Research Design and Setting
This was a cross-sectional quantitative study. The study was carried out in Taipei Tzu Chi Hospital. Taipei Tzu Chi Hospital was established in northern part of Taiwan in 2005 with a mission to safeguard life and to provide a comprehensive medical treatment for all, in particularly those with more challenged social determinants of health for services with 1000 beds.
Recruitment
A total of 759 questionnaires were sent to the clinical nursing staff of the Taipei Tzu Chi Hospital. The period of data collection was between May 4, 2017 and April 30, 2018.
Data Collection
Variables
The data were collected using a self-report questionnaire consisting of two sections: demographic information and job satisfaction. Demographic data obtained included gender, age, education level, religion, seniority among nursing staff, seniority among hospital staff, and time of any medical or human-related education and training received in the past six months. Anonymous questionnaires were surveyed among clinical nursing staff in general wards, intensive care wards, and oncology wards but excluded in outpatient, emergency, and other ward services to ensure consistency of work content.
Measures
The content of the questionnaire was discussed with six nursing experts, and the interviewee's (participant’s) understanding of the vocabulary was measured. The content of the questionnaire was constructed accordingly to consensus and presented so that participants were asked to respond according to the five-point Likert scale method (responses ranging from 1 to 5). Three nursing experts will conduct tests of expert validity according to predefined inspection items such as “clear meaning,” “related to the investigation content,” and “easy to answer.” The content validity index (CVI) values of each item were greater 0.8. There were a few items that were “easy to answer” or “exactly clear”, with corresponding CVI values less than 0.8, but the overall impact was small, indicating that the questionnaire had good content validity.
The questionnaire content designed based on theoretical predictions from Maslow's hierarchy of needs. Participants completed the questionnaire, which assessed participants along the following dimensions of Maslow's hierarchy of needs: (1) Physical needs, (2) Safety needs, (3) Love and belonging needs, (4) Esteem needs, (5) Self-actualization needs, (6) behind self-actualization needs, (7) medical humanities education relevance, and (8) retention relevance. Participants required to rate their degree of satisfaction about Maslow's hierarchy of needs from their job on a scale ranging from Strongly Agree (SA); Agree (A); Neutral (N); Disagree (D); Strongly Disagree (SD) which coding 1, 2, 3, 4, 5, respectively. We also conducted a pilot study with 30 employed nurses to investigate the reliability of the questionnaire. Cronbach’s alpha (α) for the overall questionnaire was .94. Cronbach’s α of each dimension was as follows:(1) physical needs, .75; (2) safety needs, .61; (3) love and belonging needs, .83;(4) esteem needs, .79; (5) self-actualization needs, .83; (6) behind self-actualization needs, .8; (7) medical and humanities education relevance, .94; and (8) retention relevance, .9. According to the results of the investigation, the scale used in this study has good reliability.
In the present study, the job satisfaction scale used items rated on a five-point Likert scale. It included 10 items related to job satisfaction that were: salary, total weekly working hours, safety in working environment, mutual assistance, acceptability of constructive advice, and learning resources and opportunities for growth. Its design was discussed with six nursing experts CVI of each related items are above .8. Participants were asked to rate their degree of satisfaction about their jobs on a scale ranging from Strongly Agree (SA); Agree (A); Neutral (N); Disagree (D); Strongly Disagree (SD) which coding 1, 2, 3, 4, 5, respectively. The 10 item job satisfaction scale produced an acceptable level of reliability (Cronbach’s α = .889).
Statistical Analysis
In this study, the relationships between facets of Maslow's hierarchy of needs were by using the Pearson's correlation test, and the correlation between each facet and any wish is discussed. We also performed simple and multiple regression analysis to investigate the impact of Maslow's hierarchy of needs on the retention of nursing staff in a faith-based hospital in Taiwan.
Pearson correlations were used to assess relationships between all variables in the model. Chi-square tests were used for category variables to detect the differences among the different groups. Linear regression analysis was used to examine the pattern of the relationships among all variables. Logistic regression analyses were used to investigate the association between the nurses’ characteristics and intention to stay the hospital. To assess model fit, we examined R-square and the p value of F statistic (<0.05) as fit indices. SPSS version 24.0 was used to perform descriptive statistical analysis.
Ethical approval
This study was performed in Taipei Tzu Chi Hospital from May 2017 to April 2018 and was coordinated by the superintendent offices of Taipei Tzu Chi Hospital and Buddhist Tzu Chi Medical Foundation. This study was approved by the Institutional Review Board of Taipei Tzu Chi Hospital (IRB number: 06-X10-026).