Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

Promoting Resilience in Healthcare Workers: A Preventative Mental Health Education Program

Healthcare workers face greater risks for mental health conditions and chronic stress due to the demanding nature of their roles. The COVID-19 pandemic exacerbated these challenges and increased vulnerabilities to long-term mental health conditions. The present study adapts an existing resilience-based educational workshop program to address the time constraints and unique needs of the healthcare workforce in a post-COVID-19 world. Expanded from its initial focus on resilience, the workshop curriculum incorporates psychoeducation on common mental health issues. Between July 2022 and June 2024, a 15 min "huddle" format offered on-site training to equip HCWs in a large urban health system with coping strategies to prevent, manage, and recover from stress. Attendance and anonymous feedback were collected at each session via brief electronic surveys. Participant responses (n = 1403) obtained immediately post-huddle suggested positive impact on stress management, perceived leadership support, and resilience. Findings show the potential of brief huddles to improve mental health and resilience in healthcare workers and similar workforces. Our findings support the efficacy of brief, evidence-based educational huddles in enhancing resilience, mental health awareness, and coping skills among HCWs. This model holds significant potential for widespread implementation across healthcare and other high-stress workplaces.

Assessment of Nurses' Job Satisfaction and Associated Factors in Management of Neurosurgery Procedures at Fujita Health University Bantane Hospital (Aichi, Nagoya, Japan)

Introduction  Job satisfaction is a professional aspect that contributes to the achievement of objectives in general and in the health sector; it is a golden standard for having quality care. The satisfaction of nurses is a path toward humanized nursing. This article aims to evaluate the job satisfaction among nurses of the neurosurgery department at Bantane Hospital. Materials and Methods  We conducted a cross-sectional study including 74 nurses at Bantane Hospital in Nagoya Japan in August 2023. Nurses responded to a questionnaire relating to job satisfaction. Univariate analysis was supported by bivariate analyses at the 95% significance level. Results  The survey revealed that nurses aged between 18 and 29 were mostly represented (62.2%). Drip-injection medication was the most preferred activity (15 times) by Bantane nurses. The satisfaction rate was 63.5% and the fact of considering nurses point of view, good interpersonal relationships, and a considerable lunchtime period was statistically significant ( p  < 0.05). Conclusion  Transcendental motivation is a priority in the approach to humanize nursing by considering both monetary and nonmonetary incentives to motivate nurses.

The Existence-Relatedness-Growth Theory for Job Satisfaction and Motivation of Greek National Healthcare Service Employees in the Context of Severe Financial Constraints

The hospital environment is often quite complicated due to interdisciplinary workflow procedures and multitasking staff, which are exacerbated during periods of economic crisis. This study aimed to examine the motivation and job satisfaction factors of Greek National Healthcare Service (NHS) employees in relation to the Existence-Relatedness-Growth (ERG) theory of motivation during a period of severe financial constraints. A cross-sectional study was conducted in three public hospitals in Greece from 2018 to 2019, utilizing a survey tool to measure the factors of motivation and job satisfaction among Greek NHS employees. The study also aimed to identify the most relevant motivational theory applicable to the complex Greek hospital environment. Exploratory factor analysis (EFA) was employed to extract the structural factors of the survey tool, and analysis of variance (ANOVA) was used to identify statistical differences between the means of three or more independent groups. A sample of 363 Greek NHS employees participated in this study. Statistically significant differences were detected between hospital units and job satisfaction factors, as well as between the functions of hospital clusters and job positions. Specifically, managerial staff presented higher levels of job satisfaction, while nursing staff had the lowest scores in terms of psychological contracts when compared to medical and administrative staff. This study demonstrated that job satisfaction in Greek public hospitals, in a context of severe financial constraints, was mainly driven by strong interpersonal connections and employee trust in management, despite significant cuts in salaries, staff numbers, and hospital budgets.

Fatigue based on the subjective feeling of people representing selected medical professions

OBJECTIVES

Fatigue can be the result of overexertion and overload. It occurs when the burdened body does not have enough time for regeneration and biological renewal. The aim of this study was analysis of fatigue based on the subjective feeling in physiotherapists, nurses, and paramedics.

MATERIAL AND METHODS

The research covered 193 women and 107 men aged 30-60 years, including 100 physiotherapists, 100 nurses and 100 paramedics with higher education, employed in clinics and hospitals in the Podkarpackie Voivodeship, Poland. The research tool of choice was 30-item Research Committee on Industrial Fatigue Fatigue Scale, adapted into the Polish language by Paluch. The data were analyzed based on ANOVA Kruskal-Wallis test, Mann-Whitney U test and Spearman's rank correlation.

RESULTS

Values determining frequency of decrease in activity were higher in nurses than in physiotherapists (p < 0.001) and paramedics (p = 0.005). Physiotherapists and nurses showed statistically significant positive associations of all fatigue indices with age and seniority. Sex-related differences in the frequency of physical fatigue symptoms have been noted (p = 0.044). Among people working in outpatient clinics and hospitals there were statistically significant differences in the frequency of decrease in activity (p = 0.001) and general level of fatigue (p = 0.031).

CONCLUSIONS

In nurses and physiotherapists, the frequency of experiencing ailments increases with age and work experience. This suggests that in the case of these professions it is important to quick identification of signs of fatigue and taking actions to prevent its worsening. Women experience fatigue more often, so they especially need to take steps to prevent and, if necessary, treat this condition. Hospitals should be an area of special involvement in the process of implementing programs to counteract fatigue of employees in the medical services sector. Int J Occup Med Environ Health. 2024;37(1):72-83.

About half of Ethiopian midwifery professionals reported being dissatisfied with their jobs: A systematic review and meta-analysis

Background

Increasing well qualified health professionals is a part of sustainable development goal to specially to decrease maternal mortality below 70 per 100,000 deaths. Contrarily, The Nursing and midwifery councils (NMC) expect that 36% of healthcare workers, especially midwives, are leaving their jobs due to high turnover rates and job unhappiness worldwide.

Methods

Studies were rigorously searched utilizing international databases from PubMed, Google Scholar, Cochrane Library, and Embase. Using the New Castle Ottawa scale for a cross-sectional study design, the quality of the articles that were searched was evaluated. The systemic review was conducted using the random effect approach, and statistical analysis was done using STATA version 17 software for the window. The Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guideline was followed for reporting results.

Results

A total of nine observational cross-sectional studies were included in this review. The pooled level of job satisfaction among midwives in Ethiopia was 52.2% (95% CI =41.7, 62.9). The pooled odds ratio showed that a significant positive association was found between midwives' job satisfaction and studied variables. Male midwife (OR = 0.45; 95% CI: 0.04, 0.87), fair supervision (OR = 2.03; 95%CI: 1.58-1), workload (OR = 1.72; 95%CI: 1.102-2.43) and motivation (OR = 1.64; 95%CI: 1.02-2.25) were strongly associated with job satisfaction.

Conclusion

Evidence suggested that motivating employees, providing fair supervision, fair workloads, and fostering positive relationships with managers are all crucial tactics for retaining and enhancing the satisfaction of health professionals at health care facilities in Ethiopian.

Nurses job satisfaction identified by personal preferences and perceived saturation divergence: a comparative cross-sectional study in Czech hospitals between 2011 and 2021

BACKGROUND

The perception of the quality of care provided by the medical institution to patients is directly affected by the job satisfaction of nurses. The feeling of job satisfaction is caused besides other things by the subjective expectations of employees about what their work should provide them with in return. The aim of the study is to evaluate and compare job satisfaction of hospital nurses in the Czech Republic in 2011 and 2021 by identifying differences between their personal preferences and perceived saturation.

METHODS

The respondents are hospital nurses in the Czech Republic in 2011 and 2021. A developed questionnaire was used to determine the job satisfaction factors. The order of factors of personal preferences, perceived saturation and differences between them was compiled. For evaluation was used the Euclidean distance model that enables to capture the order and determine the significance given by the distance in which the factors are located.

RESULTS

At the top of personal preferences of hospital nurses, the factors salary and patient care are in the first two places with a similar distance. The salary factor is the most preferred by hospital nurses in both evaluated periods, and at the same time there is the greatest discrepancy between personal preferences and perceived saturation. By contrast, image of profession and working conditions were sufficiently saturated by the employer in both periods, but nurses do not significantly prefer these factors.

CONCLUSIONS

The salary and patient care (i.e. the mission of the nurse's work itself) are at the top of personal preferences of hospital nurses, with an exclusive position among other factors. We consider it important that the hospital management emphasizes them in the management of hospital nurses. At the same time, the patient care is perceived by the hospital nurses as one of the most saturated factors - in contrast to salary, which is located at the complete opposite pole as the least saturated factor and therefore emerges from the mutual comparison as the factor with the greatest degree of divergence. The stated conclusions are valid for both compared periods. New method of data evaluation was successfully tested.

Leadership to promote patient safety culture in public hospitals managed by social health organizations

PURPOSE

This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

DESIGN/METHODOLOGY/APPROACH

Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

FINDINGS

Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

RESEARCH LIMITATIONS/IMPLICATIONS

All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents' profiles, demographic variables were not analyzed.

PRACTICAL IMPLICATIONS

This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

ORIGINALITY/VALUE

This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

Investigating the intentions and reasons of senior high school students in registering for nursing education in China

BACKGROUND

A shortage of qualified nurses and their low level of educational qualifications hinders the development of global health services. Studies have proven the role of nursing education in addressing these problems. However, no related studies have focused on senior high school students in China. This study aimed to explore senior high school students' intentions to learn nursing and identify the factors influencing their decision-making processes.

METHODS

An anonymous questionnaire was distributed to 8050 senior high school students, which included questions regarding their demographic characteristics, obtaining nursing specialty information, cognition of the nursing occupation and the impact of the COVID-19 on the nursing profession. Descriptive calculation, the chi-square test and logistic regression were used for the analysis.

RESULTS

Only 0.73% of the participants had a clear intention to study nursing. Academic performance and family support were significant predictors of students' intentions to pursue nursing education. Students' interest in nursing specialties was associated with their choice. There was a positive correlation between cognition of nursing occupation and students' choice of nursing. Students' experience of the COVID-19 pandemic also had a positive impact on their nursing career choice.

CONCLUSION

This survey to some extent reflects the problem of nurses shortage in China. In addition, these findings may also provide a new perspective for predictors of nursing shortage and potential interventions.

Reporting of adverse events and the fundamental tasks of managers-A qualitative interview study

AIM

To describe healthcare professionals' experiences of adverse event reporting in relation to the fundamental tasks of managers.

DESIGN

Qualitative interview study.

METHOD

Twenty-four semi-structured interviews including six managers, six medical doctors, six Registered Nurses and six Enrolled Nurses were carried out in Slovenia from January to May 2019. The data were analysed using a multi-stage qualitative content analysis procedure. The COREQ checklist guided the reporting in this study.

RESULTS

The researchers found that all four fundamental tasks of managers, namely planning, organising, leading and controlling, influence the safety culture and thus adverse events reporting by employees. For each function, the researchers have identified the key factors that either promote or inhibit adverse events reporting in a healthcare institution. The results have implications for all those involved in adverse event reporting from the perspective of the fundamental tasks of managers and can contribute to the improvement of the reporting system and subsequently safer treatment.

Talent management and job satisfaction of medical personnel in Polish healthcare entities

Background

There is a mass exodus of qualified medical personnel in countries such as Poland. As a result, it is becoming increasingly important to study the satisfaction of medical personnel employed in public healthcare entities and the factors influencing this satisfaction. One such factor is the quality of talent management.

Purpose

The study aimed to assess the quality of talent management in Polish healthcare entities and its impact on the job satisfaction of medical personnel. The study also considered the impact of other demographic, organizational and behavioral factors on medical personnel satisfaction, such as social competencies, job mobility, orientation toward the patient, gender and education stage.

Methods

A questionnaire for healthcare professionals was used to collect data. A total of 747 respondents (506 defined as medical talent) participated in the survey. A 5-point Likert scale was adopted to assess job satisfaction and talent management practices. Reliability analysis was conducted to investigate the properties of this scale and the items that comprise it. The data was analyzed using descriptive statistics and structural equation modeling.

Results

The survey showed that the quality of talent management in Polish healthcare institutions is not well assessed. Professional satisfaction of medical personnel working in Polish public healthcare entities depends mainly on talent management measured by talent motivation, talent development, employee appraisal and organizational culture. Among the factors that have a positive but smaller impact on job satisfaction are job mobility and the education stage. The impact of gender, patient orientation and social competence had the smallest but most significant impact on job satisfaction.

Conclusion

Healthcare organizations should improve their talent management strategy to meet healthcare professionals' current and future demands and improve their job satisfaction.

Fatigue as a Cause of Professional Dissatisfaction Among Chinese Nurses in Intensive Care Unit During COVID-19 Pandemic

Aim

To clarify the mediating role of burnout and the moderating role of turnover intention in the association between fatigue and job satisfaction among Chinese nurses in intensive care units (ICU) during the COVID-19 pandemic.

Methods

A cross-sectional survey of fifteen provinces in China was conducted, using an online questionnaire, from December 2020 to January 2021, during the COVID-19 pandemic. A total of 374 ICU nurses (effective response rate: 71.37%) provided sufficient responses. Sociodemographic factors, job demographic factors, fatigue, burnout, job satisfaction, and turnover intention were assessed using questionnaires. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive modeling (GAM) were performed to examine all the considered research hypotheses.

Results

Fatigue was found to be negatively and significantly associated with job satisfaction. Moreover, burnout played a partial mediating role and turnover intention played a moderating role in the relationship between fatigue and job satisfaction.

Conclusion

Over time, a state of physical and mental exhaustion and work weariness among Chinese ICU nurses potentially results in job burnout and consequently promotes the level of job dissatisfaction. The results also found that turnover intention played a moderating role in the relationship between burnout and job satisfaction. Specific policies could be considered to eliminate nurses' fatigue and negative attitudes during times of public health emergencies.

Predictors of Healthcare Professionals' Work Difficulty Perception during the COVID-19 Pandemic: Study of Work Environment in a Pandemic Hospital

COVID-19 has dramatically changed the work environment in healthcare, which is creating an additional burden for healthcare professionals. In this study, we investigate the factors that trigger professionals to have negative perceptions of their jobs during the pandemic. A cross-sectional survey is used for this study. The respondents are selected based on convenience random sampling. We use 345 questionaries for the analysis. Respondents are health care professionals (nurses, doctors, midwives, technicians, etc.) working in a pandemic hospital in Turkey. We run a multivariable logistic regression model to analyze the predictors of work difficulty perception. The model is adjusted for the respondents’ demographical characteristics and emotional wellbeing. We found that depression and burnout are significantly correlated with the perception of job difficulty (OR Severe PHQ-9 = 10.8, p = 0.004; OR Severe Burnout = 7.83, p < 0.001). The professionals who are changed from one department to another are also more likely to perceive the job as difficult (OR Department Change = 1.60, p = 0.045). However, the professionals that received sufficient applause from society are more likely to think that they did not face any difficulties doing their job during the pandemic (OR Applause = 0.56, p < 0.016). Anxiety, monetary motivation, religious beliefs, and information availability did not contribute to the perceived difficulty in their jobs. Thus, efforts need to be made to give them more social support and smooth their changes in departments and functions to facilitate their jobs.

[First wave of COVID-19 in Quebec: Healthcare workers' motivation to treat infected patients]

INTRODUCTION

Retention of healthcare workers (HCWs) in the healthcare system during the COVID-19 pandemic could become a challenge. It is therefore important to better understand what are the motivational elements that could explain a greater or lesser motivation to care for infected patients.

OBJECTIVES

To evaluate factors modulating HCWs' willingness to treat COVID-19 infected patients.

METHODS

HCWs from Québec, Canada, were invited to complete an online survey during the first wave of the COVID-19 pandemic between the months of April and July 2020. The survey focused on the intention to avoid treating infected patients, prior experiences in treating COVID-19 patients and anxiety levels. Descriptive statistics and multiple regression analysis were used to assess which factors explained differences in HCWs intention to avoid treating patients.

RESULTS

A total of 430 HCW completed the survey. A majority were women (87%) and nurses (50%). Of those, 12% indicated having considered measures to avoid working with COVID-19 infected patients and 5% indicated having taken actions to avoid working with infected patients. A further 18% indicated that they would use a hypothetical opportunity to avoid working with infected patients. Having previously treated infected patients was associated with a significant reduction in the intention to avoid work (OR: 0.56 CI 0.36-0.86). Amongst HCWs, physicians had a significantly reduced intention to avoid treating infected patients (OR: 0.47 CI 0.23-0.94). We also found that an increase in anxiety score was associated with a greater intention to avoid treating COVID-19 infected patients (OR: 1.06 CI 1.04-1.08).

CONCLUSION

Study results suggest that previous experience in treating COVID-19 infected patients is protective in terms of work-avoidance intentions. We also found that amongst HCWs, physicians had a significantly lower intention to avoid working with COVID-19 infected patients. Finally, our results show that increase in anxiety is associated with a higher intention to avoid treating infected patients. Characterization of factors associated with low anxiety levels and low reluctance to work during the COVID-19 pandemic could be useful in staffing facilities during the present and future healthcare crisis.

Internal Quality and Job Satisfaction in Health Care Services

(1) Background: The main purpose of this study was to evaluate the health services' internal quality level in Greek public hospitals and to investigate whether there is a relation between internal quality and health care professionals' job satisfaction. (2) Material and Methods: A cross-sectional study was conducted in six public hospitals (four general and two specialized hospitals). The following tools were used to collect data: (a) the SERVQUAL questionnaire, which is designed to measure service quality through five dimensions, and (b) the Job Satisfaction Survey (JSS) questionnaire, which is designed to measure employees' job satisfaction. Convenience sampling was used as a sampling technique. (3) Results: The level of internal quality service was found to be low as regards the dimensions of: reliability, assurance, responsiveness, and empathy, while the "tangibles" dimension was the only one which was assessed as having a satisfactory internal quality level. Τhe results also revealed a positive correlation between the job satisfaction subscales and the quality dimensions. Regarding demographic characteristics and their effect on employees' perceptions of internal quality dimensions, the study found that the gender and the educational factor had no effect while younger employees have a more positive perception of the quality of responsiveness dimension in the health organizations where they work. In terms of profession, administrative staff had a lower perception of the quality of tangibles dimension than doctors and nurses. Concerning years of experience, the results indicated that employees with more previous working experience had a worse perception of the quality of reliability, responsiveness, and assurance dimensions. (4) Conclusions: According to the results, establishing a sense of trust and understanding between management and health professionals through effective communication, transparent evaluation, and reward is critical to developing, enhancing, and promoting an internal quality culture in a hospital setting.

Exploring system features of primary care practices that promote better providers' clinical work satisfaction: A qualitative comparative analysis

BACKGROUND

Health care delivery system features can have a profound effect on how frontline physicians and other clinical personnel in primary care practices (primary care providers [PCPs]) view the quality and safety of what they deliver and, ultimately, their clinical work satisfaction.

PURPOSE

The aim of this study was to investigate the combinations of system features (i.e., team dynamics, provider-perceived safety culture, and patient care coordination between PCPs) that are most conducive to positively enhancing PCPs' clinical work satisfaction.

APPROACH

Nineteen Harvard-affiliated primary care practice sites participated in the Academic Innovations Collaborative 2012-2016, which aimed to establish team-based care and improve patient safety. An All-Staff Survey was administered to 854 PCPs in 2015. The survey measured provider experience of team dynamics, provider-perceived safety culture, patient care coordination between PCPs, and providers' clinical work satisfaction. We performed a qualitative comparative analysis to identify "recipes," that is, combinations of conditions necessary and sufficient for enhancing PCPs' clinical work satisfaction.

RESULTS

Strong provider-perceived safety culture and effective team dynamics constitute sufficient conditions that, when present in practices, could best support PCPs to achieve greater clinical work satisfaction.

CONCLUSIONS

Our findings suggest the importance of creating and sustaining a strong safety culture and of establishing and implementing highly functioning teams in primary care practices for enhancing PCPs' clinical work satisfaction.

PRACTICE IMPLICATIONS

Conducting the qualitative comparative analysis provides a new perspective for informing primary care and encouraging primary care practices to pursue strategic priorities for enhancing PCPs' clinical work satisfaction and providing safe, high-quality care.

Malaysian dental therapists' job motivation, job satisfaction, intention to leave and perceived future roles

OBJECTIVE

To assess Malaysian dental therapists' job satisfaction, motivation, turnover intention, and perceived future roles, following recent changes in the regulations that allow them to provide dental care within their scope of practice in the private sector.

METHODS

A self-administered questionnaire was distributed to public dental therapists who were selected using a stratified random sampling technique. Questions included items on social structure, job satisfaction and motivation (based on the Warr-Cook-Wall scale), turnover intention (based on four cognitive processes) and perceived future roles. Multiple logistic regression was used to assess the predictors of dental therapists' turnover intention.

RESULTS

Overall, a majority (> 90%) of participants had high job satisfaction and job motivation, with total mean scores of 45.70 ± 6.86 and 21.16 ± 2.63, respectively. A total of 8.3% intended to leave the public sector to work in a different organisation. Of those who chose to remain as a dental therapist in the next five years, only 7% considered working in the private sector. The significant predictors for turnover intention were educational attainment, years of working experience, job satisfaction level and future preferred working sector.

CONCLUSION

Although the newly introduced Dental Act allows dental therapists to expand their roles to the private setting, very few intended to do so. This could be related to them having a high level of job satisfaction and job motivation while serving in the public sector.

Job satisfaction among Syrian healthcare workers in refugee health centres

BACKGROUND

Achieving universal health coverage is subject to the availability, accessibility, acceptability, and quality of health workers. Countries that host refugees and migrants, such as Turkey, must strengthen the capacity of their health systems to increase access to services, especially for refugees and migrants. The Turkish Ministry of Health adapted Syrian refugee healthcare workers in the healthcare services to boost Syrian refugees' access to healthcare. This study aimed to assess job satisfaction and the factors influencing job satisfaction among refugee physicians and nurses working in Refugee Healthcentres (RHCs) in Turkey.

METHODS

A self-administered, cross-sectional survey targeted all Syrian physicians and nurses working in RHCs across Turkey. The short-form Minnesota Satisfaction Questionnaire(MSQ) was used to assess job satisfaction. In total, 555 nurse/midwives and 336 physicians responded, yielding a total response rate of 56.5%. Descriptive analyses and linear regression tests were conducted to determine the level of job satisfaction and to analyze determinant factors.

RESULTS

Nurses/midwives reported the highest level of general job satisfaction, followed by specialist physicians and general physicians. Physicians who had worked as specialists in Syria but were now working as general physicians in Turkey had the lowest job satisfaction levels. Multiple regression analysis showed that professional status in Turkey, income, teamwork and team management were significantly associated with job satisfaction.

CONCLUSIONS

To maintain a high level of job satisfaction in refugee healthcare workers, human resources management should consider matching job placements with training specialization and support good leadership and good teamwork. Remuneration that accounts for the cost of living and non-financial incentives could also play a significant role in job satisfaction.

Exploring the factors that influence healthcare providers care quality in Jordanian hospitals: the perspectives of nurses, pharmacists and physicians

Objectives

The key point of this investigation is to explore factors that influence healthcare providers’ quality care in government hospitals in Jordan, from the perspective of nurses, pharmacists and physicians.

Method

A qualitative technique (case study) was executed in this project. Semi-structured interviews (face-to-face) were used. The thematic analysis was applied in this study. The interviews were conducted with five physicians, five pharmacists and five nurses at different levels, including different specialists from Jordanian government hospitals.

Key findings

Four vital factor influencing of nu healthcare providers’ quality care were recognised in the sampled hospitals: manager ability and leadership support of staff, adequate and qualified hospital nurses and physicians, building a trusting work environment and good salaries and incentive.

Conclusions

This examination attempted to offer an in-depth comprehending factor that impacts healthcare providers’ quality care. Furthermore, it contributes to healthcare theory and practice by developing a conceptual framework that offers policymakers and managers a practical understanding of factors that influence healthcare providers’ quality care.

An investigation of the intention and reasons of senior high school students in China to choose medical school

BACKGROUND

Shortages of qualified health workers have been a global concern, especially in developing countries. China also faces this dilemma, which hinders the development of public health services. Senior high school students are a group who are considering their college majors and careers after graduation. They are also a potential and basic talent reserve for the health sector. This survey focused on senior high school students' intention to learn clinical medicine and explored potential influencing factors.

METHODS

An anonymous questionnaire containing 20 items was distributed to 5344 senior high school students. The questions covered the following topics: students' intention to learn clinical medicine, personal and family information, understanding of medical education, cognition of doctors' working conditions, and doctor-patient relationships. Logistic regression and the chi-square test were used to compare students with and without a clear intention to learn clinical medicine to explore influencing factors.

RESULTS

Only 5.6% of senior high school students had a clear intention to learn medicine (CILCM). Personal and family information had distinct impacts. Interest and anatomy course were also associated with students' choice. There was a positive correlation between understanding of medical education and students' intention Meanwhile, students' cognition of doctors, career prospects, and social status had significant impacts. The more optimistic students were about doctors' working conditions and doctor-patient relationships, the more likely they were to have a CILCM.

CONCLUSION

To some extent, this survey reflects the shortage of medical talent in China and provides possible clues for solving this problem. In addition, these findings may provide a perspective for understanding the development of health services in developing countries.

Job satisfaction and caring behavior among nurses in a military hospital: A cross-sectional study

Background: Caring is the major focus of nursing practice, and their behavior has an impact on the quality of patient care, and it is very important that they are satisfied while working. The strong relationship between job satisfaction and nurses caring behavior is well established, and therefore the managers can be encouraged to provide better conditions for nurses’ satisfaction. The aim of this study was to investigate the relationship between job satisfaction and the caring behavior of nurses in the Military Hospital.

Design and Methods: A survey with a self-assessment questionnaire was carried out from August to December 2019. Participants were 121 nurses working in a military hospital Malang, Indonesia. The data was collected using the Job Satisfaction Survey (JSS) and Caring Behavior Inventory (CBI- 24). The data were analyzed using rank Spearman and multiple linear regression.

Results: Job satisfaction had a positive correlation with the caring behavior of nurses (p=0.003; r=0.266). Furthermore, there were four job satisfaction dimensions namely supervision, contingent rewards, co-workers, nature of work and communication dimensions were positively correlated with nurses’ caring behavior (p<0.05) while salary, promotion, benefits, operating procedure dimensions are not related to nurse’s caring behavior (p>0.05).

Conclusions: Caring behavior of nurses is influenced by job satisfaction. Therefore, it is necessary to provide supervision, contingent rewards, empowerment, collaboration program for the nurses to reconstruct the nursing working environment to be healthier and increase the caring behavior of nurses.

Job satisfaction behind motivation: An empirical study in public health workers

The health sector is characterized as labor-intensive, which means that the effectiveness of an organization that operates within its context is inextricably linked to the level of employee performance. Therefore, an essential condition, in order to achieve higher standards, in terms of the effectiveness of the health units, as well as set the foundations of a solid health system, is to take maximum advantage of the full potential of human resources. This goal can only be accomplished by providing the appropriate incentives, which will naturally cause the adoption of the desired attitude and behavior. In the case of Greece, there is not enough research relative to the needs of health workers and, consequently, the incentives that can motivate them. This article aims to investigate the dynamics that may be behind health workers at a public hospital in Northern Greece. Data were collected from 74 employees in the hospital and were analyzed using ANOVA analysis. The results show that key motivators for the employees can be considered the relationships with their colleagues and the level of achievement, while the level of rewards and job characteristics play a secondary role. These results make it clear that, in order for the hospital's management to be able to improve the level of employee performance, it should ensure the establishment of a strong climate among employees, and also acknowledge the efforts made by them.

An Investigation of Healthcare Professionals' Motivation in Public and Mission Hospitals in Meru County, Kenya

Strengthening health systems in developing countries such as Kenya is required to achieve the third United Nations’ Sustainable Development Goal of health for all, at all ages. However, Kenya is experiencing a “brain drain” and a critical shortage of healthcare professionals. There is a need to identify the factors that motivate healthcare workers to work in the health sector in rural and marginalized areas. This cross-sectional study aims to investigate the factors associated with the level and types of motivation among healthcare professionals in public and mission hospitals in Meru county, Kenya. Data were collected from 24 public and mission hospitals using a self-administered structured questionnaire. A total of 553 healthcare professionals participated in this study; 78.48% from public hospitals and 21.52% from mission hospitals. Hospital ownership was statistically nonsignificant in healthcare professionals’ overall motivation (p > 0.05). The results showed that sociodemographic and work-environment factors explained 29.95% of the variation in overall motivation scores among participants. Findings indicate there are more similarities than disparities among healthcare professionals’ motivation factors, regardless of hospital ownership; therefore, motivation strategies should be developed and applied in both public and private not-for-profit hospitals to ensure an effective healthcare workforce and strengthen healthcare systems in Kenya.

Psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses

Addressing the worldwide challenge of shortage of nurses contributes to the national and international efforts to enhance the health and well-being of the global population. The main aim of this research is to investigate the level and the relationship between psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses in public and private practices while accounting for their socio-demographic characteristics. This was a cross sectional study of 173 primary health care nurses. The Oldenburg Burnout Inventory and General Health Questionairre-12 were used to assess burnout and psychological distress among nursing staff. High psychological distress was present in 21.38% of all respondents and was significantly related to intention to quit. The results indicated a mean job satisfaction score of 3.54 with higher job satisfaction among private vs. public sector nurses. Furthermore, nurses with higher burnout levels and lower job satisfaction were more likely to consider leaving the profession compared with those with lower burnout and higher job satisfaction. The study provides valuable insight for managers of general healthcare practice and healthcare policy makers in effectively managing and retaining primary healthcare nurses.

Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap

Large disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income countries where, unlike in high-income countries, a substantial proportion of births occur in primary care facilities that cannot offer definitive care for complications. We argue that the current inequity in care for childbirth is a global double standard that limits progress on maternal and newborn survival. We propose that health systems need to be redesigned to shift all deliveries to hospitals or other advanced care facilities to bring care in line with global best practice. Health system redesign will require investing in high-quality hospitals with excellent midwifery and obstetric care, boosting quality of primary care clinics for antenatal, postnatal, and newborn care, decreasing access and financial barriers, and mobilizing populations to demand high-quality care. Redesign is a structural reform that is contingent on political leadership that envisions a health system designed to deliver high-quality, respectful care to all women giving birth. Getting redesign right will require focused investments, local design and adaptation, and robust evaluation.

Exploration of factors affecting the use of Web 2.0 for knowledge sharing among healthcare professionals: an Indian perspective

Purpose

This study aims to explore knowledge sharing (KS) attitudes and intention of healthcare professionals in India through the use of information and communication technology platforms such as Web 2.0. The research specifically focuses on individual motivators such as the face, reputation and reciprocity, which, to an extent, are influenced by indigenous culture.

Design/methodology/approach

The study uses a cross-sectional survey design to collect data. A sample of 207 was obtained from professionals working in healthcare in India. The data were analyzed using the partial least square-structural equation modeling.

Findings

The results confirmed that attitude toward KS leads to the intention to share knowledge. Attitude toward KS using Web 2.0 was found to be positively related to self-efficacy and reciprocity. Furthermore, face and reputation were found to moderate the relationship between attitude and intention to share knowledge while the moderating effect of rewards was found to be insignificant.

Research limitations/implications

This study was limited to healthcare professionals in India. Knowledge workers in other industries can be considered for further studies.

Practical implications

This study provides useful insights into KS practices using Web 2.0 among knowledge workers. Particularly it emphasizes the individual motivators, which can be manipulated by Web 2.0 designers to nurture a positive attitude toward KS and to encourage user’s participation.

Originality/value

The study investigates, using an integrated theoretical framework, how certain factors act as a motivator or a barrier for sharing knowledge using Web 2.0. in the specific cultural context of healthcare professionals in India.

Motivators for medical staff with a high gap in healthcare efficiency: Comparative research from Poland and Ukraine

INTRODUCTION

This article examines different motivators for medical staff in countries with a high gap in healthcare efficiency by comparing them in two healthcare systems-Polish (ie efficient) and Ukrainian (ie inefficient).

METHOD

This survey-based study applies a six-stage conceptual framework to two Polish and two Ukrainian hospitals as well as medical faculties of one university from each country. Following ethical approval, data were collected in the first quarter of 2019, using the 'Evaluation of motivators questionnaire for medical staff'.

FINDINGS

Medical staff perceived their working conditions in the inefficient healthcare system much worse than in the efficient system; however, they generally had a more optimistic outlook. Medical staff in efficient and inefficient healthcare systems has different motivational targets, including sizable differences from profession, gender, and age. These factors play an important role in developing a high-performance healthcare system. Results are illustrated in terms of motivators for medical staff.

CONCLUSION

Optimising a healthcare system requires useful reform of enablers, especially in countries with inefficient systems, including policymaking and regulatory action. Best practices must incorporate all stakeholders interested in high healthcare performance-usage of suitable practices from abroad can act as an important resource.

Motivation factors affecting the job attitude of medical doctors and the organizational performance of public hospitals in Warsaw, Poland

Background

This paper examines the relationship between selected motivation factors that affect the attitude to work among medical doctors at public hospitals and the organizational performance of hospitals.

Methods

This study was based on World Health Organization questionnaires designed to estimate motivation factors according to Herzberg’s motivation theory and to measure the level of organizational performance of hospitals by using the McKinsey model. A survey was conducted among physicians (n = 249) with either surgical (operative) or nonsurgical (conservative) specialty in 22 departments/units of general public hospitals in Warsaw, Poland.

The relationship between the chosen job motivation factors and organizational effectiveness was determined using Spearman’s rank correlation. Furthermore, 95% confidence intervals were calculated. The independent samples t-test was used to confirm statistically significant differences between the independent groups. Normality of the data was tested by the Kolmogorov–Smirnov test.

Results

The survey revealed that motivation factors related to “quality and style of supervision” have the highest effect on the organizational performance of hospitals (Spearman’s rank correlation coefficient = 0.490; p < 0.001), whereas “performance feedback” has the lowest effect on organizational performance according to the surveyed healthcare professionals (54% of physicians).

Conclusion

The principles of Individual Performance Review should be incorporated into strategies designed to improve the organizational performance of hospitals (with NHS serving as a potential role model) in order to establish specific rules on how to share performance feedback with individual physicians. The present study contributes to literature on human resource management in the healthcare sector and highlights the importance of nonfinancial aspects in improving the organizational performance of hospitals.

Why do graduates choose to work in a less attractive specialty? A cross-sectional study on the role of personal values and expectations

BACKGROUND

Primary health care (PHC), of which preventive medicine (PM) is a subspecialty, will have to cope with a deficiency of staff in the future, which makes the retention of graduates urgent. This study was conducted in Vietnam, where PM is an undergraduate degree in parallel to medical training. It aims to identify facilitating and hindering factors that impact recruitment and retention of PM graduates in the specialty.

METHODS

A cross-sectional study enrolled 167 graduates who qualified as PM doctors from a Vietnamese medical school, between 2012 and 2018. Data were collected via an online questionnaire that asked participants about their motivation and continuation in PM, the major life roles that they were playing, and their satisfaction with their job. Multiple regression analyses were used to identify which life roles and motivational factors were related to the decision to take a PM position and to stay in the specialty, as well as how these factors held for subgroups of graduates (men, women, graduates who studied PM as their first or second study choice).

RESULTS

Half of the PM graduates actually worked in PM, and only one fourth of them expressed the intention to stay in the field. Three years after qualification, many graduates had not yet decided whether to pursue a career in PM. Satisfaction with opportunities for continuous education was rated as highly motivating for graduates to choose and to stay in PM. Responsibility for taking care of parents motivated male graduates to choose PM, while good citizenship and serving the community was associated with the retention of graduates for whom PM was their first choice.

CONCLUSIONS

The findings demonstrate the importance of social context and personal factors in developing primary care workforce policy. Providing opportunities for continued education and enhancing the attractiveness of PM as an appropriate specialty to doctors who are more attached to family and the community could be solutions to maintaining the workforce in PM. The implications could be useful for other less popular specialties that also struggle with recruiting and retaining staff.

Sleep quality of nurses in the emergency department of public hospitals in China and its influencing factors: a cross-sectional study

Background

Studies have shown that poor sleep could result in many unpleasant consequences and is prevalent in nurses. Considering the fact of high stress, overwhelming workload and many night shifts in the emergency department in China, this study aimed to evaluate the current status of emergency nurses’ sleep quality in public hospitals in Shandong, China and explored its influencing factors.

Methods

A self-administered questionnaire incorporating the Job Content Questionnaire and Pittsburgh Sleep Quality Index (PSQI) was conducted among 4856 emergency nurses in five randomly selected city emergency command systems in Shandong, China. The association of potential influencing factors, including occupational, psychosocial and individual factors, with poor sleep (PSQI> 5) was quantified by multivariate logistic regression analysis.

Results

The average PSQI score of 4730 emergency nurses in public hospitals was 8.2 ± 3.9, including 3114 (65.8%) subjects with PSQI > 5 and 2905 (61.4%) > 8; these figures were found highest for 337 emergency nurses in 14 tertiary hospitals with 11.8 ± 4.3, 257 (76.3%) and 232 (68.8%), followed by 1044 emergency nurses in 43 secondary hospitals with 9.5 ± 3.9, 725 (69.4%) and 675 (64.7%) and 3349 emergency nurses in 167 primary hospitals with 7.4 ± 3.5, 2132 (63.7%) and 1998 (59.7%). The following factors were associated with poor sleep: hospital level (tertiary vs. primary, secondary vs. primary), female sex, less of exercise, long work hours per week, many patients in the charge of at night, high monthly night shift frequency (4–6 vs. never, ≥7 vs. never) and high occupational stress.

Conclusions

The sleep quality of emergency nurses in public hospitals in China was poor, especially in tertiary hospitals. Many factors as listed above, especially occupational stress, night shift taking and workload at night, should be considered when improving emergency nurses’ sleep quality.

Understanding job satisfaction and motivation among nurses in public health facilities of Ethiopia: a cross-sectional study

Background

Poor job conditions and limited resources are reducing job satisfaction and motivation among nurses in low-income countries, which may affect the quality of services and attrition rates. The objective of this study was to examine job satisfaction, motivation and associated factors among nurses working in the public health facilities of Ethiopia, with the aim of improving performance and productivity in the health care system.

Methods

The study employed a cross-sectional two-stage cluster sampling design. From a random sample of 125 health facilities, 424 nurses were randomly selected for face-to-face interviews in all regions of Ethiopia. Nurses responded to questions about their overall job satisfaction and job conditions, including items related to intrinsic and extrinsic motivation, using a 5-point Likert scale. Multilevel analysis was performed to adjust for different clustering effects. Satisfaction levels (percent of respondents who were satisfied) were calculated for individual items, and composite mean scores (range: 1–5) were calculated for motivational factors. Adjusted odds ratios were computed to examine the association of these factors with overall job satisfaction.

Results

Overall, 60.8% of nurses expressed satisfaction with their job. Composite mean scores for intrinsic and extrinsic motivational factors were 3.5 and 3.0, respectively. Job satisfaction levels were significantly higher for female nurses (65.6%, p = 0.04), those older than 29 years (67.8%, p = 0.048) and had over 10 years work experiences (68.8%, p = 0.007). Satisfaction with remuneration (AOR = 2.04, 95% CI = 1.36, 3.06), recognition (AOR = 2.21; 95% CI = 1.38, 3.53), professional advancement (AOR = 1.54; 95% CI = 1.06, 2.29), features of the work itself (AOR = 1.65; 95% CI = 1.20, 2.91) and nurses’ work experiences from 5 to 10 years (AOR = 0.37, 95% CI = 0.17, 0.79) were significantly associated with overall job satisfaction after controlling for other predictors.

Conclusions

The study findings are signals for the Ministry of Health to strengthen the human resource management system and practices to improve nurses’ overall job satisfaction and motivation, especially among nurses with 5 to 10 years of experience on the job. Expanded recognition systems and opportunities for advancement are required to increase nurses’ job satisfaction and motivation. Equitable salary and fringe benefits are also needed to reduce their dissatisfaction with the job.

Nurse career mapping: a qualitative case study of a new hospital

BACKGROUND

Career mapping is an effective strategy for providing nurses with a clear direction and a realistic time scale for achieving their career goals. The purpose of this research is to investigate career mapping for nurses at a new hospital in Jakarta.

METHOD

The study design is qualitative and implements a focussed case study approach. Data were collected from focus group discussions (FGDs) with two groups: one group consisted of eight staff nurses and the other consisted of six nurse managers. An inductive content analysis of all transcripts from the FGDs and of field notes was conducted independently.

RESULT

This research produced seven themes that together portray the entire career mapping process. In Hospital X, the career map for a particular nurse is based on the level of formal education, the length and nature of their work experience and a competency assessment. A self-assessment process and considerations related to competence in all aspects of nursing have been included in the process for nurses at Hospital X. The idea that nurses should be positioned in a working environment that matches their level of competency is a fundamental principle for nursing managers.

CONCLUSION

As a new hospital, Hospital X has implemented nurse career mapping and striven for accreditation. Career developments not only become the responsibility of an organisation but also the responsibility of individuals to develop themselves and their careers.

Motivation for cardiopulmonary resuscitation: Scale development and psychometric analysis

BACKGROUND

The high motivation of rescuers for cardiopulmonary resuscitation (CPR) can result in high-quality CPR. However, there is no instrument to measure the CPR motivation. The purpose of this study was to design the Cardiopulmonary Resuscitation Motivation Scale (CPRMS) and evaluate its psychometric properties.

METHODS

Directed qualitative content analysis and other related instruments were used for the production of items pool, and then the psychometric properties of the CPRMS were evaluated using face, content and construct validities, and internal consistency, and stability for reliability.

RESULTS

The CPRMS was consisted of 43 items. The Scale-Content Validity Index was reported as 0.97. Exploratory factor analysis led to eight factors, which in total accounted for 48.58% of observed variance. Confirmatory factor analysis also showed the average fit of the explored model. The values of alpha, omega and intraclass correlation coefficients were reported as 0.92, 0.76-0.86, and 0.90 respectively.

CONCLUSION

CPRMS is a valid and reliable instrument for the measurement of CPR motivation in eight dimensions of facilitators of resuscitation, feeling of achievement, high chances of success, low chances of success, recognition and appreciation, accountability, perceived importance, and beliefs. CPRMS can differentiate between rescuers with high and low motivation.

Analysing drivers and outcomes of job and professional satisfaction at health centres in Portugal

Purpose

The purpose of this paper is to analyse antecedents, associations and outcomes of job and professional satisfaction of doctors and nurses in Portuguese health centres.

Design/methodology/approach

The authors have used structural equation modelling to examine the causal relationships between multiple variables placed in a path model reflecting the theoretical foundation.

Findings

The percentage of those satisfied or very satisfied with their jobs was just above 50 per cent. Doctors’ satisfaction stems from personal achievement and the formal component of work environment, leading them to strongly recommend their work in the health centre to dear ones but not to put aside other job options. Nurses’ level of job satisfaction seems to be affected by co-workers and interpersonal relationships beside personal achievement and has more strong and multifaceted impact on their feelings and behaviour that goes from recommending their job position to considering to quit job and even regretting the option made in terms of career.

Originality/value

This study represents the first attempt to conceptualise and test a simultaneous model comprising antecedents and outcomes of both job satisfaction and professional satisfaction in primary care, investigating also differences between genders and professions. Results shed light on determinants of satisfaction among specialised staff in Portuguese primary care and how they affect commitment to the organisation and the way career choice is regarded.

Job satisfaction among Community-Based Rehabilitation (CBR) workers in caring for disabled persons in the east coast region of Peninsular Malaysia

Background

Job satisfaction influences staff retention, motivation, and performance in providing services. A considerable amount of published studies has reported on the job satisfaction level of healthcare workers, but to date, very few studies focused on Community-Based Rehabilitation (CBR) workers. This study aimed to explore the job satisfaction level among Community-Based Rehabilitation (CBR) workers and associated factors related to their overall job satisfaction.

Methods

A one-year survey was conducted in three states of the east coast region of Peninsular Malaysia involving 204 CBR workers selected through universal sampling method where all CBR staff who fulfilled the inclusion criteria were selected as participants. Self-completed questionnaires consisted of 20 association factors on six-point Likert scale responses were distributed. Total mean satisfaction level and mean associated factors were reported in this study.

Results

The results showed that the majority of the participants were between 20 and 40 years old (72%), female (96%), Malay (99%) and had 1–5 years of working experience. The mean total satisfaction score was 79.8 ± SD = 7.85. The highest mean satisfaction level for the associated factor was 4.6 ± SD = 0.59 with about 95% of the participants were satisfied that “CBR programme is a challenging work”, while the lowest satisfaction level for associated factor was on “salary of community-based rehabilitation staff is acceptable”, with mean score of 2.3 ± SD = 0.97 with about 59% of the participants felt dissatisfied. The results of this study determined that the highest dissatisfied factors among CBR workers were on salary.

Conclusion

These findings provided useful information for policymakers to evaluate this issue for a sustainable CBR programme in the future.

Trial registration

This study has been registered for trial as ‘retrospective registered’ in the Australian New Zealand Clinical Trials Registry (ANZCTR) (registration no.: ACTRN 12618001101279) on 5th October 2018.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6520-z) contains supplementary material, which is available to authorized users.

Psychological strains, depressive symptoms, and suicidal ideation among medical and non-medical staff in urban china

BACKGROUND

The Strain Theory of Suicide has been tested and well supported regarding rural people who show risk of suicide. Studies on the impact of psychological strains on psychopathologies and suicidality in urban environments in China have been lacking.

AIMS

This study was designed to further examine the associations between psychological strains, depressive symptoms, and suicidal ideation in two separate urban samples of adults in China.

METHODS

One sample consisted of randomly selected medical employees of a large hospital (n = 1012), and a second sample included heterogeneous office employees (n = 1052). A self-administered questionnaire was used to collect demographics, psychological strains, social support, depressive symptoms, and suicidal ideation.

RESULTS

Depressive symptoms were associated with longer work hours, less social support, value strain, aspiration strain and coping strain among medical staff, and were linked to longer work hours, less social support, aspiration strain and coping strain among non-medical staff. Suicide ideation was associated with longer work hours, coping strain, and depression among medical staff, and was linked to longer work hours, gender, religion, value strain and depression among non-medical staff.

CONCLUSIONS

Both depressive symptoms and suicidal ideation were associated with psychological strains among Chinese urban professionals. Reduction of psychological strain is necessary to help maintain proper mental health and to ensure optimal performance at work.

Enablers of clinician involvement inclination, care delivery agility and clinical productivity

Purpose

Healthcare services have enormous potential for growth in the country. However, the drivers of clinical productivity are yet to be explored. The purpose of this paper is to examine the effect of clinician buy-in, clinician ease of use, clinician work stream flexibility and device placement comfort on clinician’ s involvement. The study further examines the effect of converged devices implementation and wireless portable devices adoption on care delivery agility. Lastly, the authors examine the influence of clinician’s involvement and care delivery agility on clinical productivity.

Design/methodology/approach

Measures for the constructs were developed from extant literature and expert feedback complemented with pre-testing. Further, perceptual responses were collected from 221 doctors through internet surveys and were analyzed using partial least squares.

Findings

The study identified clinician’s ease of use and workflow streamlining flexibility as key enablers of clinician’s involvement. Findings further reveal that converged devices implementation and wireless portable adoption as prominent enablers of care delivery agility. Further, the authors found clinician’s involvement and care delivery agility to have a positive contribution in enhancing clinical productivity.

Research limitations/implications

The study has collected perceptual responses from doctors practicing both in hospitals and private clinics and their perceptions have been based on their experiences at those specific institutions or sites, which may limit generalizability of the current study findings. This study incorporated only doctors and ignored other assistant staffs’ perceptions who assisted and aided doctors in executing treatment procedures either in private clinics or hospitals.

Practical implications

The study has practical implications for enhancing clinical productivity.

Social implications

The study findings highlight the role of process focus and infrastructure focus on the human elements of involvement and agility which often play pivotal role for motivation for individual physicians and their productivity.

Originality/value

The study is the foremost to develop perceptual measures for several constructs in the healthcare services.

Developing and assessing a tool to measure motivation among physicians in Lahore, Pakistan

Physicians' motivation plays a vital role in health systems particularly in dense and urban cities, which deal with high volumes of patients in a variety of settings. The loss of physicians due to low motivation to developed countries is also a critical aspect affecting the quality of care in many regions. Fewer studies have explored health provider and particularly physicians' motivation in developing countries, which is critical to health service delivery. In addition, limited relevant tools have been developed and tested in low and middle-income settings like Pakistan. The purpose of this study was to create and test a tool for measuring physician motivation. A tool was developed to explore physicians' motivation in the Lahore district, Pakistan. Three sections of the questionnaire, which included intrinsic, socio-cultural and organizational factors, were tested with a stratified, random sample of 360 physicians from the public and private health facilities. Factor analysis produced six factors for 'intrinsic motivation,' seven for 'organizational motivation' and three for 'socio-cultural motivation' that explained 47.7%, 52.6% and 40.6% of the total variance, respectively. Bartlett's test of sphericity and the KMO were significant. Cronbach's α and confirmatory factor analysis were found satisfactory for all three sections of questionnaires. In addition to identifying important intrinsic, socio-cultural and organizational factors study found the questionnaires reliable and valid and recommend further testing the applicability of the instrument in similar and diverse settings.

Communication With Physicians as a Mediator in the Relationship Between the Nursing Work Environment and Select Nurse Outcomes in Jordan

PURPOSE

To test whether communication mediated relationships among nurses' work environments and nurse outcomes of job satisfaction and intent to stay.

DESIGN

This study used a cross-sectional, quantitative survey design to query 650 nurses who worked in three hospitals in Jordan.

METHODS

We used Arabic versions of valid, reliable instruments measuring the nursing work environment, nurse perceptions of communication with physicians, intent to stay, and job satisfaction. Mediation analysis was used to test hypotheses.

FINDINGS

A total of 582 questionnaires were returned (89.5% response rate). Nurse perceptions of communication with physicians mediated the relationship between the nursing work environment and job satisfaction in medical, surgical, and critical care units. Nurse perceptions of communication with physicians mediated the relationship between the nursing work environment and intent to stay in all but maternity and "other" units.

CONCLUSIONS

Depending on the nurse outcome, communication was a significant mediator for various unit types. These results may be related to the type of work that is done in each unit and the influence of patient care. Communication is one of many mechanisms that can specify how a positive nursing work environment can contribute to nurses' job satisfaction and intent to stay.

CLINICAL RELEVANCE

A potential solution to the nursing shortage in Jordan emerges by identifying communication with physicians as a mediator in the relationship between the work environment and selected nurse outcomes.

Exploring a motivation of medical staff

This paper aims to identify the true motivators (needs) of medical staff, compare them with the current labor incentives, and detect possible differences in motivators for main groups of medical staff. Observing personnel of 5 hospitals and students of the medical institute by special questionnaires, the author confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author used special questionnaires to collect the data. Study results confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author also found significant differences between the motivation of Ukrainian health workers and their colleagues from other countries. The main conclusion is that no matter how we would like to satisfy gender and age equality, all people are individual and what is good for an elderly male doctor cannot be acceptable for a young female nurse. Therefore, forming the motivation system for employees of medical institutions, it is necessary to take into account the age, gender, professions, and other characteristics of each employee. In this way, we can achieve the highest health-care performance.

Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals

Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation.

Assessment of motivation levels and associated factors among the nursing staff of tertiary-level government hospitals

The present study assessed the motivation level of nurses working in 3 highly decorated tertiary-level government hospitals of India and also underpins the factors attributing to motivation levels. A sequential mixed-method design was used in this study wherein 400 nurses working in 5 units of nursing care in the hospitals were enrolled based upon proportionate random stratified sampling techniques. A self-administered questionnaire with Likert scale was developed based upon scale used by Mbindyo et al. The attributes of motivation were then categorized into external and internal attributes. For the qualitative component, participants with varied responses in quantitative data were selected and interviewed. Overall mean motivation score of the nursing staff was found 3.57 ± 0.93, which was higher for extrinsic motivational attributes (3.67 ± 0.88) as compared with intrinsic attributes (3.47 ± 0.98). The intrinsic motivational attribute of organizational commitment was rated highest followed by general motivation, conscientiousness, and self-efficacy. Personal issues, timeliness, and burnout were prime discouraging attributes among study participants. Sociodemographic characteristics and work profile characteristics showed significant relationship with the attributes of motivation. This study underscores the significance of different attributes of motivation which needs to be considered while framing administrative strategies and policy guidelines by authorities.

What motivates medical students to select medical studies: a systematic literature review

BACKGROUND

There is a significant shortage of health workers across and within countries. It is of utmost importance to determine the factors that motivate students to opt for medical studies. The objective of this study is to group and review all the studies that investigated the motivational factors that underpin students' selection of medical study in recent years.

METHODS

The literature search was carried out by two researchers independently in PubMed, Google Scholar, Wiley and IndMED databases for articles published from year 2006 till 2016. A total of 38 combinations of MeSH words were used for search purpose. Studies related to medical students and interns have been included. The application of inclusion and exclusion criteria and PRISMA guidelines for reporting systematic review led to the final selection of 24 articles.

RESULTS

The majority of the studies (n = 16; 66.6%) were from high-income countries followed by an equal number from upper-middle and lower-middle income countries (n = 4,16.7%). None of the studies were from low-income countries. All of the studies were cross-sectional in nature. The main motivating factors that emerged were scientific (interest in science / medicine, social interest and academia, flexible work hours and work independence), societal (prestige, job security, financial security) and humanitarian (serving the poor and under priviledged) in high-, upper-middle and lower-middle income countries, respectively. The findings were comparable to Maslow's hierarchy of needs theory of motivation.

CONCLUSION

This systematic review identifies the motivational factors influencing students to join medical studies in different parts of the globe. These factors vary per country depending on the level of income. This study offers cues to policy makers and educators to formulate policy in order to tackle the shortage of health workers, i.e. medical doctors. However, more research is needed to translate health policy into concrete and effective measures.

Job satisfaction and turnover intentions among health care staff providing services for prevention of mother-to-child transmission of HIV in Dar es Salaam, Tanzania

BACKGROUND

Option B+ for the prevention of mother-to-child transmission (PMTCT) of HIV (i.e., lifelong antiretroviral treatment for all pregnant and breastfeeding mothers living with HIV) was initiated in Tanzania in 2013. While there is evidence that this policy has benefits for the health of the mother and the child, Option B+ may also increase the workload for health care providers in resource-constrained settings, possibly leading to job dissatisfaction and unwanted workforce turnover.

METHODS

From March to April 2014, a questionnaire asking about job satisfaction and turnover intentions was administered to all nurses at 36 public-sector health facilities offering antenatal and PMTCT services in Dar es Salaam, Tanzania. Multivariable logistic regression models were used to identify factors associated with job dissatisfaction and intention to quit one's job.

RESULTS

Slightly over half (54%, 114/213) of the providers were dissatisfied with their current job, and 35% (74/213) intended to leave their job. Most of the providers were dissatisfied with low salaries and high workload, but satisfied with workplace harmony and being able to follow their moral values. The odds of reporting to be globally dissatisfied with one's job were high if the provider was dissatisfied with salary (adjusted odds ratio (aOR) 5.6, 95% CI 1.2-26.8), availability of protective gear (aOR 4.0, 95% CI 1.5-10.6), job description (aOR 4.3, 95% CI 1.2-14.7), and working hours (aOR 3.2, 95% CI 1.3-7.6). Perceiving clients to prefer PMTCT Option B+ reduced job dissatisfaction (aOR 0.2, 95% CI 0.1-0.8). The following factors were associated with providers' intention to leave their current job: job stability dissatisfaction (aOR 3.7, 95% CI 1.3-10.5), not being recognized by one's superior (aOR 3.6, 95% CI 1.7-7.6), and poor feedback on the overall unit performance (aOR 2.7, 95% CI 1.3-5.8).

CONCLUSION

Job dissatisfaction and turnover intentions are comparatively high among nurses in Dar es Salaam's public-sector maternal care facilities. Providing reasonable salaries and working hours, clearer job descriptions, appropriate safety measures, job stability, and improved supervision and feedback will be key to retaining satisfied PMTCT providers and thus to sustain successful implementation of Option B+ in Tanzania.

Motivation of the nurses in pre-hospital emergency and educational hospitals emergency in the southeast of Iran

INTRODUCTION

Nurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Therefore, due to the importance of this issue, this study aimed to determine job motivation of the nurses in pre-hospital and educational hospitals emergency in the southeast of Iran.

METHODS

In this study, a cross-sectional method was used, and it was conducted in educational hospitals and pre-hospital emergencies under supervision of the Kerman University of Medical Sciences in 2017. Using a valid and reliable questionnaire, we assessed job motivation of the nurses using a census method (N = 275). Data were analyzed by implementing descriptive statistics including mean and standard deviation (SD), and analytical statistics such as Kolmogorov-Smirnov, ANOVA, t-test, X2, Pearson, and multivariate regression tests using SPSS 16 and P ≤ 0.05.

RESULTS

Among the pre-hospital emergency nurses, the average of the educational factors was 25.33, financial factors was 6.34, psychological factors was 20.07, welfare factors was 0.63, and administrative factors was 8.16. Among the nurses of the educational hospitals emergency, these factors were 25.33, 6.51, 20.34, 16.55, and 8.39, respectively. Two group's nurses were at the intermediate level of the job motivation.

CONCLUSION

Dynamic and predetermined goals of emergency include providing services as soon as possible and stabilizing patient's condition during the golden and vital time of rescue. Findings suggest that national and local policies in Iran may need to examine factors that contribute to the promotion of the motivation as well as focusing on how to improve them.