Introduction

Job satisfaction is a construct with three elements contained in its definition. First, job satisfaction as an emotional state involving an affective component. Second, job satisfaction and experiences different from other satisfactions and third, there is a cognitive or evaluative component¹.”

The evaluation of job satisfaction has gained special relevance for all organizations, including health organizations not only because of its association with adherence to the organization, job rotation, and loss of work hours but also in terms of productivity and quality². Employees with a high level of involvement at work identify with the kind of work they do and really care and are associated with lower absenteeism and resignation rates³. This is why the directors of the institutions must be able to attract, motivate, reward, retain, train, and satisfy their staff so that they provide a quality service that satisfies the client, showing kindness and good spirit.

Any medical organization must serve the interests of service providers, since inattention to the satisfaction of the individual's needs structure and motivators easily translates into burnout syndrome. Burnout is the result of a process in which the worker is exposed to a situation of chronic work stress (at least 6 continuous months) and in which the coping strategies used are not effective. The symptoms of burnout can be classified according to the committed sphere, psychiatric: progressive and covert deterioration of the person, such as chronic depression and anxiety, character disorders, suicide, serious family dysfunctions (violence), and addictions (including work addiction). Somatic: Table of stress with varied expressions of muscular, endocrine, nervous, circulatory, and other psychosomatic types. Organizational: Deterioration in labor relations that cause different types of effects, such as the impoverishment of professional development, rivalry, individualism, repeated operational failures, demotivation, and non-conformity⁴. Therefore, it can be concluded that job satisfaction is related to job productivity and performance, as well as to situations that are not favorable for the employee such as stress, burnout syndrome, absenteeism, and turnover⁵.

In March 2020 in Mexico, the red traffic light was established, which began the contingency phase due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, bringing not only a new disease (COVID-19) but also uncertainty, stress, emotional, and physical fatigue and sometimes unfortunately mourning in the medical staff. The foregoing could affect job satisfaction since the high risk of infection, inadequate personal protective equipment, absence of security conditions or unfavorable hiring working conditions, lack of biosanitary or therapeutic supplies, isolation, exhaustion, long hours, and lack of family contact are factors that contribute to a greater presence of symptoms of stress or anxiety, feelings of panic, depression, and anguish in doctors who work in the midst of epidemics. Lifestyle changes as a result of the epidemic have sometimes been associated with greater emotional disturbance in health professionals, therefore, they must make cognitive and behavioral efforts as coping responses to stressful situations⁶.

A study of medical personnel in Iran at the beginning of the SARS-CoV-2 pandemic found in a sample of 304 health professionals that 28% suffered from anxiety, 30.6% depression, and 20.1% stress. It is mentioned that job satisfaction was also decreased but it is not mentioned which tool they used for the measurement⁷. Previous research studies related to job satisfaction carried out in Mexico, are led mainly by the Mexican Institute of Social Security (IMSS) focused only on nursing personnel⁸. As a direct consequence, a limited frame of reference is generated for the planning, implementation, and monitoring of strategies that allow motivating and increasing the sense of belonging in doctors and health professionals toward their institutions.

Due to the aforementioned, it was essential to know the job satisfaction in health personnel within the outpatient area of the ISSEMyM Maternal and Child Hospital in times of a COVID-19 pandemic, to determine areas for improvement, which allow generating strategies that have an impact on the quality of care for the beneficiary and in hospital productivity.

Material and Methods

A descriptive, cross-sectional study was carried out using the Meliá and Peiró measuring instrument S20/23 to the 64 members of the health staff who provided outpatient consultation in May 2020 at the ISSEMyM Maternal and Child Hospital. The questionnaire consisted of a section with demographic variables such as gender, age, marital status, degree of studies, occupation, working hours, and service in which they carry out their activities and employment situation; and another section with the 23 items of the five study factors, with the five ratings from 1 to 5 for each item. The instrument was given to each of the health professionals who provided outpatient consultation, during their work shift with the recommended health measures. The objective of the study was fully explained to each participant and since the staff did not know the instrument, it was explained in detail how to answer it. A period of 48 h was given to be answered. After 48 h, each of the questionnaires was collected personally. The Research Ethics Committee of the unit with number 01-2020 approved this work.

The S20/23 version is an instrument that consists of 23 items and can be considered the most structurally complete reduced version of those developed from Meliá and Pieró's S4/82. The General Questionnaire of Satisfaction in Labor Organizations (S4/82) is a measure of 82 items with seven alternatives each (From “1. Very Dissatisfied” to “7. Very Satisfied”). Unfortunately, the investment of time due to the length of the questionnaire and the motivational costs due to the exhaustiveness of the content are especially important, consequently, the S20/23 instrument was developed, which presents an alpha of 0.92 and the factors range between 0.76 and 0.89.22. This was designed to obtain a useful and rich evaluation of content of job satisfaction taking into account, the motivational and temporal restrictions to which subjects are frequently exposed in organizational contexts and excluded the items for which the answer “Indifferent” is too common. The selection of the items of the questionnaire S2/84, to carry out S20/23, it was carried out through a complex interactive multicriteria process where a solution was sought. In conjunction with the following selective criteria:

The selections of the 23 items presented relevant content for practically any organizational role in any organization⁷. Within the variables of interest, the five factors measured by the S20/23 questionnaire were taken into account, these are:

The data obtained from each of the previously qualified questionnaires were emptied into a spreadsheet of the Microsoft Excel program, placing a consecutive number on each of the questionnaires, maintaining the anonymity of the participants by emptying their responses according to each of the questions in the questionnaire, and placing the response number from 1 to 5. Where number 5 corresponded to very satisfied, number 4 to satisfied, number 3 to indifferent, number 2 to dissatisfied, and finally number 1 to very dissatisfied. Responses 4 and 5 were taken into account to rate the questionnaires with satisfaction and responses 3, 2, and 1 for all questionnaires with dissatisfaction. Finally, percentages were made according to the number of people who were satisfied and those who were not. Inferential statistics were performed using the SPSS versus 23 program to determine if there were statistically significant differences between the age groups, shifts, marital status, and degree of studies, among others, considering as significant p < 0.05.

Results

A total of 64 S20/23 instruments were delivered to the workforce of the outpatient clinic every shift at the ISSEMyM Maternal and Child Hospital. Thirteen surveys (20%) were eliminated, since the staff did not agree to collaborate with this research work. It is worth mentioning that the work shift that least agreed to participate was the special shift (Saturdays, Sundays, and holidays); where, out of six people who work that shift, only two people agreed to carry out the survey (33%).

The average age of the 51 participants was 44 years with a range of 24 and 60 years, respectively. The service that conducted the most surveys was the pediatric service with 27 surveys, which represented 52.9% (Fig. 1). Male gender predominated among those surveyed with 28 participants. Due to the fact that the highest number of consultations is granted in the morning shift, the shift with the highest participation was this with a total of 38 surveys conducted, which represented 74.5% (Table 1).

Figure 1 Number of participants surveyed by service. 

The majority of health personnel who provided outpatient consultation at the time of the survey were married (32 participants, 63%). The most frequent academic degree was bachelor's degree in 47%.

And finally, 86% of the surveyed health personnel (44 participants) were base doctors, and the remaining 14% (11 participants) were substitute doctors, this because the surveys were carried out in times of health contingency due to the SARS virus-CoV-2 and some basic physicians were in home care (Table 1).

At a general level, the staff maintained an intrinsic satisfaction of 83% (43 participants),

This factor being the highest of the 5. The satisfaction factor with the benefits was the lowest where only 26 of the participants (51%) were satisfied. The lowest item in the entire survey was salary, with 69% of participants considering that salary is low (Fig. 2).

Figure 2 Degree of job satisfaction in the 5 areas. 

The satisfaction factor with the physical environment obtained 69%, this due to the greater number of consultations that are granted in the morning shift, which is why, sometimes, it is necessary to share an office and there are physical spaces that have had to be adapted to offer medical assistance.

Statistically significant differences were sought between the different satisfaction factors of the instrument by age group, gender, marital status, academic degree, employment status, hours, and work area, without finding statistically significant differences between all groups (Tables 2-6).

Discussion

Despite the fact that the study was carried out in a period of time with peculiar characteristics, such as the health contingency caused by the SARS-CoV-2 virus, the health personnel of the external consultation who worked and agreed to carry out the survey presented 83% satisfaction in factor IV or intrinsic satisfaction which indicated that health personnel were emotionally satisfied just for doing their job, even in times of a pandemic. This situation was favorable for the medical unit, for patient care and in general for the ISSEMyM, assuming emotional intelligence and resilience in the health personnel working in the outpatient clinic.

Research studies have shown that employees who are clearly intrinsically motivated in relation to their work perform better than those who are extrinsically motivated; in addition, they have greater job satisfaction and a more positive attitude toward their organization¹⁰. In this research work, the substitute staff showed greater job satisfaction, as in the Colombian research work in the medical staff of the outpatient clinic, this derived from the fact that the performance is stronger among new employees, and considerably more weak for the more experienced³.

Satisfaction with benefits and especially with salary was low, however, it does not seem to be an issue that affects the intrinsic satisfaction factor, and reiterates that monetary remuneration is not the only factor that motivates the worker, since to the extent where money becomes a standard factor at work, it immediately loses its motivational capacity¹¹.

However, job satisfaction in general differs from that found in previous research studies such as the one carried out in Colombia, where the most satisfied outpatient personnel were young personnel. In this research study, it was shown that the personnel with the highest satisfaction in the intrinsic factor were found at the extremes of life, both in the personnel aged 20-29 years and 60-69 years. An explanation for this would be that young people and older health personnel expect a lot from their work and consider that the rewards at work are close to their expectations¹².

Another factor that affects the job satisfaction of Mexican doctors is multiemployment, low pay, and low non-tangible incentives such as professional promotions and lack of recognition². This research study corroborates this statement since the satisfaction factors with the benefits and with the participation were low with 51% and 70%. Unfortunately, this study did not investigate whether medical personnel had more than one job. The reason why the weekend and holiday shift had little participation in this study is unknown, but we know that it is usually the shift that least participates in various hospital activities.

Conclusion