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      Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

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          Abstract

          Background

          Nurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces.

          Methods

          During 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis.

          Results

          A total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001).

          Conclusion

          Allowing nurses greater choice of clinic to work in, the prevention of violence and addressing workloads could improve the practice environment and job satisfaction of PHC clinic nursing managers.

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          Most cited references39

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          Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

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            Patient safety: fatigue among clinicians and the safety of patients.

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              Estimating health workforce needs for antiretroviral therapy in resource-limited settings

              Background Efforts to increase access to life-saving treatment, including antiretroviral therapy (ART), for people living with HIV/AIDS in resource-limited settings has been the growing focus of international efforts. One of the greatest challenges to scaling up will be the limited supply of adequately trained human resources for health, including doctors, nurses, pharmacists and other skilled providers. As national treatment programmes are planned, better estimates of human resource needs and improved approaches to assessing the impact of different staffing models are critically needed. However there have been few systematic assessments of staffing patterns in existing programmes or of the estimates being used in planning larger programmes. Methods We reviewed the published literature and selected plans and scaling-up proposals, interviewed experts and collected data on staffing patterns at existing treatment sites through a structured survey and site visits. Results We found a wide range of staffing patterns and patient-provider ratios in existing and planned treatment programmes. Many factors influenced health workforce needs, including task assignments, delivery models, other staff responsibilities and programme size. Overall, the number of health care workers required to provide ART to 1000 patients included 1–2 physicians, 2–7 nurses, <1 to 3 pharmacy staff, and a much wider range of counsellors and treatment supporters. We estimate from these data that the equivalent of 20 000 to 100 000 physicians, nurses, pharmacists and other core clinical staff will be needed to meet the WHO target of treating 3 million people by the end of 2005. The total number of staff, including counsellors, administrators and other cadres, could be substantially higher. Discussion These data are consistent with other estimates of human resource requirements for antiretroviral therapy, but highlight the considerable variability of current staffing models and the importance of a broad range of factors in determining personnel needs. Few outcome or cost data are currently available to assess the effectiveness and efficiency of different staffing models, and it will be important to develop improved methods for gathering this information as treatment programmes are scaled up.
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                Author and article information

                Contributors
                Journal
                Hum Resour Health
                Hum Resour Health
                Human Resources for Health
                BioMed Central
                1478-4491
                2014
                15 May 2014
                : 12
                : 27
                Affiliations
                [1 ]Centre for Health Policy & Medical Research Council Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Private Bag X3, Wits 2050 Braamfontein, Johannesburg, South Africa
                [2 ]Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
                Article
                1478-4491-12-27
                10.1186/1478-4491-12-27
                4024627
                24885785
                586fb7e2-2e5b-412d-b0cd-617c173a8002
                Copyright © 2014 Munyewende et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 November 2013
                : 29 April 2014
                Categories
                Research

                Health & Social care
                job satisfaction,primary health care,nursing managers,health workforce,south africa

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