ORIGINAL RESEARCH

Sociodemographic and occupational influences over job satisfaction between nurses in a public hospital

Evelin Daiane Gabriel Pinhatti^I; Marli Terezinha Oliveira Vannuchi^II; Mariana Neves Faria Tenani^III; Maria do Carmo Lourenço Haddad^IV

^INurse. Master in Nursing. State University of Londrina. Londrina, Paraná, Brazil. E-mail: evelin.gabriel@sercomtel.com.br
^IINurse. PhD in Public Health. Professor, Department of Nursing, State University of Londrina. Londrina, Paraná, Brazil. E-mail: marlivannuchi@gmail.com
^IIINurse. Master in Nursing. Auditor in the Regulation, Control, Evaluation and Audit Section - 17^th Regional of Health. Londrina, Paraná, Brazil. E-mail: mariana.tenani@gmail.com
^IVNurse. PhD in Nursing. Professor, Department of Nursing, State University of Londrina. Paraná Brazil. E-mail: carmohaddad@gmail.com

DOI: http://dx.doi.org/10.12957/reuerj.2017.14405

ABSTRACT

Objective: to analyze professional satisfaction of nurses and ascertain the influence of socio-demographic and labor characteristics on that. Method: cross-sectional study, with quantitative aproach, conducted with 39 nurses who answered a structured questionnaire comprising socio-demographic and labor characteristics and the Work Satisfaction Index (WSI). Research project was approved by Research Ethics Committee, CAAE nº 0272.0.268-10. Results: characteristics as female gender, single marital status, managerial position, presence of children, belonging to the age group of 40 years or more, single employment relationship and having a masters' degree presented lower levels of professional satisfaction. General WSI score was of 13.28, indicating that work satisfaction is close to the dissatisfaction limit, considering the possible range from 0.9 to 37.1. Conclusions: financial rewards and developed activities are satisfaction factors, while the lack of recognition of the profession and difficulties in interpersonal relationships cause dissatisfaction.

Keywords: Job satisfaction; nursing; occupational health; health manpower.

INTRODUCTION

Economic transformations resulting from globalization have made men more susceptible to work-related psychobiological pressures and stimuli. In the capitalist context, the pursuit of high productivity and low production costs has had repercussions on the workers' health and quality of life¹.

Health professionals are part of a group in which rapid exhaustion is observed to result from numerous stressful situations, as these professionals have to act often under inadequate working conditions such as inappropriate physical structure, lack of human and material resources, and exposure to biological, chemical, physical and psychosocial risks².

Regarding the nursing work process, studies emphasize that nursing professionals are in constant contact with pain, suffering and death, work overload and poor working conditions^2,3, not to mention inadequate remuneration, lack of professional recognition and devaluation at work⁴. These and other factors reinforce the exposure of nurses to situations of stress, suffering and conflicts that may negatively affect their health and job satisfaction.

As job satisfaction can have repercussions in the health of workers, and also in institutional losses, investigations on the theme are sorely needed.

The guiding questions of this study were: What is the level of job satisfaction of nurses? Do sociodemographic and work-related characteristics interfere in the professional satisfaction of nurses? What are the sources of greater (dis)satisfaction among nurses?

In order to answer these questions, the present study was proposed to reach the following objectives: to analyze the professional satisfaction of nurses and to investigate the influence of sociodemographic and work-related characteristics on satisfaction.

LITERATURE REVIEW

Job satisfaction is a complex phenomenon and difficult to define because it refers to a subjective state. Although there is no consensus on the concept and definitions proliferate, the philosophical conception stands out, which is a "positive affective state resulting from the appreciation of the job or from work-related experiences"^5:9.

It is noteworthy that job satisfaction can be influenced by forces that may be internal or external to the work environment. In the individual sphere, the variables age, time of professional experience, marital status, level of education, social integration and expectations regarding work stand out. The professional sphere, in turn, includes autonomy, interaction, professional status, work characteristics, organizational norms, wages, recognition, routines, professional role played, among others⁶.

In the hospital context, the activities developed by nurses entail physical and emotional exhaustion and can lead to poor quality of life and job satisfaction⁷. Some authors highlight the deleterious effects of job dissatisfaction, which not only affects the quality of life but also hampers professional performance, as well as can generate institutional losses and a deficit in the quality of care^8,9.

Job dissatisfaction has also been related to stress. Occupational stress is common in the nursing profession and is associated with negative results at the individual and organizational levels and frequent in settings where the demands are not compatible with the individual capacity of workers, or where the opportunities of the environment do not meet their needs and expectations¹⁰.

Considering the aspects raised, the present study is relevant because knowing the factors that influence the satisfaction of nurses can subsidize interventions to meet the needs of these professionals, as well as, increase the quality of care provided to the clients of the institution.

METHODOLOGY

This is a cross-sectional study with descriptive and quantitative approach carried out in May and June 2011 in a medium-complexity public hospital located in the north of Paraná that assists clients of the Unified Health System.

The sample consisted of 39 nurses. The inclusion criteria of the study were: workers recently approved in public tender; workers linked to the institution for at least six months; and formal agreement to participate in the study. The time of at least six months linked to the institution was chosen because it refers to the minimum necessary for the worker to adapt to the new unit and to avoid false responses regarding job satisfaction due to the adaptation period⁵.

Data was collected during working hours with a questionnaire given to each participant in a closed envelope to preserve the confidentiality of the information and to guarantee the anonymity of the participants. The Index of Work Satisfaction (IWS) was created by Stamps¹¹ and translated and validated in Brazil⁵ to evaluate the satisfaction of nurses in intensive care units and has been increasingly used in studies of different areas, specialties and work contexts^7,12-16.

The IWS is composed of two parts, the part I has questions for sociodemographic and professional characterization of nurses and the part II corresponds to the questionnaire for evaluation of job satisfaction, subdivided into two sub-items (A and B).

In sub-item A, there are 15 pairs of combinations of the six IWS components, namely: autonomy - independence, initiative and freedom in daily work activities; interaction - opportunities for social and formal and informal professional contacts during work; professional status - perceived importance or significance of the work performed, both in participant's point of view and in that of others; work requirements- tasks or activities performed as a regular part of the job; organizational norms - administrative norms and procedures proposed by the hospital and management of the nursing service; remuneration - payment and additional benefits received for the work performed. In this sub-item, the paired comparisons are the basis for the respondent to attribute a measure of importance to the IWS components by indicating one component in each combination.

The sub-item B is a 44-item likert-type scale where responses vary from 1 to 7. In this gradation, the closer the answer is to the number one, the more the respondent agrees with the statement, while the closer the number is to seven, the greater is the disagreement.

After collection, data were recorded in the Microsoft Office Excel ® software and transferred into theStatistical Package for Social Sciences (SPSS) version 20.0 ^® for descriptive statistical analyses.

A weighted measure between sub-items A and B of the part II of the IWS was used to obtain the actual level of satisfaction. The weighting coefficient, obtained in the calculation of the paired comparisons, was multiplied by the average score of each component. The later was obtained by dividing the total score of each component by the number of items. This resulted in the score adjusted per component of professional satisfaction. The scores of the adjusted components were then summed and divided by the number of components (6), resulting in the IWS score, whose variation ranged from a lowest of 0.9 and a maximum of 37.1.

In order to check the relationship between the IWS and sociodemographic and work-related data, the IWS for the following variables was calculated: sex, age, marital status, presence of children, training, position, employment bonds. Afterwards, a descriptive analysis of the IWS in relation to each of the variables was provided.

The study project was submitted and approved by the Research Ethics Certificate of Presentation for Ethical Appraisal of Presentation for Ethical Assessment (CAAE) nº 0272.0.268-10.

RESULTS AND DISCUSSION

To describe the studied population, sociodemographic and work-related characteristics of the workers, as well as the relation of IWS values ​​with each of the studied variables, are presented in Table 1.

TABLE 1: Distribution of sociodemographic and work-related variables and Index of Work Satisfaction (IWS) scores of nurses in a public hospital. Paraná, 2011. (n=39)

... The instrument does not allow the calculation of IWS for a single individual.

The study group showed a predominance of females - 25 (64.1%), married status - 22 (56.4%), age group between 30 and 39 years - 19 (48.7%), and absence of children - 22 (56.4%). The significant percentage of female nurses is in line with studies that have highlighted the nursing history as a predominantly female profession^9,12,13. Regarding the age group, the findings resembled studies that describe nursing teams made up of professionals in the most productive age range^7,9,14.

With respect to the IWS, we observed that some variables had lower scores, among them: female sex (13.03); single marital status (13.03); managerial position (12.74); presence of children (12.60); age group of 40 years or more (13.02); single employment bond (13.08); and attainment of master degree (12.88).

Regarding gender, the findings converge with studies that found a higher IWS among men^9,14. The low satisfaction index in women may be linked to the fact that, besides productive participation outside the home, the respondents dedicate time caring for the family, performing the so-called double journey, which is a common trait in the lives of contemporary women¹⁷.

Regarding the age group, it was observed that as the age of the respondents increases, job satisfaction decreases, possibly due to exposure to occupational hazards, and this finding is consistent with another study¹². However, other researches presented the opposite results, emphasizing that older professionals have greater satisfaction because financial resources and benefits increase proportionally with age^8,9.

As for the position occupied in the work, this can be source of greater or lesser satisfaction. In this study, the group of nursing managers presented a lower level of satisfaction, unlike another survey that found a higher level of satisfaction among employees with management positions⁸ . In the daily routine of nurses who are managers, purely administrative activities can contribute to job dissatisfaction mainly because they get distant from direct patient care⁷.

Most nurses (84.6%) reported having no further employment bonds, as also found in another studies conducted in Brazil^9,13. This may be related to current job satisfaction, especially wages, considered to be one of the causes of dissatisfaction that leads workers to choose to hold more than one job¹³.

When job satisfaction components were evaluated, the adjusted score for the satisfaction component identified the general component value of 13.28, the highest satisfaction component being remuneration, and the lowest professional status, as evidenced in Figure 1.

FIGURE 1: Classification of work satisfaction components of nurses in a public hospital, according to index of satisfaction. Paraná, 2011.

Professional satisfaction of nurses in the present study was higher than other studies^6,9, which obtained job satisfaction indices of 9.53 and 8.62, respectively. However, a similar result (13.19) was found in a study that evaluated the job satisfaction of nurses who provide home care⁷.

The IWS value found in this study may be related to the time of work in the institution, as the newly hired nurses had had been working for less than one year. For some authors^8,12, working time influences job satisfaction because it is proportional to the exposure to exhaustive working hours and risk factors such as biological exposure and physical and psychic overload, which interfere with job satisfaction.

The components that obtained the highest and lowest job satisfaction scores, according to sociodemographic and work-related data, are shown in Table 2.

Remuneration stood out as the predominant component of job satisfaction in nurses, according to Table 2. This differs from most IWS studies which revealed autonomy as the component that causes greater satisfaction^5,16. In the national literature, remuneration has been highlighted as a factor of dissatisfaction^5,6,15,18. However another study found similar results to the present ones, showing remuneration as the highest source of satisfaction, followed by organizational norms, work requirements, professional status, interaction, and, finally, autonomy¹². It should be noted that although remuneration was the main component contributing to greater satisfaction in this sample, this is not the only factor capable of promoting satisfaction, as can be seen in Table 2.

It is necessary to take into account the current context of the research, in which nurses got into the institution through public tender. In this case, the salary was one of the attractions. This kind of selection also allows the evolution in the career plan, positions and salaries. It is noteworthy that satisfaction with remuneration can be a way to increase job satisfaction related to the social and historical reality experienced today, with a tendency to overestimate capital, because money can bring greater power and status⁹.

Regarding the autonomy, the following characteristics were elected as sources of greater satisfaction: managerial position; work requirements for those who held double employment bonds; and age group of 40 years or more. As for the component organizational norms, attainment of master degree was a source of greater satisfaction. Studies emphasize that for a work to be a rewarding activity, besides its material meaning, other aspects of human activities must be met, including psychological and social aspects, which are essential to determining job satisfaction^8,18.

In the present study, autonomy was component deriving higher satisfaction among the nurses with managerial positions. Managers present characteristics typical of the position they occupy, which give them greater independence in their actions, individual responsibility and active roles in the process of decision making¹⁵. At the same time, although managerial nurses appreciate ​​ autonomy, the distancing from care activities, among other factors linked to the position, may indicate that the managers are less satisfied than the caregivers. See Table 1.

Regarding the interaction component, this was found to have a lower job satisfaction index, with a higher occurrence among the variables, according to Table 2. This component ranked fifth in satisfaction of the study group, as shown in Figure 1, thus exerting less influence on job satisfaction in this study. This finding contradicts research results that have shown interpersonal relationship as a source of professional satisfaction, being a fundamental factor in the coexistence and a facilitator in the solution of conflicts^7,18. It is inferred that the low score of the interaction component can be attributed to the fact that the participant workers were recently hired by the institution and interpersonal relationships have, therefore, not become important yet in the work conception, considering that they are still in the phase of insertion in the occupational team.

Studies have showed that conflicting relationships occur frequently in health services, in multiprofessional teams, where each member wants to show a preponderant role in the treatment of patients. In the same way, conflicts also occur in nursing teams, in which power relations and hierarchy stand out as constant causes of conflicts in professional relationships, resulting in a deterioration of relationship within the team and turning work activities difficult^7,19.

Regarding the organizational norms, lower satisfaction index was seen among the variables single marital status, absence of children and age group between 20 and 29 years, that is, young workers. The literature points out younger employees as having lower rates of organizational commitment and greater desire for status and autonomy at work, corroborating the findings of the present study. These observations suggest a more careful look at this group which, according to the characteristics verified, is considered a generation with a high need for satisfaction²⁰.

Professional status had the lowest satisfaction index according to Figure 1, and this is related to lack of professional valorization, inadequate remuneration, work overload, conflicting hierarchical and interpersonal relationships, as well as lack of awareness about the duties of nurses and the charitable and submissive historical view of the profession. It may still be related to the level of influence and respect achieved by the individuals as result of experience in their work. This aspect may be incipient in the case of the investigated professionals, due to their short time in the institution¹⁶.

Regarding this matter, we emphasize that nurses have to constantly deal with the lack of professional appreciation. Even when there is recognition of their work as really important, nurses still need to demonstrate that their role is fundamental and need to be respected by other professions in the health area. These and other factors may have an impact on the self-esteem of these professionals and on the image of the profession^7,12,21.

CONCLUSION

This study allowed evaluating the job satisfaction of newly hired nurses in a hospital of medium complexity. Although the objectives of the study were achieved, the fact that the study was carried out in a single institution is a limitation, for the information obtained cannot be generalized. Despite of this, the data contribute to the construction of knowledge of aspects that interfere with job satisfaction.

In relation to the overall IWS, it was found that this was above the other scores presented in the Brazilian literature. However the values ​​obtained cannot be considered high, because the IWS of the nurses were close to the limit of dissatisfaction.

Some sociodemographic and work-related variables presented lower scores, namely, the female gender, single marital status, managerial position, presence of children, age group of 40 years or more, single employment bond, and attainment of master degree. Regarding the components, it was found that the professionals were more satisfied with remuneration, followed by autonomy, work requirements, organizational norms, interactions and, finally, professional status.

It is noteworthy that financial reward and the activities developed were factors that promoted greater job satisfaction. On the other hand, nurses are dissatisfied at work mainly with respect to difficulties in interpersonal relationships and lack of professional recognition.

We hope that the results obtained in this study may awaken interest in the development of actions to meet the demands and needs of professionals, considering the importance of the nursing work for human beings. Thus, we suggest that nurses, managers and organizations of the class seek the social and scientific dissemination of the nursing work, to foster professional appreciation and better multidisciplinary interaction.

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