Intrinsic Motivation Factors for Nurses’ job Satisfaction

Background: Job satisfaction is defined as the emotional feelings as well as the behavioral expression for a job.

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Nurses’ job satisfaction contributes to the delivery of high-quality healthcare. Even though nurses are the backbone of patient caring, there was no study done on intrinsic motivation factors for nurses’ job satisfaction West Amhara Hospitals in North West Ethiopia. Therefore, the aim of this study was to assess intrinsic motivation factors for nurses’ job satisfaction and associated factors in three selected hospitals in Amhara regional state, North West Ethiopia, 2018.

An institutional-based cross-sectional study was conducted from 1st January to 15th February 2018. After, proportional sample size allocation, 178 participants were selected by simple random sampling method. Data were collected by using a self-administered structured questionnaire.

The collected data were entered, cleaned, coded, and analyzed by SPSS version 23.0. Both bivariable and multivariable logistic regression was used to assess the association between independent and dependent variables. Finally, the statistical significance was set at P < 0.05. From a total of 178 nurses, 170 of them were participating in this study making a response rate of 95.

5%. From all nurses, 71.2% of them were BSc in Nursing while 25.3% were diploma holders. In this study, nurses’ overall job satisfaction job was. Nurses’ job satisfaction with the intrinsic motivational factors in the current study was moderate. It was also boosted by achievement and recognition at work. Hence, we recommended that hospital managers should maintain other intrinsic motivational factors. Keywords: job, satisfaction, nurse, factors, Ethiopia.

Job satisfaction is defined as the emotional feelings as well as the behavioral expression for a job. On the other corner, scholars defined as job satisfaction is the extent to which an employee enjoys his/her job. Job satisfaction is one of the most important factors that determine the efficiency and productivity of human resources. As key members of the health system, nurse job satisfaction is a key issue for healthcare professionals and to contribute high-quality healthcare delivery systems around the world . However, intrinsic and extrinsic work values affecting job satisfaction of nurses. Any activity or action being performed for the sake of enjoyment and include advancement, recognition, work itself and achievement are motivation intrinsic factors for job satisfaction. Herzberg’s theory of motivation such as achievement, recognition, work itself, responsibility and advancement are intrinsic to the job and lead to positive attitudes towards it, because they satisfy the ‘need for growth or self-actualization’.

According to Huber, motivation as the process that arouses, energizes, directs, and sustains behavior and performance. That is the process of stimulating people to action and to achieve a desired task[11]. Nurses who are motivated to intrinsically become passionate in persistently performing their duties. According to study done in Kurukshetra showed that achievement of work motivation positively and significantly related to skill variety and task variety. The achievement was also associated to feedback from self. When achievement needs to be combined with affiliation, the employee may become an effective manager or team leader and can help coworkers develop their need for achievement as well as decision-making abilities. Achievement is linked with nurses having opportunities to make independent nursing decisions as professionals, with regular feedback on their performances. The study revealed that recognition can be in the form of public affirmation, written commendation financial reward, or recognition by a formal recognition program in the organization is provided by the organization to their employees for achievement of organizational goals.

But, employee recognition often has greater value than compensation packages and serves to encourage employee creativity. Another study conducted in Sidama revealed that 45.9 % of nurses were dissatisfied with their given level of recognition. A study conducted in Tehran indicated that intrinsic factors were perceived to be the most essential determinants of nurses motivation as they tend to increase nurses’ sense of belonging. However, the health system is highly embedded with serious challenges such as low pay, low staff motivation, unequal distribution of the health workforce, poor supervision, poor staff performance, high rates of absenteeism, migration, high rates of turnover and low levels of job satisfaction. Despite the above reason, staff motivation is generally stated as a series of energizing force that develop both internally and externally with the degree of workers’ willingness to perform their job.

The Impact of Intrinsic Motivation Factors on nurses’ job satisfaction has a significant impact on the performance, stability and productivity of the health facility. Thus, this issue should be received considerable attention worldwide specifically in developing countries since the evidence is scarce in such areas. Dealing with the impact of intrinsic motivation factors of nurses’ job satisfaction and associated factors are very important to design strategies for nurses’ promotion in the Ethiopian context. This study is also very important to add evidence for policy planners and program managers to improve such problems. Additionally, it will narrow the evidence gap, and provide fruitful findings for responsible bodies to avoid facilitating factors of it.

In Ethiopia like other developing countries, there were little or no studies done before on the issue of nurses’ job satisfaction in Ethiopia. Therefore, the purpose of this study was to assess the impact of intrinsic motivation factors on nurses’ job satisfaction and associated factors in three selected hospitals, Amhara region, Northwest Ethiopia, 2018. Cross-sectional study design was conducted in selected hospitals which are located in Amhara national regional state, Northern Ethiopia from 1st January to 15th February 2018. Amhara national regional state is the second-largest and populous region in Ethiopia. The region has five specialized, 3 General and 74 primary hospitals. Among these, Debre Markos, Finote Selam and Asrade Zewdie Memorial (Burnie)hospitals were selected randomly. In the study area, there was a total of 280 nurses during the study.

Simple random sampling was used to select hospitals participating in the study. Every hospital in the population had an equal chance of being selected and therefore would be accepted as being representative of the population of this public hospitals in Amhara Region. The sample was selected from the three hospitals. All professional nurses at the participating hospitals were requested to complete questionnaires. We calculated the sample size for this study by using a single population proportion formula. The following assumptions, such as a 95% confidence interval (CI), 5% the margin of error (d), 10% non-response rate and 43.6% of proportion (p) were considered. Lists of nurses were obtained from each facility payroll. The number of sample size for each selected hospital was allocated proportionally based on the number of nurses.

Then, the study participants were selected by simple random sampling methods. The nurses in annual, learning and maternity leave were excluded from the study. A structured self-administered questionnaire was used to collect the data. The authors measured the outcome variables based on Job satisfaction scale and Minnesota Questionnaire. The Minnesota job satisfaction scales (MJSS) were developed at the University of Minnesota based on the Theory of Work Adjustment[26]. It is a Likert-type questionnaire with 20 sub-scales with five items in each scale. It has been found to be a valid instrument to measure job satisfaction among various occupational groups. Negative items were reversed to positive before summing. The measuring items on nurses’ job satisfaction were achievement, advancement, work itself, recognition and growth at work. We calculated the scores of each factor based on the answers to all items. Finally, nurses’ job satisfaction was determined by using the demarcation.

We coded, entered, cleaned and analyzed the data using SPSS version 23. The frequency of each variable was calculated. The logistic regression model was used to determine statistical significance of variables. In this model, the odds’ ratio with 95% confidence interval was used to determine the strength of association between dependent and independent variables. The variables with a p-value of less or equal to 0.2 in the bivariate analysis model were transferred to multivariate. Finally, we considered the p-values less than 0.05 as statistically significant. A total of 170 copies of the questionnaires was returned out of 178 copies distributed to the respondents and making a response rate of 95.5%. Among the participants, 107(62.9%) were females. The mean age of the study participants was 30.94 ± 6.52 years and majority (78.2%) of nurses were aged from 20-35 years old. The majority of the respondents 106(62.4%) were married. Regarding education, most of the respondents (71.2%) had BSc in Nursing while 25.3% were diploma holders. In the current study, 70(41.2%) of them had greater than 5 years of work experience.

Of all participants, 52.4% of them had satisfied with the intrinsic motivational factors. All participants were agreed with the intrinsic motivational factors as determined to nurse job satisfaction. From all participants, who had satisfied with the intrinsic motivational factors 77.1% and 74.1 % of them had agreed with Growth at work and advancement intrinsic factors respectively. Factors associated with Intrinsic Motivation Factors on nurses’ job satisfaction In bivariate analysis; Institution, advancement, work itself, growth at work achievement and recognition were statistically associated with nurses’ job satisfaction. Nevertheless, after adjustment for co-founders, only achievement and recognition at work was the main determinants of nurses’ job satisfaction.

For instance, those study participants who agreed with the achievement as intrinsic motivation factors for job satisfactions were 3.152 times more likely to job satisfaction as compared with their counterparts. Similarly, those study participants who agreed in the recognition given to their work had 2.371 odds of job satisfaction than their counterparts. The current study was aimed to assess intrinsic motivational factors on nurses’ job satisfaction and associated factors by using a cross-sectional study in selected hospital in Amhara Regional state. Focused on such objective, 52.4% of nurses had job satisfaction which was compared with studies done in South Africa with job satisfaction of nurse, in Ekiti State (Nigeria) with job satisfaction of nurse (54.7%) and Sidama zone public health facilities, south Ethiopia with overall job satisfaction of nurses.

In this study achievement was the positive determinant factors for nurses’ job satisfaction. This is in line with the studies done in England, Tigray. Sense, achievement is intrinsic and is one of the greatest motivators to promote job satisfaction of nurse, which supports the current study’s result that intrinsic motivation factors is an important source of job satisfaction. Satisfaction with the care they give to patients and their families represents the highest form of intrinsic motivation and achievement as presented by the theories of Maslow and Herzberg. The high level of job satisfaction in achievement might be due to the nurses’ perception of gradual development. Since achievement is linked with nurses having opportunities to make independent nursing decisions as professionals, with regular feedback on their performances. Nurses need to feel challenged when there is no improved patient outcome although; this may result in frustration, unhappiness and lack of job satisfaction. Work that give nurses an opportunity to use a wide range of professional skill and ability will enhance job satisfaction among nurses. This result is consistent with the findings of.

Similarly, the current study revealed that recognition as an intrinsic motivational factor had a positive association with job satisfaction of nurses and has greater value than compensation packages and serves to encourage employee creativity. This finding is consistent with a research done in England, Jordan, Antalya, India, Turkey, Pakistan, and Ethiopia, where recognition are the main source of job satisfaction for nurses. Another research finding also shows that intrinsic factors such as recognition increased job satisfaction and creating a culture of excellence in perinatal care for their patient. Hence, constructive recognition should be given to promote job satisfaction of employees. The finding of this study revealed that there is a direct and positive relationship between intrinsic motivation and nurses’ job satisfaction. On the other hand, nurses perceived that their organizations are offering right way of intrinsic motivation and this has created moderate job satisfaction for them.

The effectiveness of health quality and customer satisfaction is dependent upon the motivation of nurses. The study was approved by the Scientific Ethical Review Committee of Bahir Dar University. Permission letters were obtained from Amhara Regional health office and respective institutions. Informed verbal consent was obtained from nurses after a detailed explanation of the purpose of the study. Any involvement of the nurses was after their complete verbal consent. Nurses were told as they would have the right to withdraw from the study at any time during the study.