International Journal of Public Health Science (IJPHS)

Vol. 11, No. 4, December 2022, pp. 1416~1423

ISSN: 2252-8806, DOI: 10.11591/ijphs.v11i4.21529  1416

Job satisfaction among primary health care nurses

Edy Soesanto1, Arief Yanto1, Ninin Irani2, Satriya Pranata1, Sri Rejeki1, Priyo Sasmito3
1
Department of Nursing, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang, Semarang, Indonesia
2
Karangawen Primary Health Care, Demak, Indonesia
3
Department of Applied Anesthesia Nursing, Faculty of Vocational Sciences, Universitas Medika Suherman, Bekasi, Indonesia

Article Info ABSTRACT

Article history: This study aimed to analyze the job satisfaction of nurses in primary health
care facilities. This study employed a quantitative descriptive design. The
Received Nov 11, 2021 research used a cross-sectional approach. This study involved 226 nurses
Revised Aug 20, 2022 who worked in 15 inpatients primary health care. The sampling technique
Accepted Aug 6, 2022 uses a proportionate simple random sampling technique. Nurse job
satisfaction instruments assessed context factors and content factors. Nurse
job satisfaction on context factor was in a good category by a big
Keywords: responsibility for nurse's work (55.2%), progress in work developed well
(63.4%), nurses had the opportunity to achieve achievement (54.5%), nurses
Job satisfaction got great recognition for performance (58.6%) and felt their work is valuable
Nurse (65.5%). Job satisfaction was supported by policy indicators, supervision,
Performance salary, interpersonal relationships, and good working conditions. On the
Primary health care other hand, nurses' job satisfaction on the content factor still needs to be
optimized. This is supported by the job satisfaction of nurses on the indicators
of responsibility, achievement, performance recognition that has not reached
60%. Therefore, job satisfaction among nurses in inpatient primary health care
was quite good enough but still requires optimization on the content factor.
This is an open access article under the CC BY-SA license.

Corresponding Author:
Edy Soesanto
Department of Nursing, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang
Kedungmundu Street No.18, Kedungmundu, Tembalang, Semarang City, Indonesia
Email: [email protected]

1. INTRODUCTION
Society is starting to realize the importance of health, professionalism, and high quality from health
service to reach high service quality requires a strong and quality resource component, including human
resources [1], [2]. Primary health care is the foremost and closest health service place to the community which
has a public service function and a medical service function. Primary health care services are comprehensive
providers, covering aspects of promotion, prevention of health problems, treatment, and recovery [3], [4].
Nurses are an important component in a health service at primary health care. The number of nurses
dominates until (55-65%). Nursing services are carried out constantly and continuously for 24 hours to patients
every day [3], [5]. This reality shows the large contribution of the nursing profession in determining the quality
of health services. Based on several studies on the average productive working time of nurses at primary health
care in Indonesia about 46.8% was used for non-productive and 53.2% for productive activities. On the other
hand, about 39.9% is used for visitor activities [6], [7]. This shows a problem related to the performance of
nurses in providing health services because of lack of patient satisfaction at the primary health care caused by
waiting time for emergency care, nurse vacancies, responsiveness, competence, and visit schedules [8]–[10].
Nurses who experience low work motivation can reduce the quality of nursing care delivery [11]–[13]. Nurses

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Int J Public Health Sci ISSN: 2252-8806  1417

still think that their high workload is not supported by appropriate policies will further reduce work
motivation [12], [14], [15]. The situation was exacerbated by the violations committed by the troubled nurse.
The results of the preliminary study indicate that the nursing service gap can be caused by the
unsatisfactory working of the nursing services. Nurse job satisfaction is very important in an effort to
maximize the quality of health services because satisfaction is one component of work motivation. Staff job
satisfaction is the result or response of individual perceptions of factors in their work and is supported by
social factors [16]. According to Herzberg's theory, job satisfaction is also influenced by intrinsic factors
(achievement, recognition, responsibility, and progress) and extrinsic factors (salary, security, working
conditions, employment status, standards, supervision, and interpersonal relationships) [17]. Job satisfaction
status can affect the implementation of the next job. Self-actualization of workers can be formed from the job
satisfaction they have. A nurse's psychological maturity is determined by job satisfaction. Failure to achieve
job satisfaction can result in decreased morale, work fatigue and unstable emotional conditions. Therefore, it
is necessary to do research that can provide an overview of the job satisfaction of nurses in basic services.

2. RESEARCH METHOD
This was a descriptive quantitative study with a cross-sectional approach. This study examined the
job satisfaction among nurses at primary health care. The respondents of this study are 226 nurses who
served in 15 primary health care inpatients in Demak Regency, Central Java, Indonesia. The inclusion criteria
were nurses with undergraduate education, registered as nursing staff at inpatient health centres in Demak
Regency and willing to become participants. Meanwhile, the exclusion criteria were nurses with chronic
illness and still in study assignment at a university. Chronic illness will disrupt a person's psychology and
have an impact on satisfaction. Moreover, staff who are pursuing high-level education are sometimes more
satisfied with their jobs because of their learning and career opportunities. These exclusion criteria are
confounding factors and need to manage in this study. The sampling technique was carried out using a
proportionate simple random sampling. This study had been declared ethically qualified according to the
ethical clearance certificate number: 346/KEPK-FKM/UNIMUS/2020.
Measurement of job satisfaction was using a questionnaire. The research instrument is arranged based
on the measured variable indicators: variable context factor and content factor. Context factor indicators
include: i) Primary health care policies; ii) Supervisor/supervision; iii) Salary; iv) Interpersonal relationships;
and v) Working conditions. Each indicator consists of 5 questions, while the content factor includes: i)
Responsibility; ii) Progress in work; iii) Opportunities for achievement; iv) Recognition of performance; and v)
Work value [16], [17]. The instrument has been through expert testing for content validity and declared valid at
the context validity. Pearson product-moment test revealed that the instrument variable context factor consists of
25 items with a value of r=0.430-0.777, and the content factor instrument consists of 26 items with a value of
r=0.429-0.763. The instrument has been declared reliable with an alpha value of 0.970.
Respondents were given an explanation about the study before data collection. The respondents
agreed to join the study by signing an informed consent sheet. Data were collected by direct interviews with
respondents by referring to the questions in the questionnaire. Researchers maintainws confidentiality by not
including the identity of the research subject or anonymous. The research data that has been obtained was
carried out by descriptive analysis on each variable and indicator. The characteristics of respondent can be
seen in Table 1, meanwhile job satisfaction data is presented in Tables 2 and 3.

Table 1. Respondents’ characteristics

Indicator F %
1. Age
Young adult (≤30 years old) 64 44
Adult (>30 years old) 81 56
2. Gender
Male 46 31.8
Female 99 68.2
3. Length of work
Beginner (<60 months) 11 7.6
Expert (≥60 months) 134 92.4
4. Marital status
Married 103 71
Single 42 29
5. Employment status
Civil servant 95 65.5
Non civil servant 50 34.5
6. Job position
Nurse coordinator/head of nurse 11 7.6
Nurse operational 134 92.4

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Tabel 2. Distribution frequency of job satisfaction among nurses context factor

Indicator F %
1. Satisfaction with Public Health Care’s policies
No 42 29
Yes 103 71
2. Satisfaction with supervision
No 56 38.6
Yes 89 61.4
3. Satisfaction with salary
No 39 27
Yes 106 73
4. Satisfaction with interpersonal relationships
Yes 113 78
No 32 22
5. Satisfaction with working conditions
No 49 33.8
Yes 96 66.2

Tabel 3. Frequency distribution of job satisfaction among nurses content factor

Indicator F %
1. Satisfaction with responsibility
Yes 80 55.2
No 65 44.8
2. Satisfaction with the progress at work
No 53 36,6
Yes 92 63.4
3. Satisfaction with the opportunity for achievement
Yes 79 54.5
No 66 45.5
4. Satisfaction with recognition of performance
Yes 85 58.6
No 60 41.4
5. Satisfaction with the value of work
Yes 95 65.5
No 50 34.5

3. RESULTS AND DISCUSSION

3.1. Respondent characteristics
Indicators of respondent characteristics measured in this study included: i) Age; ii) Gender; iii)
length of Work; iv) Marital status; v) Employment status; and vi) Job position. Most of respondent were adult
56%, female 68.2%, length of work ≥60 months, married 71%, civil servant 65.5% and as nurse operational
92.4%. The data can be seen in Table 1.

3.2. Nurse job satisfaction

Nurse job satisfaction is identified through context factors can be seen in Table 2 and content factors
can be seen in Table 3. Context factor indicators include: i) public health care’s policies; ii) implementation
of supervision; iii) wages or salaries; iv) interpersonal relationships; and v) working conditions. Indicators of
content factor include: i) Responsibility; ii) Progress at work; iii) Opportunities for achievement;
iv) Recognition; and v) Work value.
Nurse job satisfaction is an assessment response to the conditions by nurses in the clinical setting.
Job satisfaction is subjective which is the impact of the needs that exist in a person associated with the
conditions received. Job satisfaction is influenced by motivation, commitment, and work discipline [17].
Factors that affected job satisfaction is a content factor included: responsibility, progress,
opportunities for achievement, recognition, and job value. While the context factors include: i) Applicable
policies within the company; ii) Supervision; iii) Wages/salaries; v) Interpersonal relationships; and
v) Working conditions [18]. Context factors can encourage someone to meet the needs of lower levels.
Failure to fulfill context factors can make staff dissatisfied.
Indicators that built job satisfaction (content factor) in this study are: a big responsibility for nurse's
work (55.2%). Progress in work developed well (63.4%). Nurses had the opportunity to achieve achievement
(54.5%). Nurses also get great recognition for performance (58.6%) and feel their work is valuable (65.5%).
Based on the results above, it can be concluded that factors that can encourage people to be able to meet the
needs of their upper level have been met. As a result, nurses become satisfied with their work. Meanwhile,
indicators that lead to job dissatisfaction (context factor) in this study were: most respondents consider the

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primary health care policy to be appropriate (71%) and support supervisors/supervision (61.4%) and consider
their salaries to be appropriate (73%). The interpersonal relationship among nurses quite good (78%) and
working situations were appropriate (66.2%). Based on the result above, it can be concluded that factors
related to the work environment have provided opportunities for nurses to fulfill lower-level needs, therefore
prevent nurses to be dissatisfied with their work.
Each individual has different job satisfaction according to the value system adopted. Individual
perceptions of a value affect their expectations. Matching between expectations and what is received in the
job, may impact job satisfaction [18]. The description of the indicators that cause job dissatisfaction (context
factors) in this study are as follows:

3.2.1. Satisfaction with public health center’s policies

Public health center’s policies that nurses feel so far has been in accordance with the wishes of
nurses. It can be seen from several statements of respondents where policymaker at the primary health care
always discussed widely and openly to nurses (87%), primary health care always encourages nurses to
continue to develop (83%) and each assignment is clearly defined so that nurses can understand their duties,
responsibilities, and rights properly (80%). Policies can determine the type of job of nurses, workload,
responsibility, promotion system, wages/salary, and work environment either physically or psychologically
[18], [19]. Therefore, policies that were based on nurses' needs and fairly (fair and just) will be able to
improve job satisfaction [17].

3.2.2. Satisfaction with supervision

Most of the respondents in this study mentioned that supervision had good applied and received
good support, this is reflected in the following statements; their leaders had treated nurses with respect as
many as 121 people (83.4%) and leaders had provided support and high work motivation, about 116 people
(80%), willing to receive nurse suggestions of 112 people (77. 2%). The study shows that job satisfaction can
be improved with direct supervision because direct supervision related to friendly, understanding, listening,
and positive reinforcement. Supervision is an important part of nursing service management which is useful
for managing any problems quickly. Good supervisors are able to motivate nursing staff to work in a
comfortable atmosphere and enjoyable. So, these also can improve job satisfaction [20].

3.2.3. Satisfaction with salary

Salary is in accordance with the wishes of nurses, it can be seen from several statements which
strengthen; nurses receive increases salary periodically and automatically by 95 people (65.5%). Received
appropriate salary each month 74 people (51%), but there are some nurses who mention that they received
salary inappropriate where the income received was not sufficient to meet the daily needs of 24 people
(16.6%). If the salary is given fairly according to job demands, individual skill level, and community wage
standard, it will likely result in worker satisfaction [18]. A person will feel satisfied if there is no gap between
expectations and reality. The bigger the gap, the bigger dissatisfied. Vice versa, if salary received are higher
than expected, it will improve job satisfaction [21].

3.2.4. Satisfaction with interpersonal relationships

This study illustrated that the interpersonal relationship in public health care is quite good. It can be
seen by the data from nurse’ statements, nursing activities by team and helps each other between colleagues
as many as 138 people (95.2%) and they feel well accepted as a team of 131 people (90.3%). A harmonious
relationship with superiors will make subordinates respect their superiors and every task given will be done
well and with full sincerity. The existence of a relationship that is mutually supportive and caring for each
other between colleagues will create a comfortable and warm work environment that results in job
satisfaction for nurses [22], [23].

3.2.5. Satisfaction with working conditions

The majority of nurses understand with the working conditions and high responsibility at the public
health center were suitable and supported the duties in providing nursing services. It was indicated by several
statements that the workflow in the nursing department is well supported about 128 people (88.3%),
the division of tasks in the nursing section can assist in providing services to 126 patients (86.9%), and
a manual standard operating procedure for the implementation of nursing tasks is already supported for 116
people (80%). Many studies state that employees prefer a physical environment that is not dangerous in terms
of place, facilities, and infrastructure. The comfort of the workplace can make nurses feels at home in their
workroom to carry out his duties. A work environment that is too extreme, such as air temperature, lighting,
ventilation, and noise will affect job satisfaction because it can cause physical disturbances [24]. The
description of the indicators that cause job satisfaction (content factor) in this study is as follows:
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3.2.6. Satisfaction with responsibility

The majority of nurses understand with the working conditions and high responsibility at the public
health center. Understanding working conditions will encourage a person's initiative to feel that the
workplace is more friendly [25]. This is in accordance with the statement of the respondent who states that
they have been given the freedom to carry out his work as a nurse as many as 100 people (69%) and is often
involved by the leadership in making important decisions related to work as many as 73 people (50.3%).
Nurses who have high personal responsibility can find out whether a nurse in doing work will be able to
improve productivity in accordance with the standards desired by an organization or not [26], [27]. Someone
who has high personal responsibility will actively try to show commitment, behavior, and lifestyle that can
maximize achievement and fully actualize themselves according to their own ways [24].

3.2.7. Satisfaction with the work progress

This study shows that nurses have been given many opportunities to improve the ability to provide
professional nursing services, this is reflected in the statement of respondents that the leadership has given
permission to take part in training, courses, seminars, and a higher level of study about 129 people ( 89%)
and leaders encourage to always improve skills in nursing as many as 120 people (83%). A person who is
promoted is generally considered to have good achievements, and there are also several other supporting
considerations [28], [29]. Promotion levels can increase the enthusiasm and passion of employees at work.

3.2.8. Satisfaction in the opportunity for achievement

In this study, the nurses feel that they have the opportunity to achieve and improve their abilities,
this is in accordance with what they said that the leadership conducted an evaluation (feedback) to improve
employee performance as many as 106 people (73.1%) and the leadership always encouraged to improve
performance by 104 people (71.7%). Good employee performance can increase the award received.
Appropriate and fair rewards according to employees will increase job satisfaction. Likewise, if the award is
deemed inappropriate, it will also result in decreased job satisfaction [26], [27]. The relationship between job
satisfaction and job performance becomes an interacting and sustainable system. An organization must have
a career management system for employees. Career development can increase work productivity while
reducing the adverse effects of work [30]. Career management is able to improve the creativity of human
resources and foster commitment for employees to improve performance to achieve organizational goals.

3.2.9. Satisfaction with recognition of performance

The description of recognition of the performance among nurses in this study mostly stated that they
received recognition for their performance, especially related to the performance appraisal system at the
primary health care. Recognition in this study mean formal acknowledgement of their existence as health
professionals. The recognition was not favouritism for 104 people (71.7%) and the ideas of nurses for
changes were well received by the leadership because the performance of nurses was good for 78 people
(53.8%). Recognition of employee abilities can improve job satisfaction. This is because the employee's need
to feel valued can be fulfilled. This recognition can also improve employee motivation. With good
motivation, employees will be able to work optimally [21].
Employees’ success influenced by self-confidence and consistent work motivation. As a social
human being has a need for self-actualization. Recognition by an organization or company can improve
teamwork. Besides, there is also a need for mutual understanding among team members to achieve optimal
organizational performance [21]. Basically, everyone likes to be appreciated by others. In fact, most of the
workers consider personal recognition to be more motivating than material rewards [17].

3.2.10. Satisfaction of job value

In satisfaction of job value, they understand well their duties and responsibilities as a nurse.
They have understood well the job description as a nurse 138 people (95.2%) and the jobs given in
accordance with the skills/competencies that they have 129 people (89%). No matter how small the work we
did, if we understand that the work is part of a big plan, or that the work is a process towards the realization
of something big, then there will be no small feelings in our hearts when doing that work. Job satisfaction
itself is the main source of satisfaction, where the job provides interesting tasks, opportunities to learn,
opportunities to accept responsibility, and progress for employees [29].

4. CONCLUSION
The study revealed that most of the respondents were satisfied to their job. Aspects that meet the job
satisfaction of nurses in this study were: i) Satisfaction with appropriate salaries; ii) Satisfaction with

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comfortable working conditions; iii) Satisfaction with responsibility as a nurse by dividing tasks equally
among all nurses so that they feel involved in the process of improving care services; iv) Satisfaction with the
opportunity for achievement by giving encouragement among nurses to always improve their performance
and provide varied or different tasks; and v) Satisfaction with recognition of their performance through
giving rewards that are more than criticism and giving appreciation for their performance both financial and
non-financial. However, nurses' job satisfaction on the content factor still needs to be optimized. This is
supported by the job satisfaction of nurses on the indicators of responsibility, achievement, performance
recognition that has not reached 60%.

ACKNOWLEDGEMENTS
The research was supported by a grant from Universitas Muhammadiyah Semarang, Indonesia.

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BIOGRAPHIES OF AUTHORS

Edy Soesanto is a researcher and lecturer at Universitas Muhammadiyah

Semarang. His current activities are teaching, researching and writing books. He has published
many peer-reviewed scientific articles in major journals on the subjects of public health, bio-
moleculer and nursing. He has written the books about nurse competencies with national scope.
He can be contacted at email: [email protected].

Arief Yanto is a researcher and lecturer at Universitas Muhammadiyah Semarang.

His current activities are teaching and researching. He has published many peer-reviewed
scientific articles in major journals on the subjects of public health, bio-moleculer and nursing.
He can be contacted at email: [email protected].

Ninin Irani is a nurse at Primary Health Care in Demak Regency Semarang. His
current activities are providing nursing services and researching. She has published peer-
reviewed scientific articles in major journals on the subjects of nursing. She can be contacted at
email: [email protected].

Satriya Pranata is now working as a lecturer at Universitas Muhammadiyah

Semarang since 2017-present. His current activities are teaching, researching and writing books.
Currently, Satriya Pranata is pursuing a doctoral degree in Nursing at the National Taipei
University of Nusing and Health Sciences, Taiwan. He has published research in international
and national journals as well as books related with diabetes. He can be contacted at email:
[email protected].

Int J Public Health Sci, Vol. 11, No. 4, December 2022: 1416-1423
Int J Public Health Sci ISSN: 2252-8806  1423

Sri Rejeki is a researcher and lecturert at Universitas Muhammadiyah Semarang.

His current activities are teaching, researching and writing books. He has published many peer-
reviewed scientific articles in major journals on the subjects of public health, bio-moleculer and
nursing. He has written the books about pregnancy with national scope. She can be contacted at
email: [email protected].

Priyo Sasmito is a researcher and lecturer at Universitas Medika Suherman. His

current activities are teaching and researching. He has published many peer-reviewed scientific
articles in major journals on the subjects of nursing management, emergency nursing and
disasters. He can be contacted at email: [email protected].

Job satisfaction of nurses at inpatients primary health care in Demak Regency (Edy Soesanto)