Job satisfaction and its related factors among nurses in Taif hospitals, Saudi Arabia: A Cross-sectional study

Introduction

According to the previous reports, nurses represent a larger sector of the workforce in the Saudi healthcare system (1-3). Numerous studies have identified job satisfaction as the main predictor of better performance among nurses. In addition, the job satisfaction of nurses was recently linked to a lower risk of mortality (4-7). Nursing job satisfaction is defined in the literature as the extent to which nurses feel fulfilled and motivated in their duties, measured using specific scale (8, 9). The psychological pressure among nurses was defined in literature as the stressors and mental challenges experienced by nurses in the working settings (10).

Nursing is considered one of the most difficult and important professions. Nurses are exposed to different degrees of psychological pressure, and the intensity of that pressure increases when what they want does not match the size of those pressures, and this is what causes them to feel a state of job dissatisfaction (11, 12). Several studies have been conducted in Saudi Arabia showed that nurses and nursing students expressed different degrees of stress and anxiety due to various factors (13-18).

The lack of job satisfaction among nurses brings many problems to the effectiveness of the profession (9, 19). Job satisfaction is a psychological state in which the employee’s personality is integrated with the duties of the work (20). The more nurse is satisfied with the work, its nature, and the surrounding environment, this leads to a higher level of performance and efficiency in the quality of providing effective and successful nursing care (21). Therefore, paying attention to the job satisfaction of nurses working in health sectors is particularly important in improving nurses’ satisfaction.

However, nurses are facing more than just the usual professional challenges, and many of them go beyond their workplaces (22). The issues governing job satisfaction among nurses in Taif City include the leadership styles demanded as well as the extraordinary pandemic challenges that arose during the COVID-19 period (23, 24). Job satisfaction for nurses in Taif City is multidimensional and involves some of the major forces at play in the current nursing environment. Indeed, job satisfaction greatly impacts retention and performance, along with their healthiness as nursing professionals (25).

The satisfied nurses with the environment and work, this reflects the quality of care provided to patients, as nurses’ satisfaction increases their level of performance in providing health care, so its quality is high and safe for patients. Job satisfaction enhances team spirit, enhances communication between them, and makes nurses feel comfortable and confident in the work environment (26-29). Moreover, a previous study by Al-Hammouri F. el. al., have reported that hospital environment affect nurse care quality and the authorities should consider this factor when improving the quality of care (30), while other studies conducted in Saudi Arabia nurses and nursing students faces several challenges preventing them of providing high quality of care (1, 6, 11, 13, 15, 18, 31, 32).

Nurses are indeed the key players in healthcare, making it possible to give meaningful care that ensures positive patient outcomes and improves the effectiveness of healthcare systems (33). A case study of the nurses’ job satisfaction in the city of Taif in Saudi Arabia is thus presented as an exercise aimed at exploring the nurses’ job satisfaction, taking into account the city’s unique sociocultural dynamics and ever-changing healthcare setting (25). The nursing profession is dominant by female nurses within the culture of Saudi Arabia and interpersonal relationships with the sector (34, 35). Furthermore, a recent systematic review has identified that job satisfaction of nurses in intensive care units depends on lack of experiences and working conditions (36).

However, several studies have investigated the phenomenon in the context of Saudi Arabia, this study is contributing differently into the literature by investigating job satisfaction in four governmental hospitals. Furthermore, studying the challenges and problems faced by nurses helps officials and management take corrective measures to improve the nurses’ satisfaction and their overall performance. The current study aims to assess nurses’ satisfaction and its related factors in Taif, Saudi Arabia. While the study findings provide exploration for job satisfaction among nurses in Taif city, they are shaped by the region’s specific context and the findings could be applicable to other cities in the Kingdom of Saudi Arabia.

Materials and Methods

Study design:

A cross-sectional study design was utilized to assess nurses’ satisfaction in four hospitals in Taif City. The study utilized a quantitative approach to investigate nurses’ work satisfaction in Taif City. In this study, researchers distributed structured surveys among nurses in four healthcare hospitals in Taif City.

Study setting:

Study was conducted in Taif city, Saudi Arabia. It was conducted in four hospitals. The distribution of questionnaires was as follows,

Hospital name	Type of hospital	Number of participants
King Faisal Hospital	Governmental, General Complex	29
King Abdulaziz Hospital	Governmental, General Hospital	30
Children’s Hospital	Governmental, Children Hospital	19
Shahar Mental Hospital	Governmental, Mental Hospital	22

Study population:

The study was conducted on nurses working in hospitals in Taif, Saudi Arabia. The total nurse’s population was 4935 in the city of Taif. It was conducted in the period April to May 2024.

Sampling and sample size:

A convenience sampling technique was used in this study. The nurses working in the four selected governmental hospitals were invited to participate in the study. The total sample size was one hundred participants. The sample size was calculated using sample size calculator through http://www.raosoft.com/samplesize.html. The total population of 4935, margin of error of 9.7, confidence of ninety-five.

Data Collection

Data were collected through a survey questionnaire designed for this purpose. The researcher collected the data and reviewed them to ensure the completeness of the answers and to exclude incomplete questionnaires. Social and demographic variables, including gender (male, female), marital status (married, single, divorced, widowed), and the nurses’ educational qualification and extent of job satisfaction were collected. Processes began by sending the study package to participating nursing administration departments. The packages included information on the study, a poster, and an electronic link. These departments then sent the packages to their nursing staff through E‐mail, using Barcode if they wanted private for identification. The link directed potential participants to the study’s electronic questionnaire within the researcher’s account on the Google Forms Survey website. Participants were asked to open the link to participate and respond to the questionnaire with an estimated total response time of 5-7 min. The survey link was distributed to all nurses working in the hospitals while the researchers received one hundred complete responses.

Study instrument:

Participation in the study was voluntary; therefore, responding to the study questionnaire was accepted as consent by the participant. The study instrument was adapted from one job satisfaction scale by Warr et al., 1979 (37). It consists of several items on various aspects related to factors of job satisfaction. The tool was assessed on ten nurses working at different hospital in Taif city, the reliability and consistency of the test were acceptable, and the Cronbach alpha was 0.78 indicating acceptability of the tool. A Likert scale of five responses was used to measure the satisfaction of nurses ranging from strongly disagree (0), disagree (1), neutral (2), agree (3), and strongly agree (4). The total number of questions was twenty-one items, and the overall satisfaction was measured out of eighty-four points, a cut point of forty-two out of eighty-four was used to divide the responses into satisfied if more than forty-two and dissatisfied if forty-two or less. The percentage of 50% was considered as cut point for satisfied or unsatisfied.

Data analysis:

The data were analyzed by Statistical Package for Social Sciences (SPSS) version 26. Descriptive and inferential statistics were applied to analyze the data. A confidence interval of 95% was used in this study. The descriptive statistics includes frequencies and percentages in addition to the graph presenting overall satisfaction. The inferential analysis includes a Chi square test to identify the differences between demographics and overall satisfaction groups, p-value less than 0.05 was considered as a significant association.

Results

Table 1 shows that the study was conducted among one hundred nurses working at four governmental hospitals in Taf, Saudi Arabia. They were from both male (40%) and female (60%), about 48% of them were married followed by 32% single and 12% were divorced. Regarding their education, 74% have bachelor education, followed by diploma by 13%, master’s by 6% and higher diploma by 5%. They were mainly between 25 to 40 years old.

Table 1: Sociodemographic characteristics of nurses in Taif, Saudi Arabia
Variables	Freq (%)
Age	25-40 years	85 (85%)
41-60 years	15 (15%)
Gender	Male	40(40%)
Female	60 (60%)
Marital Status	Married	48(48%)
Divorced	12(12%)
Single	32(32%)
Widowed	8(8%)
Nursing Qualification	Diploma	13(13%)
Bachelor’s	74(74%)
Higher Diploma	5(5%)
Masters	8(8%)

Figure 1 shows the percentages of nurses who were satisfied with their current jobs in Taif four hospitals. It indicates that 83% of nurses were satisfied with the job while 17% were not satisfied with nursing job.

Table 2 indicates factors influencing the nurses’ job satisfaction. Most nurses either agree or strongly agree with the statements that indicated the high level of satisfaction; they feel fulfilment and satisfied with their jobs (83%), recognition of their supervisor (81%), respect from other healthcare providers (89%), flexibility independence (77%), organizational structures (76%), feedback from patients (68%), and guideline and supervision protocols (78%).

Table 2: Factors Influencing nurses' job satisfaction in Taif hospitals
	StronglyDisagree	Disagree	Neutral	Agree	StronglyAgree
The feeling of fulfillment and satisfactionyou get from your job	3	3	10	23	61
Recognition from supervisor	3	3	12	36	45
Respect from co-workers	1	0	10	45	44
Feedback from supervisor	0	2	16	39	43
Feedback from patients	7	16	9	28	40
Promotion	12	22	17	23	26
Opportunities for further learning e.gprofessional training	5	16	17	30	32
Career Development	6	24	13	28	29
Responsibility allotted to you	3	8	10	44	35
Flexibility and independence allowed	1	10	12	34	43
The feeling of being treated equally	3	14	13	32	38
Salary	1	9	13	41	36
The rules and routine of supervision	0	11	13	35	41
The comprehensive goals and guidelines in your hospital	4	9	9	37	41
The organizational climate	2	9	13	30	46
The quantity of allotted work to you(workload)	1	15	14	34	36
The equipment used in your hospital	13	23	6	27	31
The Criticality	0	12	15	38	35
He/She relationship with doctors	2	17	11	44	26
The relationship with Co-workers	0	5	9	44	42
The relationship with patients	2	13	10	29	46

The Chi square test showed that the marital status as married was associated with more satisfaction among nurses in four hospitals in Taif, Saudi Arabia, while other factors such as gender and nursing qualification were not significantly associated with nurses’ satisfaction in the city (Table 3). It also shows that married participants were 2.9 more satisfied compared to singles (OR=2.9), divorced nurses were also 2.1 more satisfied compared to singles (OR=2.1).

Table 3: association between demographics of nurses and satisfaction levels in four hospitals in Taif city.
Variables	Satisfied	Not Satisfied	p-value	Odds Ratio (OR)
Freq	%	Freq	%
Gender	Male	32	80%	8	20%	.071	1.00 (Ref)
Female	51	85%	9	15%	1.4
Marital Status	Married	43	90%	5	10%	.035*	2.9
Divorced	10	83%	2	17%	2.1
Widowed	6	75%	2	25%	1.3
Single	24	75%	8	25%	1.00 (Ref)
Nursing Qualification	Diploma	9	69%	4	31%	.17	1.6
Bachelor’s	64	86%	10	14%	2.4
Higher Diploma	4	80%	1	20%	2.1
Masters	5	63%	3	38%	1.00 (Ref)
Age	25-40 years	73	85.9%	12	14.1%	.084	1.8
41-60 years	12	80%	3	20%	1.00 (Ref)

Figure 1: Overall satisfaction of nurses in Taif hospitals, Saudi Arabia

(*) significant

Discussion:

The study was conducted to provide a comprehensive analysis for the nurses’ job satisfaction and for the sociodemographic factors in Taif, Saudi Arabia. It also investigates the association between nurses' demographics and their job satisfaction in four hospitals at Taif city. Both female and male participated in the study with an equal distribution and slightly higher female as in nursing profession, near half of them were married and about three quarters held a bachelor’s degree in nursing.

The overall job nurses’ satisfaction in the four Taif hospitals indicates that a majority of nurses were satisfied with their profession. Participants’ satisfaction with their professional growth opportunities was lower than earlier national studies, that is to say that the current study findings have reported where 26% have strongly agree and 23% have agree that promotion as influencing factor for their job satisfaction while studies conducted in the country have reported that promotion as one of the main factors for their job satisfaction, one study conducted on nurses in Saudi Arabian hospitals by Alshmemri 2014 showed that possibility for growth was reported as average of 2.7 out of five (38), another study conducted in hospitals in Makkah region indicated a possibility for professional growth is one of the motivation factors for job satisfaction (39) and one study conducted at Al-Baha region reported that critical care nurses have reported that 4.98 out of 5 is the possibility for development (40). This could be the result of a lack of adequate staff, which may reduce in-service education attendance. These findings are in the same line with previous studies conducted in Saudi Arabia, it was found that Saudi nurses have higher job satisfaction compared to other nationality nurses, while they were less satisfied that expatriate nurses in term of professional development and co-worker relationships (41) and another study conducted in the country indicated that nurses have higher level of job satisfaction (42) and other studies have reported same findings (23, 43, 44).

On the other hand, a study conducted by AL‐Dossary, Reem, J. Vail, and F. Macfarlane (2012) reported that nurses were neutral in term of job satisfaction (43), it was linked to requestion more payment for extra duties and provide more opportunities for training but the study was conducted before 12 years which may report las situation. The recent review indicated that it is fundamental to ensure nurses have high level of job satisfaction to ascertain more job retention (23). The variation in our study findings and some previous studies findings could be because of different settings, different measurements, or due to different personal and demographic characteristics.

The association between demographic factors and job satisfaction were investigated using both cross-tabulation and One-Way Anova tests. The overall job satisfaction was significantly influenced by marital status, being married was associated with higher satisfaction among participated nurses in this study where the association was statistically significant. That is to say that the married participants were about three times more satisfied compared to singles (OR=2.9), divorced nurses were also twice more satisfied compared to singles (OR=2.1). This could be because the married nurses have experienced greater job stability or work-life balance, or it could be due to their family support. The underlying reasons for the association are not explored in depth. Other demographics such as gender and level of qualification were not significantly associated with nurses’ satisfaction in Taif. These findings were not in the same context with some previous studies, a study conducted by Al Bazroun et al., which showed no significant relationship between demographics and job satisfaction in Saudi Arabia (32). Furthermore, another study conducted in Saudi Arabia indicated that the nationality is the main predictor for job satisfaction among nurses and Saudi nurses are more satisfied than others (41). In addition, a recent systematic review has indicated that lack of nurses’ experiences and working environment are the main influencing factors on intensive care units nurses’ job satisfaction (36).

The findings highlight the importance of focusing on specific factors that could influence nurses’ job satisfaction such as marital status. Several limitations were found throughout the process of research. The first limitation was that it was conducted on small sample size selected by convenience sampling methods in one city which could limit findings generalizability. Another limitation was that it depended on self-reporting approach which could be affected by bias. The third limitation of the study was that it utilized descriptive design which could not measure the causality and approve the influencing factors on nurses’ satisfaction and the last limitation was that the study was conducted in one city which associated with lack of generalizability of the findings.

Conclusions:

In conclusion, the study stated that the majority of nurses in the sample reported being satisfied with their jobs in Taif hospitals, being married was significantly associated with higher job satisfaction among nurses. These findings are essential to understanding the nursing profession in Taif and explore the influencing factors on the nurses’ satisfaction.

Recommendations:

It is recommended to conduct further research to address the causal relationships between demographic factors and job satisfaction, explore other geographic areas in Saudi Arabia, it is also recommended to use longitudinal designs to assess changes over time and considering more influencing factors such as institutional factors (e.g., leadership style, workload) and its impact nurses' satisfaction and to initiate programs for career development, workload management, and equipment maintenance. It is also advised that both private and governmental hospital nurses to be included and to explore different regions in Saudi Arabia in longitudinal studies.

Declarations

Ethical Approval

This study adhered to ethics to protect and safeguard the rights and welfare of respondents. The voluntary nature of their participation and informed consent was guaranteed for all participants. Ethical approval was obtained before conducting the study from the included hospitals.

References

1. Qahtani SA, Alghamdi RS, Fallatah TI, Alluqmani RM, Alluqmani RM, Althobaiti AS, et al. Challenges Facing The Saudi Healthcare System In The Future. Journal of Namibian Studies: History Politics Culture. 2023;39:130-42.

2. Alluhidan M, Tashkandi N, Alblowi F, Omer T, Alghaith T, Alghodaier H, et al. Challenges and policy opportunities in nursing in Saudi Arabia. Human Resources for Health. 2020;18:1-10.

3. Al‐Dossary R. The Saudi Arabian 2030 vision and the nursing profession: The way forward. International nursing review. 2018;65(4):484-90.

4. Al-Makhaita HM, Sabra AA, Hafez AS. Job performance among nurses working in two different health care levels, Eastern Saudi Arabia: a comparative study. International Journal of Medical Science and Public Health. 2014;3(7):832-7.

5. Kagan I, Hendel T, Savitsky B. Personal initiative and work environment as predictors of job satisfaction among nurses: cross-sectional study. BMC nursing. 2021;20:1-10.

6. Mohammed BMA, Ahmed WAM. Evaluation of nurse interns' satisfaction and hospital as an educational environment in nursing internship training program, Saudi Arabia. Saudi Journal for Health Sciences. 2020;9(1):22-9.

7. Baker OG, Alshehri BD. The Relationship between Job Stress and Job Satisfaction among Saudi Nurses: A Cross-Sectional Study. Nurse Media Journal of Nursing. 2020;10(3).

8. Liu Y, Aungsuroch Y, Yunibhand J. Job satisfaction in nursing: a concept analysis study. International nursing review. 2016;63(1):84-91.

9. Lu H, Zhao Y, While A. Job satisfaction among hospital nurses: A literature review. International journal of nursing studies. 2019;94:21-31.

10. Riedl EM, Thomas J. The moderating role of work pressure on the relationships between emotional demands and tension, exhaustion, and work engagement: An experience sampling study among nurses. European Journal of Work and Organizational Psychology. 2019;28(3):414-29.

11. Alsadaan N, Jones LK, Kimpton A, DaCosta C. Challenges facing the nursing profession in Saudi Arabia: an integrative review. Nursing Reports. 2021;11(2):395-403.

12. Obročníková¹ A, Magurová¹ D, Majerníková¹ Ľ, Kaščáková¹ M, Harčariková M. Psychological strain between nurses. 2015.

13. Ahmed WA, Abdulla YHA, Alkhadher MA, Alshameri FA. Perceived stress and coping strategies among nursing students during the COVID-19 pandemic: a systematic review. Saudi Journal of Health Systems Research. 2022;2(3):85-93.

14. Ali SAA, Diab SSEM, Elmahallawy EK. Exploring the psychological stress, anxiety factors, and coping mechanisms of critical care unit nurses during the COVID-19 outbreak in Saudi Arabia. Frontiers in public health. 2021;9:767517.

15. Ahmed WA, Mohammed BM. Nursing students' stress and coping strategies during clinical training in KSA. Journal of Taibah University Medical Sciences. 2019;14(2):116-22.

16. Alyousef SM. Psychosocial stress factors among mental health nursing students in KSA. Journal of Taibah University Medical Sciences. 2019;14(1):60-6.

17. Mohamed BM, Ahmed ES. Perception of nursing students towards clinical stressors in the faculty of applied medical sciences-Al Jouf University-Saudia Arabia. Journal of American Science. 2012;8(12):608-17.

18. Ahmed WAM. Anxiety and related symptoms among critical care nurses in Albaha, Kingdom of Saudi Arabia. AIMS Med Sci. 2015;2(4):303-9.

19. Jafar Jalal E, Hajibabaee F, Farahaninia M, Joolaee S, Hosseini F. Relationship between job satisfaction, absence from work and turnover among nurses. Journal of Nursing and Midwifery Sciences. 2014;1(1):12-8.

20. Sowunmi OA. Job satisfaction, personality traits, and its impact on motivation among mental health workers. South African Journal of Psychiatry. 2022;28:1801.

21. Akinwale OE, George OJ. Work environment and job satisfaction among nurses in government tertiary hospitals in Nigeria. Rajagiri Management Journal. 2020;14(1):71-92.

22. Ulrich CM, Rushton CH, Grady C. Nurses confronting the coronavirus: Challenges met and lessons learned to date. Nursing outlook. 2020;68(6):838-44.

23. Alsubaie A, Isouard G. Job satisfaction and retention of nursing staff in Saudi hospitals. Asia Pacific Journal of Health Management. 2019;14(2):68-73.

24. Kamal SM, Al-Dhshan M, Abu-Salameh KA, Abuadas F, Hassan M. The effect of nurses’ perceived job related stressors on job satisfaction in Taif governmental hospitals in Kingdom of Saudi Arabia. Journal of American Science. 2012;8(3):119-25.

25. Falatah R, Almuqati J, Almuqati H, Altunbakti K. Linking nurses’ job security to job satisfaction and turnover intention during reform and privatization: A cross‐sectional survey. Journal of Nursing Management. 2021;29(6):1578-86.

26. Alqahtani SJ, Al Thobaity A, Althobaiti SW, Jimenez JL. Factors affecting nursing performance during COVID-19 period at Taif government hospitals. Journal of Medical and Health Studies. 2022;3(4):152-60.

27. Alilyyani B. The effect of authentic leadership on nurses’ trust in managers and job performance: A cross-sectional study. Nursing Reports. 2022;12(4):993-1003.

28. Mohammad A, Wang Q. Factors contributing job satisfaction and job performance of nurses in the healthcare industry. International Journal of Humanities and Social Development Research. 2019;3(1):7-23.

29. Al-Banna DA. Impact of nurse’s satisfaction on work performance. Erbil Journal of Nursing and Midwifery. 2018;1(1):2-9.

30. Al‐Hammouri F, Hamdan KM, Haymour AM, Ibrahim MO, Malkawi A, Al‐Hiary SS, et al. Quality of nursing care: Predictors of patient satisfaction in a national sample. Nursing Open. 2024;11(8):e2252.

31. Althobaiti MM, Issa LFM. Burnout among Health Worker in Primary Health Care Center in Taif City, Saudi Arabia. Journal of Survey in Fisheries Sciences. 2023;10(3S):569-77.

32. Al Bazroun MI, Aljarameez F, Alhamza R, Ahmed GY, Alhybah F, Al Mutair A. Factors influencing job satisfaction and anticipated turnover among intensive care nurses in Saudi Arabia. British Journal of Healthcare Management. 2023;29(6):1-10.

33. Aljohani KA. Nurses' job satisfaction: A multi-center study. Saudi Journal for Health Sciences. 2019;8(3):167-81.

34. Felemban E, O’Connor M, McKenna L. Cultural view of nursing in Saudi Arabia. Middle East Journal of Nursing. 2014;101(1505):1-7.

35. Alghamdi AB, Alghamdi FE, Alzahrani SS, Alghamdi SA, Ali MS, Alghamdi W, et al. Community Perception towards the Nursing Profession in Al-Baha, Saudi Arabia. Majmaah Journal of Health Sciences. 2023;11(3):35-.

36. Quesada-Puga C, Izquierdo-Espin FJ, Membrive-Jiménez MJ, Aguayo-Estremera R, Cañadas-De La Fuente GA, Romero-Béjar JL, et al. Job satisfaction and burnout syndrome among intensive-care unit nurses: A systematic review and meta-analysis. Intensive and Critical Care Nursing. 2024;82:103660.

37. Warr P, Cook J, Wall T. Scales for the measurement of some work attitudes and aspects of psychological well‐being. Journal of occupational Psychology. 1979;52(2):129-48.

38. Alshmemri MS, Shahwan‐Akl L, Maude P. Job satisfaction of Saudi nurses working in Saudi Arabian public hospitals. Unpublished doctoral dissertation) Royal Melbourne Institute of Technology, Melbourne, Australia. 2014.

39. Alshmemri M, Shahwan-Akl L, Maude P. Job satisfaction of Saudi nurses working in Makkah region public hospitals, Saudi Arabia. Life Science Journal. 2016;13(12):22-33.

40. Alostaz Z. Job satisfaction among critical care nurses in Al Baha, Saudi Arabia: a cross-sectional study. Gulf Medical Journal. 2016;5(1):64-8.

41. Almansour H, Gobbi M, Prichard J, Ewings S. The association between nationality and nurse job satisfaction in Saudi Arabian hospitals. International nursing review. 2020;67(3):420-6.

42. Bdair IA, Alshloul MN. Job satisfaction among nurses in Saudi Arabia. International Journal of Advances in Nursing Management. 2021;9(2):204-10.

43. AL‐Dossary R, Vail J, Macfarlane F. Job satisfaction of nurses in a Saudi Arabian university teaching hospital: a cross‐sectional study. International nursing review. 2012;59(3):424-30.

44. Al-Ahmadi HA. Job satisfaction of nurses in Ministry of Health hospitals in Riyadh, Saudi Arabia. Saudi medical journal. 2002;23(6):645-50.