Job satisfaction and work context among rehabilitation care professionals in Alagoas, Brazil: an observational study

ABSTRACT

Job satisfaction is multifactorial and is directly related to the quality of health services. The main objective of this study was to characterize the level of job satisfaction and the work context of the multidisciplinary teams in specialized rehabilitation services in the state of Alagoas, Brazil. We evaluated the professional profile of participants and sociodemographic information. The Work Context Assessment Scale (WCAS) which is divided into three dimensions and questions adapted from the satisfaction and remuneration dimensions of the Great Place to Work methodology for the Organizational Climate Survey, was used. We included 190 professionals, the mean age was 35.47±9.25 and 86.3% were women. Most participants worked in the capital (60%) and 84.7% had a monthly wage ranging from R$1,000 to R$3,000. The dimension of “work organization” was crucial. The items “pace of work,” “strong demand,” “performance monitoring,” and “repetitive tasks” presented the worst results, but 92.7% are satisfied with their professional activities. The logistic regression analysis showed that more years since graduation and lower scores of Work conditions and Socio-professional relationships were associated with higher job satisfaction. Job satisfaction was found to be high, the dimension of work organization was crucial, and almost half of the participants have already thought about leaving their careers.

Keywords:
Rehabilitation Services; Job Satisfaction; Health Personnel

RESUMEN

La satisfacción laboral es multifactorial y está directamente relacionada con la calidad de los servicios de salud. El objetivo principal de este estudio fue identificar el nivel de satisfacción y el contexto de trabajo de equipos multidisciplinarios en servicios especializados de rehabilitación en el estado de Alagoas, Brasil. Se evaluó el perfil profesional y el perfil sociodemográfico, y se aplicaron la Escala de Evaluación del Contexto de Trabajo (EACT), dividida en tres dimensiones, y preguntas adaptadas de las dimensiones de satisfacción y remuneración de la metodología de encuesta de clima organizacional, Great Place to Work. Se incluyeron a 190 profesionales, de los cuales el 86,3% eran mujeres, y la edad media fue de 35,47±9,25 años. La mayoría trabajaba en la capital (60%) y el 84,7% ganaba entre R$1.000 y R$3.000. La dimensión “organización del trabajo” fue crítica. Los ítems “ritmo de trabajo”, “exigencia de resultados”, “control del rendimiento” y “tareas repetitivas” obtuvieron los peores resultados, pero el 92,7% de los participantes estaban satisfechos con su actividad profesional. La regresión logística mostró que a más años de formación y puntuaciones más bajas en las dimensiones “condiciones de trabajo” y “relación socioprofesional” se asociaban a una mayor satisfacción laboral. La satisfacción laboral fue alta, la dimensión “organización del trabajo” crítica, y casi la mitad de los participantes había pensado en dejar su carrera.

Palabras clave:
Servicios de Rehabilitación; Satisfacción en el Trabajo; Personal de Salud

RESUMO

A satisfação no trabalho é multifatorial e está diretamente relacionada com a qualidade dos serviços de saúde. O objetivo principal deste estudo foi caracterizar o nível de satisfação e o contexto de trabalho de equipes multidisciplinares de serviços especializados em reabilitação no estado de Alagoas, Brasil. Foi avaliado o perfil profissional e sociodemográfico e foram aplicadas a escala de avaliação do contexto de trabalho (EACT), que é dividida em três dimensões, e questões adaptadas das dimensões de satisfação e remuneração da metodologia Great Place to Work da pesquisa de clima organizacional. Incluímos 190 profissionais, sendo 86,3% do sexo feminino, e a idade média foi de 35,47±9,25 anos. A maioria trabalhava na capital (60%) e 84,7% recebiam mensalmente de R$ 1.000,00 a R$ 3.000,00. A dimensão organização do trabalho foi considerada crítica. Os itens ritmo de trabalho, cobrança por resultados, fiscalização do desempenho e tarefas repetitivas tiveram os piores resultados, mas 92,7% dos participantes estavam satisfeitos com suas atividades profissionais. A regressão logística mostrou que mais anos de formado e menores pontuações nas dimensões condições de trabalho e relações socioprofissionais estão associados com maior satisfação no trabalho. A satisfação no trabalho foi alta, a dimensão organização do trabalho crítica, e quase metade dos participantes já pensaram em deixar sua carreira.

Descritores:
Serviços de Reabilitação; Satisfação no Trabalho; Pessoal de Saúde

INTRODUCTION

In 2019, a study based on the Global Burden of Disease (GBD), described that 2,41 billion people were living with some condition that would benefit from rehabilitation services. This number represents an increase of 63% compared with 1990¹. In Brazil, there were approximately 12 million individuals living with disabilities, according to the census of 2010².

In 2012, the Brazilian Ministry of Health has instituted the Network of Care for People with Disabilities (RCPD), aiming to regulate the rehabilitation services and allowing for the assistance of all individuals with disabilities by a multiprofessional team³. However, the number of rehabilitation services is low, as well as the number of professionals. An example is the state of Alagoas, where, in 2020, only 17 rehabilitation services were operational, serving about 6% of the population that declared to live with a disability⁴.

Health systems must offer efficient services and respond to users’ expectations. However, health professionals are a relevant factor to meet this aspects, and it is known that the quality of services is directly related to the level of job satisfaction⁵. In this context, job satisfaction is defined as a positive evaluation that people express after assessing their job at a cognitive and an affective level⁶.

Job satisfaction depends on the work environment, relationships with colleagues and superiors, and acceptable wages^{7), (8}. Health professionals who experience poor job satisfaction are more likely to leave their positions and less likely to provide the best services^{9), (10}. Job satisfaction was also shown to present a protective effect on health, happiness, well-being, and self-esteem¹¹.

To the best of our knowledge, there are no studies on job satisfaction in rehabilitation services in Brazil. Thus, it is important to characterize the work processes that exist in the Brazilian rehabilitation services and the implications for the satisfaction/dissatisfaction of these professionals¹². Therefore, this study outcomes may contribute to the adoption of measures to improve the job satisfaction of health professionals and, consequently, the quality of care.

This study aims to characterize the level of job satisfaction and the work context of the multidisciplinary teams in specialized rehabilitation services in the state of Alagoas, Brazil.

METHODOLOGY

Study design and population

This is a cross-sectional observational study conducted with health professionals who worked in rehabilitation services of Alagoas State, registered in the Ministry of Health during 2020. Health professionals with incomplete higher education, professionals who work at administrative and telework areas, and professionals whose training was not categorized as higher education in Brazil, such as orthotics and prostheses courses, were excluded.

In 2020, 17 rehabilitation services were found registered in Alagoas, with approximately 850 health professionals. The 17 rehabilitation services were distributed in seven cities (Maceió, Arapiraca, Penedo, Marimbondo, Maragogi, Delmiro Gouveia, and Palmeira dos Índios) (Figure 1). For this population, a sample of 191 participants was calculated, assuming a 5% error and an 80% proportion of job satisfaction. Participants from all the cities with rehabilitation services in Alagoas were included.

Figure 1
Location of rehabilitation services included in the study (n=17)

Study variables

To evaluate participants’ professional profile and sociodemographic information, the following data were collected: gender, age, marital status, workplace (capital or inland), staff, specialization area, weekly workload (hours), salary (R$), and forms of professional development.

The participants were also evaluated using the Work Context Assessment Scale (WCAS) developed by Ferreira and Mendes¹³ and validated by Mendes¹⁴. The scale is composed of 30 items and divided into three dimensions: work organization, work conditions, and socio-professional relationships. Each dimension is analyzed separately, and results of 1.0 to 2.3 points are considered satisfactory, 2.3 to 3.7 points are considered critical, and 3.7 to 5.0 points are considered serious¹⁵.

To analyze job satisfaction, questions adapted from the satisfaction and remuneration dimensions of the Great Place to Work methodology for the Organizational Climate Survey were used¹⁶.

Procedures

The data collection occurred from August 2020 to December 2021. The professionals were invited to participate during face-to-face visits or by sending a virtual form (Google Forms) to the sector coordinator. All the 17 rehabilitation services were contacted and received information about the objective and procedures of the study. After the authorization, the participants signed an informed consent form and answered the questionnaires.

Statistical analysis

All data were analyzed using the SPSS software (version 22.0; Chicago, IL, United States) at a 5% significance level. The distribution of the data was verified by the Kolmogorov-Smirnov test. Descriptive statistics were used to show the sociodemographic information, professional profile, WCAS results, and job satisfaction assessment.

Logistic regression analysis was performed using a dichotomous dependent variable (Job Satisfaction: No=0 and Yes=1), with the following admission variables to predict group associations: age, years since graduation, weekly workload, number of patients assisted per day, and score in WCAS dimensions. All variables were classified as continuous and were entered into the logistic regression to confirm the final variables in the model. The Hosmer and Lemeshow test confirmed that all the regression models adequately fitted the data (p>0.05).

RESULTS

A total of 190 health professionals who worked in rehabilitation services were included in this study. Table 1 describes the demographic characteristics. Most participants worked in Maceió, the capital of the state of Alagoas (60%), 28.4% worked in Arapiraca, 6.3% in Palmeira dos Índios, 2.1% in Delmiro Gouveia, 1.6% in Marimbondo, 1.1% in Penedo, and 0.5% in Maragogi. A total of 91 (47.9%) participants have been working less than five years in the rehabilitation services, 72 (37.9%) from 6 to 15 years, and 27 (14.2%) for more than 15 years. The mean number of patients assisted per day was 15.36, ranging from 0 to 50. A total of 108 participants (56.8%) declared to have another job, 161 (84.7%) declared a monthly wage ranging from R$1,000 to R$3,000, with a mean weekly workload of 19.1±8.6 hours.

Table 1
Characteristics of rehabilitation professionals (n=190), Alagoas 2020-2021

Characteristic	Rehabilitation health professionals
Age (years)	35.47 (9.25)
Women (%)	164 (86.3%)
Marital Status (%)
Married	92 (48.4%)
Single	84 (44.2%)
Divorced	11 (5.8%)
Widowed	3 (1.6%)
Undergraduate degree (%)
Physical Therapy	50 (26.3%)
Psychology	38 (20%)
Speech Therapy	28 (14.7%)
Occupational Therapy	25 (13.3%)
Social Assistance	21 (11.1%)
Nursing	13 (6.8%)
Medicine	1 (0.5%)
Others	14 (7.4%)
Years since graduation	9.48 (8.17)
Specialization (yes)	152 (80%)
Specialization area (%)
Neurology	29 (15.3%)
Musculoskeletal	10 (5.3%)
Cardiology/pulmonology	6 (3.2%)
Women’s health	1 (0.5%)
Management	2 (1.1%)
Pediatrics	14 (7.4%)
Others	92 (48.4%)
Workplace
Public	70 (36.8%)
Private	38 (20%)
Both	82 (43.2%)
Weekly workload (hours)	26.41 (7.76)
Monthly wage (R$)
1,000 to 3,000	161 (84.7%)
3,000 to 5,000	24 (12.6%)
5,000 to 7,000	3 (1.6%)
>7,000	2 (1.1%)

Regarding professional development, short-term courses were cited by 147 (77.3%), conferences were cited by 69 (36.3%), scientific papers were cited by 112 (58.9%), and books were cited by 66 (34.7%). A total of 124 (65.3%) have studied scientific papers. However, 139 (73.1%) consider their ability to read a paper in a second language regular or insufficient, and 83 (43.7%) have already thought about quitting the career.

The WCAS scale presents three dimensions, in which the mean work context dimension score was 2.17±0.93, the work organization dimension score was 2.62±0.66, and the socio-professional relationship score was 2.02±0.73. The dimension of work organization was considered critical. The item pace of work, strong demand, performance monitoring, and repetitive tasks presented the worst results. Table 2 describes the items of work organization dimension. Table 3 describes the items related to job satisfaction. The participants showed high levels of job satisfaction (92.7%) and most considered the salary unfair (76.6%).

Table 2
Results of Work Context Assessment Scale (WCAS), work organization dimension, Alagoas 2020-2021

Item (work organization dimension)	Mean (standard deviation)
The pace of work is excessive	3.19 (1.04)
Tasks are met with deadline pressure	2.54 (1.10)
There is a strong demand for results	3.09 (1.12)
The rules for performing tasks are strict	2.61 (1.06)
There is a performance monitoring	3.02 (1.07)
The number of people is insufficient to carry out the tasks	2.23 (1.06)
The expected results are unrealistic	2.01 (1.00)
Lack of time to take a rest break at work	2.39 (1.13)
There is a division between those who plan and those who execute	2.63 (1.26)
Tasks are repetitive	2.90 (1.13)
The tasks performed are discontinued	2.23 (1.02)

Table 3
Results of job satisfaction assessment, Alagoas 2020-2021

Job Satisfaction	Yes	No
Are you satisfied with your professional activities and do you consider that your work contributes to the success of your team?	178 (92.7%)	12 (6.3%)
Would you recommend your health unit for a friend or acquaintance’s selection process?	176 (91.7%)	13 (6.8%)
Would you recommend your specialized rehabilitation center for someone in your family or friend to use?	183 (95.3%)	6 (3.1%)
Do you consider your salary fair?	42 (21.9%)	147 (76.6%)
Is it a psychologically and emotionally healthy place to work?	150 (78.1%)	34 (17.7%)
Are you satisfied with the way your team contributes to society?	168 (87.5%)	17 (8.9%)

Table 4 shows the results from the logistic regression analysis. The model was significant, categorizing 92.9% correctly. Longer time since graduation and lower scores of Work conditions and Socio-professional relationships were more associated with job satisfaction (Table 4).

Table 4
Results from logistic regression analysis (dependent variable Job satisfaction - No=0 and Yes=1)

Independent variables	ß	SE	Wald	df	P	Odds ratio	95% CI
Age	−0.10	0.68	2.26	1	0.13	0.90	0.79-1.03
Years since graduation	0.26	0.11	4.80	1	0.02	1.29	1.02-1.63
Weekly workload	0.08	0.06	2.04	1	0.15	1.09	0.96-1.23
Number of patients assisted per day	−0.03	0.06	0.32	1	0.56	0.96	0.85-1.09
Work condition	−1.17	0.53	4.85	1	0.02	0.30	0.10-0.87
Work organization	−0.04	0.81	0.003	1	0.95	0.95	0.19-4.68
Socio-professional relationships	−2.17	0.68	10.05	1	0.002	0.11	0.03-0.43
Salary	−0.44	1.12	0.15	1	0.69	0.64	0.07-5.76
Constant	11.63	3.89	8.91	1	0.003	112806.9
Model X2	41.96, df=8, p=0.000
Pseudo R2	0.54
N	169
Hosmer and Lemeshow test (χ2)	2.66, df=8, p=0.54

• SE: standard error; Wald: Wald statistics; Pseudo R²: Nagelkerke R square; df: degrees of freedom; CI: confidence interval.

DISCUSSION

To the best of our knowledge, this is the first study analyzing job satisfaction among rehabilitation health professionals in Brazil. Our sample was mostly composed of women, with approximately 10 years since graduation, 80% had a specialization course, more than half had another job, and more than 80% reported a monthly salary ranging from R$1,000 to R$3,000. The dimensions of socio-professional relationships and work conditions were satisfactory, but the dimension of work organization was critical. The worse items were “the pace of work is excessive,” “there is a strong demand for results,” “there is performance monitoring,” and “tasks are repetitive.” Despite that, 92% of the participants reported being satisfied with their professional activities, but 76% did not consider their salary fair. Longer time since graduation and lower scores of work conditions and socio-professional relationships were more associated with job satisfaction.

Previous studies found that job satisfaction among health professionals ranges from high to moderate and several factors seem to influence it^{17), (18), (19}. Scanlan and Still¹⁷ found disengagement and exhaustion associated with lower job satisfaction and higher turnover intention among occupational therapists, and Berry et al.¹⁹ highlighted that productivity standards may negatively impact job satisfaction. Other studies also pointed out personal factors, such as mood and work-private life conflicts^{20), (21}.

In our study, years of professional experience showed to be a significant factor related to job satisfaction. Rostami et al.¹⁸ found similar results, showing that less experienced occupational therapists (1-4 years of work experience) had more stressful situations related to work and less job satisfaction, and a mentor for younger professionals may be a useful strategy²².

High wages positively influence job satisfaction and retention, but it is not the most important factor. Several non-monetary factors also present a significant influence, such as flexibility, professional development, communication, and a good workplace environment that support and value the employees²³. In our logistic regression, the monthly salary was not associated with job satisfaction, but 76.6% consider the salary unfair. Although unfair, the value is in accordance with the labor regulation for the category. In Alagoas, the average salary for a physical therapist is around R$1,700.00. Moreover, most participants have less than 5 years in the service, which may explain the low wages. However, this does not fully explain our results. For this reason, more studies focusing on the relationship between low wages and job satisfaction of health professional from rehabilitation services are necessary.

The general objective of the RCPD is to promote health care related to four main areas of rehabilitation: physical, auditive, visual, and intellectual. Besides rehabilitation, the RCPD should also promote prevention and early identification of disabilities. To achieve all these objectives, the RCPD must have an adequate structure and enough professionals. However, the RCPD is fragmented and underfunded²⁴. In Alagoas, only one public rehabilitation service is operational, and the other are philanthropic or private services affiliated with the Unified Health System (SUS). These services receive a monthly contracted amount that ranges from R$140,000.00 to R$345,000.00 depending on the complexity of the rehabilitation service³. Furthermore, the rehabilitation service needs to treat a minimal number of patients each month and the professionals need to achieve standard productivity²⁵.

This arrangement directly impacts the work organization of the health professionals. The professionals must assist a high number of patients per day, have high work demands, low salaries, and still do bureaucratic tasks. All these factors play an important role and are associated with the desire to leave their career and their poor job satisfaction^{26), (27}. In our study, we found that 43.7% participants have already thought about leaving their career. Such frustration can be related to the lack of opportunities for professional development²⁸.

A qualified health professional is essential to the quality of health services. The participants of our study are engaged in training programs but had insufficient ability to read in a second language. In the last 20 years, evidence-based practice (EBP) expanded but several challenges can be pointed. A systematic review highlights the lack of time, language, and lack of methodological skills as the main barriers to implementing EBP in clinical practice²⁹. For this reason, continuing training programs are important to help professionals to improve their knowledge. However, an organizational development culture is also important to encourage the best practices³⁰.

The main findings of this study point out problems related to the institutional organization of the rehabilitation services in Brazil. Generally, the rehabilitation services are underfunded by the Brazilian Ministry of Health and the high productivity goals directly affects health professionals and job satisfaction. A revision of the rules for rehabilitation services is necessary, as well as alternative ways to improve the financial support of the rehabilitation services. It is also important to prioritize the quality of the service and not just the quantity of patients treated.

At the same time, the rehabilitation services should invest in professional development and implementation of good clinical practices. Future studies should investigate quality management programs for rehabilitations services in low- and middle-income countries.

This study presents some limitations. Job satisfaction and work context are influenced by culture-based factors and these limit the generalizability of our results. Brazil is a large-sized country with different socioeconomic realities. For this reason, a national wide study is necessary to understand the profile of health professionals and the factors that influence job satisfaction in rehabilitation services.

CONCLUSION

The job satisfaction among health professionals that work in rehabilitation services in Alagoas is high and the associated factors were more professional experience and lower scores in the WCAS dimensions of work conditions and socio-professional relationships. Furthermore, the dimension of work organization is critical and almost half of the participants have already thought about leaving their careers.

REFERENCES

• ¹
  Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, et al. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021;396(10267):2006-17. doi: 10.1016/S0140-6736(20)32340-0.
  » https://doi.org/10.1016/S0140-6736(20)32340-0
• ²
  Instituto Brasileiro de Geografia e Estatística. Censo Demográfico 2010: Nota Técnica 01/2018: Releitura dos dados de pessoas com deficiência no Censo Demográfico 2010 à luz das recomendações do Grupo de Washington. Rio de Janeiro: IBGE; 2018.
• ³
  Brasil. Ministério da Saúde. Portaria nº 793, de 24 de abril de 2012: institui a Rede de Cuidados à Pessoa com Deficiência no âmbito do Sistema Único de Saúde. Diário Oficial da União. 2012 Apr 25;1:94-5.
• ⁴
  Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Saúde 2013: percepção do estado de saúde, estilos de vida e doenças crônicas: Brasil, grandes regiões e unidades da Federação. Rio de Janeiro: IBGE; 2014.
• ⁵
  Pérez-Ciordia I, Guillén-Grima F, Brugos A, Aguinaga Ontoso I. Job satisfaction and improvement factors in primary care professionals. An Sist Sanit Navar. 2013;36(2):253-62. doi: 10.4321/s1137-66272013000200008.
  » https://doi.org/10.4321/s1137-66272013000200008
• ⁶
  Di Marco D, López-Cabrera R, Arenas A, Giorgi G, Arcangeli G, et al. Approaching the discrimatory work environment as stressor: the protective role of job satisfaction on health. Front Psychol. 2016;7:1313. doi: 10.3389/fpsyg.2016.01313.
  » https://doi.org/10.3389/fpsyg.2016.01313
• ⁷
  Oven A, Domajnko B. Job satisfaction and creativity at work among occupational therapy practitioners: a mixed-methods study. Work. 2021;69(4):1351-62. doi: 10.3233/WOR-213555.
  » https://doi.org/10.3233/WOR-213555
• ⁸
  Hasan H, Aljunid SM. Job satisfaction among Community-Based Rehabilitation (CBR) workers in caring for disabled persons in the east coast region of Peninsular Malaysia. BMC Public Health. 2019;19(1):208. doi: 10.1186/s12889-019-6520-z.
  » https://doi.org/10.1186/s12889-019-6520-z
• ⁹
  Hayes LJ, O'Brien-Pallas L, Duffield C, Shamian J, Buchan J, et al. Nurse turnover: a literature review. Int J Nurs Stud. 2006;43(2):237-63. doi: 10.1016/j.ijnurstu.2005.02.007.
  » https://doi.org/10.1016/j.ijnurstu.2005.02.007
• ¹⁰
  Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ. 2012;344:e1717. doi: 10.1136/bmj.e1717.
  » https://doi.org/10.1136/bmj.e1717
• ¹¹
  Satuf C, Monteiro S, Pereira H, Esgalhado G, Afonso RM, et al. The protective effect of job satisfaction in health, happiness, well-being and self-esteem. Int J Occup Saf Ergon. 2018;24(2):181-9. doi: 10.1080/10803548.2016.1216365.
  » https://doi.org/10.1080/10803548.2016.1216365
• ¹²
  Salles FLP, d'Angelo MJ. Assessment of psychological capital at work by physiotherapists. Physiother Res Int. 2020;25(3):e1828. doi: 10.1002/pri.1828.
  » https://doi.org/10.1002/pri.1828
• ¹³
  Ferreira MC, Mendes AM. Trabalho e riscos de adoecimento: o caso dos auditores fiscais da Previdência Social Brasileira. Brasília (DF): LPA; 2003.
• ¹⁴
  Mendes AM, editor. Psicodinâmica do trabalho: teoria, método e pesquisa. São Paulo: Casa do Psicólogo; 2007.
• ¹⁵
  Ferreira MC, Mendes AM. Contexto de trabalho. In: Siqueira MMM, editor. Medidas do comportamento organizacional: ferramentas de diagnóstico e de gestão. Porto Alegre: Artmed; 2008. p. 111-23.
• ¹⁶
  Great Place to Work. Metodologia GPTW: Relatório de Práticas Culture Audit(c) [Internet]. São Paulo: GPTW; [cited 2020 Jun 29]. Available from: http://conteudo.gptw.com.br/metodologia_pesquisa_culture_audit
  » http://conteudo.gptw.com.br/metodologia_pesquisa_culture_audit
• ¹⁷
  Scanlan JN, Still M. Job satisfaction, burnout and turnover intention in occupational therapists working in mental health. Aust Occup Ther J. 2013;60(5):310-8. doi: 10.1111/1440-1630.12067.
  » https://doi.org/10.1111/1440-1630.12067
• ¹⁸
  Rostami HR, Akbarfahimi M, Ghaffari A, Kamali M, Rassafiani M. Relationship between work-related quality of life and job satisfaction in Iranian occupational therapists. Occup Ther Int. 2021;2021:6692752. doi: 10.1155/2021/6692752.
  » https://doi.org/10.1155/2021/6692752
• ¹⁹
  Berry JW, Schurhammer NL, Haugen TJ, Piche SE, Buskness SL, et al. Job satisfaction and productivity requirements among physical therapists and physical therapist assistants. J Allied Health. 2022;51(1):e33-8.
• ²⁰
  Peter KA, Hahn S, Schols JMGA, Halfens RJG. Work-related stress among health professionals in Swiss acute care and rehabilitation hospitals-a cross-sectional study. J Clin Nurs. 2020;29(15-16):3064-81. doi: 10.1111/jocn.15340.
  » https://doi.org/10.1111/jocn.15340
• ²¹
  Aloisio LD, Coughlin M, Squires JE. Individual and organizational factors of nurses' job satisfaction in long-term care: a systematic review. Int J Nurs Stud. 2021;123:104073. doi: 10.1016/j.ijnurstu.2021.104073.
  » https://doi.org/10.1016/j.ijnurstu.2021.104073
• ²²
  Horner DK. Mentoring: positively influencing job satisfaction and retention of new hire nurse practitioners. Plast Surg Nurs. 2017;37(1):7-22. doi: 10.1097/PSN.0000000000000169.
  » https://doi.org/10.1097/PSN.0000000000000169
• ²³
  Bimpong KAA, Khan A, Slight R, Tolley CL, Slight SP. Relationship between labour force satisfaction, wages and retention within the UK National Health Service: a systematic review of the literature. BMJ Open. 2020;10(7):e034919. doi: 10.1136/bmjopen-2019-034919.
  » https://doi.org/10.1136/bmjopen-2019-034919
• ²⁴
  Ferrer MLP, Silva AS, Silva JRK, Padula RS. Microrregulação do acesso à rede de atenção em fisioterapia: estratégias para a melhoria do fluxo de atendimento em um serviço de atenção secundária. Fisioter Pesqui. 2015;22(3):223-30.
• ²⁵
  Brasil. Ministério da Saúde. Rede de cuidados à pessoa com deficiência no âmbito do SUS: instrutivo de reabilitação auditiva, física, intelectual e visual: Centro Especializado em Reabilitação - CER e oficinas ortopédicas. Brasília (DF): MS; 2020.
• ²⁶
  Hämmig O. Explaining burnout and the intention to leave the profession among health professionals - a cross-sectional study in a hospital setting in Switzerland. BMC Health Serv Res. 2018;18(1):785. doi: 10.1186/s12913-018-3556-1.
  » https://doi.org/10.1186/s12913-018-3556-1
• ²⁷
  Li J, Galatsch M, Siegrist J, Müller BH, Hasselhorn HM. Reward frustration at work and intention to leave the nursing profession-prospective results from the European longitudinal NEXT study. Int J Nurs Stud. 2011;48(5):628-35. doi: 10.1016/j.ijnurstu.2010.09.011.
  » https://doi.org/10.1016/j.ijnurstu.2010.09.011
• ²⁸
  Arkwright L, Edgar S, Debenham J. Exploring the job satisfaction and career progression of musculoskeletal physiotherapists working in private practice in Western Australia. Musculoskelet Sci Pract. 2018;35:67-72. doi: 10.1016/j.msksp.2018.03.004.
  » https://doi.org/10.1016/j.msksp.2018.03.004
• ²⁹
  Paci M, Faedda G, Ugolini A, Pellicciari L. Barriers to evidence-based practice implementation in physiotherapy: a systematic review and meta-analysis. Int J Qual Health Care. 2021;33(2):mzab093. doi: 10.1093/intqhc/mzab093.
  » https://doi.org/10.1093/intqhc/mzab093
• ³⁰
  Yoo JY, Kim JH, Kim JS, Kim HL, Ki JS. Clinical nurses' beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: the first step to creating an evidence-based practice culture. PLoS One. 2019;14(12):e0226742. doi: 10.1371/journal.pone.0226742.
  » https://doi.org/10.1371/journal.pone.0226742

• 1
  Financing source: nothing to declare
• 3
  Approved by the Research Ethics Committee: CAAE 34735020.0.0000.5013.

Publication Dates

• Publication in this collection
  04 Dec 2023
• Date of issue
  2023

History

• Received
  02 Feb 2023
• Accepted
  31 July 2023