published_or_final_version / Public Health / Master / Master of Public Health

From day's ceremonial, the nursing profession, was held in high esteem and was the most cherished health career amongst the black community. The profession popularised by Florence Nightingale, alias, "The lady with the lamp," highly emphasised absolute virtues, such as selflessness, dedication and hard work, to mention just a few. Some individuals like the late Sister Lekgetha and Cecilia Makiwana later became epitome of the health profession and were marvelled by the community at large. The paradigm has shifted somewhat, unfortunately, with today's nurses capable of leaving their death-bed-ridden patients in hospital wards, to take to the streets in demand of salary increases. Their hostile attitudes are perceived in community circles as irresponsible and uncaring, culminating in poor health service deliveries at health centres. Nurses, on the other hand, cite a number of issues that have rendered the health profession a disaster, in which it find itself. These range from the working conditions to the job description as rolled out by the supervisor and the Department. It is for this reason that a study at the Mafikeng Provincial Hospital was prompted, to try and reach the bottom of the truth. / M. Admin (HRM) North-West University, Mafikeng Campus, 2006

Health care professionals play a pivotal role in contributing towards the sustainability of a healthy economy and the standard of quality health care. It is therefore important that organisations understand what influences the job satisfaction levels of health care professionals as it could have an impact on their motivational levels and ultimately the quality of health care that is provided. The aim of this study was to assess the levels of job satisfaction amongst health care professionals in a public hospital in the Eastern Cape. Research for this study included a literature review to define what job satisfaction is and to establish a theoretical foundation to identify the factors that influence job satisfaction. Various motivational theories were explored after which Herzberg’s two-factor theory was identified to serve as a theoretical basis for investigating the job content and organisational factors that influence job satisfaction. Selected demographic factors that could possibly influence levels of job satisfaction were also identified. An empirical study, consisting of a survey with a questionnaire as measuring instrument, was conducted amongst 146 health care professionals at a public hospital in the Eastern Cape. The purpose of the questionnaire was to determine the extent to which job content factors and organisational factors that were associated with job satisfaction were present in the jobs of health care professionals in state hospitals. In addition, the purpose was also to determine whether selected demographic variables had an influence on the responses provided to the factors that were associated with job satisfaction and the job satisfaction levels of the target group. The major findings of the study indicated that all job content and organisational factors had an influence on the job satisfaction levels of health care professionals in a public hospital. Three factors namely Achievement, Responsibility and Work itself were identified to have a significant positive influence on the job satisfaction levels. Relationships between the demographic variables and the job content and organisational factors were identified. Work itself, Responsibility and Achievement were the top three factors whilst leadership/supervision, Human Resource systems and policies and Remuneration and benefits were the bottom three factors in terms of presence in the organisation and influence on the job satisfaction levels of health care professionals. Safety aspects, work environment standards, availability of resources, remuneration and benefits were amongst the major concerns highlighted. The job content factors were identified to be overall more present than the organisational factors. Recommendations were suggested to address the areas of concern that were highlighted in this study in order to ensure high levels of job satisfaction amongst the health care professionals.

Thesis (MBA) --University of Limpopo, 2007 / If medical doctors are expected to function effectively and efficiently to provide the highest quality of care to the largest number of patients in rural hospitals, it is imperative that they derive job satisfaction from their work and thus perform well. The present study aimed to investigate whether the doctors in the target population have job satisfaction. The doctors were selected from the rural hospitals of the Waterberg District of the Limpopo Province. An exploratory qualitative research design was used, which included a self administered questionnaire enquiring about the demographic and work situation variables. Content analysis was used to analyse qualitative data. The main findings that emerged from the study were that the respondents were dissatisfied with their work environment. The most common theme that emerged was related to the bad working conditions, lack of support from management, lack of proper equipment, and the salary or incentives in proportion to the workload. These findings highlighted the issues that can be addressed by the employing organisation.

Thesis (DTech (Human Resource Management))--Cape Peninsula University of Technology, 2012. / This study's main aim was to develop a model of employee satisfaction for health-related professions in South Africa. Health-related professions refer to a variety of practitioners who work in the healthcare sector mostly in support capacity to the clinical or medical practitioner. They include laboratory technologists, pharmacists, radiographers, emergency medical services (paramedics), nurses, and optometrists. These practitioners comprise a diverse group who deliver high quality care to patients across a wide range of care pathways and in a variety of settings. This band of professionals was chosen as the focus of the study because most studies, which relate to health workers' satisfaction and motivation in South Africa, have concentrated on medical doctors and nurses without a commensurate interest in other health-related professionals. The study is a multi-faceted one, and incorporates both qualitative and quantitative approaches. The study is also exploratory because no model of this kind exists amongst health-related professions of South Africa. Permission to access selected institutions for the study was granted before the researcher approached the population for the study. The researcher decided not to use a sample, but to include all members of this population in the participating institutions in order to get as many participants as possible. From a total population of 987, only 117 usable questionnaires were returned. Data that was collected was coded for Statistical Program for Social Science (SPSS) suitability. SPSS was utilized to generate the frequency and descriptive statistics. The data collection instrument was the Plus Delta Organizational Climate Questionnaire, which was modified on the basis of a preliminary study. The data instrument achieved a coefficient alpha (Cronbach) of 0.8, which extended its reliability. With the use of factor analysis, this study was able to identify seven (7) factors which influence employee satisfaction within the health-related professions in South Africa. These factors include Role Clarification and Job Design, Equitable Performance Management, Integrated Leadership and Knowledge Sharing and Self-efficacy, while the other factors include Family-friendly Work Environments, Leader Credibility and Innovation, and Excellent Customer Relations and Technology. These factors make up the model of employee satisfaction for health-related professions considered in this research. While the researcher suggests that further studies should be conducted in order to establish the validity of the model, the researcher also makes a call for a data collection instrument to be distilled from the model. However, this study will undoubtedly add to the sparse literature on health-related practitioners. This position is assumed because most literature on health professions' job satisfaction/dissatisfaction favours doctors and nurses. The study will also assist in understanding some of the reasons for the often reported sense of job insecurity among practitioners in South Africa. The study has produced a model, which health-related professions can utilise to manage themselves better. It is hoped that the model will serve health-related professions with better gains, such as reduction in health-related professional attrition, elimination of low levels of trust between management and staff and reduction in high incidences of absenteeism, which constituted research problems of this study.

The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.

This research study evaluated the impact specific work-related factors have on home and family life for female managers in the health care food service industry. A random sample of 333 (33%) of the population was chosen to participate in this study. Each participant was a member of the American Dietetic Association's Management in Health Care Systems dietetic practice group. The work aspects with the most negative impact were number of hours worked per week, work schedule, and job security. Two variables found to significantly predict the overall impact of work on home and family life were number of hours worked per week (p-value .002) and annual gross income (p-value .002).

Introduction: Amongst all public servants in Hong Kong, health care workers are one of the groups suffering from highest working pressure. They have long working hours and may have overnight shift duties, including Sundays or even public holidays. This may lead to poor job satisfaction, psychological stress and the recent high resignation rate in public hospitals. The aim of this study is to assess the prevalence of the psychological stress, psychological symptoms and job satisfaction of health care workers, the association between stress, psychological symptoms and job satisfaction; and also the factors associated with job satisfaction in a regional hospital in Hong Kong. Method: Health care workers in a large regional hospital of Hong Kong were surveyed by means of a questionnaire assessing basic demographic data, questions of the General Health Questionnaire (GHQ-12), Perceived Stress Scale (PSS), Warr-Cook and Wall job satisfaction scale (JSS). Four groups of health care workers (doctors, nurses, allied health workers and supporting staffs) were surveyed. Summary of descriptive statistics were calculated for each group to compare the prevalence of job dissatisfaction, perceived stress, and psychological symptoms. Two-stage analysis will be used. The first stage analysis will use ANOVA test to access the association between job satisfaction and different variables. The second stage analysis will use multivariate regression model to further assess the coefficient correlation of significant factors drawn from ANOVA test with job satisfaction. Results: There were 674 eligible questionnaires. About half (47%) of the health care workers reported having perceived stress and a third (33.8%) psychological symptoms. Doctors reported the (76.8%, 95% C.I = 69.43%, 84.17%) highest level of job satisfaction amongst all the health care workers surveyed. Among staff reporting a GHQ score equal to or more than three, supportive staff had significantly higher prevalence (38.7%, 95% C.I.=27.96%, 49.44%) and doctors the lowest prevalence (28.1%, 95% C.I.= 15.11%, 41.09%) of psychological symptom but proportions were compatible with their counterparts in other countries. The mean score for GHQ-12 was 2.41+/- S.D. 3.28. The overall mean perceived stress score was 18.14 with SD +/- 5.0. There was no significant difference when different subgroups were compared. The mean PSS scores of all subgroups were lower than their counterparts in other counties but were quite similar to the mean PSS reported during SARS period. Sixty eight percent of all health care workers surveyed were satisfied with their job (respondents indicating “moderately satisfied”, “very satisfied” and “extremely satisfied” on their overall job satisfaction). Values equal to or above 5 reflect being satisfied. The mean value for Job satisfaction was 4.58 +/-S.D. 1.21. The factors including shift duty, perceived stress, and psychological symptoms were negative correlated with job satisfaction. Factors such as clinical work, doctor and secondary school level were positive correlate with job satisfaction. Conclusion: Prevalence of perceived stress and psychological symptoms among health care workers were high when compared with the general population (14-17.6% for perceived stress and 28.1% for psychological symptom), but not as high as expected. In contrast to popular belief, doctors had the lowest perceived stress level, lowest prevalence of psychological symptom and the highest job satisfaction among different groups of health care workers. This may be related to higher income, social status and, education background that might help to protect them from depression and anxiety. Supportive staffs, who felt neglected by management, were found to have the highest prevalence of psychological symptom and higher stress levels. Nurses got highest prevalence of perceived stress. More attentions and resources should be devoted to these groups to cope with their psychological needs and stress. / published_or_final_version / Public Health / Master / Master of Public Health

The shortage of skilled professionals in the health sector has been an ongoing problem. This has resulted in poor service delivery and ultimately increased patient deaths. The primary objective of this study was to develop a conceptual model to retain scarce skilled professional workers in the health sector. An exploratory study was conducted which included both professionals and non-professionals in the pathology sector. Recruitment was done from a population of 207 employees. In total 188 employees responded, of which 116 were professionals and a comparator group of 72 being the non-professionals. The study was conducted in three phases. In the first phase, quantitative data collection methods such as the job diagnostic survey, career orientation inventory, organisational commitment questionnaire and intention to quit questionnaire were used to assess the characteristics of the groups of interest. The relationship between the independent and dependent variables were calculated. The results revealed that only a few of the traditional predictors influenced retention in the professional group. The predictors worked much better for the non-professional group. It was concluded that traditional retention strategies are not suitable to retain professionals in the health sector. The second and third phases utilised qualitative methods. The second part of the study related to identifying factors which retain professional staff. Following interviews with 15 professionals, ten themes were identified which relate to the retention of professionals. The third phase of the study consisted of interviews with 3 managers, and this was to determine what the managers can do to influence retention. A retention model for the professionals was then developed. This model not only contributes to the body of knowledge, but is also a useful managerial tool to manage professionals in the health sector / Graduate School of Business Leadership (SBL) / D.B.L. (Business Leadership)

This thesis reports a study of work ethic values, beliefs and attitudes held by medical professionals in selected hospitals in the Eastern Cape, South Africa. The study was in response to the public outcry about the declining work ethic and poor service delivery in South Africa’s healthcare sector. Scholarly interest in the work ethic and its role in economic development dates back to Max Weber’s classical work, which was the starting point for my study. The German economic sociologist published his seminal essay on The Protestant Ethic and the Spirit of Capitalism in 1904/1905. Since that time, Weber’s ideas on the Protestant work ethic continue to inform and influence studies of the contemporary work ethic, which is thought to have become secularised. My study was informed by data collected in 2009 through a questionnaire survey and personal interviews. A total of 174 doctors and nurses, working in four urban, periurban and rural hospitals near East London, completed a self-administered questionnaire. The questionnaire replicated the Multi-Dimensional Work Ethic Profile (MWEP) developed by Miller, Woehr and Hudspeth in 2001/2002. The instrument examines seven critical dimensions of the work ethic, namely self-reliance, morality, (foregoing) leisure, hard work, centrality of work in life, not wasting time, and delay of gratification. In addition, I conducted personal interviews in the same four hospitals with 41 hospital managers, doctors, nurses, and patients to discuss their understanding of the work ethic and its practical application. The study found that both doctors’ and nurses’ overall work ethic scores on the MWEP scale were above average. Although there was no significant difference between the overall work ethic scores of the two professions, doctors scored significantly higher than nurses on the ‘hard work’ and ‘self reliance’ dimensions of the work ethic scale. In the qualitative study, the doctors’ work ethic was rated much more highly than the nurses’ by their superiors and patients; and the work ethic of nurses in the urban hospitals was rated much lower than that of their rural colleagues. In contradiction to the idea of the secularization of the contemporary work ethic, religiosity and religious beliefs were influential in the endorsement of work ethic principles. In line with the notion that ‘happy’ workers are more productive, job and life satisfaction were found to be strong correlates of the work ethic of medical professionals.