Factors affecting job satisfaction of advanced practice registered nurses in Korea
Abstract
Background & Aim: The activities of advanced practice registered nurses in Korea have expanded, but studies on their job satisfaction are lacking. This study aimed to determine the factors influencing job satisfaction among Korean advanced practice registered nurses.
Methods & Materials: A cross-sectional correlational study was conducted with 142 APRNs selected from three tertiary hospitals in Korea from December 2020 to January 2021. Job satisfaction and the factors influencing it were investigated using structured questionnaires; factors affecting job satisfaction were identified by multiple regression analysis. Data analysis was processed using the SPSS/WIN 25.0 program.
Results: Advanced practice registered nurses’ sex (β=.15, p=0.004), satisfaction with workload (β=.24, p<0.001), professional visibility (β=. 21, p=0.004), and APRN-physician relations in the work environment (β=.38, p<0.001), and clinical decision-making ability (β=.17, p=0.004) were identified as the factors influencing job satisfaction, which together explained 67% of the variance in job satisfaction.
Conclusion: To increase advanced practice registered nurses' job satisfaction, nurse managers must consider strategies for providing administrative and educational support for workload control, recognition of professional identity and autonomy, and improving the work environment to encourage efficient interaction with physicians and improved clinical decision-making ability.
1. Korean Nursing Association. 2016 Status of nursing staff discharge in Korea. Available from:http://webzine.koreanurse.or.kr/Webzine2014/search_read.php?webzine_id=44&article_id=10
03&page=1&keyfield=all&key=Accessed September 10, 2022
2. Hospital Nurses Association of South Korea. 2010-2019 Hospital Nursing Personnel Arrangement and Working Condition Survey. Available from:
https://khna.or.kr/home/pds/utilities.php?bo_table=board1&sca=&sop=and&sfl=wr_subject&stx=2010-2019%EB%85%84+%EB%B3%91%EC%9B%90%EA%B0%84%ED%98%B8.Accessed September 11, 2022
3. Kim Y, Oh Y, Lee E, Kim SJ. Impact of nurse–physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. International Journal of Environmental Research and Public Health. 2022 Jan;19(2): 661.
https://doi.org/10.3390/ijerph19020661
4. Wheeler KJ, Miller M, Pulcini J, Gray D, Ladd E, Rayens MK. Advanced practice nursing roles, regulation, education, and practice: A global study. Annals of Global Health. 2022 Jun; 88(1):42. https://doi.org/10.5334/aogh.3698
5. Tsay SL, Tsay SF, Ke CY, Chen CM, Tung HH. Analysis of nurse practitioner scope of practice in Taiwan using the longest policy cycle model. Journal of the American Association of Nurse Practitioners, 2019 Jan;31(3),198-205. https://doi.org/10.1016/j.nurpra.2020.10.026
6. Kwak CY, Park JA. Current roles and administrative facts of the Korean physician assistant. The Journal of the Korea Contents Association. 2014 Oct;14(10):583-95. https://dx.doi.org/10.5392/JKCA.2014.14.10.583
7. Lim SY, Kang KA. A study on the job satisfaction of the physician assistant (PA) male nurses: A mixed-method design. Korean Journal of Occupational Health Nursing. 2017 May;26(2):93-104. https://dx.doi.org/10.5807/kjohn.2017.26.2.93
8. Ryu MJ, In WY, Cho EH. Development of Korea version of the practice environment scale for advanced practice registered nurses. Korean Academy of Nursing Administration. 2020 Mar;26(2):160-71. https://doi.org/10.11111/jkana.2020.26.2.160
9. Yoon JE, Cho OH. Intention to stay in specialist trauma nurses: Relationship with role conflict, stress, and organizational support. Journal
of Trauma Nursing. 2022 Jan/Feb;29(1):21-8. https://doi.org/10.1097/jtn.0000000000000628
10. Hoff T, Carabetta S, Collinson GE. Satisfaction, burnout, and turnover among nurse practitioners and physician assistants: a review of the empirical literature. Medical Care Research & Review. 2019 Feb;76(1), 3-31. https://doi.org/10.1177/1077558717730157
11. Nantsupawat A, Kunaviktikul W, Nantsupawat R, Wichaikhum OA, Thienthong H, Poghosyan L. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. International Nursing Review. 2017 Mar;64(1):91-8. https://doi.org/10.1111/inr.12342
12. Van Bogaert P, Meulemans H, Clarke S, Vermeyen K, Van de Heyning P. Hospital nurse practice environment, burnout, job outcome and quality of care: Test of a structural equation model. Journal of Advanced Nursing. 2009 Oct;65(10):2175-85. https://doi.org/10.1111/j.1365-2648.2009.05082.x
13. Seren Intepeler S, Dirik HF, Esrefgil G, Yilmazmis F, Bengu N, Gunes Dinc N, Ileri S, Ataman Z, Fehmi Dirik H. Role of job satisfaction and work environment on the organizational commitment of nurses: A cross-sectional study. Contemporary Nurse. 2019 Oct;55(4-5):380-90. https://doi.org/10.1080/10376178.2019.1673668
14. Wafa'a F, Alhurani J, Alhalal E, Al-Dwaikat TN, Al-Faouri I. Nursing empowerment: How job performance is affected by a structurally empowered work environment. JONA: The Journal of Nursing Administration. 2020 Dec;50(12):635-41. https://doi.org/10.1097/NNA.0000000000000951
15. Choi SJ, Kim MY. Effects of structural empowerment and professional governance on autonomy and job satisfaction of the Korean nurses. Journal of Nursing Management. 2019 Nov;27(8):1664-72. https://dx.doi.org/10.1111/jonm.12855
16. Li H, Shi Y, Li Y, Xing Z, Wang S, Ying J, Sun J. Relationship between nurse psychological empowerment and job satisfaction: A systematic review and meta-analysis. Journal of Advanced Nursing. 2018 Jun;74(6):1264-77. https://doi.org/10.1111/jan.13549
17. Farčić N, Barać I, Plužarić J, Ilakovac V, Pačarić S, Gvozdanović Z, Lovrić, R. Personality traits of core self-evaluation as predictors on clinical decision-making in nursing profession.
Plos One. 2020 May;15(5):e0233435. https://doi.org/10.1371/journal.pone.0233435
18. Driever EM, Stiggelbout AM, Brand PLP. Shared decision making: Physicians’ preferred role, usual role and their perception of its key components. Patient Education and Counseling. 2020 Jan;103(1):77-82. https://doi.org/10.1016/j.pec.2019.08.004
19. Poghosyan L, Nannini A, Finkelstein SR, Mason E, Shaffer J. Development and psychometric testing of the nurse practitioner primary care organizational climate questionnaire. Nursing Research. 2013 Sep/Oct;62(5):325-34. https://doi.org/10.1097/NNR.0b013e3182a131d2
20. Spreitzer GM. Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academy of Management Journal. 1995 Oct;38(5):1442.
21. Jenkins HM. Improving clinical decision making in nursing. The Journal of Nursing Education. 1985 Jun;24(6):242-3. https://doi.org/10.3928/0148-4834-19850601-07
22. Slavitt DB, Piedmont EB, Haase AMB, Stamps PL. Nurses’ satisfaction with their work situation. Nursing Research. 1978 Mar;27(2):114-20. https://doi.org/10.1097/00006199-197803000-00018
23. Coplan B, McCall TC, Smith N, Gellert VL, Essary AC. Burnout, job satisfaction, and stress levels of PAs. Journal of the American Academy of PAs. 2018 Sep;31(9),42-46. https://doi.org/10.1097/01.JAA.0000544305.38577.84
24. Cai C, Zhou Z. Structural empowerment, job satisfaction, and turnover intention of Chinese clinical nurses. Nursing & Health Sciences. 2009 Oct;11(4), 397-403.
https://doi.org/10.1111/j.1442-2018.2009.00470.x
25. Schlak AE, Aiken LH, Chittams J, Poghosyan L, McHugh M. Leveraging the work environment to minimize the negative impact of nurse burnout on patient outcomes. International Journal of Environmental Research and Public Health. 2021 Jan;18(2):620. https://doi.org/10.3390/ijerph18020610
26. Li-Hui, H. O., Chang, S. C., Kevin, K. A. U., Shu-Ying, S. H. I. U., Huang, S. S., Ya-Jung, W. A. N. G., & Shiow-Luan, T. S. A. Y. (2021). The impact of organizational support on practice outcomes in nurse practitioners in Taiwan.The
Journal of Nursing Research,29(3), e148. doi:10.1097/JNR.0000000000000425
27. Kanai-Pak M, Aiken LH, Sloane DM, Poghosyan L. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. Journal of Clinical Nursing. 2008 Dec;17(24):3324-9. https://doi.org/10.1111/j.1365-2702.2008.02639.x
28. Poghosyan L, Kueakomoldej S, Liu J, Martsolf G. Advanced practice nurse work environments and job satisfaction and intent to leave: Six-state cross sectional and observational study. Journal of Advanced Nursing. 2021
Aug;78(8):2460-71. https://doi.org/10.1111/jan.15176
29. Pursio K, Kankkunen P, Sanner‐Stiehr E, Kvist T. Professional autonomy in nursing: An integrative review. Journal of Nursing Management. 2021 Sep;29(6):1565-77. https://doi.org/10.1111/jonm.13282
30. KeshkLI,Qalawa SAA,AlyAA.Clinical decision-making experience of the critical care nurses' and its effect on their job satisfaction: Opportunities of good performance. American Journal of Nursing Research. 2018May;6(4),147-157. https://doi.org/10.12691/ajnr-6-4-2.
03&page=1&keyfield=all&key=Accessed September 10, 2022
2. Hospital Nurses Association of South Korea. 2010-2019 Hospital Nursing Personnel Arrangement and Working Condition Survey. Available from:
https://khna.or.kr/home/pds/utilities.php?bo_table=board1&sca=&sop=and&sfl=wr_subject&stx=2010-2019%EB%85%84+%EB%B3%91%EC%9B%90%EA%B0%84%ED%98%B8.Accessed September 11, 2022
3. Kim Y, Oh Y, Lee E, Kim SJ. Impact of nurse–physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. International Journal of Environmental Research and Public Health. 2022 Jan;19(2): 661.
https://doi.org/10.3390/ijerph19020661
4. Wheeler KJ, Miller M, Pulcini J, Gray D, Ladd E, Rayens MK. Advanced practice nursing roles, regulation, education, and practice: A global study. Annals of Global Health. 2022 Jun; 88(1):42. https://doi.org/10.5334/aogh.3698
5. Tsay SL, Tsay SF, Ke CY, Chen CM, Tung HH. Analysis of nurse practitioner scope of practice in Taiwan using the longest policy cycle model. Journal of the American Association of Nurse Practitioners, 2019 Jan;31(3),198-205. https://doi.org/10.1016/j.nurpra.2020.10.026
6. Kwak CY, Park JA. Current roles and administrative facts of the Korean physician assistant. The Journal of the Korea Contents Association. 2014 Oct;14(10):583-95. https://dx.doi.org/10.5392/JKCA.2014.14.10.583
7. Lim SY, Kang KA. A study on the job satisfaction of the physician assistant (PA) male nurses: A mixed-method design. Korean Journal of Occupational Health Nursing. 2017 May;26(2):93-104. https://dx.doi.org/10.5807/kjohn.2017.26.2.93
8. Ryu MJ, In WY, Cho EH. Development of Korea version of the practice environment scale for advanced practice registered nurses. Korean Academy of Nursing Administration. 2020 Mar;26(2):160-71. https://doi.org/10.11111/jkana.2020.26.2.160
9. Yoon JE, Cho OH. Intention to stay in specialist trauma nurses: Relationship with role conflict, stress, and organizational support. Journal
of Trauma Nursing. 2022 Jan/Feb;29(1):21-8. https://doi.org/10.1097/jtn.0000000000000628
10. Hoff T, Carabetta S, Collinson GE. Satisfaction, burnout, and turnover among nurse practitioners and physician assistants: a review of the empirical literature. Medical Care Research & Review. 2019 Feb;76(1), 3-31. https://doi.org/10.1177/1077558717730157
11. Nantsupawat A, Kunaviktikul W, Nantsupawat R, Wichaikhum OA, Thienthong H, Poghosyan L. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. International Nursing Review. 2017 Mar;64(1):91-8. https://doi.org/10.1111/inr.12342
12. Van Bogaert P, Meulemans H, Clarke S, Vermeyen K, Van de Heyning P. Hospital nurse practice environment, burnout, job outcome and quality of care: Test of a structural equation model. Journal of Advanced Nursing. 2009 Oct;65(10):2175-85. https://doi.org/10.1111/j.1365-2648.2009.05082.x
13. Seren Intepeler S, Dirik HF, Esrefgil G, Yilmazmis F, Bengu N, Gunes Dinc N, Ileri S, Ataman Z, Fehmi Dirik H. Role of job satisfaction and work environment on the organizational commitment of nurses: A cross-sectional study. Contemporary Nurse. 2019 Oct;55(4-5):380-90. https://doi.org/10.1080/10376178.2019.1673668
14. Wafa'a F, Alhurani J, Alhalal E, Al-Dwaikat TN, Al-Faouri I. Nursing empowerment: How job performance is affected by a structurally empowered work environment. JONA: The Journal of Nursing Administration. 2020 Dec;50(12):635-41. https://doi.org/10.1097/NNA.0000000000000951
15. Choi SJ, Kim MY. Effects of structural empowerment and professional governance on autonomy and job satisfaction of the Korean nurses. Journal of Nursing Management. 2019 Nov;27(8):1664-72. https://dx.doi.org/10.1111/jonm.12855
16. Li H, Shi Y, Li Y, Xing Z, Wang S, Ying J, Sun J. Relationship between nurse psychological empowerment and job satisfaction: A systematic review and meta-analysis. Journal of Advanced Nursing. 2018 Jun;74(6):1264-77. https://doi.org/10.1111/jan.13549
17. Farčić N, Barać I, Plužarić J, Ilakovac V, Pačarić S, Gvozdanović Z, Lovrić, R. Personality traits of core self-evaluation as predictors on clinical decision-making in nursing profession.
Plos One. 2020 May;15(5):e0233435. https://doi.org/10.1371/journal.pone.0233435
18. Driever EM, Stiggelbout AM, Brand PLP. Shared decision making: Physicians’ preferred role, usual role and their perception of its key components. Patient Education and Counseling. 2020 Jan;103(1):77-82. https://doi.org/10.1016/j.pec.2019.08.004
19. Poghosyan L, Nannini A, Finkelstein SR, Mason E, Shaffer J. Development and psychometric testing of the nurse practitioner primary care organizational climate questionnaire. Nursing Research. 2013 Sep/Oct;62(5):325-34. https://doi.org/10.1097/NNR.0b013e3182a131d2
20. Spreitzer GM. Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academy of Management Journal. 1995 Oct;38(5):1442.
21. Jenkins HM. Improving clinical decision making in nursing. The Journal of Nursing Education. 1985 Jun;24(6):242-3. https://doi.org/10.3928/0148-4834-19850601-07
22. Slavitt DB, Piedmont EB, Haase AMB, Stamps PL. Nurses’ satisfaction with their work situation. Nursing Research. 1978 Mar;27(2):114-20. https://doi.org/10.1097/00006199-197803000-00018
23. Coplan B, McCall TC, Smith N, Gellert VL, Essary AC. Burnout, job satisfaction, and stress levels of PAs. Journal of the American Academy of PAs. 2018 Sep;31(9),42-46. https://doi.org/10.1097/01.JAA.0000544305.38577.84
24. Cai C, Zhou Z. Structural empowerment, job satisfaction, and turnover intention of Chinese clinical nurses. Nursing & Health Sciences. 2009 Oct;11(4), 397-403.
https://doi.org/10.1111/j.1442-2018.2009.00470.x
25. Schlak AE, Aiken LH, Chittams J, Poghosyan L, McHugh M. Leveraging the work environment to minimize the negative impact of nurse burnout on patient outcomes. International Journal of Environmental Research and Public Health. 2021 Jan;18(2):620. https://doi.org/10.3390/ijerph18020610
26. Li-Hui, H. O., Chang, S. C., Kevin, K. A. U., Shu-Ying, S. H. I. U., Huang, S. S., Ya-Jung, W. A. N. G., & Shiow-Luan, T. S. A. Y. (2021). The impact of organizational support on practice outcomes in nurse practitioners in Taiwan.The
Journal of Nursing Research,29(3), e148. doi:10.1097/JNR.0000000000000425
27. Kanai-Pak M, Aiken LH, Sloane DM, Poghosyan L. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. Journal of Clinical Nursing. 2008 Dec;17(24):3324-9. https://doi.org/10.1111/j.1365-2702.2008.02639.x
28. Poghosyan L, Kueakomoldej S, Liu J, Martsolf G. Advanced practice nurse work environments and job satisfaction and intent to leave: Six-state cross sectional and observational study. Journal of Advanced Nursing. 2021
Aug;78(8):2460-71. https://doi.org/10.1111/jan.15176
29. Pursio K, Kankkunen P, Sanner‐Stiehr E, Kvist T. Professional autonomy in nursing: An integrative review. Journal of Nursing Management. 2021 Sep;29(6):1565-77. https://doi.org/10.1111/jonm.13282
30. KeshkLI,Qalawa SAA,AlyAA.Clinical decision-making experience of the critical care nurses' and its effect on their job satisfaction: Opportunities of good performance. American Journal of Nursing Research. 2018May;6(4),147-157. https://doi.org/10.12691/ajnr-6-4-2.
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| Issue | Vol 9 No 4 (2022): Autumn | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v9i4.11204 | |
| Keywords | ||
| clinical decision-making job satisfaction nurses | ||
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How to Cite
1.
Seo H, Cho O-H. Factors affecting job satisfaction of advanced practice registered nurses in Korea. NPT. 2022;9(4):326-336.
