All_additional_files_24.zip

CH1.docx
· Introduction, Amis and Thesis Summary

1.1 My Role in studying the relationship between job satisfaction, autonomy and self-efficacy among school nurses in Bahrain.( nurses working in the school) Comment by user: 1200 words plz

· talk about the History of school nurses( nurses working in the school)in Bahrain

· when it was started in Bahrain

· what it is reached till this day and how do nurses( nurses working in the school)in working in the school operate in the school

· why this study needed to be done about the school nurse( nurses working in the school)in in Bahrain , and why nobody has done this study before

· why it is needed to use 3 kinds of tools ( job satisfaction tool , autonomy scale and self-efficacy scale) to do this study

· the impartments to use them (the 3 scales) together

· what kind of result hoped to gain from all the scales used to gather

· Why it is need to know about the relationship between job satisfaction, autonomy and self-efficacy among school nurses ( nurses working in the school)in in Bahrain.

· what the researcher is looking to get for this study

· full description of the study

1.2 Aims and Objectives Comment by user: 1000 words plz

· The significant of the study ( the most important point is to talk about student benefit then the nurses working in the schools

· aims

· analysis

1.2.2 Questions

1.2.3 Overall aim of thesis

1.2.4 Specific objectives of the thesis

1.2.4.1 Primary objective

1.2.4.2 Secondary objective

1.3 Thesis summary

· Background

· Method

· Result

· Conclusion

Study_P.docx

1. Introduction

This proposal outlines a research study investigating the factors influencing job satisfaction among school nurses in Bahrain and the importance and significance in filling this research gap. Bringing fresh primary research to an underexplored area that has a limited amount of empirical evidence is urgently required.

2. Study Aim

To investigate the factors influencing job satisfaction among school nurses in Bahrain.

3. Study Objectives

3.1. Primary Objective

To investigate the factors associated with job satisfaction among school nurses.

3.2. Secondary Objectives

1. To create a profile of school nurses in Bahrain;

2. To explore the scope of the role of school nurses in Bahrain; and

3. To examine the relationship between job satisfaction, autonomy, and self-efficacy among school nurses in Bahrain.

4. Study Background

Job satisfaction is regarded as a complex concept that is described as an inner feeling that contains individual meaning and is capable of impacting numerous dimensions within a specific work environment (Giallonardo, Wong, and Iwasiw, 2010). Job satisfaction has an effect on productivity, absenteeism, recruitment, retention, patient care and satisfaction, and organizational commitment (Sypniewska, 2014). Top and Gider (2013) further state that job satisfaction has been subject to broad scholarly research and is correlated with improved performance of organizations and outcomes for employees.

Numerous definitions of job satisfaction are now available in healthcare. Pomirleanu and John (2015) indicate that job satisfaction means the degree to which an employee likes the job. Hosie, Jayashree, Tchantchane, and Lee (2013), on the other hand, describe job satisfaction as the level of positive effect the components of the job, or the job itself, have on the employee. Hackman and Oldham (1976) show that autonomy, including core job dimensions, such as task significance and feedback, promotes outcomes on such job aspects as “positive motivation, performance, satisfaction, absenteeism, and turnover” (P. 162). Another study indicated that there is a significant relationship between job satisfaction, stress, collaboration, and autonomy among nurses (Zangaro & Soeken, 2007). Furthermore, Hayes et al. (2010) found that coping strategies, coworker interaction, autonomy, provision of adequate resources, and education opportunities are some of the primary job satisfaction factors.

Scholars have identified autonomy as the main significant factor that contributes to job satisfaction and retention among nurses (Luszczynska, Scholz, and Schwarzer, 2005). Self-efficacy can be described as the process by which individuals are able to exercise control over demands that affect them due to their beliefs (Luszczynska, Scholz, & Schwarzer, 2005). Autonomy and self-efficacy are believed to be inherent in job satisfaction among school nurses, and both autonomy and self-efficacy affect job performance among nurses.

According to Schwarzer and Jerusalem (1999), individual self-efficacy can be described as the self-confidence an individual has when coping with different situations in life. General self-efficacy (GSE) can be described as the process by which people in different environments use various domains to achieve their goals (Scholz et al., 2002). It has been argued that autonomy and self-efficacy contribute to job satisfaction. Moreover, employees with high degrees of self-efficacy have relative strength in their fields, resulting in patient outcomes that are positive and that raise job satisfaction for employees (Shu-Fang et al., 2012). It is likely that higher self-efficacy beliefs will have direct implications on the capacity of a nurse to cope with a myriad of challenging demands. Furthermore, employment satisfaction is of particular interest in nursing given the demanding work environment to which nurses are exposed and nurses’ significant role in patient care (Salsgiver, 2011). Job satisfaction is therefore a complex construct that requires consideration of a myriad of factors for analysis.

Bahrain’s Education Ministry and Ministry of Health have adopted the policy to which you are referring in terms of the direction and need for school-based health programs in public and private Bahraini schools. School nurses in Bahrain offer health education by directly providing health information to individual learners, groups of learners, or classes. Also, they offer guidance concerning health education programs that encourage sequential, comprehensive, and age-accurate information (Uys and Gwele, 2004).

4.1. Research Questions

· What are the factors associated with job satisfaction among school nurses in Bahrain?

· What is the scope of the role of school nurses in Bahrain?

· What is the relationship between job satisfaction, autonomy, and self-efficacy among school nurses in Bahrain?

5. Methodology

5.1. Study Design

The study adopts a mixed-methods design with both qualitative and the quantitative aspects. A mixed-methods design was chosen because of the capability to triangulate the sources, as in public versus private settings, and methods, as in qualitative and quantitative data, to increase both the validity and the reliability of the findings. The results would have aspects of generalization and contextualization.

· Quantitative aspect

Involving administration of questionnaires to 150 nurses, which is the total population of private and public school nurses in Bahrain.

· Qualitative aspect

Involving semi-structured interviews for 30 school nurses, 15 private and 15 public.

5.2. Study Subjects

All the nurses working in public and private schools in Bahrain will be invited to take part in this study.

The criteria for inclusion are as follows:

· The participant is a registered nurse;

· The participant works in an educational institution as a full-time employee; and

· The participant has worked within the institution as a school nurse for more than one month.

The criteria for exclusion will be:

· The participant is not a registered nurse;

· The participant does not work within an institution of learning or is not a full-time employee;

· The participant has worked within the institution for a period that is less than one month; and

· The participant qualifies to be part of the study but does not consent to participate in the study.

5.3. Sample Size and Pilot Study

The survey uses a mixed-methods design.

5.3.1. Quantitative Aspect

For this aspect of the study, a total population sampling technique will be utilized. Total population sampling is a common technique where the overall size of the population is small (Ellstrand and Diane, 1993). The total population of school nurses in Bahrain is relativity small. The total population is 150 and includes 85 nurses in private schools and 65 in public schools. The researcher will invite all school nurses to participate in the study as further division of the population would lead to results that are not robust enough. This is based on the advice of RCSI Biostatistics Consulting and Support Services (BCSS).

5.3.2. Qualitative Aspect

For the qualitative research, a nonprobability of approximately 30 participants will be chosen, 15 from private and 15 from public schools. The sampling technique will be purposeful or judgmental, a method which aims to target those best placed to answer the research questions. According to advice from BCSS, in this instance, 30 is considered a reasonable number to archive data saturation.

5.4. Ethical Issues

5.4.1. Recruitment

Consent will be sought from the RCSI Ethics Review Committee, the Ministry of Health Ethics Review Committee, and the Ministry of Education Ethics Review Committee, in that order. The consent of the three committees will allow the study and the researcher to access all schools and nurses in Bahrain.

5.4.2. Quantitative Aspect

Once consent from the ethics committees and access have been granted, the researcher will meet the gatekeeper (the headmaster of each school) to provide the three ethics committee approval letters, and the gatekeeper will approach the school nurses, give information about the study, and provide the researcher with the school nurses’ emails so that each school nurse can receive the study questionnaire with the participant information pack. A school nurse’s completion and return of the questionnaire will be taken as consent to participation in the study.

5.4.3. Qualitative Aspect

Through the gatekeeper, the researcher will approach school nurses with a view to participating in the qualitative aspect of the study through interviews. The nurses will also be told that they must sign the ethical consent form in order to take part in the study.

The researcher will be expected to take full responsibility for the research conducted, and, as such, a verification process must be in place to ensure that ethical guidelines are followed

5.5.1. Ethical Principles

The study follows three ethical principles and guidelines: informed consent, voluntary participation, and nondisclosure .Ethical standards require research participants to give valid consent freely and without pressure, such as coercion, threats or persuasion. Voluntary participation requires that people not be coerced into participating in research. Closely related to the notion of voluntary participation is the requirement of informed consent. Making sure that participants in research not only give consent but give informed consent is critical to ensuring that consent is truly given freely and that a participant is knowingly, and thus voluntarily, participating in the stud. The other ethical standard is the privacy of research participants. Almost all research guarantees the participant’s confidentiality. The participant is assured that identifying information will not be made available to anyone who is not directly involved in the study. The stricter standard is the principle of anonymity, which essentially means that the participant will remain anonymous throughout the study, even to the researchers (Trochim and William, 2006).

In the case of quantitative data, the participant’s completion of the required study questionnaire will be considered his or her consent. The researcher will then be responsible for ensuring that the participant’s information is kept confidential. Such information includes anything that may lead someone to identify the participant. The researcher will not require the participants to indicate their names or personal identification numbers. Notably, the study will enable the participants to remain autonomous. Autonomy will also be achieved by analyzing the quantitative data and reporting the results in the form of summaries.

In the case of qualitative data, consent will be obtained before recording each participant’s interview. The researcher will keep participants’ respective institutions confidential. All study data (such as consent forms, participant leaflets, and approval letters) will be scanned, encrypted, and saved onto the “RCSI V:” drive. Data will be stored in this location for five years.

5.5.2. Data Protection

As aforementioned, the researcher will ensure that the respondents have the maximum level of confidentiality possible (Ivey, 2015). This confidentiality will be partly ensured through the protection of the participants’ data (Snowden, 2014). Firstly, given that participants have the right to such protection, the researcher will make it known to the participants that all the information they provide will be treated as confidential. However, the details of how the data will be kept will only be revealed to the participants who seek such information. Secondly, the data protection is the researcher’s mandate, and, before research can begin, the ethics review committees must have determined that the researcher has an adequate plan to ensure the protection of data. The study data will be securely stored and encrypted within the researcher’s” unique project folder located within the “RCSI V:” drive. All study data (such as consent forms, participant leaflets, and approval letters) will be scanned, encrypted and saved onto the “RCSI V:” drive. Data will be stored in this location for five years.

The data will be protected as follows:

• Data in soft copy will be password protected.

• All study data (such as consent forms, participant leaflets, and approval letters) will be scanned, encrypted, and saved onto the “RCSI V:” drive. Data will be stored in this location for five years.

• Analyzed data (quantitative) will be presented in summarized form.

• Analyzed data (qualitative) will be submitted in general form, but when a particular quote is referred to, the participant will then be mentioned, provided that his or her name will be replaced with a number and without reference to the institution with which the participant is affiliated.

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3. Data Collection

For the quantitative aspect of this research, permission has been granted to use instruments that have been used in previous studies. The Measure of Job Satisfaction (MJS), the Hampton Peterson Scale, the Factual Autonomy Scale (FAS), and the General Self-Efficacy Scale (GSE) questionnaires will be used. (Appendices 1, 2 and 3).

For the qualitative aspect of this research, the researcher will require the participants to sign the consent forms before taking part in the interviews (Appendix 5), which will be semi-structured.

5.6. Instrument

5.6.1. Demographic Data in Quantitative Data Collection

Before the respondents fill in the answers to the questions concerning different measures, the researcher will require the respondents to indicate their demographic attributes (see Appendix 1).

5.6.2. Measure of Job Satisfaction (MJS)

The construction of the MJS emanated from literature and discussions with key informants (Traynor and Wade, 1993). The dimensions of the MJS were identified through the use of the principal component analysis with varimax rotation. The five dimensions included personal satisfaction, job satisfaction, and satisfaction with professional support, workload, training, and pay. The scale was administered to nurses in a longitudinal study (Traynor and Wade, 1993). The results of the factor analysis indicate positive factor loadings of greater than 0.3 for the five subscales, with the correlations between the factor scores and the raw scores being between 0.88 and 0.93. It was established that the scale had a high level of internal consistency, discriminatory and concurrent validity, and test and retest reliability (see Appendix 1).

5.6.3. Factual Autonomy Scale (FAS)

The first trial regarding the formulation of a more factual scale of control was in Spector (1987) (Spector and Fox, 2003). Following the administration of the scale, the correlations were 0.25 with a single measure of job satisfaction and 0.12 with a single dimension of job satisfaction. There were complaints that participants had difficulty choosing from the options provided in some questions because more than one option applied. This scale became the foundation of the FAS. There are about seven items that were included in the evaluation of autonomy, after two items were added and others, which overlapped with other constructs, were deleted. The FAS was developed for the purpose of reducing subjectivity and has a high level of discriminant and convergent validities. It also significantly correlates with the measures of job performance (Spector and Fox, 2003).

5.6.4. General Self-efficacy Scale (GSE)

The GSE has become popular in the measurement of general self-efficacy (Luszczynska, Gutiérez-Doña, and Schwarzer, 2005; Jian-Feng, Ze-Wei, and Xue-Ting, 2015). It helps in the evaluation of a wide and stable sense of personal competence that enables one to deal effectively with situations that are stressful. The scale comprises ten items rated from not at all true (1) to exactly true (4) (Bonsaksen, Kottorp, Gay, Fagermoen, and Lerdal, 2013). An overall score on the scale is calculated through the summation of the scores, ranging from lowest (10) to highest (40), of each item. The scale has been used among cohorts, students, and clinical populations. Its use among school nurses should therefore be valid. Moreover, the scale has been found to have total item correlations ranging from 0.25 to 0.63 and factor loadings ranging from 0.32 to 0.74. Moreover, Schwarzer, Mueller, and Greenglass (1999) found the internal consistency of the scale to be 0.82.

5.6.5. Qualitative

The interviews will be semi-structured (Appendix 4). Thus, they will consist of closed-ended and open-ended questions. The semi-structured nature of the interviews will allow the emergence of new evidence and will permit the clarification of questions and answers. The interviews will be conducted at the convenience of the interviewees and at interviewees’ preferred times and venues. The interviews will be audio recorded and will then be transcribed verbatim. The audio records and the transcriptions will be securely stored and encrypted within the researcher’s unique project folder located within the “RCSI V:” drive for future reference.

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Data Analysis

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Analysis of Demographic Attributes Using Descriptive Statistics

All quantitative data analysis will be carried out in SPSS. After data are collected, the demographic attributes will be summarized using pie charts, bar graphs, and frequency tables. For continuous variables, the mean and standard deviation will be calculated. Thus, the data will be analyzed using descriptive statistics.

The summarization of the data will enable the researcher to compare the data and, with the advice of the BCSS, to have a complete view of the characteristics that relate to testing the relationship between the data relating to public school nurses and the data relating to private school nurses.

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Relationships between the Data

The relationships between the data will be tested using correlational statistics. Total scores from each instrument will be used to investigate relationships between the concepts of interest—i.e., job satisfaction, autonomy, and self-efficacy—using Spearman’s correlations. Investigation of differences between groups will be carried out using Chi-squared tests. This is in line with the advice provided by the BCSS.

0. Analysis of Qualitative Data

The qualitative data that will be obtained from 30 interviews will be analyzed using the 14 stages proposed by Burnard (1991). The stages include note-taking; immersion of the researcher in the data; open coding; reducing and refining the data; checking, reading, and categorizing the data; and rearranging the data. Moreover, the stages also involve checking the data analyzed by the informants and making preparations toward writing and finally reporting the results as well as linking them to literature.

The first stage will involve audio recording and then transcribing each interview to enable the categorization of the data at a later time. The data will be analyzed using the Burnard process of thematic analysis. Thus, the researcher will cover the following steps: familiarization with the data, coding, searching for themes, reviewing the themes, defining and naming the themes, and production of the report.

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Expected Outcome and Benefits

Given that the study will look into the factors that contribute to job satisfaction of nurses, the results established will be recommended to the Ministry of Health and the Ministry of Education for purposes of improving the working environment of school nurses in Bahrain. Research indicates that a satisfied employee is less likely to be absent, has a lower intent of leaving employment, and has a greater level of involvement with the organization or the unit with which the employee is affiliated. In this case, the organization is the school at which the school nurse works. For this reason, the school will benefit from decreased human resource problems arising from dissatisfaction, such as conflict with others.

Additionally, the literature indicates that job satisfaction of nurses may lead to improved patient care (Top and Gider, 2013). This means that the students served by the school nurses may benefit from improved care if the recommendations are implemented. This improved care comes from the provision of better health services that result in enhanced school attendance, as well as the prevention and control of communicable diseases.

Lastly, the study will explore the differences and similarities between private and public school nurses in Bahrain. Cooperation between learning institutions’ major stakeholders will have a direct impact on the quality of health care services being rendered by such institutions. Thus, the study should provide information on which relationships can be forged.

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