Dissertation Sample

ASSESSING JOB SATISFACTION OF DOCTORS AND NURSES WORKING IN MINISTRY OF HEALTH HOSPITALS IN MUSCAT, OMAN

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Instructor

APPROVAL

ABSTRACT

DEDICATION

ACKNOWLEDGEMENT

TABLE OF CONTENTS

List of Tables…………………………………………………………………………………….7 

List of Figures……………………………………………………………………………………8

CHAPTER 1: Introduction. 9

Background: Oman. 10

Oman-Medical country. 11

Problem Statement 17

General Problem.. 17

Specifications. 17

Purpose. 18

Significance of the Study. 18

General 18

Significance of the Study to the Field of Leadership. 19

Nature of the Study. 20

Research Methods. 20

Design Appropriateness. 22

Data Collection. 22

Statistical data analysis. 23

Hypothesis. 25

Research Questions. 25

Theoretical Framework. 26

Definition of Terms. 30

Limitations of the Study. 30

Scope of study. 31

Chapter Summary. 32

CHAPTER 2: LITERATURE REVIEW… 34

Historical Overview and current findings. 35

The Hawthorne Studies of 1924 – 1930s. 38

Recent Studies. 39

Job Satisfaction Studies in the Medical and Health care fields. 40

Jobs satisfaction and attitude. 41

Measuring Job satisfaction. 43

Theories of job satisfaction. 44

Value Theory of Job Satisfaction. 45

Two- Factor Theory. 46

Equity Theory. 47

The Met Expectations Theory. 47

The Opponent Process Model of Job Satisfaction. 48

Determination of job satisfaction. 48

Individual Factors. 49

Age of the Employee. 49

Gender 49

The Leadership Factor 50

Working Conditions. 50

The Reward System.. 51

The Work itself 52

Effect on Performance. 53

Effect on Turnover 55

Employee Creativity. 56

Absenteeism.. 57

Mental Health. 58

Individual’s Culture. 58

Other Spheres of Life. 60

Chapter Summary. 61

CHAPTER 3: RESEARCH METHODS. 63

Research Method and Design Appropriateness. 63

Population, Sampling and Data Collection Procedures and Rationale. 65

Sample Size. 69

Validity. 71

Internal Validity. 71

External Validity. 73

Statistical data analysis. 74

Chapter Summary. 75

References. 77

LIST OF TABLES

LIST OF FIGURES

CHAPTER 1: INTRODUCTION

In a world that is characterized by extensive competition and cut throat culture, there is an obvious need for organizations to ensure they are able to utilize the internal resources of the company as instruments of strategic competition. Burt (1992) states one of the best methods to make certain this happens is to ensure the employees within the organization are happy and satisfied with the work they are respectively responsible for completing. This will ensure greater productivity and better output from every single employee that is part of the organization. Cunningham and Eberle (2008) believe job satisfaction would invariably have to be studied in the context of organizational behavior. The following research is aimed at ensuring that one is able to develop understanding of the forces at work behind levels of job satisfaction for medical practitioners in Oman and also to measure how satisfied these people actually are with the work that they do.  The study would work with the objective of analyzing the factors of job satisfaction among doctors and nurses in Omani health care system. This study will be a starting point for further research in the field of patient’s safety in Oman. 

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The following chapter will capture the essence of the research so that one is able to understand the proposal, its related methodologies and the expected results. To this end, the chapter will introduce Oman as a nation, the kind of situation that characterizes the medical scene in the country, following this the hypothesis will be introduced along with the methodology that the research will use to prove the hypothesis. The chapter willconclude with the limitations and the cost perspectives the study will have to face while it runs its full course.

 

Background

Oman

      Oman is a small developing nation situated on the southeastern apex of the Arabian Peninsula. Oman’s population according to the 2003 census is approximately 2,340,815 (Ministry of National Economy, 2006). A Gulf News Report (2008) discussed  the third census in Oman will be held in 2010 following the first census of 1993 and the latest census of 2003. Estimates made in 2006 by the Regional Health Systems Observatory place the population estimate at 2.5 million individuals (Regional Health Systems Observatory- EMRO, 2006). The Omani government funds the health services and as such, the services are available free to all Omani citizens and non-citizens except those who are employed within the government sector.. Oman has a high standard of health services that would measure up to the standards of various industrialized nations. (Oman Ministry of Information, 2008).

      According to the World Health Organization report (2000), the Omani health system ranks high, much like those of most developed countries.  The same report indicates the performance in the Omani health care system is rapidly developing when compared to the 1970s Omani health system performance that was low given that the number of hospitals was few and health care provision was limited to the fee-for-service basis. MoH (2009) statistics reveal the significant growth and development of the Omani health sector by illustrating that in the early 70s, the total number of hospitals in Oman was two. This number has increased to 59 in 2009. Al Bulushi and West (2006) noted that due to improved medical care and standards of health in Oman’s health sector, the mortality and morbidity rates of children has been reduced significantly. 

Oman-Medical country

The Regional Health System Observatory (2006) states that between 1970 and 1980 there was a manifestation of significant development in Omani healthcare system. One can get the modern history of the country from Al Bulushi & West (2006) which states that the Sultan came to power in 23rd of July 1970 and part of the accomplishment in the decade from 1970 to 1980 is that the Sultan instituted the MoH and gave the citizens assurance of access to free medical services as a fundamental right.

According to a study by the Directorate General of Planning- Oman (2008), the decade that followed was marked by sustained expansion of the hospital network and health centers, which needed to be bolstered by an equated human resource development planning. In addition, the study by the Regional Health Systems Observatory- EMRO, (2006) states that by then it had become imperative that these developments were synchronized with proper planning in terms of human resource development and this effort was achieved through the help of the World Health Organization

       In 2005, the Ministry of Health of Oman released the annual report on population, which indicated that the 2005 mid-year population was 2,508,837. Of this population Muscat had the highest proportion of the total national population accounting for 27.72 percentage of the total population (695,432 Individuals). According to the Ministry of Health Annual Report (2005) in relation to the age structure, the median age for the population stands at 18.8 years implying that a greater proportion of the population is composed of people under the age of 19 years.

      In 1976 health plans with a range of 5 years were developed and operated the health care system in Oman. The report by the Seventh Five-Year Plan for Health Development (2006-2010, n.d) states that the purpose of five year plans is using appropriate scientific process for planning to enhance the use of available resources to maximize the quality of comprehensive healthcare coverage.  Ghosh (2006) proves that in the 5th of the 5 year plans (1996-2000), the human resource projection for Omani national doctors and nurses was that nurses to reach 85.5% Omanization and Doctors 44.7% Omanization by 2010. A study by Gosh (2006) reveals an increasing attrition rate of Omani doctors and nurses between the periods 1995 and 2003. The doctors attrition rate increased to 38.9% from 0.11% in 1995 to 0.25% in 2003 while nurses attrition rate increased 51.4% from 0.09% in 1995 to 0.28% in 2003 (Ghosh, 2006). According to the Ministry of Health Directorate General of Planning (2008), the current projection for Oman in 2010 has fallen to less than 79% for nurses and less than 43% for physicians and is expected to continue falling as the attrition rate of Omani doctors and nurses grows. The attrition rate increase as described by the Directorate of Human Resources (2009) is a problem that is directly linked to the staff satisfaction level of doctors and nurses in Oman.

      The crude death rate for Oman according to 2005 statistics was 2.53 per mille while the infant mortality rate 10.28 per mille. The statistics of the Directorate of Human Resources in Oman’s Ministry of Health (2009) indicate that the Omani health care providers (doctors and nurses) continue to relocate out of the country to other areas that promise better job satisfaction while the patients travel to other countries for better health care services. Neal and Woloshynowych (2005) explained that this might be a sign of a trend that deserves an exploration of its causes, such as lack of trust or safety of care delivered, which can be a direct correlation to the dissatisfaction on the part of the doctors and nurses.

      While healthcare services are imperative to a healthy society, the satisfaction of the care providers with their job is a defining factor to the quality of healthcare given (Kankaanranta, 2008). Harris Interactive for Kronos Inc. conducted the ” Working in America: What Employees Want Working in America Survey” (2006) which revealed that while healthcare services are imperative to a healthy society, the satisfaction of the care providers with their job is a defining factor to the quality of healthcare given. Job satisfaction of doctors and nurses determines how the healthcare services are delivered to the public. Most developing nations have continued to experience low job satisfaction indicators of health care professionals (Buchan & Sochalski, 2005). Even nations that have improved health care systems like that of Oman still experience patient outflows from the countries as well as outflows of care providers to other countries (Buchan & Sochalski, 2005).

      The career choices made by doctors, their destinations and the views they hold concerning their jobs provide valuable insight to workforce planning, which also contributes to better chances of such significant improvements to be achieved in the health care system (Kankaanranta 2008). Kankaanranta (2008) while discussing the salient factors that influence doctors and nurses to make their own career decisions notes that knowledge of such factors might help in motivation and morale boosting of the physicians.

      This planning is even imperative for the government institutions to ensure that public resources are used to generate the best and optimal inflow or ultimate value (Unni et al, 2006). In addition, lack of satisfaction among employees of a given organization or institution results in the movement of labor resources to places the workers perceive will give them value for what they can deliver and in turn, give them maximum job satisfaction (Clark & Oswald, 2005). Luo and Homburg (2007) discussed this trend leads to a staged competition between the private and public sectors as each side would wish to attract the best employees in the market. At the same time, the availability of the employees for the work is partly and strongly dependent on the ability of the employment to provide full job satisfaction (Nauert, 2005). Unni et al. (2006) conducted a study in Norway in which they assessed the predictors of job satisfaction among the Norwegian physicians. According to Unni et al. (2006), the government institutions and the private health care system are in an incessant competition over the doctors and nurses; therefore, the decisions made by the physicians partly and imperatively rest on their perceived destinations of job satisfaction. A report by Directorate of Human Resources, (2009) states that the Ministry of Health in Oman is the main provider of healthcare services in Oman and minimal competition is available over healthcare human resources within the country.

      Boudreau and Ramstad (2006) discussed that one strong backbone upon which an organization can base its employee retention is knowledge of job satisfaction drivers of the employees it has. Though there is  great significance of using health care providers’ opinions and attitudes, very few studies have specifically focused on assessing the attitudes of health care providers with regard to their job satisfaction especially in developing health care systems. Knowledge regarding their job satisfaction can enhance health care provision by providing drivers to optimal satisfaction of the doctors and nurses. It has been discussed in Kacel et al, (2005) that in the case of developing economies like Oman it would help alleviate brain drain that is characteristic of most developing nations where workforce move to developed nations where job satisfaction drivers are perceived to be well appreciated.

Though few academic inquiries have focused on attitudes of health care providers in developing economies in terms of job satisfaction, some of the studies that have been done have revealed the satisfaction of doctors and nurses and by extension health care service providers greatly impacts on consumer expectations and customer retention. In fact, it is not only imperative that brain drain be checked but without satisfaction of the consumer, consumers are most likely to flee to other countries for services (Akerlof et al, 2005).  

One study carried out in Germany (Bates et al, 1995), revealed that there is a complex interrelation between job satisfaction of doctors and the end user – customer satisfaction which again, in turn, is intermarried with improved compliance, continuity and eventually better outcomes. This is in agreement with the findings of Cooper (2008) who observes that as a result of this knowledge about job satisfaction of doctors and nurses it should help in strengthening the complex intermarriage of various variables across the board. This is with respect to satisfaction of healthcare providers and the consumer of the services; satisfaction of one is dependent on satisfaction of the other in one or more ways.

Saiyadain (2006) observed that the availability of data from health care providers facilitates proper interdepartmental programs and relations. Saiyadain (2006) further explains that motivation and morale boosting of the employee is anchored on withdrawal, modification or provision of a factor in the working environment. Such programs may be geared towards providing relevant drivers to ensure maximum satisfaction of the medical service providers like doctors and nurses (Kacel et al 2005). In addition to the above information, according to Kacel et al. (2005), the programs may aim at improving the medical service providers’ knowledge of the role of different parties should play to bring about maximum satisfaction. While the system has a role to play in ensuring this satisfaction, the individual medical service provider (the particular doctor or nurse) plays a role toward achieving the desired satisfaction. In the end, the quality of healthcare delivery will be made better.

Problem Statement

The Ministry of Health Directorate of Human Resources (2009) reports an unexpected growth in the rate of turnover among Omani doctors and nurses of 70% from 2000 to 2008. Another report by Directorate General of Planning (2008) finds that the exit interviews explain a low job satisfaction level as the prominent indicator for Omani doctors and nurses leaving the country. The problem lies in the fact that there is no research data that addresses the impact of job satisfaction drivers on the degree of job satisfaction among Omani doctors and nurses working in Oman’s healthcare system. The gap in literature implicates the need to analyze the factors that influence job satisfaction of Omani doctors and nurses. The general population group in this research is healthcare workers in Oman Ministry of Health.

2.        

The proposed descriptive quantitative method study will collect data that may demonstrate the impact of demographic factors and factors identified by Kacel et al. (2005) as intrinsic and extrinsic drivers of medical providers’ job satisfaction in Muscat hospitals. The data may reveal the factors that influence job satisfaction of Omani doctors and nurses which may be focused on improving the health care system as a working environment for doctors and nurses in the Omani Ministry of Health.

Purpose

The purpose of this descriptive quantitative method study is to study and discover, using a “Pearson Correlation”, the influence of demographic factors (age, gender, educational qualification) as well as factors identified by Kacel, Miller, and Norris (2005) as intrinsic (achievement, recognition, advancement, responsibility, and patient mix), both of which are independent variables, on job satisfaction. In addition, a relationship will be described between extrinsic factors (i.e. salary, supervision, organization policy and administration, working conditions, and involvement in research) and the degree of job satisfaction among Omani doctors and nurses working in Ministry of Health hospitals in Muscat, Oman. A comparison will be made between the influences of different independent variables on job satisfaction among members of the population. These comparisons and relationships will be an important indicator of the areas that require improvements in order for job satisfaction levels among medical professionals in Muscat, Oman to be increased.

The population group will be all the doctors and nurses work in ministry of health hospitals in Muscat, Oman. Data will be collected from a sample that represents the entire population in order to come up with the correct relationships correlations are comparisons between dependent and independent variables.

Significance of the Study

The study intends to conduct a quantitative descriptive research on doctors and nurses working in the Ministry of Health of Oman. The desired outcome of the data collected from this research is to add to the existing body of literature relating to employee job satisfaction. In addition, the data collected from the study can aid in the quest at enhancing job satisfaction of doctors and nurses, especially those who are exposed to the same conditions of work. Developing health care systems may also find the data of benefit.

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The role that both the system and the individual should play is to be explored so that the responsibility of each party is clearly brought out. The study hopes also to contribute to augmenting the findings of job satisfaction of doctors and nurses in public health institutions and assess medical service providers’ perception of job satisfaction, experiences and attitudes about various significant factors that have been identified to affect job satisfaction. In addition to this, the research intends to explore factors influencing medical providers’ job satisfaction as well as compare the findings of developed health care systems to those of a developing healthcare system.

Significance of the Study to the Field of Leadership

Krogstad (2006) states that the most important factor for job satisfaction as far as medical practitioners are concerned are factors of local leadership. In this context, one could state that the professional value of medicine and the organizational and holistic experiences of nurses need to be valued in building independent micro teams. One would also have to remember a majority of the populations working in the Middle East is consistive of expatriates. Black (2006) identifies the factors involved in the management of expatriates.

In this context the following study will seek to assess the medical providers’ job satisfaction (doctors and nurses) in the Omani Ministry of Health. Though the study hopes to focus on the job satisfaction of doctors and nurses working in the hospitals under Ministry of Health in Muscat, Oman, it is hoped that the study is found to be useful for other doctors and nurses who work under similar settings. The study intends to:

  • Enhance knowledge and understanding about job satisfaction of doctors and nurses in the public sector
  • Identify and discuss factors that lead to higher job satisfaction among doctors and nurses
  • Identify barriers to the achievement of higher job satisfaction
  • Increase an understanding of the influences that various factors can have in the health care delivery system
  • Gain an understanding of the perceptions medical service providers have about the health care system in Oman in terms of their job satisfaction
  • Define and describe current job satisfaction drivers among doctors and nurses in the Ministry of health of Oman
  • Improve employee awareness about job satisfaction in the health institutions
  • Recommend interventions designed to decrease the occurrence of job dissatisfaction among doctors and nurses in health care systems
  • Complement existing bodies of research on employee job satisfaction in health care systems

Nature of the Study

            The study aims to provide an assessment of the satisfaction of the doctors and nurses working with the ministry of health hospitals in Muscat, Oman. This is as far as job satisfaction is concerned. The study will take a descriptive approach because job satisfaction of Omani doctors and nurses has not yet been explored from a research standpoint.

Research Methods

The study intends to use inferential and descriptive quantitative approach to gain a deeper understanding of the research objectives. The approach will expectedly help in the examination of the current job satisfaction status of the Omani doctors and nurses while exploring the various factors that act as drivers to the satisfaction. The method will likely help in ensuring that the research retains its empirical nature. According to Matveev (2002), the quantitative research employs numerical indicators to ascertain the relative size of a particular communication phenomenon. The quantitative method is appropriate here given the fact that the quantitative method of research is guided by a functional or positivist paradigm. According to Morgan & Smircich (1980) this has its basis in the assumption that social reality has an objective ontological structure and individuals are responding agents to this objective environment. Smith (2008) further reports that the quantitative method of research is one that is made up of counting and measuring events and performing the statistical analysis of a body of numerical data.

According to Cassell and Symon (2009) the basic functioning assumption behind the positivist paradigm is that there is an objective truth existing in the world that can be measured and explained scientifically. The main concerns of the quantitative paradigm are that measurement is reliable, valid and generalizable in its clear prediction of cause and effect. This may be effective given the fact that the basic issue is the measurement of behavioral trends in the most scientific manner possible.

This method is highly deductive and particularistic. This implies that the research would be based on the formulation of a research hypothesis. Frankfort-Nachmias & Nachmias, (2006) explain that the method is then followed by verification backed by data that has been empirically obtained. According to Ting-Toomey, (2005) the scientific hypotheses are value-free; the researcher’s own values, biases and subjective preferences have no place in the quantitative approach. Researchers can view the communication process as concrete and tangible and can analyze it without contacting actual people involved in communication.

The quantitative method of inquiry would mean that the researcher aims at investigating the relationship of influence between various factors such as demographic, intrinsic and extrinsic on the degree of job satisfaction among Omani doctors and nurses.

Design Appropriateness

Usage of the quantitative research method is recommended for this research given the fact that it would help in stating the problem in very specific and set terms. The use of quantitative methodology would also likely aid the researcher in precisely specifying both the independent and the dependent variables under investigation and would likely ensure a more objective set of conclusions, testing the hypothesis, and in determining the issues of causality. This would mean that at the end of the research, the results would expectedly have high levels of reliability because according to a study by Balsley (2006), the data gathered due to controlled observations, laboratory experiments, mass surveys, or other form of research manipulations is usually more empirically correct.

Data Collection

The data collection method would involve using a survey with the incorporation of the Likert scale in the survey and other forms of scalar measurement integrated into the survey.  The survey will be distributed by the researcher in two major hospitals in the Muscat region with a sealed envelope for research subjects to return the survey. The survey will be sent to at least 500 respondents and the data collection would be based on the Minnesota Job Satisfaction Questionnaire (MSQ). The MSQ survey is designed so the researcher would be able to quantify the level of satisfaction that a person derives from his/her job and includes three basic forms: two long forms (1977 version and 1967 version) and one short form. The idea in the MSQ survey is to provide the researcher with precise ideas on the various facets of the work that a given individual thinks is rewarding in his or her given job scenario vis-à-vis a more general measure of job satisfaction. The basic reason behind using the MSQ is because the method has been found to be useful in an exploration of client vocational needs, along with PSM activities like counseling follow-up studies (Schwartzmiller, 2005).

The dependent variable (job satisfaction) will be measured by the Minnesota Satisfaction Questionnaire formulated by Weiss et al. (1967) with an approximate Cronbach’s alpha of 0.91.  The predictor variables will be measured using the various elements designed in the questionnaires for collecting data. According to Moulds et al. (2009) reliability is to be measured with reference to a prior Cronbach’s alpha of 0.70.

Statistical data analysis

All categorical items with reference to job satisfaction will be transformed to an ordinal scale that ranges from the minimum value (for instance “do not agree at all”) to the maximum value (for instance “fully agree”). Items or questionnaires that do not receive a response will be coded as missing values. Scale values will be calculated as the average or mean of the single items. All items will be assumed to be consistent with the characteristics of a normal distribution.

The data will be coded so that it allows for the possibility of analyzing it using quantitative techniques. For this reason, appropriate segments will be demarcated within the data and then coded. Highly structured data (ie. open-responses from respondents) will be coded without subjecting it to any further segmentation. According to Denzin and Lincoln (2005) this would make it possible to make the data analyzable using the above mentioned quantitative techniques.

Descriptive statistics and the Analysis of Variance (ANOVA) will be performed to evaluate whether there is significant relationship between job satisfaction of doctors and nurses working in Omani Ministry of Health and the various quantitative variables like the demographic factors. The relationship between the various variables will be measured using the Pearson product-moment correlation coefficients.

Hierarchical regression analysis will be applied to investigate the degree, to which job satisfaction is contingent on physicians’ needs and resources. The variables will be arranged in different hierarchical steps. The first step will entail assessment of the background variables such as years of experience of the respondents, their age and gender. In the second step, personal resources will be evaluated to establish their relationship with job satisfaction of the respondents. In this step, personal resources such as optimism will be assessed to establish how they relate to job satisfaction of the doctors and nurses. Such job demands as the quantitative demands and emotional demands will also be assessed while another step will entail an evaluation of the job resources, for instance social support at workplace and leadership.

All the p-values will be two-tailed. P-values of less than 0.05 will be considered significant given that the significance level will be 0.05 or 5%. The values will be stated  as mean and standard deviation and the data will be calculated using SPSS Version 16. Chapter three on Research Methods provides an in-depth illustration of the methodology the researcher intends to use in carrying out the research study.

Hypothesis

The following research will work on the basic hypothesis that the levels of job satisfaction in the medical practitioners in Middle East are low when compared to the global levels of the same variable. To this end, the study will analyze the factors of job satisfaction and the fulfillment of these factors in the context of the medical practitioners in Oman. The basic assumption is that the medical practitioners in Oman do not enjoy high levels of job satisfaction-where job satisfaction is measured modern scales judging the same. The hypothesis also states the culture of medical organization is largely unprofessional with barely any institutionalization of the scientific methods of appraisals, rewards and punishments. Assuming a positive correlation between job satisfaction and organizational culture dissatisfaction with culture would invariably lead to decreasing levels of job satisfaction.

Research Questions

Given the study will endeavor to assess the problem through a quantitative approach, a number of research questions are designed in consideration of both the perspectives, which the study shall seek to answer.

  1. Do demographic factors (age, gender, and educational preparation) (IV) influence the degree of Job Satisfaction (DV) among Omani doctors and nurses working in Oman’s Ministry of Health healthcare facilities?
  2.  Do intrinsic factors (achievement, recognition, advancement, responsibility, and patient mix) (IV) influence the degree of job satisfaction (DV) among Omani doctors and nurses working in Ministry of Health hospitals in Muscat, Oman?
  3. Do extrinsic factors (salary, supervision, organization policy and administration, working conditions, and involvement in research) (IV) influence the degree of job satisfaction (DV) among Omani doctors and nurses working in Ministry of Health hospitals in Muscat, Oman?

Theoretical Framework

Moulds et al. (2009) while investigating the effect of migration on the status of healthcare in developing countries observed job dissatisfaction is one of the major causes or drivers of migration of doctors from the developing to the developed world.  This observation is made in their study, which they carried out recently exploring the aspect of professional satisfaction in the Fiji healthcare system. The migration of healthcare providers is identified as a serious threat to the heath status of those populations that remain behind. Moulds et al. (2009) further points out in their investigation that professional satisfaction is anchored on three main factors: professionalgrowth (where the doctor or nurse wishes to augment his or her skills in the field of choice), service and recognition, with considerable overlapbetween categories.

An investigation into job satisfaction of employees was carried out by the National Business Research Institute, which revealed six statistically significant drivers that have an effect on employee job satisfaction. Opportunity is one major driver for employee satisfaction. In relation to opportunity, employees wish to be given or presented with chances that allow them to participate in motivating projects and to be assigned satisfactorily challenging tasks which exhibit more responsibilities on their part (Arnold, Cppoer & Robertson 2004).

Though organizational dynamics have made promotional opportunities to be rare, promotional opportunity is also an important factor that counts towards the employee satisfaction, especially where such opportunities imply an increased level of responsibility and appreciation for their input at workplace (Angerer 2003). Thus, Feuss et al (2005) recommend that through special assignments to the employees, giving them team leadership positions and projects, employees are able to get the challenge that gives them a contribution to their job satisfaction. For this reason, though chances may arise within an organization, the management may find it a better option to promote from within the organization (Angerer 2003).

Promising employees may also be rewarded by assigning them interesting projects, while on the organizational level a division of job is done in levels that signify increase in leadership and responsibility. One way of achieving this is through the creation of job titles that exhibit rising rank in expertise and which indicate achievement.

Stress is another factor that affects employee job satisfaction. Job satisfaction diminishes when negative stress is incessantly high. In addition, jobs that meddle in employees’ private or personal lives contribute to high level of negative stress since they cause a great deal of worry to the employee. To alleviate such stress that leads to low job satisfaction, appropriate actions need to be undertaken which include:

  1. Encouraging a balance of work and employees’ private lives
  2. Even and fair distribution of work within the work teams
  3. Constant review of procedures followed at work so that any unnecessary bureaucracy is done away with
  4. Managing and limiting the number of disruptions at the workplace
  5. Proper utilization of exercise breaks at work so that employees use them to release stress 

Leadership at the workplace infces significantly on employee job satisfaction. Previous inquiries into employee job satisfaction indicate that when managers of an organization are good leaders the employees of that organization are more satisfied. Managers that encourage their employees and motivate them to do better are desirable. In addition, the managers should strive for excellence on their side too. These features require that the managers be well trained since leadership is an intermarriage of behavior and attitudes and therefore it can be learned through training. The managers should be trust-worthy, inspiring people.

Work standards are very important in defining the level of job satisfaction of employees. Scholarly research into employee job satisfaction has shown that job satisfaction is greater when the whole workgroup is proud of its work. Consequently, employee/customer communication should be encouraged to expose the employees to the impact caused by their own quality work. This could act as a further motivator (Brennan et al. 2007). Developing evocative measures of quality is also important so that achievements in quality are celebrated.

Fair rewards for the work done by employees are just as important in achieving job satisfaction. This means that when rewards or reward systems are being formulated consideration must be made as to the amount of effort employees put forth to accomplish a given assignment, the demands of a particular task and responsibilities of the employees. In order to ensure that fair rewards are used as a way to reach employee job satisfaction, it should be ascertained that the rewards are designed for genuine input to the organization. Luo & Homburg (2007) observe that consistency must also be maintained in the reward policies to avoid any double standards. It seems that employees need to be made aware of all the features of the wages, for instance, if the wages bear a competitive feature. Rewards should be diverse to incorporate other forms of benefits other than money

Adequate authority for the employees has been identified as a good driver to job satisfaction. Therefore, the employees should have the authority and freedom to accomplish their tasks. Appropriate actions that have been cited as able to help an organization achieve this are:

  • Allowing employees to make decisions
  • Allowing employees to contribute in decision making, especially those decisions which will affect them
  • Establishing work goals through allowing employees to determine the way they will attain them
  • Identification of decisions that make the best options in terms of value addition to the organization (Luo & Homburg, 2007)
  • Dedication that has been made in terms of working to establish the patterns in job satisfaction have led to revelation of clear patterns that are common to employees that are highly satisfied with their jobs. A workforce that is characterized by high job satisfaction has features that are common among the employees of the workforce. They believe that the institution they are working for will be satisfying in the end (Luo & Homburg, 2007)
  • Employees that have higher job satisfaction are also concerned about the quality of the work and are more productive than those who have lower job satisfaction. They have high commitment to the organization and their retention rates are higher (Luo & Homburg, 2007)

Definition of Terms

Job satisfaction as used in this study consistently aligns itself in meaning as defined by Porter and Lawler (1968 qtd in l-Aameri, 2005). Thus, job satisfaction is the emotional or affective response exhibited by individuals to their current job conditions.

Medical service providers: for the sake of this study in the phrase have been used where doctors and nurses working in Omani ministry of health hospitals ought to be used.

Job satisfaction drivers: various dimensions, which form the basis for which employees; and in this case doctors and nurses, develop affective response to work conditions. The response could be negative or positive. These drivers include pay or reward, leadership factors among others which are highlighted in the study. These dimensions can also be looked at in the same perspective as Saiyadain (2006) views them as job satisfaction determinants.

Crude death rate: in a given geographic region like a country, administrative area, state or county, the crude death rate would be used to measure the number of deaths occurring in the particular population within a specific period (this period is mostly one year) for every 1000 individuals of that population. It is related to a specific cause; for instance, a certain disease and it also relates to gender and sex (Hao et al, 2006). 

Assumptions

The research is based on a number of basic assumptions:

  1. There is a certain type of singularity about the work culture within which the medical practitioners in Oman function. For this reason, any factor that is used to establish relationships, causations and correlations between dependent and independent ones in the sample will be generalized on the entire population. The results of such findings will be considered to be a reflection of status of job satisfaction among medical practitioners in Muscat, Oman.
  2. These practitioners are not completely dissatisfied nor are they completely satisfied with the work that they do. it is assumed that demographic factors (specifically age, gender and educational qualification) as well as intrinsic factors (recognition, achievement, advancement, patient mix and responsibility) have an influence on the level of satisfaction among doctors and nurses among all members of the population.
  3. It will be possible to assess their levels of satisfaction, which in essence may be subjective criteria in objective terms. The subjective criteria may arise in the course of referring to data that may have been collected through use of approaches that were not very objective. However, such data will be analyzed in an objective manner while all suspected subjectivities will be highlighted, acknowledged, and their influence on the outcome of the research assessed.

 

 

Scope of study

The research using the methods of empirical study would seek to identify and expand on the notion of job satisfaction within the medical practitioners in Oman, thereby creating grounds for further research in the more particular areas of dissatisfaction aiding in better policy choices, promoting satisfaction and better efficiency in them. Given the fact that the results of the study could be in the establishment, a novel approach in further assessment of factors governing job satisfaction, the study participants would automatically benefit from any improvements such as betterment of work culture, issues highlight and more resource allocations. In addition, the policy makers in the context of the study participants would benefit from knowing that their participation may help prove that the plight of the doctors and nurses, thereby reducing attrition. If the study is deemed successful, the investigator may be better able to secure continued funding for this project and secure many subjects nationwide and worldwide.

Limitations and Delimitations of the Study

Just like other studies of this form, this study also has its limitations. The most notable limitation in the study is existence of method bias.  Because of the use of a single questionnaire for collecting the data, the relationships, which may exist between constructs under study, may be inflated. In addition to this, it was noted that there exists some apathy towards participation in research. This is possibly explained by the fact that there are many studies carried out within the organization, leading to a loss of interest on the part of a large number of employees. Because of the negative attitude, there were relatively low return rates of the questionnaires, leading to a possible compromise on the reliability of the research findings (l-Aameri, 2005).

The way in which an employee may perceive factors as influencing their performance is a highly personal issue that might vary from one setting to the other (Armstrong, 2001). The pattern of responses is likely to be specific to the context of doctors and nurses working in the Omani Ministry of Health within Muscat. The level of findings is considerably low. Because of this, there is a need for more research on related areas. There is also the possibility of an individual not being able to effectively rate the various factors. This is because the factors might have been many and might have at times seemed to have equal weight.

There are several areas that would ultimately be outside the scope of this research or would work as limiting agents where the research results are concerned. The primary factors of limitation would be that judging behavior is in itself a tricky issue given the fact that there can be no absolutes where the workings of the human mind are concerned. The survey is also tricky given the fact that many times responders answer questions not in terms of the truth but in terms of what they think the correct answer should be, throwing off the correctness of the ultimate results.

Chapter Summary

The chapter introduced the primary themes prevalent in the research and dealt with all the major issues in the context of the proposed research. The chapter outlined the essence of the research, the methodology that the research quantitative method would be applied in the data collection and analysis. The Minnesota Questionnaire and the 5-point Likert Scale would be used for this purpose. To this end, Oman was introduced as a nation and the kind of situation that characterizes the medical scene in the country was discussed. Finally, the chapter identified the research scope and the delimitations that the research would ultimately have to contend with for its success.  The researcher will also examine a vast body of literature on themes that are related to job satisfaction.  This may further demonstrate the researchers understanding of important views around key areas of the research from the perspective of important academic and other views.

 

 

Notes


CHAPTER 2: LITERATURE REVIEW

This chapter scrutinizes the available literature as it relates to employee job satisfaction with an aim of bringing out their profound understanding, be able to compare, contrast and establish any missing gaps in the literature. This scrutiny is intended to provide further rationale for the study to be undertaken. Various studies have been undertaken to uncover the relationship job satisfaction has with different factors at work environment. The review examines literature that relates to job satisfaction in different fields, in addition to those that have specifically targeted the health care system.

The literature examines original investigations, other literature reviews, peer reviewed academic literature, research databases, reviews, journals in various academic fields and original manuscripts. This is intended to bring a better understanding. One of the most recent studies, which directly involved investigation of employee job satisfaction of nurses is the study carried out by Barriball et al (2009). Since a search in the research databases produces a large number of results, the reviewed literature sources are picked on a random sample strategy. Databases searched include the UoP library databases, Cardiff University database, the BMC research database, and JAMA database among others. Original investigations looked at include the Hawthorne Studies carried out in the early 1930s.

Many studies are required in the area of employee job satisfaction given that job satisfaction is a multidimensional factor. Job satisfaction consists of both intrinsic and extrinsic factors. The intrinsic factors include decision autonomy and employee recognition. On the other hand, extrinsic factors include job security salary and wages. Studying these factors as a whole may not yield results that can be subjected to a generalized conclusion (Stefanie et al 2009).

Knowledge of these intrinsic and extrinsic factors is a strong backbone upon which an organization can base its employee retention by knowing the satisfaction drivers of the employees it has. Furthermore, though there is a great significance of using health care providers’ opinions and attitudes, very few studies have specifically focused on assessing the attitudes of health care providers with regard to their job satisfaction especially in developing health care systems. This chapter attempts to give an assessment of the studies that have been undertaken in an attempt to investigate the relationship of the two broad dimensions of employee job satisfaction and the satisfaction itself.

Research studies that have investigated employee satisfaction in the healthcare field are also explored. Moreover, the trend in the literature indicates that the number of research studies exploring employee job satisfaction in the health care systems is steadily increasing. This is very important, as knowledge regarding job satisfaction should enhance health care provision by providing the human resource practitioners in these institutions with information that can make planning a better exercise. This knowledge should in the end lead to optimal job satisfaction of the doctors and nurses (Kacel et al 2005).

Historical Overview and Current Findings

Job satisfaction as a facet of the work environment has been an area of increased interest though this interest intensified with the dawn of the 20th century (Wright 2006). Though studies have been carried out relating to organizational behavior, not many of them targeted job satisfaction as a particular concern  (Ibid). However, due to factors like organizational dynamics and general paradigm shift in employee relations, time has seen steady interest growing, thus attracting scholars and social scientists to put their efforts in unraveling a number of predicaments that befall organizational performance; among these being job satisfaction. However, job satisfaction is only an aspect of a larger unit- the organization (I-Chuan et al 20008).

Between late 19th century and early 20th century, Fredrick Taylor showed interest in the behavior of people by attempting to study their behavior at work. Prior to this, Adam Smith had advocated for the division of labor as a way, which would lead to a better organizational structure. Taylor incorporated employee satisfaction in his work. He achieved this by incorporating the idea of motivation of employees into organizational goal setting.  Thus, as Taylor believed, employee motivation would be achieved through a fair wage to the employees and by assigning them work that could be done quickly, which does not generate fatigue. Achievement of the motivation would then lead to effective productivity (Wright 2006).

Max Weber also touched on organizational behavior by coming up with the idea of rational organizations, which in turn gave birth to charismatic leadership. All these were contributions to the organizational attitudinal facets like job satisfaction and organizational commitment. In addition, these early contributions were broad since the organization was yet to be well understood (Hamermesh 2008).

In the 1930s, numerous large scale studies on job satisfaction were carried out. These studies attempted to explore the assorted variables that are related to employee job satisfaction. Knowledge of these variables, it was purposed, would help in improving productivity. It was imperative for nations to improvise ways in which their own productivity would be bolstered given the heightened tension among nations around this period.

In recent years, the definition of job satisfaction changed to fall in line with other attitudinal concepts. Job satisfaction, job involvement, morale at work and organizational commitment all blend to bring an understanding of employee attitudes. During the early part of the twentieth century, businesses in American were seized by the Frederick Taylor’s idea of Scientific Management. Fredrick Taylor had pioneered the utilization of time and motion studies to improve the worker’s environment. The management would break the employee tasks into easily understandable pieces. After the management had come up with the simplest chunk of the tasks, the next task would be to come up with the best way of executing them after which the tasks would now be presented to the employees for execution.

As a component of the Scientific Management system, corporations and business organizations customarily examined the consequences of the physical work setting on their employees. For instance, they varied the lighting to find the optimum level of light for maximum productivity. They piped in music, varied the temperature, tried different compensation schemes, adjusted the number of working hours in a day, etc.

The perspective at which the job itself has been looked at has been changing drastically over the decades as Stefanie and associates (2009) observe. For this reason, given that job satisfaction has now been looked at from different angles such as socially, legally and morally among other areas, employee job satisfaction has been linked tightly to labor management decisions. This is recounted by Stewart (2007) while discussing the dynamics of unemployment and low-wage employment. Stewart observes the job environment touches the life of the employee in different aspects since the employee will spend as much time at workplace as any other area of their lives. Thus, as Saiyadain (2006) employee job satisfaction or dissatisfaction has in impact on the employee’s social life.

The Hawthorne Studies of 1924 – 1930s

These studies, which were carried out at the Western Electric Company between 1924 and 1932, were very important for their discovery of the significant role played by human elements in organizational functions. The studies were headed by Elton Mayo and were initiated as an effort to explore the effect of various characteristics of the work setting on the fatigue and performance of employees. 

The Hawthorne studies examined various human elements in the organization including the social aspect. The Bank Wiring Room was used for the study of the social aspects of work environment. The initial position of the researchers was that the attitudes of the employees caused their reactions at work (Saiyadain 2006: 56- 67).

When the employees were interviewed and asked to talk about themselves in terms of what they liked or disliked at work, the researchers were able to come up with  mixed results concerning employee satisfaction. The respondents showed varied reactions as to what gave them satisfaction or dissatisfaction at work. The researchers also discovered that most employees when asked about such issues that affect their satisfaction or dissatisfaction talk about social aspects of the work settings than the economic aspects of the job environment. This lead them to conclude that money was not a significantly salient factor in determining employee satisfaction since most of the respondents who were interviewed desired social recognition more than the economic part of the job.

The initial studies led to emergence of two effects (Diaz-Serrano & Vieira 2005). The first was the experimenter effect, which was construed by the employees to imply that management cared. This effect was also interpreted as a stimulation that was meant to add a fillip to the workers’ morale and productivity. The second effect was the social effect. Here, the respondents were separated accordingly in groups, which would be interpreted by the workers as being accorded special treatment; hence their increased productivity due to an increased bond and camaraderie. The researchers found that employee productivity improved in spite of whether lighting was raised or lowered. However, this came to be known as the Hawthorne effect. Because of the awareness of the employees about the research being carried out, they reacted independently as a result of the knowledge of being studied (Mishler 2006).

Recent Studies

Researchers and scholars have continuously showed in the issue of employee job satisfaction; therefore, studies in this area have increased in the past years (Lamarche and Tullai2009). In their recent study, Lamarche and Tullai (2009) attempted to examine the level of job satisfaction and its relationship with inherent and extrinsic characteristics of employee job satisfaction. The target respondents to the study were nurse practitioners in the Canadian primary healthcare. The researchers wanted to establish the level of the nurses’ job satisfaction and establish the factors that determined that satisfaction. The findings of their study agree with the findings of Pouliakas and Theodossiou (2005) and Stewart (2007) where both the studies found that pay affects employee job satisfaction,  in that low paid employees exhibit low satisfaction while high-paid employees show high levels of job satisfaction. Such studies have helped in offering a foundation upon which effective management functions can be strengthened without bias (National Business Research Institute 2009; also Krogstad et al 2006; Kankaanranta 2008; Bakhshi et al 2008; Zurmehly, Martin & Fitzpatrick April 2009).The studies also help in improving the strategies employed in recruitment and employee retention (Lamarche and Tullai, 2009)

The study carried out by O’Leary and associates offers a good steppingstone into understanding the various variables and factors that affect job satisfaction of physicians in the contemporary society. Though the study is based in the Russian health care system, it identifies supervisor factors, autonomy at work, flexibility of the administration, working conditions and the social recognition of the physicians as some of the salient factors that determined their satisfaction with the job (O’Larry et al. 2009).

An investigation into job satisfaction of employees was carried out by the National Business Research Institute, which revealed six statistically significant drivers that have an effect on employee job satisfaction (National Business Research Institute, 2009). Opportunity is a major driver for employee satisfaction. In relation to opportunity, employees wish to be given or presented with chances that allow them to participate in motivating projects and to be assigned satisfactorily challenging tasks which exhibit more responsibilities on their part.

Job Satisfaction Studies in the Medical and Health care fields

Moulds et al (2009) while investigating the effect of migration on the status of healthcare in developing countries observed that job dissatisfaction is one of the major causes or drivers of migration of doctors from developing to developed nations.  This observation is made in their study, which they carried out recently exploring the aspect of professional satisfaction in the Fiji healthcare system. The migration of healthcare providers is identified as a serious threat to the health status of those populations that remain behind. Moulds et al. (2009) further point out in their investigation that professional satisfaction is anchored on three main factors: professionalgrowth (where the doctor or nurse wishes to augment his or her skills in the field of choice), service  and recognition, with considerable overlapbetween categories.

Jobs satisfaction and attitude

Scientific researchers have been interested in the relationship between employee attitudes and their job satisfaction. They wish to know what causes employee attitudes and how the attitudes could be measured or influenced. At the work place, employees develop various viewpoints about many aspects that relate to their jobs. These attitudes also have an impact on how they view the organization and their careers (Diaz-Serrano & Vieira, 2005; Panos & Theodossiou, 2009 and Cooper, 2008).

Job satisfaction is the most focal point of employee attitude with respect to research and practice (Hamermesh, 2008). Job satisfaction and attitude are inextricably linked since psychologists have also showed there is a strong link between cognition and affect; such that individuals have to think about what they feel whenever they have feelings (Zurmelhy et al, April 2009).

Some research work has also delved into finding out what causes employee attitudes. Dispositional influences have been identified by researchers as one factor that causes attitudes among employees (Cooper, 2008). Earlier studies showed that dispositional influences on an individual’s job satisfaction counts remain stable for a longer period even with job changes (Wright, 2006). Childhood temperament was also identified in the studies to be related to adult job satisfaction (Moulds et al, 2009).

However, as Saari and Judge (2008) note, though disposition and temperament of  employees can lead to differences in their job satisfaction, the relationship between job satisfaction and dispositional influences need more research to bring out a better understanding of how they are related. Saari and Judge (2008) further highlight that self-evaluation is very important in contributing to the theoretical development of the literature that attempts to assess employee job satisfaction and the related factors.

Cultural influences also sway the employee job satisfaction by affecting their attitudes. Research work conducted in early to mid 1980s on cultural influences on employee job satisfaction revealed that cultural influences have an effect on job satisfaction on four basic dimensions (Panos & Theodossiou, 2009). These dimensions include:

  1. Individualism versus collectivitism
  2. Inequality in power distribution or power distance
  3. Achievement orientation (masculinity versus femininity)
  4. Uncertainty avoidance versus risk taking

Employee job satisfaction with regard to attitudes can be understood based on the four dimensions highlighted above. Different cultures will score differently based on the cultural dimensions.

Lastly, the work situation also influences employee attitudes impacting their job satisfaction. The work situation plays a major role when it comes to, not only job satisfaction, but also organization impact. Various facets that relate to work or job situation include promotion, power and autonomy, supervisor behavior, coworkers and pay among other issues. Overall job satisfaction of the employees has been found to be firmly anchored on the nature of the work assigned to the employees (Kankaanranta, 2008).

Measuring Job Satisfaction

The process of measuring employee job satisfaction has been one of great challenges social scientists have faced (Saiyadain, 2006). The challenge arises from the fact that job satisfaction is a parameter apart from being multidimensional, it cannot be observed directly and it cannot be inferred with precise accuracy (Diaz-Serrano & Vieira, 2005). Yet it remains very important to attempt measuring the satisfaction of employees with their work. For this reason, various tools have been built in an attempt to measure job satisfaction.

The most frequently applied technique is the Paper Pencil Test where standardized scales are used to collect relevant data. The scales are also tested using varied norms so that they can provide a basis of comparison for the particular groups from which the data is collected. An example of the Paper Pencil Test is the Job Descriptive Index developed in the mid twentieth century (I-Chuan et al, 2008).

Secondly, another method that has been used to measure job satisfaction is the Critical Incident Method where individual employees are given a chance to talk about the incidents in which they were specifically satisfied or dissatisfied with their work. The responses are then scrutinized to find out the fundamental themes in the satisfaction or dissatisfaction.

The researcher may also conduct an interview with a respondent or respondents to establish causes, nature and level of their job satisfaction or dissatisfaction (Krogstad et al 2006). The interview technique has an advantage in that it gives room for an in-depth questioning, thus giving an understanding of variables under measure or target factors.

Confrontation meeting is a technique that can be applied where there is a small group of employees. This technique is anchored on the assumption that individuals feel free to speak out when they are in a group rather than when interviewed individually. Thus, as they come in a group, they are encouraged to talk about the feelings they have on various factors that relate to job satisfaction.

The techniques may not be explored exhaustively in this literature as various techniques exist that can be used to measure job satisfaction. In fact, development of so many techniques shows the difficulty of measuring employee job satisfaction and it also indicates the interest that has been developed in this area and the ultimate desire to understand it exhaustively. The technique used depends on the level of job satisfaction to be measured. For instance, when global satisfaction is being measured, a different approach is used to evaluate global satisfaction and the assessment statements specifically address global satisfaction of employees with their work or job.

Theories of Job Satisfaction

Many theories have been put forward in an attempt at drawing an explanation to the relationship that exists between employee job satisfaction and various factors that influence this satisfaction or dissatisfaction. Initially, the main task was to establish the various factors or variables as it relates to job satisfaction. As the variables that are related to job satisfaction were identified through surveys, researches and studies, the kind of relationship the variables exhibit with job satisfaction became the next target of most subsequent studiers and research works.

Value Theory of Job Satisfaction

Locke proposed the value theory in 1984 in an attempt to provide a succinct explanation as to why individuals show particular feelings about their job. He argued that an individual’s job satisfaction is contingent on the fact that the individual feels is of value rather than the accomplishment or lack of fulfillment of their needs. This theory is also known as the discrepancy theory (Diaz-Serrano & Vieira, 2005) or the affect theory (I-Chuan et al, 2008).

The key principle of the value theory is that satisfaction is influenced by a difference between what an individual employee desires in a job and what is actually available for the individual in a job (Clark & Oswald, 2005). The theory affirms that the degree or extent of satisfaction depends on the degree to which an individual employee values a particular facet of the job. As such, there is a positive impact on an individual’s satisfaction when the desired value is met. The satisfaction is impacted negatively if the desired value is not met; hence, leading to dissatisfaction (Yip et al, 2009).

According to this idea, the main focal point of interest should be the outcome that individuals value without taking keen interest in the quality or quantity of the outcome. Therefore, regardless of the quality or quantity of the desired outcome, the value of the outcome is what is considered important. For this reason, the idea postulates the employee satisfaction is greater when the expected outcome is of greater value and vice versa, if the expected outcome is of lesser value then their satisfaction will also be lesser (Kankaanranta, 2008).

The discrepancy between the present employee job aspects and their desired aspects, for instance pay, promotion and learning opportunities, is an essential element of the value theory. The theory focuses on the aspects of the job that need to be changed so that the employees can experience full satisfaction. Though individuals may have different perceptions in relation to the discrepancies, the different perceptions result from the fact that not all individuals can have the same feelings (Krogstad et al, 2006).

Two- Factor Theory

This theory was formulated by Hertzberg when he contended that job dissatisfaction is not the opposite of job satisfaction. Hertzberg stated that while the presence of satisfaction motivators boosts job satisfaction among employees, the absence of these factors does not lead to employees’ job dissatisfaction, but rather it leads to lessened satisfaction (Saiyadain, 2006). This theory is also referred to as the dual-factor theory (O’Leary, 2009)

In a similar manner, Hertzberg argued, hygiene factors only lead to employee job dissatisfaction when present but do not contribute to satisfaction when absent. The findings of various research works carried out to test the validity of Hertzberg’s theory have generated mixed results.

The theory has been extensively criticized for a number of flaws especially in its methodology (Saiyadain, 2006: 61). While Hertzberg’s presupposition proposed on prior basis a correlation between the employee job satisfaction and their productivity, the methodology failed to measure the productivity though it measured satisfaction. Nevertheless, the work of Hertzberg on employee job satisfaction has stimulated the interest in the variables that play role in employee job satisfaction and dissatisfaction.

Equity Theory

This theory proposes that individuals compare themselves to others in terms of the ratio of their outcome over input. A difference in their ratio to that of others causes dissatisfaction since they will perceive it as an inequity. In order for these individuals to experience job satisfaction the ratios have to be equal for equity to be achieved. 

The equity theory, nevertheless, is based on the fact that each individual employee bases his comparison on personal perception. Despite this, organizations must strive to ensure that there is equity; otherwise, the feeling of dissatisfaction among employees may be unavoidable. Garland (2006) says that this theory is very effective for establishing the effect of equity on level of job satisfaction. for this reason, it will be consulted throughout this study.

The theory has been attacked on the grounds that it lacks sufficient precision with which it addresses feelings of inequity. This is because there are alternate ways of addressing such feelings of inequity. The theory has a strong implication in that it brings out the importance of dealing fairly with employees.

The Met Expectations Theory

Newly employed individuals develop expectations about what they expect from their employment. Even the employees who are already in the organization have expectations about their work from time to time. This is as proposed by Porter and Steers (1973: qtd. Saiyadain, 2006). If the expectations the employees have developed are not met they become dissatisfied with their job. If on the other hand, the expectations are met as the employees expected, they become satisfied with their job and become more motivated to develop greater expectations, which leads to more productivity.

In order to reduce employee job dissatisfaction according to the met expectations theory, it is important that the employee expectations be brought in alignment with the prevailing reality. According to the theory, job dissatisfaction is influenced by the inherent processes that take place within an individual. The idea is criticized on the basis that it does not put into account the individual’s social context. Individual’s social context is the backbone of the equity theory.

The Opponent Process Model of Job Satisfaction

Job characteristics may be changed to bring about an increased worker satisfaction. Nevertheless, the increased employee job satisfaction will not necessarily remain the same over time. The reason for this is the input may be maintained at a constant level, the resulting output will not remain constant.

Based on the process of adaptation, a constant input results in a decreasing output. In order for the output to be increased or maintained at a constant level, the job characteristics can be changed as time changes.

Determination of Job Satisfaction

These could be broadly divided into two: organizational determinants and individual determinants. Organizational determinants of job satisfaction include: leadership factors, working conditions, the reward system and the work itself. On the other hand, individual determinants include: age of the employee, gender, status and seniority, marital status and years of experience in the field or in the work under consideration.

Individual Factors

Individual determinants of job satisfaction are factors that are either biosocial or relate to the individual’s personality. These factors provide an opportunity for the organization to satisfy the individual employee by satisfying the employee’s individual motivational needs. The position of the individual employee in the organization has been generally associated with the level of satisfaction of the individual (Green & Heywood, 2008). In addition, literature indicates that on general perspective, the higher the position, the higher the level of satisfaction. One explanation that has been attributed to this relationship is that when an individual holds a higher status in the organization it implies that the individual has better working conditions as compared to others. The rewards the individual gets while holding a higher status are better than those received by the lower level individuals.

Age of the Employee

Literature provides evidence that age and employee job satisfaction exhibit direct linear relationship (l-Aameri, 2005). Organizational change has made the long-term workers to develop feelings of being not being needed in the organization. This especially goes with the advent of increased mergers and downsizing. With the introduction of such changes in the organizations, long-term employees feel less satisfied with their jobs while the younger employees feel satisfied with their work (Kacel et al, 2005).

Gender

Job satisfaction among doctors and nurses has been studied in the recent past (e.g. Quinlan et al. 20009) in relation to gender. Quinlan et al. (2009) while carrying out an investigation into the employee job satisfaction among the Russian physicians to establish the relationship between work attributes and job satisfaction sought to determine if gender has any relationship with the job satisfaction of these physicians.

The findings of the study revealed that on an overall scale, male physicians exhibited higher job satisfaction than their female counterparts. The study also established that the job satisfaction of the Russian physicians who work in hospitals showed lower job satisfaction as compared to their counterparts employed in polyclinics (O’Leary et al, 2009). In relation to other facets that relate to job environment, female physicians demonstrated more satisfaction in their relations with clients and coworkers than their male counterparts did. The study also found that a majority of physicians are dissatisfied with management and time constraints.

The Leadership Factor

Leadership factors include supervisory behavior and style. Research has shown that employee job satisfaction is bolstered when they perceive their supervisor to be competent. Such a supervisor is perceived by the employees as one who takes their best interests and accords them respect and dignity.

The supervisor that takes keen interest into the welfare of the employees and provides them with appropriate advice is one that employees wish to work with. This kind of a supervisor makes the employees feel more satisfied with their job.  This is according to the findings of a research study conducted recently by O’Leary and associates (2009) attempting to assess job satisfaction of nurses in Russia.

Working Conditions

Organizational policies and the work environment have been changing to align with the organizational dynamics and the rapid changes that the organization has seen over the past years. Change in the organization is one of the areas that the organization design experts have been keen of given that the change in the way of doing things dictates the working conditions as well (Green and Heywood, 2008).

The concept of working condition is broad based and it holds a defining position in the organization’s existence since it helps in managing diversity at work (Quinlan et al, 20009). Employee job satisfaction has also been found to correlate to their satisfaction with co-workers and the supervisory style. All these are factors relate to working conditions, which have been found to relate to employee job satisfaction.

The Reward System

Saiyadain (2006) contends that there is sufficient evidence, which suggests that an organizational reward system is a significant contributor and determinant of employee job satisfaction. The reward system includes the pay and other monetary benefits that given to the employees. Studies have shown that organizational reward systems have a direct relationship to the level of employee job satisfaction (Barriball et al, 2009).

The organization’s method of dealing with payment of benefits and how it distributes promotions, both determine the levels of satisfaction of the organization’s employees (Quinlan et al, 20009).  Research studies have pointed to the positive relationship between fair reward system and the employee satisfaction. The employees perceive the fairness of the organizational reward system in terms of the level of the compensation they receive and the method the organization uses to distribute the pay.

It has been found that employee job satisfaction increases when they are given flexible fringe benefits where they select their own benefits (Saiyadain, 2006).  This implies that the overall employee job satisfaction increases while at the same time boosting their satisfaction with the reward system.

Saiyadain (2006) adds that the top management in the organization is more responsive to the relationship between their satisfaction and the pay they receive. However, as indicated earlier from the findings of the Hawthorne studies, not all research studies have come up with evidence to support a strong positive correlation between job satisfaction and the pay or salary.  Even the Hawthorne researchers concluded after conducting their studies that the employee salary or monetary benefits are not necessary for the employee job satisfaction. Some other studies have also indicated that the two variables (salary and employee job satisfaction) do not have any relationship (Saiyadain, 2006). With that being said, more research needs to be carried out in this area as the already available literature does not offer sufficient evidence for drawing a conclusion.

The Work itself

There are a number of factors at work, which interact to determine the level of satisfaction in the employees. Flexibility given to the employees in performance of their tasks, the freedom they have and discretion available to them are very important contribution to their satisfaction at work and with the work itself.

As opposed to that, when employees are assigned ambiguous tasks and given confusing instructions that lead them to fail to clearly understand their job they felt dissatisfied with their job in general (Lamarche & Tullai, 2009). Low job satisfaction among senior management has been found to relate to the nature of work itself (Neal & Woloshynowych, 2005).

Effect on Performance

The effect of job satisfaction on the performance of employees has been one of the most frequently examined facets of the variables as it relates to employee job satisfaction (Stewart, 2007).  The relationship between job satisfaction and employee performance is yet to be fully resolved for a better understanding. Research has been carried out which shows that the individual employee’s experience of work is multifaceted making job satisfaction to be of a complex nature (Panos & Theodossiou 2009; also Green & Heywood, 2008).

Job performance of employees is related to their satisfaction with an extended interrelationship through other facets, which have to be considered when investigating the relationship between these variables. In their study, Green and Heywood (2008) attempted to investigate the relationship that job satisfaction has with employee job performance. They posit that the study not only revealed a strong interrelation between other contingent variables like dispositional factors and affective disposition but also the findings of the study demonstrated that the contingent variables strongly interact to influence job satisfaction and ultimately employee performance. The same observation on the relationship between job satisfaction and other contingent variables had earlier been made by Grund and Sliwka (2005).

The study comprised a sample of 270 employees selected from among the managerial positions in the hotel chains in the US. The study gave a good understanding of the interactions of the various factors that lead to negative and positive affective disposition. Though the researchers postulated a positive relationship between employee job performance and their job satisfaction, the research did not bring out a coherently understandable relationship between the two variables (Yip et al, 2009).

More research still needs to be done to investigate fully how job performance relates to job satisfaction. As more researchers continue to develop interest in the study of employee job satisfaction on a broader perspective, one factor that significantly attracts the researchers’ attention is that organizational dynamics call for improvements in the job designs, betterment of the work organization and improved quality of the work settings. These improvements can only be achieved when the impacting factors are well understood to attempt any change.

Job satisfaction was earlier on viewed as positively and directly related to performance in that satisfied employees were expected to perform better. Another perspective is that rather than employee satisfaction leading to their improved performance, their performance leads to satisfaction. Thorough research has yet to be achieved to bring out a succinct understanding of the relationship between the two (Lamarche & Tullai, 2009).

On general perspective, as Stewart (2007) notes, a number of factors determine employee performance. These factors include their motivation at work, employees’ desire to do the assigned job, their capability or capacity to do it, information they need to do the job and the work environment. Understanding of these factors is helpful for the managers to have less challenging tasks in their wok. The intangible nature of most of the factors makes their influence on the employee performance significant since they call for a keener evaluation. Training, environmental adjustments and replacement of the worker are some of the tools available to the manager to solve issues related to lack of ability among employees and environmental problem unfavorable to the employees.

Some studies have suggested that research has not found significant relationship between satisfaction and employee productivity at work. This means that those who have sought to confirm that a satisfied employee is also a better performer or a productive worker have not successfully been able to substantiate their claims with any statistically significant findings (Barriball et al, 2009).

Effect on Turnover

When a non-performing or a low-performing employee leaves the organization, this could be beneficial to the organization. On the other hand, if an important and valuable employee exits from the organization the organization incurs a loss in addition to the cost of training and nurturing another pool of human resources of the same tacit knowledge and expertise to fill the gaps that have been left by the exiting personnel. However, more research probably needs to be done in relation to this to substantiate as not many studies have been carried out to debunk it (Saiyadain, 2006)

High labor turnover and absenteeism have generally become to be associated with employee job satisfaction. Saiyadain (2006) notes that the cost associated with employee turnover can be approximated to fall between 50 and 100 percent of the entire employee’s cost taken on annual basis (excluding the cost of tacit knowledge). Given this cost, the implication is that employee turnover erodes  the organization’s operating profits.

The negative effects of high employee turnover in an organization make this area one that needs more inquiry. Long-term effects like poor revenue growth can easily lead to the collapse of the organization if it is not balanced. Dwindling net profits because of turnover costs may hinder any chances of expansion and contribute to increased poor revenue growth.

Employee Creativity

Research studies have pointed to the statistical significance and consistency of employee creativity as a predictor of their peak performance. The desire to establish the underpinning relationship between employee job satisfaction and the creativity sprouts from the fact that while change is inevitable in the organization, innovation is of great importance to guarantee survival of the organization (Foley et al, 2006).

It is amazing that various researchers have found that creativity is inversely related to the employee job satisfaction (Panos & Theodossiou, 2009). The researchers (Panos & Theodossiou, 2009) continue to note that even though low and high pay will cause a difference in the job satisfaction of the employees, the employees who are less satisfied with their job exhibit high levels of creativity than their counterparts who are highly satisfied. These views are also supported by Arnold, Cppoer and Robertson (2004) who note that conditions of dissatisfaction with work made the workers who were dissatisfied more creative than their satisfied counterparts.

In addition, Saiyadain (2006) adds that the employees who feel dissatisfied will exhibit higher creativity in conditions where they experience high continuance commitment; their co-workers give them feedback, or the co-workers provide help and support. Moreover, the employees who feel dissatisfied also perceive that the organization highly supports their creativity. This illustrates how all these factors interact to influence employee satisfaction. It becomes almost impossible to specifically point to one factor on a singular basis and claim that it influences employee satisfaction without incorporating the other factors. 

Absenteeism

A variety of studies have attempted to investigate the relationship between absenteeism and job satisfaction. This is because absence is generally viewed as one of the ways of getting out of stressful work situations. According to Foley et al (2006), research has generally showed that employee job satisfaction is consistently and inversely related to their absenteeism. This implies that as employee satisfaction increases, absenteeism tends to reduce and when their satisfaction reduces, absenteeism increases.

The underlying assumption when carrying out the investigation of the relationship between absenteeism and job satisfaction is that at least absenteeism results from employee job dissatisfaction (Foley et al, 2006). This assumption is further supported by a study carried out by I-Chuan et al (2008). In their study, though the researchers set out to investigate the relationship between job performance and satisfaction, they also highlight in their secondary findings that absenteeism had a correlation with job satisfaction.

 Research studies further indicate that the impact of job satisfaction is exhibited by the frequency at which an employee is absent from work as opposed to the number of days that employee stays out of work or absent. The inference that can be made from already carried out studies is not conclusive enough to give clear cut substantial claims that can be supported with statistical significance. Despite this gap in the available literature, Foley et al. (2006) observes that it still makes sense to make a general assumption that employee job dissatisfaction will lead them to miss work. Foley et al. (2006) posit further that the complexity of employee absenteeism as a variable may not allow the assumption to be taken easily at the surface observation of employee behavior.

On the other hand, Kacel, Miller and Norris (2005) note that organizations with generous sick leave benefits might possibly be encouraging their staff to take sick leave. Foley et al. (2006) indicate that it is imperative for organizations to recognize the repercussions of satisfaction on the job as it might lead to employee absenteeism. Absenteeism can become very costly to the employers in the end.

Mental Health

Good mental health has generally been associated with high-expected job satisfaction. Research studies accomplished in early 80s concluded that employees who have good mental health are faster at learning job-related tasks than those who have bad mental health (Bakhshi et al, 2008).

Good mental health is also associated with a smaller amount of accidents at work and reduced number of grievances. When employees experience high degrees of frustration at their place of work, this could lead to an impact on their life and mental health. Prolonged dissatisfaction may either aggravate the frustration or result in it Krogstad et al. 2006).

Individual’s Culture

Cultural disposition has been identified as one of the major factors that interact to influence employee job satisfaction. There has been a steadily increasing interest by researchers to investigate the impact of culture or country on the employee job satisfaction and their attitudes (Foley et al. 2006).

Bakhshi et al. (2008) noted that the organizational dynamics and the general wave of globalization, which have affected the organization, have brought new challenges with them, which in turn, pose a significant challenge to the human resources practitioners. Bakhshi et al. (2008) continued to point out that research in the area of cross-cultural organization and human resources should be increased because it is of help to these practitioners who need the knowledge for better understanding and guidance.

Though a vivid analysis of cross-cultural effect on employee attitudes was carried out between early 80s to mid 80s by Hofstede (Angerer, 2003), some recent studies have also attempted to illustrate the relation between employee job satisfaction and their attitudes (Bakhshi et al, 2008).  These works and the earlier ones have given a clearer picture of how the workers attitudes are influenced by the cross-cultural effect. The employee attitudes include their job satisfaction among other attitudinal facets mentioned earlier in the chapter.

Although the research studies that have been conducted earlier and in the recent past have given a better understanding of the connection between employee attitudes and the country or culture, more research would help in understanding the consistency of the relationship across the vast professional fields. For instance, there has been limited research in the connection between employee attitudes and their culture or country in the health care industry (Saiyadain, 2006). 

Other Spheres of Life

The interplay between employee job satisfaction and life satisfaction has recently become a subject of scholarly inquiry (Grund & Sliwka 2005). Researchers have hypothesized that there are three likely forms of the relationship between employee job satisfaction and their satisfaction in life. The first possible form of the relationship is spillover. This involves job experiences spilling over into non-work life and vice versa (Saiyadain 2006; 61- 67; also Bakhshi et al. 2008).

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Secondly, segmentation may also bring a strong relationship between employee job satisfaction and their satisfaction in life. On the perspective, of segmentation, job experiences have little or nothing to do with life experiences and in the same manner, life experiences have little or nothing to do with job experiences.

The third form is competition. At work, employees have their expectations, which they expect to be satisfied. If their expectations are not satisfied as such they get dissatisfied, then they can only compensate for that by seeking for a fulfillment that is accompanied with happiness in the non-work life (Stefanie et al, 2009). 

One study carried out in Germany (Bates et al. 1995) revealed there is a complex interrelation between job satisfaction of doctors and the end user  which, in turn, is intermarried with improved compliance, continuity and eventually better outcomes. These findings are also in agreement with the findings of Cooper (2008). Cooper (2008) observes that because of this knowledge about job satisfaction of doctors and nurses, it should help in strengthening the complex intermarriage of various variables across the board with respect to satisfaction of healthcare providers and the consumer of the services; satisfaction of one is dependent on satisfaction of the other in one or more ways.

Chapter Conclusion

Evaluation of the historical overview of job satisfaction reveals that job satisfaction started gaining impetus as an area of academic concern in the last century despite organizational behavior having emerged in the 18th century as a field worth attention (Grund & Sliwka, 2005). This shows job satisfaction is still young as an area of serious academic inquiry, especially considering that serious inquiry into this facet of the work setting begun just recently in the 60s to 80s (Clark, and Oswald, 2005; l-Aameri, 2007; Cppoer et al. 2004).

For that reason it is imperative for the organization to measure job satisfaction to gain understanding of the various drivers that influences the job satisfaction of the employees, various techniques that are used to measure job satisfaction have been explored. The difficulty that goes with any method adopted to measure job satisfaction is that job satisfaction is attitudinal and not observable. In addition, it is multidimensional, and cannot be observed directly and it cannot be inferred with precise accuracy (Diaz-Serrano & Vieira, 2005). This means that each technique finds its application depending on number of employees targeted as respondents, the work setting and the scope of measured.

Evaluation of the determinants of employee job satisfaction indicates that these factors can be classified into two broad categories: individual factors and organizational factors (Angerer, 2003). The available literature conflicts with the relationship of some of the factors with job satisfaction (Stefanie et al. 2009). Nevertheless, they provide good starting point for any future studies.

Having carried out the evaluation and scrutiny of the literature available from various studies, the next chapter shall attempt to propose the approach that can best fit the study. The research method chapter shall attempt to develop the tools that the study will make use of to collect, evaluate, analyze and interpret the data collected.

Chapter Summary

The review of the literature reveals that though the interest in investigating employee job satisfaction has been escalating since the start of the last decade, the research studies that have been conducted have mostly been broad and they have targeted developed systems. The broadness of the studies may make it difficult for a particular dimension of the job satisfaction to be explored thoroughly for a better understanding and for clear conclusion to be drawn from the results. By targeting the developed systems, the studies may make the external validity of the findings limited.

Most research studies have been broad-based and do not highlight the in-depth relationship between a particular variable and employee job satisfaction. As Bakhshi et al (2008) states, job satisfaction of employees is very important as it also influences other spheres of the individual employee’s life.

In summary, this chapter has delved into an examination of diverse literature and  has attempted to investigate job satisfaction through an in-depth review, critique, and analysis. Most recent studies have also been scrutinized. These studies are defining to the quest for knowledge as they give light of whether there is any change in direction of employee job satisfaction given the rapid organizational changes and change in the work settings.

With the examination of an exhaustive amount of literature undertaken, the researcher must also perform actual primary research.  The researcher will present a plan to undertake this scholarly inquiry in the next chapter.


CHAPTER 3: RESEARCH METHODS

      The purpose of the proposed phenomenological quantitative research study will be to discover the perception and level of job satisfaction of Omani doctors and nurses. The study seeks to explain the influence of demographic factors, intrinsic factors and extrinsic factors on the degree of job satisfaction among Omani doctors and nurses working in Ministry of Health hospitals in Muscat, Oman.

      The study intends to use various tools to explain the influence of these factors on the job satisfaction of the physicians working in the Ministry of Health hospitals in Muscat, Oman. The intrinsic factors to be examined include factors identified by Kacel, Miller and Norris (2005). These are achievement, recognition, advancement, responsibility and patient mix. Extrinsic factors as identified by the same scholars are also examined. These include salary, supervision, organization policy and administration, working conditions and involvement din research. Demographic factors (age, gender, educational qualification) are also examined.

Research Method and Design Appropriateness

      The study would utilize primarily quantitative methods of fact data collection and analysis. The idea would be to examine, on the one hand, the status of Omani doctors and nurses in keeping with the intrinsic and extrinsic factors already outlined, it will also aim at an exploration of the various factors that act as drivers to the satisfaction. To this end, the research will use primarily the quantitative method given the essentially empirical nature of the study that provides very little to no space for value judgments of any kind. The idea will be to establish, first and foremost, a relationship between the factors outlined and job satisfaction. If one were to assume that job satisfaction is a positive correlation of achievement, recognition, advancement and responsibility through the quantitative method of inquiry, one could investigate the relationship of influence between various factors such as demographic, intrinsic and extrinsic on the degree of job satisfaction among Omani doctors and nurses.

      The research design for this study will be descriptive. Ayelet, Lingard and Levinson (2008) state that the primary concern of such studies should be to find out “what is?” By conducting the study, the research intends to assess the following:

a)  The intrinsic levels of job satisfaction of doctors and nurses in the Omani Ministry of Health hospitals in Muscat.

b)  The extrinsic levels of job satisfaction of doctors and nurses working in the Omani Ministry of health hospitals in Muscat, Oman.

c)   The extrinsic, intrinsic and general job satisfaction levels of these physicians with respect to the demographic variables mentioned above.

d)   The satisfaction levels for various dimensions of the job.

e)  Their job satisfaction level for each of the various dimensions with respect to the mentioned demographic variables.

      As such, the study will endeavor to identify and explain, using a “Pearson Correlation”, the influence of demographic factors as well as factors identified by Kacel, Miller, and Norris (2005) as intrinsic (achievement, recognition, advancement, responsibility and patient mix) and extrinsic (salary, supervision, organization policy and administration, working conditions and involvement in research) on the degree of job satisfaction among Omani doctors and nurses working in Ministry of Health hospitals in Muscat, Oman.

Population, Sampling and Data Collection Procedures and Rationale

For part of the interview, the study intends to use a letter of invitation to clarify what the research study is about and give clarification of the estimated or approximate duration of the survey. The letter will also be an opportunity to explain the purpose of the study, assure the respondents of confidentiality and emphasize to them that contribution is voluntary and one can take part or refuse to take part. The research would be based on the usage of inferential statistics collection and analysis.  Asadoorian and Kantarelis (2005) suggest that inferential statistics utilize probabilistic techniques to analyze sample information from a certain population (known part) to improve knowledge about the population (unknown whole). If data is defined as information that has been collected from observations, counts, measurements, and responses, inferential statistics are those that seek to arrive at a conclusion that would extend further than the direct data by itself.

The idea would be the usage of inferential statistics in order to ‘infer’ or glean information from the collected samples and data with respect to what the unknown whole might think. Latham (2006) concludes this would help in the creation of conclusions about matters that are mostly subjective through methods that are empirical, thereby ensuring some kind of definite (scientific) results about something that is usually difficult to predict. One normally uses inferential statistics to make judgments of the probability that an observed difference between groups is a dependable one or one that might have happened by chance in this study. Thus, the study will use inferential statistics to make inferences from the data to more general conditions.

Given the fact that the study would be using the Minnesota questionnaire, the basic data collection method would be a paper-and-pencil inventory that would seek to make an assessment of the degree to which vocational needs and values are satisfied on the job in the context of Omani doctors and nurses. The MSQ Long Form requires 15 to 20 minutes to complete. The Short Form requires about 5 minutes. Unless the 15 to 20 minutes required for the Long Form is impractical, the Long Form would be used, as it provides much more information for the short additional administration time required.

     The usage of inferential statistics for this research would ensure there is flexibility allowed to the research which is necessary in making a study about a subject as subjective and individualistic as the phenomenon of job satisfaction obviously would be. This may further enhance the understanding of job satisfaction through the perspective of doctors and nurses and help ignite inductive reasoning that can be used to draw out conclusions (Grinnell & Unrau 2007).

For the purpose of the study it becomes essential that one defines the term sample. Sample is a subset of a population, selected by either ‘probability’ or ‘non-probability’ methods.  The portion of the population selected for analysis is called the sample, thereby making the method one that would aim at arriving at conclusions, about a population that is contained in a sample. One of the main reasons why the use of inferential statistical methods would be useful in this study is because of the fact that more than anything else, the study would be modeled along the lines of a poll. The idea, in essence, is to tabulate the levels of comfort and satisfaction as far as doctors and nurses are concerned in the country of Oman. This could be computed by taking into consideration the confidence interval.  For this purpose one would first have to tabulate the mean of the sampling distribution is which could be symbolized as μ and the standard error of the mean which is arrived at by the following formula:

            After a set of data has been established, one would have to calculate the 95% confidence interval for the mean. This could be done with the help of the following formula:

Lower limit = M – Z.95σm
Upper limit = M + Z.95σm

The formula could be interpreted as follows: In cases where the Z.95 is the number of standard deviations expanding from the mean of a normal distribution required to contain 0.95 of the area and σm is the standard error of the mean. Stephens (2006) believes this would mean on closer inspection that the standard deviation would need to be known (σ) so the mean is able to be calculated. Babbels (2005) believes this might seem impossible or even impracticable and to an extent it actually is. Nevertheless, while calculating the confidence interval when σ is known is simpler than in a case where σ has to be predicted, thereby serving a pedagogical purpose. Z.95 could be calculated through the usage of a normal distribution calculator and through the specification of the fact that the shaded area is 0.95. This would also be indicative of the fact that one wants the area to be between the cutoff points.

In such cases, given the fact that the variance is unknown and has to be figured out from the use of sample available, one would be using the t distribution method rather than the normal distribution and given the fact that the sample size is large; the t distribution would be similar to the standard normal distribution. The values of t to be used in a confidence interval would be looked up in a table of the t distribution. The next step in this context would be the calculation of the standard error of mean using the formula stated above. The value of t would then be calculated and finally, the confidence interval is computed using the formula:

Lower limit = M – (tCL)(sm)

Upper limit = M + (tCL)(sm)

Sample size determination is based on the following formula extrapolated from http://www.surveysystem.com/sample-size-formula.htm whereby sample size is calculated based on specific details provided and the website generates an answer based on the built-in sample size calculator:

Sample Size:

  ss = Z 2 * (p) * (1-p)
c 2

Where:

Z = Z value (e.g. 1.96 for 95% confidence level)
p = percentage picking a choice expressed as a decimal
(.5 used for sample size needed)
c = confidence interval expressed as a decimal
(e.g., .04 = ±4)

Retrieved November 22, 2009, from http://www.surveysystem.com/sample-size-formula.htm

The following research would be modeled on a larger sample size that would consist of medical practitioners, both doctors, and nurses. Since the purpose of the study is to determine the job satisfaction levels of doctors and nurses working in the Omani Ministry of Health hospitals in Muscat, 500 nurses and doctors will be randomly selected and a survey will be sent to them  (Mishler 2006). A safe sample size of about 10% of the total number of physicians and nurses in the target hospitals will cover the required sample size calculated by www.Surveysystem.com sample size calculator that came out to be 355. Having an extra sample size of 145 participants will ensure that a confidence level of 95% will be reached even if some participants do not return back the survey. For the purposes of efficiency, representative effectiveness, reliability and flexibility of the sample, a proportional stratified random sampling technique will be used. Muscat has about 4,680 nurses and doctors and a sample of 500 will be selected for the study.

            There are also other variables that one would use for the purely quantitative capacity of the research. The Likert Scale surveys will be distributed to two major hospitals in the Muscat region. These will be alongside a sealed envelope for subjects to return the survey. They will be sent to at least 500 subjects. Other than demographic information, the doctors and nurses’ job satisfaction questionnaire will focus on respondents’ level of organizational commitment, job satisfaction and apparent organizational support. All elements of organizational commitment and perceived organizational support will be responded to on a 5-point Likert Scale. The response to the job satisfaction will be based on a 5-point Likert Scale. Total scores on each measure will be obtained by averaging across items.

The dependent variable (job satisfaction) will be measured by the Minnesota Satisfaction Questionnaire formulated by Weiss et al (1967) with an approximate Cronbach’s alpha of 0.91.  The predictor variables will be measured using the various elements designed in the questionnaires for collecting data on the various elements. Reliability will be measured with reference to a prior Cronbach’s alpha of 0.70 (Moulds et al 2009).

Validity

Internal Validity

      The internal validity of the research is low as with most field research. A number of factors are likely to impact the response of the respondents. Some of the factors that have been identified to cause an impact on the internal validity of a study include the following. First, reactivity effects or the Hawthorne effects may have an impact on the internal validity where they respond, not because of the procedures of the study but simply as an independent response or reaction to being studied. For instance, in the Hawthorne study, the researchers found though they had created different environments for the employees, the workers’ productivity just kept increasing. They made a conclusion that the workers were merely responding, not because of the experimental conditions that had been created but because of their awareness of being studied.

      Another notable threat to internal validity is selection bias. Since participation in the study by respondents is voluntary, selection bias is likely to affect the internal validity. Wood and Haber (2009) noted that in most studies in which target respondents decide themselves whether they wish to participate or not face the impact of selection bias. Instrumentation is also identified by the scholars as another factor that affects internal validity. In this threat, any change or alterations made in the measurement of variables or changes in the techniques of observation may justify changes in the measurement that is ultimately obtained. A high-quality way of dealing with this threat is to ensure consistency of the instruments used and techniques applied in the study.

      Another threat that may cause a considerable impact on the internal validity of this research study is the hypothesis guessing threat. This threat is exhibited where the respondents base their reply and behavior on what they perceive the study to be about, responding as a reaction to the study rather than just responding to the survey program. The researcher will minimize the impact of this threat by clarifying to the respondents the concepts of the study before the actual study commences.

      A history threat may also pose a hazard to the internal validity of the study. Given that the study examines job satisfaction of doctors and nurses based on various levels and variables, historical events that might have taken place in the recent past may influence the outcome. For instance, if the respondent had recently been at loggerheads with the supervisor over other issues, this could influence the response given by the interviewee. This threat to internal validity is more often experienced where such an event happens between the pre-test and post-test.

Since the researcher intends to make a prior request to the administrators in the Omani Ministry of health hospital under study and to the relevant authorities, another threat that may come into play is the testing threat where participants carry out their own research, which may affect the actual study by acting as a pre-test study. Mortality threat may also hamper the credibility of the internal validity where respondents drop out of study leading to an inflated measure of the revealed effects.

These threats will be addressed through randomization, careful and systematic consideration and elimination of alternative causes of particular responses as much as possible and putting plausibility into consideration.

External Validity

      The external validity as it relates to the extent to which the results of the study can be generalized to particular populations, settings or times for instance, where there is true random sampling of the respondents with random assignment. It also relates to the extent to which the results of the study could be generalized across particular populations, settings and times. This is a serious threat to external validity since the results of the study may not hold across all groups despite the use of true random sampling. The salient threats to external validity of the study are related to the extent of generalization that can be drawn from the study. First, whether the results of the study can hold for all times is a threat that sprouts from the interaction of history and treatment. Secondly, the interaction of selection and treatment poses the uncertainty of whether the results of the study stand across all groups. Lastly, it may be uncertain whether the results of the treatment may hold across all settings.

The biggest limitation is the trend in quantitative research to look for bigger patterns in small patterns. The generalization issue is one that would need to be correctly contested and addressed. Moreover, there would automatically be the issue of ensuring the research is able to find implications and importance in further researches. The idea would be to ensure there is a correct generalization available along with subscribing to the essentially quantitative view that random events be predictable. The problem here would be:

  1. The answers would depend primarily on the opinion of the respondents.
  2. The contexts would have to be described in detail.
  3. Social change is the aim of the research, the very essence of the research is thus subjective; predicting behavior is always going to be tricky.
  4. The research approach is not very flexible.

      In order to reduce the impacts of the threats to external validity, the researcher has identified the target population (the doctors and nurses working in the ministry of health hospitals in Muscat, Oman). In addition, the researcher will ensure that the samples sampled out are representative.   

Data Analysis

Statistical data analysis

All categorical items with reference to job satisfaction will be transformed to an ordinal scale that ranges from the minimum value (ie. do not agree at all) to the maximum value (ie.fully agree). Items or questionnaires that do not receive a response will be coded as missing values. Scale values will be calculated as the average or mean of the single items. All items are assumed consistent with characteristics of a normal distribution.

The qualitative data will be coded appropriately to allow for the possibility of handling it using quantitative techniques. For this reason, appropriate segments will be demarcated within the qualitative data and then coded. Highly structured data (ie. open-responses from respondents) will be coded without subjecting it to any further segmentation. This makes such data analyzable using both qualitative and quantitative techniques (Denzin and Lincoln 2005).

Descriptive statistics and Analysis of Variance (ANOVA) will be performed to evaluate whether there is significant relationship between job satisfaction of doctors and nurses working in Omani Ministry of Health and the various quantitative variables like demographic factors. The relationship between the various variables will be measured through the Pearson product-moment correlation coefficients (Grinnell & Unrau 2007).

            Hierarchical regression analysis will be applied to investigate the degree to which job satisfaction is contingent on physicians’ needs and resources. The variables will be arranged in different hierarchical steps. The first step will entail assessment of the background variables such as years of experience of the respondents, their age and gender. In the second step, personal resources will be evaluated to establish their relationship with job satisfaction of the respondents. In this step, personal resources akin to optimism will be assessed to establish how they relate to job satisfaction of the doctors and nurses. Job demands such as the quantitative demands and emotional demands will also be assessed while another step will entail an evaluation of the job resources, for instance, social support at workplace and leadership.

All the p-values will be two-tailed. P-values of less than 0.05 will be considered significant given that the significance level will be 0.05 or 5%. The values will be given as mean and standard deviation and the data will be calculated using SPSS Version 16.

Chapter Summary

Ayelet, Lingard and Levinson (2008) corroborate qualitative interviews for being a flexible and powerful tool that can be used open up many new areas for research. It can enable researchers in different fields to explore research questions of immediate bearing to their everyday work (Bryman & Bell 2007). This chapter has succinctly provided the rationale for the research approach giving a vivid clarification of how the descriptive statistics will be applied to achieve the desired goal. The concepts of internal and external validity have been addressed in the chapter and methods of addressing the threats to this validity also highlighted. The external validity is influenced by threats that relate to people (or populations), settings (or places) and times (or settings). This concept is well illustrated by wood and Haber (2006).

In data analysis, the demographic variables will be described using frequency, percentage and other measures of central tendency like mean and standard deviation. One way ANOVA and independent T-test will be used in examining the comparison of job satisfaction among the respondents (Scott 2005). 

The researcher will carry out extensive data analysis, as described above once the proposal is approved and permission is received to commence research.  The data analytical steps and the research findings will be described in detail in the next chapter.

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