Middle East Journal of Family Medicine

ABSTRACT

Objective: Our aim was to evaluate the extent of job satisfaction and stress of Primary Health Care givers in Qatar.

Subject and Methods: A population based cross sectional study was conducted in July 2007. 323 questionnaires were distributed to all the physicians/General Practitioners (GPs) working in Primary Health Care Centers in Qatar. Out of 323, only 176 (54%) responded. Data on socio-demographic characteristics and job satisfaction and stress were collected on self-administered English forms developed by Warr-Cook Wall (5).

Results: Out of 176 participants 85 (48%) were nale and 91 (52%) were female. Most were non-Qatari of age between 30-45 years and married withchildren. The overall job satisfaction and stress were below average. There were no significant differences in overall job satisfaction for nationality, sex, marital status and number of children whereas female Qatari Health Caregivers were found to be more stressed than their counterparts. There was negative correlation between job satisfaction and stress (r =-0.29, p=0.01).

Conclusion: Job satisfaction of primary health caregivers is critical for improvement of health systems. The results of our study showed that Qatari physicians were less satisfied with the rate of pay and the amount of variety in work. Stress was more in Qatari Health Caregivers than Non-Qatari.

Key words: Health Caregivers, Job satisfaction, Stress.

Primary Health Caregivers are responsible for providing medical care to the larger extent of the Qatar population. They play a pivotal role in medical care and medical care could be improved by facilitating them in working conditions, improving rate of pay and other peripheral facilities at work. The World Health Organization (WHO) has also recognized the importance of Primary Health Caregivers in 1978 in Alma Ata Declaration (1).

Ibrahim S Al-Eisa (2) published a study on job satisfaction of Primary Health Care (PHC) Physicians at Capital Region Kuwait in 2005. The authors concluded that attention should be given to income, variety in work and practice conditions in order to improve overall Physician satisfaction.

Al Mari S.A.(3) in 2002 from Qatar suggested improving job satisfaction of PHC Physicians by giving incentives, reducing workloads and providing vocational training for improving the quality of PHC services.

Khalid A Kalantan (4) published a similar study in 1999 on factors influencing job satisfaction among PHC Physicians in Riyadh suggested to provide vocational training, adequate incentives as well as administrative support to PHC Physicians.

Although, few studies are published in Qatar on job satisfaction for Physicians working in PHCs in past, and giveing no clues to improve job satisfaction of PHCs Physicians, recent changes in incentives and other facilities in PHCs are warranted to look into this matter again.

Our aim is to determine job satisfaction and stress levels of Primary Health Center Physicians and GPs in Qatar.

A total of 323 questionnaires were sent to all primary health care physicians of 24 Primary Health Centers in the state of Qatar. Out of a total only 176 (54%) Care Givers responded. The questionnaire was adopted from Warr -Cook Wall (5) specially designed for job satisfaction and stress level in caregivers. The data were collected on demographic, job satisfaction and stress characteristics during July 2007. Responses were collected on satisfied, not satisfied and cannot tell or cannot say, for job satisfaction and stress characteristics. Variables, age, gender, religion, nationality, marital status, specialty, number of years working in primary health care and number of households were collected for demographic characteristics of the participants.

Job satisfaction and stress scores were calculated for each participant in the study. One value was assigned for satisfaction or agree, 0 for cannot tell or cannot say, and -1 for no satisfaction or disagree for quantification of the given responses by the participants on job satisfaction and stress simultaneously. All the items were added for each individual and divided by total numbers of items for respective scores on job satisfaction and stress.

Frequency distribution with percentage for categorical variables and mean and standard deviations for continuous variables were calculated. Student t test and One-Way ANOVA with post-hoc analysis by Bonefirroni were applied to see significant differences in continuous variables (Job satisfaction and stress scores) between and among categories for categorical variables. Chi-square tests were applied to see the association between categorical variables. Two-tailed probability 0.05 has been considered as a statistical significance level. SPSS 14.0 statistical package has been used for the analysis.

A total of 176 questionnaires were collected from Physicians and General Practitioners from all the Primary Health Centers. Most were of 30-45 years of age. There was 1:1 ratio of male to female. There were 80% non-Qataris in the study. More or less all the participants were married and had 5 or more children. There were 119 (68%) participants from the General Practitioner community and 49 (27.8%) from Physicians whereas 8 (4.5) participants didnot mention their discipline. The distribution of demographic data has been described in Table 1.

Table 2 described the distribution of job satisfaction items. More than 75% of participants from both specialties were satisfied with physical working conditions, colleagues and fellow workers and working hours. 60-70% satisfaction was for freedom to choose own method of work, variety of jobs and job satisfaction of today in comparison to the past. Below average satisfaction was for rate of pay whereas above average satisfaction was for two shifts at work and appointment system in subspecialty.

Table 3 described the stress level at work in Primary Health Centers for Physicians and General Practitioners. 87.5% were of the opinion that there was increased demand from patients and 80% agreed there was insufficient time to do justice with patients during consultations. 104 (59%) participants were of the opinion they were interrupted by emergency cases during consultation. Out of 176, 103 (58.5%) were of the opinion that thet were not getting sufficient time to update themselves. There was no disturbance of family life for 52% of participants in the study.

Overall job satisfaction score was below average in the study with mean level 0.36± 0.39. There was no statistical difference in job satisfaction score for all the demographic variables included. The results have been displayed in Table 4.

Stress level at work was also of the same level with mean 0.38±0.42. The study suggested that there was more stress in females than males (p =0.001) and more stress in Qatari participants than non-Qatari participants (p=0.02). Qatari female proportion was higher than the Qatari males in Health Caregivers (Chi-square= 16.7, p=0.00). Other demographic and professional variables like age, specialty, numbers of years working in practice and number of households in the study did not have a statistical difference at stress level. The results have been shown in Table 5.

Most of the Caregivers in PHCs were non-Qatari; a similar proportion was described in a previous study done in 2002 (3). It may be due to the demand of PHCs services or Qatari Care Givers may have an inferior sotiation in comparison to other specialties. Our data showed a significant negative association between derived job satisfaction score and stress score. The study showed more stress in Qatari Health Care Givers than non-Qataris in PHCs. It may be due to more female Qataris working in PHCs than males. Qatari Health Caregivers might have household jobs at home. Our study also showed more job satisfaction compared to past experience in PHCs Caregivers. It may be due to increases in salary, increases in numbers of doctors, and other facilities in PHCs.

More thrust is warranted to update ithe medical education system, as Caregivers are not able to update themselves with new developments in their fields due to workload.

C.L. Cooper (6), Bonnie Sibbald (7), and Barbara (9) showed that job satisfaction has increased whereas Bruce E. Landon (8) demonstrated job satisfaction did not change dramatically.

Similar results have been described and suggested regarding demographic and professional variables in studies (1),(2),(4).

Our study showed that job satisfaction and stress are both are below average. More facilities, incentives and suitable working conditions should be provided to increase job satisfaction and to reduce stress. Further, it suggested a large study on job satisfaction, stress and mental health be undertaken to generalize the results in the region.