Job Satisfaction and Its Determinants Among Nurses at Tibebe Ghion Specialized Hospital, Bahir Dar University, Bahir Dar, Ethiopia.

doi:10.21203/rs.3.rs-4806502/v1

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Research Article

Job Satisfaction and Its Determinants Among Nurses at Tibebe Ghion Specialized Hospital, Bahir Dar University, Bahir Dar, Ethiopia.

https://doi.org/10.21203/rs.3.rs-4806502/v1

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Aim

The main goal of the study is to examine the level of job satisfaction and its determinants among nurses at Tibebe Ghion Specialized Hospital, Bahir Dar University, Bahir Dar, Ethiopia.

Methods

The research used a quantitative approach. Primary data was collected using an institutional-based cross-sectional study from 178 respondents through a simple random sampling technique. The data was collected from June 12–19, 2022. Demographic data and job-related satisfaction were measured using the Job Satisfaction Survey (JSS) by Paul E. Spector.

Results

The descriptive statistics of this study revealed that nurses at TIbebe Ghion Specialized Hospital are slightly satisfied, with a mean score of 3.3 and a satisfaction percentage of 56.5%. The study also showed that job satisfaction has a significant and positive correlation with the sex of the respondents, concluding that sex influences the overall job satisfaction level of nurses.

Job satisfaction

TIbebe Ghion Specialized Hospital

nurses

As a central point of view, 'Job satisfaction is more than how much the person enjoys the job tasks. It also depends on how important the job is to the person, and how well it fits in with their long-term aims (1). Job satisfaction, which refers to the overall relationship between an employee and the employer for which they are paid, is essential for adults because they spend most of their waking hours working on career development, which accounts for nearly 70% of all living person's developmental tasks. This will increase motivation at work and prevent frustration, anger, and in some cases, even depression (2).

Limited studies that address the job satisfaction of health workers have been undertaken in Ethiopia. The job satisfaction of health workers in developing countries in general, and in Ethiopia in particular, is very low (3). Even though there have been some studies conducted in different parts of the country related to job satisfaction those studies were done in different settings than ours, where there are significant differences in various parameters. Currently, nurses in TGSH seem to be less satisfied due to many unidentified factors, and hence, there is a constant threat of attrition. The nursing profession itself is also unable to attract an adequate number of new individuals due to factors mostly related to salaries, shift schedules, and the social perception of nurses. Nowadays, in Ethiopia, the number of nurses leaving their profession and trying to join other non-nursing fields is increasing (4).

Implications of the study (key massages)

What is already known about this topic? Limited studies addressing the job satisfaction of health workers have been undertaken in Ethiopia. Job satisfaction of health workers in developing countries in general, and in Ethiopia in particular, is very low. Why did this study need to be done? There is no documented study on the determinants of nurse job satisfaction at Tibebe Ghion Specialized Hospital. Nationally, a study done in Harar found that only 27.9% of nurses were satisfied (3). Another study in public health facilities across Ethiopia reported extremely low satisfaction levels among nurses for all items related to remuneration (ranging from 11.6–28.6%). Therefore, this study aims to assess the level of job satisfaction among nurses and its association with various work-related factors to identify the causes of their dissatisfaction. What does this study add? This study could provide updated and significant evidence to help reveal the causes of nurse satisfaction and dissatisfaction specifically in the study area. What are the implications of these findings for clinical practice and/or further research? The rationale for this study is to help, encourage, and motivate the concerned stakeholders to identify interventions that the organization should use to enhance and improve overall satisfaction. This, in turn, would indirectly improve the performance of nursing personnel, contributing to the achievement of the overall organizational goal of serving our community in a quality and standard manner.

Design, Periods, and Area

An institution-based cross-sectional study was conducted from June 12–19, 2022, to assess job satisfaction and its determinants among nurses at Bahir Dar University Tibebe Ghion Specialized Hospital in Bahir Dar. Bahir Dar is the capital city of the Amhara National Regional State, located 565 kilometers northwest of Addis Ababa, the capital city of Ethiopia. The total population of Bahir Dar is estimated to be 345,084, at an elevation of 1,800 meters above sea level (6). Tibebe Ghion Specialized Hospital is one of the top government-run hospitals in Ethiopia. According to the hospital's quality improvement team, it is one of the specialized hospitals in Bahir Dar city, along with Felege Hiwot Comprehensive Specialized Hospital.

Research Questions

What is the level of nurses' job satisfaction?

Do work-related factors determine nurses' job satisfaction?

What work-related factors correlate with overall job satisfaction?

Sample

It was determined using single population formula n = (Zα/2)² (p (p − 1))/d², Degree of precision d = 0.05.The proportion (p) = 67% (4).

Where; n = the required sample size, Z α/2 = the standardized normal distribution curve value for a 95% confidence level (1.96), d = degree of precision. The population correction formula; n/ (1+ [n/N]), was used since the target population was less than 10,000. By adding 111000% non-response rate the final sample size for this study was found to be 178. The sample was stratified based on their department and working area and from each strata members were drawn by using proportionally allocated ways. From each department and working area, the samples were taken randomly using a simple random sampling method.

Inclusion Criteria

All nurses who were at the hospital during the data collection period.

Exclusion Criteria

Nurses who weren’t at the hospital during the data collection period

Data collection tools

An institution-based cross-sectional study was employed through a pre-tested structured self-administered questionnaire divided into two sections that cover questions to assess socio-demographic and occupational characteristics, and components consisting of thirty-six job satisfaction questions from Paul E. Spector (Ph.D.) (7).

Data Quality Control

Since the study used a standard and internationally recognized questionnaire, there was no need for pretesting and other confirmations.

Patient and Public Involvement

No patients were involved in this study.

Data Processing and Analysis

First, all data were cleaned manually before being entered into the software. After cleaning, the data was inserted into SPSS version 26 for analysis. Overall satisfaction scores and analyses were calculated using the total of all individual responses with SPSS 26 and STATA 14.2. Descriptive statistics were conducted to describe the research population concerning important factors. Correlation analysis was employed to examine the relationships and the strength of these relationships between overall job satisfaction and its dimensions. Furthermore, logistic regression, specifically bivariate and multivariate logistic regression analysis, was used to identify the determinants of job satisfaction. To assess the relationship between the dependent variable and independent variables, correlation and binary logistic regression analysis were conducted. The outcomes are displayed using appropriate tables and pie charts in terms of frequency and percentage. The Hosmer and Lemeshow test and other post-estimation tests were used to assess the model fitness, and binary logistic regression was also used to assess the relationship between the variables

Socio-demographic Characteristics of Respondents

The demographic profile of the respondents is presented in this section. More than half, 86 (58.5%) of the respondents, were male nurses. A majority, 104 (70.75%), were in the age group 25–29, with the average age of respondents being 28.12 years. In terms of religious affiliation, 126 (85.71%) of respondents were followers of Orthodox Christianity, followed by Muslims (10.88%) and Protestants (3.40%) (Table 1).

Table 1

Description of Demographic Characteristics of Nurses at BDU/CMHS TGSH
Variables	Category	Frequency	Percent	Mean	SD	min	Max
Gender	Male	86	58.5%	-	-	-	-
Gender	Female	61	41.5%	-	-	-	-
Age (years)	<=24	4	2.72%
	25–29	104	70.75%
	30–34	34	23.13%
	>=35	5	3.40%
	-	-	-	28.12	2.59	24	39
Marital Status	Single/unmarried	81	55.1%	-	-	-	-
Marital Status	Married	66	44.9%	-	-	-	-
Educational Level	BSc degree	144	97.96%	-	-	-	-
Educational Level	MSc degree	3	2.04%	-	-	-	-
Religion	Orthodox	126	85.71%	-	-	-	-
	Muslim	16	10.88%	-	-	-	-
	Protestant	5	3.40%	-	-	-	-
Work Experience (Years)	< 5	144	77.5%
	5–10	31	21.09%
	> 10	2	1.36%
	-	-	-	3.8	2.17	0.5	10
Monthly salary	<=6193	66	44.90%
	6193–7071	57	38.78%
	7071–8017	18	12.24%
	8017–9056	4	2.72%
	9056–10150	2	1.36%
	-	-	-	6899.45	875.62	6193	11305
current working department	Medical	12	8.2%
	Surgery	14	9.5%
	Orthopedics	10	6.8%
	Pediatrics	9	6.1%
	ICU/NICU	32	21.8%
	Emergency	16	10.9%
	OPD	19	12.9%
	OR	29	19.7%
	Dental	1	0.7%
	TB	2	1.4%
	VCT/ART	2	1.4%
	Endoscopy	1	0.7%

Descriptive of analysis of the questionnaire

Approximately 58% of participants strongly disagreed with the statement, "I feel I am being paid a fair amount for the work I do," and 46% of participants strongly agreed with the statement, "The benefits we receive are as good as what other organizations offer" (Table 2).

Table 2

Descriptive Analysis of the Questionnaire and Participant Responses, 2023, Bahir Dar, Ethiopia
Items	Disagree Very Much	Disagree Moderately	Disagree Slightly	Agree Slightly	Agree Moderately	Agree Very Much
I feel am being paid a fair amount for the work I do.	85	29	19	8	4	2
I feel am being paid a fair amount for the work I do.	57.8%	19.7%	12.9%	5.4%	2.7%	1.4%
Rules are too few and far between.	21	35	37	31	9	14
Rules are too few and far between.	14.3%	23.8%	25.2%	21.1%	6.1%	9.5%
I feel unappreciated by the organization when I think about what they pay me.	30	30	29	14	15	29
	20.4%	20.4%	19.7%	9.5%	10.2%	19.7%
I am satisfied with my chances for a salary increase.	60	31	17	20	9	10
I am satisfied with my chances for a salary increase.	40.8%	21.1%	11.6%	13.6%	6.1%	6.8%
There is really too little chance for promotion on my job.	23	20	16	33	21	34
There is really too little chance for promotion on my job.	15.6%	13.6%	10.9%	22.4%	14.3%	23.1%
Those who do well on the job stand a good chance of being promoted.	40	33	29	34	6	5
	27.2%	22.4%	19.7%	23.1%	4.1%	3.4%
I am satisfied with my chances for promotion.	49	24	32	21	9	12
I am satisfied with my chances for promotion.	33.3%	16.3%	21.8%	14.3%	6.1%	8.2%
People get ahead here as fast as they do in other places.	44	27	30	32	10	4
People get ahead here as fast as they do in other places.	29.9%	18.4%	20.4%	21.8%	6.8%	2.7%
My supervisor is quite competent in doing his/her job.	28	22	30	42	16	9
My supervisor is quite competent in doing his/her job.	19.0%	15.0%	20.4%	28.6%	10.9%	6.1%
My supervisor is unfair to me.	38	26	30	30	14	9
My supervisor is unfair to me.	25.9%	17.7%	20.4%	20.4%	9.5%	6.1%
My supervisor show too little interest in the feelings of subordinates.	21	28	37	38	18	5
	14.3%	19.0%	25.2%	25.9%	12.2%	3.4%
I like my supervisor.	34	20	25	35	18	15
I like my supervisor.	23.1%	13.6%	17.0%	23.8%	12.2%	10.2%
I am not satisfied with the benefits I receive.	27	12	14	26	15	53
I am not satisfied with the benefits I receive.	18.4%	8.2%	9.5%	17.7%	10.2%	36.1%
The benefits we receive are as good as other organizations offer.	67	25	30	14	7	4
	45.6%	17.0%	20.4%	9.5%	4.8%	2.7%
The benefits program we have is equitable.	58	36	27	13	6	7
The benefits program we have is equitable.	39.5%	24.5%	18.4%	8.8%	4.1%	4.8%
There are benefits we do not have that we should have.	25	27	29	19	16	31
There are benefits we do not have that we should have.	17.0%	18.4%	19.7%	12.9%	10.9%	21.1%
When I do a good job, I receive the recognition for it that I should receive.	49	28	28	23	9	10
	33.3%	19.0%	19.0%	15.6%	6.1%	6.8%
I do not feel that the work I do is appreciated.	24	29	32	28	11	23
I do not feel that the work I do is appreciated.	16.3%	19.7%	21.8%	19.0%	7.5%	15.6%
There are few rewards for those who work here.	45	29	27	26	13	7
There are few rewards for those who work here.	30.6%	19.7%	18.4%	17.7%	8.8%	4.8%
I don’t think my efforts are rewarded the way they should be.	18	26	31	28	22	22
	12.2%	17.7%	21.1%	19.0%	15.0%	15.0%
I find I have to work harder at my job because of the incompetence of people I work with.	22	24	38	37	13	13
	15.0%	16.3%	25.9%	25.2%	8.8%	8.8%
I like the people I work with.	10	7	17	36	42	35
I like the people I work with.	6.8%	4.8%	11.6%	24.5%	28.6%	23.8%
There is too much bickering and fighting at work.	24	28	30	37	13	15
There is too much bickering and fighting at work.	16.3%	19.0%	20.4%	25.2%	8.8%	10.2%
I enjoy my coworkers.	10	14	31	39	32	21
I enjoy my coworkers.	6.8%	9.5%	21.1%	26.5%	21.8%	14.3%
My efforts to do a good job are often blocked by red tape.	11	20	43	46	13	14
My efforts to do a good job are often blocked by red tape.	7.5%	13.6%	29.3%	31.3%	8.8%	9.5%
I have too much to do at work.	6	10	21	43	34	33
I have too much to do at work.	4.1%	6.8%	14.3%	29.3%	23.1%	22.4%
Many of our rules and procedures make doing a good job difficult.	11	16	34	38	24	24
	7.5%	10.9%	23.1%	25.9%	16.3%	16.3%
I have too much paperwork.	20	22	45	27	21	12
I have too much paperwork.	13.6%	15.0%	30.6%	18.4%	14.3%	8.2%
I like doing the things I do at work.	14	18	21	38	28	28
I like doing the things I do at work.	9.5%	12.2%	14.3%	25.9%	19.0%	19.0%
I have a sense of pride in doing my work.	16	17	33	38	22	21
I have a sense of pride in doing my work.	10.9%	11.6%	22.4%	25.9%	15.0%	14.3%
My job is enjoyable.	32	24	34	25	19	13
My job is enjoyable.	21.8%	16.3%	23.1%	17.0%	12.9%	8.8%
I sometimes feel my job is meaningless.	37	24	30	21	22	13
I sometimes feel my job is meaningless.	25.2%	16.3%	20.4%	14.3%	15.0%	8.8%
The goals of this organization are not clear to me.	21	18	30	24	21	33
The goals of this organization are not clear to me.	14.3%	12.2%	20.4%	16.3%	14.3%	22.4%
I often feel that I don’t know what’s going in with the organization.	15	24	21	37	23	27
	10.2%	16.3%	14.3%	25.2%	15.6%	18.4%
Work assignments are not fully explained.	16	17	34	31	29	20
Work assignments are not fully explained.	10.9%	11.6%	23.1%	21.1%	19.7%	13.6%
Communication seems good within this organization.	41	33	27	16	16	14
Communication seems good within this organization.	27.9%	22.4%	18.4%	10.9%	10.9%	9.5%

Perceived Overall Job Satisfaction

Total satisfaction score accordingly, the descriptive statistics showed in Fig. 1

Satisfaction of nurses with the facet of JSS

Overall satisfaction of the respondent regarding payment was 59.3% with a mean score of 2.966 which indicates that the respondents were dissatisfied with their payment.

Payment, Promotion, Coworkers, Supervision, Fringe Benefits, and Contingent Rewards

The overall satisfaction of the respondents regarding payment was 59.3%, with a mean score of 2.966, indicating that the respondents were dissatisfied with their payment. The average scores of various evaluation questions revealed that the majority of respondents were dissatisfied with the limited opportunities for promotion, with a mean score of 3.24 (64.8%). The satisfaction level of the respondents towards supervision was 71.7%, with a mean score of 3.6. The majority of respondents were dissatisfied with the benefits, scoring 2.99 (59.8%). However, 71% of nurses working in TGSH were satisfied with contingent rewards, with a mean score around 3.5. The total satisfaction of the respondents concerning coworkers was 79%, with a mean score of 3.95.

Operating Procedures, Nature of the Work, and Communication About 65.6% of the respondents were dissatisfied with the hospital's operating procedures, with a mean score of 3.28. The respondents were satisfied with the nature of their work, with a satisfaction percentage of 73% and a mean score of 3.65. The overall mean score for communication was 3.12, indicating dissatisfaction, with a percentage of 62.4%. Communication was 3.12 which means they are dissatisfied with a percentage of 62.4%. The full result presented as followed in the table 15.

Correlation analysis and goodness of fit

Since these six Likert scales are treated as interval scales to conduct statistical analysis (8) and for the correlation analysis of such interval scale measurement data’s Pearson correlation is used. (9) In the table below, the correlation coefficients between overall job satisfaction and its dimensions illustrate as there is positive but different strength of associations.

Overall, the positive and significant correlation between job satisfaction and each work related factors except coworker which implies that when the satisfaction level of employees increases for each dimension, the overall job satisfaction level or score of nurses increases.

Variables		1	2	3	4	5	6	7	8	9	10
Job satisfaction	Pearson Correlation	1
Job satisfaction	Sig. (2-tailed)
Payment	Pearson Correlation	.369^**	1
Payment	Sig. (2-tailed)	.000
Promotion	Pearson Correlation	.560^**	.414^**	1
Promotion	Sig. (2-tailed)	.000	.000
Supervision	Pearson Correlation	.290^**	.036	.133	1
Supervision	Sig. (2-tailed)	.000	.666	.108
Fringe benefits	Pearson Correlation	.584^**	.273^**	.427^**	.153	1
Fringe benefits	Sig. (2-tailed)	.000	.001	.000	.065
Contingent reward	Pearson Correlation	.381^**	.125	.168^*	.039	.424^**	1
Contingent reward	Sig. (2-tailed)	.000	.131	.042	.637	.000
Coworker	Pearson Correlation	− .032	− .186^*	.002	.191^*	− .192^*	− .158	1
Coworker	Sig. (2-tailed)	.699	.024	.985	.020	.020	.056
Operating	Pearson Correlation	.232^**	.085	.170^*	.148	.319^**	.139	− .191^*	1
Operating	Sig. (2-tailed)	.005	.308	.039	.074	.000	.094	.021
Nature	Pearson Correlation	.240^**	− .125	.073	.143	.023	− .044	.221^**	− .165^*	1
Nature	Sig. (2-tailed)	.003	.132	.377	.084	.784	.597	.007	.046
Communication	Pearson Correlation	.543^**	.266^**	.309^**	.113	.443^**	.281^**	− .197^*	.206^*	.112	1
Communication	Sig. (2-tailed)	.000	.001	.000	.171	.000	.001	.017	.012	.176

**. Correlation is significant at the 0.01 level (2-tailed).

*. Correlation is significant at the 0.05 level (2-tailed).

Table 13: Correlations Matrix of job satisfaction with its dimension of nurses at BDU/CMHS TGSH

Regression Analysis

Binary or dichotomous dependent variables are modeled using logistic regression, commonly known as a binary logistic model. The primary justification for using this model in this study is because the dependent variable's value is a binary outcome with unsatisfied and satisfied being represented by 0 and 1, respectively. The factors that affect job satisfaction were found using binary logistic regression analysis. Each variable's average marginal effect was calculated, along with its matching standard error and 95% confidence ranges. To designate a variable statistically significant when paired with the dependent variable, a P-value of 0.05 with a 95% confidence interval was used.

The factors associated with job satisfaction of nurses

In bivariate logistic regression analysis, sex and age category of respondents were fitted to multivariable logistic regression at p-value of < 0.25. In computation of multivariable logistic regression analysis, sex of the respondents was found to be significantly associated with overall job satisfaction of nurses. At p-value < 0.05, as shown in table 15 there are variables that affect the overall job satisfaction level of nurses although the statistical significance level of each variable is different. This implies that female’s nurses had 0.380 times the odd of being satisfied with their job than males (AOR = 0.380, 95% CI: 0.187, 0.774). This implies that for a one-unit change in a nurse's mean satisfaction score in pay, the probability of the overall Job satisfaction status of nurses being satisfied increases by 0.380.

Job satisfaction of nurses
Variables	Satisfied	Not satisfied	COR (95%CI)	AOR (95%CI)	P-value
Sex
Female	42	19	0.412 (0.207, 0.820)*	0.380 (0.187, 0.774)*	0.008*
Male	41	45	1.00	1.00
Age
<= 24	3	1	0.750 (0.032, 17.506) 0.270 (0.029, 2.498) 0.458 (0.046, 4.578)	0.521(0.021, 13.030) 0.244 (0.025, 2.345) 1.491(0.047, 5.082)	0.692 0.222 0.555
25–29	54	50
30–34	22	12
>= 35	4	1	1.00	1.00

Note: *Significant at p < 0.05

Research on nurse satisfaction is crucial, as nurses form a significant and growing part of the healthcare sector. This study aimed to fill a notable gap in the existing knowledge on nurse job satisfaction. The primary objective was to assess the overall level of job satisfaction and identify the factors affecting nurses in Bahir Dar, BDU/CMHS-TGSH. The study found that the overall job satisfaction level among nurses was 56.5%. This finding is comparable to studies conducted in Jimma, Ethiopia (51.3%) (10), Italy (58.5%) (11) and turkey (58%) (12). On the other side, it is higher than studies conducted in Nepal (36.8) (13), Iran (47.9%) (14), Harari (44.8%) (3), Kenya (33%) (15) and Pakistan (41%) (16) but lower than the study done in Poland (84.5%) (17). Discrepancies may be due to differences in study settings, respondents' educational backgrounds, measurement tools, salaries, and currency conversion rates. Another objective was to determine the impact of sociodemographic characteristics on job satisfaction. A statistically significant association was found between the respondents' sex and job satisfaction, indicating that being female positively influences job satisfaction. This finding aligns with a study in Nepal (13) with the finding that being female has a positive factor towards job satisfaction of nurses.

Job satisfaction is a critical concern for delivering high-quality nursing care. Higher job satisfaction among nurses ensures better healthcare services and enhances their commitment to their careers. This study examined the major elements of job satisfaction among nurses at TGSH. On average, nurses reported a job satisfaction rating of 3.3 out of 6, indicating that 56.2% of nurses are moderately satisfied with their work. The study highlighted the significant role of gender in increasing job satisfaction. The results are consistent with investigations conducted in other countries. A strong correlation was also found between work-related factors and job satisfaction. Given that job satisfaction can impact the overall efficacy, effectiveness, and sustainability of the health system, addressing inadequate satisfaction is essential. Various direct and indirect elements of satisfaction may affect organizational outcomes.

ALT	Alanine transaminase
AST	Aspartate transaminase
CR	Creatinine
DBP	Diastolic blood pressure
HDP	Hypertensive disorder of pregnancy
HELLP	Hemolytic elevated liver function and low platelet count
PLT	platelet
SBP	Systolic blood pressure
SSA	Sub-Saharan Africa

Authors’ contribution

Seid muhammed developed the proposal, analyzed the data, and wrote and interpreted the result and also drafted the manuscript, checked the data, and revised the manuscript and approved the final manuscript

Ousman Adal prepare the manuscript and revised the overall quality of the manuscript.

Funding: No funding sources are available yet.

Availability of data and materials

The data that support the findings of this study are available upon reasonable request from the corresponding authors.

Ethical approval and consent to participants

The ethical review board of the College of Health Sciences Bahir Dar University approved this study. Certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent for publication: not applicable

Competing interest

There is no competing interests.

Acknowledgements

The authors are grateful to the advisor, data collectors, emergency coordinators, and all study participants for their contributions to the study's success.

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No competing interests reported.

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Job Satisfaction and Its Determinants Among Nurses at Tibebe Ghion Specialized Hospital, Bahir Dar University, Bahir Dar, Ethiopia.

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Abstract

Aim

Methods

Results

Figures

INTRODUCTION

Implications of the study (key massages)

METHODS

Design, Periods, and Area

Sample

Inclusion Criteria

Exclusion Criteria

Data collection tools

Data Quality Control

Patient and Public Involvement

Data Processing and Analysis

RESULTS

Socio-demographic Characteristics of Respondents

Descriptive of analysis of the questionnaire

Perceived Overall Job Satisfaction

Satisfaction of nurses with the facet of JSS

Payment, Promotion, Coworkers, Supervision, Fringe Benefits, and Contingent Rewards

Correlation analysis and goodness of fit

Regression Analysis

The factors associated with job satisfaction of nurses

DISCUSSION

CONCLUSION

Abbreviations

Declarations

References

Additional Declarations

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