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Acta Bio Medica : Atenei Parmensis logoLink to Acta Bio Medica : Atenei Parmensis
. 2022 Oct 26;93(5):e2022230. doi: 10.23750/abm.v93i5.13095

Job satisfaction and associated factors in Greek public hospitals

Dimitris Karaferis 1,✉, Vassilis Aletras 2, Dimitris Niakas 1
PMCID: PMC9686176  PMID: 36300228

Abstract

Background and aim:

To investigate the level of job satisfaction of health care professionals in the public hospitals of the 1st Regional Health Authority of Attica and further to assess its determining factors.

Methods:

The Job Satisfaction Survey questionnaire was administered to health professionals in thirteenhospitals. The 36 items of the questionnaire are expressed on a Likert scale and are divided into nine dimensions. Additional questions were added covering the demographic and socio-economic characteristics.

Results:

The reliability of the tool was: α Cronbach = 0.89. The response rate was 81.95%, 3,278 questionnaires were collected overall, of which 52,96% (n=1,736) originated from the nursing staff, 24.50% (n=803) from the medical staff and 22.54% (n=739) from other health employees. The average overall job satisfaction is moderate (3.33 out of 6). The category with the lowest score in job satisfaction was that concerning salaries (2.12). Questions related to promotion (2.45), additional benefits (2.67), operating procedures (2.82) received low job satisfaction rates. Instead, the categories that garnered positive job satisfaction concerned questions related to the supervision (4.66), the nature of work (4.34), and co-workers (4.25). Questions related to communication received 3.79.

Conclusions:

The findings showed lowest satisfaction levels in pay, fringe benefits, contingent rewards, promotion and operating procedures dimensions of job satisfaction. Participants were more satisfied with the nature of work, supervision and co-workers. The findings can be used as a set of reference levels and indicators for the human resources development component of the quality management system in the public hospitals. (www.actabiomedica.it)

Keywords: job satisfaction, public hospitals, hospital employees, Greece

Introduction

The quality of health care services is affected by various factors including the health infrastructure, human resources and health care system. Among these, human resources are the most important component in the provision of health care services. One of the main factors which impact the productivity of human resources is job satisfaction, as plays a prominent role in determining a person’s intention to stay at an organization. Job satisfaction is defined as the positive response of professionals to working conditions that meet their needs, as a result of their assessment of the value or fairness of their professional experience. Also, it is regarded as an indicator of working-life quality (1).

In the public health care sector, the job satisfaction of professionals plays an protrusive role in their performance and is further reflected in the health of the patients. Employees directly influence patient satisfaction because of their involvement and interaction with patients (2). In addition, job satisfaction has been closely associated with the effectiveness and sustainability of a health care system (3,4). Managers should concentrate on job satisfaction of employees because, if dissatisfied, they are more likely to provide inferior service. It is necessary to understand what motivates them and the extent to which the organization and other factors affect their job satisfaction in order to be more productive. Health care systems cannot function effectively without skilled, motivated and supported health workers (5,6).

Objectives

The research study attempted to assess the level of job satisfaction and its relationship with the personal and professional characteristics of the employees in public hospitals of 1st Regional Health Authority of Attica in Athens, Greece. Additionally, to identify the sources of satisfaction or dissatisfaction. For the Ministry of Health (MoH) the purpose of the study was to establish a system of indicators and reference levels for measurement of job satisfaction as a component of human resources development in public hospitals.

Materials and methods

Instrument

Αll organizations recognize the need to monitor the satisfaction levels of their employees, because employee dissatisfaction could be very costly and disruptive to organizational effectiveness and commitment. The Job Satisfaction Survey (JSS) questionnaire developed by Spector, is the most frequently used instrument and has the purpose of evaluating the individual’s satisfaction (7,8).

The current research is based on the Greek JSS. The validity and reliability of which was documented by Tsounis and Sarafis (2018) and was tested with a sample of 239 employees of various specialties in drug addiction treatment (9). The study instrument consists of 36 items and nine dimensions of job satisfaction: pay, fringe benefits, promotion, co-workers, contingent rewards, nature of work, supervision, operating procedures and communication. The items are written in both directions, so about half of them must be reverse scored. The measurement scale was a six-point Likert, where 1=strongly disagree, 2=moderately disagree, 3=slightly disagree, 4=slightly agree, 5= moderately agree and 6=strongly agree – the higher the score, the greater the job satisfaction. The survey instrument also included socio-demographic data, like participants’ age, gender, marital status, educational status and work-related information such as professional category, professional qualification and experience time.

Ethical considerations

The Ethical Committee of National and Kapodistrian University of Athens approved the study protocol. Additionally, the study was conducted after review and written approvals from relevant institutional ethics and research committees were secured from all thirteen hospitals and from the 1st Regional Health Authority of Attica (approval number: 31707-7/6/2019). The researcher informed each participant about the purpose of the study. Furthermore, participation of employees was voluntary and based on written informed consent prior to data collection. Anonymity of participants and confidentiality of data were assured.

Settings and participants

A pilot study was carried out with 30 volunteer participants to identify any problems. Since, all questionnaires were returned with no problems reported; no alterations were made. The reliability of the pilot study was checked, as Cronbach’s alpha was 0.78 the reliability of the instrument was verified (10).

The survey was conducted between July 2019 and October 2020, in 13 hospitals out of a total of 24 in 1st Regional Health Authority of Attica. The region of Attiki with its capital Athens, is the largest region of Greece, has a total population of around 3,75 millions, approximately 35% of total Greece population. For those employees who agreed to participate in the study, an envelope containing the instruments and the consent form was delivered. Thus, the participants filled a personal and professional characterization form and answered the Greek version of the JSS. Of the 4,000 questionnaires distributed, 3,278 (81.95%) were returned. Respondents were informed that the study results would be used only for scientific purposes.

Statistical analysis

Descriptive statistics were used to report the job satisfaction of respondents. The 36 items of job satisfaction and other variables on ratio scales were expressed as means (M) and standard deviations (SD) and qualitative data as absolute and relative frequencies. Percentages of agreement/disagreement with different aspects of job satisfaction were also calculated. The Kolmogorov-Smirnov and Shapiro-Wilk tests were used for normality assessment. Kruskal Wallis test were used for comparisons according to gender, education, age and job-related variables. Spearman Rank Differences correlation analysis were developed to explore intercorrelations among subscales. Reliability analysis included Cronbach’s Alpha for internal consistency. The level of statistical significance was set at 0.05. All statistical analyses were performed using the Statistical Package for Social Sciences, Version 26.0 for Windows.

Results

Normality analysis

The Kolmogorov-Smirnov and Shapiro-Wilk normality tests were used for normality. Based on the results, the data was determined as not normally distributed, since the p-value was less than 0.05 for both tests.

Sociodemographic analysis

The majority of the respondents were female (2,666; 81.33%) mostly due to the large number of female nursing staff (1,736; 52.96%). Men represented the minority (612; 18.67%). The age distribution was: 1.49% under 25 years old, 15.86% between 26-35, 33.25% between 36-45, 38.16% between 46-55, and 11.23% over 56. As far as the educational level is concerned, the majority was university graduates (59.55%), while 19.37% had post-graduate studies. Concerning employment status, the majority worked as permanent staff (2,655; 80.99%) and only 623 (19.01%) employees worked as temporary staff. As regards length of service, 19.37% had under 5 years, 11.90% of study participants had worked from 6 to 10 years, 17.63% from 11 to 15 years, 22.45% from 16 to 20 years, while 28.65% had worked for more than 20 years. About half employees stated that they managed to cope with their financial obligations but without having much money left aside whereas 4 out 10 faced greater economic problems (Table 1).

Table 1.

Sociodemographic characteristics of the sample per professional category.

Characteristics Professional Categories
Doctors Nurses Other Health Professionals Overall Sample
N=803 % N=1,736 % N=739 % N=3,278 %
Gender
Male 294 36.61% 150 8.64% 168 22.73% 612 18.67%
Female 509 63.39% 1,586 91.36% 571 77.27% 2,666 81.33%
Age
< 25 years 5 0.62% 32 1.84% 12 1.62% 49 1.49%
26-35 years 236 29.39% 243 14.00% 41 5.55% 520 15.86%
36-45 years 273 34.00% 612 35.25% 205 27.74% 1,090 33.25%
46-55 years 210 26.15% 723 41.65% 318 43.03% 1,251 38.16%
56 > years 79 9.84% 126 7.26% 163 22.06% 368 11.23%
Marital Status
Married 385 47.95% 1,170 67.40% 499 67.52% 2,054 62.66%
Single 393 48.94% 431 24.83% 152 20.57% 976 29.77%
Divorced 24 2.99% 124 7.14% 62 8.39% 210 6.41%
Widowed 1 0.12% 11 0.63% 26 3.52% 38 1.16%
Level of Education
Compulsory 0 0.00% 7 0.40% 43 5.82% 50 1.53%
Secondary 0 0.00% 313 18.03% 328 44.38% 641 19.55%
Bachelor 559 69.61% 1,099 63.31% 294 39.78% 1,952 59.55%
Master’s / PhD 244 30.39% 317 18.26% 74 10.01% 635 19.37%
Employment status
Permanent 425 52.93% 1,590 91.59% 640 86.60% 2,655 80.99%
Temporary 378 47.07% 146 8.41% 99 13.40% 623 19.01%
Professional Experience
< 5 years 290 36.11% 221 12.73% 124 16.78% 635 19.37%
6-10 years 158 19.68% 158 9.10% 74 10.01% 390 11.90%
11-15 years 114 14.20% 376 21.66% 88 11.91% 578 17.63%
16-20 years 135 16.81% 457 26.32% 144 19.49% 736 22.45%
20 > years 106 13.20% 524 30.18% 309 41.81% 939 28.65%
Economic situation
I cannot cope with my financial obligations 2 0.25% 70 4.03% 55 7.44% 127 3.87%
I manage financially with great difficulties 108 13.45% 716 41.24% 363 49.12% 1,187 36.21%
I manage financially but I do not have much left aside 570 70.98% 871 50.17% 274 37.08% 1,715 52.32%
I am financially comfortable 105 13.08% 31 1.79% 25 3.38% 161 4.91%
I do not know / I do not answer 18 2.24% 48 2.76% 22 2.98% 88 2.68%
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On a scale of 1 to 6, male respondents were a little more satisfied with their jobs than were female staff. The overall score was 3.49, indicating neither satisfaction nor dissatisfaction among the staff. The overall female job satisfaction score was 3.30. Both male and female employees were most satisfied with “Co-workers”: 4.37/4.23 and “Nature of work”: 4.34/4.34 respectively. Both genders were least satisfied with “Pay”: 2.42/2.05 and “Promotion”: 2.77/2.38 respectively. Only on the “Supervision” job satisfaction facets did female respondents report being slightly more satisfied than their male counterparts: 4.61/4.67 respectively. The results indicate a weak relationship between respondents’ gender and facets of job satisfaction. In a more detailed analysis of age, it was possible to detect differences in job satisfaction by age group. Although the differences were small (M=3.30-3.60), youngest respondents in the range ≤ 25 years old (M=3.60), showed a higher satisfaction level compared to the intermediate age groups. Respondents who were between 46 to 55 years old (M=3.30) expressed lower satisfaction levels (Table 2).

Table 2.

Mean scores and Standard Deviations (SD) by demographic and job related variables for Job Satisfaction.

Demographic variables Pay Promotion Supervision Fringe Benefits Contingent Rewards Operating Conditions Co-workers Nature of work Communication Overall Job Satisfaction
Gender N % Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD
Male 612 18.67% 2.42 0.82 2.77 0.86 4.61 0.87 2.98 0.86 3.18 0.92 2.85 0.67 4.37 0.71 4.34 0.77 3.86 0.82 3.49 0.56
Female 2,666 81.33% 2.05 0.78 2.38 0.82 4.67 0.88 2.59 0.82 2.85 0.90 2.81 0.69 4.23 0.70 4.34 0.76 3.77 0.82 3.30 0.50
Overall 3,278 100% 2.12 0.80 2.45 0.84 4.66 0.88 2.67 0.84 2.91 0.92 2.82 0.69 4.25 0.71 4.34 0.76 3.79 0.82 3.33 0.52
P-sig 0.000 0.000 0.143 0.000 0.000 0.149 0.000 0.877 0.014
Age N % Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD
< 25 years 49 1.50% 2.44 1.07 2.79 1.04 4.97 0.98 2.84 1.20 3.23 1.19 3.27 0.79 4.37 0.91 4.65 1.02 3.85 0.89 3.60 0.74
26-35 years 520 15.86% 2.31 0.82 2.49 0.84 4.69 0.86 2.78 0.86 3.01 0.92 2.79 0.77 4.32 0.73 4.35 0.77 3.77 0.82 3.39 0.54
36-45 years 1,090 33.25% 2.12 0.78 2.39 0.79 4.71 0.81 2.63 0.81 2.88 0.87 2.82 0.63 4.23 0.69 4.25 0.78 3.73 0.78 3.31 0.49
46-55 years 1,251 38.16% 2.02 0.79 2.43 0.85 4.60 0.95 2.61 0.85 2.85 0.93 2.80 0.70 4.25 0.71 4.36 0.76 3.79 0.85 3.30 0.52
56 > years 368 11.23% 2.18 0.80 2.60 0.89 4.60 0.81 2.76 0.80 3.06 0.92 2.82 0.68 4.26 0.69 4.48 0.69 3.96 0.80 3.41 0.51
Overall 3,278 100% 2.12 0.80 2.45 0.84 4.66 0.88 2.67 0.84 2.91 0.92 2.82 0.69 4.25 0.71 4.34 0.76 3.79 0.82 3.33 0.51
P-sig 0.000 0.000 0.002 0.000 0.000 0.000 0.112 0.000 0.000
Level of Education N % Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD
Compulsory 50 1.53% 2.30 0.88 2.47 0.73 4.53 0.86 2.69 0.76 3.02 0.84 3.19 0.59 4.09 0.66 4.41 0.61 4.06 0.61 3.42 0.74
Secondary 641 19.55% 1.92 0.74 2.31 0.82 4.66 1.03 2.49 0.82 2.75 0.95 2.82 0.76 4.19 0.80 4.37 0.86 3.76 0.91 3.25 0.54
Bachelor 1,952 59.55% 2.16 0.79 2.48 0.82 4.69 0.78 2.71 0.83 2.95 0.86 2.84 0.65 4.30 0.65 4.32 0.70 3.80 0.75 3.36 0.49
Master’s /PhD 635 19.37% 2.20 0.85 2.49 0.92 4.58 1,00 2.72 0.91 2.95 1.02 2.72 0.71 4.21 0.77 4.34 0.86 3.73 0.94 3.32 0.52
Overall 3,278 100% 2.12 0.80 2.45 0.84 4.66 0.88 2.67 0.84 2.91 0.92 2.82 0.69 4.25 0.71 4.34 0.76 3.79 0.82 3.33 0.52
P-sig 0.000 0.000 0.046 0.000 0.000 0.000 0.000 0.536 0.021
Marital Status N % Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD
Married 2,054 62.66% 2.07 0.75 2.45 0.84 4.63 0.85 2.63 0.80 2.89 0.87 2.83 0.66 4.25 0.67 4.35 0.71 3.80 0.79 3.32 0.49
Unmarried 976 29.77% 2.28 0.86 2.51 0.83 4.69 0.90 2.78 0.90 3.02 0.97 2.80 0.74 4.30 0.76 4.33 0.82 3.76 0.85 3.39 0.57
Divorced 210 6.41% 1.87 0.81 2.22 0.83 4.78 1.06 2.46 0.91 2.64 1.02 2.70 0.74 4.15 0.82 4.30 0.99 3.69 0.94 3.20 0.54
Widowed 38 1.16% 2.06 0.82 2.42 1.00 4.55 0.81 2.68 0.75 2.84 0.78 2.93 0.56 4.09 0.46 4.20 0.65 3.95 0.66 3.30 0.44
Overall 3,278 100% 2.12 0.80 2.45 0.84 4.66 0.88 2.67 0.84 2.91 0.92 2.82 0.69 4.25 0.71 4.34 0.76 3.79 0.82 3.33 0.52
P-sig 0.000 0.000 0.052 0.000 0.000 0.025 0.015 0.523 0.085
Professional Experience N % Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD
< 5 years 635 19.37% 2.44 0.87 2.62 0.86 4.84 0.89 2.93 0.95 3.18 1.02 2.84 0.78 4.40 0.78 4.41 0.85 3.77 0.91 3.49 0.60
6-10 years 390 11.90% 2.25 0.84 2.50 0.81 4.74 0.79 2.79 0.83 3.03 0.86 2.89 0.68 4.30 0.69 4.33 0.77 3.81 0.74 3.40 0.50
11-15 years 578 17.63% 2.04 0.73 2.35 0.78 4.62 0.79 2.62 0.78 2.83 0.83 2.87 0.59 4.21 0.66 4.27 0.70 3.79 0.76 3.29 0.49
16-20 years 736 22.45% 2.02 0.68 2.39 0.80 4.62 0.77 2.60 0.76 2.85 0.81 2.84 0.61 4.21 0.59 4.28 0.66 3.82 0.71 3.29 0.44
20 > years 939 28.65% 1.99 0.79 2.42 0.88 4.56 1,01 2.51 0.81 2.79 0.95 2.72 0.73 4.21 0.75 4.37 0.81 3.75 0.90 3.26 0.51
Overall 3,278 100% 2.12 0.80 2.45 0.84 4.66 0.88 2.67 0.84 2.91 0.92 2.82 0.69 4.25 0.71 4.34 0.76 3.79 0.82 3.33 0.52
P-sig 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.002 0.421
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Notes: N=3,278, p<0.001, p<0.05

Bivariate Correlation Analysis

In Table 2, Kruskal Wallis Test shows that there is a significant difference in dimensions of pay, promotion, fringe benefits and contingent rewards of respondents with respect to gender, age, level of education, marital and employment status, professional experience and economic situation (p=0.000) at 0.05 level of significance. Similarly, there is a significant difference in supervision of respondents with respect to age, professional experience, marital and employment status (p=0.000), but no significant difference with respect to gender (p=0.287) and level of education (p=0.166). Yet, a significant difference there is in operating conditions of respondents with respect to level of education, professional experience, economic situation (p=0.000), marital status (p=0.012), employment status (p=0.003), gender (p=0.020). Again, a significant difference observed in co-workers of respondents with respect to gender, level of education, professional experience, marital and employment status, economic situation (p=0.000), but no significant difference with respect to age (p=0.040). Moreover, there is a significant difference in nature of work of respondents with respect to age, professional experience, employment status (p=0.000) and economic situation (p=0.002), but no significant difference with respect to gender (p=0.236), level of education (p=0.279) and marital status (p=0.291). Additionally, there is a significant difference in communication of respondents with respect to age, economic situation, gender (p=0.000) and marital status (p=0.043), but no significant difference with respect to professional experience (p=0.601), employment status (p=0.838) and level of education (p=0.153).

Correlation Analysis

We calculated the correlations between dimensions using the pair wise Spearman’s correlation coefficient. Positive intercorrelations among subscales ranged between 0.059 to 0.636. Only one intercorrelation among subscales (supervision-operating procedures) founded. Cohen (1988) proposed the following interpretation for correlations: if the r-value equals 0.10 to 0.29 (positive) or -0.29 to -0.10 (negative), there is a weak correlation between the two independent variables. If the r-value is 0.30 to 0.49 (positive) or -0.49 to -0.30 (negative), there is a moderate correlation. If the r-value equals 0.50 to 1.00 (positive) or -1.00 to -0.50 (negative), a strong correlation is indicated (11). Correlations were strong in seven cases, while there were also eleven moderate and sixteen weak intercorrelations (Table 3).

Table 3.

Spearman correlation among JSS dimensions.

Dimensions 1 2 3 4 5 6 7 8 9
1 Pay 1 0.556** 0.034* 0.624** 0.547** 0.265** 0.220** 0.211** 0.288**
2 Promotion 0.556** 1 0.072** 0.576** 0.526** 0.194** 0.223** 0.241** 0.283**
3 Supervision 0.034* 0.072** 1 0.076** 0.230** -0.01 0.401** 0.254** 0.229**
4 Fringe benefits 0.624** 0.576** 0.076** 1 0.617** 0.332** 0.282** 0.249** 0.318**
5 Contingent rewards 0.547** 0.526** 0.230** 0.617** 1 0.338** 0.389** 0.348** 0.470**
6 Operating procedures 0.265** 0.194** -0.01 0.332** 0.338** 1 0.139** 0.132** 0.359**
7 Co-workers 0.220** 0.223** 0.401** 0.282** 0.389** 0.139** 1 0.360** 0.383**
8 Nature of work 0.211** 0.241** 0.254** 0.249** 0.348** 0.132** 0.360** 1 0.344**
9 Communication 0.288** 0.283** 0.229** 0.318** 0.470** 0.359** 0.383** 0.344** 1
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Notes: N=3,278.

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

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

Reliability analysis

The overall job satisfaction was 0.89. The internal consistency values of each dimension of Spector’s Job Satisfaction Survey range from 0.41 to 0.81. Two subscales, supervision and contingent rewards have alpha values in the range of 0.74 to 0.81. Six other subscales have the alpha values slightly lower than the mark of α=0.70. More specifically, fringe benefits (α=0.68), pay (α=0.66), promotion (α=0.65), communication (α=0.64), co-workers (α=0.62), nature of work (α=0.62). Exceptionally, the subscale operating conditions reports an outstandingly low value of Cronbach’s alpha (α=0.41). This subscale also reported a very low internal consistency in the Greek Sample of Tsounis and Sarafis (0.48). Despite that, the whole Spector’s Job Satisfaction Survey show cases a very high level of internal consistency (α=0.91), similar to the value achieved by Spector himself. Generally (12), if a Cronbach’s alpha value is α<0.40 the scale is not reliable, if 0.40≤α<0.60 then the scale reliability is low, if 0.60≤α<0.80 then the size is quite reliable and if 0.80≤α<1.00 the scale is highly reliable (Table 4).

Table 4.

Internal consistency coefficients of JSS.

United States Sample Spector (2007) Greek Sample Tsounis & Sarafis (2018) Current Study
Dimensions Doctors Nurses Other Health Professionals Overall Job Satisfaction
Pay 0.75 0.62 0.71 0.58 0.57 0.66
Promotion 0.73 0.67 0.74 0.55 0.59 0.65
Supervision 0.82 0.87 0.78 0.80 0.83 0.81
Fringe Benefits 0.73 0.73 0.70 0.58 0.63 0.68
Contingent Rewards 0.76 0.71 0.75 0.65 0.80 0.74
Operating Conditions 0.62 0.48 0.48 0.38 0.41 0.41
Coworkers 0.60 0.67 0.59 0.58 0.62 0.62
Nature of work 0.78 0.74 0.64 0.58 0.69 0.62
Communication 0.71 0.71 0.66 0.59 0.68 0.64
The final score 0.91 0.87 0.91 0.85 0.90 0.89
The sample size 2,870 239 803 1,736 739 3,278
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Split-half reliability (Table 5) was also assessed by dividing the measure into two halves; Part 1: consisted of first 18 items and Part 2: consisted of the remaining 18 items of the scale. The findings showed that JSS had good split-half reliability as assessed through the Guttman Split-Half Coefficient (0.77). A general accepted rule is that α value of 0.60-0.70 indicates an acceptable level of reliability, and 0.80 or greater a very good level (13).

Table 5.

Split-Half reliability analysis.

Cronbach’s Alpha Part 1 Value 0.81
N of Items 18a
Part 2 Value 0.83
N of Items 18b
Total N of Items 36
Correlation Between Forms 0.63
Spearman-Brown Coefficient Equal Length 0.77
Unequal Length 0.77
Guttman Split-Half Coefficient 0.77
a. The items are: Q1, Q2, Q3, Q5, Q7, Q9, Q11, Q13, Q15, Q17, Q20, Q22, Q25, Q27, Q28, Q30, Q33, Q35.
b. The items are: Q4, Q6, Q8, Q10, Q12, Q14, Q16, Q18, Q19, Q21, Q23, Q24, Q26, Q29, Q31, Q32, Q34, Q36.
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The mean score of overall perception of job satisfaction of healthcare staff who worked at the 1st Regional Health Authority of Attica was 3.33 on a one to six scale. The overall perception of job satisfaction exceeded slightly disagree (score 3) and approached slightly agree (score 4). Employees are thus neither satisfied nor dissatisfied with their job. The dimension associated with the highest levels of dissatisfaction was pay or remuneration. Additionally, the dimension associated with the highest levels of satisfaction was supervision. The findings reported that more respondents were dissatisfied (52.3%) than those who were satisfied (47.7%). Regarding Doctors, more respondents were satisfied (57%) than those who were dissatisfied (43%). On the contrary, more nursing staff (57.8%) and other health professionals (56.2%) were dissatisfied than those who were satisfied (Table 6).

Table 6.

Scores and percentages of satisfaction levels for dimensions of job satisfaction.

Doctors Nurses Other Health Professionals Overall Sample
N=803 N=1,736 N=739 N=3,278
Dimensions Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied
Pay 2.60 0.79 22.3% 77.7% 1.90 0.69 7.1% 92.9% 2.13 0.81 13.4% 86.6% 2.12 0.80 14.3% 85.7%
Promotion 2.87 0.87 34.0% 66.0% 2.26 0.75 13.2% 86.8% 2.44 0.85 18.1% 81.9% 2.45 0.84 21.8% 78.2%
Supervision 4.73 0.70 91.4% 8.6% 4.66 0.88 87.5% 12.5% 4.57 1.02 83.8% 16.2% 4.66 0.88 87.6% 12.4%
Fringe Benefits 3.17 0.80 45.9% 54.1% 2.41 0.73 14.0% 86.0% 2.73 0.87 23.7% 76.3% 2.67 0.84 27.9% 72.2%
Contingent Rewards 3.38 0.84 53.7% 46.3% 2.70 0.82 20.2% 79.8% 2.90 1.02 28.3% 71.7% 2.91 0.92 34.1% 65.9%
Operating Procedures 2.81 0.64 27.0% 73.0% 2.86 0.67 28.4% 71.6% 2.72 0.77 24.9% 75.1% 2.82 0.69 26.7% 73.3%
Coworkers 4.50 0.62 83.3% 16.7% 4.18 0.69 70.0% 30.0% 4.16 0.77 69.6% 30.5% 4.25 0.71 74.3% 25.7%
Nature of work 4.47 0.65 86.4% 13.6% 4.32 0.74 75.7% 24.3% 4.24 0.90 76.1% 23.9% 4.34 0.76 79.4% 20.6%
Communication 3.94 0.74 69.4% 30.6% 3.79 0.79 63.4% 36.3% 3.60 0.94 56.8% 43.2% 3.79 0.82 63.2% 36.7%
Overall Job Satisfaction 3.61 0.51 57.0% 43.0% 3.23 0.44 42.2% 57.8% 3.28 0.58 43.8% 56.2% 3.33 0.52 47.7% 52.3%
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Table 6a.

Scores and percentages of satisfaction levels for dimensions of job satisfaction before of March 13, 2020.

Doctors Nurses Other Health Professionals Overall Sample
n=761 - 94,8% of Total n=1,553 - 89,5% of Total n=659 - 89,2% of Total n=2,973 - 90,7% of Total
Dimensions Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied
Pay 2.60 0.80 22.6% 77.4% 1.88 0.72 8.0% 92.0% 2.14 0.85 14.9% 85.1% 2.12 0.83 13.3% 86.7%
Promotion 2.85 0.88 33.7% 66.3% 2.24 0.77 14.0% 86.0% 2.44 0.88 19.7% 80.3% 2.44 0.86 20.3% 79.7%
Supervision 4.74 0.72 91.0% 9.0% 4.71 0.91 86.7% 13.3% 4.60 1.08 82.1% 17.9% 4.69 0.91 86.7% 13.3%
Fringe Benefits 3.16 0.82 45.7% 54.3% 2.39 0.76 15.1% 84.9% 2.72 0.90 25.0% 75.0% 2.66 0.87 25.1% 74.9%
Contingent Rewards 3.36 0.85 51.4% 48.6% 2.67 0.85 21.2% 78.8% 2.88 1.07 29.2% 70.8% 2.90 0.95 30.7% 69.3%
Operating Procedures 2.80 0.66 26.7% 73.3% 2.82 0.70 28.0% 72.0% 2.68 0.80 24.9% 75.1% 2.79 0.71 27.0% 73.0%
Co-workers 4.50 0.63 82.8% 17.2% 4.20 0.72 69.6% 30.4% 4.19 0.81 69.0% 31.0% 4.27 0.73 72.8% 27.2%
Nature of work 4.46 0.67 86.0% 14.0% 4.33 0.77 75.0% 25.0% 4.23 0.95 74.4% 25.6% 4.34 0.80 77.7% 22.3%
Communication 3.92 0.75 68.4% 31.6% 3.74 0.81 59.7% 40.3% 3.53 0.97 52.7% 47.3% 3.74 0.84 60.4% 39.6%
Overall Job Satisfaction 3.60 0.52 56.5% 43.5% 3.22 0.46 41.9% 58.1% 3.27 0.61 43.5% 56.5% 3.33 0.54 46.0% 54.0%
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Table 6b.

Scores and percentages of satisfaction levels for dimensions of job satisfaction after of March 14, 2020.

Dimensions Doctors Nurses Other Health Professionals Overall Sample
n=42 - 5,2% of Total n=183 - 10,5% of Total n=80 - 10,8% of Total n=305 - 9,3% of Total
Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied Mean SD Satisfied Dissatisfied
Pay 2.74 0.58 16.7% 83.3% 2.06 0.33 0.0% 100.0% 2.01 0.67 0.9% 99.1% 2.15 0.45 2.5% 97.5%
Promotion 3.22 0.50 39.3% 60.7% 2.46 0.48 7.1% 92.9% 2.42 0.81 5.6% 94.4% 2.56 0.56 11.1% 88.9%
Supervision 4.60 0.36 99.0% 1.0% 4.24 0.28 94.9% 5.1% 4.36 1.45 97.8% 2.2% 4.32 0.32 96.3% 3.7%
Fringe Benefits 3.40 0.49 49.4% 50.6% 2.56 0.36 4.4% 95.6% 2.75 0.92 12.8% 87.2% 2.74 0.49 27.7% 72.3%
Contingent Rewards 3.69 0.45 54.9% 35.1% 2.95 0.36 11.9% 88.1% 3.07 1.02 20.6% 79.4% 3.09 0.45 21.5% 78.5%
Operating Procedures 2.99 0.22 31.6% 68.4% 3.16 0.27 32.0% 68.0% 3.06 1.02 24.7% 75.3% 3.10 0.28 30.0% 70.0%
Co-workers 4.48 0.27 91.7% 8.3% 4.01 0.27 78.7% 21.3% 3.96 1.32 74.4% 25.6% 4.07 0.33 76.2% 23.8%
Nature of work 4.57 0.24 94.6% 5.4% 4.22 0.31 80.9% 19.1% 4.23 1.41 90.0% 10.0% 4.28 0.32 85.2% 14.8%
Communication 4.23 0.26 86.9% 13.1% 4.23 0.30 94.9% 5.1% 4.12 1.37 90.0% 10.0% 4.21 0.29 92.5% 7.5%
Overall Job Satisfaction 3.77 0.26 63.8% 36.2% 3.32 0.19 45.0% 55.0% 3.33 1.11 46.3% 53.7% 3.39 0.26 49.2% 50.8%
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Notes: As of March 13, 2020, the World Health Organization (WHO) has declared Europe as the center of the coronavirus pandemic 2019–2020 [31]

Discussion

In this study, the average level of overall job satisfaction was 3.33 out of 6 (Doctors 3.61, Nurses 3.23, Other Health Professionals 3.28). Our study findings discovered that most of the employees of the hospitals were neither satisfied nor dissatisfied, they were ambivalent regarding their job satisfaction. The professionals showed dissatisfaction with most JSS dimensions, namely pay (2.12), promotion (2.45), and fringe benefits (2.67). A perception of dissatisfaction was expressed regarding the operating procedures (2.82) and contingent rewards (2.91) dimensions. However, satisfaction was found with supervision (4.66), co-workers (4.25), and the nature of work (4.34). Τhe results of this study are consistent with those of the research findings in the Greek Sample of Tsounis and Sarafis (2018) (9).

Still, salary and fringe benefits negatively influenced the perception of job satisfaction (14,15). Bratton and Gold (2009) define fringe benefit as that part of the total reward package provided to employees in addition to base or performance pay (16). Low salaries and unjust payments of doctors and nurses pose a threat, mainly because this does not seem to be the case in other professional sectors (17). As result of the economic crisis in Greece, the salaries of Greek hospital professionals decreased or remained frozen for over a decade (2008-2019). Salary levels in other EU countries and the US seem rather unreachable for hospital employees in Greece.

Further, a large number of the respondents in our study were mostly dissatisfied with promotion (78.2%). The average level of job satisfaction was 2.45 (Doctors 2.87, Nurses 2.26, Other Health Professionals 2.44). Various other researches indicated that job satisfaction is highly related to opportunities for promotion (18,19).

In addition, supervision (87.6%) was a source of satisfaction for the healthcare workers in our study, as the average level of job satisfaction was 4.66 (Doctors 4.73, Nurses 4.66, Other Health Professionals 4.57). Some studies have shown that supervision plays a decisive influence on the quality and safety of care provided to patients (20-22). Three-fourths of the respondents (74.3%) reported that they were satisfied with their colleagues. Employees who lack support at work are generally less satisfied. Job satisfaction is higher in a work environment in which supervisors and subordinates consult each other and individuals are involved with peers in decision making and task definition (23,24); therefore, satisfaction due to supervision was found to be critical. Lack of feedback and insufficient clarity of demands from supervisors are associated with low levels of job satisfaction. Yet, supervision is also important to coping with demands, job clarity and stress (25-27).

In this analysis, respondents to our survey considered the tasks and duties of helping others (79.4%) as the major source of their satisfaction, the average level of job satisfaction being 4.34 (Doctors 4.47, Nurses 4.32, Other Health Professionals 4.24). Several relative studies found that the most important for healthcare workers’ job satisfaction is the ‘nature of work’. The study confirmed that health professionals were dissatisfied with operating procedures (73.3%), the average level of job satisfaction being 2.82 (Doctors 2.81, Nurses 2.86, Other Health Professionals 2.72). Robbins (2009) defines operating procedures as the organization policy and the work itself (28-30). Additionally, professionals reported ambivalence concerning only for the communication domain.

According to our study, males were found to have slightly higher job satisfaction scores in several aspects than females. Young health workers were more satisfied with salary, supervision, and co-workers rather than old health workers. Marital status did not have significant relationship with job satisfaction. The lower job satisfaction scores were reported among nurses. What is more, health workers in this study have various qualifications, mostly physicians and nurses with significant proportion of medicine doctors and public health bachelors.

This survey was carried out in the midst of the pandemic crisis of COVID-19, as on 13 March 2020 the WHO declared Europe as the epicentre of the pandemic (31). As a result, our survey was dichotomized in two periods, before and after March 13, 2020. Regarding the data in Table 6a, was found that a great number of the respondents were mostly before the 13th of March 2020, pre-COVID period, employees (2,973; 90,7% of total) were mostly dissatisfied (54.0%) and the average level of overall job satisfaction was 3.33 out of 6 (Doctors 3.60, Nurses 3.22, Other Health Professionals 3.27). After the 13th of March 2020 (Table 6b), first wave of the COVID-19 pandemic, employees (305; 9,3% of total) remained dissatisfied, but to a lesser extent (50.8%), as the average level of overall job satisfaction was 3.39 out of 6 (Doctors 3.77, Nurses 3.32, Other Health Professionals 3.33), slightly improved compared to the pre-COVID period. Therefore, the study findings revealed improvements in most of the dimensions of job satisfaction, as supervision, fringe benefits, operating procedures, co-workers, nature of work, communication but the results concerning the pay, promotion and contingent rewards remained low. During this period, Greece and its public health system were still struggling to recover from the multiyear global financial crisis of the past decade, hospitals’ staff worked longer hours than usual, with no days off. The findings reveals that the strict protocols and procedures were implemented, the recognition and trust of society and the collaboration of employees seems that affected positively in job satisfaction of employees in hospitals.

Our findings are in alignment with prior studies. According to 61 studies conducted in European Union countries, in which enrolled a total of 50,001 physicians working in hospitals among 17 different countries, the majority of whom were conducted in Germany (13 studies), Sweden (7 studies), the UK (6 studies), Spain (5 studies), Italy (5 studies) and the Netherlands (5 studies), the level of satisfaction of physicians was moderate. Low levels of satisfaction connected with salaries, increasing workloads, working conditions as well as migration and ageing of doctors (32). Moreover, it was found Italian female physicians perceived a lower level of procedural justice related to their work situation (career path, type of activities, workload and level of remuneration) and their levels of anxiety, depression and psychological problems were higher than in males. In this same vein, in a sample of 1,304 nurses from 15 different wards working in Italian public hospitals the results show a low level of job satisfaction. From data were gathered in 2013, revealed dissatisfaction with task requirements, organizational policies and advance in career - although to a lesser extent - with the relationship with colleagues and physicians (33). Similarly, in Bulgaria 60% of respondents expressed general dissatisfaction with their work and over 44% would not recommend their profession to young people; 90% were dissatisfied with healthcare reforms. Job satisfaction in the nursing profession is also important. Remuneration was the biggest reason for dissatisfaction, followed by poor working conditions and poor interpersonal relationships. In a survey of 31,627 nursing staff distributed between 2009-2010, in 2,170 general medical/surgical units within 488 hospitals across 12 European countries: Belgium, England, Finland, Germany, Greece, Ireland, Netherlands, Norway, Poland, Spain, Switzerland and Sweden, overall 8,666 nurses (27%) experienced high emotional exhaustion, 3,127 nurses (10%) experienced high depersonalization and 5,300 nurses (17%) experienced low feeling of personal accomplishment. Still, a total of 8,268 nurses reported being very or a little dissatisfied with their job (26%). Hence, a total of 8,016 nurses (25%) reported being greatly or a little dissatisfied with work schedule flexibility and 10,440 (33%) reported intention to leave their current job (34). In Spain, within 5,654 respondents that collected between 2009-2010, about 55% of nurses (3,080) showed moderate job satisfaction, 26% of nurses (1,468) showed their intention to leave the hospital, as the work environment was unfavorable for 48% (2,729) of nurses. 22% (1,091) showed high burnout levels (35). Lastly, in a survey was conducted in 2013 among 494 nurses working in 5 hospitals in the prefecture of Achaia, West-Greece (36). The results indicate that further stress increasing and satisfaction reducing factors were connected with the limited decision latitude and autonomy, low participation in decision making and low supervisors’ support. The lack of support and respect and lack of communication and collaboration between doctors and colleagues affect negatively the quality of the provided nursing care. The present study revealed higher stress levels in nurses with regular working hours. This paradox could be explained by the lower salary they receive and the difficulties to cover their everyday family expenses.

This study was conducted in Athens the capital of Greece, where there are several hospitals, future research needs to expand the scope of this study by focusing on a large and geographically more diverse sample so that its results can be generalized to the entire public health care sector of Greece.

Conclusion

Research findings showed that the job satisfaction of employees in general is on the decline. In hospitals, job dissatisfaction is strongly associated with staff’s intention to quit, suboptimal healthcare delivery and poor clinical outcomes. Hospital employees will demonstrate pleasurable positive attitudes when they are satisfied with their job.

Can any steps be taken to improve job satisfaction? In our view, now, even more than in the past, increasing pay and perks may not be easy in days of shrinking budgets. As job satisfaction is affected by many variables to different degrees and public hospitals in Greece are under the supervision of the Ministry of Health (MoH), emphasis should be placed straight away on positive factors (supervision, communication, favorable conditions of work) that can enhance employees’ satisfaction and organizational commitment. Negative factors (promotion, operating procedures, contingent rewards) should be addressed to assist in increasing the satisfaction level and diminishing staff turnover, tardiness, absenteeism and low productivity. There is a need to innovate and come up with low/no cost measures. Appreciation and recognition of staff can be one of the easiest, cost-effective strategies to retain experienced mature staff. Job satisfaction significantly influenced by factors such as opportunities to develop and responsibility. Moreover, job satisfaction can be higher in a work environment in which there are health and safety measures, supervisors and subordinates consult together and individuals are involved with peers in decision making and task definition. Encouragement from management and organizational support are remarkable factors when there are exist.

In summary, an employee’s overall satisfaction with his job is the result of a combination of factors. The findings of this study clearly suggest that implementing career plans and benefits, as well as readjustment of staff and improvement of working conditions may result in job satisfaction.

Acknowledgements:

The authors acknowledge all those who participated in the study and also those who helped with conducting this survey.

Conflict of Interest:

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article

References

  1. Kinzl JF, Knotzer Traweger C, Lederer W, Heidegger T, Benzer A. Influence of working conditions on job satisfaction in anesthetists. Br J Anaesth. 2005;94:211–5. doi: 10.1093/bja/aei035. doi:10.1093/bja/aei035. [DOI] [PubMed] [Google Scholar]
  2. Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA. Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med. 2000 Feb;15(2):122–8. doi: 10.1046/j.1525-1497.2000.02219.x. doi: 10.1046/j.1525-1497.2000.02219.x. PMID: 10672116; PMCID: PMC1495336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Mahmoud AL-Hussami RN. A Study of Nurses’ Job Satisfaction: The Relationship to Organizational Commitment, Perceived Organizational Support, Transactional Leadership, Transformational Leadership, and Level of Education. European Journal of Scientific Research. 2008;22:286–95. [Google Scholar]
  4. Giri VN, Kumar BP. Assessing the impact of organizational communication on job satisfaction and job performance. Psychological Studies. 2010;55:137–43. doi:10.1007/s12646-010-0013-6. [Google Scholar]
  5. Liu Cong, Borg Ingwer, Spector Paul. Measurement Equivalence of the German Job Satisfaction Survey Used in a Multinational Organization: Implications of Schwartz’s Culture Model. The Journal of applied psychology. 2005;89:1070–82. doi: 10.1037/0021-9010.89.6.1070. doi:10.1037/0021-9010.89.6.1070. [DOI] [PubMed] [Google Scholar]
  6. Faragher EB, Cass M, Cooper CL. The relationship between job satisfaction and health: a meta-analysis. Occup Environm Med. 2005;62:105–12. doi: 10.1136/oem.2002.006734. doi:10.1136/oem.2002.006734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Spector PE. Measurement of human service staff satisfaction: development of the Job Satisfaction Survey. Am J Community Psychol. 1985 Dec;13(6):693–713. doi: 10.1007/BF00929796. doi: 10.1007/BF00929796. PMID: 4083275. [DOI] [PubMed] [Google Scholar]
  8. Spector PE. Job satisfaction. Application, assessment, cause & consequences. Psychology Faculty Publications. 1997 doi:10.4135/9781452231549. [Google Scholar]
  9. Tsounis A, Sarafis P. Validity and reliability of the Greek translation of the Job Satisfaction Survey (JSS) BMC Psychology. 2018;6:1–6. doi: 10.1186/s40359-018-0241-4. doi:10.1186/s40359-018-0241-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cronbach LJ. Coefficient alpha and internal structure of tests. 1951;6:297–334. doi:10.1007/BF02310555. [Google Scholar]
  11. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale NJ: Lawrence Erlbaum Associates; 1988. doi:10.4324/9780203771587. [Google Scholar]
  12. Taber KS. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Res Sci Educ. 2018;48:1273–96. https://doi.org/10.1007/s11165-016-9602-2. [Google Scholar]
  13. Cortina JM. What Is Coefficient Alpha? An Examination of Theory and Applications. Journal of Applied Psychology. 1993;78:98–104. doi:10.1037/0021-9010.78.1.98. [Google Scholar]
  14. Prakash Sharma J, Bajpai N. Salary satisfaction as an antecedent of job satisfaction: development of a regression model to determine the linearity between salary satisfaction and job satisfaction in a public and a private organization. Eur.J.Soc.Sci. 2011;18(3):450–61. [Google Scholar]
  15. Kaur S, Sharma R, Talwar R, Verma A, Singh S. A study of job satisfaction and work environment perception among doctors in a tertiary hospital in Delhi. Indian J Med Sci. 2009;63:139–44. doi:10.4103/0019-5359.50762. [PubMed] [Google Scholar]
  16. Artz B. Fringe benefits and job satisfaction. International Journal of Manpower. 2010;31(6):626–44. doi: 10.1108/01437721011073346K. [Google Scholar]
  17. Roditis K, Samara E, Louis K. A survey to assess job satisfaction among junior doctors in Greece. Scientific Chronicles. 2019;24(1):72–96. doi:10.11212/exronika/2019.1.7. [Google Scholar]
  18. Castle NG, Degenholtz H, Rosen J. Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania. BMC Health Services Research. 2006;24:60–70. doi: 10.1186/1472-6963-6-60. doi:10.1186/1472-6963-6-60. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Pergamit MR, Veum JR. What is a Promotion? ILR Review. 1999;52(4):581–601. doi:10.1177/001979399905200405. [Google Scholar]
  20. Snowdon DA, Sargent M, Williams CM, et al. Effective clinical supervision of allied health professionals: a mixed methods study. BMC Health Serv Res 20. 2020;2 doi: 10.1186/s12913-019-4873-8. doi:10.1186/s12913-019-4873-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Janíková Eva, Bužgová Radka. Satisfaction with supervision of healthcare workers in relation to job satisfaction and selected characteristics of supervision. Central European Journal of Nursing and Midwifery. 2021;12:487–94. doi:10.15452/cejnm.2021.12.0004. [Google Scholar]
  22. Tomlinson J. Using clinical supervision to improve the quality and safety of patient care: a response to Berwick and Francis. BMC Med Educ 15. 2015;103 doi: 10.1186/s12909-015-0324-3. doi:10.1186/s12909-015-0324-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Vera M, Martínez IM, Lorente L, et al. The Role of Co-worker and Supervisor Support in the Relationship Between Job Autonomy and Work Engagement Among Portuguese Nurses: A Multilevel Study. Soc Indic Res. 2016;126:1143–56. doi:10.1007/s11205-015-0931-8. [Google Scholar]
  24. Tsai Y. Relationship between Organizational Culture, Leadership Behavior and Job Satisfaction. BMC Health Serv Res. 2011;11(98) doi: 10.1186/1472-6963-11-98. doi:10.1186/1472-6963-11-98. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Liu Y, Aungsuroch Y, Yunibhand J. Job satisfaction in nursing: a concept analysis study. Int Nurs Rev. 2018;63:84–91. doi: 10.1111/inr.12215. doi:10.1111/inr.12215. [DOI] [PubMed] [Google Scholar]
  26. Burke R. Nursing staff attitudes following restructuring: the role of perceived organizational support, restructuring processes and stressors. International Journal of Sociology and Social Policy. 2003;23:129–157. doi:10.1108/01443330310790679. [Google Scholar]
  27. Burke R, Greenglass E. Hospital restructuring and nursing staff well-being: The role of perceived hospital and union support. Anxiety, Stress & Coping: An International Journal. 2001;14(1):93–115. doi:10.1080/10615800108248350. [Google Scholar]
  28. Bhatnagar K, Srivastava K. Job satisfaction in health-care organizations. Ind Psychiatry J. 2012 Jan;21(1):75–8. doi: 10.4103/0972-6748.110959. doi: 10.4103/0972-6748.110959. PMID: 23766585; PMCID: PMC3678186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Chiok Foong Loke J. Leadership behaviours: effect on job satisfaction, productivity and organizational commitment. Journal of Nursing Management. 2001;9:191–204. doi: 10.1046/j.1365-2834.2001.00231.x. doi:10.1046/j.1365-2834.2001.00231.x. [DOI] [PubMed] [Google Scholar]
  30. Sansoni J, De Caro W, Marucci AR, Sorrentino M, Mayner L, Lancia L. Nurses’ Job satisfaction: an Italian study. 2016;28:58–69. doi: 10.7416/ai.2016.2085. doi:10.7416/ai.2016.2085. [DOI] [PubMed] [Google Scholar]
  31. WHO. WHO Director-General’s Opening Remarks at the Media Briefing on COVID-19-13 March 2020. Available online: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-mission-briefing-on-covid-19---13-march-2020. (accessed on 30 May 2021) [Google Scholar]
  32. Domagała A, Bała MM, Peña-Sánchez JN, et al. Satisfaction of physicians working in hospitals within the European Union: state of the evidence based on systematic review. Eur J Public Health. 2019 Apr 1;29(2):232–241. doi: 10.1093/eurpub/cky117. doi: 10.1093/eurpub/cky117. PMID: 29992236. [DOI] [PubMed] [Google Scholar]
  33. Sansoni J, De Caro W, Marucci AR, Sorrentino M, Mayner L, Lancia L. Nurses’ Job satisfaction: an Italian study. Ann Ig. 2016 Jan-Feb;28(1):58–69. doi: 10.7416/ai.2016.2085. doi: 10.7416/ai.2016.2085. PMID: 26980510. [DOI] [PubMed] [Google Scholar]
  34. Dall’Ora C, Griffiths P, Ball J, Simon M, Aiken LH. Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open. 2015 Aug 23;5(9):e008331. doi: 10.1136/bmjopen-2015-008331. doi: 10.1136/bmjopen-2015-008331. PMID: 26359284; PMCID: PMC4577950. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Fuentelsaz-Gallego C, Moreno-Casbas T, López-Zorraquino D, Gómez-García T, González-María E. consorcio RN4CAST-España. Percepción del entorno laboral de las enfermeras españolas en los hospitales del Sistema Nacional de Salud. Proyecto RN4CAST-España [Perception of work environment of nurses in hospitals of the Spanish national health system. RN4CAST-Spain project]. Enferm Clin. 2012 Sep-Oct;22(5):261–8. doi: 10.1016/j.enfcli.2012.09.001. Spanish. doi: 10.1016/j.enfcli.2012.09.001. Epub 2012 Oct 6 PMID: 23043730. [DOI] [PubMed] [Google Scholar]
  36. Jelastopulu Eleni, et al. Self-reported Sources of Stress, Job Satisfaction and Quality of Care in Professional Hospital Nurses in West-Greece. Nursing and Health. 2013;1:1–9. doi:10.13189/nh.2013.010101. [Google Scholar]

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