Journal of Medical Systems

, Volume 32, Issue 4, pp 333–341 | Cite as

A Proposed Instrument for the Assessment of Job Satisfaction in Greek Mental NHS Hospitals

  • Georgios LabirisEmail author
  • Kleoniki Gitona
  • Vasiliki Drosou
  • Dimitrios Niakas
Original Paper


Since its introduction in 1983, the Greek NHS is under an almost constant reform, aiming improvement on the efficiency and the quality of provided services. The national program of psychiatric reform “Psychargos” introduced new models of therapeutic approach to the care of the mentally ill, that required expansion of the existing roles and development of new roles of the healthcare staff. Consequently, the efficient management of the healthcare workforce in Greek mental facilities was identified as a primary determinant of the successful implementation of the program. Primary objective of this study was the development of a research framework for the assessment of job satisfaction in Greek Mental Health Hospitals. Among the objectives was the evaluation of the capacity of the underlying motivators and hygiene factors and the identification of potential correlations of the global job satisfaction and the motivation and retention factors with the demographic, social and occupational characteristics of the employees. A custom questionnaire was developed, based on Herzberg two-factor theory, after a systematic review of the relevant literature. The instrument was constructed by two parts and 37 items. Ten items addressed the sociodemographic characteristics of the subjects, while the remaining 27 items were distributed in 11 subscales which addressed the global satisfaction index and the “retention” and the “motivation” variables. The instrument was validated by means of the Cronbach alpha for each subscale and by confirmatory factor analysis. The study was conducted at the Public Mental Hospital of Chania (PMHC). From the 300 employees of the PMHC, 133 subjects successfully responded to the questionnaire (response rate, 44.3%). In accordance to former surveys, subjects presented average scores in the global satisfaction index (GSI). The professional category of the employee was identified as the primary determinant of the GSI. Nurses presented statistically significant lower scores in comparison to the rest of the employees. Strong Pearson correlations were detected between GSI and “working conditions”, “interpersonal relations”, “organization”, “salary” and “supervision” factors. The retention factors presented stronger impact on GSI in comparison to the motivation ones. The results of the study indicate that the proposed instrument presents satisfactory validity and reliability for the assessment of job satisfaction in Greek mental NHS hospitals.


Motivation Herzberg Job satisfaction Validation LISREL Mental hospital Greece 


Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

GL was responsible for designing the study and drafting the manuscript. KG was responsible for conducting the literature review, developing the questionnaire and acquiring the data. VD conducted the statistical analysis. DN was responsible for the conception of the study.


  1. 1.
    Stefanis, C., Madianos, M. G., and Gittelman, M., Recent developments in the care, treatment and rehabilitation of the chronic mentally ill in Greece. Hospital & Community Psychiatry 37:1041–1044, 1986.Google Scholar
  2. 2.
    Madianos, M. G., Tsiantis, J., and Zacharakis, C., Changing patterns of mental health care in Greece (1984-1996). Eur. Psychiatr. 14:1–4, 1999.Google Scholar
  3. 3.
    Mossialos, E., Allin, S., and Davaki, K., Analysing the Greek health system: A tale of fragmentation and inertia. Health Econ. 14:S151–S168, 2005.CrossRefGoogle Scholar
  4. 4.
    Kontodimopoulos, N., Bellali, T., Labiris, G. , et al., Investigating sources of inefficiency in residential mental health facilities. J. Med. Syst. 3:169–176, 2005.Google Scholar
  5. 5.
    Linn, L. S., Brook, R. H., Clark, V. A. , et al., Physician and patient satisfaction as factors related to the organization of internal medicine group practices. Med. Care 23:1171–1178, 1985.CrossRefGoogle Scholar
  6. 6.
    Stamps, P. L., Nurses and work satisfaction: An index for measurement, 2nd edition. Health Administration Press, Chicago, IL, 1997.Google Scholar
  7. 7.
    Greenberg, J., and Baron, A., Behavior in organizations, 7th edition. Prentice Hall, New Jersey, 2000.Google Scholar
  8. 8.
    Parkes, K. R., Shiftwork and environment as interactive predictors of work perceptions. J. Occup. Health Psychol. 4:266–281, 2003.CrossRefGoogle Scholar
  9. 9.
    Steinhardt, M. A., Dolbier, C. L., Gottlieb, N. H. , et al., The relationship between hardiness, supervisor support, group cohesion, and job stress as predictors of job satisfaction. Am. J. Health Promot. 6:382–389, 2003.Google Scholar
  10. 10.
    Shikdar, A. A., and Das, B., The relationship between worker satisfaction and productivity in a repetitive industrial task. Appl. Ergon. 6:603–610, 2003.CrossRefGoogle Scholar
  11. 11.
    Herzberg, F., Manseur, B., and Synderman, B., The motivation to work. Wiley, New York, 1959.Google Scholar
  12. 12.
    Herzberg, F., One more time: How do you motivate your employees. Harvard Business Review, 1968, Jan/Feb.Google Scholar
  13. 13.
    Mak, B., and Sockel, H., A confirmatory factor analysis of IS employee motivation and retention. Inf. Manage. 38:265–276, 2001.CrossRefGoogle Scholar
  14. 14.
    Kim, J. O., and Mueller, C. W., Introduction to factor analysis: What it is and how to do it. Thousand Oaks, CA: Sage Publications, Quantitative Applications in the Social Sciences Series, No.13., 1978.Google Scholar
  15. 15.
    Byrne, M., The implications of Herzberg’s “motivation-hygiene” theory for management in the Irish health sector. Health Care Manag. 1:4–11, 2006.MathSciNetGoogle Scholar
  16. 16.
    Davaki, K., and Mossialos, E., Plus ça change: Health sector reforms in Greece. J. Health Polit. Policy Law. 1–2:143–167, 2005.CrossRefGoogle Scholar
  17. 17.
    Brokalaki, H., Matziou, V., Tanou, J. , et al., Self-rated health, work characteristics and health related behaviours among nurses in Greece: A cross sectional study. BMC Nurs 4:8, 2005.CrossRefGoogle Scholar
  18. 18.
    Paleologou, V., Kontodimopoulos, N., Stamouli, A. , et al., Developing and testing an instrument for identifying performance incentives in the Greek health care sector. BMC Health Serv. Res. 6:118, 2006.CrossRefGoogle Scholar
  19. 19.
    Kaarna, M., Polluste, K., Lepnurm, R. , et al., The progress of reforms: Job satisfaction in a typical hospital in Estonia. Int. J. Qual. Health Care 3:253–261, 2004.CrossRefGoogle Scholar
  20. 20.
    Woodward, C. A., Shannon, H. S., Cunningham, C. , et al., The impact of re-engineering and other cost reduction strategies on the staff of a large teaching hospital. Med. Care 37:556–569, 1999.CrossRefGoogle Scholar
  21. 21.
    Luthans, B. C., and Sommer, S. M., The impact of downsizing on workplace attitudes. Group Org. Manage. 24:46–70, 1999.CrossRefGoogle Scholar
  22. 22.
    Curtis, E. A., Job satisfaction: A survey of nurses in the Republic of Ireland. Int. Nurs. Rev. 1:92–99, 2007.CrossRefGoogle Scholar
  23. 23.
    Zangaro, G. A., and Soeken, K. L., A meta-analysis of studies of nurses’ job satisfaction. Res. Nurs. Health 4:445–458, 2007.CrossRefGoogle Scholar
  24. 24.
    Bovier, P. A., and Perneger, T. V., Stress from uncertainty from graduation to retirement—A population-based study of Swiss physicians. J. Gen. Intern. Med. 5:632–638, 2007.CrossRefGoogle Scholar
  25. 25.
    Keeton, K., Fenner, D. E., Johnson, T. R., and Hayward, R. A., Predictors of physician career satisfaction, work-life balance, and burnout. Obstet. Gynecol. 4:949–955, 2007.Google Scholar
  26. 26.
    Bogue, R. J., Guarneri, J. G., Reed, M. , et al., Secrets of physician satisfaction. Study identifies pressure points and reveals life practices of highly satisfied doctors. Physician Exec. 6:30–39, 2006.Google Scholar
  27. 27.
    Ernst, M. E., Messmer, P. R., and Franco, M., Nurses’ job satisfaction, stress, and recognition in a pediatric setting. Pediatr. Nurs. 3:219–227, 2004.Google Scholar
  28. 28.
    Piko, B. F., Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: A questionnaire survey. Int. J. Nurs. Stud. 3:311–318, 2006.CrossRefGoogle Scholar
  29. 29.
    Ward, M., and Cowman, S., Job satisfaction in psychiatric nursing. J. Psychiatr. Ment. Health Nurs. 5:454–461, 2007.CrossRefGoogle Scholar
  30. 30.
    Hendel, T., Fish, M., and Berger, O., Physician conflict management mode choices: Implications for improved collaborative practice. Nurs. Adm. Q. 3:244–253, 2007.Google Scholar
  31. 31.
    Rosenstein, A. H., and O’Daniel, M., Disruptive behavior and clinical outcomes: Perceptions of nurses and physicians. Am. J. Nurs. 1:54–64, 2005.Google Scholar
  32. 32.
    Begat, I., Ellefsen, B., and Severinsson, E., Nurses’ satisfaction with their work environment and the outcomes of clinical nursing supervision on nurses’ experiences of well-being—A Norwegian study. J. Nurs. Manag. 3:221–230, 2005.CrossRefGoogle Scholar
  33. 33.
    Laschinger, H. K., Almost, J., and Tuer-Hodes, D., Workplace empowerment and magnet hospital characteristics: Making the link. J. Nurs. Adm. 8:410–422, 2003.Google Scholar
  34. 34.
    French, F., Ikenwilo, D., and Scott, A., What influences the job satisfaction of staff and associate specialist hospital doctors? Health Serv. Manag. Res. 3:153–161, 2007.CrossRefGoogle Scholar
  35. 35.
    French, F. H., Andrew, J. E., Awramenko, M. , et al., Consultants in NHS Scotland: A survey of work commitments, remuneration, job satisfaction and retirement plans. Scott. Med. J. 2:47–52, 2004.Google Scholar
  36. 36.
    Janus, K., Amelung, V. E., Gaitanides, M. , et al., German physicians “on strike”. Shedding light on the most physician dissatisfaction. Health Policy 3:357–365, 2007.CrossRefGoogle Scholar
  37. 37.
    Crawford, J., and Gressley, D., Job satisfaction in the medical imaging profession: Alleviating the shortage of personnel. Radiol. Manage. 2:35–40, 1993.Google Scholar
  38. 38.
    Lamberth, B., and Comello, R. J., Identifying elements of job satisfaction to improve retention rates in healthcare. Radiol. Manage. 3:34–38, 2005.Google Scholar
  39. 39.
    Van Ham, I., Verhoeven, A. A., Groenier, K. H. , et al., Job satisfaction among general practitioners: A systematic literature review. Eur. J. Gen. Pract. 4:174–180, 2006.Google Scholar
  40. 40.
    Takase, M., Maude, P., and Manias, E., Comparison between nurses’ professional needs and their perceptions of their jobs. Aust. J. Adv. Nurs. 2:28–33, 2005.Google Scholar
  41. 41.
    Garfinkerl, P. E., Bagby, R. M., Schuller, D. R. , et al., Predictors of professional and personal satisfaction with a career in psychiatry. Can. J. Psychiatry 6:333–341, 2005.Google Scholar
  42. 42.
    Sturm, R., Datapoints: Are psychiatrists more dissatisfied with their careers than other physicians. Psychiatr. Serv. 5:581, 2001.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Georgios Labiris
    • 1
    Email author
  • Kleoniki Gitona
    • 1
  • Vasiliki Drosou
    • 2
  • Dimitrios Niakas
    • 1
  1. 1.Hellenic Open UniversityPatrasGreece
  2. 2.Intermedico NetworkAthensGreece

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