Factors Affecting Satisfaction with Performance of Duties of Nurses in Canada
Date
2019-09-24
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0000-0001-7737-093X
Type
Thesis
Degree Level
Doctoral
Abstract
Nurse shortages are frequently experienced in the provincial health care systems of Canada. Nurses leave their profession due to dissatisfaction with their work environment: heavy workloads; constant cuts to health care funding; lack of professional development opportunities; high levels of job stress; and limited management support. In order to improve Satisfaction with Performance of Duties (SPD) of nurses, the environment in which they provide patient care needs to be improved. A hypothesized model was developed to find the factors associated with the SPD of nurses.
A cross-sectional study covering two similar sized Canadian health regions – Saskatoon and Halifax – was used to test the model developed. A self-reported survey was conducted for a sample of nurses (n=236) working at the health regions in Halifax and Saskatoon. A regression model was built to test the hypothesized model. The final model included only significant predictors of SPD and the control variable, Years in Practice. Significant predictors were: Hassles which explained 22.3% of the variance (β = -0.102, p = 0.018); Positive Attitude explained 22.8% of the variance (β = 0.121, p = 0.007); Unit Organization explained 11.9% of the variance (β = 0.150, p = 0.004); Leader Actions explained 2.1% of variance (β = 0.123, p = 0.008); Objective Culture explained 1.3% of the variation (β = 0.131, p = 0.004); Fulfillment explained 7.6% of variance (β = 0.257, p = 0.000); and Recognition explained 3.7% of the variation (β = 0.281, p = 0.000) (Table 4-10). The final model cumulatively explained 71.8% of the variation in SP which is considered a large effect (Cohen, 1988).
A Structural Equation Model (SEM) was also built to test whether the SEM adds value to the regression model. A multi-layer model was configured that adequately fit the data (χ2 = 346.591 with df =128 and p=.0000). The CFI was 0.916, NFI was 0.875, IFI was 0.917, GFI was 0.851 and the RMSEA was 0.086. SRMR was 0.069. Leadership was at the base of the model with paths leading to Unit Support, Distress and Culture with all three path coefficients being statistically significant at p < .001. Two of the three paths had strong coefficients Leadership to Unit Support (β = 0.74) and Leadership to Organizational Support (β = 0.74) but the third, Leadership to Distress was very weak (β = 0.03). An intermediate level appeared to exist with four paths from Unit Support to: Equity (β = 0.37), SPD (β = 0.14), QR (β = 0.15), and Distress (β = - 0.25); two paths from Distress to: Equity (β = - 0.27) and QR (β = - 0.17); and four paths from Culture to: Distress (β = - 0.48), Positive Attitude (β = 0.41), SPD (β = 0.21) and Quality Ratings (β = 0.51). All ten intermediate level path coefficients were statistically significant at p < .001. An upper level also appeared to exist with a path coefficient from Positive Attitude to Equity (β = 0.46) and a path coefficient from Equity to SPD (β = 0.74). Finally, a very weak path appeared to connect the two dependent variables from QR to SPD (β = 0.01). The upper level paths were also significant with p < .001.
The evidence from this study provided insight into factors associated with the SPD of nurses. Theory-driven strategies to manage the work environment of hospitals to improve SPD of nurses have potential to alleviate projected nursing shortages; thus ensuring an experienced and satisfied nursing workforce in hospitals.
Description
Keywords
Job Satisfaction, Nurses in Canada
Citation
Degree
Doctor of Philosophy (Ph.D.)
Department
School of Public Health
Program
Public Health