Lu Et Al 2005 Job Satis Lit Review IJNS

ARTICLE IN PRESS

0020-7489/$ - se

doi:10.1016/j.ijn

�CorrespondE-mail addr

International Journal of Nursing Studies 42 (2005) 211–227

www.elsevier.com/locate/ijnurstu

Job satisfaction among nurses: a literature review

Hong Lu�, Alison E. While, K. Louise Barriball

Florence Nightingale School of Nursing and Midwifery, King’s College London, James Clerk Maxwell Building,

57 Waterloo Road, London SE1 8WA, England, UK

Received 13 May 2004; received in revised form 15 August 2004; accepted 7 September 2004

Abstract

The current nursing shortage and high turnover is of great concern in many countries because of its impact upon the

efficiency and effectiveness of any health-care delivery system. Recruitment and retention of nurses are persistent

problems associated with job satisfaction. This paper analyses the growing literature relating to job satisfaction among

nurses and concludes that more research is required to understand the relative importance of the many identified factors

to job satisfaction. It is argued that the absence of a robust causal model incorporating organizational, professional and

personal variables is undermining the development of interventions to improve nurse retention.

r 2004 Elsevier Ltd. All rights reserved.

Keywords: Job satisfaction; Nurse shortage; Nurse retention; Nurse turnover; Intention to quit

1. Introduction

The widespread nursing shortage and nurses’ high

turnover has become a global issue (Kingma, 2001)

which is of increasing importance to both the developed

and developing countries (Cavanagh, 1990; Blegen,

1993; Hancock, 1998; Lee, 1998; Aiken et al., 2001;

Fang, 2001; Lu et al., 2002). In light of this, concern

about recruitment and retention of nursing staff is

increasing in a number of countries (Lundh, 1999).

While numerous factors have been linked to nurses’

turnover, job satisfaction is the most frequently cited

(Cavanagh and Coffin, 1992; Blegen, 1993; Irvine and

Evans, 1995), and therefore merits attention. This review

examines the extensive empirical literature regarding

nurses’ job satisfaction and its associated factors.

e front matter r 2004 Elsevier Ltd. All rights reserve

urstu.2004.09.003

ing author.

ess: [email protected] (H. Lu).

2. The definition of job satisfaction

Job satisfaction is a topic of wide interest to both

people who work in organizations and people who study

them. It is a most frequently studied variable in

organizational behaviour research, and also a central

variable in both research and theory of organizational

phenomena ranging from job design to supervision

(Spector, 1997). The traditional model of job satisfac-

tion focuses on all the feelings that an individual has

about his/her job. However, what makes a job satisfying

or dissatisfying does not depend only on the nature of

the job, but also on the expectations that individuals

have of what their job should provide.

The work of Maslow (1954) is seminal and suggested

that human needs form a five-level hierarchy ranging

from physiological needs, safety, belongingness and

love, esteem to self-actualization. Based on Maslow’s

theory, job satisfaction has been approached by some

researchers from the perspective of need fulfillment

(Kuhlen, 1963; Worf, 1970; Conrad et al., 1985).

d.

www.elsevier.com/locate/ijnurstu

ARTICLE IN PRESSH. Lu et al. / International Journal of Nursing Studies 42 (2005) 211–227212

However, this approach has become less popular with

increasing emphasis on cognitive processes rather than

on underlying needs so that the attitudinal perspective

has become predominant in the study of job satisfaction

(Spector, 1997).

In contrast to the traditional view, Herzberg and

Mausner (1959) formulated the two-factor theory of job

satisfaction and postulated that satisfaction and dis-

satisfaction were two separate, and sometimes even

unrelated phenomena. Intrinsic factors which they

named ‘motivators’ (i.e. factors intrinsic to the nature

and experience of doing work) were found to be job

‘satisfiers’ and included: achievement, recognition, work

itself and responsibility. Extrinsic factors which they

named ‘hygiene’ factors were found to be job ‘dissatis-

fiers’ and included: company policy, administration,

supervision, salary, interpersonal relations and working

conditions. Herzberg and Mausner’s Motivation-Hy-

giene theory has dominated the study of the nature of

job satisfaction, and formed a basis for the development

of job satisfaction assessment (Table 1).

Thus job satisfaction is the affective orientation that

an employee has towards his or her work (Price, 2001).

It can be considered as a global feeling about the job or

as a related constellation of attitudes about various

aspects or facets of the job. The global approach is used

when the overall attitude is of interest while the facet

approach is used to explore which parts of the job

produce satisfaction or dissatisfaction. Based on the

review of the most popular job satisfaction instruments,

Spector (1997) summarized the following facets of job

satisfaction: appreciation, communication, co-workers,

fringe benefits, job conditions, nature of the work itself,

the nature of the organization itself, an organization’s

policies and procedures, pay, personal growth, promo-

Table 1

Definition of job satisfaction

Definition

The individual matching of personal needs to the perceived

potential of the occupation for satisfying those needs (Kuhlen,

1963)

Need fulfillment, that is, whether or not the job met the

employee’s physical and psychological needs for the things

within the work situation (Worf, 1970)

A match between what individuals perceive they need and

what rewards they perceive they receive from their jobs (Conrad

et al., 1985)

A function of satisfaction with the various elements of the job

(Herzberg and Mausner, 1959)

All the feelings that an individual has about his job (Gruneberg,

1976)

The affective orientation that an employee has towards his or

her work (Price, 2001)

tion opportunities, recognition, security and super-

vision.

3. Identification of the literature

The literature relating to job satisfaction and nurses

was identified through electronic databases. The electro-

nic databases used to obtain the relevant literature were:

CINAHL (1982–2004), Medline (1966–2004), PsycIN-

FO (1974–2004) and British Nursing Index (1985–2004).

Some databases in Chinese such as China Medical

Academic Conference (1985–2004) and China Academic

Journal (1985–2004) were also used. To maximize the

amount of relevant literature, key phrases and similar

phrases were utilized in the subject search in combina-

tion with nurses following guidelines for searching

OVID interface. This identified 1189 published research

papers from all the databases searched. The abstracts or

full texts of the papers were reviewed prior to their

inclusion in the literature review. One thousand and

eighty-eight papers were deemed not relevant and 47

papers were of poor quality (research method including

data analysis unclear). Additionally, the reference lists of

the selected papers were examined to identify earlier

seminal sources.

4. Sources of nurses’ job satisfaction

Given that job satisfaction has been found to be

related to performance within the work setting

(Landeweerd and Boumans, 1988), it is not surprising

that the concept of job satisfaction has attracted much

attention. Researchers have attempted to identify the

Related theory

Maslow’s human needs theory (Maslow, 1954)

Herzberg and Mausner’s motivation-hygiene theory (Herzberg

and Mausner, 1959)

Focus on cognitive process (Spector, 1997)

ARTICLE IN PRESSH. Lu et al. / International Journal of Nursing Studies 42 (2005) 211–227 213

various components of job satisfaction, measure the

relative importance of each component of job satisfac-

tion and examine what effect these components have on

workers’ productivity (Burnard et al., 1999). A range of

findings derived from quantitative studies as well as

qualitative studies has been reported in the literature on

sources of job satisfaction among nurses.

Aiken et al. (2001) found job dissatisfaction among

nurses was highest in the United States (41%) followed

by Scotland (38%), England (36%), Canada (33%) and

Germany (17%). One third of nurses in England and

Scotland and more than one fifth in the United States

planned on leaving their job within 12 months of data

collection. More striking, however, was that 27–54% of

nurses under 30 years of age planned on leaving within

12 months of data collection in all countries. Regarding

the work climate, only about one third of nurses in

Canada and Scotland felt that they participated in

developing their own work schedules in comparison with

more than half in the other three countries. When

compared with other countries, the nurses in Germany

(61%) reported that they were more satisfied with the

opportunities for advancement while the nurses in the

United States (57%) and Canada (69%) felt more

satisfied with their salaries.

Similarly, Adamson et al. (1995) found that British

nurses perceived themselves to be more dissatisfied than

Australian nurses (po0:001). The British nurses per-

ceived their professional status to be lower (po0:01),their relationship with hospital administrators to be

poorer (po0:01), and their working conditions to be lessadequate than Australian nurses (po0:01). They alsoreported more conflict between the idealized perspective

of work gained during training and actual work practice

(po0:01), and were less satisfied with their professionalorganization (po0:01). The British nurses were also

more concerned about the lack of communication

between nurses and doctors (po0:01) and reported

being less respected by other allied health professionals,

hospital administrators and doctors (po0:01). However,there was no overall significant difference between the

Australian and British nurses regarding perceived level

of autonomy of the medical profession (p40:01).Different measurements regarding nurses’ job satis-

faction show various sources of satisfaction. The

findings derived from different studies using the same

scales are more valuable in providing comparative

information, particularly some cross-culture data. For

example, the Adams et al.’s (1995) Ward Organizational

Features Scales were used in a set of studies to collect

information from nurses about their perceptions of the

various aspects of ward life and the impact which they

had on care organization (Tovey and Adams, 1999;

Adams and Bond, 2000). The tool comprised six sets of

measures comprising 14 sub-scales rated on a 4-point

Likert scale (1=strong disagree/very bad/very difficult,

4=strongly agree/very good influence/very easy): phy-

sical environment of the ward, professional nursing

practice, professional working relationships, ward lea-

dership, nurses’ influence and job satisfaction. The

test–retest reliabilities of the scales were good with a

correlation coefficient of 0.7 or above (Adams et al.,

1995).

Utilizing this questionnaire, Tovey and Adams (1999)

found that key sources of nurses’ dissatisfaction

included working relationships, particularly those with

management, lack of staff, professional concerns about

poor standards of care and external work pressure.

Adams and Bond (2000) found that most nurses

positively rated aspects of ward services, facilities and

layout (mean43, respectively). The highest correlationswere found between job satisfaction and cohesion of the

ward nursing team (r ¼ 0:51; po0:001), staff organiza-tion (r ¼ 0:46; po0:001), the level of professional

practice achieved within the ward (r ¼ 0:46; po0:001)and collaboration with medical staff (r ¼ 0:41;po0:001). Furthermore, the most important contribu-tors to nurses’ job satisfaction were the degree of

cohesion existing among ward nurses (R2 ¼ 0:26), thedegree of collaboration with medical staff (R2 ¼ 0:20)and perception of staff organization (R2 ¼ 0:20).Nolan et al.’s (1995) Job Satisfaction Questionnaire

was also utilized in a series of studies in the different

countries to assess nurses’ job satisfaction and morale

(Nolan et al., 1995, 1998; Lundh, 1999). It comprises 16

items addressing aspects of the work environment,

perceptions of change in the last 12 months and overall

satisfaction and morale. Responses are rated on a 5-

point Likert scale (‘strongly agree/increased a lot’ to

‘strongly disagree/ decreased a lot’).

Nolan et al. (1995) found that level of job satisfaction

had remained stable and two factors were dominant in

nurses’ understanding of satisfaction and morale,

namely: the perceived ability to deliver good patient

care and good collegiate relationships with co-workers.

Together, these accounted for more than 50% of all the

additional positive comments received. Nolan et al.

(1998) further found that the vast majority of respon-

dents (85%) considered that their work was interesting,

and this was one of the most significant factors

influencing job satisfaction. Regarding job satisfaction

and morale, 35% of respondents considered that their

job satisfaction had decreased in the last year and 69%

felt that overall morale had fallen.

Similarly, Lundh’s (1999) study showed that over

90% of respondents saw their work as interesting and

most respondents also thought that they received respect

from their superiors (68%). Conversely, however, 55%

of respondents reported that leadership within the

organization was not seen to be particularly democratic

with limited opportunities to influence the decisions

of managers. In addition, nearly three quarters of


respondents reported that their levels of stress had

increased over the last 12 months, while important

aspects of their job satisfaction, such as satisfaction with

pay and satisfaction with overall working conditions

had fallen.

In addition to providing a general outline of reported

job satisfaction, Price (2002) explored key areas of job

satisfaction using the Mueller and McCloskey’s

(1990a, b) Satisfaction Scale. It is a 5-point Likert scale

(5=very satisfied, 1=very dissatisfied) comprising 31

items on eight dimensions: extrinsic rewards, scheduling,

balance of family and work, co-workers, interaction

opportunities, professional opportunities, praise and

recognition, control and responsibility. The global

scale’s correlation coefficient was reported as 0.89 and

the validity ranged from 0.53 to 0.75, with the scale

correlating positively with several established satisfac-

tion scales. The results demonstrated that over half of

the respondents (58%) were generally satisfied with their

job. They identified that highest satisfaction was related

to co-workers and extrinsic rewards (mean=3.8 and 3.5,

respectively) and that most dissatisfaction was with the

amount of control and responsibility they had and with

professional opportunities (mean=2.7 and 2.6, respec-

tively). The individual items on this scale with which

nurses were most satisfied were identified as annual

leave, nursing peers and hours worked (79%, 78% and

Table 2

Sources of nurses’ job satisfaction

Sources of job satisfaction

Working conditions

Interaction

Relationships with patients

Relationships with co-workers

Relationships with managers

Work itself

Workload; scheduling; challenging work; routinization; task

requirements (abilities, skills etc)

Remuneration (pay, salary)

Self-growth and promotion

Professional training; opportunities of advancement; job

promotion; personal achievement

Praise and recognition

Control and responsibility

Autonomy; decision-making

Job security

Leadership styles and organizational policies

76% of respondents scored 4 or 5, respectively), and for

dissatisfaction compensation for working weekends and

control over work conditions and childcare facilities

(55%, 55% and 46% of respondents scored 1 or 2,

respectively). Using the same scale, Wang (2002) found

that Chinese nurses were more dissatisfied than satisfied

(mean=2.51) and were mostly dissatisfied with pay

(mean=1.85) and job promotion (mean=1.97).

From another point of view, Lee’s (1998) cross-

sectional survey examined the level of job satisfaction

regarding six job components (autonomy, professional

status, pay, interaction, task requirements and organiza-

tional policies) using the Index of Work Satisfaction

(Stamps and Piedmonte, 1986). The first part addresses

the relative importance of each of the six job compo-

nents, using 15 sets of paired comparison statements.

The second part is a 44-item Likert scale that requires

subjects to respond to one of seven choices from

‘strongly disagree’ to ‘strongly agree’ to measure current

levels of satisfaction regarding each of the six compo-

nents. The results showed that nurses were dissatisfied

more than satisfied (mean=3.46) and reported most

satisfaction with professional status (mean=4.17) and

most dissatisfaction with task requirements

(mean=2.81). The level of need for autonomy was

below the mid-score of the sub-scale with no significant

relationship (r ¼ 0:11; p40:1) between their satisfaction

Key empirical sources

Adamson et al. (1995), Nolan et al. (1995), Tovey and Adams

(1999), Adams and Bond (2000), Tzeng (2002a, b)

Adamson et al. (1995), Nolan et al. (1995), Lee (1998), Tovey

and Adams (1999), Adams and Bond (2000), Aiken et al. (2001),

Price (2002), Tzeng (2002a, b), Wang (2002)

Nolan et al. (1995, 1998), Lee (1998), Lundh, (1999), Tovey and

Adams (1999), Adams and Bond (2000), Price (2002), Tzeng

(2002a, b), Wang (2002)

Adamson et al. (1995), Nolan et al. (1995), Lee (1998), Aiken et

al. (2001), Price (2002), Tzeng (2002a, b), Wang (2002)

Nolan et al. (1995), Lee (1998), Aiken et al. (2001), Price (2002),

Tzeng (2002a, b), Wang (2002)

Nolan et al. (1995), Lundh (1999), Aiken et al. (2001), Price

(2002), Wang (2002)

Nolan et al. (1995, 1998), Lee (1998), Price (2002), Wang (2002)

Nolan et al. (1995, 1998)

Lee (1998), Tzeng (2002a, b)


with job autonomy and their individual need for

autonomy.

Tzeng (2002a, b) has also noted that expectation and

reality may be a source of nurses’ dissatisfaction. The

Nurses’ Job Satisfaction and the Perceived Importance

Questionnaire was specially designed for the study and

included 92 items, comprising of 8 job satisfaction scales

and 8 importance indicators (indirect working environ-

ment, direct working environment, salary and promo-

tion, self-growth, challenging work, interaction with

patients, leadership style and working atmosphere).

Responses were given on a 5-point Likert scale ranging

from 1 (least satisfied) to 5 (most satisfied) for job

satisfaction items and from 1 (least important) to 5

(most important) for importance items. Pearson correla-

tion analyses revealed that, except for the scale of

indirect working environment, all the scales were

statistically and significantly correlated to their corre-

sponding scales (pp0:05). The nurse sample identifiedfactors such as indirect working environment (a

hospital’s policies, benefits, leisure activities, housing,

parking, and vacation policy), salary and promotion as

very important but strongly dissatisfying (Table 2).

In conclusion, job satisfaction of nurses is an

important concept as levels of job satisfaction may

impact upon the global nursing workforce. Although the

reported studies differed regarding levels of job satisfac-

tion among nurses, the literature reveals that the sources

of job satisfaction are relatively similar, e.g., physical

working conditions, relationships with fellow workers

and managers, pay, promotion, job security, responsi-

bility, the recognition from managers and hours of

work. Furthermore, it seems that nurses who had

received tertiary education felt less satisfied with their

jobs than those who had not received tertiary education

(Table 3).

5. Effects of job satisfaction of nurses on absenteeism,

burnout, turnover and intention to quit

Absenteeism is an important problem for health-care

providers because it is costly and related to preventable

job stress (Matrunola, 1996). The impact of job

satisfaction upon nursing absenteeism, burnout and

nurses’ intention to quit and turnover has been explored

in a number of research studies, however, the findings

are equivocal.

Siu’s (2002) study of nurses in Hong Kong found that

involvement (the degree of commitment displayed

towards employees by the organization) (b ¼ �0:42;po0:05), job satisfaction (b ¼ �0:21; po0:05), psycho-logical distress (b ¼ 0:20; po0:01) and age (b ¼ �0:20;po0:01) were significant predictors of absenteeism for

sample 1; and organization (the interaction between the

worker and the organization) (b ¼ �0:70; po0:01),

involvement (b ¼ �0:51; po0:05) and occupational type(b ¼ 0:33; po0:001) were significant predictors of

absenteeism for sample 2. The inconsistent findings

may be explained by the relatively small sample sizes, the

unmatched gender ratios, the unmatched occupational

type, the relatively low response rate in sample 2 (57%)

and the use of self-report sickness-absence. Such

inconclusive results suggest that further research in this

area should be replicated among other Chinese nurses.

Conversely, Matrunola’s (1996) found study of English

nurses that there was no relationship between job

satisfaction and absenteeism. In the light of the small

sample size, the generalization of the findings needs to

be treated with caution.

Lee et al.’s (2003) South Korean study showed that

the most frequently mentioned reasons for nurses’

intending to leave their jobs were work overload,

rotating shifts and conflict in interpersonal relationships.

A total of 24%, 15% and 35% of variance regarding

depersionalization, emotional exhaustion and personal

accomplishment, respectively, was explained by the

individual characteristics, job stress and personal

resources. It was particularly noteworthy that nurses

who experienced higher job stress showed lower

cognitive empathy and empowerment, and worked on

night shifts at tertiary hospitals were more likely to

experience burnout.

Regarding the effect of job satisfaction on nurse

turnover, there are some similar findings in the different

studies. Cavanagh (1990) found that US public hospital

nurse turnover could be predicted using kinship

responsibility, promotion, salary and instrumental com-

munication (R2 ¼ 0:37; po0:05). Cavanagh and Coffin(1992) further found job satisfaction and participation at

work to be important variables in the turnover process.

There were four variables significantly related to intent

to stay (po0:05): job satisfaction (r ¼ 0:338), kinshipresponsibilities (r ¼ 0:123), pay (r ¼ 0:086) and oppor-tunity (r ¼ �0:072). However, these findings do not

conclusively support the Price and Mueller’s (1981)

model of nursing turnover.

Gauci Borda and Norman (1997a) found a significant

positive relationship between job satisfaction and intent

to stay (rs ¼ 0:48; po0:005) and negative relationshipsbetween job satisfaction and frequency of 1 day absence

and short-term absence (lasting 3 days or less)

(rs ¼ �0:14; po0:05; respectively) among Maltese

nurses.

Yin and Yang’s (2002) meta-analysis also found that

the strongest individual and organizational factors

related to nurse turnover were job satisfaction

(rxy ¼ �0:23; po0:05), autonomy (rxy ¼ �0:23;po0:05), advancement opportunity (rxy ¼ �0:22;po0:05), job stress (rxy ¼ 0:21; po0:05), pay

(rxy ¼ �0:20; po0:05), group cohesion (rxy ¼ �0:19;po0:05), marital status (rxy ¼ 0:14; po0:05) and

ARTIC

LEIN

PRES

STable 3

Summary of included studies regarding sources of nurses’ job satisfaction

Code study Location Sample and response rate Instruments Key findings Comments

Adams and Bond

(2000)

England 834 nurses of clinical grade C and

above; a response rate of 57%

Adams et al’s

(1995) ward

organizational

features scales

The most important contributors to

nurses’ job satisfaction were the

degree of cohesion (R2=0.20) and

perception of staff organization

(R2=0.20)

Adamson et al.

(1995)

Australia,

England

133 Australian nurses (83%

response rate) and 108 British

nurses (78% response rate)

Specially

designed scales:

British nurses were more dissatisfied

than Australian nurses (po0.001)Medical dominance is a barrier to

both Australian and British nurses’

workplace satisfactionNurses’

dissatisfaction

scale

Medical

autonomy scale

The British nurses perceived their

professional status to be lower, their

relationship with hospital

administrators to be poorer and

their working conditions to be less

adequate than Australian nurses.

Medical

authority scale

Aiken et al.

(2001)

US, Canada,

England,

Scotland,

Germany

43,329 nurses working in adult

acute hospital; a response rate of

42–53%

Nurses’ working

perceptions

questionnaire

(specially

designed)

Job dissatisfaction among nurses

was highest in US

The core problems in nurses’ work

design and workforce management

hold much in common

Maslach and

Jackson’s (1986)

burnout

inventory

The nurses in Germany were more

satisfied with the opportunities for

advancement while the nurses in the

US and Canada (69%) felt more

satisfied with their salaries

Lee (1998) Hong Kong 190 nurses; response rates of

45–83%

Stamps and

Piedmonte’s

(1986) index of

work satisfaction

Nurses more dissatisfied than

satisfied

Edward’s (1959)

personal

preference

schedule (EPPS)

No significant relationship between

satisfaction with job autonomy and

individual need for autonomy

Lundh (1999) Sweden 439 nurses, 83 laboratory

technologists, 31 midwives and 72

managers; an overall response rate

of 59%

Nolan et al.’s

(1995) job

satisfaction

questionnaire

Nurses’ levels of stress had

increased

Satisfaction with pay and overall

working conditions had fallen

H.

Lu

eta

l./

Intern

atio

na

lJ

ou

rna

lo

fN

ursin

gS

tud

ies4

2(

20

05

)2

11

–2

27

216

ARTIC

LEIN

PRES

SNolan et al.

(1995)

Wales 676 nurses, midwives and health

visitors; a response rate of 41%

Nolan et al.’s

(1995) Job

satisfaction

questionnaire

Job satisfaction had remained

stable

Falling confidence in the future of

the NHS

Nolan et al.

(1998)

Sheffield 518 nurses; a response rate of 35% Nolan et al.’s

(1995) job

satisfaction

questionnaire

About 35% of respondents

considered that their job

satisfaction had decreased in the

last year and 69% felt that overall

morale had fallen

Price (2002) England 141 E-grade nurses in a large

teaching hospital; a response rate of

82%

Mueller and

McCloskey’s

(1990a, b)

satisfaction scale

Over half of the respondents (58%)

were generally satisfied with their

job

Caution is needed in generalizing

the results due to the sample bias

with only one grade of nurses

working in acute wards representedHighest satisfaction was related to

co-workers and extrinsic rewards

and most dissatisfaction was with

the amount of control and

responsibility they had and with

professional opportunities

Tovey and

Adams (1999)

England 265 nurses Adams et al.’s

(1995) ward

organizational

features scales

Key sources of dissatisfaction:

working relationships, lack of staff,

professional concerns about poor

standards of care and external work

pressure

Tzeng (2002b) Taiwan 786 nurses; a response rate of 76% Tzeng’s (2002b)

nurses’ job

satisfaction and

the perceived

important

questionnaire

Indirect working environment,

salary and promotion were very

important but strongly dissatisfying

Wang (2002) Mainland China 191 nurses; a response rate of 100% Mueller and

McCloskey’s

(1990a, b)

satisfaction scale

Nurses were more dissatisfied than

satisfied and mostly dissatisfied with

pay and job promotion

H.

Lu

eta

l./

Intern

atio

na

lJ

ou

rna

lo

fN

ursin

gS

tud

ies4

2(

20

05

)2

11

–2

27

217

ARTIC

LEIN

PRES

S

Table 4

Summary of included studies regarding effects of nurses’ job satisfaction

Code study Location Sample and response rate Instruments Key findings Comments

Cavanagh (1990) US 232 hospital nurses; an overall

response rate of 38.5%

Price and

Mueller’s (1981)

turnover scale

The combination of the variables

accounted for 36.8% (po0.05) ofthe explained variance in turnover

rate

Cavanagh and

Coffin (1992)

US 221 nurses; a response rate of 80.5%

in a public hospital and 19.5% in a

private hospital

Price and

Mueller’s (1981)

turnover scale

Factors related to intention to stay:

job satisfaction, kinship

responsibilities, pay and

opportunity

The Price and Mueller’s (1981)

model of nursing turnover was not

conclusively support

Job satisfaction was a key

determinant in the turnover process

Gauci Borda and

Norman (1997a)

Malta 171 nurses; a response rate of 67% Lyons’ (1971)

global

satisfaction scale

A significant positive relationship

between job satisfaction and

intention to stay (r ¼ 0:48;po0:005) and negative relationshipsbetween job satisfaction and

frequency of 1 day/short-term

absence (r ¼ �0:14; po0:05;respectively)

The model of absence and turnover

(Gauci Borda and Norman, 1997b)

was not totally supported

Mueller and

McCloskey’s

(1990a, b)

satisfaction scale

Redfern’s (1981)

propensity to

leave index

Lee et al. (2003) South Korea 178 nurses; a response rate of 81% Maslach and

Jackson’s (1981)

burnout

inventory

A total of 24%, 15% and 35% of

variance in depersionalization,

emotional exhaustion and personal

accomplishment, respectively, were

explained by the predictor variablesMehrabian’s

(1994) emotional

empathy scale

Barrett-Lennard’s

(1978) empathy

scale, etc.

Lu et al. (2002) Taiwan 21,971 nurses; a response rate of

86.2%

Specially designed

scales:

professional

commitment scale

Job satisfaction was positively

correlated with professional

commitment and negatively

correlatively correlated with

intention to leave the organization

and profession

Further research needs to explore

the effect of organizational

commitment regarding any

interrelationships

H.

Lu

eta

l./

Intern

atio

na

lJ

ou

rna

lo

fN

ursin

gS

tud

ies4

2(

20

05

)2

11

–2

27

218

ARTIC

LEIN

PRES

SJob satisfaction

scale

About 38.4% of nurses had the

intention to leave the organization

and 30.4% intending to leave the

profession because of lack of job

satisfaction

Intention to quit

scale

Matrunola (1996) England 34 nurses working within an elderly

care unit; a response rate of 68%

Matrunola’s

(1996) job

satisfaction

questionnaire

There was no significant

relationship between job

satisfaction and absenteeism

Due to the small sample size,

generalization of these findings

needs to be treated with caution

Maslach and

Jackson’s (1981)

burnout

inventory

Beck et al.’s

(1974)

hopelessness scale

Siu (2002) Hong Kong 144 nurses (sample 1) and 114

(sample 2); response rates of 100%

and 57%, respectively

Siu and Cooper’s

(1998)

psychological

distress scale

Job satisfaction was a significant

predictor of absenteeism in sample

1; while no similar result was found

in sample 2

Further research in this area should

be replicated among other Chinese

nurses

Tzeng (2002a) Taiwan 648 nurses; a response rate of 82% General job satisfaction was

significant predictor of nurses’

intention to quit

Wu et al. (2000) Mainland China 382 nurses; a response rate of 92.5% Job stress scale

(specially

designed)

There was a positive and significant

relationship between job stress and

intention to quit (r ¼ 0:46; po0:05)

Further research is needed to

confirm the findings

Yin and Yang

(2002)

Taiwan (meta-

analysis)

129 studies relating to nursing

turnover from 1978–1998

The strongest factors related to

nurse turnover were job satisfaction,

autonomy, opportunities for

promotion, job stress, pay group

cohesion, marital status and

educational level

It suggests to group studies using

the same measures for satisfaction

and the related variables

H.

Lu

eta

l./

Intern

atio

na

lJ

ou

rna

lo

fN

ursin

gS

tud

ies4

2(

20

05

)2

11

–2

27

219


educational level (rxy ¼ 0:09; po0:05). Similarly, Wu etal. (2000) reported a positive and significant relationship

between job stress and intention to quit among Main-

land Chinese nurses (r ¼ 0:46; po0:05). Using the

multiple regression, Tzeng (2002a) reported that institu-

tion (privately owned local hospital), age of the youngest

child, level of education (e.g., diploma and associate

degree), salary and promotion, general job satisfaction

and general job happiness were significant predictors of

Taiwanese nurses’ intention to quit (the Nagelkerke

Pseudo R2 ¼ 0:410).The influence of job satisfaction on intention to leave

the nursing profession was examined in Lu et al.’s (2002)

study of Taiwanese nurses. It’s findings indicated that

job satisfaction was positively correlated with profes-

sional commitment (r ¼ 0:386; po0:01) and negativelycorrelated with intention to leave the organization and

profession (r ¼ �0:480; r ¼ �0:370; respectively,

po0:01). In the discriminant analysis, 38.4% of the

nurses could be classified as having the intention to leave

the organization and 30.4% as intending to leave the

profession because of lack of job satisfaction.

In summary, most published research from various

countries indicates that job satisfaction is a significant

predictor of nursing absenteeism, burnout, turnover and

intention to quit; however, there have been some

inconsistent findings (Table 4).

6. Related factors to job satisfaction of nurses

Job satisfaction is a complex phenomenon, as

evidenced by the many related factors identified in the

studies already discussed. The identification of these

factors and exploration of their effects on job satisfac-

tion has the potential to refine the theoretical models of

nurses’ job satisfaction and aid the development of

management interventions (Blegen, 1993). Blegen’s

(1993) meta-analysis found that job satisfaction was

most strongly associated with stress (r ¼ �0:61) andorganizational commitment (r ¼ 0:53). Seven variableshad correlations between 0.20 and 0.50: communication

with supervisor, autonomy, recognition, routinization,

communication with peers, fairness and locus of control;

and four variables had very weak correlations: age

(r ¼ 0:13), years of experience (r ¼ 0:09), education(r ¼ �0:07) and professionalism (r ¼ 0:06).A causal model of job satisfaction has been tested in

Chu et al.’s (2003) study of Taiwanese nurses and Seo et

al.’s (2004) study of South Korean nurses, respectively.

In this model 11 independent variables included: job

involvement, positive affectivity, negative affectivity,

autonomy, distributive justice, procedural justice, job

stress (role ambiguity, role conflict, workload and

resource inadequacy), pay, promotional chances, routi-

nization and social support. Chu et al. (2003) found

that, with the exception of pay (p40:05), all of theindependent variables were significantly related to job

satisfaction (po0:05). Seven of the exogenous variableswere the major determinants of job satisfaction accord-

ing to Pearson’s correlation coefficients: positive affec-

tivity (r ¼ 0:452), routinization (r ¼ �0:441), resourceinadequacy (r ¼ �0:341), negative affectivity

(r ¼ �0:333), role ambiguity (r ¼ �0:327), supervisorsupport (r ¼ 0:325) and co-worker support (r ¼ 0:309).The regression results indicated that six of the exogen-

ous variables hypothesized to impact upon job satisfac-

tion were significant: routinization (b ¼ �0:286;po0:001), positive affectivity (b ¼ 0:266; po0:001),involvement (b ¼ 0:147; po0:01), negative affectivity(b ¼ �0:118; po0:05), co-worker support (b ¼ 0:118;po0:05) and role ambiguity (b ¼ �0:018; po0:05). Theexogenous variables in this model explained 45% of the

association of variance in job satisfaction.

Seo et al. (2004) also found a reasonable fit between

the causal model and the data (CFI=0.904,

IFI=0.907). When considering all of the independent

variables (Model 1), seven variables had statistically

significant net effects on job satisfaction (po0:05):positive affectivity, supervisory support, pay, routiniza-

tion, negative affectivity, workload and job opportunity

(b ¼ 0:286; b ¼ 0:11; b ¼ 0:095; b ¼ �0:250; b ¼

�0:213; b ¼ �0:211; b ¼ �0:105; respectively). Model1 explained about 53% of the variance in satisfaction,

but when the psychological variables (positive and

negative affectivity) were not included (Model 2), job

opportunity was no longer significant (p40:05). Pay andsupervisor support positively impacted upon job satis-

faction (b ¼ 0:185; b ¼ 0:164; respectively) while routi-nization and workload negatively impacted upon it

(b ¼ �0:347; b ¼ �0:24; respectively). Model 2 ex-

plained 40% of the variance in satisfaction.

Interestingly, Packard and Motowidlo (1987) found

that stress and job satisfaction in the US were not

directly related and that stress, primarily acting through

depression, was associated with lower levels of job

performance. Job satisfaction correlated with depression

(r ¼ �0:55; po0:01), hostility (r ¼ �0:41; po0:01),subjective stress (r ¼ �0:27; po0:01), frequency of

stressful events (r ¼ �0:22; po0:01), intensity of stress-ful events (r ¼ �0:18; po0:05) and anxiety (r ¼ �0:16;po0:05). However, multiple regression analysis showeddepression had a strong effect on job satisfaction

(b ¼ �0:53; po0:01) and hostility (b ¼ �0:23; po0:01)and fear of negative evaluation (b ¼ 0:20; po0:01) hadweaker direct effects, but others showed no significant

impacts upon job satisfaction (p40:05).Organizational commitment refers to identification

with and loyalty to the organization and its goals (Blau

and Boal, 1987) which Mowday et al. (1979) defined as

the relative strength of an individual’s identification with

and involvement in a particular organization. In


particular, commitment is characterized by three factors:

a strong belief in and an acceptance of the organization’s

goals and values; a willingness to exert considerable

effort on behalf of the organization; and a strong desire

to maintain membership in the organization. It has been

found that organizational commitment is positively

related to job satisfaction of hospital nurses (Blegen,

1993; Al-Aameri, 2000). Knoop (1995) found that

organizational commitment was related to overall job

satisfaction (r ¼ 0:64; po0:001), satisfaction with work(r ¼ 0:58; po0:001), promotion opportunity (r ¼ 0:55;po0:001), supervision (r ¼ 0:54; po0:001), co-workers(r ¼ 0:30; po0:001) and pay (r ¼ 0:22; po0:01) amongCanadian nurses. Furthermore, the regression analysis

revealed that organizational commitment explained

41% of the variance in job satisfaction.

Professional commitment is a person’s involvement,

pledge, promise or resolution towards his/her profession

(Fang, 2001). It has an incremental effect on a

professional’s intention to leave the organization (Blau

and Lunz, 1998). Therefore, enhancing professional

commitment in nursing has the potential to produce

benefits for both the individual and their organization

(Cohen, 1998; Cohen, 1999). Furthermore, professional

commitment is positively related to the job satisfaction

of nurses (Lu et al., 2000; Jones, 2000). For example,

Fang’s (2001) study of Singaporean nurses demon-

strated that job satisfaction was significantly and

positively related to organizational commitment

(r ¼ 0:571; po0:01), professional commitment

(r ¼ 0:347; po0:01) and supervisor satisfaction

(r ¼ 0:155; po0:05) and negatively related to job stress(r ¼ �0:545; po0:01), turnover cognition (r ¼ �0:415;

Table 5

Related factors to job satisfaction of nurses

Related factors

Substantial to very strong relationship with job satisfaction

(correlation coefficient40.5)Job stress; organizational commitment; depression; cohesion

of the ward nursing team

Moderate to substantial relationship with job satisfaction

(correlation coefficient 0.2–0.5)

Affectivity; role ambiguity; professional commitment;

routinization; supervisor/co-worker support; collaboration with

medical staff; job performance; job involvement; hostility staff

organization; autonomy; recognition; fairness; locus of control;

communication with supervisor/peers

Slight relationship with job satisfaction (correlation

coefficiento0.2)Role conflict; job involvement; age; year of experience;

educational level; professionalism; anxiety; supervisor

satisfaction

po0:01) and intention to quit (r ¼ �0:283; po0:01).About 41% of the variance in turnover cognition was

explained by the mentioned antecedents; however, the

contributions of job stress, organizational commitment

and professional commitment to job satisfaction were

not identified.

In addition, the nurses’ roles within their work

situations and its effect on job satisfaction are also of

primary concern with role conflict and ambiguity being

the main sources of job stress (Hingley and Cooper,

1986). Role conflict is defined in terms of the dimensions

of congruency-incongruency or compatibility-incompat-

ibility in the requirements of the role, where congruency

of compatibility is judged relative to a set of standards

or conditions which impinge upon role performance.

Role ambiguity is the predictability of the outcome or

responses to one’s behaviour and the existence or clarity

of behavioural requirements, often in terms of inputs

from the environment, which would serve to guide

behaviour and provide knowledge that the behaviour is

appropriate (Rizzo et al., 1970). Role conflict and

ambiguity are significantly related to job stress, organi-

zational commitment, job satisfaction and intentions to

leave the nursing profession (Rosse and Rosse, 1981).

Dailey (1990) found that tension discharge rate, role

ambiguity and role conflict were significant predictors of

experienced stress symptoms (b ¼ 0:24; 0.15, 0.08,

respectively) among US nurses. Together, the three

produced an overall multiple R2 value of 0.47

(po0:001). On the other hand, the most significant

predictor of intention to quit was experienced job-

induced stress symptoms (b ¼ 0:36), followed by tensiondischarge rate (b ¼ 0:22). Role ambiguity (b ¼ 0:13) and

Key empirical sources

Packard and Motowidlo (1987), Blegen (1993), Knoop (1995),

Adams and Bond (2000), Fang (2001)

Packard and Motowidlo (1987), Blegen (1993), Knoop (1995),

Adams and Bond (2000), Fang (2001), Chu et al. (2003)

Packard and Motowidlo (1987), Blegen (1993), Fang (2001),

Lu et al. (2002), Chu et al. (2003)

ARTICLE IN PRESS

Table 6

Predictors of job satisfaction among nurses

Predictors Key empirical sources

Depression Packard and Motowidlo (1987)

Organizational commitment Knoop (1995)

Cohesion existing among ward nurses; collaboration of medical

staff; perceptions of professional practice; team building skills

of the ward managers

Adams and Bond (2000)

Organizational commitment; job stress; supervisor satisfaction Fang (2001)

Psychological distress; occupational type (psychiatric/general);

the physical conditions in the work area

Siu (2002)

Routinization; affectivity; job involvement; co-worker support;

educational level

Chu et al. (2003)

H. Lu et al. / International Journal of Nursing Studies 42 (2005) 211–227222

role conflict (b ¼ 0:04) were also significant predictors ofintention to quit. The regression model explained 75%

of the variance in intention to quit (po0:001).However, Mitchell’s (1994) US study found that there

was not a significant linear association between a nurse’s

job satisfaction and the correlation between work role

values and actual work roles (p40:05). This may beattributed to several factors. Firstly, the mean correla-

tion (r ¼ 0:58) between work roles and work role valueswas weak and non-significant (p40:05) and secondly,the scores of job satisfaction did not have a normal

distribution, with 54% of respondents having a high

level of satisfaction. Furthermore, the roles as used in

the questionnaire for this study were not tested for

validity and reliability. Therefore, further explanation of

the relationship between personal work role values and

actual work roles is needed in relation to nurses’

expressed job satisfaction (Tables 5 and 6).

In summary, much research has revealed that job

satisfaction of hospital nurses is closely related to job

stress, role conflict and ambiguity, organizational

commitment and professional commitment (Table 7).

7. Conclusion

Most member states of the WHO have reported nurse

resource difficulties (Kingma, 2001). Developed coun-

tries are faced with the double challenge of having an

ageing nurse workforce and increasing demand for

nursing care from an ageing population (Buchan, 2001).

International migration of nurses has increased as

nurses pursue opportunities for improved pay and

opportunities in the wake of global liberalization of

trade spurred on by developed countries increasing their

international recruitment to meet their health-care

workforce needs and in so doing creating a ‘skills drain’

in many developing countries (Kingma, 2001). This

increased mobility of the nursing workforce means that

factors which contribute to nurses’ turnover merit

attention. Job satisfaction among nurses has been

identified as a key factor in nurses’ turnover with the

empirical literature suggesting that it is related to a

number of organizational, professional and personal

variables.

While the literature indicates common issues across

the world, it is possible that different issues have greater

significance in different countries due to the social

context of the different labour markets. Further, the

literature suggests that nurses are experiencing increas-

ing levels of work-related stress over time and increased

levels of work-related stress are associated with lower

levels of satisfaction with reward packages and working

conditions. Current workforce shortages are likely to

place greater demands upon nurses which might be

expected to increase their work-related stress and may

reduce the quality of workplace relationships which has

emerged as an important source of job satisfaction and

contributes to organizational commitment. The lower

levels of job satisfaction among nurses with tertiary

education are noteworthy as such nurses probably

represent the most well-educated element of the nursing

workforce and the future leadership of the profession.

Also noteworthy is the lower job satisfaction of those

who had unfulfilled expectations regarding nursing work

which suggests that some nurses retain an idealized view

of nursing despite most initial nurse education including

extended periods of clinical practice to prevent reality

shock on entry into the workforce.

The current worldwide shortage of nurses highlights

the importance of understanding the impact and

interrelationships of the identified variables if health-

care organizations are to implement interventions to

improve the retention of their nursing workforce.

Although several models of job satisfaction have been

postulated, these models require further testing espe-

cially regarding the relative contribution of different

factors. The literature suggests that the current models

ARTICLE IN PRESS

Table 7

Summary of included studies regarding related factors to job satisfaction of nurses

Code study Location Sample and

response rate

Instruments Key findings Comments

Blegen (1993) (Meta-

analysis)

48

quantitative

studies

Job satisfaction was most

strongly associated with

stress (r ¼ �0:61) andorganizational commitment

(r ¼ 0:53)

Chu et al.

(2003)

Taiwan 308 nurses; a

response rate

of 75%

The items from Price and

Mueller (1986b), Watson et

al. (1987), Cyphert (1990);

Kim et al. (1996) and Price

(2001)

Six variables had significant

impact job satisfaction:

routinization, positive

affectivity, involvement,

negative affectivity, co-

worker support and role

ambiguity, which explained

45% of the variance in

satisfaction

Impact of work unit on job

satisfaction should be

considered

Dailey (1990) US 116 nurses; a

response rate

of 38.7%

Rose et al.’s (1978) Tension

Discharge Rate Scale

The regression model

explained 75% of the

variance in intention to quitRizzo et al.’s (1970) Role

Conflict and Ambiguity

Scale

Symptoms of Stress Index

Fang (2001) Singapore 180 nurses; a

response rate

of 90%

Mowday et al.’s (1979)

Organizational

Commitment Scale

Job satisfaction was

significantly and positively

related to organizational

commitment, professional

commitment and negatively

related to job stress

The contributions of job

stress, organizational

commitment and

professional commitment to

satisfaction were not

identified

Fang’s (2001) Professional

Commitment Scale

Fang’s (2001) Nursing

Turnover Scale

Knoop (1995) Canada 171 nurse

educators and

nurses; a

response rate

of 70%

Mowday et al.’s (1979)

organizational Commitment

Questionnaire

Organizational commitment

was related to overall job

satisfaction (r ¼ 0:64;po0:001) and explained41% of the variance in job

satisfaction

The impact of professional

commitment upon job

satisfaction should be taken

into accountKanungo’s (1982) Graphic

Job Involvement

Iris and Barrett’s (1972) Job

Satisfaction Scale, etc.

Mitchell

(1994)

US 201 nurses; a

response rate

of 33%

Weiss et al.’s (1967)

Minnesota Satisfaction

Questionnaire

There was not significant

linear association between a

nurse’s job satisfaction and

the correlation between

work role values and actual

work roles (p40:05)

Further explanation of the

non-relationship is needed

Benner’s (1984) Work Role

Scale

Packard and

Motowidlo

(1987)

US 206 nurses; a

response rate

of 56%

Price and Mueller’s (1981)

Job Satisfaction Scale

Job satisfaction correlated

with depression, hostility,

subjective stress, frequency

of stressful events, intensity

of stressful events and

anxiety

The model of job

satisfaction was reasonable

but incompleteOthers from Motowidlo et

al. (1986)

Seo et al.

(2004)

South

Korea

353 nurses; a

response rate

of 65.4%

The items from Kahn et al.

(1964), Rizzo et al. (1970),

House (1981), Breaugh

(1985), Watson and Tellegen

(1985), etc.

There was a reasonable fit

between the causal model

and the data

The model could be used in

Korean work organizations

All of the variables

explained 53% of the

variance in satisfaction

H. Lu et al. / International Journal of Nursing Studies 42 (2005) 211–227 223


of job satisfaction need to be modified as they omit some

important predictors of job satisfaction such as role

perception. The lack of a comprehensive model of job

satisfaction in nursing is a major shortcoming and

without which effective management interventions

cannot be developed or tested.

References

Adams, A., Bond, S., 2000. Hospital nurses’ job satisfaction,

individual and organizational characteristics. Journal of

Advanced Nursing 32 (3), 536–543.

Adams, A., Bond, S., Arber, S., 1995. Development and

validation of scales to measure organisational features of

acute hospital wards. International Journal of Nursing

Studies 32 (6), 612–627.

Adamson, B., Kenny, D., Wilson-Barnett, J., 1995. The impact

of perceived medical dominance on the workplace satisfac-

tion of Australian and British nurses. Journal of Advanced

Nursing 21, 172–183.

Aiken, L., Clarke, S., Sloane, D., Sochalski, J., Busse, R.,

Clarke, H., Giovannetti, P., Hunt, J., Rafferty, A.,

Shamian, J., 2001. Nurses’ reports on hospital care in five

countries. Health Affairs 20 (3), 43–53.

Al-Aameri, A.S., 2000. Job satisfaction and organizational

commitment for nurses. Saudi Medical Journal 21 (6),

531–535.

Barrett-Lennard, G.T., 1978. The relationship inventory: later

development and adaptation. JSAS: Catalog of Selected

Documents in Psychology 8, 1–33.

Beck, A.T., Weissman, A., Lester, D., Trexler, L., 1974. The

measurement of pessimism: the hopelessness scale. Journal

of Consulting and Clinical Psychilogy 42, 861–865 (Cited in

Matrunola, P., 1996. Is there a relationship between job

satisfaction and absenteeism? Journal of Advanced Nursing

23, 827–834).

Benner, P., 1984. From Novice to Expert. Addison-Wesley,

Menlo Park, CA.

Blau, G.J., Boal, K.P., 1987. Conceptualizing how job

involvement and organizational commitment affect turn-

over and absenteeism. Academy of Management Review 12,

288–300.

Blau, G.J., Lunz, M., 1998. Testing the incremental effect of

professional commitment on intent to leave one’s profes-

sional beyond the effects of external, personal and work-

related variables. Journal of Vocational Behavior 52,

260–269.

Blegen, M., 1993. Nurses’ job satisfaction: a meta-analysis of

related variables. Nursing Research 42 (1), 36–41.

Breaugh, J.A., 1985. The measurement of work autonomy.

Human Relations 38, 551–570 (Cited in Seo, Y., Ko, J.,

Price, J.L., 2004. The determinants of job satisfaction

among hospital nurses: a model estimation in Korea.

International Journal of Nursing Studies 41, 437–446).

Buchan, J., 2001. Nurse migration and international recruit-

ment. Nursing Inquiry 8, 203–204.

Burnard, P., Morrison, P., Phillips, C., 1999. Job satisfaction

amongst nurses in an interim secure forensic unit in Wales.

Australian and New Zealand Journal of Mental Health

Nursing 8, 9–18.

Cavanagh, S., 1990. Predictors of nursing staff turnover.

Journal of Advanced Nursing 15, 373–380.

Cavanagh, S., Coffin, D., 1992. Staff turnover among hospital

nurses. Journal of Advanced Nursing 17, 1369–1376.

Chu, C.I., Hsu, H.M., Price, J.L., Lee, J.Y., 2003. Job

satisfaction of hospital nurses: an empirical test of a causal

model in Taiwan. International Nursing Review 50,

176–182.

Cohen, A., 1998. An examination of the relationship

between work commitment and work outcomes among

hospital nurses. Scandinavia Journal of Management 14,

1–17.

Cohen, A., 1999. Relationships among five forms commitment:

an empirical assessment. Journal of Organizational Beha-

viour 20, 285–308.

Conrad, K.M., Conrad, K.J., Parker, J.E., 1985. Job satisfac-

tion among occupational health nurses. Journal of Com-

munity Health Nursing 2, 161–173.

Cyphert, S.T., 1990. Employee absenteeism: an empirical test of

the brook model. Ph.D Thesis, The University of Iowa,

Iowa. (Cited in Chu, C.I., Hsu, H.M., Price, J.L., Lee, J.Y.,

2003. Job satisfaction of hospital nurses: an empirical test of

a causal model in Taiwan. International Nursing Review 50,

176–182).

Dailey, R.C., 1990. Role perceptions and job tension as

predictors of nursing turnover. Nursing Connections 3 (2),

33–42.

Edwards, A.L., 1959. Edwards Personal Preference Schedule.

Psychological Corporation, New York (Cited in Lee, F.-K.,

1998. Job satisfaction and autonomy of Hong Kong

registered nurses. Journal of Advanced Nursing 27,

355–363).

Fang, Y., 2001. Turnover propensity and its causes among

Singapore nurses: an empirical study. International Journal

of Human Resource Management 12 (5), 859–871.

Gauci Borda, R., Norman, I.J., 1997a. Testing a model of

absence and intent to stay in employment: a study of

registered nurses in Malta. International Nursing Studies

34 (5), 375–384.

Gauci Borda, R., Norman, I.J., 1997b. Factors influencing

turnover and absence of nurses: a research review. Interna-

tional Journal of Nursing Studies 34 (6), 385–394.

Gruneberg, M.M. (Ed.), 1976, Job Satisfaction—A Reader.

Macmillan Press, London.

Hancock, C., 1998. Keeping staff means demonstrating to

nurses that they matter. Nursing Times Research 3 (3),

165–166.

Herzberg, F., Mausner, B., 1959. The Motivation to Work,

second ed. Wiley, New York.

Hingley, P., Cooper, C.L., 1986. Stress and the Nurse Manager.

Wiley, Chichester.

House, J.S., 1981. Work Stress and Social Support. Addison

Wesley Publishing Company, MA (Cited in Seo, Y., Ko, J.,




Iris, B., Barrett, G., 1972. Some relations between job

satisfaction and job performance. Journal of Applied

Psychology 56, 301–304.


Irvine, D.M., Evans, M.G., 1995. Job satisfaction and turnover

among nurses-integrating research across studies. Nursing

Research 44 (4), 246–253.

Jones, J.M.S., 2000. The impact of hospital mergers on

organizational culture, organizational commitment, profes-

sional commitment, job satisfaction and intent to turnover

on registered professional nurses on medical-surgical

hospital units (Doctoral Dissertation Research). State

University of New York, Buffalo.

Kahn, R.L., Wolfe, D.M., Quinn, P.R., Snoek, J.D., Rosenthal,

R.A., 1964. Organizational Stress: Studies in Role Conflict

and Ambiguity. Wiley, New York (Cited in Seo, Y., Ko, J.,




Kanungo, R., 1982. Work Alienation: An Integrative Ap-

proach. Praeger, New York.

Kim, S.W., Price, J.L., Mueller, C.W., Waston, T.W., 1996.

The determinants of career intent among physicians at a US

air force hospital. Human Relations 49 (7), 947–976 (Cited

in Chu, C.I., Hsu, H.M., Price, J.L., Lee, J.Y., 2003. Job

satisfaction of hospital nurses: an empirical test of a causal

model in Taiwan. International Nursing Review 50,

176–182).

Kingma, M., 2001. Nursing migration: global treasure hunt or

disaster-in-the-making? Nursing Inquiry 8, 205–212.

Knoop, R., 1995. Relationships among job involvement, job

satisfaction and organizational commitment for nurses. The

Journal of Psychology 129 (6), 643–647.

Kuhlen, R.G., 1963. Needs, perceived need satisfaction

opportunities, and satisfaction with occupation. Journal of

Applied Psychology XL VII (1), 56–64.

Landeweerd, J.A., Boumans, N.P.G., 1988. Nurses’ work

satisfaction and feelings of health and stress in three

psychiatric departments. International Journal of Nursing

Studies 25, 225–234.

Lee, F.K., 1998. Job satisfaction and autonomy of Hong Kong

registered nurses. Journal of Advanced Nursing 27,

355–363.

Lee, H., Song, R., Cho, Y.S., Lee, G.Z., Daly, B., 2003. A

comprehensive model for predicting burnout in Korean

nurses. Journal of Advanced Nursing 44 (5), 534–545.

Lu, K.Y., Chious, S.L., Chang, Y.Y., 2000. A study of the

professional commitment changes from nursing students to

registered nurses. The Kaohsiung Journal of Medical

Science 16, 39–46.

Lu, K.-Y., Lin, P.-L., Wu, C.-M., Hsieh, Y.-L., Chang, Y.-Y.,

2002. The relationship among turnover intentions, profes-

sional commitment, and job satisfaction of hospital nurses.

Journal of Professional Nursing 18 (4), 214–219.

Lundh, U., 1999. Job satisfaction among Swedish nurses and

laboratory technologists. British Journal of Nursing 8 (14),

948–952.

Lyons, T.M., 1971. Role clarity, need for clarity, satisfaction,

tension and withdrawal. Organizational Behaviour and

Human Performance 6, 99–110 (Cited in Gauci Borda, R.,

Norman, I.J., 1997a. Testing a model of absence and intent

to stay in employment: a study of registered nurses in Malta.

International Nursing Studies 34(5), 375–384).

Maslach, C., Jackson, S.E., 1981. The measurement of

experienced burnout. Journal of Occupational Behavior 2,

99–113 (Cited in Lee, H., Song, R., Cho, Y.S., Lee, G.Z.,

Daly, B., 2003. A comprehensive model for predicting

burnout in Korean nurses. Journal of Advanced Nursing 44

(5), 534–545).

Maslach, C., Jackson, S.E., 1986. Maslach Burnout Inventory

Manual (2nd). Consulting Psychologists Press, Palo Alto

Calif (Cited in Aiken, L., Clarke, S., Sloane, D., Sochalski,

J., Busse, R., Clarke, H., Giovannetti, P., Hunt, J., Rafferty,

A., Shamian, J., 2001. Nurses’ reports on hospital care in

five countries. Health Affairs 20(3), 43–53).

Maslow, A., 1954. Motivation and Personality. Harper and

Row, New York.

Matrunola, P., 1996. Is there a relationship between job

satisfaction and absenteeism? Journal of Advanced Nursing

23, 827–834.

Mehrabian, A., 1994. Manual for Emotional Empathic

Tendency Scale (EETS). Available from Albert

Mehrabian, 1130 Alta Mesa Road, Monterey, CA 93940

(Cited in Lee, H., Song, R., Cho, Y.S., Lee, G.Z., Daly, B.,

2003. A comprehensive model for predicting burnout in

Korean nurses. Journal of Advanced Nursing 44 (5),

534–545).

Mitchell, M.B., 1994. The effect of work role values on job

satisfaction. Journal of Advanced Nursing 20, 958–963.

Motowidlo, S., Packard, J.S., Manning, M.R., 1986. Occupa-

tional stress: its causes and consequences for job perfor-

mances. Journal of Applied Psychology 4, 618–629.

Mowday, R.T., Steers, R.M., Porter, L.M., 1979. The

measurement of organizational commitment. Journal of

Vocational Behavior 14, 224–227.

Mueller, C.W., McCloskey, J.C., 1990a. Nurses’ job satisfac-

tion: a proposed measure. Nursing Research 39 (2), 113–117

(Cited in Price, M., 2002. Job satisfaction of registered

nurses working in an acute hospital. British Journal of

Nursing 11(4), 275–280).

Mueller, C.W., McCloskey, J.C., 1990b. Nurses’ job satisfac-

tion: a proposed measure. Nursing Research 39 (2),

113–117.

Nolan, M., Nolan, J., Grant, G., 1995. Maintaining nurses’ job

satisfaction and morale. British Journal of Nursing 4 (19),

1148–1154.

Nolan, M., Brown, J., Naughton, Nolan, J., 1998. Developing

nursing’s future role 2: nurses’ job satisfaction and morale.

British Journal of Nursing 7 (17), 1044–1048.

Packard, J., Motowidlo, S., 1987. Subjective stress, job

satisfaction and job performance of hospital nurses.

Research in Nursing and Health 10, 253–261.

Price, J.L., 2001. Reflections on the determinants of voluntary

turnover. International Journal of Manpower 22 (7),

600–624.

Price, M., 2002. Job satisfaction of registered nurses working in

an acute hospital. British Journal of Nursing 11 (4),

275–280.

Price, J.L., Mueller, C.W., 1981. Professional Turnover: The

Case for Nurses. Lowa State University Press, Ames (Cited

in Cavanagh, S., 1990. Predictors of nursing staff turnover.

Journal of Advanced Nursing 15, 373–380).

Price, J.L., Mueller, C.W., 1986b. Absenteeism and Turnover

Among Hospital Employees. JAI Press, Greenwich, CN

(Cited in Chu, C.I., Hsu, H.M., Price, J.L., Lee, J.Y., 2003.

Job satisfaction of hospital nurses: an empirical test of a


causal model in Taiwan. International Nursing Review 50,

176–182).

Redfern, S.J., 1981. Hosptial Sisters: Their Job Attitudes and

Occupational Stability. Royal College of Nursing, London

(Cited in Gauci Borda, R., Norman, I.J., 1997a. Testing a

model of absence and intent to stay in employment: a study

of registered nurses in Malta. International Nursing Studies

34(5), 375–384).

Rizzo, J.R., House, R.J., Lirtzman, S.F., 1970. Role conflict

and ambiguity in complex organizations. Administrative

Science Quarterly 15, 150–163.

Rose, R.M., Jenkins, C.D., Hurst, M.W., 1978. Air Traffic

Controller Health Study: A Prospective Investigation of

Physical, Psychological and Work-Related Changes. Uni-

versity of Texas Press, Austin (Cited in Dailey, R.C., 1990.

Role perceptions and job tension as predictors of nursing

turnover. Nursing Connections 3(2), 33–42).

Rosse, J.G., Rosse, P.H., 1981. Role conflict and ambiguity: an

empirical investigation of nursing personnel. Evaluation

and the Health Professional 4, 385–405.

Seo, Y., Ko, J., Price, J.L., 2004. The determinants of job

satisfaction among hospital nurses: a model estimation in

Korea. International Journal of Nursing Studies 41,

437–446.

Siu, O.L., 2002. Predictors of job satisfaction and absenteeism

in two samples of Hong Kong nurses. Journal of Advanced

Nursing 40 (2), 218–229.

Siu, O.L., Cooper, C.L., 1998. A study of occupational stress,

job satisfaction and quitting intention in Hong Kong firms:

the role of locus of control and organizational commitment.

Stress Medicine 14, 55–66 (Cited in Siu, O.L., 2002.

Predictors of job satisfaction and absenteeism in two

samples of Hong Kong nurses. Journal of Advanced

Nursing 40(2), 218–229).

Spector, P.E., 1997. Job Satisfaction: Application, Assessment,

Causes, and Consequences. SAGE Publications, London.

Stamps, P.L., Piedmonte, E.B., 1986. Nurses and Work

Satisfaction: An Index for Measurement. Health Adminis-

trative Press, USA (Cited in Lee, F.K., 1998. Job satisfac-

tion and autonomy of Hong Kong registered nurses.

Journal of Advanced Nursing 27, 355–363).

Tovey, E., Adams, A., 1999. The changing nature of nurses’ job

satisfaction: an exploration of sources of satisfaction in the

1990s. Journal of Advanced Nursing 30 (1), 150–158.

Tzeng, H.-M., 2002a. The influence of nurses’ working

motivation and job satisfaction on intention to quit: an

empirical investigation in Taiwan. International Journal of

Nursing Studies 39, 867–878.

Tzeng, H.-M., 2002b. Satisfying nurses on job factors they care

about: a Taiwanese perspective. Journal of Nursing

Administration 32 (6), 306–309.

Wang, Y., 2002. Job satisfaction of nurses in hospital. Chinese

Journal of Nursing 37 (8), 593–594 (in Chinese).

Watson, D., Tellegen, A., 1985. Toward a consensual structure

of mood. Psychological Bulletin 98, 219–235 (Cited in Seo,

Y., Ko, J., Price, J.L., 2004. The determinants of job



437–446).

Watson, D., Pennebaker, J.M., Floger, R., 1987. Beyond

negative affectivity: measuring stress and satisfaction in

the workplace. Journal of Organizational Behaviour Man-

agement 8, 141–157 (Cited in Chu, C.I., Hsu, H.M., Price,

J.L., Lee, J.Y., 2003. Job satisfaction of hospital nurses: an

empirical test of a causal model in Taiwan. International

Nursing Review 50, 176–182).

Weiss, D., Dawis, R., England, G., Lofquist, L., 1967. Manual

for the Minnesota Satisfaction Questionnaire. Work Ad-

justment Project, Industrial Relations Center, University of

Minnesota, Minnesota (Cited in Mitchell, M.B., 1994. The

effect of work role values on job satisfaction. Journal of

Advanced Nursing 20, 958–963).

Worf, M.G., 1970. Need gratification theory: a theoretical

reformulation of job satisfaction/dissatisfaction and job

motivation. Journal of Applied Psychology 54, 87–94.

Wu, X.J., Zhang, X.J., Gao, F.L., 2000. A study on the

relationship between nurses’ intention to quit and work

stress. Chinese Journal of Nursing 35 (4), 197–199 (in

Chinese).

Yin, J.-C.T., Yang, K.-P.A., 2002. Nursing turnover in Taiwan:

a meta-analysis of related factors. International Journal of

Nursing Studies 39, 573–581.

Further Reading

Beehr, T.A., Walsh, J.T., Taber, T.D., 1976. Relationship of

stress to individually and organizationally valued states:

higher order needs as a moderator. Journal of Applied

Psychology 61, 41–47 (Cited in Lee, H., Song, R., Cho,

Y.S., Lee, G.Z., Daly, B., 2003. A comprehensive model for

predicting burnout in Korean nurses. Journal of Advanced

Nursing 44(5), 534–545).

Bluedorn, A.C., 1976. A causal model of turnover in organiza-

tion. Unpublished Ph.D. Dissertation, University of Iowa.

(Cited in Dailey, R.C., 1990. Role perceptions and job

tension as predictors of nursing turnover. Nursing Connec-

tions 3(2), 33–42).

Fang, Y., Baba, V.V., 1993. Stress and turnover: a comparative

study among nurses. International Journal of Comparative

Sociology 34, 24–38 (Cited in Fang, Y.Q., 2001. Turnover

propensity and its causes among Singapore nurses: an

empirical study. International Journal of Human Resource

Management 12(5), 859–871).

Hatcher, S., Laschinger, H.K.S., 1996. Staff nurses; perceptions

of job empowerment and level of burnout: a test of Kanter’s

theoty of structural power in organizations. Canadian

Journal of Nursing Administration 9, 74–94 (Cited in Lee,

H., Song, R., Cho, Y.S., Lee, G.Z., Daly, B., 2003. A

comprehensive model for predicting burnout in Korean

nurses. Journal of Advanced Nursing 44(5), 534–545).

McNeese-Smith, D., 1995. Job satisfaction, productivity, and

organizational commitment: the result of leadership. Jour-

nal of Nursing Administration 25 (9), 17–26.

McNeese-Smith, D., 1999. A content analysis of staff nurse

descriptions of job satisfaction and dissatisfaction. Journal

of advanced Nursing 29 (6), 1332–1341.

Morrow, P.C., Wirth, R.E., 1989. Work commitment among

salaried professionals. Journal of Occupational Behavior 34,

57–68.

Oldham, G.L., Stepina, L.P., Ambrose, M.L., 1986. Relations

between situational factors and the comparative referents


used by employees. Academy of Management Journal 29,

599–608 (Cited in Seo, Y., Ko, J., Price, J.L., 2004. The

determinants of job satisfaction among hospital nurses: a

model estimation in Korea. International Journal of

Nursing Studies 41, 437–446).

Parker, D.F., Decotiis, T.A., 1983. Organizational determi-

nants of job stress. Organizational Behavior and Human

Performance 32, 160–177 (Cited in Fang, Y.Q., 2001.

Turnover propensity and its causes among Singapore

nurses: an empirical study. International Journal of Human

Resource Management 12 (5), 859–871).

Price, J.L., Mueller, C.W., 1986. Handbook of Organizational

measurement. Harper Collins, Scranton (Cited in Seo, Y.,

Ko, J., Price, J.L., 2004. The determinants of job satisfac-

tion among hospital nurses: a model estimation in Korea.


Price, J.L., Mueller, C.W., 1990. Wilford Hall Medical Center

Retention Survey, Lackland Air Force base, TX (Cited in

Seo, Y., Ko, J., Price, J.L., 2004. The determinants of job



437–446).

Siu, O.L., 1999. Organizational climate, occupational stress,

and employee health in Hong Kong and China. Ph.D.

Thesis, The University of Liverpool, UK (Cited in Siu, O.L.,

2002. Predictors of job satisfaction and absenteeism in two

samples of Hong Kong nurses. Journal of Advanced

Nursing 40(2), 218–229).

Lu Et Al 2005 Job Satis Lit Review IJNS

Documents

Transcript of Lu Et Al 2005 Job Satis Lit Review IJNS