Job Demands and Job Resources on Job Satisfaction: A Study of Staff Nurses at a General Hospital in Malaysia

The complexity of nursing working environment can adversely affect their satisfaction towards the job. In general, job characteristics can be categorized into job demands and job resources. Job demands can be managed by having sufficient job resources to meet the favourable work outcome. Job satisfaction is much influenced by both job demands and job resources. Therefore, this paper attempts to examine the relationship between job demands and job resources on job satisfaction among staff nurses at a general hospital in Malaysia. A total of 180 staff nurses were randomly selected from a general hospital in Malaysia to determine the relationship. The finding of present study found that there is only one dimension that is emotional demands under job demands was found a significant negative relationship with job satisfaction. Meanwhile, only one dimension that is feedback at work under job resources was found to have a significant positive relationship with job satisfaction among staff nurses in Malaysia.


Introduction
There are many studies on job satisfaction for the past few decades (Castaneda & Scanlan, 2014;Mavridis, 2014). Job satisfaction is typically defined as "a pleasurable or positive emotional state resulting from the appraisal of one's job or job experiences" which originally defined by Locke (1969). In other words, job satisfaction means an individual's inner perception towards his or her job and job experiences (Laschinger, Zhu, & Read, 2016). According to Lambert, Minor, Wells and Hogan (2015), job satisfaction can be described as an employee's emotional response concerning his or her job. Simply put, the term of job satisfaction is an individual's emotional condition which derives from his or her experiences of the working environment.
people nowadays spend much of their time at work, especially in the service sector. Positive working experiences result in a greater level of job satisfaction (Mafini & Dlodlo, 2014). In contrast, negative working experiences result in a lower level of job satisfaction (Mafini & Dlodlo, 2014). The degree of an individual's job satisfaction resulting in his or her productivity at work (Paposa & Kumar, 2015) such as job performance and absenteeism (Alghamdi, 2015).
In nursing, there are many recent studies that focused on job satisfaction among nurses (Atefi, Abdullah, Wong, & Mazlom, 2014;Liu, While, Li, & Ye, 2015). This is imperative for nurses to have a higher level of job satisfaction since they are managing overwhelming workload to deal with an expansive number of patients day by day (Atefi et al., 2014). Heavy workload requires them to perform tasks within longer working hours which affect their satisfaction towards job (Atefi, Abdullah, & Wong, 2014). Additionally, heavy workload occurs due to the shortage of nurses (Atefi et al., 2014;Atefi, Abdullah, & Wong, 2014). In a study of 215 cardiac critical care nurses in Shanghai, it was found that 58.1 percents of the respondents were satisfied with their jobs (Liu et al., 2015). Similarly, a study of 1641 of nurses in the United States, it was found that 75 percents were satisfied with their jobs (Han, Trinkoff, & Gurses, 2015). However, in a study of 1271 registered nurses in Hong Kong, it was found that 44.5 percents of the respondents were dissatisfied toward their jobs and more than 60 percents of the respondents had an aim to turnover from their present positions (Choi, Cheung, & Pang, 2012). In the context of Malaysia, a study found that 40 percents of the 141 nurses had an intention to leave from their current employment due to a lower level of job satisfaction (Ramoo, Abdullah, & Piaw, 2013, Ejike, 2018. The challenging of nurses nature of work requires them to cope with a higher level of emotional, sensorial and cognitive demands such as deal with various characters and conditions of patients that influence their work outcome (Sabil, Abu, Kasuma, & Lizzan, 2016). However, the job demands can be managed by having great job resources (Donoso, Demerouti, Hernandez, Moreno-Jimenez, & Cobo, 2015). Due to the issues arise, job resources are required to meet the favourable work outcome. There are many studies related to job satisfaction among nurses with various factors including job stress (Cheng, Liou, Tsai, & Chang, 2015), work environment (Choi et al., 2012), autonomy and support from peer and supervisor (Han et al., 2015). However, past studies have not greatly emphasized job demands and job resources as the factors which influence job satisfaction among staff nurses in Malaysia. Thus, this study aims to determine: (i) the relationship between job demands (emotional demands, sensorial demands and cognitive demands) and job satisfaction and (ii) the relationship between job resources (degree of freedom at work, social support and feedback at work) and job satisfaction among staff nurses in Malaysia. Proposed framework of this study appeared in Fig. 1.
Job satisfaction is a key issue for healthcare professionals (Platis, Reklitis, & Zimeras, 2015), especially nurses. Past studies highlighted that nurse's job satisfaction has been associated with turnover intention, quality of care (Laschinger et al., 2016) and job performance (Platis et al., 2015). Thus, it shows that the level of job satisfaction may result in either a favourable or non-favourable way. Therefore, it is imperative for both nurse managers and healthcare organizations to understand a sense of job satisfaction for nurses that can greatly influence by various factors such as working condition and lack of medical resources (Atefi et al., 2014).
The Job Demands-Resources (JD-R) model which developed by Demerouti and Bakker (2011) looks particularly favourable in the present study. It is originally developed by Demerouti, Bakker, Nachreiner and Schaufeli (2001); Yatin, Hamid, Shah, & Hassan (2018) which consist of two general categories of work environment characteristics including job demands and job resources. The JD-R model is significant to determine the relationship between job demands and job resources on job satisfaction among staff nurses, specifically in Malaysia.
Basically, previous literature often defined job demands as any job aspects that require physical or psychological effort and are therefore associated with certain physiological or psychological costs (Demerouti & Bakker, 2011) such as heavy workload (Demerouti et al., 2001). Based on the JD-R model by Demerouti and Bakker (2011) and issues arise, this study tends to include emotional demands, sensorial demands and cognitive demands as dimensions of job demands. Emotional demands can be defined as dealing with strong inner feelings such as frustration (Demerouti & Bakker, 2011). Sensorial demands mean dealing with physical effort (Demerouti & Bakker, 2011) such as arm movement. Meanwhile, cognitive demands refer to deal with mental effort in carrying out duties (Demerouti & Bakker, 2011) such as remembering every patient's information.

H1(a):
There is a negative significant relationship between emotional demands and job satisfaction.

H1(b):
There is a negative significant relationship between sensorial demands and job satisfaction. H1(c): There is a negative significant relationship between cognitive demands and job satisfaction.
Conversely, job resources typically described as any job aspects that have the motivational potential to attain the organization's goals, deal with the job demands and stimulate personal growth and development such as performance feedback (Demerouti & Bakker, 2011). Based on the JD-R model which developed by Demerouti and Bakker (2011), this study tends to include the degree of freedom at work, social support and feedback at work as the dimensions of job resources. The degree of freedom at work can be described as the state of freedom perceived by the individual at work (Bakker & Demerouti, 2007) such as time to take a break. Social support refers to support perceived by the individual at work (Bakker & Demerouti, 2007) such as peer support. Feedback at work can be described as the state of feedback received on how well they carry out the task given (Bakker & Demerouti, 2007) such as performance appraisal. Previous studies found that degree of freedom at work (van den Tooren & de Jong, 2014), social support (Zhang, Lin, & Wan, 2015) and feedback at work (Paposa & Kumar, 2015) have a significant relationship with job satisfaction, respectively. Therefore, it is hypothesized that:

H2(a):
There is a positive significant relationship between degree of freedom at work and job satisfaction.

H2(b):
There is a positive significant relationship between social support and job satisfaction.

H2(c):
There is a positive significant relationship between feedback at work and job satisfaction.

Method
The present study is a quantitative research which used questionnaires to collect data. The questionnaires were distributed through a nurse manager or known as Matron of a general hospital in Malaysia upon obtaining the ethical approval from the Medical Research and Ethics Committee (MREC) and approval from the hospital itself. A total of 180 staff nurses of Grade U29 with at least one-year working experience as the inclusion criteria were included in the sample.
Job satisfaction was measured using three items of Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale (MOAQ-JSS) which adopted from Cammann, Fichman, Jenkins and Klesh (1979). Meanwhile, all 21 items of job demands and job resources were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ) in the medium-length version which adopted from Kristensen, Hannerz, Hogh and Borg (2005). In details, emotional demands consist three items, sensorial demands consist four items, cognitive demands consist four items, the degree of freedom at work consists four items, social support consists four items and feedback at work consists only two items. All items in the survey were presented using a seven-point Likert Scale which ranging from (1) strongly disagree to (7) strongly agree. IBM SPSS Statistic version 23 was used for statistical analysis.

Results and Discussion
Out of 180 samples of staff nurses, the samples were predominantly women (93%). More than half of the participants were aged ranging from 26 to 35 years old (51.1%). There were only 0.6 percents of the participants were aged ranging from 56 years old and above. 56.7 percents (n = 102) of the participants were married and 42.2 percents (n = 76) were single. The majority of participants   Table 1 reveals the summary of descriptive statistics and Cronbach's alpha of all variables studied. Among the variables, sensorial demands indicated the highest mean of 5.70. It was followed by the cognitive demands with the mean of 5.52. Meanwhile, degree of freedom at work indicated as the lowest mean of 3.23. The mean results indicated that respondents consider their job as a responsible duty for communities even though the job requires a higher level of sensorial and cognitive effort. In fact, the respondents received good social support from superiors and colleagues. The standard deviation for independent variables ranged from 0.98 (degree of freedom at work) to 1.40 (feedback at work). The mean scores for job satisfaction is 4.74 (SD=1.02). The Cronbach's alpha of the variables studied ranged from 0.59 to 0.83. According to Nunally (1978), the Cronbach's alpha value of more than 0.50 is considered acceptable. However, the Cronbach's alpha that exceeds 0.7 is considered high reliability.  Table 2 shows a series of multiple regression analyses between job demands (emotional demands, sensorial demands and cognitive demands) and job resources (degree of freedom at work, social support and feedback at work) as the independent variables on job satisfaction as the dependent variable to investigate the relationships among the variables. As shown in Table 2, the independent variables explained 29.8 percent of the variance (R 2 = 0.298) in job satisfaction.
Surprisingly, only one dimension that is emotional demands under job demands was found to be the predictor of job satisfaction. Thus, the result indicated that there was a significant negative relationship between emotional demands and job satisfaction. Hypothesis 1(a) was fully supported. However, sensorial demands and cognitive demands were found to have no significant relationship with job satisfaction, thus giving no support to Hypothesis 1(b) and 1(c). Emotional demands were significant with job satisfaction may be due to the fact that nurses are facing with the overwhelming workload to handle the expansive number of patients with various characters (Atefi et al., 2014). Thus, the state of inner feelings towards work condition may influence the level of job satisfaction. Meanwhile, both sensorial demands and cognitive demands were not significant with job satisfaction might be because of the fact that the career and responsibility as a nurse itself to meet the patient's need through delivering the quality of care by using their sensorial and cognitive effort (Hayes, Douglas, & Bonner, 2013).
Next, only one dimension that is feedback at work under job resources were found to be the predictor of job satisfaction. Thus, the result indicated that there was a significant positive relationship between feedback at work and job satisfaction. Hypothesis 2(c) was fully supported. However, the degree of freedom at work and social support were found no significant relationship with job satisfaction, thus giving no support to Hypotheses 2(a) and 2(b). The degrees of freedom at work and social support were not significant with job satisfaction may be due to their responsibility to handle a large number of patients (Atefi et al., 2014) which much more important than other matters. In fact, the result reported that they received the lower level of degree of freedom at work due to the lowest mean of 3.23. Additionally, the work environment of nurses is originally working as