Previous studies(23, 24) have shown that many factors, such as age, remuneration, educational level, working pressure, are influencing factors of job satisfaction. This study aimed to review the satisfaction of township health center staff and the associated factors in Huangpi. Township health centers serve as a central hub in primary health care in rural areas of China. Improving satisfaction is of great significance for the provision of high-quality medical services.
In the present study, there was a significant correlation between marital status and job satisfaction. Married (living with a spouse) had the highest satisfaction, followed by married (not living with a spouse), and the lowest was divorce or widowhood. The study results of Mirzraie was in accordance with our study (25). Similar study have shown that young age, being female and being married were significantly associated with a higher level of job satisfaction by Narge et al(26). However, there was no significant correlation between marital status and score of overall job satisfaction in the study of Hossein (27). Hossein divided marital status into three categories (married, single, other), while we subdivided it into four categories including married (living with spouse), married (not living with spouse), unmarried, divorced/widowed. The single status is divided into unmarried and divorced / widowed, these are two different states and the corresponding age groups varies greatly, the married state are classified as living with the spouse or not. We infer that simply dividing marital status into married and single is not conducive to finding the relationship between marital status and job satisfaction.
Healthcare staff who had a professional status of lower than primary were less likely to be satisfied with their job than the respondents with senior or deputy professional status. Similarly, a previous study has have shown that higher salary and having more leadership roles were independently associated with higher career satisfaction(28). However, a study in Guangdong Province conducted by Yong Lu(21) pointed out that empolyees with a higher professional status were less likely to be satisfied with their job than those with lower status. Participants of the above studies consisted of various types of health centers, including tertiary public hospital which undertake a large number of heavy health tasks, while our research included only medical staff of township health centers. A study have shown that medical staff in tertiary hospitals undertake the heaviest workload among those in health facilities of different levels which adversely affect the overall job satisfaction and could also develop into higher stress rating and burnout syndrome (29). This also explains why staff who work too long hours per week are less satisfied in our study. Another possible explanation is that in China, professional titles are usually associated with status and income. Staff with low professional titles enjoy less reputation and income than those with high professional titles.
This study found that the level of satisfaction was relatively higher among highly paid staff and this was consistent with a number of previous studies (30–32). A study(33) among pharmacy in Maryland reported that low satisfaction with salary as a reason for intending to leave an employer. Health care staff pay more attention to remuneration because it has a direct impact on their quality of life. According to a study by Nomura Y (34), salary was only the determinant for the dental hygienists who strongly disliked their work. One reason for this discrepancy may originate from the national insurance system of Japan; the Japanese insurance system covers a wide range of dental treatments, and the treatment fees are not expensive.
The result that staff who are employed on a long-term basis are more satisfied than those employed on a temporary basis was in line with other study (35). According to Simone's research (36), temporary contracts form can increase worker's vulnerability to work-related stress and therefore influence the job satisfaction. Thereby, we speculate that temporary contracts are linked to higher job insecurity. There was no significant difference in job satisfaction between personnel agents and long-term employees, combined with the actual situation of China's public medical institutions, we surmise that it is likely to be related to the fact that personnel agency system in many aspects, such as salary, performance, and benefits, has no obvious difference with long-term employees.
In terms of the association between the parents' job stability and job satisfaction, it was found that higher satisfaction with parents having a stable job. Those whose parents have stable jobs often mean less time and financial cost in caring for elderly parents. Similar results are reported in Linda' s study (37). Another explanation is that parents with stable jobs partly means less work-family conflict and can provide more internal support from family, thereby, job satisfaction is higher than those whose parents’ job is not stable.
Employees who has a moderate working hours per week reported higher levels of job satisfaction than those who work too long. Previous studies (38, 39) have also shown a negative correlation between extended work hours and job satisfaction as a whole. A possible explanation is that long working hours tend to be associated with higher workloads and higher stress levels. And compared with working too few hours, moderate working hours promote proper work enthusiasm and positive work stress.
There are a few limitations we must be open to acknowledge in this study. First, the representativeness of this sample is limited, as our sample was from the health centers in each township. Second, the questionnaire used in this study was self- administrated according to the conditions of Huangpi and has only been used in this district. Third, some of the questions such as income and work hours asked in this study were self-reported and may have generated less reliable responses. Fourth, the results only reflected the situations in Huangpi, and might not adapt to other regions due to differing implementation of policy and health system reforms across. However, the results were useful for reflecting the satisfaction situation of Huangpi especially under the reform background of health union in Huangpi District. Fifth, as the study was a cross-sectional design, the causal effects of job satisfaction could not be determined. Further study is perhaps needed for measuring the effects.