Quality of life in the workplace for nursing staff at public healthcare institutions 1

Abstract Objective: to determine the quality of life in the workplace for nursing staff at public institutions in Hermosillo, Sonora, Mexico. Method: quantitative, correlational, cross-sectional, and comparative. We used a probabilistic sample of 345 nurses with data collected in 2013 using an instrument created by the authors to gather bio-socio-demographic data and the CVT-GOHISALO instrument with a Cronbach's alpha of 0.95. SPSS 15 was used to analyze the data. A Kolmogorov-Smirnov test was used to calculate the normality of the data; the medians were compared using the Mann-Whitney U test and Kruskal-Wallis test with the significance level set at 0.05. Results: the average overall quality of life in the workplace for nursing staff was 207.31 (DE 41.74), indicating a moderate level. The quality of life in the workplace was higher for people with permanent contracts (p=0.007) who did not engage in other remunerative activities (p=0.046). Differences in the quality of life in the workplace were observed depending on the institution where the subjects worked (p=0.001). Conclusion: the nursing staff perceives itself as having a moderate-level quality of life in the workplace. This level was determined in the statistical analysis based on the type of contract, whether the person performed other remunerated activities, and the institution where the person worked.


Introduction
Quality of life in the workplace is a multidimensional concept that applies when the employee is able to cover the following personal necessities through employment or his or her own ventures: institutional support, security and integration into his or her role at work and satisfaction related to this role, a sense of wellbeing obtained through his or her work and the personal development achieved, and the management of his or her free time (1) . This concept has been used with increasing frequency to describe certain environmental and humanistic values that are neglected by industrial societies in their pursuit of technological advancement, productivity, and economic growth (2) .
Among healthcare professionals, quality of life in the workplace ought to meet the highest standards because these professionals appear to have the knowledge and the means necessary to avoid risks and perform self-care activities in all areas. However, various studies underscore that this ideal is far from the reality.
Convincing evidence exists that healthcare professionals are faced with various problems.
In the specific case of nursing, employees have developed pathologies including Burnout Syndrome, workplace stress, conflicts related to violence within healthcare institutions (directed at both clients and the nursing staff itself), indices of poor workplace satisfaction, and depression. This situation could be associated with workplace conditions related to the types of contracts, employees having two or more jobs, and the type of institution where a given employee works, among other factors. The issues could also be related to risks recognized in the literature related to hospital work, which involves a mental workload that directly impacts the quality of care, quality of life in the workplace, and overall quality of life (3)(4)(5)(6)(7)(8) .
The quality of life of nursing employees in the workplace has been studied worldwide. Diverse workrelated issues are notable across all of Latin America, including unstable employment, inadequate workplace conditions, limited availability of equipment and materials that are essential to effectively improve the quality of care, overwork related to the scarcity of nursing staff, devaluation of the nursing profession, and expectations that nursing professionals will migrate (9)(10)(11)(12)(13)(14)(15)(16) .
In northwestern Mexico, the social evidence of this problem can be seen in protests related to current workplace conditions for nursing staff. Therefore, it is especially important to understand the level of the quality of life in the workplace of those who are professionally responsible for the health of the population.
This study has the general objective of determining the quality of life in the workplace of nursing staff employed in public healthcare institutions in Hermosillo, Sonora, Mexico. The following hypotheses are proposed: -Nursing staff with permanent contracts have a better overall quality of life in the workplace than nursing staff who have fixed-term contracts.
-The quality of life of nursing employees who perform another remunerated activity is lower than that of employees who do not perform another remunerated activity.
-Overall quality of life in the workplace is perceived differently depending on the institution in which a nursing employee works.

Results
The  The average overall quality of life in the workplace for the nursing staff was 207.31 (SD 41.74), which indicated a moderate level.
The first hypothesis is that nursing staff with permanent contracts have a better overall quality of life in the workplace than nursing staff with fixed-term contracts. We rejected the null hypothesis with the value p=0.007 and observed that overall quality of life in the workplace for the nursing staff according to the type of contract was higher for people with permanent contracts compared with those who had fixed-term contracts ( Table 2). The second hypothesis is that nursing staff who perform another remunerated activity have a lower overall quality of life in the workplace than those who do not perform another remunerated activity. The null hypothesis was rejected with the value p=0.046. We observed that the overall quality of life in the workplace for nursing staff was greater among nursing employees who did not perform another type of remunerated activity compared with nursing employees who did perform another type of remunerated activity. This finding is shown in Table 3.  Table 4.

Discussion
This study found that the nursing staff were moderately satisfied with their overall quality of life in the workplace. This finding is consistent with the results obtained in other related studies in which the majority of the nursing staff display moderate levels of satisfaction with their quality of life in the workplace (15,19) . Taking life is a predictor of this effectiveness (14) . Accordingly, attending to the needs of the nursing staff should be a priority for the healthcare system because it represents a quality standard that has direct repercussions for the people receiving care. The healthcare system (i.e., the body charged with caring for the nursing staff) is responsible for making demands of nurses, getting the most out of their work, providing them with a decent salary, and making it possible for them to receive consistent training (19) . In this study, 13% of the members of the nursing team performed another type of remunerated activity.

Conclusion
This study demonstrated that both nursing staff who have fixed-term contracts and those who perform

Recommendations
Promote lines of research that deepen the understanding of quality of life in the workplace for nursing staff and deploy strategies and programs directed at improvement. In the long term, this approach will translate into improvements in workplace satisfaction and the quality of care provided by the nursing staff.