Farhad Jafari¹, Seyed Ehsan Beladian Behbahan², Fatemeh Azami³, Maryam Gharahgozloi⁴ and Behzad Tadayyon⁴

¹Department of Health and Social Medicine, School of Medicine, Shahed University, Tehran, Iran.

²Department of Health and Social Medicine, School of Medicine, Shahidbeheshti University, Tehran, Iran.

³Ministry of Agriculture, Tehran, Iran.

⁴MD.,Tehran,Iran.

DOI : https://dx.doi.org/10.13005/bpj/446

Abstract

Job satisfaction and its contributing factors are critical subjects to be surveyed in organizations. These assessments for health care workers are of great importance because they deal with patients and, on the other hand, this working group is in hard work category. This study aimed to determine the job satisfaction among personnel of teaching Hospitals in Tehran. In a descriptive analytical study on 420 hospital employees (53.3% male), a job satisfaction questionnaire including 40 questions in 10 different aspects, was utilized. The data was analyzed using descriptive and inferential statistics in SPSS software. Most subjects (46.5%) were in 30-39 years age group and had 10-19 years service record (48.5%). Overall, 71.9% of the respondents were dissatisfied with their jobs. The level of satisfaction about “payments and benefits” (90.4%) and “policy management” (90%) was lower than the other aspects. There was a significant lower satisfaction among women than men, nurses, official employees, personnel with upper education and individuals whose spouse had higher education. The results of our study emphasize on the need for more attention to increase the level of job satisfaction in Hospital employees which includes various areas, particularly the payments and benefits.

Keywords

Job Satisfaction; Hospital Staff; Teaching Hospital

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Copy the following to cite this article: Jafari F, Behbahan S. E. B, Azami F, Gharahgozloi M, Tadayyon B. Staff’s Job Satisfaction Survey in Tehran’s Teaching Hospitals. Biomed Pharmacol J 2014;7(1)

Copy the following to cite this URL: Jafari F, Behbahan S. E. B, Azami F, Gharahgozloi M, Tadayyon B. Staff’s Job Satisfaction Survey in Tehran’s Teaching Hospitals. Biomed Pharmacol J 2014;7(1). Available from: http://biomedpharmajournal.org/?p=2821

Introduction

A job satisfies individuals’ financial needs. It also has a profound effect on their self-evaluation, identity as well as their self-esteem. Each employed person spends most of his awaking hours at work (1). In addition, the workforce is regarded as the most valuable investment of any organization; and the success of  each organization  depends upon how content its employees are with their jobs (2). Therefore, providing satisfactory for employees is one of the organizational goals (2). Job satisfaction is defined as employees’ positive emotional assessment and perception towards their jobs'[1]. Some studies have shown that job satisfaction increases the worker’s commitment to the organization and their cooperation towards organizational goals which results in customer satisfaction as well as an increase in productivity and profitability of the company. Unfortunately, the opposite is also true; In the case of poor working conditions, staff turnover may happen, and or this has an adverse effect on the quality of the services and products. However, job satisfaction could prevent the prevalence of the burnout among workers (3, 4). The earlier studies have indicated that what makes people satisfied with their jobs is not only the job itself, but also its prospects. So, job satisfaction is a complex process which creates workers incentives and affects their professional decision- making, personal health as well as their interpersonal communication (5, 6).

Job satisfaction is correlated with cultural, fundamental, environmental and individual aspects. Different factors have impact upon job satisfaction, such as the inner aspects like being familiar  with the job, the type of work and their responsibility towards the job and the outer aspects such as working condition, organizational policies as well as paying which directly  or  indirectly, influences worker’s job satisfaction (7).

Organizations which provide people with medical care, are of critical importance since they have sensitive responsibility for preventing diseases from spreading and catering for the patients as well as giving them medical treatment (8). Hence the job satisfaction of the medical profession is immensely important and thus creating motivation in the workers in this field is regarded as one of the most important and challenging tasks of a manager (9). Many studies have been conducted into professional satisfaction among health care workers which indicated that the job satisfaction among these groups is between 22.4% to 60% (10, 11). Most of health workers have very little job satisfaction which has a direct impact on their work behavior such as changing shifts, absenteeism or poor performance (12). Job satisfaction among these groups of people can, therefore, has an impact on the quality of health services. Similarly, according to some researches, the job satisfaction among medical practitioners is associated with patient satisfaction (13, 14). The performance of the hospitals’ personnels is so important that in many countries, hospitals are ranked according to their personnels’ performance and the provided services of  hospitals are according its ranking (15-17).

In several countries, various studies have been carried out in order to assess job satisfaction’s level in different organizations and wards. This research that was conducted on one of the main medical care, providers aimed to determine the contributing factors in job satisfaction as well as putting forward suggestions based on research findings for increasing the level of hospital worker’s job satisfaction through improving all aspects of their job.

Materials and Methods

This descriptive cross-sectional study was conducted on 420 hospital personnels of teaching hospital located in Tehran. Informed consent was obtained from all participants before the study began and their identities were remained confidential; Also they were reassured that their personal details were treated as confidential. Before starting the program, the subjects were explained by procedure and objective of the study. The appropriate people for this study are the one who had at least one year work experience in a hospital. All subjects participated voluntarily and were allowed to pull out of the survey at any time. The researcher’s questionnaire consisted of 40 questions in which demographic data as well as the level of satisfaction with each aspects of the job were asked. Content analysis methods were employed to validate the questionnaire and content analysis methods.  The other test was done on 30 people after a period of two weeks which gave a Cronbach alpha of 0/76.  Its validation and accuracy were confirmed. Choices of the questions were according to Likret 4-point scale (totally dissatisfied, dissatisfied, satisfied and totally satisfied).

The level of people’s satisfaction was assessed in 8 different aspects of the job: 1. working condition (8 questions); 2. Relationship with colleagues (3 questions); 3. Payments and benefits (5 questions); 4. Working overtime (3 questions) 5. Job security (4 questions); 6. Management supervision (6 questions); 7. Management policies (2 questions); 8. The relationship between work and personal life; the overall score in the mentioned aspects was set as the satisfaction score which fluctuated from 0 to 4 for each person (and in overall).

They were also asked about their satisfaction with on-the job training and the quality of the teaching hospitals; they were also required to express their overall satisfaction with their jobs considering all aspects.

The input data was analyzed using SPSS software 16. To describe the data, the number of occurrences, percentage and overall scores, negative and positive were utilized and for the statistical analysis tests such as Chi squire, T test, and variance and regression analysis were used.

Results

In this research, 100 out of 520 eligible people excluded because of different reasons  such as concerning about losing their jobs, not believing in  research findings’ effectiveness, lack of motivation as well as not having the time or the inclination to fill in the questionnaire. As a result, just 80.7% of the questionnaires were completed. First table indicates the demographics of the respondents. From these 420 people, 224 (53.3%) were men and 196 (46.7%) were women. Workers’ main positions (71.9%) were customer services workers (22.8%), nurses (20.6%), office staff (%14.4) and careers (14.1%). Non-medical experts, hospital technicians and nursing assistants (each 7.7%), caretaker, hospital technical personnel and head nurses (5% altogether) comprised the other positions. 39.1% of them had higher education and most of the staff worked in morning shifts (40.7%) and 35.2% of them did work shifts.

Most subjects (46.5%) were in 30-39 years age group. Nearly half of them (48.5%) had 10-19 years of service. 38.8% of the staff was on a full-time and permanent basis and 25.1% were on a temporary basis. 62 people (14.9%) had a second job and 25% of the personnel stated that they worked overtime in the hospital.

According to the data, 219 of the staff lived in rented accommodation. 80.9% of the subjects were married and 83% of them had one to three children. The spouses of the male employees in 70.5% of the cases were housewives and those of female employees in 54.3% of the cases were clerks. 14.6% of the male workers’ and 39.4% of the female workers’ spouses had higher education qualifications.

Table 1: Demographic data of the subject

		Number	Percentage
Sex
	Male	196	49.7%
	Female	224	53.3%
Age Group
	30-39	195	14.3%
	40-49	136	32.4%
	50+	29	6.9%
Education
	BA	125	29.8%
	Further Education	39	9.3%
	High school	114	27.1%
	Basic education	134	31.9%
	Illiterate	8	1.9%

In second table, the overall satisfaction score for each aspect has been shown. According to the results, ‘payments and benefits’ account had the highest level of dissatisfaction and relation with co-workers was the most satisfying aspects of the job. According to the results of the research, the level of dissatisfaction with different areas of the job is as follows: ‘payments and benefits'(90.9%), ‘management policy’ (90%), ‘management supervision’ (85%), working conditions (81.6%), on-the job training (80.1%), working overtime (78%), correlation between work and personal life(75%), the quality of the training hospital (72.9%), job security (58%) and the relations with colleagues (41.7%).

Table 2: Satisfaction overall score in Eight areas

Aspects of the satisfaction	Percentage (%)	Overall satisfaction score ± Positive/Negative	The lowest level of satisfaction in each aspects	The highest level of satisfaction in each aspects
Work environment	18.4%	1.21±0.53	The quality of the provided food	Available facilities for working
Relationship with colleagues	58.3%	2.28±0.92	Personal relationship with co-workers	Superior workers’ relationship with subordinate workers
Payment and benefits	9.06%	1.01±0.65	Allocated benefits for hard work	Perks
Overtime	22%	1.39±0.88	The amount of overtime pay	Overtime hours
Job security	42%	1.11±0.68	Inequality and discrimination	Insurance
Management supervision	15%	1.15±0.72	Recognition and reward	The availability of managers in time of need
Management policies	10%	1.05±0.79	Support from managers	involving the employees in making-decision process
The relation of the job with personal life	25%	1.39±0.08	leisure activities and pilgrimage	Condition for Paid leave
Total Satisfaction	28%	1.32±0.50

Totally, 19.5% of the people were dissatisfied with on-the job training and 27.4% of them  with teaching hospitals’ quality. Regarding the question in which the respondents were asked to express their overall satisfaction considering all factors and aspects, 71.9% were dissatisfied with their jobs and only 28.1% expressed satisfaction.

Overall satisfaction score in women (1/22) were significantly lower than in men (1/42) (001/0>p).

Nurses were more dissatisfied with their job than other positions. The highest level of satisfaction was seen among service workers. The type of employment has an effect on workers satisfaction (0.014) – official employees expressed the highest level of dissatisfaction. Statistically, those with basic education were considerably more satisfied than those with higher education (p=0/029). Those whose spouses had a better education expressed a higher level of dissatisfaction (p=o/oo4). The job of the spouse influenced the workers’ satisfaction (p=0/003).Job satisfaction is not significantly related to the age, marital status, the number of the children, years of service, working shift, having a second job or type of accommodation(p>0/05).

Regression line forward was used to determine the effect of the independent area. Table 3 gives information about the effect of each area in isolation on satisfaction.

Table 3: Results of the Regression analysis

Independent variable	Regression coefficient	P value	The confidence	R2
Sex	0.2	0.000	0.10 – 0.29	0.39
Marital status	-0.89	0.045	-0.176 –  –0.002	0.001
Position	0.18	0.018	0.003 – 0.033	0.013
Type of employment	0.38	0.027	0.004 – 0.071	0.012

Discussion

Job satisfaction plays a significant role in someone’s working life and has a great effect on personal satisfaction. This is particularly important when it comes to medical-related professions. Hospitals are the organizations whose purposes are improving people’s general health, preventing and treating diseases as well as alleviating patients pains and sufferings; and since those working in a hospital play a crucial role in improving and reforming medical care and treatment (9), health authorities should give particular attention to their needs and demands . A survey conducted in Germany demonstrates the strong association between hospital staff’s job satisfaction and patient satisfaction. Competency and motivation are two factors that have a profound impact on health workers’ performance. It is said that different individuals have different expectations when it comes to monetary rewards.

In our research, the highest level of dissatisfaction was ‘pay and benefits’. Similar researches in Iran had  the same results (18, 19) According to the personnel; nearly 25% of them worked overtime in the hospital and 15% of them were out of the hospital. Other studies had the same results. A study that was carried out in Imam Khomeini Hospital in 1379 revealed a strong association between working overtime and the prevalence of depression among the nurses in this hospital (20). According to labor law for health category, working more than one shift is not recommended and where the workers have no choice – which drives from their needs  for the family’s providing – it is better at least to be done in their main workplace because of stressful and difficult condition of works  (specially for nurses). Also working overtime and the resultant burnout could affect their productivity as well as their temperament in their main workplace.

Nearly half of the workers lived in rented accommodation. In a survey that conducted in 1384 in two teaching hospitals in Birjand, only 54.2% of nurses lived in private accommodation (18). In the study that was carried out in two hospitals in Tehran also only 38.6% of nurses had private accommodation (21).

The study that was conducted by Masoud Asl and his colleagues indicated that giving attention to 6 factors ‘good work environment’, ‘job security in the organization’, ‘official rules and regulations’, ‘reasonable payment’, ‘having a sense ad responsibility towards the job’, ‘interest I the work’ and ‘being successful in the job’ could have an effect on workers’ performance (22). A rise in payment, sufficient facilities for training and opportunity for advancement in the job could increase the level of job satisfaction (23).

The highest satisfaction was ‘the relationships with co-workers’. This could be due to the fact that the hospital is the smaller one and therefore the staffs have more connection with each other. Hence providing a friendlier environment could be employed to enhance productivity and help achieve organizational goals as well as raising workers’ satisfaction.

With regard to working environment, as the quality and quantity of the provided food and the condition of the self-service canteen accounted for the highest level of dissatisfaction, to satisfy personnel’s basic needs, the organization should reconsider their food provider and make an effort to better self-service conditions. In terms of job security avoiding inequality and discrimination against employees could minimize dissatisfaction in this area. Finally, as some researches confirmed dissatisfaction with leisure activities, reconsideration and reform of the existing rules in this area is highly crucial (24, 25).

Therefore, pay and benefits’ is one of the most important factors when it comes to employees’ satisfaction. There is no escaping the fact that salary is regarded as a very strong motivation. Nevertheless, if the payments are not according to a fair and standard system based on the position level, it could cause employees remitting dissatisfaction (26).

Job satisfaction like other variables is caused by some factors and influences some other factors.

Job satisfaction is an independent variable which has an influence on dependent area such as productivity, absenteeism, moving workplace, turnover, worker’s social behavior, worker’s behavior towards their family and to some extent their outlook towards social, cultural, political, etc. matters. On the other hand, is a dependent area that is influenced by some independents factors such as payments and benefits, relationship between co-workers and managers, job security and type of job. It is true that the amount of the salary is one of the most motivating factors when it comes to job satisfaction, but other factors for example, interesting job, the room for creativity in the job, the importance of the job and the respectfulness in the work environment are also have a great impact on job satisfaction.

Competent, approachable, available, courteous, flexible, etc. supervisor or manager could also increase employees’ job satisfaction (27).

Conclusion

Authorities should consider taking some measures to improve working areas that these workers, according the study, dissatisfied with -considering the difficulty of the job- such as the pay and benefits as well as working overtime. This point becomes more significant with Adams’s equity theory. According to this theory, employees compare their own pay with  other colleagues; this comparison may lead them to come to the conclusion that the organization treats the employees unfairly and leave them feel being discriminated (28). This could happen in different countries and different organizations.

Hopefully, this research finding makes the authorities take necessary action to raise job satisfaction among health care workers which directly and indirectly has an impact on services in hospitals.

Acknowledgment

We would like to take this chance to thank the managers of the teaching hospitals and other people who helped us to collect data for this research.

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