Relationships of Job Satisfaction and Caring Behaviors among Nurses Working in Inpatient Wards in Indonesia

Relationships of Job Satisfaction and Caring Behaviors among Nurses Working in Inpatient Wards in Indonesia

Ira Rizqana¹, Asniar²*, Mudatsir³

¹Master Program of Nursing Science, Faculty of Nursing, Universitas Syiah Kuala

²Departement of Community Health Nursing, Faculty of Nursing, Universitas Syiah Kuala

³Faculty of Medicine, Faculty of Nursing, Universitas Syiah Kuala

*Corresponding author

DOI: https://doi.org/10.47772/IJRISS.2023.70547

Received: 22 April 2023; Accepted: 02 May 2023; Published: 04 June 2023

ABSTRACT

Nurse job satisfaction must be adequately managed to improve working performance, particularly in applying caring behavior in nursing services. Caring behavior is an essential and fundamental component of the nursing profession. It can affect the quality of health services by increasing patient satisfaction, patient recovery processes, and hospital revenue. This study aimed to determine the relationship between job satisfaction and caring behavior among hospital nurses in Banda Aceh. This cross-sectional study was conducted in a public hospital for two weeks in December 2022 and involved 173 nurses selected using the total sampling technique. The Caring Behavior Inventory-24 (CBI-24) questionnaire and the Job Satisfaction Survey (JSS) were used to collect data. The Chi-square test showed a relationship between job satisfaction and nurses’ caring behavior (p=0.001). It can be concluded that job satisfaction influences nurses’ caring behavior, which impacts improving health care quality.

Keywords: nurses’ role, nurses practitioners, and job satisfaction

INTRODUCTION

Caring behavior is one of the determining factors for the success of nursing services. All nursing activities are used to evaluate the caring behavior of the nurse. Caring, as the fundamental concept and characteristic of nursing, is defined as nurses’ actions in providing nursing care to patients and can be effectively demonstrated and practiced interpersonally to meet the needs of patients [1]. High-quality care can be achieved when nurses successfully conceptualize caring in clinical practice; they can provide high-quality care [2]. Moreover, caring behavior is a distinct concept in nursing that encompasses nurses’ attitudes, concerns, responsibilities, and affective involvement with patients.

In Indonesia, which has an Eastern culture, the caring behavior of nurses is an essential consideration for the community in using health services. According to the Ministry of Health of the Republic of Indonesia, the number of nurses in Indonesia was 344,399 in 2022. Data show that there are still nurses who lack caring behavior, as evidenced by a study conducted on 507 patients in a hospital on the Indonesian island of Sumatra, which revealed that the majority of patients (59.5%) were dissatisfied with the health services they received due to nurses’ lack of caring behavior [3]. This claim contradicts the findings of a study conducted on 414 patients in a hospital on the Indonesian island of Java, which concluded that nurses’ caring behavior was in a suitable category [4], as well as research conducted in Surabaya, which concluded that nurses’ caring behavior was in a good variety (57.7%) [5].

Some of the research evidence above shows contradictions in nurses’ caring behaviors. The same conditions were also found among nurses working in hospitals in Banda Aceh. Several studies on the caring behavior of nurses show that 93.3% of hospital nurses in Banda Aceh have high (good) caring behavior [6]. In line with research conducted at the University Hospital in Banda Aceh, it was stated that 81% of patients had a high perception of nurse caring behavior [7]. However, research at the Aceh Provincial Hospital found that 70% of patients still complained about the caring behavior of nurses [8]. The caring behavior of nurses in Banda Aceh is a crucial matter to pay attention to because the hospital in Banda Aceh is a district/city hospital referral.

Nurse job satisfaction is one of many factors that influence nurses’ caring behavior toward patients. Job satisfaction is something that every nurse strives for at work. Job satisfaction must be optimized to improve nurses’ work morale, love, dedication, and discipline. A better understanding of nurse job satisfaction and the factors that influence it can assist in developing effective strategies for improving the quality of patient care services. Improving nurse job satisfaction is essential because it can improve patient perceptions of care quality and ensure competent nursing staff in nursing care [9]. This is in line with several studies which report that nurses’ caring behavior is influenced by job satisfaction. Another study shows that job satisfaction affects nurses’ caring behavior. Another study found that job satisfaction can improve nurse performance and patient care [1] [10].

The evidence presented above demonstrates contradictions relating nurses’ caring behavior and job satisfaction as influencing factors. Therefore, the authors were interested in examining the relationship between job satisfaction to nurse caring behavior.

MATERIALS AND METHODS

This cross-sectional study involved 173 nurse practitioners in the inpatient wards of a general hospital in Banda Aceh who were selected using a total sampling technique. The research was conducted for two weeks in December 2022 to collect data by distributing questionnaires to respondents. This study collected data on nurses’ caring behavior, job satisfaction, and demographic data such as age, gender, education level, and years of service.

Caring behavior

Caring behavior is any activity related to a patient’s welfare, such as sensitivity, comfort, attentive listening, honesty, and nonjudgmental acceptance [11]. In this study, nurses’ caring behavior was assessed using the Caring Behavior Inventory-24 (CBI-24) questionnaire, which is based on ten factors developed by Watson (1979) [12]. The CBI-24 questionnaire used in this study is an Indonesian translation of Elvandi’s (2020) questionnaire, with a Cronbach’s Alpha reliability coefficient of 0.92 [13]. This instrument consists of 24 question items on a 6-point Likert scale that reflect nurses’ level of caring behavior.

Job satisfaction

Nurse job satisfaction was assessed using Spector’s (1985) Job Satisfaction Service (JSS) questionnaire, which covers nine factors, including pay, supervision, benefits, promotions, contingent rewards, co-workers, nature of work, operating procedures, and communication [14]. The JSS questionnaire used in this study is an Indonesian translation of Rindyantika and Safitri’s (2014) version, with a Cronbach’s Alpha reliability coefficient of 0.876 [15].

This questionnaire contains 36 items on a 6-point Likert scale, consisting of 16 positive and 20 negative questions.

Statistical Analysis

The data in this study were analyzed using a computer application, and Univariate analysis was performed to describe each research variable. At the same time, a bivariate analysis was conducted to determine the relationship between job satisfaction and the caring behavior of nurses using the chi-square test.

Ethical Clearance

This research was approved by the Ethics Committee of the Faculty of Nursing at Universitas Syiah Kuala, and the respondents involved gave their consent and signed the informed consent form.

RESULTS

According to the study findings, the majority of respondents (61.8%) were between the ages of 26 and 35, were female (77.5%), graduated  Diploma III (74%), and had 1 to 5 years of working experience (64, 2%). Table I contains more information about the demographic data of the respondents.

Table I: Demographic Data

Bivariate analysis using the Chi-Square test showed a relationship between job satisfaction and nurses’ caring behavior (P = 0.001). Bivariate analysis is further explained in Table II.

Table II: Relationship between job satisfaction and nurse caring behavior

*Significance p ≤ 0,05

Among all the nurse’s job satisfaction aspects, the lowest average nurse score is in the contingent rewards aspect, which is 11.79, with a variation of 4,396 and an interquartile range is 7.

Table III: Frequency Distribution of Nurse Job Satisfaction Aspects

SD: Standard deviation; IQR: Inter-Quartile Range

DISCUSSION

Job satisfaction is a global concern because it affects the quality and safety of patient care and nurses’ loyalty to their profession. Salary, supervision, coworkers, work environment, rewards, motivation, promotions, security/safety, and working conditions are all factors that contribute to nurses’ job satisfaction [16]. Nurse job satisfaction must be appropriately considered because it can improve performance, particularly by applying caring behavior in nursing services.

A study conducted in Malang, Indonesia, discovered that job satisfaction is one of the factors associated with nurses’ caring behavior. The main reason for increasing efforts to improve the quality of nursing services is salary. The salary and rewards received by nurses are known to have an impact on their caring behavior, according to this study. Furthermore, supervision is one factor that influences nurse performance, one of which is caring behavior. The better the hospital’s monitoring system, the better the nurse’s performance [17].

According to research conducted in Southwest Ethiopia, nurse job satisfaction is related to caring behavior. Nurses who are satisfied with their work have good caring behavior. This study discovered that nurses are more concerned with caring in the technical professional aspect than the psychosocial aspect. This means that nurses focus more on concrete behavior that can be observed than caring behavior from an expressive standpoint. In that study, job satisfaction was measured in terms of personal satisfaction, professional satisfaction, collaboration in the patient care process, and satisfaction with nurse management.

The findings revealed a significant relationship between job satisfaction and caring behavior [1].

In addition, other research describes the findings of studies that support the notion that there is a significant relationship between nurses’ job satisfaction and engagement with caring behavior and that these two variables significantly contribute to caring behavior. This study emphasizes how job satisfaction motivates nurses to provide excellent nursing care, which means that nurses who are happy with their jobs will be more caring. In other words, when nurses are satisfied with their work, they tend to be more caring and help the hospital meet its goals of providing high-quality healthcare services [10].

This study revealed a relationship between job satisfaction and nurse caring behavior. This is consistent with previous research showing that nurses who are satisfied with their work are more dedicated to their professional jobs and exhibit optimal work performance through caring behavior toward patients. However, 37% of nurses in this study were still dissatisfied. The reward aspect has the lowest nurse satisfaction of the nine elements of job satisfaction studied (11.79). This demonstrates that nurse practitioners continue to feel a lack of recognition and appreciation for their work and a lack of rewards from the institutions where they work.

Previous research has found that rewards influence nurses’ caring behavior. Nurses who receive appropriate workplace rewards will be motivated to improve their performance through caring behavior. Nurses require both financial and non-financial rewards through awards or appreciation. Underpaid nurses will be less motivated to provide compassionate patient care [18]. This is supported by a study that discovered that the reward influences nurses’ caring behavior. A performance-based reward system will promote a work culture centered on patient satisfaction [19]. This is consistent with a study that discovered that nurses who receive awards and recognition for their performance exhibit work performance manifested in good caring behavior toward patients and are highly committed to their roles and responsibilities as nurses [20].

Based on the values ​​that underlie caring about nursing, Watson (1979) directs nurses to carry out the nursing process rather than just procedures, tasks, and techniques in practice. On the other hand, nurses are encouraged to interpret aspects of the nurse-patient relationship based on caring to achieve therapeutic results. To attain total and wholehearted nurse performance, as Watson (1979) addressed, it is necessary to pay attention to the factors that motivate nurses to work, including nurse job satisfaction.

CONCLUSION

Job satisfaction influences nurses’ caring behavior, influencing health care quality. It is recommended that hospital management improve nurse performance by focusing on job satisfaction through recognition or appreciation and service training that focuses on professional values to increase nurses’ motivation to demonstrate good caring behavior when providing nursing services to patients.

ACKNOWLEDGEMENTS

The Institute for Research and Community Service of Universitas Syiah Kuala supported this research.

REFERENCES

1. A. Oluma and M. Abadiga, “Caring behavior and associated factors among nurses working in Jimma University specialized hospital, Oromia, Southwest Ethiopia, 2019,” BMC Nurs., vol. 19, no. 1, pp. 1–7, 2020, doi: 10.1186/s12912-020-0407-2.
2. A. Klarare, M. Söderlund, A. Wikman, J. McGreevy, E. Mattsson, and A. Rosenblad, “Caring Behaviors Inventory-24: translation, cross-cultural adaptation and psychometric testing for use in a Swedish context,” Hum. Resour. Health, vol. 19, no. 1, pp. 1–7, 2021, doi: 10.1186/s12960-020-00540-5.
3. F. Mailani and N. Fitri, “Hubungan perilaku caring perawat dengan tingkat kepuasan pasien BPJS di RSUD Dr. Rasidin Padang,” J. Endur., vol. 2, no. 2, pp. 203–208, 2017.
4. A. Pragholapati and S. A. D. Gusraeni, “Gambaran Perilaku Caring Perawat di Rumah Sakit,” J. Keperawatan Sriwij., vol. 8, no. 1, pp. 42–55, 2021.
5. L. Hidayati, F. Rifai, and L. Ni’mah, “Emotional Intelligence and Caring Behavior Among Muslim Nurses: A Study in Religious-Based Hospital in Surabaya-Indonesia,” Adv. Heal. Sci. Res., vol. 3, no. Inc, pp. 137–139, 2017, doi 10.2991/inc-17.2017.41.
6. R. Muzaiyanah and P. Mayasari, “Gambaran Perilaku Caring Perawat Di Rumah Sakit Di Banda Aceh an Overview of Caring Behavior of Nurses in Hospitals in Banda Aceh,” vol. IV, no. 2, pp. 56–63, 2019.
7. U. Urzia and N. Jannah, “Persepsi Pasien terhadap Perilaku Caring Perawat di Rumah Sakit,” JIM FKep, vol. 4, no. 2, pp. 132–140, 2020.
8. H. Sakdiah, Hubungan Motivasi Intrinsik Perawat dengan Penerapan Perilaku Caring Kepada Pasien di Ruang Rawat Inap Kelas III Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh (Tugas Akhir). Banda Aceh: Universitas Syiah Kuala, 2014.
9. H. Lu, Y. Zhao, and A. While, “Job satisfaction among hospital nurses: A literature review,” Int. J. Nurs. Stud., pp. 1–33, 2019, doi: 10.1016/j.ijnurstu.2019.01.011.
10. A. A. Janet and L. J. Labrague, “Job engagement and satisfaction are associated with nurse caring behaviors: A cross-sectional study,” J. Nurs. Manag., vol. 29, no. 7, pp. 2234–2242, 2021, doi: 10.1111/jonm.13384.
11. S. Salimi and A. Azimpour, “Determinants of Nurses’ Caring Behaviors (DNCB): Preliminary Validation of a Scale.,” J. Caring Sci., vol. 2, no. 4, pp. 269–78, 2013, doi: 10.5681/jcs.2013.032.
12. Y. Wu, J. H. Larrabee, and H. P. Putman, “Caring behaviors inventory: A reduction of the 42-item instrument,” Nurs. Res., vol. 55, no. 1, pp. 18–25, 2006, doi: 10.1097/00006199-200601000-00003.
13. M. D. Elvandi, Hubungan Perilaku Caring Perawat dengan Tingkat Kecemasan Pasien Pra Operasi di Rumah Sakit Tingkat III Baladhika Husada Jember. Jawa Timur: Universitas Jember, 2020.
14. P. E. Spector, “Measurement of human service staff satisfaction: Development of the Job Satisfaction Survey,” Am. J. Community Psychol., vol. 13, no. 6, pp. 693–713, 1985, doi: 10.1007/BF00929796.
15. A. Rindyantika and N. Safitri, “Analisis Kepuasan Kerja Karyawan Berdasarkan Job Satisfaction Survey (Studi Pada Karyawan Tetap Kantor Pusat PT Airindo Sakti),” Fisip Ui, pp. 1–6, 2014.
16. R. Fitnanto, T. S. Parulian, and E. A. Setyarini, “Faktor Kepuasan Kerja Perawat Di Rumah Sakit,” Elisabeth Heal. J.  J. Kesehat., vol. 6, no. 2, pp. 137–141, 2021, doi: 10.32660/jpk.v6i2.493.
17. K. R. Putra, T. Andayani, and E. H. Ningrum, “Job satisfaction and caring behavior among nurses in a military: A cross-sectional study,” J. Public health Res., vol. 10, no. 2, pp. 313–316, 2021, doi: 10.4081/jphr.2021.2212.
18. E. Supriatin, “Perilaku Caring Perawat Berdasarkan Faktor Individu dan Organisasi,” J. Keperawatan Indones., vol. 18, no. 3, pp. 192–198, 2015, doi: 10.7454/jki.v18i3.425.
19. I. G. A. A. S. Prihandhani, N. M. S. Nopiyani, and D. P. Duarsa, “Hubungan Faktor Individu dan Budaya Organisasi dengan Perilaku Caring Perawat Pelaksana di Ruang Rawat Inap Rumah Sakit Umum Ganesha Gianyar,” Public Heal. Prev. Med. Arch., vol. 3, no. 1, pp. 44–48, 2015, doi: 10.15562/phpma.v3i1.86.
20. N. M. Geyer, S. K. Coetzee, S. M. Ellis, and L. R. Uys, “Relationship of nurses’ intrapersonal characteristics with work performance and caring behaviors: A cross-sectional study,” Nurs. Heal. Sci., vol. 20, no. 3, pp. 370–379, 2018, doi 10.1111/nhs.12416.