看護とケアのジャーナル

Characteristics of the Work Environment of Magnet Hospitals and Job Satisfaction among Nurses in Japan: A Cross-Sectional Study Using Multi- Level Analysis

Abstract

Maki Tei-Tominaga, Masao Tsuchiya and Fusako Sato

Background: The Magnet hospital is a recognition system in the US having a low turnover and high retention of nurses and providing a high quality of patient care. We sought to examine the effect of characteristics of the work environment of Magnet hospitals on nurses’ job satisfaction using multi-level analysis in hospitals in Japan.

Methods: We distributed anonymous self-administered questionnaires in August 2011 to all nurses via the directors of the nursing departments of four private hospitals. The response rate of nurses was 91%; 373 completed questionnaires in 21 wards were used for analysis. The questionnaire items addressed basic attributes and employment characteristics, the Japanese version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) for assessing characteristics of the work environment of Magnet hospitals, and a job satisfaction scale. We conducted multi-level analysis to examine effects of the PES-NWI sub-scales at both the individual and ward levels on nurses’ job satisfaction.

Results: Results of the multi-level analysis for nurses’ job satisfaction showed that a full model which included the sub-scales of the PES-NWI at both the individual and ward levels was the most appropriate model. Additionally, coefficients of ward-level values showing significant relationships with job satisfaction were greater than those of individual-level values. At the individual level, all sub-scales of the PES-NWI except for “nurse participation in hospital affairs” showed positive relationships with nurses’ job satisfaction, while at the ward level “nurse participation in hospital affairs” showed a significant positive relationship, and “nurse manager ability, leadership, and support of nurses” showed a significant negative relationship, with nurses’ job satisfaction.

Conclusion: These findings suggest that while characteristics of the work environment of Magnet hospitals are important predictors, factors relating to cultural differences, such as decentralized department structures, might influence nurses’ job satisfaction at the ward level.