Objectives: This study aimed to explore the status of job satisfaction, emotional labour, core competencies and job stress and the associations of emotional labour and core competencies with the job satisfaction of nurses in China. Methods: Data were collected by using a self-designed general information questionnaire, a job satisfaction questionnaire (McCloskey/Mueller Satisfaction Scale), a nurse emotional labour questionnaire, the Competency Inventory for Registered Nurses questionnaire, and a nurse job stressor questionnaire. A total of 13,448 nurses from 92 hospitals across mainland of China were surveyed, and 11,337 respondents (84.3% response rate) completed the questionnaires. Results: The survey results indicated that Chinese nurses had average job satisfaction (24.77±۵٫۲۳), moderate job stress (86.84±۲۱٫۱۲), moderate to high emotional labour experiences (55.08±۹٫۶۳) and high competency (195.77±۳۷٫۶۱). Multiple linear regression indicated that surface acting was negatively correlated with job satisfaction(P<0.01), while deep acting (P<0.01) and nurses’ core competence (P<0.01) were positively associated with job satisfaction. Besides, The results also indicated job stress,geographical distribution, hospital category, gender, work shift, only children, parenting status, monthly salary, nursing experience, professional title, hospital area were the influencing factors of job satisfaction(P<0.05). Conclusion: The improvement of the emotional labour and competency of nurses may help enhance their job satisfaction.

Introduction

Healthcare workers in hospitals experience high levels of job stress and low job satisfaction[1]. Hospital nurses are at high risk for occupational burnout, reduced job satisfaction and high levels of job stress worldwide, thus leading to poor nursing outcomes [2- 4]. Numerous studies have described job stress, satisfaction and burnout among nursing professionals[5-8]. Nantsupawat et al[4] reported that 28% of nurses in Thailand are dissatisfied with their job. Aiken and colleagues [9] reported that job dissatisfaction among nurses varied from 17% to 60% in nine sample countries. The work environment is an important factor that substantially contributes to nurses’ job dissatisfaction[9] . In China, the demand for quality health care service has greatly increased in the last two decades, and hospitals are facing challenges to provide high-quality service in this rapidly changing environment[10]. A limited number of nurse staff against a growing patient population and their needs further poses serious challenges to providing quality healthcare service [11]. Low job satisfaction of nurses has also been reported in China. Lu and colleagues [12] reported that low salary (79.2%) is the major reason for nurse job dissatisfaction. A survey conducted in six hospitals in Harbin, China, showed that nurses were dissatisfied mainly for workload and compensation reasons [13]. Liu and colleagues [14] reported that more than 50% of nurses were dissatisfied with their job in Guangdong Province, China. The results of studies and surveys conducted in China varied widely because of the different sites of selection and the use of various measurement instruments. The clinical competency of nurses is an important factor affecting job satisfaction. A previous study demonstrated that the core competencies of nurses correlated significantly with job satisfaction, stress, burnout and turnover [7]. In addition, emotional labour, which is required in the nursing profession, may also reduce job satisfaction. In the 1980s, Arlie Russell Hochschild introduced the concept of ‘emotional labour’, referring to the management of a person’s inner emotions to meet the requirement of emotional expression of an organisation. The management of personal emotion to fulfil job requirements is essential in the nursing profession. However, to date, only a limited number of studies have related the parameters of nurses’ job satisfaction with the status of emotional labour in China. The present study aimed to explore the status of emotional labour, core competencies, job satisfaction and stress of nurses in tertiary hospitals in mainland of China. In addition, the associations of emotional labour and core competency with job satisfaction were analysed.