A

RESEARCH PAPER
ON THE JOB SATISFACTION
OF HEALTH CARE PROFESSIONALS IN
ILIGAN CITY

An UNDERGRADUATE THESIS
Presented to the Faculty of the
College of Nursing and Midwifery of Iligan Medical Center College
San Miguel Village, Palao, Iligan City

In Partial Fulfilment
Of the Requirement for the Degree Bachelor of Science in Nursing

By

PANDAPATAN, SITTIE ASHRY I.

June 2022
 CHAPTER I

INTRODUCTION

Background of the Study

Health care professionals were among the first and most important pillars of any health system

and institution, providing care and managing the health-related issues. Job satisfaction has a

major impact on the performance and efficiency of health-care systems. Worker attitudes toward

their employment are measured by their level of job satisfaction, which includes both cognitive

and behavioral factors. According to a research by the World Health Organization, 40% of

medical professionals (including nurses, midwives, and doctors) will resign from their positions

due to job dissatisfaction. Whenever health care workers and college students pursuing medical

courses experience burnout and challenging situations such as extended work hours, patient

overload, several serious cases, and lack of sleep, they commonly describe their job as "toxic."

Those who refuse to work for more than eight hours will be chastised by the nursing supervisor.

In Iligan City, some volunteer nurses in government hospitals have not signed a contract with

their hospital-employers. They are paid 6,000 pesos per month without benefits. They had been

working there for a long time but were unable to find another job due to a lack of work

experience certificates due to the "non-contractual" status of volunteers. [A nurse's]

responsibility is enormous because the nursing profession deals with human lives; however, in a

private hospital, nurses only receive a minimum monthly take-home pay of 9,000 to 12,000

pesos with few or no social benefits. Complaints for overload work nurses in localities

nationwide with 103 million total populations and 49.54 million total female population.

According to a 2015 research by the Department of Health and the World Bank, unjust
compensation and the fear of poor supervision cause nurses to be dissatisfied with their jobs.

Filipino nurses are caring in their profession, placing their patients' needs ahead of their own.

The majority of Filipino nurses find fulfillment in providing their patients with compassionate

and high-quality nursing care. Satisfaction is primarily based on affect, work resources, and self-

care, which are the primary factors influencing one's positivity-negativity ratio (Tamayo, 2015).

However, they are dissatisfied with their jobs due to low wages (government low budget

appropriation) and, in the worst-case scenario, are volunteering (lack of security of tenure). Some

nurses desire to fulfill their contracts with hospitals and pursue their dreams of working in other

countries (Umil, 2015). The "toxic" scenario is discussed in the context of the country. Local

health worker dynamics have yet to be established. The researcher's goal is to describe the job

satisfaction of health professionals in Iligan City and to identify the factors that influence their

level of job satisfaction in order to provide legislative inputs and policy to local public and

private executives and health administrators.

STATEMENT OF THE PROBLEM:

The purpose of this study is to determine the effects of organizational factors on job satisfaction

of health workers in Iligan City, specifically (1) engagement, (2) fair compensation, (3)

supervision, and (4) physical environment. Specifically, this study will seek to answer to the

following questions:

1. Demographic Profile

1.1 Age

1.2 Gender

1.3 Years of Working Experience

1.4 Type of Institutions

2. Opportunity to Develop
3. Responsibility
4. Patient Care
5. Staff Relation

6. Is there a significant difference in the levels of job satisfaction of health workers in

terms of performance and efficiency?

7. What job satisfaction strategies can be developed by the government and other health

administrators of Iligan City?

HYPOTHESIS:

H 1 : T h e r e is no significant difference in levels of job satisfaction among Healthcare

Professionals as a result of their performance and efficiency.

THEORITICAL FRAMEWORK

The framework of the study is based from the theories of renowned philosophers: McLellands'

Theory, Maslow's Hierarchy of Needs, and Herzberg's 2-Factor Theory. Individual differences in

characteristic patterns of thinking, feeling, and behaving are commonly defined as "the coherent

pattern of affection, cognition, and desires (goals) as they lead to behavior" and "individual

differences in characteristic patterns of thinking, feeling, and behaving" respectively (Ackerman,

2017).

Hippocrates (460-380 BCE) proposed that temperament might be divided into two categories:

hot and cold, and wet and dry (Greek Medicine, 2017). This concept leads to four different

"humors" (hot/moist, hot/dry, cold/moist, cold/dry) that are regarded to be major elements in

health concerns, death, and personality idiosyncrasies (Ackerman, 2017) that can be harmful to

humans. To be competent in nature and to endeavor to understand what man is in regard to food
and drink, as well as his other vocations and what affects each has on everyone, if he wants to

accomplish his tasks.

There are many other types of structures both inside and outside the body that differ greatly in

terms of health and illness suffers, such as whether the head is tiny or enormous. He also

believed that thoughts, ideas, and feelings originate in the brain rather than the heart, as others at

the time did" (Hippocrates in Adams, 2017; Hyppocrates in Primer on Psychology, 2017).

Plato proposed a four-factor personality classification: artistic, sensible, intuitive, and rational.

While Aristotle pondered a possible link between the physical body and personality, he provided

a similar set of criteria to explain personality: iconic (or artistic), pistic (or common sense),

noetic (intuition), and dianoetic (or logic). Man's satisfaction is reflected in happiness and

pleasant feelings, which are related to neuroscience, which discovered the truthfulness of several

early philosophers of Medicine, Personality, and Brain hypotheses and theories.

Happiness, according to Aristotle, has at least two aspects: hedonia (pleasure) and eudaimonia

(well-being) (a life well lived). These components are commonly referred to as pleasure and

meaning in contemporary psychology, and positive psychologists have lately proposed to add a

third separate component of engagement relating to feelings of commitment and participation in

life (Seligman et al. 2005, in Kringelbach, M& Berridge, K., 2011).

Scientists have made significant progress in defining and measuring happiness in the form of

self-reports of subjective well-being, finding its distribution among people in the actual world,

and determining how happiness is influenced by numerous life aspects ranging from income to

other people (Kahneman 1999).

There is a clear conceptual separation between pleasure and engagement-meaning components,

hedonic and eudaimonic parts actually cohere together in happy people and research is focused

on making significant progress in understanding the psychology and neurology of sensory

pleasure. These developments have made the hedonic side of happiness the most tractable to a

scientific approach to the neural underpinnings of happiness. (Kringelbach, M. & Berridge, K.

2008,2010, 2011; Kahneman 1999). (Smith et al. 2010inKringelbach, M & Berridge, K., 2011).

Each component has conscious and unconscious parts that can be researched in humans—and at

least the latter can be investigated in other animals.

Herzberg’s 2-Factor Model

According to Herzberg's motivator-hygiene theory, job satisfaction and dissatisfaction are not

two ends of the same continuum, but rather two distinct and, at times, unrelated concepts. In

order for an employee to be satisfied with their work,'motivating' factors such as pay and

benefits, recognition, and achievement must be met. However, 'hygiene' factors (such as working

conditions, company policies and structure, job security, interaction with coworkers, and

management quality) are linked to job dissatisfaction (Herzberg, 1966).

Based on the Two-Factor Theory, managers must focus on ensuring the hygiene factors are

adequate in order to avoid employee dissatisfaction. Managers must also ensure that the work is

engaging and fulfilling so that people are inspired to work harder and achieve higher results. This

philosophy focuses on job enrichment as a means of motivating employees. The job must make
the most of the employee's skills and abilities. Work quality can be improved by focusing on

motivational factors (Management Study Guide, 2017). Frederick Herzberg, a behavioral

scientist, proposed a two-factor hypothesis, often known as the motivator-hygiene theory, in

1959.

Accordingly, satisfaction is linked to motivation (e.g., achievement, recognition, advancement,

growth, and responsibility), whereas dissatisfaction is linked to hygiene factors (e.g. company

policy and administration, supervision, interpersonal relationships, working conditions, pay,

status, and job security). Since time immemorial, the Philippines has been committed to

providing patient-centered care, despite the need to improve nurses' job satisfaction (Tamayo,

2015). Herzberg denotes that some job variables lead to contentment, while others lead to

unhappiness. The inverse of "satisfaction" is "no satisfaction," and the opposite of

"dissatisfaction" is "no dissatisfaction," according to Herzberg. Herzberg classified these job

factors into two categories such as:

a. Hygiene factors- Hygiene considerations are those aspects of the job that are required for

motivation to exist at work. These do not contribute to long-term good satisfaction. However, if

these factors are missing or non-existent in the job, unhappiness will result. In other words,

hygiene considerations are those aspects of a job that, when adequate and reasonable, calm

people and prevent them from being unsatisfied. These are factors that are not related to work.

Because they are required to avert unhappiness, hygiene factors are also known as “Dissatisfiers”

or maintenance factors. These factors describe the work environment.

b. Motivational factors- The hygiene factors, according to Herzberg, can't be considered

motivators. Positive contentment results from motivational causes. These factors encourage
employees to perform at a high level factors called “Satisfiers” that affect how the job is done

that are naturally motivating for employees.

The Motivation Theory

Abraham Maslow (1943) developed a hierarchy of human needs in which he described the basis

of human behavior in terms of survival priorities. Once these basic needs, beginning with

physiological, are met, we can move up the hierarchy to meet needs for safety/security,

love/belonging, and esteem. Finally, Maslow asserts that the highest human needs revolve

around discovering one's purpose and realizing one's full potential, culminating at the top of the

hierarchy in self-actualization (Vertino, 2014). Maslow's theory was founded on Freud's (1905)

psychoanalytic theory that at least some aspects or drivers of personality are buried deep within

the unconscious mind (Freud, 1905, in Cronenberg, 2011). One of the first theories to probe the

important contributors to job satisfaction was the Hierarchy of Needs theory. According to the

theory, human needs are organized into a five-level hierarchy (Figure 1), which includes

physiological needs, safety, belongingness/love, esteem, and self-actualization. Maslow's

hierarchy of needs, there are basic needs that must be met first (such as physiological needs and

safety) before more complex needs can be met (such as, belonging and esteem).

Figure 1. Maslow’s Hierarchy of Needs (https://www.simplypsychology.org/maslow.html4)

Maslow's hierarchy of needs was designed to explain human motivation in particular. Its major

applications, however, are applicable to the workplace and have been used to explain job

satisfaction. Financial compensation and healthcare are two benefits provided by an organization

that assist employees in meeting their basic physiological needs. Employees' safety needs can

manifest as a sense of physical safety in the workplace, as well as job security and/or having

appropriate company structures and policies. When this is met, employees can concentrate on

feeling like they belong at work. This can manifest as positive relationships with colleagues and

supervisors at work, as well as whether or not they feel a part of their team organization.

Once satisfied, the employee will seek to feel valued and appreciated by their colleagues and

their employer. The final step is where the employee strives for self-actualization; where they

must grow and develop in order to become everything they are capable of becoming. Although

they may appear to be independent, the progressions from one step to the next all contribute to

the process of self-actualization. As a result, organizations seeking to improve employee job

satisfaction should first address employees' basic needs before moving on to higher-order needs.

However, this approach has recently become less popular because it fails to consider the

employee's cognitive process and, in general, lacks empirical support. Furthermore, others have

criticized the final stage of self-actualization. The lack of a clear definition and conceptual

understanding of self-actualization, combined with the difficulty of measuring it, makes it

difficult to determine what the ultimate goal is and when it has been met (Specter, 1997; Maher,

2002).

However, the researcher considers self-actualization to be a component of organizational job

aspects that provide workers with a challenging role in which their own expertise or professional
knowledge and skills are utilized, as well as supervision that includes autonomy, trust, and

confidence in the worker's abilities. The Maslow’s Motivation and Personality, a health-

promoting culture must be created in order for individuals to thrive and excel, as he believed that

when parents fail to provide a safe, nurturing environment for their children, they will develop

deep feelings of insecurity. Maslow considered humans to be energized by an actualizing

tendency. and believed that happiness occurs when people are free to express their inherent

potential (Froh, 2004; Tim & Sheldon, 2000; Tim & Ryan, 1993).

McClelland's Trichotomy of Needs Theory

According to this theory, three needs influence human behavior: the need for power,

achievement, and affiliation. The desire to excel, to achieve in relation to a set of standards, to

struggle to achieve success is referred to as the need for achievement. It is a learned requirement

(nACH). The desire to influence other people's behavior according to your wishes is referred to

as a need for power. In other words, it is the desire to have power and influence over others.

Affiliation requires open and sociable interpersonal relationships. In other words, it is a desire for

a cooperative and mutually beneficial relationship (Arnolds &Boshoff, 2018).

CONCEPTUAL FRAMEWORK

According to Herzberg's Two-Factor Theory, contentment is linked to motivation and

dissatisfaction, or hygiene factors that can be employed to prevent dissatisfaction. Organizational

factors that are separate, unrelated, and diverse from one other are characterized as motivation

and dissatisfiers (or maintenance), and include and emphasis on engagement, fair compensation

(and benefits), supervision, physical working environment, and job aspects. All of these, or the

lack of one or more, will result in a shift in employee satisfaction, which will influence behavior,

including commitment.
Maslow's hierarchy of needs theory is used in this study not in order nor in a hierarchical

manner, but rather overlapping, which means physiological (fair compensation and benefits) and

self-actualization needs, as well as other needs (job security, safe, conducive, and convenient

working environment, supervision—relationships and policies for advancement) are used to

motivate workers in the performance of their duties and responsibilities.

Ackerman's (2017) meta-analysis of the 5-Factor Hypothesis is consistent with Herzberg's

motivation (and dissatisfier) theory. The contextual personality traits (exploring how personality

evolves dependent on environment and time) and an emphasis on the biological origins of

personality and behavior are among the conceptualizing qualities that are on a "spectrum" rather

than as dichotomous variables. Each motivating (or dissatisfying) factor stimulated a different

and specific trait of the person, which is greatly influenced by neural circuitry (Shonkoff, 2017 in

Agustin, 2017) and frontal cortex, hypothalamic-pituitary glands, and other cortical regions of

the brain as philosophized and theorized in Aristotelian Hedonic Brain Circuitry, as well as

physiological reward and pleasure in Hedonia, which are most relevant to happiness.

Figure 2. Conceptual Diagram of the Job Satisfaction of Health Care Professionals

Independent Variables Dependent Variables

1. Demographic Profile
1.1 Age
1.2 Gender
1.3 Years of Working Experience Job Satisfaction of Health Care
1.4 Type of Institutions Professionals
2. Opportunity to Develop 1. Performance
3. Responsibility 2. Efficiency
4. Patient Care
5. Staff Relation
SCOPE AND DELIMITATION OF THE STUDY

The research will concentrate on the job satisfaction of health workers in Iligan City including

the Nursing Students who are currently doing their clinical internship in any of the hospitals in

Iligan City. It will exclude any employees from other sectors, such as those who live in Iligan but

do not work as health workers in the city.

SIGNIFICANCE OF THE STUDY

The study that will describe the health workers’ job satisfaction will benefit the following:

 Policy-makers. The findings of this study will aid in the formulation of local health

policy and budget allocation from the government.

 Health Administrators. The study will aid health administrators, both public and

private, in the formulation and implementation of human resource management policies

and strategies.

 Health Workers. The results of this study will help provide information to Nurses on

how they can understand their job, themselves and their organization or employers.

 Nursing Students. The students will grasp understanding on how to deal with their job

satisfactions.

 Researchers. The study could serve as a good reference for future researchers who will

undertake a similar research.

DEFINITION OF TERMS

1. Engagement. In this study, engagement is defined as employer engagement or sincerity with

employees on a regular and permanent basis with full benefits. It is also part of commitment,

which is the commitment of the health workers to remain and engage with their job for a long

period of time despite the huge disparity in cross-cultural and politico-economic standards.
2. Compensation. It is a form of monetary and social benefits for labor; the money is equivalent

to the workers' time and effort based on their needs and abilities.

3. Health Workers. It is defined specifically for licensed nurses working in Iligan City,

including Nursing Students currently doing their clinical internship at the city's hospitals.

4. Job Aspect. It involves meaningful work, the job's challenging and dynamic nature, the job's

substance or nature (policy on duties and responsibilities and actual job content), the ability to

take initiative, autonomy at work (self-actualization), and opportunities for professional

development and promotion.

5. Job Satisfaction. A sense of accomplishment or enjoyment derived from one's job.

6. Motivation. It refers to the health workers’ general desire desire to continue striving for

meaning, purpose, and a willingness to strive hard for work.

7. Organizational Factor. In this study, a variety of factors influence employees' job

satisfaction, it consists of Engagement, Motivation, Physical Environment, Compensation,

Supervision and Job Aspect.

8. Supervision. In this study, supervision is defined as a system and process of organizational

dynamics that includes policies (human resources reward and disciplinary actions, career

advancement, etc.), superior-subordinate relationships (respect, trust and confidence, absence of

threats), training and continuing education programs, autonomy, communication and so on.

9. Physical Environment. This refers to the technology, equipment, facilities, and the

relationships of fellow health workers, clients, and patients.

 CHAPTER II

REVIEW OF THE RELATED LITERATURE AND STUDIES

The selected related literatures are reviewed in this chapter to validate the theories and concepts

discussed in the previous chapter.

A. Related Literature

Hippocrates believed that thoughts, ideas, and feelings come from the brain rather than the heart,

as others at the time did" (Hippocrates in Adams, 2017; Hippocrates in Primer on Psychology,

2017). Job satisfaction is defined as a pleasant feeling and enjoyment of one's own work. It is a

broad expression of employees' positive attitudes toward their jobs. Workers maintain a positive

attitude toward their jobs as a result of various aspects of their jobs, social and economic status

gained from their jobs, and experiences in their work environment. This attitude can also be

detrimental to one's job (Celik, 2011). The single question asks only one question to determine

an employee's level of job satisfaction. This is common in large surveys, such as the United

States National Longitudinal Survey. The survey asks, ‘How do you feel about the job you have

now ', and asks respondents to rate themselves on a scale (like it very much, like it fairly well,

dislike it somewhat, dislike it very much). Proponents of this approach believe that employees

generally know how happy they are, so asking them multiple questions about the same thing is

pointless. The global measurement aims to produce a single score that represents an employee's

overall job satisfaction. Several questions or statements about various aspects of the job (such as

pay, work activities, working conditions, and career prospects) are provided, but they are

combined to provide an overall score.

Several questions or statements about various aspects of the job (such as pay, work activities,

working conditions, and career prospects) are provided, but they are combined to provide an

overall score. Facet measurements, on the other hand, include questions or items for each of

these areas and provide a single score to represent each. The Job Satisfaction Scales and the

Overall Job Satisfaction Scale are two established global measures, while the Job Description

Index (JDI) is one established facet measure (War, Cook, Wall, 1979; Brayfield, A.H., &Rothe,

H.F, 1951, and Bowling Green State Univeristy,2012, in Hassard, Teoh, & Cox, 2017).

Because there are numerous job satisfaction measurements available, those wishing to assess this

concept can select the one that best suits their needs. However, the variety of options can make

comparisons difficult, and a poor choice of measurement can result in unreliable or invalid

results (Astrauskaite, Vaitkevicius&Perminas, 2011). Plato proposed four personality types or

factors: artistic, sensible, intuitive, and reasoning. Aristotle proposed a similar set of personality

factors: iconic (or artistic), pistic (or common sense), noetic (intuition), and dianoetic (or logic).

While Aristotle speculated on a possible link between the physical body and personality, this link

did not become widely accepted until the rise of phrenology and the shocking case of Phineas

Gage. The story of Phineas Gage, also known as the 'American Crowbar Case,' was an unwitting

and involuntary contributor to the history of neuroscience. Gage suffered a terrible brain injury

in 1848, when he was only 25 years old, that destroyed up to 4% of the cerebral cortex and about

11% of the total white matter in the frontal lobe, according to Jack Van Horn of UCLA's

Laboratory of Neuroimaging. Gage's miraculous survival and the effects of the injury on his

character made him a public curiosity as well as an important case study for scientists hoping to

learn more about the brain. Ackerman (2017) In 1850 Henry J Bigelow, Professor of Surgery at

Harvard University, reported Gage to be “quite recovered in faculties of body and mind”.
While philosophical, neuroscience, and psychology are all related, future scientific advances may

allow for a better classification of psychological aspects of happiness and their underlying brain

networks. If this is the case, more of us may one day be shifted into a better position to enjoy

daily events, to find life meaningful and worth living—and perhaps even to achieve a degree of

bliss (Kringelbach &Berridge, 2011).

Dopamine has been shown in studies to play an important role in human motivation. It acts as a

neurotransmitter in the brain, which is a chemical released by neurons (nerve cells) to send

signals to other nerve cells. There are several distinct dopamine pathways in the brain, one of

which is important in reward-motivated behavior (Schultz, 2015). Dopamine is commonly

associated with the brain's 'pleasure system,' providing feelings of pleasure and reinforcement to

motivate us to do or continue doing certain activities. Certainly, naturally rewarding experiences

such as food, sex, and neutral stimuli that become associated with them release dopamine

(particularly in areas such as the nucleus accumbens and striatum).

However, the idea that dopamine is the 'reward chemical' of the brain now seems too simple as

more evidence has been gathered. Dopamine is known to be released when unpleasant or

aversive stimuli are encountered, suggesting that it is not only associated with 'rewards' or

pleasure. Also, the firing of dopamine neurons occur when a pleasurable activity is expected,

regardless of whether it actually happens or not. This suggests that dopamine may be involved in

desire rather than pleasure. Other theories suggest that the crucial role of dopamine may be in

predicting pleasurable activity (like work---mental or physical). Related theories argue that

dopamine function may be involved in the salience ('noticeableness') of perceived objects and

events, with potentially important stimuli (including rewarding things, but also things which

may be dangerous or a threat) appearing more noticeable or more important.

According to this theory, dopamine's role is to aid decision making by influencing the priority of

such stimuli to the person in question. Dopamine is involved in executive functions, motor

control, motivation, arousal, reinforcement, and reward, as well as lower-level functions such as

lactation, sexual gratification, and nausea. The dopamine system, which is neuromodulatory, is

made up of dopaminergic cell groups and pathways. Pleasure provides a definition of reward as

an aspect of reward; however, while all pleasurable stimuli are rewarding, not all rewarding

stimuli are pleasurable (e.g., extrinsic rewards like money). The approach behavior that

rewarding stimuli induce reflects their motivational or desirable aspect, whereas the pleasurable

component of intrinsic rewards is derived from the consummatory behavior that follows their

acquisition (Schultz, 2015; Robinson &Berridge, 11993).

Goldberg’s 5-Factor Model (or Big Five Personality Traits)

Lewis Goldberg reduced down Raymond Cattell's 16 "basic characteristics" of personality into

five primary factors in Ackerman's essay (2017) about the 5-Factor Model, identical to the five

factors discovered by fellow psychology researchers in the 1960s. Agreeableness,

Conscientiousness, Neuroticism, and Neuroticism are the five primary personality factors

identified by Goldberg.

Openness to experience, and Extroversion

The Big Five draws up to the current day in terms of personality study and still reigns supreme,

however some of the most important parts of current personality study include: conceptualizing

traits on a spectrum rather as dichotomous variables, personality traits that are contextual

(exploring how personality shifts based on environment and time) and emphasis on the

biological bases of personality and behavior (Ackerman, 2017).

Openness to experience. It is an appreciation of art, emotion, adventure, unusual ideas,

curiosity, and a wide range of experiences. Openness is a measure of a person's intellectual

curiosity, creativity, and desire for novelty and variation. It can also relate to a person's level of

creativity or independence, as well as a preference for a variety of activities over a regular

regimen. Unpredictability or a lack of focus can be interpreted as high openness. Furthermore,

people with a high level of openness are reported to seek out strong, euphoric experiences in

order to achieve self-actualization. Those with low openness, on the other hand, seek fulfillment

via perseverance and are described as pragmatic and data-driven, sometimes even dogmatic and

closed-minded. There is still some dispute on how to interpret and frame the openness element.

Openness has been linked to knowledge and abilities, as well as creativity, originality, and a

desire to examine their inner selves with a therapist or psychiatrist. It has also been found to be

negatively associated with conservative political attitudes. A person with a high openness to

experience is likely to appreciate learning, like the arts, engage in a creative vocation or activity,

and enjoy meeting new people (Lebowitz, 2016a in Ackerman, 2017).

Conscientiousness. It is a tendency to be organized and dependable, to exercise self-control, to

act responsibly, to strive for success, and to favor planned rather than spontaneous behavior.

High conscientiousness is frequently misinterpreted as obstinacy and obsession. Low

conscientiousness is linked to spontaneity and flexibility, but it can also manifest as sloppiness

and unreliability. It's a personality feature that's defined as the ability to control urges and act in

socially acceptable ways, behaviors that help people achieve their goals. Someone with a high

level of conscientiousness is more likely to procrastinate, be flighty, impetuous, and impulsive,

whereas someone with a low level of conscientiousness is more likely to procrastinate, be

flighty, impetuous, and impulsive (Lebowitz, 2016a).

Extroversion. This factor, which dates back to Jung's works (1905, Cronenberg, 2011), is

divided into two categories: extroversion and introversion. It has to do with where a person gets

their energy from and how they interact with others. Extroverts gain their energy or "recharge"

from connecting with people, whereas introverts become tired of interacting with others and get

their energy from isolation. Extroverts seek out opportunities for social engagement, and they are

frequently the "life of the party," since they are at ease with others, gregarious, and action-

oriented rather than contemplative (Lebowitz, 2016a). People that are quiet, contemplative,

restrained, and thoughtful are more likely to be introverts (Ackerman, 2017).

Agreeableness. This aspect has to do with how well people get along with one another. While

extroversion is concerned with sources of energy and the pursuit of social contacts,

agreeableness is concerned with your attitude toward others. It's a construct based on how you

connect with others in general. It is a tendency to be empathetic and cooperative toward people

rather than suspicious and antagonistic.It also indicates whether or not a person is trusting and

helpful, as well as whether or not they are generally well-tempered. High agreeability is

frequently interpreted as naive or submissive. People with low agreeableness are generally

competitive or challenging, which can be seen as argumentativeness or untrustworthiness

(ibid.;Toegel, 2012). People with a high agreeableness score are loved, respected, and sensitive

to others' needs. They are likely to have few enemies, are sympathetic and affectionate toward

their friends and loved ones, and sympathetic to others' plights (Lebowitz, 2016a). Others are

less likely to trust and like people who are on the low end of the agreeableness scale. They are

sardonic, callous, blunt, rude, ill-tempered, and antagonistic. Although not all persons who have

a low level of agreeability are rude or unpleasant, they are unlikely to make others feel good.
Neuroticism. The only Big Five element in which a high score suggests more negative traits is

neuroticism. Neuroticism is a trait of confidence and being at ease in one's own skin, not of

malice or incompetence. It refers to one's emotional stability and general disposition. It's the

proclivity to readily experience negative emotions including wrath, anxiety, depression, and

vulnerability. The low pole of neuroticism, "emotional stability," is frequently used to describe

the degree of emotional stability and impulsive control. A strong desire for stability emerges as

stable and calm personality, but can be seen as uninspiring and unconcerned. A reactive and

excitable personality, typically very dynamic persons, is caused by a low demand for stability,

although they can be seen as unstable or insecure (Ackerman, 2017; Toegel, 2012). People who

have a low neuroticism score are more likely to be confident, sure of themselves, and

adventurous. They may also be brave and free of worry or self-doubt.

B. RELATED STUDIES

According to the research of Rana et al. (2022), performance appraisal is a formal process for

proper evaluation of all employees' appraisal of inner characteristics in order to expand employee

commitment, productivity, and performance. Moreover, when medical healthcare employees are

recognized by their hospital employer, they are more productive, have the highest performance, and

have enhanced well-being (included provision of safety and security). Thus, a compelling

performance appraisal framework is required for satisfactory performance, identifying medical

employees' mental states (burnout, exhaustion, negative emotions, psychological distress, and

occupational stress) during crises, and incorporating practices to shape constructive hospital

administration. Employee satisfaction and performance appraisal are perhaps affected by equal

opportunities, fairness in the appraisal system, the impact of job tasks, work-load compensation, and

motivation towards personal and career growth, performance appraisal through rewards and
applause, safety and security, compensation for overtime, and social reinforcement towards their job

activities. Work participation, intrinsic job motivation, greater order need strength, perceived

intrinsic job qualities, job satisfaction, life contentment, happiness, and self-rated anxiety are some

of the topics covered by Warr, Cook, and Wall (1979). In addition, cluster studies revealed

components of job and life satisfaction. The scales are factorial different and have strong internal

reliability. As a basis for future applications, comprehensive data is provided. Adaptive processes

are frequently required for accurate measurement of complex psychological states; researchers must

travel back and forth between conceptualization and operationalization multiple times, revising their

concepts and measures as they go. This is not always possible within the scope of a single study

endeavor, and it may be essential to accept or adapt an already published measure or to construct a

new scale with limited opportunities for systematic development. Neither technique is totally

satisfactory, especially because most investigators have rightly prioritized the supply of precise

information regarding samples, means, variances, inter-correlations, and other factors that would aid

in subsequent assessment of their measures in their reports.

Some government hospital registered nurses are fairly compensated than private hospital, and

government hospitals had lower registered nurses vacancy and turnover rates than private

hospitals on average. All respondents said they had no trouble finding registered nurses with less

than a year of experience. In comparison to government hospitals, however, private hospitals

found it more difficult to hire more experienced registered nurses. The most effective incentives

for both recruitment and retention were found to be higher salary, better benefits, and

outstanding career options (Perrin ME, Hagopian A, Sales A, Huang B., 2007)

In the effect evaluation survey in Central China, the average scores of total job satisfaction and

satisfaction of community health workers with compensation, contingent rewards, operational

procedures, and communication were statistically considerably higher than the baseline survey.

In the effect evaluation survey, the average satisfaction with promotion was statistically

considerably lower than in the baseline survey. The average satisfaction scores with income,

benefits, and promotion were statistically considerably lower in both polls. Before and after the

LCMR, CHWs show reduced satisfaction in the dimensions of income, promotion, and benefits.

As a result, policymakers should take steps to increase CHWs' remuneration and pay more

attention to their professional development in order to boost their JS (Ding H, Sun X, Chang

WW, Zhang L, Xu XP, 2013). In Canada, between 15 and 30 variables (out of 40 potential

predictors) were shown to be statistically associated with job satisfaction, depending on the

organization (univariate analyses). The greatest determinants of job satisfaction were determined

by logistic regression analysis, and these are shown for each of the six organizations as well as

for all organizations together. The findings suggest that job satisfaction is a multifaceted entity,

and that while certain predictors of job satisfaction appear to be organization and context

specific, others appear to be organization and context particular (Krueger, Brazil, Lohfeld, et. al.,

2002). There were many quite negative than positive changes in the health care system reported

by Mid-Atlantic nursing and allied health professionals, including less job security, efficiency,

and time available to spend with individual patients, as well as increases in workload,

paperwork, and insurance company control of health care. Despite these unfavorable changes,

nurses and other allied health professionals are very happy with their jobs. Having a sense of

worthwhile accomplishment from their job, opportunities for personal and professional growth,

recognition, and satisfaction with their workload were found to be the best predictors of job

satisfaction in an investigation into the aspects of their jobs that were most related to satisfaction

(Lyons, Lapin, Young. 2003). According to Lu H, While AE, Barriball KL (2005), job
satisfaction is important among health workers. The current nursing shortage and high turnover

is of great concern in many countries because of its impact on efficiency and relating to job

satisfaction among nurses. More research is needed to understand the relative importance of the

many identified factors to job satisfaction. The development of interventions to promote nurse

retention is said to be hampered by the lack of a robust causal model that incorporates

organizational, professional, and personal factors effectiveness of any health-care delivery

system. Recruitment and retention of nurses are persistent problems associated with job

satisfaction.
 CHAPTER III

METHODOLOGY

The empirical study will gather data and information on how the performance and efficiency of

healthcare professionals in Iligan City affect their job satisfaction. The researcher's analysis,

conclusion, and suggestions will be based on the potential findings, which will aid in identifying

areas for policy and organizational reform.

Research Design

The study will employ a causality research design to examine the respondents' socio-

demographic and economic profiles and to see how job satisfaction influence their performance

and efficiency at work.

Locale of the Study

The study will take place in the lone district of Iligan City, Philippines, of Northern Mindanao,

Region X, and Province of Lanao del Norte.

Respondents of the Study

Iligan City government operates eight (8) hospitals, including one (1) government hospital,

Gregorio T. Lluch Memorial Hospital, and seven (7) private hospitals, including Iligan Medical

Center Hospital, Mercy Community Hospital Inc., Adventist Medical Center – Iligan, Dr. Uy

Hospital Incorporated, E&R Hospital, St. Mary's Maternity & Children's Hospital, Inc., and

Grospe Polymedic Infirmary Hospital.

Sampling Method

Purposive sampling, such as judgmental and nonprobability sampling will be used for the study.

The researcher will utilize selection of participants for the study through their professional

judgment, with the assistance of the hospitals' human resources management, to ensure validity

and reliability of identities and employment. There will be a total of 20 nurses as respondents,

totaling up the entire population of the study.

Research Instrumentation

Data and information for the empirical part of this study will be gathered using 5-point Scale

Likert-Type Questionnaires. There will be two (2) sets of questionnaires used: (1) Survey

Questionnaire for Midwives-respondents and (2) Survey Questionnaire for Nurse-respondents.

The instrument will be validated by panelists from the College of Nursing and Midwifery faculty

as well as an independent consultant.

Data Gathering Procedure

The researcher gathered data from the health workers-respondents who represent the total

population of the study via a personal interaction. To protect the participants' safety, integrity,

and/or credibility, all identities, data, and information will be kept confidential.
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