all other management and may improve people’s ability to live a good life with OA, as well as being an enabler of, aspects such as physical activity. 87 The prioritisation of the recommendations for implementation activities is also important with respect to the effective utilisation of healthcare services. As the OA population is growing, the need for effective healthcare utilisation and sustainable management strategies to improve outcomes will be vital to minimising the burden of OA at an individual and a societal level. 88

To conclude, the TF reached a broad consensus on the updated recommendation for non-pharmacological core OA management as well as on a research agenda highlighting the current evidence gaps, on an educational agenda and on the priority of the recommendations to support implementation activities.

Ethics statements

Patient consent for publication.

Not applicable.

Acknowledgments

We thank the librarian Hilde Iren Flaatten, University of Oslo, Norway, for supporting the literature searches and Emilie Andrea Bakke, Ingrid Skaalvik and Geir Smedslund, Diakonhjemmet Hospital, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Oslo, Norway, for their thorough work in the AMSTAR II and Cochrane risk of bias assessments of the included studies.

PGC is funded in part by the National Institute for Health and Care Research (NIHR) through the Leeds Biomedical Research Centre.

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Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1

Handling editor Josef S Smolen

X @DrS_Battista

Contributors TM was the research fellow for the project, undertaking the SLR in cooperation with NØ. The fellow was supervised by the steering group consisting of NØ (convenor) and TPMVV (methodologist). NØ and TPMVV supervised the process of the SLR. NØ organised and chaired the TF meetings. TM drafted the manuscript with advice from NØ and TPMVV. All authors have contributed to the recommendations by participating in the TF meetings; during discussion and agreement on the recommendations; revising and approving the manuscript for publication.

Funding This study was funded by European League Against Rheumatism (HPR055).

Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Competing interests TPMVV was the Vice president EULAR health professionals 2020–2022 and is part of the EULAR Advocacy Committee 2020–present. MG holds a leadership position in OpenReuma/Spanish Association of Health Professionals in Rheumatology (unpaid). CDM received Grants from Versus Arthritis, MRC, NIHR (paid to Keele University) and is the director of the NIHR School for Primary Care Research. SL received payment as scientific consultant from Arthro Therapeutics AB and received payment from AstraZeneca as a member of DSMB. DC received grants from Fundação para a Ciência e Tecnologia SFRH/BD/148420/2019 and Pfizer (ID 64165707). GZ received payment for expert testimony from Casa di Cura San Francesco, Verona and Support for attending meetings and/or travel from Orthotech and Jtech, payment for participation on a Data Safety Monitoring Board or Advisory Board from VIVENKO for Gruenenthal and Ethos for Angelini and holds other financial interests related to clinical practice as an orthopedic surgeon (performing total joint replacement, arthroscopies and other types of surgeries), either directly from private patients or indirectly from the health system or insurances acting as a private consultant. JEV has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Lilly Netherlands BV. TG has received paid honoraria for lectures by Abbvie, Novartis, Boehringer Ingelheim, UCB, Berlin-Chemie/A. Menarini Bulgaria, Sandoz and received support for attending meetings by Abbvie, Pfizer and UCB. DW is an International Advisory Board Member of DRFZ (Germany) 2019–current and was the EULAR PARE Chair 2015–2017and an EULAR Vice President representing PARE 2017–2021.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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