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Job satisfaction in PHC Kuwait
Huda Youssef Al-Ghareeb
Rihab Abdullah Al-Wateyan
Correspondence:
Dr Huda Youssef Al-Ghareeb
Email: alghareeb.huda@gmail.com
Received: March 2019; Accepted: April 2019;
Published: May 1, 2019
Citation: Huda Youssef Al-Ghareeb, Rihab Abdullah
Al-Wateyan. Job satisfaction in PHC Kuwait.
World Family Medicine. 2019; 17(5): 4-15. DOI:
10.5742MEWFM.2019.93640
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Abstract
Background: Job
satisfaction of staff is an important
issue for performance of a health care
system. The aim of our study was to assess
employee satisfaction in Kuwait regarding
their opinion of their job, training and
development, adequacy of resources, interaction
with patients and co-workers, degree of
supervision and evaluation from supervisor
and manager, overall experience regarding
quality and safety, to determine the views
and preferences of the health care personnel
regarding the current health system, and
the recent introduction of accreditation
programme to gain a better understanding
of the impact of accreditation on quality
of care as perceived by PHC staff members
and directors (the key enablers and challenges
to the implementation of accreditation)
to identify possible strategies to improve
implementation of accreditation in PHC
in Kuwait and to identify the barriers
and problems the employee faces in the
primary health care centers in Kuwait
and make appropriate recommendations in
the light of the results of this study
to help the decision-makers in solving
the problems which can contribute to the
development of policies regarding the
health system and improve the quality
and safety in PHC centers.
Methods: This
comparative cross sectional study was
conducted in Kuwait in one year (September
2016 to September 2017) in 60 PHC centers
in five health regions in Kuwait and surveyed
7,253 staff members who are working at
the Primary Health Centers (physicians,
nurses, pharmacists and assistant pharmacists,
lab technician, x-ray technician, administrative)
by using a designed self-administered
employee satisfaction questionnaire.
Results: The
response rate for all staff was 55%; the
highest respondent rate was for nurses
( 74%) and the lowest respondent rate
was for administrative staff (34% ) and
assistant nurses (34% ).
Conclusions:
The presented results contribute to
an understanding of factors that influence
levels of satisfaction between primary
health care staff and interventions need
to be implemented in order to improve
the level of job satisfaction among healthcare
professionals.
Implementing accreditation
is an important first step towards improving
the quality and safety in PHC centers.
Key words:
Job satisfaction, staff, accreditation,
primary healthcare centres, Kuwait
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Kuwait is one of the leading countries that
has adopted and implemented the PHC approach
in the Middle East.
Primary health care services cover a wide range
of health care that is provided for patients
who are not admitted to the hospital. The growth
of these services has been driven by patient
desire to receive a service that is accessible
at an appropriate cost, with a focus on health
promotion and disease prevention (1). Primary
health care centers serve the health care needs
of their community and thus are integral to
the well-being of these communities (1).
One increasingly employed method for promoting
quality at the healthcare organizational level
is accreditation (2, 3,4).
Accreditation of PHC practices was reported
to increase emphasis on the role of PHC within
the healthcare system and to ensure quality
control and improvement (2, 5).
In 2012, the Kuwait Ministry of Health (MOH)
launched the Primary Healthcare (PHC) Canadian
accreditation program to improve quality across
the continuum of care.
Accreditation contributes to increased job
satisfaction among physicians, nurses, and other
providers (6).
Accreditation is a process whereby an organization
is assessed on a set of pre-determined standards.
It intends to promote quality improvement through
diverse approaches; they are either mandated
by the government, voluntary or initiated by
independent agencies (7).
Employees are considered as the wealth of each
organization. Effectiveness and performance
of organizations depend upon effectiveness and
performance of the human workforce of that organization
(8).
So the term “satisfaction” is a complex
notion because it involves not only the personal
experience and expectations, individual and
social values but is also related behaviours,
such as motivation, faithfulness, professional
fulfillment, etc. and contains different meanings
for each individual. In spite of this multi-lateral
and complex structure, it is vital to ensure
the satisfaction of the employees in the sectors
like health care sector where intense, often
long term, and emotionally charged labor and
human relations take place, and thus measurement
of this elusive and variable quality is necessary
(9).
Job satisfaction is the contentment that employees
get from the work they do and from the physical
environment and the “atmosphere” existing
in the environment. Because job satisfaction
is an emotional notion, its perception differs
from person to person (10).
Healthcare worker job satisfaction is a very
important parameter that influences productivity
as well as quality of work. This complex phenomenon
is an attitude towards one’s job that has
an impact not only on motivation, but also on
career, health and relations with co-workers.
Healthcare worker job satisfaction has a great
impact on quality, effectiveness, and commitment
to work and at the same time on healthcare costs
(11).
Due to the importance of human resources in
providing quality PHC services, it is integral
for PHC leaders to assess their Quality of work
life (QWL) and to understand their organizational
and career intentions. Such procedures may assure
the continuity and improvement of the health
services being provided (12).
The study of primary care clinics is important
because clinics are often the entry point for
patients into a given medical system (13).
Study design, setting, and duration:
This descriptive cross-sectional study was conducted
over a period of one year (September 2016 to
September 2017) in 60 PHC centers in five health
regions in Kuwait, for all staff employees who
are working at the Primary Health Centers (physicians,
nurses, pharmacists and assistant pharmacists,
lab technician, x-ray technician, administrative)
by using a designed self-administered employee
satisfaction questionnaire whereas semi-structured
interviews were conducted with directors. The
researcher was personally responsible for the
distribution and collection of all questionnaires.
The number of staff members for each clinic
was taken from the health statistics section
in primary care central department of the Ministry
of Health (MOH).
Sample:
Questionnaires were distributed to 60 PHC centers
in the five Governmental Health regions to all
full time PHC centers employees (physicians,
nurses, technical and administrative staff).
The respondents are those who completed more
than 50% of the items of the questionnaire and
the selected 60 PHC centers were representative
of 106 PHC centers in Kuwait.
Inclusion and exclusion criteria:
The inclusion criteria were all employees at
the PHCs who were available at the time of the
study and willing to participate. The exclusion
criteria were those who were not available,
such as those who were on leave and those who
decided to exercise their right not to participate.
Data collection Tool:
Components and details of the instrument:
Following permission from the MOH in Kuwait
to conduct the study with ethical approval the
survey was sent to the PHC centers through the
principal investigator.
Data collection was conducted using a self–administered
structured Questionnaire adapted from a tool
used by Canadian accreditation with minor changes
to the wording.
Only 3,969 of the 7,253 staff answered the questionnaire
and returned it completed after distribution
to 60 PHC centers in five health regions in
Kuwait.
The highest percentage of staff response rate
per health region was from Hawali (60%) and
the lowest from Jahra (44%) as shown in Table
1.
A total of 74% of respondents were nurses,70%
were X-ray technicians, 69% were lab and assistant
technicians, 65% were pharmacists and assistant
pharmacists, 59% were physicians and 34% were
assistant nurses and administrative staff as
shown in Table 2.
Overall grades of safety and Quality for all
staff were all above 50% as shown in Table 3.
Only
3,969
of
the
7,253
staff
answered
the
questionnaire
and
returned
it
completed
after
distribution
to
60
PHC
centers
in
five
health
regions
in
Kuwait.
The
highest
percentage
of
staff
response
rate
per
health
region
was
from
Hawali
(60%)
and
the
lowest
from
Jahra
(44%)
as
shown
in
Table
1.
A
total
of
74%
of
respondents
were
nurses,70%
were
X-ray
technicians,
69%
were
lab
and
assistant
technicians,
65%
were
pharmacists
and
assistant
pharmacists,
59%
were
physicians
and
34%
were
assistant
nurses
and
administrative
staff
as
shown
in
Table
2.
Overall
grades
of
safety
and
Quality
for
all
staff
were
all
above
50%
as
shown
in
Table
3.
Separating
the
studied
domains
in
physician
job
satisfaction
questionnaire
the
main
score
of
job
satisfaction
by
order
of
preference
obtained
was
as
following:
Safety
and
health
59.9±16.03;
Your
overall
experience
41.5±12.1;
Job
nature
(your
job)
36.2±9.9;
Your
supervisor/manager
28.9
±
6.2;
Your
Co-worker
16.5
±
3.4;
Training
and
development
7.3
±
1.9;
Your
overall
opinion:
(Quality
grade2.2
±
0.83,
Safety
grade
2.1
±
0.81
).
The
highest
and
lowest
domains
were
safety
and
health
and
Training
and
development
respectively
as
shown
in
Table
4.
Separating
the
studied
domains
in
Nurse
job
satisfaction
questionnaire
the
main
score
of
job
satisfaction
by
order
of
preference
obtained
was
as
following:
Safety
and
health
70.3±15.4;
Job
nature
(your
job)
43.0±
9.04;
Your
overall
experience
41.1±10.9;
Your
Co-worker
17.0±
2.6;
Your
supervisor
12.6
±2.1;
Training
and
development
8.06
±
1.6;
Your
overall
opinion:
(Quality
grade
1.5
±0.61,
Safety
grade
1.5
±
0.67).
The
highest
and
lowest
domains
were
Safety
and
health
and
Training
and
development
respectively,
as
shown
in
Table
5.
Separating
the
studied
domains
in
pharmacists
and
assistant
pharmacists
job
satisfaction
questionnaire,
the
main
score
of
job
satisfaction
by
order
of
preference
obtained
was
as
following:
Job
nature
(your
job)
41.2±
10.5;
safety
and
health
38.2
±7.9;
Your
overall
experience
35.6
±10.4;
Your
Co-worker
17.2±
2.9;
Your
manager
(head
of
the
clinic)
16.1±3.3;
Your
supervisor
12.8
±0.11;
Training
and
development
7.2
±
1.9;
Your
overall
opinion:
(Quality
grade
2.2
±0.82,
Safety
grade
2.1±0.84
.
The
highest
and
lowest
domains
were
Job
nature
(your
job)
and
Training
and
development
respectively,
as
shown
in
Table
6.
Separating
the
studied
domains
in
administrative
job
satisfaction
questionnaire,
the
main
score
of
job
satisfaction
by
order
of
preference
obtained
was
as
following:
Job
nature
(your
job)
30.5
±8.4;,
Your
overall
experience
18.2±5.5;
Your
manager
(head
of
the
clinic)
15.9±3.9;
Safety
and
health
15.1±
4.3;
Your
supervisor
11.9±3.1;
Your
Co-worker
11.7±3.1;
Training
and
development
7.3
±2.3;
Your
overall
opinion:
(Quality
grade
3.6±1.08,
Safety
grade
3.7±1.1).
The
highest
and
lowest
domains
were
Job
nature
(your
job)
and
Training
and
development
respectively
as
shown
in
Table
7.
Separating
the
studied
domains
in
Lab
job
satisfaction
questionnaire
,the
main
score
of
job
satisfaction
by
order
of
preference
obtained
was
as
following:
Job
nature
(your
job)
30.8
±8.1;
Your
overall
experience
17.3±5.4;
Your
manager
(head
of
the
clinic)
14.4±4.3;
Safety
and
health
13.9±
4.5;
Your
supervisor
12.5±2.8;
Your
Co-worker
11.7±2.8;
Training
and
development
7.4±2.2;
Your
overall
opinion:
(Quality
grade
3.4±1.06,
Safety
grade
3.4±1.06).
The
highest
and
lowest
domains
were
Job
nature
(your
job)
and
Training
and
development
respectively
(Table
8).
Separating
the
studied
domains
in
Assistant
nurse
job
satisfaction
questionnaire,
the
main
score
of
job
satisfaction
by
order
of
preference
obtained
was
as
following:
Job
nature
(your
job)
31.3
±7.5;
Your
overall
experience
19.2
±4.8;
Your
manager
(head
of
the
clinic)
16.2±3.7;
Safety
and
health
16.1±
3.08;
Your
supervisor
12.0±2.6;
Your
Co-worker
11.9±0.49;
Training
and
development
7.6±1.6;
Your
overall
opinion:
(Quality
grade
3.9±0.79,
Safety
grade
3.8±0.90).
The
highest
and
lowest
domains
were
Job
nature
(your
job)
and
Training
and
development
respectively
(Table
9).
Separating
the
studied
domains
in
X-ray
technician
job
satisfaction
questionnaire,
the
main
score
of
job
satisfaction
by
order
of
preference
obtained
was
as
following:
Job
nature
(your
job)
34.6
±6.1;
Your
overall
experience
20.0
±4.1;
Your
manager
(head
of
the
clinic)
17.2±2.45;
Safety
and
health
16.9±2.9;
Your
Co-worker
13.2±2.09;
Your
supervisor
12.4±2.4;
Training
and
development
8.5±1.6;
Your
overall
opinion:
(Quality
grade
4.2±0.68,
Safety
grade
4.3±
0.7).
The
highest
and
lowest
domains
were
Job
nature
(your
job)
and
Training
and
development
respectively
as
shown
in
Table
10.
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