Job satisfaction refers to the general feelings of a person about his occupation and assessment of his job [1]. Employees with higher job satisfaction are physically and mentally in good condition [2,3]. The factors affecting job satisfaction can be classified into four categories: organisational factors, environmental factors, the nature of work and individual factors [4].
Organisational culture is considered as an important and fundamental component in the body of an organisation, and it is a social reality based on unmatched interactions among organisation members [5]. Organisational culture actually represents the cognition of the organisation, and the beneficial organisational culture has a positive effect on staff performance. Indeed, the development of organisational culture facilitates the feeling of identity and commitment as well as enhancing the organisation’s stability [6]. Despite a strong and coherent organisational culture, individuals are satisfied with the feeling of responsibility, commitment, and willingness to work while they are more aware of the goals and strategies of the organisation towards values and norms [7]. Organisations often cause job dissatisfaction among employees. Large organisational structures always cause the power to be concentrated in the hands of a relatively few individuals, and the individual is in the last chain, which leads to an individual’s lack of interest in the organisation and job dissatisfaction [8].
Job satisfaction and organisational culture are the factors that can affect the health of staff in the hospitals.
The Health Promoting Hospital (HPH) is a hospital that focuses on promoting health and using health promotion strategies to review and change health care services at three levels of prevention, treatment and rehabilitation, staff and community [9].
In this regard, this study aimed to investigate organisational culture and job satisfaction of specialty hospitals in Hamadan.
Materials and Methods
This descriptive-analytical study was performed in the specialty hospitals of Hamadan University of Medical Sciences (Iran) from May to September 2017 Hamadan has two specialty hospitals which are under the supervision of the medical university and have 315 and 340 personnel respectively. The inclusion criteria for the study were, lack of significant physical and psychological disorders, at least one year of work experience and completing the informed consent form. Based on inclusion criteria, 600 staff was entered in this study.
In order to conduct this study, the code of ethics was received (883.1395IR.UMSHA.REC.) from Ethics Committee of Hamadan University of Medical Sciences and an informed consent form for participation in the study was prepared.
Study Tool
This study aimed to assess job satisfaction and organisational culture using Minnesota Satisfaction Questionnaire and Robins’ Organisational Culture Questionnaire.
Minnesota Satisfaction Questionnaire (MSQ) is a popular measurement instrument for job satisfaction, originally designed and developed by Brumfield and Roth (1951) at the University of Minnesota. This questionnaire evaluates the satisfaction in three concepts of external satisfaction, internal satisfaction and overall satisfaction. Internal satisfaction means what people think about the nature of their job responsibilities. However, external satisfaction is associated with aspects that are distinct from job tasks. This questionnaire has 20 questions, which measures 10 questions of internal satisfaction and 10 questions of external satisfaction. The scoring of questions is based on 5-point Likert scale. The scoring range is from 1 (very dissatisfied) to 5 (very satisfied) in the questions. The minimum score obtained from the questionnaire is 20 and the maximum is 100. The score obtained from 20 to 47 indicates low satisfaction, 48 to 76 average satisfactions, and 77 to 100 indicate a high satisfaction [10].
The reliability of this questionnaire in current study was determined as 0.86 using Cronbach’s alpha.
Robins’ organisational culture questionnaire was utilised to assess the organisational culture [11]. This questionnaire consists of 56 questions. The scoring in questions is based on 5-point Likert scale. The scoring range is from 1 (I totally agree) to 5 (I totally disagree) in the questions. The minimum score obtained from the questionnaire is 56 and the maximum 280. The score obtained from 56 to 130 indicates low organisational culture, 131 to 206 average organisational cultures, and 207 to 280 indicate a high organisational culture. The reliability of this questionnaire was determined 0.82 using the Cronbach’s alpha.
Statistical Analysis
The questionnaires were completed by researcher to avoid errors in data collection. The data was analysed by SPSS 21 after the questionnaires were completed for the staff in the studied hospitals.
Results
The results show that the majority of staffs were female (83.7%) and their age range was between 20 and 50 years, with an average age of 32.55±8.45. [Table/Fig-1] shows the demographic characteristics of the participants.
Demographic characteristics of participants.
| Demographic index | Category | Hospital 1 | Hospital 2 | Total |
|---|
| Frequency | Percentage | Frequency | Percentage | Frequency | Percentage |
|---|
| Employment status* | Official | 103 | 34.3 | 114 | 38.0 | 217 | 36.2 |
| Treaty | 61 | 20. 3 | 4 | 1.3 | 65 | 10.8 |
| Contractual | 52 | 17.3 | 43 | 14.3 | 95 | 15.8 |
| Plan | 47 | 15.7 | 114 | 38.0 | 161 | 26.8 |
| Others | 37 | 12.3 | 25 | 8.3 | 62 | 10.3 |
| Education status | Bachelor | 253 | 84.4 | 256 | 85.3 | 509 | 84.8 |
| Master | 21 | 7.0 | 12 | 4.0 | 33 | 5.5 |
| MD | 4 | 1.3 | 6 | 2.0 | 10 | 1.7 |
| PhD | 3 | 1.0 | 3 | 1.0 | 6 | 1.0 |
| Others | 19 | 6.3 | 23 | 7.7 | 42 | 7.0 |
| Shift work | Morning | 65 | 21.7 | 76 | 25.3 | 141 | 23.5 |
| Evening | 4 | 1.3 | 0 | 0.0 | 4 | 0.7 |
| Night | 6 | 2.0 | 10 | 3.3 | 16 | 2.7 |
| Rotational | 225 | 75.0 | 212 | 70.7 | 437 | 72.8 |
| Others | 0 | 0.0 | 2 | 0.7 | 2 | 0.3 |
| Work experience (year) | <5 | 126 | 42.0 | 140 | 46.7 | 266 | 44.3 |
| 5-10 | 71 | 23.7 | 66 | 22.0 | 137 | 22.8 |
| 10-15 | 54 | 18.0 | 31 | 10.3 | 85 | 14.2 |
| 15-20 | 25 | 8.3 | 13 | 4.3 | 38 | 6.3 |
| >20 | 24 | 8.0 | 50 | 16.7 | 74 | 12.3 |
*Personnel in Iran are usually employed in several ways: Official: Official staffs have higher job security and employed by government for 30 years; Treaty: Temporarily staff hired by government for a specified period of time (3 or 5 years); Contractual: Contractual staff hired by government for one year; Plan: Plan staff hired by government equal to the period of governmental university education; Corporative: Corporative staff hired by company for one year
The results of the organisational culture status in studied hospitals are presented in [Table/Fig-2]. According to the table, the mean score of organisational culture in hospital 1 is higher than that of hospital 2, but this difference is not statistically significant. The organisational culture is average in both hospitals (131-206).
The status of organisational culture in the studied hospitals.
| Hospital | Range | Min | Max | Mean±SD | p-value |
|---|
| 1 | 56-280 | 56 | 280 | 175.89±12.35 | 0.216 |
| 2 | 56 | 280 | 171.86±11.35 |
| Overall | 56 | 280 | 173.85±13.2 | |
The results of job satisfaction status in terms of internal, external, and overall satisfaction in the studied hospitals are presented in [Table/Fig-3].
The status of job satisfaction in the studied hospitals.
| Hospital | Range | Min | Max | Mean±SD | p-value |
|---|
| Internal satisfaction | 1 | 10-50 | 10 | 50 | 30.69±7.22 | 0.013 |
| 2 | 10 | 50 | 29.29±7.45 |
| Total | 10 | 50 | 30.00±7.34 | |
| External satisfaction | 1 | 10-50 | 10 | 50 | 29.60±6.80 | 0.356 |
| 2 | 10 | 50 | 29.07±7.15 |
| Total | 10 | 50 | 29.33±6.94 | |
| Overall satisfaction | 1 | 20-100 | 20 | 100 | 60.29±13.61 | 0.076 |
| 2 | 20 | 100 | 58.27±14.17 |
| Total | 20 | 100 | 59.28±13.92 | |
According to the results from the table, the average score of internal, external and overall job satisfaction in hospital 1 is better than hospital 2, and this difference is statistically significant for internal job satisfaction (p<0.013), but for external and overall satisfaction is not statistically significant (p>0.05). According to this table, job satisfaction is average in two hospitals (48-76).
[Table/Fig-4] shows the relationship between some of the demographic factors (Organisational factors) with job satisfaction and organisational culture. According to this table, employment type and education level have a significant relationship with job satisfaction (p<0.05).
The relation of demographic characteristics with job satisfaction and organisational culture.
| Demographic index | Category | Mean ±SD | Organisation culture | Job satisfaction |
|---|
| p-value |
|---|
| Type of employment | Official | 130.01±19.3 | 0.001 | 0.002 |
| Treaty | 128.5±23.0 |
| Contractual | 127.2±18.1 |
| Plan | 129.0±21.3 |
| Others | 136.1±24.3 |
| Education status | Bachelor | 263.3±21.2 | 0.123 | <0.001 |
| Master | 136.1±20.5 |
| MD | 127.4±17.0 |
| PhD | 132.0±13.2 |
| Others | 133.2±27.2 |
| Shift work | Morning | 133.1±19.6 | 0.441 | 0.211 |
| Evening | 128.2±26.6 |
| Night | 130.4±22.2 |
| Rotational | 128.7±21.0 |
| Others | 126.5±14.9 |
| Work experience (year) | <5 | 132.0±21.9 | 0.024 | 0.060 |
| 5-10 | 126.0±18.2 |
| 10-15 | 125.5±18.9 |
| 15-20 | 128.4±19.7 |
| >20 | 134.1±21.8 |
There is a significant relationship between employment type and work experience in the context of organisational culture (p<0.05).
The results of study on the relationship between organisational culture and job satisfaction are presented in [Table/Fig-5]. As can be seen, organisational culture has a significant relationship with internal, external and overall job satisfaction in both hospitals (p<0.001).
The Correlation between organisational culture and job satisfaction.
| Hospitals | Job satisfaction | Pearson Correlation | p-value |
|---|
| 1 | Internal satisfaction | 0.693 | <0.001 |
| External Satisfaction | 0.677 | <0.001 |
| Overall satisfaction | 0.706 | <0.001 |
| 2 | Internal satisfaction | 0.600 | <0.001 |
| External Satisfaction | 0.565 | <0.001 |
| Overall satisfaction | 0.602 | <0.001 |
| Overall | Internal satisfaction | 0.605 | <0.001 |
| External Satisfaction | 0.634 | <0.001 |
| Overall satisfaction | 0.684 | <0.001 |
Discussion
The results of this study indicated that organisational culture was average in the studied hospitals. One of the disadvantages of hospitals management across Iran is that a traditional vertical management system is used where important decisions and policy makings are taken by top level managers, and power is in the hands of a limited number of people, thus majority of the personnel are only implementing the decisions. Therefore, teamwork in hospitals is poor and participation in decision-making is least possible.
The results of this study indicated that job satisfaction was average in the studied hospitals. Lu H et al., in a systematic review found that job satisfaction of nurses working in hospitals is closely related to their working conditions and organising work environment, job stress, ambiguity, and conflict of role, understanding, and content of the role [12].
The results of studies in Iran have shown that the job satisfaction of hospital nurses is average and the allocation of welfare facilities, satisfaction with the work environment and improvement of reward are the factors that affect the job satisfaction [13,14].
The results of the study showed that type of employment and education level had significant relation with job satisfaction. This relation can be because in the studied hospitals, individuals with high levels of education had jobs with high pay, reward and benefits. Also, in these hospitals, staff were employed in the form of official, treaty, contractual and plan which have different salaries, benefits and rewards.
In the field of organisational culture, employment type and work experience have significant relation. The reason for this significant relation can be found in the fact that these individuals usually have a lot of work experience in the organisation and they are accustomed to the organisation and have positive view toward the organisation. Organisations also tend to pay more attention to people who have a lot of work experience and consider their work experience valuable. The results of study indicated that there is a strong relationship between organisational culture and job satisfaction and the level of both are on average. A positive organisational culture enhances employee satisfaction and is effective by increasing the interactions among colleagues in creating a positive working environment. In this environment, tasks are organised in a way that helps staff to reach a high level of job satisfaction and organisational goals [15]. It is shown that organisational culture affects the formulation of goals and strategy, job satisfaction, job motivation, organisational performance, creativity and innovation, the amount of staff participation, decision-making, hard work and the effectiveness of organisations [16,17]. The results of a study conducted by Zeng T et al., show that organisational culture is the most important factor that enhances job satisfaction [18]. The results of some studies show that communication with colleagues and managers is one of the important factors in job satisfaction among hospital staff [19-23].
Limitation
This study is subject to potential limitations such as, the study data were collected by self-reporting through a questionnaire that could have effect on the results. Due to the fact that most of the personnel of the studied hospitals were female and the number of male staff was lower, gender cannot be studied.
Conclusion
Considering that the main purpose of this study was to identify the weak points of the hospitals to move towards HPHs, unfortunately, organisational culture and consequently job satisfaction in the hospitals were average and establishment of proper organisational culture and consequently enhancement in job satisfaction is required in order to achieve the standards of HPHs..
*Personnel in Iran are usually employed in several ways: Official: Official staffs have higher job security and employed by government for 30 years; Treaty: Temporarily staff hired by government for a specified period of time (3 or 5 years); Contractual: Contractual staff hired by government for one year; Plan: Plan staff hired by government equal to the period of governmental university education; Corporative: Corporative staff hired by company for one year