Hamdan Medical Journal

ORIGINAL RESEARCH ARTICLE
Year
: 2018  |  Volume : 11  |  Issue : 1  |  Page : 22--28

Influence of personal characteristics on self-concept and job satisfaction of registered nurses working in cross-cultural settings in the United Arab Emirates


Vimala Edwin 
 Department of Nursing, Ras al-Khaimah College of Nursing, Ras al-Khaimah Medical and Health Sciences University, Ras al-Khaimah, United Arab Emirates

Correspondence Address:
Dr. Vimala Edwin
Ras al-Khaimah College of Nursing, Ras al-Khaimah Medical and Health Sciences University, Ras al-Khaimah
United Arab Emirates

Abstract

Background: Self-concept is vital for the nurses to understand about themselves and their patient in the health care setting. In order to meet the patient needs, it is important that the nurses should possess healthy self-concept that makes them more responsible and be more confident to handle the situations skillfully. Every nurse is an important member of the health care organization to provide quality patient care, their work environment and other related factors are essential to satisfy their job. Objective: The objective of the study was to determine the association of self-concept and job satisfaction of registered nurses working at cross-cultural setting. Study Design and Settings: A descriptive correlational study was conducted with 1061 registered nurses working in selected government hospitals using convenience-sampling method. The registered nurses self-concept and job satisfaction were surveyed using the standardized tool Nurses Self-Concept Questionnaire (NSCQ) and Mccloskey/Muller job satisfaction scale (MMSS). SPSS software version 20 was used to analyze the collected data to report descriptive and inferential statistics. Results: The current study identified that there is a relationship between registered nurses self-concept and job satisfaction and the correlation coefficients were statistically very highly significant (P < 0.001). The association of job satisfaction with sub component of self-concept reveals that Nurses General Self-Concept r = 0.273, P < 0.001, Care r = 0.141, P < 0.001, Staff relation r = 0.320, P < 0.001, Communication r = 0.174, P < 0.001, Knowledge r = 0.218, P < 0.001, and lower association with 'Leadership' (r = 0.063, P < 0.05). Conclusion: The results of this research demonstrated the importance of registered nurses self-concept and its effect on job satisfaction that is essential for nurses to provide effective care to the patients.



How to cite this article:
Edwin V. Influence of personal characteristics on self-concept and job satisfaction of registered nurses working in cross-cultural settings in the United Arab Emirates.Hamdan Med J 2018;11:22-28


How to cite this URL:
Edwin V. Influence of personal characteristics on self-concept and job satisfaction of registered nurses working in cross-cultural settings in the United Arab Emirates. Hamdan Med J [serial online] 2018 [cited 2018 Apr 25 ];11:22-28
Available from: http://www.hamdanjournal.org/text.asp?2018/11/1/22/228862


Full Text



 Introduction



Nurses' self-concept and job satisfaction were the central issues in this research. The study is aimed to explore the relationship between self-concept and job satisfaction among registered nurses working in hospital settings. Self-concept is 'the whole set of attitudes, opinions and cognitions that a person has of himself'.[1] It is a vital concern in the context of nursing, due to nurses' important role in health sectors worldwide, and in the welfare of individuals. Self-concept can help registered nurses to understand and evaluate themselves as worthy and competent in providing high-quality care to patients. Many researchers have defined self-concept as how we see ourselves in our own mind, or how we think and feel about ourselves.[2] A higher self-concept helps a person to function at a higher level, utilise his/her learning experiences in an optimal manner [3] and mitigates the effects of a stressful work environment, ultimately having a positive impact on patient care.[4]

This study measured nurses' self-concept through a structured questionnaire concerned with six dimensions: nurses' general self-concept (NGSC), care, staff relations, communication, knowledge and leadership.

The nursing literature strongly suggests that the self-concept of nurses is an important awareness for academicians, administrators and clinicians to consider in the development of the nursing profession.[5]

As registered nurses are working in a cross-cultural setting in the United Arab Emirates (UAE), it is important for the nurse administrator to understand the role of nurses' self-concept to enhance patient care. NGSC, care, staff relations, communication and leadership were positively and significantly correlated with the nurses' intention to remain in their position.[6]

Nurses are the main frontline health-care workers in hospitals, and their contribution is recognised as essential to achieve goals and deliver safe and effective care.[7] As every nurse is an important part of the health-care organisation, the work environment should enable them to be sufficiently healthy and happy to deliver high-quality patient care. The most important motivators influencing nurses' job satisfaction, identified in a study of registered nurses at selected private hospitals,[8] were satisfaction with promotions, advancement opportunities, and involvement in decision-making and policy-making activities.

A rise in chronic diseases including diabetes, an ageing population and increasingly sedentary, unhealthy lifestyles will mean a greater demand for nurses in the UAE.[9] A significant amount of literature sheds light on nurses' job satisfaction globally, but studies conducted in the UAE are limited. No previous study has explored the relationship between nurses' self-concept and job satisfaction in the UAE. The main research aim of this study was to fill these gaps in the literature by contributing results to help retain the nursing workforce. The findings make important contributions to the understanding of the relationship between nurses' self-concept and job satisfaction. The results could inform policymakers and nurse administrators about the influence of personal characteristics on the self-concept and job satisfaction of registered nurses working in government hospitals.

The objectives of this study were as follows:

To assess the level of self-concept and job satisfaction among registered nursesTo identify the relationship between registered nurses' self-concept and job satisfactionTo associate registered nurses' personal characteristics (age, sex, educational status, years of experience at present hospital, experience at the current work unit, marital status, nationality, job title, work unit, monthly income and geographical area) with their self-concept and job satisfactionTo identify the factors with the most influence on registered nurses' self-concept and job satisfaction.

 Materials and Methods



A descriptive correlational design was adopted to assess the influence of personal characteristics on the self-concept and job satisfaction of registered nurses working in cross-cultural settings. This study was conducted in selected government hospitals and carried out in a variety of work units. These included intensive care units, coronary care units, medical wards, surgical wards, orthopaedic wards, accident and emergency, paediatric wards, neonatal units, obstetrics and gynaecology, labour rooms, dialysis units, operating theatres, geriatric wards and psychiatric wards. The population under study comprised licensed registered nurses who met the inclusion criteria using the convenience sampling technique. The sample size was 1061.

The instrument used for data collection was sociodemographic data and personal characteristics (age, sex, educational status, years of experience at present hospital, experience at current work unit, marital status, nationality, job title, work unit, monthly income and geographical area). The second instrument was the nurses' self-concept questionnaire (NSCQ),[10] a 36-item, eight-point Likert-type scale questionnaire with six dimensions (NGSC, care, staff relations, communication, knowledge and leadership). The NSCQ is supported by evidence of a theoretical basis, and its construct validity and reliability have been published.[10] The third instrument was the McCloskey/Mueller Satisfaction Scale (MMSS), a copyrighted scale. Permission to use this instrument was obtained from the author, Dr Sue Moorhead, by E-mail. The scale has 31 items capturing the satisfaction levels for eight criteria: extrinsic rewards, scheduling, the balance of family and work, relations with co-workers, interaction opportunities, professional opportunities, praise and reward and control and responsibility. Each item is rated on a five-point Likert-type scale. The instruments used by the researcher, the NSCQ and MMSS, were standardised. A pilot study was conducted to test the appropriateness and quality of the instruments, and the feasibility of the study. The questionnaire was piloted among 100 registered nurses and returned by 96. The reliability of the tools was tested using the test–retest method. The internal consistency of the tool was tested using Cronbach's alpha method. The alpha of nurses' self-concept was α = 0.929 and job satisfaction was α = 0.881. The α2 values were 0.863 and 0.776, respectively.

Ethics considerations

Ethics clearance and approval to conduct this research were obtained from the Research Ethics Committee, Al Qassimi Clinical Research Center, UAE. The researcher obtained permission from the hospital directors and nursing directors from each participating hospital. Participation of the registered nurses in the study was voluntary. Each of the participating nurses received the same instructions. Completion of the questionnaire indicated consent for participation, as mentioned in the participant information sheet. The personal identity of research participants was not requested in the questionnaire to ensure anonymity and confidentiality of responses.

Data collection was carried out over a period of 3 weeks in each hospital. An envelope (containing a ballpoint pen, a covering letter summarising the purpose of the study and instructions on how to complete the questionnaire, and a participant information sheet with a request for consent to participate in the study) was distributed to each study participant by the researcher or research assistant. Three different English-version questionnaires were administered. The completion of the questionnaire took approximately 25–30 min. The completed questionnaire, in a sealed envelope, was collected from the study participants within 1 week of distribution. Of the 1286 distributed survey questionnaires, 1160 were returned and 126 were not returned. The total number of completed questionnaires that were fit for analysis was 1061, giving a response rate of 82.5%. Forty-two questionnaires were blank, and 57 were incomplete.

 Results



The collected data were analysed using IBM® SPSS® Statistics 20 (SPSS Inc., Chicago, IL, USA) for descriptive and inferential statistics. The majority of the participants were female (95.1%) and 4.9% were male [Figure 1].{Figure 1}

[Figure 2] shows that, of the study participants, 3.8% were senior charge nurses (CN), 14.3% were CN and 81.9% were staff nurses (SN).{Figure 2}

[Figure 3] shows that, according to their educational status, 56.1% of participants were diploma holders, 41.5% had a bachelor's degree and 2.4% had a master's degree.{Figure 3}

[Figure 4] depicts the percentages of registered nurses in relation to different components of self-concept. Among the studied nurses, 28.3% had a 'definitely true' result for NGSC. Of the remainder, 39.4% had 'true', 18% had 'mostly true', 9% had 'more true than false', 2.5% had 'more false than true', 1.9% had 'mostly false', 0.6% had 'false' and 0.3% had 'definitely false' responses. With respect to care, 54.9% of the participants had 'definitely true', 37.8% had 'true', 5.7% had 'mostly true', 1% had 'more true than false', 0.3% had 'more false than true', 0.2% had 'mostly false' and 0.1% had 'false' responses, and 'definitely false' had a nil value. For staff relations, 'definitely false' and 'false' had nil values and only 0.2% of the nurses had a 'mostly false' response. In the 'more false than true', 'more true than false', 'mostly true', 'true' and 'definitely true' categories, the percentages of nurses were 0.9%, 3.6%, 12.7%, 49.9% and 32.7%, respectively. For communication, the 'false' end of the scale summed to 0.6%. The remaining 99.4% of participants were within the 'true' end of the scale. Similar observations were noticed with respect to knowledge. For leadership, 18.7% of nurses had a 'definitely true' result, 45.7% had 'true', 20.1% had 'mostly true', 10.2% had 'more true than false' and 5.4% had a 'false' response.{Figure 4}

[Figure 5] depicts the job satisfaction components according to the eight MMSS categories. A total of 22.4% of the participants were satisfied with extrinsic rewards. Of the remainder, 42.6% were 'neither satisfied nor dissatisfied', 26.1% were 'moderately dissatisfied' and 9% were 'very dissatisfied'. Nearly two-thirds (64.3%) of nurses fell within the satisfied categories with respect to scheduling. The 'neither satisfied nor dissatisfied' percentage for scheduling was 29.3%. The remaining 6.4% of nurses fell into the two 'dissatisfied' categories. Regarding the balance of family and work component, 20.2% of the nurses were within the two 'satisfied' categories. A total of 41.4% of the nurses were 'neither satisfied nor dissatisfied'. Dissatisfaction prevailed among the remaining 38.4% of participants in the balance of family and work component. Nearly two-thirds (65.9%) of nurses were 'satisfied' or 'moderately satisfied' with their relations with co-workers, 26.1% of the nurses were 'neither satisfied nor dissatisfied' and only 8% of nurses fell into either of the dissatisfaction categories for co-worker relations. More than two-thirds (68.3%) of nurses were in either of the 'satisfied' categories with respect to interaction opportunities and 26.4% of participants were 'neither satisfied nor dissatisfied'. Only 5.3% of the nurses were in the 'dissatisfied' categories for interaction opportunities. Regarding professional opportunities, 43.7% had either of the 'satisfied' results, 37.8% were 'neither satisfied nor dissatisfied' and 18.5% had either of the 'dissatisfied' results. A significant proportion (71.7%) of nurses had either of the 'satisfied' results with respect to praise and rewards, and 22.3% were 'neither satisfied nor dissatisfied'. Only 6.0% had either of the 'dissatisfied' results for praise and rewards. Regarding control and responsibility, around two-thirds (67.0%) of participants had either of the 'satisfied' results and one-quarter (25.4%) were 'neither satisfied nor dissatisfied'. Only 7.6% of the nurses fell into either of the 'dissatisfied' categories regarding control and responsibility. For total job satisfaction, 62.6% of nurses had either of the 'satisfied' results, and 33.7% of them were 'neither satisfied nor dissatisfied'. The remaining 3.7% of participants were in the two 'dissatisfied' categories in relation to job satisfaction.{Figure 5}

[Table 1] shows that the correlation coefficients between participants' self-concept and job satisfaction were statistically very highly significant (P< 0.001). Of the self-concept components, NGSC determined 7.5% of job satisfaction, care determined 2% of job satisfaction, staff relations determined 10.2% of job satisfaction, communication determined 3% of job satisfaction, knowledge determined 4.8% of job satisfaction and leadership determined 0.4% of job satisfaction. The total self-concept determined 9.2% of job satisfaction for the participants.{Table 1}

 Discussion



The study findings show that the participating nurses scored a higher level of self-concept in care, staff relations, communication and knowledge. Lower scores were recorded in the components of NGSC and leadership. However, of the 1061 participants, most (81%) were SN whose roles are focussed on bedside nursing, with fewer leadership opportunities than other designations, so having a low score on the leadership subscale could be expected. A similar study conducted among nursing graduates revealed higher scores on the self-concept components of staff relations, communication and knowledge than for NGSC, care and leadership.[11]

Our research has identified that the areas producing higher levels of satisfaction were 'hours that you work' (77.6%; mean = 4), followed by 'immediate supervisor' (67.8%; mean = 3.8), 'the delivery of care method used on your unit' (67.7%; mean = 3.7), 'your amount of responsibility' (65.1%; mean = 3.6), 'flexibility in scheduling your hours' (62.7%; mean = 3.6), 'recognition of your work from peers' (63%; mean = 3.6) and 'physicians you work with' (62.5%; mean = 3.6). Participants were moderately satisfied with 'salary' (60.2%; mean = 3), 'opportunities to participate in nursing research' (66.1%; mean = 2.9), 'vacation' (57.5%; mean = 2.8), 'opportunities to write and publish' (61.5%; mean = 2.7), 'compensation for working weekends' (47.4%; mean = 2.6) and 'opportunity for part-time work' (37.3%; mean = 2.2). The participants were very dissatisfied with 'child care facilities' (51.4%; mean = 2) and 'benefits package' (60.1%; mean = 1.7). The study findings support evidence showing that the areas of highest satisfaction were 'co-workers' (mean = 3.68) and 'interaction' (mean = 3.23), and the sources of greatest dissatisfaction were 'extrinsic rewards' (mean = 2.70) and 'professional opportunities' (2.74).[12]

In addition, a relationship was found between registered nurses' self-concept and job satisfaction, the correlation coefficients being statistically very highly significant (P< 0.001). The total self-concept determined 9.2% (r = 0.304, P ≤ 0.001) of job satisfaction for the participants. Therefore, if a registered nurse's self-concept increases, it is expected that his/her job satisfaction will also increase. A similar study, conducted with Nigerian nurses, found that NGSC was positively correlated with job satisfaction (r = 0.33; P = 0.01).[13]

The research study identified that there is no association between sex and the components of nurses' self-concept (P > 5). Since the majority of participants were female, it is not possible to make any statements relating to sex difference. However, this highlights the need for further studies to include higher numbers of male participants. In addition, no statistically significant relationship with registered nurses' self-concept was found with educational status, marital status or income. Further, marital status (P< 0.01) was less statistically significantly associated with care and income (P< 0.05) than with the communication component of self-concept (P< 0.05).

Age was statistically significantly associated with care and staff relations, and more associated with participants aged ≥40 years (P< 0.001) than with nurses aged <40 years. However, the communication component of participants' self-concept was associated with both the registered nurses with <10 years' experience and those with ≥10 years' experience (P< 0.01). This research shows that there was an association between the designation of charge nurse with the care component of nurses' self-concept (P< 0.01). Head nurses have better self-concept and a higher degree of satisfaction with their jobs due to their decision-making and coping techniques.[14] Furthermore, nurses' self-concept was statistically significantly associated with having ≥10 years' experience. In the categories of nurses' professional self-concept, self-esteem and related demographic variables, those with >12 years' nursing experience reported higher professional self-concept than younger and less experienced colleagues.[15]

With regard to the association between the nationalities of registered nurses and the components of nurses' self-concept, communication was strongly associated with self-concept among participants of all nationalities (P< 0.001). In addition, work units were statistically significantly associated with the care, staff relations and communication components of nurses' self-concept (P< 0.05), except NGCS, knowledge and leadership. The registered nurses working in accident and emergency, geriatric units, medical units, paediatric units and psychiatric units had lower scores on nurses' self-concept than their counterparts in other work units.

The registered nurses' job satisfaction was statistically and significantly associated with registered nurses' self-concept components such as NGSC, care, staff relations and communication (P< 0.05). The knowledge and leadership categories were not statistically significantly associated with job satisfaction (P > 0.05). This study found no statistically significant association between job satisfaction and sex, age, income, current work unit or geographical area. However, being a diploma holder was associated with increased job satisfaction (χ2 = 19.125; P < 0.001), more so than having a bachelor's or master's degree. Surprisingly, our study shows that registered nurses with <10 years' experience had more job satisfaction than those with ≥10 years' experience (χ2 = 4.602; P < 0.05). Furthermore, a statistically significant association was found between marital status and job satisfaction (χ2 = 11.105; P < 0.01).

The study revealed that nationality was statistically significantly associated with job satisfaction (χ2 = 24.646; P < 0.01). Participants with Omani, Indian, Jordanian and Yemeni nationalities had more job satisfaction than the other nationalities. Furthermore, the study identified that nurses' job satisfaction was statistically significantly associated with their work unit (χ2 = 28.231; P < 0.01). The registered nurses working in the work units of dialysis, geriatric, medical, operating theatre and psychiatry had less job satisfaction than participants in other units. Work area research has shown that specialised nurses had higher job satisfaction than general ward nurses (P< 0.01).[16]

Furthermore, a correlational study [17] has identified moderate levels of overall job satisfaction among critical care nurses. In this study, the highest levels of job satisfaction were in the flexibility of scheduling and lowest in child care facilities. In addition, the nurses employed on medical-surgical units perceived higher levels of job stress than nurses employed in other types of speciality unit.[18] In a survey of 417 nurses, of whom the majority were female (90.7%) and aged >41 years (74.3%), and of whom 47.4% had worked in haemodialysis unit, work environment was perceived positively, and there was a moderate level of job satisfaction.[19] Furthermore, it has been reported that nurses working in obstetrics and gynaecology have the highest job satisfaction, followed by those working in paediatrics, surgery and internal medicine (P< 0.001).[20] From our study analysis, communication determines 79% of self-concept, and 49% of job satisfaction was determined by control and responsibility of the registered nurses.

Limitations of this study

As the survey instrument was a self-administered questionnaire, a response bias might exist and it is possible that the research participants reporting very high or very low levels of self-concept and job satisfaction could be hidden by the large sample size. Although the reliability and validity of the instruments were published, it was originally produced by authors from a different country and this could influence the results. As the study findings on job satisfaction were generated only from selected government hospitals, the results may be generalised to other government hospitals which have the same organisational policies and procedures. The results may not be generalisable for other health sector institutions with different organisational policies.

 Conclusion



Work satisfaction is a major factor in nurse retention and the delivery of high-quality care, but rapid changes in health-care services have placed more demands on nurses, and this has increased the need for organisations to sustain and improve nurse's job satisfaction.[21]

This study found that nurses working in selected government hospitals scored higher self-concept in areas of care, staff relations, communication and knowledge. The lowest scores were found in the components of NGSC and leadership. In overall job satisfaction, approximately three-quarters of participants were satisfied with their jobs. The total self-concept determined 9.2% (r = 0.304; P ≤ 0.001) of the job satisfaction of registered nurses in this study. Therefore, if a registered nurse's self-concept increases, it is expected that his/her job satisfaction will also increase. A similar study could be replicated for comparison between different emirates. Further research could be conducted involving nurses from outpatient departments and primary health centres. A comparative study could be conducted with different health-care professionals to measure their levels of job satisfaction.

Acknowledgements

The author would like to thank the hospital directors, nursing directors, ethics committee and research assistants, and the registered nurses who participated in this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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