Contextualisation of the Minnesota Satisfaction Questionnaire to determine job satisfaction in South African public health systems

Abstract

The South African health system consists of two environments, public and private (Young, 2016:23). Private healthcare is expensive whilst public healthcare are for free. Access to healthcare is limited and inequalities exist mainly due to poverty (Booysen, 2003:659). Wagner (2017), chief executive officer of Frere Hospital in the Eastern Cape, South Africa, voiced that health systems are currently on the right track in providing quality and affordable healthcare services to people regardless of socio-economic circumstances. When South African citizens can access healthcare, one presumes that they will receive quality care. One occupational attitude impacting on quality healthcare is job satisfaction (Pillay, 2009:2). Job satisfaction as defined by Spector (cited by Horwitz & Pundit, 2008:26) are emotions of an employees attributed towards job experiences. Lu et al. (cited by Horwitz & Pundit, 2008:26) placed an emphasis on an employee's attitudes towards different aspects of their work. Job satisfaction in the healthcare sector in general has been explored using numerous tools to determine the level of job satisfaction of many occupations within the healthcare environment (Bodur, 2002:353). A literature study related to job satisfaction in the healthcare environment and how it can be measured identified the need for a suitable tool to establish job satisfaction amongst healthcare workers contextualised to South African public health systems. Especially when most research related to job satisfaction in healthcare environments utilised tools developed in the Global North, with very different working environments. This research therefore aimed to contextualise one such measuring tool, the Minnesota Satisfaction Questionnaire (MSQ) short-form, making it more applicable to determine job satisfaction experienced by South African healthcare workers in general. The MSQ short-form presents 20 items (part B) with some demographic detail (part A). An ultimate hypothesis was a differentiation between the current MSQ short-form, compared to the MSQ short-form contextualised to South African public health systems. A quantitative research design was adopted with the setting a typical level three public hospital in the Dr Kenneth Kaunda district, North West province. The hospital has 776 beds and is regarded as a regional hospital serving the Matlosana - , Southern - and the Bophirima regions (ANSA, 2015). An all-inclusive sampling method was used, including all registered healthcare workers whilst adhering to inclusion criteria. Data was collected after face validity was obtained from a panel of experts. After official permissions and informed consent, the amended MSQ short-form was distributed, collected and captured onto RedCAP. From the 350 questionnaires distributed, 62(n) were completed despite repetitive follow-up attempts from field workers to motivate participation. During the time of data collection the North West province's health systems experienced severe staff shortages and functioned on the brim of collapse. Regarding data analysis, the original Cronbach alpha was replaced with the McDonald's omega coefficient to determine the reliability of the contextualised MSQ short-form questionnaire. The omega coefficient entailed a more complex analysis process but served as an alternative to alpha, when the data at hand presents a smaller sample size. This implied first a correlation matrix through Holm's application, utilising the Psychometric Package from R statistics. Thereafter followed an exploratory factor analysis. From the twenty items in the questionnaire, only one presented with an omega value of 0.47. This factor was 'compensation'. All other 19 items had omega coefficients larger than 0.5 implying a good internal consistency. Taking the realities of the small sample size into consideration it can be deduced that the MSQ short-form was successfully contextualised to be used in the South African public health system. Recommendations are formulated to utilise the MSQ short-form to measure job satisfaction amongst healthcare workers as a fast and simple method to not only identify job satisfaction but also to identify areas of dissatisfaction.