Introduction

Nurses are the most numerous profession in healthcare. They provide care directly to patients and constantly interact with them [1]. The working conditions of nurses should be designed to maximize their ability to focus on their duties and provide high-quality nursing care [2]. Job satisfaction reflects the extent to which nurses enjoy their professional activities [3]. Therefore, satisfaction with working conditions and work in general has a positive impact on the quality of provided medical care, which in turn influences patient treatment outcomes [4,5]. It is worth noting that general dissatisfaction with their work affects the level of emotional burnout among nurses, which leads to inefficiency and negatively impacts overall patient care [6].

Job satisfaction among nurses is trending downward worldwide. A study by Charlotte Pietersen (2005) identified the main factors of job dissatisfaction: salary level and career advancement. Therefore, it is important to conduct such studies to identify factors of dissatisfaction and determine measures that should be taken to increase work motivation and develop a work environment that meets the needs of nurses [7].

The study by Er and Sökmen (2018) showed that the work environment in a province of eastern Turkey was not physically adequate and suitable for providing safe patient care. The reason was that the physical conditions in medical organizations were not organized to meet the nurses’ needs and work requirements [4]. Furthermore, the study by White et al. (2019) noted the negative impact of both job dissatisfaction and emotional burnout of nurses on the quality of nursing care in the United States [6].

Job satisfaction is the emotional state of medical personnel, reflecting how satisfied they are with their work. The multifactorial nature of satisfaction with the working conditions of nurses provides the administration of medical organizations with ample opportunities to meet the needs of employees. Various factors influence satisfaction with working conditions, including salaries, workplace conditions, relationships within the team, and career growth [1,2]. Thus, the administration of medical organizations that understands the level of satisfaction with working conditions can focus efforts on improving them and increasing the satisfaction of nursing staff, which in turn will help to improve the quality of nursing care [1].

The purpose of this research is to study the level of satisfaction of nurses with working conditions in Pavlodar.

Methods

A cross-sectional study was conducted among nurses in Pavlodar in November-December 2023. Data collection was carried out through anonymous questionnaires completed by nurses, in compliance with the ethical standards and requirements of the Declaration of Helsinki. A total of 89 nurses participated in the study. All participants were informed about the purpose of the study and their rights before the start.

The data collection tool was a questionnaire containing 40 questions. For convenience, the survey was conducted online using Google Forms (https://forms.gle/YV2eQVSmK6pmsJCz8), which provided advantages in response speed, coverage, and more [8,9]. The questions were divided into three sections: demographic data of respondents, information about the structure of the medical organization, and questions to identify the satisfaction of medical staff with their working conditions. An invitation to the survey was distributed via WhatsApp, explaining the purpose of the study, conditions of anonymity, and respondents’ rights. If respondents agreed to participate, they simply followed the questionnaire link and filled out the required fields. In this study, the level of internal consistency of the questionnaire was measured using Cronbach’s alpha, which was 0.898 [10].

Descriptive statistics methods were used to describe the sample. The statistical package SPSS 23.0 (IBM SPSS Statistics, USA) was used to analyze the data.

Results

The study was conducted in Pavlodar in November-December 2023. A total of 89 nurses agreed to participate, among which 96.6% were female. The average age of the respondents was 40.4 years (SD = 12.5). More than half of the nurses (57.3%) were aged 40 and above, while 42.7% were between 20 and 40 years old. Most of the respondents (88.8%) were nurses, 6.7% were advanced practice nurses, and 4.5% held the position of head nurse. The average work experience of the respondents was 17.4 years (SD = 12.45). Specifically, 41.6% had 0-10 years of work experience, 14.6% had 11-20 years, 28.1% had 21-30 years, and 5.6% (five nurses) had more than 40 years of experience.

Regarding the structure of the medical organizations where the respondents worked, the vast majority (96.6%) were employed in public medical institutions located in urban areas. Only three nurses (3.4%) worked in the private healthcare sector. Nearly half of the respondents (49.4%) were employed in large medical organizations with more than 250 employees. A quarter (23.6%) worked in small organizations with up to 25 employees, and a fifth (21.3%) worked in medical organizations with 25-99 employees.

Satisfaction with working conditions is presented in Figure 1. A quarter of the respondents (20.2%-25.8%) completely disagreed with the given statements about their working conditions. Slightly more respondents indicated their agreement with all statements (21.3%-32.6%). Additionally, about a tenth of respondents found it difficult to answer all the statements (7.9%-14.6%). This indicates that nurses are willing to work even in less than ideal conditions, motivated by other factors that encourage them to continue their professional activities.

23,6 21,3 11,2 25,8 18 25,8 20,2 14,6 21,3 18 20,2 23,6 9 29,2 18 24,7 18 11,2 30,3 15,7 22,5 16,9 9 32,6 19,1 25,8 16,9 7,9 27 22,5 I am satisfied with the staffing levels My work schedule allows me to effectively balance work and personal life I am satisfied with the working conditions (lighting, temperature, cleanliness, noise,… Office space and interior are conducive to productive work I have all the necessary materials and equipment to perform my work efficiently It’s convenient for me to get to and from work (home)                                              0%        20%       40%       60%       80%     100%               I completely disagree   I probably disagree    Difficult to answer AgreeI completely agree

 

Figure 1. Work conditions for nurses (%)

Regarding payment for work, the respondents were asked to answer five statements presented in Table 1. Only a tenth of the respondents believed that their salary met their expectations and standard of living, as well as the salary level in the labor market. In contrast, 38.2% of nurses felt that their salaries did not correspond to the labor market conditions. Meanwhile, 42.7% of respondents expressed confidence in the future. The non-financial incentive system did not meet the expectations of 51.7% of nurses. Additionally, 50.6% believed that material and non-material compensation did not correspond to their level of professionalism, while 45.1% felt that their salary matched their contribution to work. However, 58.4% believed their salaries did not align with the labor market conditions. As a result, almost half of all respondents were dissatisfied with the system of material and non-material compensation at work.

Table 1. Satisfaction with compensation for work (n=89)

Index	Possible answer	n	%
I believe that my salary corresponds to situation on the labor market	I completely disagree	34	38,2
	I probably disagree	18	20,2
	Difficult to answer	11	12,4
	Agree	15	16,9
	I completely agree	11	12,4
I believe that my salary corresponds to the level of my contribution to work	I completely disagree	32	26,0
	I probably disagree	17	19,1
	Difficult to answer	18	20,2
	Agree	10	11,2
	I completely agree	12	13,5
I believe that material and non-material compensation is commensurate with my level of professionalism	I completely disagree	25	28,1
	I probably disagree	20	22,5
	Difficult to answer	18	20,2
	Agree	13	14,6
	I completely agree	13	14,6
The non-material incentive system meets my expectations	I completely disagree	22	24,7
	I probably disagree	24	27,0
	Difficult to answer	17	19,1
	Agree	12	13,5
	I completely agree	14	15,7
I feel confident in the future working in a medical organization	I completely disagree	18	20,2
	I probably disagree	20	22,5
	Difficult to answer	13	14,6
	Agree	23	25,8
	I completely agree	15	16,9

 

 

A one-way ANOVA test showed the significance of age in influencing variables such as “I believe that my salary corresponds to the situation in the labor market” (F = 2.775, p = 0.032) and “I believe that my salary corresponds to the level of my contribution to work” (F = 2.799, p = 0.031). This indicates that work experience significantly impacts perceptions of salary adequacy and alignment with market conditions. Work experience enables an adequate assessment of personal contribution and deserved salary.

As seen in Figure 2, career opportunities were rated quite highly by nurses. Almost half of the respondents (40%-60%) agreed with all statements regarding career opportunities. However, a quarter of the respondents expressed complete disagreement with these statements. Specifically, 25.8% did not understand how employees are promoted in the medical field, and 19.1% believed that their current position did not correspond to their level of professionalism and service to the organization. Thus, opinions on career development were divided, with 40% disagreeing, 50% agreeing, and 10% finding it difficult to answer.

Figure 2. Career Opportunities for Nurses (%)

Regarding relationships within the team, respondents were asked to evaluate several statements (Table 3). Half of the respondents believed that all departments worked towards a common goal and that the team had a friendly atmosphere conducive to productive work. They felt confident that if they asked for help, they would receive support. Overall, the respondents were satisfied with their team relationships. However, a fifth of the surveyed nurses expressed strong disagreement with the given statements, and a tenth abstained from expressing their opinion, finding these questions difficult to answer. Thus, in the section on team relationships, the same ratio of disagreement to agreement (40%:50%) was observed, with 10% of respondents finding it difficult to answer.

Table 2. ANOVA: influence of age on compensation level (n=89)

		Sum of squares	df	Mean square	F	Significance
I believe that my salary corresponds to situation on the labor market	Between groups	21,713	4	5,428	2,775	0,032
	Within groups	164,309	84	1,956
	Total	186,022	88
I believe that my salary corresponds to the level of my contribution to work	Between groups	20,958	4	5,240	2,799	0,031
	Within groups	157,221	84	1,872
	Total	178,180	88

Table 3. Satisfaction with relationships in the workplace (n=89)

 

Index	Possible answer	n	%
All departments work for a common result	I completely disagree	18	20,2
	I probably disagree	16	18,0
	Difficult to answer	8	9,0
	Agree	31	34,8
	I completely agree	16	18,0
I rate the atmosphere as friendly and focused on productive work	I completely disagree	19	21,3
	I probably disagree	16	18,0
	Difficult to answer	11	12,4
	Agree	28	31,5
	I completely agree	15	16,9
If I ask my colleagues for help, I most likely receive it	I completely disagree	18	20,2
	I probably disagree	15	16,9
	Difficult to answer	6	6,7
	Agree	32	36,0
	I completely agree	18	20,2
I am satisfied with the relationships I have with my work colleagues	I completely disagree	17	19,1
	I probably disagree	16	18,0
	Difficult to answer	11	12,4
	Agree	27	30,3
	I completely agree	18	20,2

Discussion

Our study examined the influence of four factors on satisfaction with working conditions among nurses. We found that 43.3% of respondents were dissatisfied with their current working conditions, while 46.3% were completely satisfied. Additionally, 42.7% of respondents felt confident in the future and financial stability of their profession. However, only 24.7% of nurses were satisfied with their salary, feeling it fully corresponded to their contribution to work. Regarding career development, 50% of respondents were satisfied, whereas 40% were dissatisfied with the existing prospects. Similarly, in terms of relationships among employees, half of the respondents were satisfied with the current level, while 40% were dissatisfied.

The limitations of our study include its limited sample size and geographic coverage. The study was conducted among 89 nurses in Pavlodar. Future research should extend the study to a larger geographic area to analyze job satisfaction levels among nurses in other regions of Kazakhstan and the country as a whole.

One strength of the study is the comprehensive questionnaire, which allowed for data collection in three main sections: demographic data, information about the structure of the medical organization, and questions to determine satisfaction with working conditions. The internal consistency of the entire questionnaire was high, with a Cronbach’s alpha of 0.898. The study showed that employees of public health sector and large medical organizations participate in social surveys most often. Four main factors influencing job satisfaction were identified: organization of work, salary, career prospects, and relationships within the team. The primary source of dissatisfaction was the level of nurses’ salaries.

A similar study by Charlotte Pietersen found that 61% of respondents were dissatisfied with their salaries in the Limpopo province of South Africa, feeling inadequately compensated for their work. Only 49% were satisfied with their organizations, and 57% of respondents, regardless of age and education, were dissatisfied with their working conditions [7].

In a study by Sommer et al. (2024), 58.3% of nurses in Germany (N=1340) were dissatisfied with their salaries and the general organization of services, highlighting the need for more reliable schedules and fewer unscheduled shifts [11].

An assessment by Er (2018) found that a majority of nurses considered their physical working conditions unsatisfactory (64.1%), although the tools and equipment at the workplace were adequate (52.1%). In general, respondents noted they did not have proper conditions to provide safe care to patients (53.4%) [4].

According to Kvist’s research, job satisfaction was quite high among Finnish nurses, but they lacked decision-making opportunities due to the peculiarities of the Finnish healthcare system [5].

A study by Abildinova et al. (2020) found a similar distribution of satisfied (50.1%) and dissatisfied (49.9%) specialists, with the main source of dissatisfaction being salary levels (17.55%). The greatest source of satisfaction was relationships with immediate supervisors and colleagues [12].

Amanbekov’s study revealed low salaries, high workloads, and a desire among nurses to change jobs if possible. However, many respondents viewed their team as family and had strong sympathy for their colleagues. To improve the quality of nursing services, the study proposed raising salaries and improving material and technical equipment [13].

Conclusion

The degree of satisfaction with working conditions depends on many factors. Our study surveyed 89 nurses in Pavlodar, with an average age of 40.4 years (SD=12.5) and an average work experience of 17.4 years (SD=12.45), most of whom work in the public health sector (96.6%).

The study revealed an average level of satisfaction among medical personnel regarding their working conditions. Specifically, 38.2% of nurses consider their salaries inconsistent with the current labor market situation, and 50.6% indicated that both material and non-material compensation do not correspond to their level of professionalism. As a result, almost half of the respondents remain dissatisfied with the system of compensation at their workplace.

Additionally, only 50% of respondents recognized opportunities for career growth and the development of friendly relationships with colleagues. Therefore, the main factors contributing to dissatisfaction are inadequate salary levels, unclear career prospects, and unfavorable relationships within the work team.

Maxudova M.Kh. – https://orcid.org/0009-0004-5354-7007

Barlykova G.B. – https://orcid.org/0009-0002-1167-5735

Ospanova D.А. – https://orcid.org/0000-0002-2206-7367

Ussebayeva N.Zh. – https://orcid.org/0009-0008-7293-7827

Yermukhanova L.S. – https://orcid.org/0000-0002-4073-0070

Dostanova Zh.A. – https://orcid.org/0000-0002-2531-7106

Kurganbekova M.B. – https://orcid.org/0000-0002-3739-2365

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10.1111/j.1547-5069.1987.tb00581.x.

4. Fatma Er, Serap S. Investigation of the working conditions of nurses in public hospitals on the basis of nurse-friendly hospital criteria. International Journal of Nursing Sciences. 2018;5(2):206-212.

      doi: 10.1016/j.ijnss.2018.01.001

5. Kvist T, Mäntynen R, Partanen P, Turunen H, Miettinen M, Vehviläinen-Julkunen K. The Job Satisfaction of Finnish Nursing Staff: The Development of a Job Satisfaction Scale and Survey Results. Nursing Research and Practice. 2012; ID 210509:11.

       doi: 10.1155/2012/210509

6. White EM, Aiken LH, McHugh MD. Registered Nurse Burnout, Job Dissatisfaction, and Missed  Care in Nursing Homes. Journal of the American Geriatrics Society. 2019;67(10):2065-2071.

       doi: 10.1111/jgs.16051.

7. Pietersen C. Job Satisfaction оf Hospital Nursing Staff. SA Journal of Human Resource Management. 2005; 3(2).

       doi: 10.4102/sajhrm.v3i2.66

8. Гладкова ЛН, Жилина АА, Кокорина МВ. Oнлайн-анкетирование как способ получения данных для написания ВКР. 2019;11(38):56-57.
9. Regmi PR, Waithaka E, Paudyal A, Simkhada P, van Teijlingen E. Guide to the design and application of online questionnaire surveys. Nepal Journal of Epidemiology. 2016;6(4):640-644.

      doi: 10.3126/nje.v6i4.17258.

10. Фомина ЕЕ. Обзор методов оценки надежности измерительной шкалы в социологических исследованиях. Экономика. Социология. Право. 2018;4(12):68-70.
11. Sommer D, Wilhelm S, Wahl F. Nurses’ Workplace Perceptions in Southern Germany-Job Satisfaction and Self-Intended Retention towards Nursing. 2024;12(2):172.

       doi: 10.3390/healthcare12020172

12. Абильдинова СК, Кулов ДБ, Болатбекова АА, Ердесов НЖ. Oценка удовлетворенности профессиональной деятельностью медицинских сестер ПМСП. Медицина и экология. 2020;2(95):95-103.
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References:

1. Krepia V, Kourakos M, Kafkia T. Special Article Job Satisfaction of Nurses: A Literature Review. International Journal of Caring Sciences. 2023;16(3):1754.
2. Yusupova KI, Matveeva TYu. Udovletvorennost trudom medicinskogo personala na primere GAUZ RKIB. Voprosy nauki i obrazovaniya. 2018;8(20):50-54. [in Russian]
3. McCloskey JC, McCain BE. Satisfaction, commitment and professionalism of newly employed nurses. Image J Nurs Sch. 1987;19(1):20-4. doi:

10.1111/j.1547-5069.1987.tb00581.x.

4. Fatma Er, Serap S. Investigation of the working conditions of nurses in public hospitals on the basis of nurse-friendly hospital criteria. International Journal of Nursing Sciences. 2018;5(2):206-212.

       doi:   10.1016/j.ijnss.2018.01.001.

5. Kvist T, Mäntynen R, Partanen P, Turunen H, Miettinen M, Vehviläinen-Julkunen K. The Job Satisfaction of Finnish Nursing Staff: The Development of a Job Satisfaction Scale and Survey Results. Nursing Research and Practice. 2012;2012:210509.

      doi: 10.1155/2012/210509.

6. White EM, Aiken LH, McHugh MD. Registered Nurse Burnout, Job Dissatisfaction, and Missed Care in Nursing Homes. Journal of the American Geriatrics Society. 2019;67(10):2065-2071.

       doi: 10.1111/jgs.16051.

7. Pietersen C. Job Satisfaction оf Hospital Nursing Staff. SA Journal of Human Resource Management. 2005;3(2).

       doi:10.4102/sajhrm.v3i2.66.

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      doi: 10.3126/nje.v6i4.17258.

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11. [in Russian]
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       doi: 10.3390/healthcare12020172

12. Abildinova SK, Kulov DB, Bolatbekova AA, Erdesov NZh. Ocenka udovletvorennosti professionalnoj deyatelnostyu medicinskih sester PMSP. Medicina i ekologiya. 2020;2(95):95-103. [in Russian]
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