Job Satisfaction and Associated Factors among Nurses Working In the Operation Theater at Government Hospitals of Eastern Ethiopia , 2017

Background: Job satisfaction is an essential part of nurses‘lives, influencing patient safety, productivity, performance, quality of care, retention, commitment to the organization and the profession. The aim of this study is to assess the level of job satisfaction and associated factors among nurses working in the operating theatre. Method: Institutional based cross-sectional study design was conducted and Simple random sampling method was used to obtain the study participants. Data was collected using a structured selfadministered questionnaire, entered in to EPI data version 3.1and analyzed using SPSS version20. Associations for statistical significance were assessed using the ‘chi square’ test of association. P-values less than 0.05 were considered as statistically significant. Results: The overall level of job satisfaction among nurses who work in operation theater was 48% room from the total participant 8(8.16%) of the respondents were satisfied 39 (39.8%) moderately satisfied whereas the rest 52% was dissatisfied. Type hospital was the only variable that is significantly associated with job satisfaction. Conclusion: The overall level of job satisfaction among nurses work in operation theater room was low Accordingly, working at operating room, type hospital were significantly associated with satisfaction of nurses working in the operating room .


Introduction
The term Job satisfaction is refers to attitude, feeling and beliefs that people have about their work.Positive and favorable attitude towards the job indicate job satisfaction.It is defined by how employees feel about their jobs and different aspects of their jobs.It is one of the important variables in work and organizational psychology, used to determine the quality of health-care systems.Negative and unfavorable attitudes towards the job indicate job dissatisfaction [1,23].
It is the degree to which employees have positive effective orientation towards employment by an organization.Job satisfaction has been conceptualized both globally (general satisfaction with job) and dimensionally (satisfaction with specific dimension of job such as remuneration, promotion and relation with colleagues).Job satisfaction has been linked to health worker motivation, stress burnout, absenteeism, intention to leave, and turnover [2].Many studies have shown that job satisfaction can be influenced by a wide variety of factors such as Salary, working environment, opportunities for personal and professional development, manageable workload, effective supervision, recognition, perceptible progress of patient care outcome, positive relationships with co-workers, autonomy, and contingent rewards [4][5][6].
Professional nurses play a vital role it the provision of health care globally in emergence department .The performance of heath care worker , including professional nurse , link closely to productivity and quality of care provision with health care organization.It was important to identify factors influencing the performance of professional nurse if the quality of health care delivery was too improved [17].Different study at different parts of the world point out the importance of job satisfaction to an organization, profession, professionals and care consumers [18][19][20][21][22].The shortage of nurses and job dissatisfaction is a worldwide phenomenon including Ethiopia.Identifying satisfaction level and associated factors among nurses working in the operating theatre enable interventional measures are taken to improve the retention rate; it will improve nurse's work performance leading to better quality care to patient [19].Therefore, this study aimed to determine the level of job satisfaction and associated factors among nurses working in the operating theatre at government hospitals.

Study Area and Period
The study was conducted in governmental hospitals Found in East Arsi Oromia Regional state.Oromia region is one of the nine regional states of Federal Democratic Republic of Ethiopia (FDRE) and East Arsi is one of the 20 zone of Oromia Regional State .Assella is the capital city of the zone and it's found at distance of 171 km from to the East of Addis Ababa, capital city of Ethiopia.

Data Collection Tool and Procedure
A structured self-administered questionnaire was used to collect data.The questionnaires comprised of three main parts; socio demography, job satisfaction and response.Job satisfaction partly consisted of 20items.For each factor, a respondent can choose from a six-point Likert scale which representing various degrees of satisfaction: 1-very dissatisfied, 2-dissatisfied, 3-somewhat dissatisfied, 4-somewhat satisfied, 5-satisfied, and 6-very satisfied.

Data quality assurance
To ensure validity of the instrument, the questionnaire was submitted to the supervisor for comment regarding the relevance of each item, pre-testing of the questionnaire was done on twenty of the sample size outside of the study area, possible amendments were made.Training was given for the data collectors.During the data collection, supervision was done by principal investigator.Data cleaning up and cross-checking will be done before data processing and analysis.

Data Processing, Analysis and Interpretation
Data was checked for completeness and accuracy, sorted, categorized and summarized.Then collected data will be analyzed SPSS version 20.Descriptive Statistics and chi square test was done to describe study variables and identify associated factors.Associations between socio-demographic characteristics and job satisfaction, as well as comparison of overall level of job satisfaction with each factors of satisfaction were assessed for statistical significance using the chi square test.P-values less than or equal to 0.05 were considered statistically significant.
The level of job satisfaction was interpreted using a mean score for each factor.Accordingly, the mean score of four and above was taken as being satisfied for each factor while the mean score of below four was classified as being dissatisfied.The overall levels of job satisfaction among nurses work in operation room was classified as being dissatisfied if the sum of the scores for the different factors is between 20-60,while 61-80 is moderate and 81-120 is satisfied.

Ethical Consideration
A letter of support and permission was obtained from the ethical review board of the Jimma University institutes of health science, school of nursing and midwifery.The advantage and purpose of the study was explained to the participants.
For confidentiality Verbal consent was taken from the study participants.

Operational About Level of Satisfaction
Satisfied: If overall score for job satisfaction Score is81-120 [33] Moderate satisfied: If overall score for job satisfaction Score is 61-80 [33] Dissatisfied: If overall score for job satisfaction Score is below 60 [33]

Socio-Demographic-Characteristics
A total of 98 nurses work in operation theater room have responded for the self-administered questionnaire.Out of 98 respondents who were included in this study, 42.85 % are male and 57.1 % are female.The majority of respondents are between the ages 31 -40 years (55.1%),29.6% of them are below the age of 30 years.More than half (58.2 %) of the respondents were married.Regarding the work experience the greatest number of employees have service year between 1-5 years (69.4%).With regard to educational qualification, 56.1 % of the participants were in possession of diploma while 43.9 % had BSC degree.(Table 1)

Overall Level of Job Satisfaction and Associated Factors
AAs it is shown on figure above the overall level of job satisfaction among nurses work in operation theater room from the total participant 8(8.16%) of the respondents were satisfied 39 (39.8%) moderately satisfied while the remaining 51 (52%) were dissatisfied (Figure 1).Finding of the study showed that females are more dissatisfied 27 (52.9%)than males highest dissatisfaction rate was in the age group between 31-40 24(47.1%).Married respondents were more dissatisfied 30 (58.8%) than single 21 (41.2%).Most of the respondents at the educational level of Bsc were dissatisfied 32 (60.8%).Respondents working in district hospital were more dissatisfied than those working at teaching hospital.Chi square test showed job satisfaction and type hospital were significantly associated with satisfaction of nurses working in the operating room (p=0.04).(Table 3)

Comparison of Factors Associated With Job Satisfaction
Table 4; shows the chi-square analysis results of factors associated with job satisfaction.The results showed that satisfaction in helping others, providing good quality of patient care, Physical working, place conditions, Patient outcome, were significantly associated with job satisfaction.Almost (87.7%) of respondents were highly satisfied with helping others, at p value .000.Almost more than three-quarters (76.5%) of participants were significantly satisfied with their providing good quality of patient care.The results also indicated that respondents were significantly satisfied with the freedom to choose method of working, public awareness about the role of operation room nurse and providing good quality of patient care at p value .001.(Table 4)

Discussion
The finding of this study indicated that the overall level of job satisfaction among nurses work in operation theater; 8(8.16%) of the respondents were satisfied 39 (39.8%) moderately satisfied while the remaining 51 (52%) were dissatisfied.The finding revealed that house allowance, hazard allowance, the availability of resource and supplies, Opportunity for training or education, feeling about job itself and inadequate salary have a significantly influence the level of job satisfaction.In this study, majority of the respondents (52%) were dissatisfied with their job.This findings were consistent with finding of study done in Pakistan, were 59% of participants dissatisfied with their jobs [40].

Job Satisfaction and Associated Factors among Nurses Working In the Operation Theater at Government Hospitals of Eastern Ethiopia, 2017
Copyright: © 2018 Admasu BG, et al.The study finding is also consistent with study conducted among operation room nurses in Nigeria in which 59% of the operation room nurses were dissatisfied with their job while 8.7 % were very satisfied, 6.5% were very dissatisfied with their job [30].Reason for dissatisfaction was reported as low salary (60.3%), little opportunity for further education, inadequate facility and supplies (20.1%) [18][19][20].Dissatisfaction with regard to salaries and benefits in this study finding seems to be a common issue that evident in several studies [42].
The commonest reasons given for job satisfaction according to this study were the helping others (87.8%) providing good quality of patient care (76.5%), the recognition you get for good work (75.5%),Patient outcome (71.4%), the amount of responsibilities you are given (70.4%).That agrees with the findings of Singh et al. who reported that anesthetists appreciated the good quality of patient care and intellectual stimulation as well as enjoyed the interaction with anesthesia colleagues and magic of anesthesia.[43] A study at Jimma university specialized hospital showed that (46.2%) of the health workers are dissatisfied with their job.The major reasons reported for their dissatisfaction were lack of motivation, inadequate salary, insufficient training opportunities and inadequate number of human resources.The rest 57.8% respondents were satisfied with their job, the major reasons given were getting satisfaction from helping others and professional gratification.Suggestion given by the respondents to improve job satisfaction and increase retention rate included motivation of staff through different incentives such us bonus, house allowance, salary increment, establishing good administration management system and improving hospital facilities and infrastructure.[41] In Ethiopia the related categories of study were not conducted in operation theater department and other department job satisfaction or dissatisfaction of nurse but generally, Ethiopia health service organization and management was studied from1995-2000 E.c for all health profession job satisfaction and dissatisfaction including nursesthe finding indicated satisfaction

Figure 1 :
Figure 1: Overall level of job satisfaction of nurses working at government hospitals in East Arsi and East Shewa, June 1, 2017

Table 1 :
Socio demographic characteristics of nurses work in operational theater room at government hospitals in East Arsi and East Shewa, June 1, 2017.Overall mean for job satisfaction among various factors.Overall mean for job satisfaction among various conditions revealed that the nurse work in operation room were satisfied with five factors, satisfaction in helping others 4.46(0.943),Status as a healthcare professional 4.06 (1.291), providing good quality of patient care 4.06(1.120),the recognition they get for good work 3.98 (1.065), and Patient outcome 3.95 (1.170) (table 2).According to the mean score of each the nurses work in operation room were dissatisfied with the remaining fifteen factors.The highest level of dissatisfaction was reported for Opportunity for training or education 1.36 (0.503).This was followed by house allowance1.53(0.749), hazard allowance for nurse, 1.93 (0.259) the availability of resource and supplies 2.17 (0.800), feeling about job itself 2.85 (1.319) Salary (3.20±1.535)respectively.(

Table 2 :
Job satisfaction for each factor of nurses who working in operation room at government hospitals in East Arsi and East Shewa, June 1, 2017.

Table 3 :
Association between socio demographic variables and overall job satisfaction of nurses working at government hospitals in East Arsi and East Shewa, Oromia regional state, June 1, 2017

Table 4 :
Shows the chi-square analysis results of factors associated with job satisfaction among Nurses working at government hospitals in East Arsi and East Shewa, Oromia regional state, June 1, 2017