|Year : 2017 | Volume
| Issue : 1 | Page : 9-16
Relationship between job satisfaction and professional identity among psychiatric nurses
Abeer Refaat A Kabeel1, Sahar Abd El-Mohsen Mosa Eisa2
1 Department of Nursing Administration, Faculty of Nursing, Modern University for Technology and Information (MTI), Cairo, Egypt
2 Department of Psychiatric Mental Health Nursing, Faculty of Nursing, Modern University for Technology and Information (MTI), Cairo, Egypt
|Date of Submission||09-Jan-2017|
|Date of Acceptance||30-Jan-2017|
|Date of Web Publication||13-Jun-2017|
Abeer Refaat A Kabeel
Department of Nursing Administration, Faculty of Nursing, Modern University for Technology and Information (MTI), Cairo, 12572
Source of Support: None, Conflict of Interest: None
Job satisfaction depicts how an individual is satisfied with the job. The more satisfied nurses are within their job, the more fulfilled they are supposed to be. Professional identity development is one of the main concerns of nursing education and practice. Nurses are considered to be the vertebral column of any healthcare organization. The WHO believes that mental health nurses, as part of a multidisciplinary team, are especially relevant in the management of mental illness.
The aim of the study was to determine the relationship between professional identity and job satisfaction among psychiatric nurses.
This was a descriptive correlation research design. The research questions for this study were as follows: (a) How do psychiatric nurses perceive their professional identity? (b) What is the level of professional job satisfaction of psychiatric nurses? (c)What are the relationships between perceptions of professional identity and job satisfaction among psychiatric nurses? This study was conducted at Abbassya Mental Health Hospital in Egypt. A convenient sample of 50 nurses was used for assessment. Tool 1: The background data sheet included age, sex, educational level, position, and years of experience of nurses. Tool 2, Nurses’ professional identity tool: This tool was designed and validated by Kabeel to determine the level of nurses’ professional identity. Tool 3: Mueller and McCloskey Satisfaction Scale as developed and advanced by Ellenbecker and colleagues.
A positive and significant correlation was determined between nurses’ job satisfaction and professional identities.
Professional identity is a factor affecting job satisfaction.
The nurse’s professional identity should be the subject of workshops, in-service programs, and other nursing education activities in various work settings, and in nursing schools and faculties’ curricula. Replication of this study is recommended on other specialty nurses in a large sample size.
Keywords: job satisfaction, professional identity, psychiatric nurses
|How to cite this article:|
Kabeel AA, Mosa Eisa SA. Relationship between job satisfaction and professional identity among psychiatric nurses. Egypt Nurs J 2017;14:9-16
|How to cite this URL:|
Kabeel AA, Mosa Eisa SA. Relationship between job satisfaction and professional identity among psychiatric nurses. Egypt Nurs J [serial online] 2017 [cited 2018 Dec 9];14:9-16. Available from: http://www.enj.eg.net/text.asp?2017/14/1/9/206939
| Introduction|| |
Kabeel (2004) Job satisfaction is an emotional response and behavioral expression and is established by an individual’s assessment of his/her job, working environment, and working life (Saygilh and Celik, 2011; Yilmazel, 2013). Job satisfaction can be defined as an employee’s affective reaction to a job, based on comparing actual outcomes with desired outcomes, and is a multifaceted construct inclusive of both intrinsic and extrinsic job factors (Klopper et al., 2012). Job satisfaction is defined from two perspectives: intrinsic and extrinsic satisfaction. Although intrinsic job satisfaction refers to people’s own feelings about the nature of the job tasks, extrinsic job satisfaction refers to feelings about aspects of the work situation that are external to the job tasks or the work itself (Kumar et al., 2013). Extrinsic factors include tangible aspects of the work, such as salary and benefits, whereas intrinsic factors include personal and professional development opportunities and recognition (Yilmazel, 2013).
Therefore, job satisfaction has to do with an individual’s perceptions and evaluation of his/her job, and this perception is influenced by person-specific circumstances such as needs, values, and expectations (Aiken et al., 2013). Studies on nurses’ job satisfaction in different countries revealed that job satisfaction is usually moderate or low in the nursing profession (Akgöz et al., 2005; Saygih and Celik, 2011; Yilmazel, 2013; Asegid et al., 2014; Sabanciogullari and Dogan, 2015a; Sabanciogullari and Dogan, 2015b). Factors leading to nurses’ job dissatisfaction have been well described as inadequate involvement in decision-making processes, poor relationship with the management, low wages and inadequate social opportunities, lack of job security, poor public recognition for nursing/poor image of nursing, and inflexible working hours (El-Jardali et al., 2009; Aiken et al., 2013).
Job satisfaction is important both for nurses and for the quality of service they provide. Nurses who are satisfied with their job work actively, establish professional goals, and improve the quality of care and patient satisfaction (Zarea et al., 2009). Nurses who are not satisfied with their job display behaviors such as complaining about the profession and are not engaged in their work (e.g. come to work late, working speed is slow, and resigning) (Deppoliti, 2008).
Professional identity, which has a core meaning of ‘occupational integration’, is the person’s perception of himself/herself as a member of the profession (Deppoliti, 2008). Cowin et al. (2013) defined professional identity as the professional self-perception or self-concept of the nurse regarding their nursing abilities in general. Self-esteem and self-evaluation are outcomes of professional identity (Pilevarzadeh et al., 2003). Professional identity is the unique perception a nurse has of their job so that it is a main area of identity and of high importance in psychological definitions and viewpoints (Razavi and Smaeili, 2010). Professional identity develops as a result of the internalization of professional knowledge, skills, attitudes, values, and standards of ethics and thereafter the integration of these characteristics into one’s personal identity and behavior within nursing education and practice (Cowin et al., 2013). A nurse with strong professional identity works in harmony with the professional values and in line with ethical codes, and is aware of his/her role that fulfills these completely (Hwang et al., 2009; Celik and Hisar, 2012).
Dynamic and positive professional identity that has its roots in one’s choice can lead to personal, social, and professional evolution (Cowin et al., 2013). Nursing is one of the most critical professions in the health sector, and the nurses preferably must have accepted their roles before entering this profession (Zamanzadeh et al., 2009). They are expected to work based on common values that represent their commitment and allegiance to their profession and the society (Price, 2009). Therefore, the nursing staff should have enough knowledge regarding their profession (Pilevarzadeh et al., 2003). Working in harmony with professional values may bring about positive changes in the working environment and expand a nurse’s role and thus may increase job satisfaction (Hwang et al., 2009; Celik and Hisar, 2012). Similarly, it is possible to assume that strengthening professional identity might increase nurses’ knowledge and the potential to use this knowledge in practice, which, in turn, might enhance job satisfaction among nurses. Nurses’ perceptions of their professional identity influence their job satisfaction. Traditional job satisfaction relates to the feeling an individual has about his/her job. It is affected by intrinsic (recognition, work itself, or responsibility) and extrinsic (working conditions, company policy, or salary) factors, which have an influence on job satisfaction (Szecsenyi et al., 2011).
Internationally, the WHO has estimated that next to coronary disease, mental illnesses such as mood disorders will be the second leading health problem by 2020 (World Health Organization, 2001). Patterson et al. (2008) state that mental health nurses ‘play a major role in the care and treatment of people experiencing mental health problems’ and are pivotal to the success of any management strategy. Mental health nurses play a central role as clinicians, case managers, clinical nurse specialists, and nurse practitioners in mental healthcare settings. They are increasingly involved in a range of psychosocial interventions and work within recovery-based models of care with consumers and careers. Community mental health nursing’s attempts to construct professional identity are often intimately connected with morale boosting drives to gain a sense of empowerment, autonomy, and job satisfaction (O’Brien-Pallas et al., 2006).
Significance of the study
Understanding how to improve job satisfaction as an outcome is important as it relates to employee health, productivity, and job performance (Whitman et al., 2010). Nursing satisfaction has become an issue of international importance. Nursing dissatisfaction in the health sector threatens the quality and safety of patient care services. Several studies have reported that higher nurse satisfaction is associated with better quality and safety of care for patients (Needleman et al., 2011; Aiken et al., 2012; Zhu et al., 2012). In the context of organizational behavior, investigating job satisfaction would be helpful to any organization (Sundaray and Tripathy, 2010). In addition, it can be assumed that sufficient development of professional identity can contribute to individual autonomy, professional self-confidence, and ability to communicate effectively, all of which are likely to increase job satisfaction. Job dissatisfaction among psychiatric nurses is a significant issue (Aronson, 2005). It is important to retain nurses working in psychiatric services and better understand the factors related to dissatisfaction, particularly in times of overall shortages of nurses globally (Ea et al., 2008). In Egypt, increase in specialization and complicacy has led the field of psychological health to develop into an independent field of nursing; at the same time challenges in this profession are growing. However, there are concerns among experts about the quality of mental health nurses. Therefore, there is a need for deeper studies in this field. The present study proposes that if mental health nurses were enabled to more fully define and describe their professional roles and identity, job satisfaction would be significantly improved.
| Aim of the study|| |
The aim of the study was to determine the relationship between psychiatric nurses’ professional identity and their job satisfaction.
The following research questions were addressed:
- How do psychiatric nurses perceive their professional identity?
- What is the level of professional job satisfaction of psychiatric nurses?
- What are the relationships between nurses’ perceptions of professional identity and job satisfaction among psychiatric nurses?
| Participants and methods|| |
This was a descriptive correlation research design.
This study was conducted at Abbassya Mental Health Hospital in Egypt.
A convenient sample of 50 nurses, except for those less than 20 years old, was used for assessment. Criteria for inclusion were age 20 years or more, both sexes, different years of experience, and different educational categories.
Tools of data collection
Three tools were utilized for data collection:
Tool 1 (background data sheet): It covered data related to age, sex, educational level, position, and years of experience of nurses.
Tool 2 (nurses’ professional identity tool): This tool was designed and validated by Kabeel (2004) to determine the level of nurses’ professional identity. It consisted of 56 items related to nurses’ professional identity. They covered three factors. The correlation coefficient for reliability of the tool was 0.96. The responses were based on a five-point Likert scale: ‘strongly agree’, ‘agree’, ‘uncertain’, ‘disagree’, and ‘strongly disagree’. The scoring system was classified as follows: low professional identity with a score less than 75%, moderate professional identity with a score from 75 to 85%, and high professional identity with a score greater than 85%.
Tool 3 (Mueller and McCloskey Satisfaction Scale): The satisfaction questionnaire sheet was developed and advanced by Ellenbecker and Byleckie (2005). It consists of two main characteristics: intrinsic characteristics and extrinsic characteristics, with a total of nine subscales from the psychometric study. It consists of 30 items. The correlation coefficient for reliability of the tool was 0.85. Items were asked on a five-point Likert scale ranging from very dissatisfied (1) to very satisfied (5). The scoring system was classified as follows: low satisfaction with a score less than 75%, moderate satisfaction with a score from 75% to less than 85%, and high satisfaction with a score greater than 85%.
Before conducting the study, an official letter was obtained from the director of El Abbassya Mental Health Hospital to carry out the study after explaining the aim of the study to him.
All ethical considerations were considered for privacy and confidentiality; hence, the researchers explained the aim of this study to all participant nurses before interviewing them to gain their confidence. Assurances about the confidentiality of data were given by coding the sheets. The topic of this study did not touch the ethical, moral, traditional, cultural, and religious issues among participants.
A pilot study was carried out on 10% of the study sample to test the feasibility of the study and applicability of the tools. The main purpose of the pilot study was to test the relevance of the tools used, to determine the time needed for data collection, detect any problem peculiar to the tools, and find out any problem that may interfere with the process of data collection.
Data collection procedure
The current study was conducted through two phases.
Preparation phase: Managerial arrangements were made to conduct the current study. Nurses who agreed to participate in the study were interviewed individually by the researchers to explain the nature and purpose of the study.
Implementation phase: Data were collected from February 2016 to March 2016. The researchers visited the selected hospital on a daily basis during the morning and afternoon shifts. Each potential nurse was interviewed for 10–15 min to fill out the background data in addition to the knowledge questionnaire. The researchers clarified any obscure questions. Later, each nurse filled the questionnaire individually for 15 min.
Data were collected and presented in tabular form. Percentages were calculated for qualitative data, and mean and SDs were calculated for quantitative data using the statistical package for the social sciences (SPSS, version 21 (IBM, 2012, USA)) for statistical analysis. Pearson correlation analysis was used for assessment of inter-relationships among quantitative variables.
| Result|| |
[Table 1] shows that most nurses were female (82%), whereas male nurses constituted only 18% of staff nurses. Regarding nursing qualifications, most nurses had a nursing school diploma (84%), compared with only 16% of nurses having a technical institute diploma. The head nurses constituted only 10% of the nursing staff. The highest percentage of nurses (40%) had 10 to less than 20 years of experience, and the mean experience was 15.8 years. The majority of nurses (34%) were aged less than 30 years, with a mean age of 35.5 years.
[Table 2] shows that the total mean score of the studied participants was 215.8±19.7 out of 280. In relation to the factors, assertiveness obtained the highest mean score of 88.56±7.33 out of 125, whereas self-responsibility showed the lowest mean score of 17.43±1.54 out of 20.
|Table 2: Total mean score and factors’ mean score of nurses’ professional identity (N=50)|
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[Table 3] shows that the total mean score of the studied participants was 124±16.5 out of 150. In relation to the subscales, the characteristics of the organization obtained the highest mean score of 16.77±3.36 out of 25, whereas autonomy and flexibility in work scheduling showed the lowest mean score of 6.94±0.64 out of 10.
Results shown in [Table 4] indicated statistically significant relations between nurses’ professional identity and nurses’ satisfaction: P=0.001 for high, P=0.000 for moderate, and P=0.002 for low. It was evident that staff nurses with high nurses’ professional identity (44%) had high nurses’ satisfaction (48%). Meanwhile, nurses with low nurses’ professional identity (16%) had low nurses’ satisfaction (18%).
|Table 4: Correlation between classification of nurses’ professional identity and their satisfaction (N=50)|
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[Table 5] reveals that there was no statistically significant correlation between nurses’ professional identity and their satisfaction level and demographic characteristics.
|Table 5: Correlation matrix among nurses’ professional identity, their satisfaction, and sociodemographic characteristics of staff nurses (N=50)|
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Results shown in [Table 6] illustrated statistically significant positive correlations between scores of total nurses’ professional identity and nurses’ satisfaction (r=0.589). Moreover, there was a statistically significant correlation between nurses’ professional identity and nurses’ satisfaction (P=0.000).
|Table 6: Correlation between nurses’ professional identity and their satisfaction (N=50)|
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| Discussion|| |
Although there are many studies on job satisfaction among nurses in Egypt, there is a gap in relation to professional identity. Job satisfaction among nurses has been studied in relation to variables such as turnover and intent to leave (Larrabee et al., 2003), acculturation (Ea et al., 2008), nursing leadership (Cummings et al., 2008), longevity in practice (Murrells et al., 2008), and area of practice (Russell and Van Gedder, 2008). Significant relationships were found between job satisfaction and nurse attitudes (Larrabee et al., 2003), acculturation (Ea et al., 2008), achievement, recognition, responsibility, advancement, and the work itself (Russell and Van Gedder, 2008). Professional identity has been reported as a strong factor associated with nurses’ job satisfaction and intention to leave the profession (Cowin et al., 2008; Sharbaugh, 2009).
Regarding sociodemographic data, the present study found that the majority of nurses were female (82%), whereas male nurses constituted only 18% of staff nurses. In addition, there were nurses aged less than 30 years, but the majority of nurses aged 30 years to less than 50 years constituted 58% of the nursing staff (mean age 35.5±8.7 years). Matos et al. (2010) found that the majority (81.2%) of the 33 nurses who participated in the study were female staff, and 68.8% were between the ages of 30 and 60. This was similar to the general 2004 nurse population in the USA. In a Health Resources and Services Administration survey (United States General Accounting Office, 2004), some of the findings included that 59.3% of the registered nurse population was between the ages of 40 and 59 years, and 94.2% were female. This is consistent with the findings of Hanrahan and Gerolamo (2004), who found that psychiatric nurses were generally older and more diverse than the general population of nurses.
With regard to total mean score and factors’ mean score of nurses’ professional identity, the present study found that the total mean score of the studied participants was 215.8±19.7. With regard to factors, assertiveness obtained the highest mean (88.56±7.33), whereas self-responsibility showed the lowest mean (17.43±1.54). The study by Kabeel (2010) found that there was a statistical significance among nurses that was related to assertiveness. Several studies have determined that members of a profession with strong professional identity have higher job satisfaction and lower burnout levels, and the occupational turnover rate among them is low (Weiss, 2007; Cowin et al., 2008; Sharbaugh, 2009). There are discussions about the positive effects of professional identity on individuals, including positive self-image, professional satisfaction, and sense of belonging and recognition of professional competence (Sharbaugh, 2009; Jourdain and Chenevert, 2010; Vliegher et al., 2011).
With regard to total and subscale mean scores of nurses’ satisfaction, the present study found that the total mean score of the studied participants was 124±16. In relation to the subscales, characteristics of the organization obtained the highest mean (16.77±3.36), and salary and benefits and perception opportunities elsewhere obtained a moderate mean (11.8±1.07), whereas autonomy and flexibility in work scheduling showed the lowest mean (6.94±0.64). Patricia et al. (2010) found that the mean satisfaction score on the pay subscale was 4.63±1.11, which indicates a moderate level of satisfaction with pay. These findings indicated that the nurses found pay to be a significant factor contributing to work satisfaction. Furthermore, the present study found that the subscale of group cohesion by physicians had a low mean (7.45±2.09). Patricia et al. (2010) found that the subscale interaction (doctor–nurse) showed the third-lowest coefficient score. This subscale also had the lowest mean score of all scales. This represents a low level of satisfaction among the nurses with the physician–nurse interaction. The study by Cummings et al. (2008) emphasizes that there was a significant relationship between job satisfaction and physician–nurse relationships.
With regard to the correlation between classification of nurses’ professional identity and their satisfaction, the present study indicated statistically significant relations between the classification of nurses’ professional identity and nurses’ satisfaction. It was evident that more staff nurses who have high nurses’ professional identity (44%) have high nurses’ satisfaction (48%). Meanwhile, nurses who have low nurses’ professional identity (16%) have low nurses’ satisfaction (18%). In several studies, it has been determined that nurses whose job satisfaction is high also have a strong professional identity (Deppoliti, 2008; Hwang et al., 2009; Sharbaugh, 2009).
Regarding the correlation between nurses’ professional identity and their satisfaction and sociodemographic characteristics, the present study revealed that there was no statistically significant correlation between nurses’ professional identity and their satisfaction and demographic characteristics. For instance, the study by Murrells et al. (2008) found no association between job satisfaction and age or sex.
With regard to the correlation between nurses’ professional identity and their satisfaction, in the present study, professional identity has been reported as a strong factor associated with job satisfaction. It found the correlations between nurses’ professional identity and nurses’ satisfaction as being statistically significantly positive. Similar results have been reported in a study by Cowin et al. (2008), which show that nurses’ professional identity had a stronger relationship with retention plans as compared with job satisfaction. Moreover, the most striking study finding of Selma and Selma (2015) was that professional identity significantly affected both job satisfaction and nurses’ intention to leave the profession; a positive and moderately significant relationship was determined between the nurses’ professional identities and job satisfaction. In the study by Hwang et al. (2009), professionalism, which also involves professional identity, was identified as an important factor affecting job satisfaction.
In contrast, the study by Sabanciogullari (2010), who prepared a professional identity development program for nurses based on Strasen’s model and investigated its effects on professional self-concept, job satisfaction, and burnout levels, found that the program significantly improved nurses’ professional self-concept and considerably reduced their burnout but did not increase their job satisfaction. The program reduced the burnout caused by job dissatisfaction, and therefore it can be argued that reduction in burnout increases job satisfaction in the long term.
| Conclusion|| |
There was a significant relationship between professional identity and job satisfaction among psychiatric nurses; the study found that professional identity is an important factor for nurses to have satisfaction in their work. Moreover, this finding is very important because it suggests that job dissatisfaction is one of the major causes that threaten the quality and safety of patient care services. The advancement of professional identity increases job satisfaction by bringing out a sense of belonging to the profession. Furthermore, the result underscores the importance of an organization and its supportive programs targeted at enhancing professional identity by increasing job satisfaction initiated by nurse managers.
- The nurse’s professional identity should be the subject of workshops, in-service programs, and other nursing education activities in various work settings.
- The concept of nurse’s professional identity requires more attention, awareness, and is to be emphasized in nursing schools and faculties curricula, with clarification of its positive impact on nurses’ satisfaction and nursing care associated with better patient outcomes and satisfaction.
- Further studies must be conducted with regard to the relationship of nurses’ professional identity and their satisfaction on other specialty nurses in a large sample size.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]