Abstract
Background
Working conditions and emotional health of healthcare workers (HCWs) are essential aspects in the delivery of qualified health services. This study aimed to explore the working conditions and the experienced positive and negative emotions among HCWs in Upper Egypt.
Methods
A cross-sectional study was conducted among HCWs in Aswan University Hospital. The studied population included 400 HCWs (215 nurses and 185 physicians). Data was collected using an interviewer-administered questionnaire. It inquired about demographic and job characteristics, working conditions, and the positive and negative experiences of HCWs.
Results
Physicians had significantly higher mean values of the total poor working conditions scale and all its domains than nurses except relationships with similar co-workers. HCWs of surgical specialty have significantly worse perceptions of total working conditions than those of medical specialty. There was no significant difference in mean values of positive and negative experience and affect balance scales between physicians and nurses (P > 0.05). The adjusted linear regression models revealed being a physician was a significant predictor of poor working conditions. The increase in age was a significant positive predictor of affect balance score. Poor working conditions and the affect balance were significantly positively intercorrelated with each other.
Conclusion and recommendations
Poor perceptions of working conditions were perceived by physicians more than nurses and by HCWs in surgical than in medical specialty. Poor working conditions and the affect balance have a positive impact on each other. There is a necessity for improving the working conditions of HCWs especially physicians in Upper Egypt. This improvement may enhance HCWs’ positive emotions.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12913-026-15238-y.
Keywords: Working conditions, Healthcare workers, Positive and negative emotions, Egypt
Introduction
The concept of working conditions has been defined by the World Health Organization as the environment in which individuals perform their work including all physical and psychological factors and the circumstances affecting labour in the workplace [1, 2].
In healthcare facilities, adverse working conditions include hard working environments, high workload in patient care, inadequate personal time, poor human relationships with lack of recognition and support from managers, supervisors, or colleagues; and presence of an organizational culture that places institutional benefits above patients [3, 4].
Daily health care system-related challenges facing healthcare workers (HCWs) in their work are not limited to aspects of medical practice and patient care. The reported HCWs’ challenges include large amount of paperwork, scarce time, documentation and practice management, limited resources, feeling undervalued and financial concerns [5].
Unfavorable working conditions can affect a healthcare worker’s health. HCWs’ health conditions are important in provision of health care services because they can affect the work performance and patients’ safety. Reduction in working time for physicians and nurses has been considered in United States and European Union as one of the aspects of patients’ safety and physicians’ health [4].
As health care facilities are stressful work environments, physicians and nurses are an important high-risk group for work stress and unfavorable working conditions [6]. Work stress results when there is a lack of matching between job requirements, available resources, and personal abilities. This in turn causes bad mental and physical health, in addition to decreased productivity and work achievements [7].
Work-related stress also differs in relation to other factors such as specialty. Poor collaboration of French emergency physicians with colleagues was linked with more intention to quit and burnout than for other physicians [8]. In Ghana, general practitioners, specialists, family doctors, and nurses had a higher possibility of work stress relative to other health care workers [9].
Subjective well-being is a concept that reflects people’s subjective and general evaluations of their lives as well as positive and negative affective reactions [10]. Scale of Positive and Negative Experience (SPANE) is a valid instrument that assesses subjective feelings of well-being and ill-being and overcomes several limitations of previous popular instruments [11, 12].
Reports revealed clear correlations between subjective well-being among different healthcare specialties. Moreover, subjective wellbeing was found to have a resolving effect on the observed stress of health care workers on their emotional health [13, 14].
Egyptian University Hospitals are considered tertiary health care institutions. They provide basic and advanced healthcare services in different medical specialties. Physicians and nurses are the backbone of this extremely overloaded healthcare institution.
Unfortunately, there is paucity of studies investigating the work conditions of HCWs and their correlates and relation with wellbeing. Aiming to provide further insights into the effect of different challenges that face healthcare workers, the present cross-sectional study aimed to assess working conditions among HCWs in Upper Egypt and to examine their correlates.
By addressing these aspects, the study seeks to fill an important gap in the literature and provide context-specific evidence that may inform workplace interventions, support programs, and policy initiatives aimed at improving the wellbeing and working conditions of HCWs in Egypt.
General objective
To assess working conditions among HCWs in Upper Egypt and examine their correlates and association with emotional wellbeing.
Specific objectives
To assess whether the perception of poor working conditions differs among HCWs by professional type (physicians versus nurses) and by specialty (medical versus surgical).
To examine the association between perceived poor working conditions and the experience of wellbeing among healthcare workers.
To measure the adjusted effect of perceived working conditions on the experience of wellbeing among HCWs.
Research questions
Does the perception of poor working conditions differ significantly between HCWs by professional type (physicians versus nurses) and by specialty (medical versus surgical)?
Is the perception of poor working conditions associated with negative experience of wellbeing among HCWs?
Research hypotheses
The current study hypothesized that perceptions of poor working conditions vary significantly among HCWs according to professional type (physicians versus nurses) and specialty (medical versus surgical). It further hypothesized that HCWs who perceive their working conditions as poor are more likely to report a negative experience of wellbeing compared with those reporting more favorable working conditions.
Participants and methods
A cross-sectional study was conducted among HCWs in Aswan University Hospital in Upper Egypt for three months between 15 January 2024 to 15 April 2024. Aswan University Hospital has been recently constructed in 2012. It is the sole tertiary care facility in Aswan Governorate. It serves patients from Aswan governorate and across the neighboring governorates. It has 24 clinical departments that cover a wide range of specialties.
According to Aswan University statistics for 2021–2022, the hospital is equipped with 440 beds and staffed by 697 nursing professionals and 231 physicians. During this period, the emergency department received 145,347 cases, while the outpatient clinics served 44,404 patients.
Aswan University Hospital has an apparent impact on improving health in Aswan governorate. According to ambulance facility statistics, a significant reduction (less than 5%) in the need for patient referrals to university hospitals in Asyut or Cairo, has been reported after its construction.
The studied population involved 400 HCWs (215 nurses and 185 physicians). Non-probability sampling technique was applied for recruitment of the studied HCWs. All HCWs who had been working in Aswan University Hospital for one year or more were eligible to participate in the study. HCWs with work duration less than one year and those who refused to participate were excluded from the study. Sample size was calculated using Epi-Info version 7.2.3.1based on a previous estimated proportion of adverse working conditions (51.9%) among HCWs [15]. Using degree of precision 0.05 and confidence interval of 95%. The minimum estimated sample size was 383 healthcare workers.
Data was collected using an interviewer administered questionnaire. Data was collected in Arabic language. It included:
Sociodemographic characteristics such as age, gender, marital status, original residence whether from Aswan or other governorates, accommodation place and frequency of return home.
Job characteristics: job type either physician or nurse, specialty, work duration in years, average number of working hours per day, and average number of work- shifts per week.
Working conditions scale was applied. It consisted of 10 subscales with a 5-points Likert scale for each question from strongly disagree=1, disagree=2, neutral=3, agree=4 and strongly agree=5. The subscales included workload, career satisfaction, patient care issues, administrative work, relationships with similar co-workers, personal time, relationships with staff, relationships with patients, resources, and income [4]. The authors reversed the coding of the positively worded items in the career satisfaction, relationships with similar co-workers, relationships with staff, relationships with patients, resources, and income. Then the scores were calculated for the total scale and its subscales. Higher values imply a high perception of poor working conditions among HCWs. The Working Conditions questionnaire used in the current study was obtained from a Japanese paper. The Japanese authors developed the questionnaire based on a review of previously published studies on physicians' work satisfaction and working conditions. The authors of the Japanese publication included the questionnaire in the appendix and permitted its use without a license.
The Scale for Positive and Negative Experience (SPANE) - Arabic version is a self-report questionnaire designed to assess positive and negative emotions. This scale consists of two six-item subscales assessing people’s positive and negative experiences over the previous 4 weeks. The answers were given on a five-point scale from 1 (very rarely or never) to 5 (very often or always). The positive and negative scales were scored separately due to the partial independence of the two types of feelings. Both the summed positive (SPANE-P) score and the negative (SPANE-N) score ranged from 6 to 30. The two scores were combined by subtracting the negative score from the positive one, resulting in the affect balance (SPANE-B) score that ranged from -24 to 24 [12]. The Scale of SPANE is copyrighted; however, according to the scale developers, it is free to use for research purposes without obtaining permission or paying a licensing fee, provided that appropriate credit is given to the original authors.
The researchers performed forward and backward translations of working conditions from the original language (English) into the target language (Arabic). Reviewing the translations was then executed by a psychiatrist and two bilingual experts. Reliability testing was done to evaluate internal consistency for the translated scale used. Cronbach’s alpha coefficient of the translated working condition scale was 0.75.
Data management and statistical analysis
Data were analyzed using the Statistical Package for Social Sciences (SPSS), version 26 for Windows. Quantitative data were expressed as mean and standard deviation, while frequencies and percentages summarized the qualitative data. Normality testing was done using Shapiro-Wilk Test and Kolmogorov-Smirnov Test. Reliability testing was done to evaluate internal consistency for the scales used. Cronbach’s alpha coefficients were as follows; working condition scale was 0.816, positive subscale of SPANE was 0.721 while negative domain SPANE was 0.781. Student t. test was used to compare difference of means between two groups and Pearson correlation was applied to test correlation between studied variables. Multiple linear regression analysis was applied to identify the different predictors of poor working conditions and affect balance. P-value less than 0.05 was considered as a significant cut-off point for all applied statistical tests.
Statistical analyses were conducted in accordance with the predefined study objectives and research questions. Comparisons of mean scores across professional categories (physicians and nurses) and medical specialties were performed to examine whether working conditions differed by professional type and specialty. Finally, multivariable linear regression model was applied to examine the association between working conditions and emotional wellbeing. No sensitivity analyses were performed. There was no missing data for the analyzed variables.
Results
Table 1 displays the sociodemographic and job characteristics of the studied HCWs. The age of the studied HCWs ranged from 17 to 60 years with a mean value of 32.56 ± 9.4 with mean age of nurses was more than physicians (35.1 ± 11.5 vs. 29.6 ± 4.8). Females formed 57% of the total participants and 78.6% of nurses. About two thirds (65%) of the total HCWs and 86.5% of nurses were originally from Aswan Governorate. Single HCWs represented about 41% of the total participants and 56.8% of physicians while currently married were 54% of the total studied HCWs and 66.5% of nurses.
Table 1.
Sociodemographic and job characteristics of the studied healthcare workers (HCWs) in Upper Egypt, 2024
| Characteristics | Total (No = 400) | Physicians (No = 185) | Nurse (No = 215) |
|---|---|---|---|
| Frequency (%) | |||
| Age in years (Mean ± SD) | 32.56 ± 9.4 (17–60) | 29.6 ± 4.8 | 35.1 ± 11.5 |
| Gender | |||
| Male | 172 (43%) | 126 (68.1%) | 46 (21.4%) |
| Female | 228 (57%) | 59 (31.9%) | 169 (78.6%) |
| Governorate | |||
| Aswan | 260 (65%) | 74 (40%) | 186 (86.5%) |
| Outside Aswan | 140 (35%) | 111 (60%) | 29 (13.5%) |
| Frequency of home return | No = 140 | No = 111 | No = 29 |
| Once every week | 14 (10%) | 9 (8.1%) | 5 (17.2%) |
| Once every two weeks or three weeks | 41 (29.3%) | 35 (31.5%) | 6 (20.7%) |
| Once monthly | 35 (25%) | 30 (27%) | 5 (17.2%) |
| More | 50 (35.7%) | 37 (33.3%) | 13 (44.8%) |
| Place of accommodation | No = 140 | No = 111 | No = 29 |
| Private apartment | 72 (51.4%) | 52 (46.8%) | 20 (69%) |
| University housing | 68 (48.6%) | 59 (53.2%) | 9 (31%) |
| Marital status | |||
| Single | 163 (40.8%) | 105 (56.8%) | 58 (27%) |
| Married | 217 (54.3%) | 74 (40%) | 143 (66.5%) |
| Widow | 7 (1.8%) | 2 (1.1%) | 5 (2.3%) |
| Divorced or separated | 13 (3.3%) | 4 (2.2%) | 9 (4.2%) |
| Specialty | |||
| Medicine | 199 (49.8%) | 86 (46.5%) | 113 (52.6%) |
| Surgical | 201 (50.2%) | 99 (53.55) | 102 (47.4%) |
| Duration of work in years | |||
| Mean ± SE | 10.43 ± 0.541 | 4.1 ± 0.3 | 15.8 ± 0.8 |
| Median (range) | 5 (1–42) | 3 (1–27) | 20 (1–42) |
| Number of working hours/day | |||
| Mean ± SD | 11.23 ± 6.6 | 15.2 ± 7.7 | 7.7 ± 2.4 |
| Minimum-maximum | 4–24 | 4–24 | 5–20 |
| Number of night shifts /week | |||
| Mean ± SD | 3.9 ± 0.1 | 4.2 ± 1.9 | 3.6 ± 2.1 |
| Median (range) | 4 (0–7) | 4 (0–7) | 3 (0–7) |
The surgical and medical specialties formed nearly equal proportions. Surgical specialties include surgery, obstetrics, ICU and anesthesia while medical specialties include internal medicine, pediatrics, radiology and clinical pathology. The mean of work duration in years was10.43 ± 0.54 and more for nurses than physicians (15.8 ± 0.8 vs. 4.1 ± 0.3). The mean of working hours per day was higher in physicians than nurses (15.2 ± 7.7 vs. 7.7 ± 2.4).
Table 2 shows the differences in mean values of total poor working conditions scale and its subscales between nurses and physicians. The physicians generally have significantly worse perception of working conditions than nurses. Physicians have significantly higher mean (90.7 ± 13.4) of total poor working conditions scale than that of nurses (81.1 ± 12.4) (P < 0.001). Similarly, the mean values of poor working conditions subscales were significantly higher among physicians compared to those of nurses (P < 0.05) except for the subscale of relation with similar co-workers (P = 0.89).
Table 2.
Relation between working condition score item and job type of the studied HCWs in Upper Egypt, 2024
| Job | Mean ± SD | Test* | p.value | ||
|---|---|---|---|---|---|
| Total | Physician | Nurse | |||
| Personal time | 10.8 ± 2.6 | 11.4 ± 2.7 | 10.3 ± 2.4 | 4.2 | < 0.001 |
| Relationship with patients | 4.3 ± 1.5 | 4.7 ± 1.5 | 4 ± 1.4 | 4.4 | < 0.001 |
| Patient care issues | 10.9 ± 3.5 | 11.5 ± 3.5 | 10.3 ± 3.4 | 3.2 | 0.001 |
| Relationships with similar co-workers | 10.1 ± 3.4 | 10.2 ± 3.5 | 10.1 ± 3.3 | 0.13 | 0.89 |
| Relationships with staff | 10.2 ± 3.2 | 10.6 ± 3.2 | 9.8 ± 3.2 | 2.3 | 0.01 |
| Income | 7.4 ± 2.1 | 7.8 ± 2 | 7.1 ± 2.1 | 3.3 | 0.001 |
| Administrative work | 6.4 ± 2.1 | 6.9 ± 2.1 | 5.9 ± 2 | 5 | < 0.001 |
| Resources | 10.3 ± 2.9 | 11 ± 2.9 | 9.7 ± 2.8 | 4.3 | < 0.001 |
| Career dissatisfaction | 5.1 ± 2.1 | 5.7 ± 2.1 | 4.6 ± 1.8 | 5.5 | < 0.001 |
| Workload | 9.8 ± 2.8 | 10.7 ± 2.6 | 9.1 ± 2.8 | 5.7 | < 0.001 |
| Total | 85.7 ± 13.7 | 90.7 ± 13.4 | 81.1 ± 12.4 | 7.3 | < 0.001 |
*Independent sample T.test
Table 3 displays the differences between surgical and medical specialties regards mean values of total poor working conditions scale and its subscales. Generally, the HCWs of surgical specialty have significantly worse perception of working conditions than medical specialty. Where, the mean of total poor working conditions scale was significantly higher among surgical (93.5 ± 9.3) compared to that of medical HCWs (91.1 ± 11.9) (P = 0.03). Similarly, the HCWs of surgical specialty have significantly higher mean values of poor perceptions of personal time, relationships with similar co-workers, relationships with staff, career satisfaction than those of medical specialty (P < 0.05).
Table 3.
Relation between working condition score item and the specialty of the studied HCWs in Upper Egypt, 2024
| Surgical | Medical | p.value | |
|---|---|---|---|
| Personal time | 11.2 ± 2.7 | 10.3 ± 2.5 | 0.001 |
| Relationship with patients | 7.6 ± 1.6 | 7.6 ± 1.5 | 0.68 |
| Patient care issues | 10.5 ± 3.5 | 11.2 ± 3.5 | 0.03 |
| Relationships with similar co-workers | 14.4 ± 3.1 | 13.2 ± 3.5 | 0.001 |
| Relationships with staff | 14.1 ± 2.9 | 13.3 ± 3.5 | 0.02 |
| Income | 4.2 ± 1.9 | 4.8 ± 2.2 | 0.002 |
| Administrative work | 6.3 ± 2.1 | 6.4 ± 2.1 | 0.8 |
| Resources | 7.8 ± 3.1 | 7.4 ± 2.8 | 0.2 |
| Career satisfaction | 7.1 ± 2.2 | 6.6 ± 1.9 | 0.07 |
| Workload | 9.9 ± 3.1 | 9.7 ± 2.7 | 0.6 |
| Total | 93.5 ± 9.3 | 91.1 ± 11.9 | 0.03 |
While HCWs of medical specialty have significantly higher poor perception of patient care issues and income than those of surgical specialty (P < 0.05). No significant associations were detected between medical and surgical specialties regards relationship with patients, administrative work, resources, or workload subscales (P > 0.05).
Figure 1 portrays the positive and negative experience and affect balance scales among the studied HCWs. There was no significant difference in mean values of positive and negative experience and affect balance scales between physicians and nurses (P > 0.05).
Fig. 1.
Relation between the positive, negative experience and the affect balance and the job type of the studied HCWs in Upper Egypt, 2024
Table 4 shows the adjusted linear regression models for predicting affect balance and poor working conditions. For poor working conditions, being a physician as job type significantly predicts higher perceived scores of bad working conditions (β = 0.35, 95% CI: 7–12). While increasing the affect balance score significantly negatively predict poor working conditions (β = -0.31, 95% CI: -0.7 - -0.4).
Table 4.
Predictors of poor working conditions and the affect balance of SPANE among the studied HCWs in Upper Egypt, 2024
| Variables | Working conditions | Variables | Affect balance of SPANE | ||||
|---|---|---|---|---|---|---|---|
| R square = 0.24 | R square = 0.145 | ||||||
| F = 20.7 | F = 12.2 | ||||||
| Correlation | Beta (95%CI) | p.value | Correlation | Beta(95%CI) | p.value | ||
| Age | -0.1, (< 0.001) |
0.02 (-0.11-0.17) |
0.67 | Age | 0.2, (< 0.001) |
0.14 (0.03–0.19) |
0.007 |
| Gender | 0.08, (0.05) |
-0.07 (-4.8-0.7) |
0.14 | Gender | 0.03, (0.2) |
0.03 (-1-2.1) |
0.51 |
| Job | 0.3, (< 0.001) |
0.35 (7–12) |
< 0.001 | Job | − 0.06, (0.11) |
0.08 (-0.36-3) |
0.13 |
| Specialty | − 0.06, (0.01) |
-0.06 (-4-0.7) |
0.18 | Specialty | 0.08, (0.04) |
0.04 (-0.7-2) |
0.34 |
|
Shifts/ Week |
0.1, (0.001) |
0.08 (-0.1-1.2) |
0.11 |
shifts/ week |
-0.14, (0.002) |
-0.04 (-0.54-0.19) |
0.36 |
| Affect balance | -0.3, (< 0.001) |
-0.31 (-0.7 - -0.4) |
< 0.001 | Working condition | -0.35, (< 0.001) |
-0.35 (-0.24–0.13) |
< 0.001 |
Adjusted linear regression models
Working condition scale: Reference groups females, nurse and surgical specialty
SPANE: Reference groups male, nurse, surgical specialty
For affect balance, the increase age of HCWs is a significant positive predictor of affect balance score (β = 0.14, 95% CI:0.03–0.19). On other hand, higher scores of perceived poor working conditions significantly predict low score of affect balance (β = -0.35, 95% CI: -0.24-0.13).
Gender, medical specialty, or number of night shifts per week were not significant predictors of either affect balance or poor working conditions scales (P > 0.05).
Discussion
Management of human resources is one of the most central keys of the success or failure of health sector [16]. HCWs are among the first six most stressful professions. Their job involves direct contact with humans and necessitates rapid decision-making skills. However, not all health professionals exposed to similar stress levels [17].
HCWs experience relatively high levels of adverse work conditions compared to other occupations. Poor work conditions not only affect health care quality and safety, but they also lead to negative consequences on HCWs health and well-being. This negative impact is presented in obvious reduction in productivity, suboptimal patient care, medical errors and continuous conflicts between work responsibilities and family roles [18]. This increases the burden on HCWs to withstand these adverse working conditions with simultaneous provision of qualified patient care.
There were different studies evaluated Egyptian HCWs perceptions of job satisfaction, burnout and experiencing violence during healthcare provision [19–23]. However, exploring the work environment of HCWs has been overlooked. The current study aimed to explore the working conditions and perceived wellbeing among the HCWs working at university hospital in Upper Egypt.
Physicians in the current study evaluated their working conditions more negatively than the nursing staff. They generally have significantly higher mean values of poor working conditions in all working conditions subscales than nurses.
Overall, the studies surveyed the working conditions among HCWs either jointly or separately for the physicians and nurses and compared the differences. In Serbia, Ilic et al., asked physicians and nurses in emergency department about their working conditions and found some differences between the two professional groups. Physicians implied higher burden, more impact at work, and more chances for advancement than the nurses [24].
In San Diego, California, Rutledge et al., reported that patterns of work stress differ according to work activities, between physicians and nurses. Physician’s emotional stress scores were about 50% higher than nurses, which indicated that physicians reported feeling less alert and more worried, unhappy, tired and stressed [25].
The observed differences for worse perception of working conditions by physicians may be explained by the variation of work characteristics between the two occupational groups. Physicians usually have more influence and responsibilities at work than nurses [26].
In Saudi Arabia, Alosaimi et al., revealed that 22.5% of physicians and nurses experienced stress. The stress was correlated with the magnitude of their work, and the occurrence of fatigue and sleep deprivation [27].
In contrast to the present study, in Germany and 12 European countries, the nurses evaluated their working conditions worse than physicians. Nurses negatively assessed their working conditions status. Several factors contributed to this issue, including limited opportunities for nurses to participate in hospital decision-making, insufficient investments in the ongoing education of nurses and lack of organization reaction to nurses’ obstacles [26, 28].
Other previous studies investigated working conditions among nurses only. In Belgium, Milisen et al., reported that more than two-thirds of nurses felt that they worked in a stressful environment due to three main factors, time constraints, poor communication and collaboration with other healthcare providers, and economic crisis [29]. Ulusoy et al., also found that Turkish nurses assessed their work environment as moderately positive while they perceived the “adequacy of manpower and other resources” subscale negatively [30].
The finding of the current research implied that nurses were more satisfied with their relations with their staff /direct supervisors than physicians. This could be explained by the variation in work structures of physicians and nurses that influence the way of their leadership perception. Nurses work with a direct supervisor on the ward while physicians may work in several units and thus may experience less direct support from their supervisors than nurses [31].
Regarding career dissatisfaction among the studied HCWs, nurses were more satisfied than physicians. This was consistent with previous Egyptian and Chinese studies, where nurse was significantly more satisfied with their job compared to physicians [19, 32]. Tense working environments provoke higher job stress and consequently increase HCWs dissatisfaction [20].
Previous studies showed that HCWs in surgical departments significantly experienced more stress compared to those working in other departments. Surgical physicians had more average workday, job tasks and operational theatre stress than their colleagues in medical departments [33–36].
On the contrary, in the current study the adjusted regression revealed that HCWs specialty have no significant impact on perception of poor working conditions. This is attributed to the nature of Aswan University Hospital as a tertiary care hospital with high work overload on HCWs of all specialties.
In the present study, medical specialties reported higher stress related to patient care than surgical specialty. HCWs in medical specialty involve more communication, emotional support and direct patient care than those in surgical fields. Moreover, they are more likely to have an increasing demand from their patients, who often have more background information, and expect more positive relationships [4, 37].
In the current study, perceptions of poor working conditions and well-being were intercorrelated. The negative impact of poor working conditions extended beyond the work environment. It adversely affects the general perception of HCWs’ life.
Subjective well-being reflects individuals’ personal evaluations of their lives, encompassing both their overall satisfaction and their experiences of positive and negative emotions [14]. The increasing age of HCWs increases their perception of wellbeing which positively predicts wellbeing perception [38]. In the present study, increasing age was a significant positive predictor of affect balance score/sense of wellbeing.
This may be because with aging, HCWs gained more experience that greatly contributes to upgrading their capacities to deal with work-related stress and consequently enhances their psychological well-being and the more positive reporting of emotions and experiences in life [38]. This finding was consistent to the usual U-shaped relationship between age and well-being [39].
Furthermore, junior physicians work in a highly demanding job. They experience a double load, besides being beginners in their profession, and simultaneously suffer low income compared to long working hours. All these factors contribute to negative insight of junior HCWs’ wellbeing [40–42].
Gender and HCWs specialty were not significant predictors for affect balance scale. Similarly, Alghamdi et al. used the General Health Questionnaire which also composed of six positive and six negative items and reported that the majority of HCWs felt under stress, and did not enjoy their day-to-today activities. In addition, there was no significant differences between physicians and nurses based on gender, or specialty [38].
Study limitations
There are few limitations that restrict the generalizability of study results for all Egyptian HCWs. First, the cross-sectional design rule out causal implications. Second, the results are limited to HCWs working in university hospital especially in Upper Egypt. There is a need to have a complementary aspect on working conditions from HCWs in Egyptian Ministry of Health and form the other Egyptian university hospitals.
However, the current study has notable strengths, including focusing on both physicians and nurses, and examining their well-being in relation to the working conditions.
Theoretical and practical implications
Despite these limitations, the study provides important insights into the work experiences of HCWs. Theoretically, the findings contribute to a better understanding of how working conditions relate to emotional wellbeing among HCWs in low- and middle-income country settings. Practically, the results highlight specific areas of the work environment, such as workload, income, administrative work and relation with patients, that could be targeted in interventions aimed at improving HCWs` wellbeing. Policymakers, hospital administrators, and professional associations may use these findings to develop strategies for enhancing workplace conditions, promoting positive emotional experiences, and ultimately supporting the retention and performance of healthcare staff.
Conclusions and recommendations
HCWs of Aswan University Hospital reported poor perceptions of their working conditions, especially physicians. Poor working conditions and bad perception of wellbeing are intercorrelated with each other. Young HCWs had a worse sense of wellbeing than the seniors.
There is a curial need to improve working conditions for HCWs specially physicians in University Hospitals in Upper Egypt. This could positively reflect on HCWs emotions.
Supplementary Information
Below is the link to the electronic supplementary material.
Acknowledgements
The authors thank all healthcare workers who participated in the study and the administration of Aswan University Hospital.
Abbreviations
- HCWs
Healthcare workers
- SPANE
Scale of Positive and Negative Experience
Author contributions
The research concept was conceived and developed by the authors of the study. DMO and SHH had analyzed the data and performed all analyses and wrote the first draft of the paper. SSA contributed to the study design and data collection. TMD performed data entry. All authors were responsible for data collection and overall study design. The final version of this manuscript has been approved by all authors before submission.
Funding
This research did not receive any specific grant from any funding agencies in the public, commercial or governmental sectors.
Data availability
Data cannot be shared openly due to participant privacy but is available on reasonable request from the corresponding author.
Declarations
Ethics approval and consent to participate
The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. The Medical Ethics Review Committee of Aswan University approved the study (IRB no: 854.11.23). Approval from administrative authority was obtained from Aswan University Hospital for conducting the research. Informed consent to participate was obtained from all the participants in the study. All ethical considerations were assured including voluntary participation and maintenance of participants’ privacy and confidentiality.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Data Availability Statement
Data cannot be shared openly due to participant privacy but is available on reasonable request from the corresponding author.