Predictors of global job satisfaction among Saudi physiotherapists: a descriptive study.

BACKGROUND AND
OBJECTIVE: Job satisfaction is an important consideration in the recruitment and retention of physiotherapists (PTs). To date, the job satisfaction of PTs working in Saudi Arabia has not been investigated. The aim of this study was to measure the level of job satisfaction of PTs working in Saudi Arabia and evaluate predictors of job satisfaction. DESIGN AND SETTINGS: This was a cross-sectional observational study among licensed physical therapists working across 11 health care centers and university hospitals in Riyadh between 2013 and 2014. SUBJECTS AND METHODS: A total of 183 physical therapists participated in the survey. Level of job satisfaction and factors influencing satisfaction were explored using a purpose-designed job satisfaction questionnaire. It consisted of 8 survey domains, and the scores were normalized to allow between-domain comparison.
RESULTS: Global job satisfaction was 37%. The highest levels of job satisfaction were seen in the domains of professional development and teamwork and the lowest levels of job satisfaction in the domains of supervisory/ management relationship (75%) and working environment (60%). Predictors of job satisfaction were gender (OR [odds ratio] 1.4, 95% CI 1.1-2.3), age (OR 0.7, 95% CI 0.5-0.9), relationships with supervisors and managers (OR 1.3, 95% CI 1.2-1.9), working environment (OR 1.2, 95% CI 1.0-2.3), and opportunities for professional development (OR 1.4, 95% CI 1.2-3.7).
CONCLUSION: Saudi PTs were moderately satisfied with their job; strategies should be designed in such a way that they experience a high level of job satisfaction and retention thus resulting in improved rehabilitation services in Saudi Arabia.

Job satisfaction is an important consideration for employers and managers, as it impacts staff recruitment, retention, and workplace culture. Job satisfaction is influenced by intrinsic factors such as meaningful work, work stress, quality of leadership, level of autonomy, and the ability to provide quality care and complete tasks within working hours. Extrinsic factors such as remuneration, career progression, and opportunity for professional development also impact job satisfaction. Studies that have investigated job satisfaction in physiotherapists (PTs) have mostly shown high levels of overall job satisfaction, with intrinsic factors, including meaningful, interesting, and challenging work, contributing more to job satisfaction than to extrinsic factors, such as status and salary.1–7 However, extrinsic factors such as salary and workplace benefits can influence staff retention.3,8 Eker et al investigated 198 PTs in Turkey, working across 13 health care settings. In contrast to other studies, they reported an overall job satisfaction rate of only 46%, with the most important predictors of job satisfaction being leadership, interpersonal relationships, opportunity for advancement, and salary.2

There is a lack of research available on the job satisfaction levels of PTs in Saudi Arabia. This is an important area of research, as over the past few decades, Saudi Arabia has witnessed enormous growth and change, with diseases of civilization, road traffic accidents, and increasing age, growing the demand for PT services. Most of the PT services in Saudi Arabia are provided by public health sectors. An awareness of the factors that influence job satisfaction in a Saudi context is important to attract Saudis to the emerging profession of PT, and enhance recruitment and retention of PT staff, thus maximizing the ability to provide high-quality health care to the Saudi Arabian population. Therefore, the aim of this study was to investigate the level of job satisfaction and to identify predictors of job satisfaction among Saudi PTs.

SUBJECTS AND METHODS

Study design

A prospective cross-sectional exploratory study was undertaken to investigate job satisfaction of Saudi PTs. The study was approved by the King Saud University Ethics Committee. Participants were recruited from 11 health care facilities located in Riyadh, Saudi Arabia. Majority of the rehabilitation services in Riyadh are provided by government organizations and university hospitals. Our study consisted of a sample of 244 PTs in Riyadh who were members of Saudi Physical Therapy Association in January 2013. A minimum of 15 full-time PTs were recruited from each facility. A stratified sampling method was used for the selection of health care centers. Eligibility criteria included that the PT had to work within the facility for at least 6 months.

Recruitment

All PT staff within the 11 health care facilities were informed about the study via the head of the department and through their mails in the months of January and February 2013. A cover letter explaining the study purpose and a copy of the survey was provided to interested staff members. The return of the completed survey was taken to represent the informed consent. The final sample consisted of 183 respondents, and the process of data collection was completed by the end of June 2013.

Questionnaire design and reliability

This survey was specifically designed to measure job satisfaction and factors influencing it. The survey included key areas of job satisfaction that were identified in previous research and other issues that were believed to be relevant in a Saudi context. The survey was pilot-tested on 30 PTs working in various health care clinics, and their feedback was incorporated into the final version. The final survey consisted of general demographic data and 32 items across 8 domains. The domains were as follows: intrinsic factors (4 items, e.g., workload distribution, being treated with respect, and dignity), basic employment needs (4 items, e.g., pay, job security, working hours, and job benefits), teamwork (3 items, e.g., cooperation between the teams, cooperation with in the team, and role as a team member), supervisor/manager relationships (7 items, e.g., supervisor’s support, freedom to express ideas, supervisor’s expectation from the employees, the evaluation process, regular feedback on the performance, manager interference in the work, and opportunity to respond to the work evaluation), systems (3 items, e.g., adequate resources, safe work practices, and rules and procedures that limit employees’ work ability), working environment (4 items, e.g., enjoy working with colleagues, feel comfortable, friendly, and acceptable environment), clients (3 items, e.g., clients’ satisfaction, clients’ services, and activities to improve their services), and professional development (4 items, e.g., opportunity and time for advanced skill developments, supervisors’ support, and promotions). Responses to each item were scored on a 5=point Likert scale (where 1=strongly disagree and 5=strongly agree). The Cronbach α coefficient of internal consistency reliability of the job satisfaction questionnaire was ICC 0.82 to 0.90.

RESULTS

Response rate

Surveys were distributed to 244 PTs, with 183 (75%) returning completed surveys. This response rate indicates the acceptability of the survey. Non-participation was due to their absence to work or refusal to take part in the study. Frequency distributions of all items were checked for outliers, missing data, and entry errors. Total scores for each of the 8 domains were calculated. As the number of items within each domain varied, domain scores were normalized to allow between- domain comparison. This was done by adding the raw scores for each respondent for each domain and then multiplying this figure by 100 divided by the highest possible raw score within that domain. Thus, the possible range of scores for each domain was 20 to 100, with higher scores reflecting greater job satisfaction. A total score across all 32 items was also calculated and normalized, and represented global job satisfaction. The internal consistency of the survey was assessed by obtaining Cronbach α coefficients, with these ranging from 0.82 to 0.90 across the 8 survey domains. Linear regression analyses were performed to identify factors significant in predicting global job satisfaction. Statistical analyses were performed using SPSS software (International Business Machines Corporation).

Characteristics of respondents

The majority of respondents (44%) were 20–39 years old, of which 102 were females and 81 males, and the maximum length of time employed at the facility was less than 5 years. (Table 1, Figure 1)

Table 1

Descriptive characteristics of the participants (n=183).

Characteristic	Percentage (%)
Gender
Female	102 (56)
Male	81 (44)
Age (yr)
20–29	81 (44)
30–39	82 (45)
40–49	16 (9)
> 50	4 (2)
Length of time employed at the facility (yr)
1–5	40
6–10	39
11–15	17
> 15	4

Figure 1

Length of employment period at a facility.

Global job satisfaction

From the total score calculated across all domains, representing global job satisfaction, 68 (37%) respondents were globally satisfied with their job. The highest level of satisfaction was observed between 30 and 39 years of age (52%) when compared to the younger PTs of 20–29 years (31%) and 40–49 years of age group (29%) (Figure 2).

Figure 2

Satisfaction level by age group.

Domain responses

The highest levels of satisfaction were seen in the domains of professional development and teamwork, and the lowest levels of satisfaction in the domains of supervisory/management relationship and working environment (Figure 3).

Figure 3

Mean scores of the respondents in each domain.

Predictors of job satisfaction

The linear regression analyses were used for investigating predictors of global job satisfaction. The significant predictors of job satisfaction identified were gender, age, supervisor/manager relationships, working environment, and professional development. A strong and persistent link between gender and job satisfaction has been identified where women reported themselves as being significantly happier at work than their male counterparts (Table 2).

Table 2

Predictors of global job satisfaction.

Predictors	Odds ratio (OR)	95% CI (OR)
Gender	1.4a	1.1–2.3
Age	0.7a	0.5–0.9
Supervisor/manager relationships	1.3a	1.2–1.9
Working environment	1.2a	1.0–2.3
Professional development	1.4a	1.2–3.7

Statistically significant at 95% CI.

The work environment was viewed less positively in our sample. We found that the importance of interpersonal relationships with colleagues and superiors was a predictor of job satisfaction. The satisfaction level was high (45%) among the PTs with the title “senior PT” when compared with PTs with the job titles “therapist” (25%) and “supervisor” (35%). (Figure 4)

Figure 4

Satisfaction level by job title.

DISCUSSION

This study investigated the job satisfaction of Saudi PTs and predictors of job satisfaction. Overall, the global job satisfaction seen in our sample was 37%. The highest levels of job satisfaction were seen in the domains of professional development and teamwork and the lowest levels of job satisfaction in the domains of supervisory/management relationship and working environment. Predictors of job satisfaction were gender, age, relationships with supervisors and managers, working environment, and opportunities for professional development.

Comparing our results with previous studies that have evaluated the job satisfaction of PTs, our global rating of job satisfaction of 37% was similar to that documented by Eker et al where 46% of PTs working in Turkey were satisfied with their job.2 However, this figure is considerably lower than the job satisfaction levels reported in other studies involving PTs or other health care workers, where more than 50% of respondents were satisfied with their jobs among various health professions.9 The reason for the lower rate of job satisfaction in our sample was not certain; the small sample size would be one of the reasons. Previous studies showed that PTs were dissatisfied with policies and administration of the organization.10 “Autonomy” is the most satisfying factor and “Pay” the least satisfying factor. 11 Intrinsic factors such as recognition, respect, dignity, and fair workload distribution are more important than income or status.5,10 This is consistent with our results that the level of job satisfaction was high (45%) among PTs with the job title “Senior Therapist,” whereas it was only 25% and 35% with the titles “Therapist” and “Supervisor,” respectively. PTs are not satisfied with the paperwork aspect of their work.7

In terms of the predictors of job satisfaction, the relationship that respondents had with their supervisors and managers was one of the strongest predictors of job satisfaction, and the highest level of dissatisfaction (i.e., lowest mean score) was recorded in this domain. This finding is consistent with other studies, where leadership quality and style have been found to be strongly correlated with job satisfaction.2,12,13 Recognition by patients and the public is also correlated with job satisfaction. 14 Mutual respect, fairness, equity, evaluation process, recognition of achievements, developmental input, and providing an environment in line with the professional’s values are all important leadership qualities valued by employees.2,4

Our finding that female PTs had higher levels of job satisfaction than had males concurs with previous research. The higher levels of job satisfaction seen in females may reflect that women have different expectations and priorities with respect to their jobs than have males. Studies showed that, at the outset, male PT students had higher career expectations and goals, such as owning a private practice or becoming a manager or administrator, than had female students.15 Women have different and distinct life issues and priorities than have males, with career success dependent on the successful balance between the marital, parental, and work roles.5 Additionally, societal expectations of men’s roles may make it more difficult for them to leave the labor force when they are unhappy at work, particularly in a patriarchal traditional society such as Saudi Arabia, where men are responsible for providing for the family.

The influence of age on job satisfaction is intriguing. Researchers found a U-shaped relationship between job satisfaction and age, with younger and older people reporting higher levels of job satisfaction.16 In contrast, we found an inverse-U–shaped relationship, with lower levels of job satisfaction in younger and older PTs. The reason for this finding is unclear. It is possible that lower levels of job satisfaction in younger PTs may reflect a gap between their expectations of the profession and its reality.6,17,18 The higher levels of job satisfaction in the middle-aged tier may reflect those PTs who have found their professional niche and thus remained in the PT profession. Lower levels of job satisfaction in older PTs may be due to their sense of accomplishments. Our finding that the opportunities for personal and professional development were one of the best predictors of job satisfaction concurs with that of other studies.4,9 Moreover, consistent with other studies carried out on PTs, we found that professional advancement opportunities were another significant predictor of job satisfaction among PTs.2

Limitations

The response rate (75%) in the current study would be considered excellent;19 it is possible that sample bias may have occurred, in that only those PTs who were either particularly satisfied or dissatisfied with their job may have chosen to participate. Furthermore, as only current employees were included, it is likely that those PTs who were extremely dissatisfied with their job may have already left the work force and thus were ineligible to participate. We did not attempt to control the day of the week on which the survey was completed; this may have affected the results, as job satisfaction has been found to be higher on Fridays than in the middle of the week.20 The authors did not take into consideration the individual work environment. Personal factors such as accessibility to work, marital status, and socioeconomic status would have affected their job satisfaction. Finally, a cross-sectional design was used in this study, which can only provide a snapshot of the perceptions of the PTs studied at a particular point of time.

Clinical implications

While the results of this study cannot be directly extrapolated to other PT departments, the results will be of interest to managers of PT departments, particularly those in Saudi Arabia. Based on our results, ways in which managers and directors of PT departments may be able to improve job satisfaction of PTs include careful consideration of issues such as workload and administrative policies. Specifically, they should consider the number of patients seen per day, quality of patient care, opportunities for professional development, time allotted for paperwork, consistency of organizational policies, and therapist input into organization decisions.

In conclusion, this study demonstrates that Saudi PTs were moderately satisfied with their jobs. Factors such as gender, age, their relationship with supervisors/managers, work environment, and professional development were found to be the chief determinants of job satisfaction. The results of this study could be utilized to design strategies to improve the job satisfaction of PTs motivation and thus enhance the recruitment and retention of PTs and improve the quality of PT services in Saudi Arabia.