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JOB SATISFACTION AMONG SAUDI PUBLIC SECTOR DENTISTS IN HAIL REGION.

Byline: MOHAMMAD ALJANAKH

ABSTRACT

The objective of this cross-sectional study was to investigate the level of job satisfaction and its association with personal characteristics and work environment among Saudi public sector dentists in Hail region. A self-administered questionnaire was distributed to 120 public sector dentists practicing in Hail Region of Saudi Arabia. Five-Points Likert's scale was used to measure job satisfaction. Of the 120 dentists, 93 completed the questionnaires, giving a response rate of 77.5%. Overall job satisfaction was neutral; with a mean score of 3.35 out of 5. For work environment factors, the highest satisfying factor was the quality of care [3.7 out of 5 (satisfied)], and the least satisfying factor was personal time [2.7/5 (neutral)].

Multiple regression analysis identified a model that included quality of care, dentist-patient relations, gender, and personal time, which accounted for 39.3% of the variation in overall job satisfaction. The majority of the variance was explained by the "quality of care" factor. In conclusions, Job satisfaction was neutral among the studied group of Saudi dentists.

Key Words: Dentists, Job satisfaction, Public sector, Saudi Arabia.

INTRODUCTION

Dentistry as a career has been considered a prestigious job with substantial financial compensation and job security.1 However, dentistry is not without risks. Dentistry as a career is one of the most stressful health professions, and has been shown to have negative impact on the dentists' general health.2,3 It is therefore important to understand the satisfaction of dentists with their job to encourage healthier work environment that enables them for better dental care of their patients.

Many studies in different countries have shown that dentists have a medium level of job satisfaction.4-8 while others have shown a high rate of job satisfaction among dentists.9,10 These studies have reported a number of factors that affect job satisfaction of the dentists, such as dentist-patient relation, stress related to working time, income level, and staff performance issues.5,8,11-13

In Saudi Arabia, dentists in the public sector are facing challenges in providing dental care.14 The Saudi government provides free health care access to public which costs about 7% of the total government budget.15 The Saudi population is increasing rapidly due to high birth rate with an average lifespan of 74 years.15

In addition, 35% of the population is under the age of 15 years.15

High prevalence of dental caries and periodontal diseases in Saudi Arabia is a health challenge.16,17

Therefore, it is important to understand the work environment of Saudi dentists and factors affecting their performance in meeting these challenges.

Few studies have assessed job satisfaction among dental health professionals in Saudi Arabia. Aljazairy et al18 found that dental assistants were generally satisfied with their careers. Haider19 reported that the majority of Saudi undergraduate dental students were satisfied with the prospect of dentistry as a career. However, no data have been published about job satisfaction among Saudi dentists. The aim of this study was to assess the level of job satisfaction and the factors affecting it, among dentists working in public sector in Hail region, Saudi Arabia.

METHODOLOGY

Ethical approval of this study was obtained from the research ethics committee of University of Hail, Saudi Arabia. This cross-sectional study was conducted among public sector dentists working in Hail region of Saudi Arabia. Dentists working in the public sector are employed by the Saudi Ministry of Health and, provide free dental care to all Saudi citizens.

An existing, validated questionnaire12 modified from the Dentists Satisfaction Survey (DSS)1 was used for this study. The questionnaire measured overall job satisfaction and other factors related to work environment. These factors included; income level, personal time, professional development time, staff performance, dentist-patient relation, and quality of care (Table 1). The participants were asked to select their level of agreement with these items on a 5-point Likert scoring system according to the degree of satisfaction with, 1= strongly disagree, 2 = disagree, 3 = neutral, 4 = agree and 5 = strongly agree; (higher score meant higher satisfaction). Of the 29 items, 13 items were negatively worded where a higher score indicated a lower job satisfaction. The responses to these negatively worded items were reverse-coded on entering the data so that a higher score indicated a higher job satisfaction.

The questionnaire also included the sociodemographic and professional characteristics of the participants. These characteristics included gender, age, marital status, years of practice and presence of dental assistant.

The questionnaires were personally distributed among public sector dentists during a continuing dental education meeting in April 2016. The completed questionnaires were then recollected on the same day by the researcher. A written informed consent was obtained from each participant before completing the questionnaires. All collected data were kept confidential and anonymous, and participation in the study was voluntary.

TABLE 1: DENTISTS SATISFACTION SURVEY ITEMS

Factors###Items

Overall job satisfaction###Dentistry meets my current career aspiration.

###I wish I could leave my job to do something else.

###I appear more satisfied with my job than I really am.

###Knowing what I know now, I would make the same decision to go to dentistry again.

###Dentistry is the place where I can make my best contribution.

###Overall, I am extremely satisfied with my career.

###I feel trapped in my current position.

Quality of care###I am skilled at dealing with dental problems of my patients.

###I lack opportunities to provide quality care.

###I am extremely pleased with the technical quality of my work.

Dentist-patient###The relationship with the patients is very frustrating to me.

relations###I do not enjoy interacting with my patients.

###The quality of interpersonal care I provide is very high.

###I enjoy helping patients.

Staff performance###The quality of my auxiliary personnel is low.

###The work performance of my auxiliaries is outstanding.

###The staff at my office works well together.

Professional###I have very little time to be updated about advances in the field of dentistry.

development time###I have enough time to improve my clinical skills.

###I have sufficient time for professional contacts with colleagues.

###I have very limited opportunity to discuss difficult cases with colleagues.

Monetary satisfaction###My income allows me to provide very well for my family.

###Compared to other dentists my total income is much lower than I desired.

###The income that I receive from my practice is most satisfactory for my needs.

###My income is not nearly as high as that of other dentists.

###My income compares favorably to that of other dentists.

Personal time###I have enough time available for my personal life.

###I have sufficient time available for leisure activity.

###I have too little time available for leisure.

Statistical analyses of descriptive and inferential statistics were performed using SPSS version 23 (SPSS Inc., Chicago, IL, USA). To calculate the mean value for overall job satisfaction and other work-related factors, the mean value of each item was calculated. Then, the mean value of each job satisfaction factor was calculated by averaging its items means. Following previous studies12,20, these mean values for each factor were divided into three categories (dissatisfied=1.0-2.5, (neutral=2.6 to 55###1 (1.1)

###Marital status

###Single###16 (17.2)

###Married###77 (82.8)

###Years of practice

###15###42 (45.1)

###6 15###40 (43)

###16 25###9 (9.7)

###>25###2 (2.2)

###Presence of dental assistant

###Yes###75 (80.6)

###No###18 (19.4)

TABLE 3: DISTRIBUTION OF OVERALL JOB SATISFACTION AND WORK ENVIRONMENT FACTORS

###Work environment factors###Distribution

###Satisfied n (%)###Neutral n (%)###Dissatisfied n (%)

###Overall job satisfaction###36 (38.7)###53 (57)###4 (4.3)

###Quality of care###64 (68.8)###23 (24.7)###6 (6.5)

###Dentist-patient relations###60 (64.5)###29 (31.2)###4 (4.3)

###Staff performance###36 (38.7)###43 (46.2)###14 (15.1)

###Professional development time###32 (34.4)###45 (48.4)###16 (17.2)

###Monetary satisfaction###21 (22.6)###62 (66.7)###10 (10.8)

###Personal time###18 (19.4)###35 (37.6)###40 (43.0)

TABLE 4: STANDARD MULTIPLE REGRESSION MODEL FOR FACTORS RELATED TO OVERALL JOB SATISFACTION

###Variablea###Beta###Std. Error beta###Standardized###P value

###Quality of care###0.315###0.082###0.359###0.000**

###Dentist-patient relations###0.257###0.085###0.280###0.003**

###Gender (female = 0, male = 1)###0.270###0.101###0.238###0.009*

###Personal time###0.157###0.067###0.223###0.021*

###F (10, 82) = 6.949; P < 0.001.###R2 = 0.459.###Adjusted R2 = 0.393.

Fig 1 and Table 3 show the mean scores, distribution of overall job satisfaction and work environment factors. For overall job satisfaction, the mean score was in neutral zone (3.35 +- 0.56); about 39% were satisfied, while only 4.3% of the participants were dissatisfied. For work environment factors, quality of care had the highest mean (3.7 +- 0.65) denoting satisfied status; nearly 69% of the participants were satisfied with the care they provided to the patient. Dentist-patient relations had the second highest satisfied mean score (3.69 +- 0.62); nearly 65% of the participants were satisfied with relation with patients and only 4.3% were dissatisfied. The participants showed lowest mean satisfaction score of 2.7+-0.80 with personal time availability; and 43% were in dissatisfied zone.

The impact of personal and professional characteristics, work environment factors on overall job satisfaction, after controlling for other variables, was assessed using a standard multiple regression analysis. Overall job satisfaction was the dependent variable, and years of practice, participant's gender, marital status, the presence of dental assistant, quality of care, dentist-patient relations, staff's performance, professional development time, monetary satisfaction and personal time were included as independent variables. Primary analysis was performed to make sure there were no violations of the assumptions of normality, linearity, multicollinearity, and homogeneity of variance. Because of the high value of multicollinearity between age and years of practice (0.86), the age was excluded from the model. The multiple regression analysis provided with the significant predictors of overall job satisfaction as shown in Table 4.

The adjusted R2 was 0.393; which indicated that the total variance explained by the independent variables together accounted for approximately 39% of the variance in the overall job satisfaction. Regarding the contribution of each independent variable, quality of care was the largest statistically significant predictor in the variation of overall job satisfaction with standardized beta value of 0.359 when the variance explained by all the other variables in the model was controlled, (p< 0.001). Dentist-patient relations, dentist's gender, and personal time were next significant predictors in the model respectively (p< 0.05). The p-value for the remaining factors was above the significant level of 0.05; therefore these variables were not making a significant contribution to the prediction of the variation in the overall job satisfaction (Table 4).

DISCUSSION

Lack of job satisfaction among dentists has been connected to loss of productivity and reduction in the quality of patient care, which can then lead to abandoning dentistry as a career.21 Few studies have been published on job satisfaction of dental health professionals in Saudi Arabia. This study was conducted to assess the level of job satisfaction in a population of Saudi dentists working in public sector.

In the present study, the mean overall job satisfaction score was 3.35+- 0.56 out of 5, which implies a neutral job satisfaction. These findings are comparable to job satisfaction of physicians working at primary health care centers in Saudi Arabia (mean score 3.42 out of 5)22, but less than that of dental assistants in Saudi Arabia (mean score 3.8 out of 5).18 The overall job satisfaction mean score in the present study is comparable to the mean score of overall job satisfaction reported in Indian (3.08 +- 0.28 out of 5), Korean (3.2 +- 0.03 out of 5) and American dentists (3.15 out of 5).8,12,23

On the other hand the mean score in this study was lower than that of Canadian orthodontists (4.0 +- 0.63 out of 5), and Lithuanian dentists (4.60 +- 0.10 out of 5).13,20

When participants were categorized as satisfied, neutral and dissatisfied, only about one-third of them were satisfied with their jobs (38.7%). This is comparable to reported satisfaction percentage rate in South Korean dentists (35.6%),12 but considerably lower than the rate reported in other countries such as Canadian orthodontists (80%)20, practicing Iowa dentists (60%)9, and general dentists in California (50%).23

As regards to work factors affecting job satisfaction, participants were most satisfied with quality of care and dentist-patient relation, and were less satisfied with staff performance, monetary satisfaction and the professional and personal time. Dissatisfaction with personal time in the present study may have resulted from the relatively long working hours. Saudi public dentists work 42 hours per week in their clinics, which is more than that reported in other countries; Denmark 37 hours per week24 and California dentists 34 hours per week.23 This may necessitate introducing more flexible work hours that might improve job satisfaction of public sector Saudi dentists. Satisfaction with staff performance also showed significantly lower mean scores in Australia.21

The regression model showed that the quality of care delivered to patients was the most significant positive predictor of job satisfaction. The next significant factor in the multiple regression model was the relationship with patients. When the relationship with the patients was higher, level of job satisfaction would be higher. Both the above mentioned factors are related to moral reward for the dentists. Quality of care and dentist-patient relations have also been reported by several other studies as main factors related to the overall job satisfaction.1,9,10,23 Gender of the dentist was the next significant work factor that affects overall job satisfaction; male gender was associated with a higher job satisfaction rate in the regression model. Finally, personal time was the least important factor that affected the overall job satisfaction.

The results of the present study have to be interpreted with caution and may not be generalized in view of several limitations of this study. This study was a cross-sectional survey conducted on a small selected sample of public sector dentists in Hail region. This study did not include other governmental dental sectors such as those in military dental services and in private practices. There is a need for further studies that include dentists practicing in all dental sectors of various regions in the Kingdom of Saudi Arabia. Nevertheless, this study has provided an insight into understanding of job satisfaction and its work-related factors among public sector Saudi dentists in the Hail region. The results of the study will help policy makers in designing and implementing plans to improve the job satisfaction level among the Saudi dentists.

CONCLUSIONS

* The level of satisfaction among the study participants was neutral. The participants were mostly satisfied with the quality of care and patient relation and neutral with the other work environment factors.

* The regression model showed that the overall job satisfaction had a significant positive association with the following predictors: quality of care, patient relations, male gender and personal time.

ACKNOWLEDGEMENT

The Author would like to thank the dental administration, Ministry of Health, Hail, Saudi Arabia for their support and assistance in data collection. The author is also grateful to all the participants for their contribution.

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Publication:Pakistan Oral and Dental Journal
Article Type:Survey
Geographic Code:7SAUD
Date:Mar 31, 2017
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