A survey of intention to leave, job stress, burnout and job satisfaction among nurses employed in the Ha'il region's hospitals in Saudi Arabia

Nurses in Saudi Arabia, as in other Arabian Gulf countries, may be nationals or non-nationals. Frequently, non-national nurses predominate in a workplace, and as they are contracted, there is a high turnover among them. Similarly, Saudis do not readily accept a nursing career, and they find it difficult in a mixed gender working environment that is incongruent with their cultural and Islamic practices. This study identified the nurses’ intention to leave using psychometric measures of job stress, burnout and job satisfaction within a population of nurses (N=297) working in the northern province of Ha’il, in the Kingdom of Saudi Arabia. A survey design method was employed using a descriptive correlational analysis and factor analysis to test relationships within and between the four concepts: job stress, burnout, job satisfaction and intention to leave. A questionnaire containing these measures was used as the research instrument. The questionnaire was in six parts; however the dominant instruments used were the Maslach Burnout Inventory (Maslach& Jackson, 1984) and Price and Mueller’s (1981) job satisfaction survey. The study results are that intention to leave is significantly associated with job satisfaction, job stress (uncertainty on treatment) and burnout (emotional exhaustion and personal accomplishment). However, survey questions asking whether the respondents intended to stay or intended to leave received a mixed response, with a majority of respondents intending to leave as soon as possible and a similar majority intending to stay. The results show an association between nurse job satisfaction and burnout, although there was no relationship between job satisfaction and job stress. Respondents who are emotionally exhausted and depersonalised tended to have low job satisfaction. In terms of stress and burnout, as expected, those who reported higher burnout levels tended to also report high stress levels particularly for factors such as workload and uncertainty on treatment. The demographics and the work profiles for the Hail nurse participants were within the Kingdom’s statistical norms, although there was a higher proportion of Saudi nationals. The participants were predominantly women under 30 years of age who held a diploma of nursing, had fewer than 10 years of nursing experience and had thus spent fewer than 10 years with their employer. The minority of non-nationals were predominantly from the Philippines and India. The implications of these findings are that Ha’il nurses were largely dissatisfied with their jobs. The Ministry of Health is aware of the healthcare issues, which were high insurance premiums and low standards of healthcare; international competition for a small pool of registered nurses; national nurse remuneration based on factors other than competency and concentration of healthcare in Riyadh, Jeddah, Makkah and Dammam. Future research could utilise this study’s model to examine the correlation of job stress, burnout, job satisfaction and intention to leave among registered nurses on a broader scale in other work environments, in other regions within the Kingdom of Saudi Arabia and globally to strengthen generalisability

The effect of foot position during static calibration trials on knee kinematic and kinetics during walking

Background Gait analysis has been used extensively for computing knee kinematics and kinetics, in particular, in healthy and impaired individuals. One variable assessed is the external knee adduction moment (EKAM). Variations in EKAM values between investigations may be caused by changes in static standing position, especially foot placement angles which may increase or reduce any differences seen. Purpose of the study The current study aimed to explore the influence of static trial foot position on knee kinematic and kinetic variables during walking. Methods Twelve healthy male participants completed three different static standing trials; 1) 20-degrees toe-in, 2) 0 degree and 3) 20-degrees toe-out before walking at their own pace during a lower limb kinematics and kinetics assessment. First and second peak EKAM was compared between static foot position trials, as well other knee kinematic and kinetic outcomes. Repeated measures ANOVA was used with post hoc pairwise comparison to determine the differences between static foot position trials. Results The first peak of EKAM was significantly smaller in the 20o toe-out angle, than the 20o toe-in angle (p = 0.04 - 8.16% reduction). Furthermore, significant changes were found in peak knee kinematics and kinetics variables (adduction angle, external rotation angle, knee flexion moment external rotation moment, abduction angle and internal rotation angle) in the different positions. Conclusion Modification in static foot position between study visits may result in changes especially in the 1st peak EKAM and other kinematics and kinetics variables during walking. Therefore, standardisation of static foot position should be utilised in longitudinal studies to ensure changes in EKAM are not masked or accentuated between assessments