The pressure to provide quality services using the same or reduced resources has been recognised by many health organisations across the world. This pressure is likely to continue for the near future, creating more stress on the employees (Brooks & Anderson, 2005). Thus, in recent decades, interest in work and organisational psychology in relation to the QWL has increased in the healthcare organisations in order to improve the retention and recruitment processes and to improve performance. A number of studies and
worldwide (Brooks & Anderson, 2004; Brooks et al., 2007; Dargahi, Gharib, & Goudarzi, 2007; Hsu & Kernohan, 2006; Khani et al., 2008). However, the majority of these studies and projects have focused on hospitals settings.
Lewis, Brazil, Krueger, Lohfeld, and Tjam (2001) tested whether extrinsic, intrinsic or ‘prior’ traits best predict satisfaction with QWL in health care. Extrinsic traits are salaries and other tangible benefits; intrinsic traits include skill levels, autonomy and challenge. Prior traits are those of the individuals involved, such as their gender or employment status. A 65-item survey of employees was conducted in seven health-care organisations providing acute, chronic, rehabilitative, long-term and home care to residents in Central- South region of Ontario, Canada. The total sample was 5486 in all locations, with a total response rate of 33%. The QWL questions of the survey instrument were classified into eight dimensions based on the literature findings: (1) co-worker and supervisor support, (2) teamwork and communication, (3) job demands and decision authority, (4) patient/resident care (5) characteristics of the organisation, (6) compensation and benefits, (7) staff training and development, and (8) overall impressions of the organisation. These factors were categorised as intrinsic and extrinsic variables, analysed using factor analysis, and regressed against a satisfaction scale, with socio-demographic variables included. The findings indicated that the pay, benefits, supervisor style and communication were the major factors in determining QWL satisfaction. The authors acknowledged that with the low response of participants, there is no guarantee that those who did not respond were similar to the respondents. Thus, caution in trying to generalise these results must be applied. Finally, the study concluded that decision-makers with an interest in improving QWL in healthcare organisations can focus on these traits and pay as well as enhancing staff autonomy or discretion.
Cole et al. (2005) investigated the understanding, collection diffusion and use of QWL indicators in Canadian healthcare organisations. Cooperation from six diverse public health organisations managing 41 sites was obtained. The researchers conducted 58 focus groups/team interviews with strategic, support and programme teams and reviewed documentation relevant to QWL. Using qualitative data techniques, group interviews were taped, reviewed and analysed for themes. Then, indicators were grouped according to the purpose and the organisation level. The findings indicated that QWL indicators were relatively new to the majority of included organisations; however, the data managed by human resources and the support team of the occupational health and safety unit were highly appropriate for monitoring the well-being of employees with 109 of 209 mentioned indicators (e.g. sickness absence). Monitoring of working conditions (62/209) was also found to be important to QWL (e.g. indicators of employee workload). Regardless of their known impact on the employees’ health and well-being, the indicators of biomechanical and psychosocial hazards at work were uncommon in this study. In spite of ambiguity in the definition of QWL indicators, limited associations with other organisations’ performance measures and inadequate resources for implementation, the majority of examined organisations reported ways in which QWL indicators had influenced planning and evaluation of prevention efforts. The authors concluded that the increase in resources, inclusion of other QWL indicators and greater integration with management systems could all improve the access of decision-makers in targeted health organisations to information relevant to employees’ health.
A cross-sectional Iranian study was conducted by Nasl Saraji and Dargahi (2006) to examine the attitudes of Tehran University of Medical Sciences (TUMS) hospitals’
α = .92) was distributed among 908 employees in 15 TUMS hospitals. A stratified random sampling technique was used to select respondents as nursing, supportive and paramedical groups. The results indicated that the respondents of this study had poor QWL. Respondents were dissatisfied with their income (97.5%), occupational health and safety standards (90%), support by intermediate managers/supervisors (89%), balance between work and family (82%), trust in senior managers (78%), career prospects (75%), and stress experienced at work (71%). Seventy-four percent of nursing participants were dissatisfied with their QWL, and in general, all employees responding to this survey had poor QWL. The study concluded by recommending more training and education for the hospitals’ managers on QWL issues.
In a Canadian study, Sale and Smoke (2007) used a participatory approach to develop a QWL survey for employees of an ambulatory cancer centre. The QWL committee and the employees themselves worked together in order to articulate the problem areas in four domains that could be measured with existing workplace tools: burnout, social support, job satisfaction, and work-family conflict. Companion tools to this measure include the Intrinsic Job Satisfaction, the Extrinsic Job Satisfaction, the Total Job Satisfaction, the National Institute for Occupational Safety and Health Scales for Job Satisfaction and Social Support, the Maslach Burnout Inventory, and Work-Family Conflict. The survey was distributed to staff in Year 1 (Y1) and Year 2 (Y2). There was a 78% and 73% response rate to the survey in Y1 and Y2, respectively. The sample (N = 319) consisted of four main groups: physicians (n = 37), nurses (n = 52), physicists (n = 24) and radiation therapists (n = 58). Overall staff QWL scores were moderate in Y1 and Y2; however, there was considerable variation among four main employee groups (physicians, nurses, physicists and radiation therapists). The scores of the nurses were the lowest compared to
the other employees on items such as total job satisfaction, intrinsic job satisfaction, extrinsic job satisfaction, and depersonalisation. The researchers concluded that the survey data provided a benchmark against which other cancer centres can be compared.
Finally, Argentero, Miglioretti, and Angilletta (2007) conducted a qualitative study using semi-structured interviews to assess QWL and identify the most important indicators among 112 health employees in the local health service in North West Italy. Findings of this study indicated a number of dimensions that were relevant for defining QWL of the participated employees. These dimensions included relationships with co-workers, work organisation, taking care of patients, professional ability and professional growth. The number of patients per week was important in the differences of QWL among the workers. This study confirmed previous findings and the determination of the most influencing indicators of QWL in recent years.