THE EFFECTS OF HEALTH WORKERS JOB SATISFACTION ON HEALTH CARE IN A TERTIARY HOSPITAL IN LAGOS STATE


Content

 

 

ABSTRACT

This study investigated the Effects of Health Workers Job Satisfaction on Health Care in a Tertiary Hospital in Lagos State. The purpose of this research was to determine the level of health workers overall job performance, to identify the factors influencing job satisfaction of health workers, to identify health workers reason to stay in the health care setting and to identify health workers reason to leave in the health care setting. The descriptive survey research method was used to assess the respondents’ opinions using  questionnaire and the sampling technique. In this study, 50 (fifty) respondents were selected and used as samples to represent the population of the study. Four (4) research questions and two (2) null hypotheses were formulated and tested in this study. Also, the ANOVA statistical tool was used to test and analyses the null hypotheses at 0.05 level of significance at the end of the exercise, the following results were obtained: Hypothesis one revealed that Job satisfaction will have a significant effect on health care delivery in a tertiary hospital while hypothesis two indicated that there is a significant difference in the level of health workers overall job performance. Based on the findings from the study the following recommendations were made on the basis of the findings of this study which include the following:  Interventions should be carried out to increase levels of job satisfaction among healthcare workers by reinforcing relevant human resources polices, improving working conditions and compensation. Priority should be given to improving relationships between management and healthcare workers and increasing decision-making latitude among staff members. It is recommended that healthcare workers’ job be redesigned to have a scope of enrichment and be of interest. Involving the healthcare staff in a cooperative, team approach will allow for consideration of ways to improve aspects relating to job satisfaction.  Improving the work environment so that it provides a context in line with the aspirations of healthcare staff is likely to increase job satisfaction and consequently have a positive effect on individual, organizational and quality of health care services and Improved working climate, suitable and market compatible perks and benefits, taking efforts to improve the career structure including capacity building, promotions and giving due rewards on job performance

 

Keywords: Health Workers, Job Satisfaction Attitude, Health Care in Tertiary Hospital

 

 

 

 

 

TABLE OF CONTENTS

PAGES

Title Page                                                                                                                               i

Certification                                                                                                                          ii

Dedication                                                                                                                             iii

Acknowledgments                                                                                                               iv

Abstract                                                                                                                                 v

Table of Contents                                                                                                                 vi

 

CHAPTER ONE: INTRODUCTION

Introduction                                                                                                                          1

Statement of the Problem                                                                                                    4

Purpose of the Study                                                                                                           5

Research Questions                                                                                                             5

Research H­ypotheses                                                                                                          6

Significance of the Study                                                                                                    6

Scope of the Study                                                                                                               7

Definition of Terms                                                                                                             7

 

CHAPTER TWO: LITERATURE REVIEW

Introduction                                                                                                                          10

Nature of Job Satisfaction                                                                                                  12

Job Satisfaction Theories                                                                                                   14       

Job Satisfaction in Public Healthcare Environment                                                       18

Motivation of Health Workers and Workplace Relationship                                       23

Job Satisfaction and Productivity                                                                                     25

Job Satisfaction and Service Delivery                                                                              29

Job Satisfaction and Work Performance                                                                          31

Determinants of Job Satisfaction                                                                                      32

Factors Affection Job Satisfaction of health care Workers Staff Relations               35

Job Satisfaction in Public Healthcare Environment                                                       37

Summary of Literature Review                                                                                          38

 

CHAPTER THREE: RESEARCH METHODOLOGY

Research Method                                                                                                                 40

Population and Sampling Procedures                                                                               41

Research Instrument                                                                                                                        41

Data Collection Techniques                                                                                               42

Validation of Instrument                                                                                                     42

Reliability of Instrument                                                                                                     43

Method of Data Analysis                                                                                                    43

 

CHAPTER FOUR: DATA ANALYSES AND RESULTS

Introduction                                                                                                                          44

Descriptive Analysis of Respondents                                                                               44

Research Questions                                                                                                             48

Hypotheses Testing                                                                                                             50

Summary of Findings                                                                                                          51

Discussion of Findings                                                                                                        52

 

CHAPTER FIVE:   DISCUSSION OF FINDINGS, SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

Introduction                                                                                                                          54

Summary of the Study                                                                                                         54

Conclusions                                                                                                                          55

Recommendations                                                                                                               56

Suggestion for Further Studies                                                                                           57

 

REFERENCES                                                                                                                    58

APPENDIX                                                                                                                           61


PROPOSAL ON

 

THE EFFECTS OF HEALTH WORKERS JOB SATISFACTION ON HEALTH CARE IN A TERTIARY HOSPITAL IN LAGOS STATE ( A CASE STUDY OF GBAGADA GENERAL HOSPITAL)

 

Introduction

 

Every healthcare institute is expected by the public to render quality and professional healthcare services. In order to doso, healthcare institutes need employees to be satisfied with their jobs. Health care workers can be a valuable source of information about factors that enable or hinder them from providing high quality care. The Nigerian health system consists of both a private for profit health sector and a public health sector. The majority of Nigerians rely on the public health care sector for their health care needs but expenditure in the private sector far outweighs that of the public sector. This scenario, exacerbated by the global financial crisis, has resulted in an over-serviced private sector, and under-serviced public sector. Provision of good quality health care requires that the whole health care system be functioning with well trained, motivated and satisfied staff, adequate services and equipment, good referral networks and appropriate management and support. The absence of some of these would lead to poor quality (Khumalo, 2014).

Health services are affected by many factors such as human resources, delivery system and health infrastructures. Among these human resources is a vital component in delivering health services. Jobsatisfaction of the health workers is highlyimportant in building up employee motivation and efficiency as higher job satisfaction determine better employee performance and higher level of patients’ satisfaction. Job dissatisfaction resulting in burn out and turn over would exacerbate the current shortage and results in serious under staffing of health care facilities. This has the potential to have a negative impact on the delivery of patient care because there is evidence to suggest that reduction in health professional staff below certain level is related to poor patient outcomes (Yami, Hamza, Hassen,  Jira and Sudhakar , 2011).

Job satisfaction in the health care field and theconsequences of that satisfaction are good indicators of the well-being and quality of life of the workers. The presence of highly motivated personnel who are satisfied with their job and their employer increases productivity and the quality of service.In the healthcare sector, the job satisfaction of professionals plays an effective and strong role in their performance and is further reflected in the health and satisfaction of the patients. In addition, the job satisfaction of health care professionals also determines the quality of services delivered by them to the respective communities (Garcia, 2000).

Job satisfaction is a multi-layered behaviour that depicts a professional’s reactions and feelings towards his/her job.Job satisfaction generally describes how content an individual is with his/her job or the feelings people have about their jobs. The most focal employees’ attitude is job satisfaction and employees have views about various aspects of their job, their career and for whom they work (Jayasuriya et al., 2012).  This is epitomized in medical care provision where a health care worker’s satisfaction influence their performance resultantly, compliance among their patients.An organization’s overall productivity and quality of individual work is related to job satisfaction( Kisa , 2006).

High job satisfaction can improve the enthusiasm of the staff and is beneficial to the success and progress of the organisation. It can lead to lower turnover and high quality service. Healthcare staff with low job satisfaction may suffer from medical problems themselves and individual employee health may influencethe overall stability of the healthcare staff. Dissatisfied employees are more likely to leave the organisation, and as a result, the remaining employees may engage in counterproductive activities such as low-quality service and cause damage to equipment. There are several factors are associated with job satisfaction. A survey conducted by Maissiat (2015)indicated that job satisfaction was associated with professional accomplishment, freedom of expression and appreciation. An investigation undertaken by Atif(2015), revealed that age, educational background, years of service and income were significantly associated with job satisfaction among doctors.

The job satisfaction of health professionals has been shown to be influenced by a range of individual and organisational factors including personality, the work itself, work organisation, remuneration, workload, interactions with colleagues, training opportunities, recognition, and leadership styles. Importantly, job satisfaction depends not only on the characteristics of a job but also on employees’ expectations of what their job should provide(   Barriball , 2012).

Statement of the Problem

Most countries especially less developed ones have been found to have less than 50% of the required staff available to provide health care in most health institutions, and in most, health care services are provided by non-qualified staff (WHO, 2006,Hongoro and Normand, 2006).

Health Workers are leaving their workplaces because of difficult working conditions. This portents grave danger to the poor who want to access health care, this scenario is no different in Nigeria as many health workers are leaving for greener pastures. The series of industrial unrest seen in the Nigerian health sector is indeed alarming. The frequency and intensity of the strikes have created a serious lacuna in health care services provision and the trust patients have in our health system has been eroded.

Organisations around the world consist of people with similar aim, objective, goals and insights, who cooperatively join hands to achieve what an individual cannot achieve in isolation. If therefore, the people thatmake the place will not relate positively with one another then, the goals of the organisation can hardly beachieved. There are organisations where there are no cordial relationships among staff members, andsubordinates and superiors; for example, when strife, jealousy, hatred, bias, backbiting, witch-hunting, all ofthese and many more co-existing with the people, there is bound to be conflict which may not be healthy for theorganisation. Hence, for a healthy atmosphere in any organisation, the people must understand their differences;there must be the “give and take” which is the basis of a true and genuine relationship. Therefore the gap of the study is to investigate the effects of health workers job satisfaction on health care in a tertiary hospital in Lagos State.

Purpose of the Study

This study is to investigate the effects of health workers job satisfaction on health care in a tertiary hospital in Lagos State.The following objectives are to achieve the purpose of the study.

1.      To determine the level of health workers overall job performance.

2.      To identify the factors influencing job satisfaction of health workers.

3.      To identify health workers reason to stay in the health care setting.

4.      To identify health workers reason to leave in the health care setting.

Research Questions

1. What is the level of health workers overall job performance?

2. What are the factors influencing job satisfaction of health workers?

3.What are the reasons why health workers intend to stay in the health care setting?

4. What are the reasons why health workers intend to leave in the health care setting?  

 

Research H­ypotheses

Hypothesis 1

H01:  There is no significant difference in the factors influencing job satisfaction of health workers

Hypothesis 2

H02: There is no significant difference in the level of health workers overall job performance

Significance of the Study

The study is relevant in the sense that it will add more to the existing literature in the area of health workers job satisfaction in ahealth care setting.

The research will also help government, practitioners and health care owners to know the required working conditions that would enhance health workers performance and facilitate higher productivity. It will also help sensitize the government on areas in which they need to focus more attention to health workers so as to boost their morale and hence elicit better efforts towards achieving their goals and organizational goals.

This study will provided information that is important to practice, health care administration and policy maker, and health education.This study will provide input for policy maker on changing worker characteristics, changing job characteristics, and working environment adjustment. It may also help in job placement strategies to retain more staff. Again, for education and training of staff this study mayindicate the area of interest for provision of problem solving education.

Administrators could use this information to build solid and supportive units. This is important because the culture of the unit and the quality of health workers staff affects every aspect of a health worker practice and the patients’ care. Health care managers and practitioners should be aware of the hardships that health worker face in trying to give quality care to patients. Therefore, it can be said that knowing a nurse’s tendency and difficulties will help predict the nurse’s job satisfaction and intention to quit.

Finally, the study will also act as a source of reference for further studies to be done on human resource in higher institutions in Nigeria.Future researchers will also benefit from this study because it will provide them with relevant information on the topic.

Scope of the Study

The scope of this study is to examine health workers job satisfaction on health care in a tertiary hospital in Lagos State with reference to Gbagada General Hospital.

 

 

Definition of Terms

Job Satisfaction: Job satisfaction is a personal feeling of contentment which a health workers has and exhibits towards his or her work situation.

Motivation:Motivation can be defined as a person’s degree of willingness toward achieving an individual goal that is consistent with that of the organization and the reasons underlying behavior which can be either intrinsic or extrinsic

Interpersonal Relations: Interpersonal relationship at work constitutes the day to day interaction between co-workers, or managers and employees. These relations are a natural part of the work environment and are usually pleasant and creative, but sometimes the source of tension and frustration.

Workplace: A workplace is a location or building where people perform physical or mental work in order to earn a living.

Rewards: Something given in return for or get from job completed, superior performance.

Payment: “A pre-set regular recompense, normally compensated on a monthly basis”.

Promotion: The progress of an employee from one employment level to a new employment level that having a high salary package, high level designation and frequently, more employment responsibilities‟.

Recognitions: “One-time cash or non-cash award for significant outstanding performance”.

Employee Performance:Employee performance is defined as whether a person executes their job duties and responsibilities well. Many companies asses their employee's performance on an annual or quarterly basis in order to define certain areas that need improvement. Performance is a critical factor in organizational success.

Job Dissatisfaction: It is a feeling of unhappiness about the work that one does in his/her own appraisal of work.

 

LITERATURE REVIEW AND THEORETICAL FRAMEWORK

This chapter discuss literature review under the following subheadings:

·        Concept of Job Satisfaction

·        Concept of Motivation

·        Concept of Interpersonal Relationship

·        Job Satisfaction in Public Healthcare Environment

·        Job Satisfaction and Service Delivery

·        Determinants of Job Satisfaction

·        Job Satisfaction and Productivity

·        Job Satisfaction and Work Performance

·        Motivation and Employee performance and Job Satisfaction

·        Motivation of Health Workers and Workplace Relationship

·        Empirical Findings

 

RESEARCH METHODOLOGY

This chapter discussed the methods and procedures used for this study under the following subheadings.

        i.      Research Design

     ii.      Population and Sampling Procedures

   iii.      Research Instrument

   iv.      Data Collection Techniques

      v.      Validation of Instrument

   vi.      Reliability of Instrument

 vii.      Method of Data Analysis

Research Design

The study will adopt the descriptive survey research design to determine health workers job satisfaction on health care in a tertiary hospital in Lagos State. Descriptive research is concerned with ascertaining conditions which prevail in group cases chosen for the study. It is essentially a method of quantitative description of the general characteristics of the group. According to Adanza (1995), survey research typically employs questionnaires and it serves the purpose of describing current or prevailing conditions, opinions, attitudes, impressions, perceptions of a group of people, or variety of subjects taken from representative or problem samples for the purpose of inferring the properties of the population.

Population and Sampling Procedures

The target population for the study will consist of health workers in Lagos State public hospitals.

The sample for the study will be selected through simple random sampling techniques. The sample for this study will comprise of 50 health workers in Gbagada General Hospital in Lagos State. This implies that 50health workers will be sampled inGbagada General Hospital.

Research Instrument

The study will employed the use of a structured research instrument titled “Health Workers Job Satisfaction Questionnaire(HWJSQ)” designed by the researcher.

The questionnaire will be divided into five sections. The first section will elicit information on the demographic information of the respondents which includes include sex age, marital status, academic qualification, department and working experience. The second section will elicit information on the level of health workers overall job performance, the third section focus on factors influencing job satisfaction of health workers, fourth section will obtain information on health workers reason to stay in the health care settingand the last section focus onhealth workers reason to leave in the health care setting.

The options of the questionnaires will be rated using the four likert scales ranging from strongly agree (SA), agree (A), disagree (D) and strongly disagree (SA).

 

Data Collection Techniques

The necessary data for this study will be obtained from health workers of the selected hospital in the study area. The questionnaire will be administered personally by the researcher having taking permission from the appropriate quarters. The researcher willexplain the procedure to the respondents and collect them immediately.

Validation of Instrument

A valid instrument is an instrument that measures what it claims to measure. An instrument has to be reliable in order for it to be valid. There are various types of validity but this study will seek to determine the content validity. Content validity addresses how well the content of the test samples the subject matter. In respect of the foregoing, the expert opinion of the assigned research supervisors will be sought.

The instrument’s validity will also be determine by the  using the spilt-half technique, whereby scores on two equivalent halves of the instrument will be totally separately and the correlation coefficient calculated, whose value will later be calculated by using the Spearman Brown Prophecy formula.

Reliability of Instrument

Reliability refers to the degree of consistency of the data gathering instrument in measuring that which it is supposed to measure. This degree of consistency is measured using Cronbach’s alpha coefficient. It is a measure of internal consistency that shows the degree to which all the items in a test measure the same attribute (Masitsa, 2011).

The research instrument will be subject to pilot test with the aim of assessing its reliability. In the context of this study, the Cronbach alpha (α) will be employ to test the instrument’s reliability. The instrument will be regarded as being reliable after all the factors returned alpha values greater than 0.7 (α > 0.7).

Method of Data Analysis

The data will be analyzed using descriptive andinferential statistics of Analysis of Variance (ANOVA) at 0.05 level of significance in analyzing the data collected.

 

 

 

 

CHAPTER ONE

INTRODUCTION

Introduction

Every healthcare institute is expected by the public to render quality and professional healthcare services. In order to do so, healthcare institutes need employees to be satisfied with their jobs. Health care workers can be a valuable source of information about factors that enable or hinder them from providing high quality care. The Nigerian health system consists of both a private for profit health sector and a public health sector. The majority of Nigerians rely on the public health care sector for their health care needs but expenditure in the private sector far outweighs that of the public sector. This scenario, exacerbated by the global financial crisis, has resulted in an over-serviced private sector, and under-serviced public sector. Provision of good quality health care requires that the whole health care system be functioning with well trained, motivated and satisfied staff, adequate services and equipment, good referral networks and appropriate management and support. The absence of some of these would lead to poor quality (Khumalo, 2014).

Health services are affected by many factors such as human resources, delivery system and health infrastructures. Among these human resources is a vital component in delivering health services. Job satisfaction of the health workers is highly important in building up employee motivation and efficiency as higher job satisfaction determine better employee performance and higher level of patients’ satisfaction. Job dissatisfaction resulting in burn out and turn over would exacerbate the current shortage and results in serious under staffing of health care facilities. This has the potential to have a negative impact on the delivery of patient care because there is evidence to suggest that reduction in health professional staff below certain level is related to poor patient outcomes (Yami, Hamza, Hassen, Jira and Sudhakar, 2011).

Job satisfaction in the health care field and the consequences of that satisfaction are good indicators of the well-being and quality of life of the workers. The presence of highly motivated personnel who are satisfied with their job and their employer increases productivity and the quality of service. In the healthcare sector, the job satisfaction of professionals plays an effective and strong role in their performance and is further reflected in the health and satisfaction of the patients. In addition, the job satisfaction of health care professionals also determines the quality of services delivered by them to the respective communities (Garcia, 2000).

Job satisfaction is a multi-layered behaviour that depicts a professional’s reactions and feelings towards his/her job. Job satisfaction generally describes how content an individual is with his/her job or the feelings people have about their jobs. The most focal employees’ attitude is job satisfaction and employees have views about various aspects of their job, their career and for whom they work (Jayasuriya et al., 2012).  This is epitomized in medical care provision where a health care worker’s satisfaction influence their performance resultantly, compliance among their patients. An organization’s overall productivity and quality of individual work is related to job satisfaction (Kisa, 2006).

High job satisfaction can improve the enthusiasm of the staff and is beneficial to the success and progress of the organisation. It can lead to lower turnover and high quality service. Healthcare staff with low job satisfaction may suffer from medical problems themselves and individual employee health may influence the overall stability of the healthcare staff. Dissatisfied employees are more likely to leave the organisation, and as a result, the remaining employees may engage in counterproductive activities such as low-quality service and cause damage to equipment. There are several factors are associated with job satisfaction. A survey conducted by Maissiat (2015) indicated that job satisfaction was associated with professional accomplishment, freedom of expression and appreciation. An investigation undertaken by Atif (2015), revealed that age, educational background, years of service and income were significantly associated with job satisfaction among doctors.

The job satisfaction of health professionals has been shown to be influenced by a range of individual and organisational factors including personality, the work itself, work organisation, remuneration, workload, interactions with colleagues, training opportunities, recognition, and leadership styles. Importantly, job satisfaction depends not only on the characteristics of a job but also on employees’ expectations of what their job should provide (Barriball, 2012).

Statement of the Problem

Most countries especially less developed ones have been found to have less than 50% of the required staff available to provide health care in most health institutions, and in most, health care services are provided by non-qualified staff (WHO, 2006, Hongoro and Normand, 2006).

Health Workers are leaving their workplaces because of difficult working conditions. This portents grave danger to the poor who want to access health care, this scenario is no different in Nigeria as many health workers are leaving for greener pastures. The series of industrial unrest seen in the Nigerian health sector is indeed alarming. The frequency and intensity of the strikes have created a serious lacuna in health care services provision and the trust patients have in our health system has been eroded.

Organisations around the world consist of people with similar aim, objective, goals and insights, who cooperatively join hands to achieve what an individual cannot achieve in isolation. If therefore, the people that make the place will not relate positively with one another then, the goals of the organisation can hardly be achieved. There are organisations where there are no cordial relationships among staff members, and subordinates and superiors; for example, when strife, jealousy, hatred, bias, backbiting, witch-hunting, all of these and many more co-existing with the people, there is bound to be conflict which may not be healthy for the organisation. Hence, for a healthy atmosphere in any organisation, the people must understand their differences; there must be the “give and take” which is the basis of a true and genuine relationship. Therefore the gap of the study is to investigate the effects of health workers job satisfaction on health care in a tertiary hospital in Lagos State (LASUTH, Lagos State University Teaching Hospital).

Purpose of the Study

This study is to investigate the effects of health workers job satisfaction on health care in a tertiary hospital in Lagos State.The following objectives are to achieve the purpose of the study.

5.      To determine the level of health workers overall job performance.

6.      To identify the factors influencing job satisfaction of health workers.

7.      To identify health workers reason to stay in the health care setting.

8.      To identify health workers reason to leave in the health care setting.

Research Questions

1. What are the effects of job satisfaction on health care delivery.

2. What are the factors influencing job satisfaction of health workers?

3.What are the reasons why health workers intend to stay in the health care setting?

4. What are the reasons why health workers intend to leave in the health care setting?  

 

 

Research H­ypotheses

Hypothesis 1

H01:     Job satisfaction will have no significant influence on health care delivery in a tertiary hospital in Lagos State

Hypothesis 2

H02:   There is no significant difference in the level of health workers overall job

performance

 

Significance of the Study

The study is relevant in the sense that it will add more to the existing literature in the area of health workers job satisfaction in a health care setting.

The research will also help government, practitioners and health care owners to know the required working conditions that would enhance health workers performance and facilitate higher productivity. It will also help sensitize the government on areas in which they need to focus more attention to health workers so as to boost their morale and hence elicit better efforts towards achieving their goals and organizational goals.

This study will provided information that is important to practice, health care administration and policy maker, and health education. This study will provide input for policy maker on changing worker characteristics, changing job characteristics, and working environment adjustment. It may also help in job placement strategies to retain more staff. Again, for education and training of staff this study may indicate the area of interest for provision of problem solving education.

Administrators could use this information to build solid and supportive units. This is important because the culture of the unit and the quality of health workers staff affects every aspect of a health worker practice and the patients’ care. Health care managers and practitioners should be aware of the hardships that health worker face in trying to give quality care to patients. Therefore, it can be said that knowing a nurse’s tendency and difficulties will help predict the nurse’s job satisfaction and intention to quit.

Finally, the study will also act as a source of reference for further studies to be done on human resource in higher institutions in Nigeria. Future researchers will also benefit from this study because it will provide them with relevant information on the topic.

 

Scope of the Study

The scope of this study is to examine health workers job satisfaction on health care in a tertiary hospital in Lagos State with reference to Gbagada General Hospital (LASUTH, Lagos State University Teaching Hospital).

 

Definition of Terms

Job Satisfaction: Job satisfaction is a personal feeling of contentment which a health workers has and exhibits towards his or her work situation.

Motivation: Motivation can be defined as a person’s degree of willingness toward achieving an individual goal that is consistent with that of the organization and the reasons underlying behavior which can be either intrinsic or extrinsic

Interpersonal Relations: Interpersonal relationship at work constitutes the day to day interaction between co-workers, or managers and employees. These relations are a natural part of the work environment and are usually pleasant and creative, but sometimes the source of tension and frustration.

Workplace: A workplace is a location or building where people perform physical or mental work in order to earn a living.

Rewards: Something given in return for or get from job completed, superior performance.

Payment: “A pre-set regular recompense, normally compensated on a monthly basis”.

Promotion: The progress of an employee from one employment level to a new employment level that having a high salary package, high level designation and frequently, more employment responsibilities.

Recognitions: “One-time cash or non-cash award for significant outstanding performance”.

Employee Performance: Employee performance is defined as whether a person executes their job duties and responsibilities well. Many companies asses their employee's performance on an annual or quarterly basis in order to define certain areas that need improvement. Performance is a critical factor in organizational success.

Job Dissatisfaction: It is a feeling of unhappiness about the work that one does in his/her own appraisal of work.


 

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