Abstract
Background
Nurses’ job dissatisfaction can be seen as an early warning indicator of occupational change and (early) termination intentions. A better understanding of job satisfaction and its determinants can help to prevent nurses from leaving their profession.
Aim
We assessed the impact of nurses’ perception of job characteristics on their overall job satisfaction in order to identify the most relevant factors. We also investigated the potential mechanisms through which the most relevant factor influences job satisfaction.
Method
We used multiple regression analysis based on a standardized survey of about 800 registered nurses (in long-term care facilities) in both inpatient care and outpatient care in Germany as well as qualitative content analysis of about 50 semi-structured interviews with nurses.
Results
We found that collaboration with the team and supervisor to be the most relevant factor associated with job satisfaction. A good team can create professional support and ideational support for professional caregivers and enhance their professional development and the quality of care.
Discussion
Our results point to the importance of leadership training, team building methods and other measures for establishing and cultivating a pleasant working atmosphere with flexible shift handovers and team meetings.
Zusammenfassung
Hintergrund
Die Arbeitsunzufriedenheit von Pflegekräften kann als Frühwarnindikator für Kündigungs- und Berufswechselabsichten angesehen werden. Ein besseres Verständnis der Arbeitszufriedenheit und ihrer Determinanten kann dazu beitragen, dass Pflegekräfte ihren Beruf nicht verlassen.
Ziel
Wir untersuchen, wie sich die Wahrnehmung von Berufsmerkmalen durch Pflegepersonen auf deren Arbeitszufriedenheit auswirkt, um die relevantesten Faktoren zu ermitteln. Darüber hinaus wurde analysiert auf welche Weise der relevanteste Faktor die Arbeitszufriedenheit beeinflusst.
Methode
Es wurden multiple Regressionsanalysen, basierend auf einer standardisierten Befragung von ca. 800 Pflegefachkräften in der Kranken- und Langzeitpflege sowie in der stationären und ambulanten Pflege in Deutschland, verwendet. Eine qualitative Inhaltsanalyse von 49 teilstrukturierten Interviews mit Pflegekräften wurde durchgeführt.
Ergebnisse
Die Zusammenarbeit mit dem Team und dem Vorgesetzten ist der wichtigste mit der Arbeitszufriedenheit assoziierte Faktor. Ein „gutes“ Team kann professionelle und ideelle Unterstützung für professionelle Pflegekräfte schaffen und deren berufliche Entwicklung sowie die Qualität der Pflege verbessern.
Diskussion
Die Ergebnisse verweisen auf die Bedeutung von Personalführungstrainings, Teambildungs- und anderen Maßnahmen zur Schaffung und Pflege einer angenehmen Arbeitsatmosphäre mit Freiräumen für Schichtübergaben und Teambesprechungen.
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Notes
Regional planning areas are constructed by the Federal Institute for Research on Building, Urban Affairs and Spatial Development for the purpose of carrying out nationwide comparisons and assessing large-scale regional tendencies. They explicitly rely on the concept of an economic center, surrounded by a more rural periphery. See www.bbsr.bund.de for more detailed information on the construction of regional planning areas.
Data access was provided within the context of a § 75 SGB X application.
The selection of these factors was based on multiple (subjective) criteria: our expectation of finding enough empirical variation, the deductibility of research hypotheses and last but not least the response burden for the target persons. As a result, work requirements (challenging work situation etc.) task variety, secure work environment, concrete management styles as well as commuting distance and self-efficacy were dropped from the survey. See [5,6,7, 14, 22, 24, 28] for research on these topics.
Large part of the data cleaning consisted of checking whether respondents’ answers were consistent with the questionnaire filters.
By including nurses who have not completed vocational training the qualitative sample differs from the sample of the quantitative study; however, the results are not typical for either nurses in training or registered nurses, and only in some points are there references to subtle differences. In these cases, references are made in the text.
The survey variables on job characteristics are still filled in about 80% of all cases, but combining all job characteristics in the regressions leads to considerably lower numbers of observations. Nevertheless, the comparison of the job characteristics commonly contained in models (3a) and (3b) and (4a) and (4b) shows that non-response to the survey variables on job characteristics does not alter the results. Unfortunately, the IEB do not cover as many job characteristics as our survey does.
This corresponds to what Barron and Kenny [4] term “Step 2” and “Step 3”. Results for step 2 are available from the authors upon request. Please note that for mediation to take place it is not necessary that job characteristics exhibit a significant relationship with overall job satisfaction in models (4a) and (4b) as there may be more than one mediator variable, whose effects potentially cancel out [29].
Future research might be interested in estimating a more complex mediation model and separate direct and indirect effects in the mediation model more rigorously. Here, our primary interest lies in finding out about the impact of different work-related factors and nurses’ perception of them, rather than in learning about nature and size of their potential mediating effects.
Estimating model (3) separately for nurses and nurses in long-term care, nurses in inpatient care and outpatient care as well as nurses aged 18–45 years and beyond the age of 45 years led largely to the same results. They are available from the authors upon request.
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Acknowledgements
We are grateful to Martin Kroczek for administering large parts of the survey and to Noemie Friedrich, who was (up to her withdrawal) a valuable member of the research team. Wilhelm Kohler is acknowledged for providing helpful comments on an earlier version of the paper. Furthermore, we thank Meike Linde, Lukas Cramer, Ida Dorn, Alexandra Walter and Friederike Schlenker for excellent research support. Not least, we thank all persons who took part in the pre-tests and survey.
Funding
This paper is an outcome of the ZAFH care4care funded by the EFRE fund and the Ministry of Science, Research and Art Baden Wuerttemberg.
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J. Höld, J. Späth and C. Kricheldorff declare that they have no competing interests.
The quantitative and the qualitative surveys were approved by the ethical commission of the German Society for Nursing Science (Deutsche Gesellschaft für Pflegewissenschaft e. V.) in October and April 2018, respectively.
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Höld, J., Späth, J. & Kricheldorff, C. What makes them happy? Professional care-givers’ job satisfaction. Z Gerontol Geriat 53, 655–662 (2020). https://doi.org/10.1007/s00391-020-01759-6
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DOI: https://doi.org/10.1007/s00391-020-01759-6