INTRODUCTION:

Skills and capabilities of the health workers are most important things in providing good quality of health care service. It is not a matter to conceal that like many states in India health care institutions in West Bengal are experiencing problems with the rendering of quality of healthcare service. The quality of work life experienced by healthcare workers is directly related with the quality of care received by patients. Identification of the nurse’s quality of work life can give important information to the nursing managers in their labors to plan managerial programs that will improve custody and work productivity. In the light of the fact the purpose of this study was to explore how public sector nurses in WEST BENGAL rate the quality of their work life

CONCEPT OF NURSE QWL:

Quality of work life (QWL) is a multidimensional concept and is a method of thinking about people, work and the organization. Brooks and Anderson (2005) states that quality of nursing work life indicates the level of satisfaction of nurses about their essential personal needs :growth, opportunity, safety and organizational requirements such as increased productivity, decreased turnover through their experiences in their work organization as achieving the organization’s goals. It seems that the link between QWL and the extent of the nurse’s attachment in their work, is a critical factor in achieving higher levels of quality of care delivery (Hsu M.Y, Kernohan, 2006).Researchers emphasize quality of work life components such as enhancing the dignity of employees, introducing changes in the organization’s culture and improving the physical and emotional wellbeing of the employees (Muller, Bezuidenhout and Jooste 2011). The concept of QWL indicates a balance both in personal and professional life of an individual. So; if someone is dissatisfied with his or her work life or family life it can be vulnerable.

Importance of Nurse QWL:

The lack of quality patient care and the poor standard of service delivery have become the features of today’s heath care system. The productivity of nurses is purportedly low. Hall (2003) reports that to continue and recover the quality of work life experienced by professional nurses requires that nurses be more trained and dynamic in their work settings. The absenteeism and turnover rates amongst the nurses are typically very high in hospitals where there is a lack of quality of work life. Assessment and improvement of the QWL might increase staff performance and might be reduced burnout among nurses .Also helps to reduce the absenteeism and turnover rates. Good QWL experience is very essential and correlated with job satisfaction and productivity. QWL also controls the mental health.

Previous studies:

Based on researchers investigation a good number of articles have been published on quality of work life. In case of India a very limited number of works has been done on quality of work life. This study has tried to introduce some concerning factors that affects the quality of work life of West Bengal’s public sector nurses.

International Context:

Results of Hegney et al (2006) study revealed that nurses have heavy work load and a majority of nurses were not capable to complete their work in the stipulated time. Workload has been the principle grounds for nurses leaving their workplace and their profession. In investigating how nurses rate QWL Khani A and Jaafarpour M et al (2008) found nurses' job satisfaction, salary, workload, staffing issues, skill mix, communication, autonomy, recognition and empowerment remain problematic and suggested that hospitals need to provide vigorous and ongoing management skill development, education of nurse managers is needed e to recognize staff for a job well done. Helping others is the main reason for choosing the profession. Lack of Recognition of the Profession and Lack of Maturation causes difficulties in professional developments. Fair and adequate compensation, working conditions and the relationship between work and personal life were the factors of QWL with which nurses were dissatisfied. Satisfaction was articulated mainly in social consequence, followed by social mixing and constitutionalism (Lourdes Margareth Leite Pizzoli, 2013). Stress and depression have not related with quality of work life and, but anxiety has influence on QWL. It is essential to the directors to considere anxiety because it reduce nurses’ quality of work life (Ashraf Mohammadi et al 2011). Pediatric nurses experienced low level of QWL. Female nurses have more satisfaction than male nurses. Working department has effect on job satisfaction and home work interface. Academic qualification showed effect on Working Conditions. To improve QWL is needed to plan for nurses’ training educational programs, encourage nursing awards and recognition, assure adequate staffing and promote autonomy among nurses. Improving working condition and availability of resource are important (Nizar B. Said et al 2015).

Indian Context

QWL factors play a significant role in determining work-life balance of nurses and related with job satisfaction. There is no key difference in the QWL factors and their impact on job satisfaction of nurses in private and government hospitals. Company health and safety policy is the only QWL factors of difference and provided in private hospital only (Nirali Pandit and Rasmi Pant, 2010). Work autonomy and open and accurate communication namely-job and career satisfaction, working conditions, control at work, work-home interface and general well-being among nursing improves quality of working life of staff which in turn could improves quality of care of nursing home residents. Organizations need to increase autonomy and communication to improve quality of working life (Gauri S. Rai, 2013).

The findings indicated the poor QWL among the nursing staff and they have the autonomy to make patient care decisions but unable to balance their work and family lives .They have stress in their work and due to work load unable to complete their work in the time. The hospital management should concentrate on improving their job satisfaction, organizational commitment, organizational climate and job characteristics to improve the QWL among nurses and to improve productivity and performance of the nurses (Naveen Ramesh1 et al 2013). Private and public sector nurses’ have good QWL. In private sector the administration has to take actions on work stress, job satisfaction and staff communication. In public sector the government has to take essential trial on working conditions, organizational climate and work stress (Dr. Nagaraju Battu and G. Karthik Chakravarthy 2014). The study of Tessy Treesa Jose and Sripathy M. Bhat, 2014 found significant association between quality of life and marital status, monthly income, area of work, working hours and total years of experience and did not show any significant association between QWL and age .

OBJECTIVES:

Considering previous studies that reported nurses dissatisfaction of their working conditions in most health institution and the lack of this type of studies in West Bengal the present study was conducted (1) to examine how Public sector nurses in West Bengal rate the quality of their work life and (2) to analyze the variables that affect the QWL of the nurses.

Hypothesis:

Research is going to apply result to get better QWL among mentioned group .According to the significance of the subject the study sought to test the following hypotheses :(1)H 1: There is a significant difference between personal factors (age, occupational qualification, work experience, native place and family type) and overall satisfaction with the QWL. (2) H 2: Nurses expressed high level of QWL and (3) H 3. Satisfaction with each of the factors of QWL is positive with overall satisfaction of QWL.

METHODOLOGY:

Sample:

The study used quantitative and descriptive research methods. Data collection was primary in nature and structured and closed ended questionnaire was used to elucidate responses of respondents. Data were collected from 592 nurses serving at all level in various public health institution in West Bengal.

Instrument:

The primary data were collected through a questionnaire containing demographic variables and 23 items work-related quality life scale (Van Laar, et.al., 2007) developed for healthcare workers . It was designed in five-point Likert-type scale ranging from "very dissatisfied" (value 1) to "Very satisfied" (value 5) and have six factors Job and career satisfaction (JCS), general wellbeing (GWB), work conditions (WCS), home-work interface (HWI), stress at work (SAW), and control at work (CAW) .

Exploratory factor analysis using principle component analysis with varimax rotation was applied to the adapted scale for checking the dimensions. As a result of the varimax rotation of the data related to the quality of work life variables, 4 items have been removed from the analysis due to the factor loadings under 0.50 and 6 factor solutions have been obtained as per theoretical structure. Factor loadings of the item ranged from 0.58 to 0.85. The Cronbach’s alpha coefficient of the quality of work scale items is 0.78. In the principal component analysis, the Kaiser-Meyer-Olkin test result (KMO value 0.72) and the result of Barlett test (5083.108; p<0.01) were significant.

Data Analysis Tools:

The collected data were analyzed with the help of statistical tools of descriptive statistics, t test, Regression One way ANOVAs, and Pearson correlation.

Data Analysis and Interpretations

Demographic Data:

The collected data were analyzed using the SPSS 19.0 package. The analysis shows that all the respondents of the survey were female nurse. The age ranged from 18 to 50 years and the majority of respondents were (54.1%) 18-30 years old, 34.5% of them were 31-40 years old and remaining 5.4% of them wee 41-50 years old. There were no respondent in the age group 50-60 years.

Majority (87.83%) of the respondents were having 1-10 years length of service, 8.4 % of them were between 11-20 years length of service ,3.5% had 21-30 years of service experience and remaining .2% of them had above 30 years of service experience. Majorities (56.8.0%) of the respondents worked at rural hospitals, 20.12% of them at semi urban health carters, remaining 23% of them at urban hospitals and no one worked at metro areas. More than half (66.2%) of the respondents were nuclear family type and the remaining 33.8% of them were joint family type. With regards to educational qualification 95.8% nurses had general nursing degree and only 4.1% had BSC nursing degree.

Demographic variables and quality of work life:

An independent samples t-test and an ANOVA were conducted to determine any significant difference in the QWL scores by demographic variables. Results of t-test and ANOVA procedures are presented in Table-1 Significant differences were found according to types of family, nursing experience, hospital settings and occupational qualification. No significant differences were found according to age range. Hypothesis 1which states that there is significant difference between demographics variables and QWL accepted except for age range.

Table -1 Quality of work life by demographic variables using t-test and analysis of variance

Variables

MEAN

t/F value

P value

Age Range:

Upto-30

30-40

40-50

Types of Family:

Joint

Nuclear

Hospital Settings:

Rural

Semi urban

Urban

Experience:

Upto-10 yrs

upto-20 yrs

Upto-30 yrs

Above-30 yrs

Occupational Qualification:

General Nursing

BSC Nursing

3.588

3.57

3.60

81.09

83.08

3.55

3.57

3.66

3.55

3.73

3.83

4.08

3.59

3.40

0.366

0.380

0.189

8.66

8.17

0.375

0.373

0.317

0.365

0.344

0.175

Nil

0.368

0.176

0.201

-2.746

4.45

7.903

2.48

0.818

0.000

0.012

0.000

0.013

The results of the present study that there was no significant relation between age and QWL are contradicted with the findings of Dargahi et al and Boonrod W. These findings are not consistent with the report by Dehghan Nayeri et al., suggesting that there is a close correlation between age and QWL.

Nurses who belong from nuclear family had better QWL than who belongs from joint family. It seems that joint family nurses are not able to balance their work and family life.

In this survey there was a significant relationship between QWL and work experience, it indicates that nurses with more work experience had enjoyed a better QWL. This finding is consistent with the results of the study by Dargahi et al.

Significant relation also found between QWL and hospital setting. Urban hospital’s nurses had better QWL than semi urban and rural areas. This finding is contradicted with the results of the study by Dargahi et al that nurses in small size hospitals had greater satisfaction with their QWL. The variance in QWL of nurses in various hospitals could be credited to the hospitals conditions.

In this survey we saw nsee that nurses with lower education level experienced better QWL than nurses with higher education. It means that nurses with higher degree have high potential of their working life and accordingly experience additional emotional exhaustion when their working environment does not meet up their prospect.

Level of satisfaction with Work Related Quality of Life:

The level of satisfaction with each of the factors of work related quality of life has been analyzed by grouping the 19 items ( After factor analysis) as the 6 factors of Van Laar et al . For each dimension, the parentage of experience of QWL of the nurses is shown in table-2.

In table 2 we see that 59.3% nurses have higher level QWL and 40.7% have average level QWL. It indicates that QWL of nurses is in high level and they do enjoy the good quality of life. A good percentage of nurses were highly satisfied with all QWL factors except SAW in this study.

Table-2 Level of QWL of Nurses

Variable	High	Average	Low
QWL	59.3	40.7	nil
WCS	54.7	31.1	14.2
GWB	78.2	21.3	nil
JCS	89.2	7.4	3.4
CAW	52.4	30	17.6
SAW	41.2	49.1	9.8
HWI	59.2	34.4	6.4

* 1-2.7=Low, 2.8-3.5=Average and 3.6-5=Higher level

*Figures in Percentage

For each dimension, the averages of the issues of the study are shown in table-3.The level of satisfaction with the quality of work life among nurses using as a basis the scale, the minimum quality of QWL was 2.7 and maximum of 4.3. The average quality rating of QWL was 3.58 (SD = 0.364), suggesting that nurses in general are satisfied with the QWL.

Table 3 also depicts that West Bengal’s public sector nurses experienced a higher level of satisfaction with QWL .Hence the Hypothesis 2 which postulates that nurses expressed high level of QWL can be retained. This finding are consistent with other similar studies (Dr. Nagaraju Battu and G. Karthik Chakravarthy) that found high levels of nurses’ QWL because of decreased workload and stress. Good QWL strategies can pick up employees’ self-esteem and managerial efficiency in health care sector. QWL can also develop the quality of service rendered and recruitment and retention of the nursing personnel (Schalk D,2010).

Table-3 reveals that nurses did not have low level of satisfaction with QWL factors. According to table nurses in general were not satisfied and dissatisfied with: WCS SAW and CAW. With the GWB, JCS and HWI factors they were satisfied. The mean score of JCS was 4.25. It was highest mean among others variable and ranked first; which means that the nurses’ had highest quality of life with regards to JCS. In the survey it was found that nurses’ had no stress due to work load and home interference because they had higher level of satisfaction with JCS and HWI factors.

Table-4 Pearson correlation coefficient between QWL of VAN LAAR and the six factors of QWL

Factors of QWT	Pearson correlation coefficient	Valuer p	Interface level
WCS	0.789	0.000	Strong
GWB	0.676	0.000	Moderate
JCS	0.538	0.000	Moderate
CAW	0.261	0.000	Weak
SAW	0.290	0.000	Weak
HWI	0.681	0.000	Moderate

From the regression analysis it was found that the R square value to be 0.974 meaning 97% of the variability in the quality of work life of nurses in the survey can be explained by these six independent factors. In this case the independent variables were WCS, GWB, JCS, CAW, SAW and HWI. The correlation was significant at the 0.01 level and results of table 4 showed that all correlations were significant (r < 0.01). Hence hypothesis 3 which states that satisfaction with each of the factors of QWL is positive with overall satisfaction of QWL is retained.

The results showed that WCS was key factors in nurses’ quality of working life but nurses’ were neither satisfied nor dissatisfied with their working conditions .Health manager should care to improve working condition. There was a Moderate relationship between QWL and GWB, JCS and HWI but the nurses’ satisfaction level with these QWL factors were high. The two factors (SAW and CAW) of QWL had weak relation with overall quality of life. It infers that autonomy at work and stress has no impact to QWL.

CONCLUSION AND SUMMARY:

QWL is the shared responsibility not only of the management and employees, but also by the society. To improve QWL is first to identify and then try to satisfy employee’s important needs. The study concludes that there is a significant difference between demographics variables and QWL and a significant association between quality of work life total and its factors. It shows QWL of nurses is in high level and they do enjoy the good quality of life. Nurses are not highly satisfied with the QWL factors which are strongly treated with QWL.

Good QWL helps in attracting and retaining employees so is essential to give further attention to the nurses QWL and its disturbing factors. Health manager should care to develop strategies for improving working conditions and QWL. Improving working condition and availability of resource are important, so that, nurses will be able to perform better care for their patients.

In this study first time an attempt has been made in understanding the work life of nurses in West Bengal setting. For improving QWL there is a necessity for outcome-driven inquiries which explore effectiveness and efficacy.

REFERENCES:

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Received on 18.12.2015 Modified on 20.01.2016

Asian J. Nur. Edu. and Research. 2016; 6(2): 199-203.

DOI: 10.5958/2349-2996.2016.00036.7

VARIABLE	MINIMUM	MAXIMUM	MEAN	SD	Level of satisfaction	RANK
QWl	2.7	4.3	3.58	0.364	higher	-
WCS	1.8	4.8	3.43	0.727	average	5
GWB	2.75	5	3.74	0.498	higher	2
JCS	2.97	5	4.25	0.583	higher	1
CAW	2	5	3.49	0.711	average	4
SAW	1.5	5	3.14	0.801	average	6
HWI	1.67	4.67	3.57	0.577	higher	3

Miss Mamata Prasad