The Relationship between Nurses’ Work Environment Characteristics, Job Performance and Patients’ Satisfaction with Nursing Care

Öz

Aim: This research aimed to examine the relationship between nurses’ work environment characteristics, their job performance and patients’ satisfaction with nursing care.

Method: A cross-sectional, descriptive and correlational design was used. The study included 367 nurses working in internal medicine and surgical wards across three training and research hospitals in Istanbul, along with 538 inpatients. Participants were selected using a proportional quota sampling method. Data from nurses were collected using the Nurse Information Form, the Practice Environment Scale of the Nursing Work Index and the Task Performance Scale. Patient data were obtained using the Patient Information Form and the Newcastle Satisfaction with Nursing Care Scale. Descriptive statistics, intergroup comparison tests and correlation analyses were applied to examine the relationships among variables.

Results: Nurses’ perceptions of their work environment were slightly above average while their self-reported job performance and patients’ satisfaction with nursing care were high. Patients’ satisfaction was higher in units where nurses worked an average of ≤45 hours per week, the nurse-to-bed ratio was ≤2 and nurses cared for ≤18 patients per shift (p<0.05). However, no significant correlations were found between nurses’ perceived work environment, their job performance and patients’ satisfaction with nursing care (p>0.05).

Conclusion: This study identifies work-related characteristics of nurses that influence patients’ satisfaction with nursing care and provides useful findings for hospital administrators to improve patients’ satisfaction. It is recommended that administrators who wish to increase patients’ satisfaction ensure that the average weekly working hours of nurses, the nurse-to-bed ratio and the average number of patients cared for per shift are within ideal limits.

Anahtar Kelimeler

• Nurses
• work performance
• inpatients
• nursing care
• patient satisfaction

Destekleyen Kurum

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Etik Beyan

The research was conducted in accordance with the Declaration of Helsinki. Ethical approval for this study was obtained from the Istanbul University Social Sciences and Humanities Research Ethics Committee (Date: 05.11.2018, Number: 10). Permission was obtained via email from the authors of the Turkish-adapted scales. Written informed consent was obtained from all participants prior to data collection.

Teşekkür

The authors would like to thank all nurses and patients who participated in the study.

Hemşirelerin Çalışma Ortamı Özellikleri ve İş Performansı ile Hastaların Bakım Memnuniyeti Arasındaki İlişki

Öz

Amaç: Bu çalışmanın amacı, hemşirelerin çalışma ortamı özellikleri ve iş performansı ile hastaların bakım memnuniyeti arasındaki ilişkinin incelenmesidir.

Yöntem: Kesitsel, tanımlayıcı ve ilişki arayıcı tasarımda olan çalışma örneklemini orantılı kota örnekleme yöntemi ile, İstanbul’daki üç eğitim ve araştırma hastanesinin dahili ve cerrahi servislerinde çalışan 367 hemşire ve yatarak tedavi gören 538 hasta oluşturdu. Hemşirelerin verileri, Hemşire Bilgi Formu, Hemşirelik İş İndeksi-Hemşire Çalışma Ortamını Değerlendirme Ölçeği, Görev Performansı Ölçeği; hastaların verileri, Hasta Bilgi Formu ve Newcastle Hemşirelik Bakım Memnuniyet Ölçeği ile toplandı. Çalışma verilerinin analizinde, tanımlayıcı testler, gruplar arası karşılaştırma testleri ve korelasyon analizi kullanıldı.

Bulgular: Hemşirelerin çalışma ortamı değerlendirmesi ortalamanın biraz üzerinde, hemşirelerin iş performansı ve hastaların hemşirelik bakım memnuniyeti yüksek saptandı. Hemşirelerin haftalık ortalama çalışma süresinin ≤45 saat olduğu, yatak başına düşen hemşire oranı ≤2 ve bir vardiyada bakılan ortalama hasta sayısının ≤18 olduğu birimlerde hastaların hemşirelik bakım memnuniyeti anlamlı olarak daha yüksek saptandı (p<0,05). Hemşirelerin çalışma ortamı değerlendirmesi, iş performansı ve hastaların bakım memnuniyeti puanları arasında anlamlı ilişki saptanmadı (p>0,05).

Sonuç: Bu çalışma, hastaların hemşirelik bakım memnuniyetini etkileyen hemşirelerin çalışma özelliklerini ortaya koymakta olup hastaların bakım memnuniyetini artırmaya yönelik hastane yöneticilerine faydalı bulgular sunmaktadır. Hastaların bakım memnuniyetini artırmak isteyen yöneticilerin; hemşirelerin haftalık ortalama çalışma saatlerinin, yatak başına düşen hemşire oranının ve bir vardiyada bakılan ortalama hasta sayısının ideal sınırlarda olmasını sağlaması önerilmektedir.

Anahtar Kelimeler

• Hemşireler
• iş performansı
• yatan hastalar
• hemşirelik bakımı
• hasta memnuniyeti

Destekleyen Kurum

Bu araştırma, kamu, ticari veya kar amacı gütmeyen sektörlerdeki herhangi bir fon kuruluşundan özel bir hibe almamıştır.

Etik Beyan

Araştırma, Helsinki Bildirgesi'ne uygun olarak yürütülmüştür. Bu çalışma için etik onay, İstanbul Üniversitesi Sosyal Bilimler ve Beşeri Bilimler Araştırma Etik Kurulu'ndan alınmıştır (Tarih: 05.11.2018, Sayı: 10). Türkçeye uyarlanmış ölçeklerin yazarlarından e-posta yoluyla izin alınmıştır. Veri toplama işleminden önce tüm katılımcılardan yazılı bilgilendirilmiş onam alınmıştır.

Teşekkür

Yazarlar, çalışmaya katılan tüm hemşirelere ve hastalara teşekkür etmek ister.

Kaynakça

1. 1. Donabedian A. The quality of care: How can it be assessed? JAMA. 1988;260(12):1743-8.
2. 2. Lake ET. Development of the practice environment scale of the nursing work index. Res Nurs Health. 2002;25(3):176-88. doi: 10.1002/nur.10032.
3. 3. Hong KJ, Lee Y. The moderating effect of nursing practice environment on the relationship between clinical nurses’ sleep quality and wellness. Int J Environ Res Public Health. 2020;17(19):7068. doi: 10.3390/ijerph17197068.
4. 4. Arslan Yürümezoğlu H, Sarıoğlu E. The effects of nurses’ work environment, working hours, and patient-to-nurse ratios on nurse outcomes: A comprehensive literature review. J Health Nurs Manag. 2022;9(1):153-67. doi: 10.54304/JHNM.2022.15367.
5. 5. Sarıköse S, Göktepe N. Effects of nurses’ individual, professional and work environment characteristics on job performance. J Clin Nurs. 2022;31(5-6):633-41.
6. 6. AbuAlRub RF. Job stress, job performance, and social support among hospital nurses. J Nurs Scholarsh. 2004;36(1):73-8. doi: 10.1111/j.1547-5069.2004.04016.x.
7. 7. Zhang J, Xu F, Wu J, et al. The effect of the nurse-patient relationship on the job performance of nurses in tertiary public hospitals in China: A cross-sectional survey. BMC Health Serv Res. 2025;25:812. doi: 10.1186/s12913-025-12850-2.
8. 8. Akin T. Assessing quality of health care in the context of patient satisfaction from patients’ perspective among a physical therapy and rehabilitation unit. BMC Health Serv Res. 2025;25:66. doi: 10.1186/s12913-025-12214-w.

9. 9. Deriba BS, Geleta TA, Beyane RS, Mohammed A, Tesema M, Jemal K. Patient satisfaction and associated factors during COVID-19 pandemic in North Shoa health care facilities. Patient Prefer Adherence. 2020;14:1923-34. doi: 10.2147/PPA.S276254.
10. 10. Guzmán-Leguel YM, Rodríguez-Lara SQ. Assessment of patients’ quality of care in healthcare systems: A comprehensive narrative literature review. Healthcare. 2025;13(14):1714. doi: 10.3390/healthcare13141714.
11. 11. Agostinho P, Potra T, Lucas P, Gaspar F. The nursing practice environment and patients’ satisfaction with nursing care in a hospital context. Healthcare. 2023;11(13):1850.
12. 12. Macnee CL, McCabe S. Understanding Nursing Research: Reading and Using Research in Evidence-Based Practice. 2nd ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2008.
13. 13. Türkmen E, Badır A, Balcı S, Akkuş Topçu S. Turkish adaptation of the Nursing Work Index–Practice Environment Scale: A validity and reliability study. J Nurs Res Dev. 2011;13(2):5-20.
14. 14. Goodman SA, Svyantek DJ. Person–organization fit and contextual performance: Do shared values matter? J Vocat Behav. 1999;55(2):254-75. doi: 10.1006/jvbe.1998.1682.
15. 15. Kül S, Sönmez B. The effect of nurse managers’ servant leadership on nurses’ innovative behaviors and job performances. Leadersh Organ Dev J. 2021;42(8):1168-84.
16. 16. Thomas LH, McColl E, Priest J, Bond S, Boys RJ. Newcastle satisfaction with nursing scales: An instrument for quality assessments of nursing care. Qual Health Care. 1996;5(2):67-72. doi: 10.1136/qshc.5.2.67.
17. 17. Akin S, Erdogan S. The Turkish version of the Newcastle Satisfaction with Nursing Care Scale used on medical and surgical patients. J Clin Nurs. 2007;16(4):646-53.
18. 18. Skela-Savič B, Sermeus W, Dello S, Squires A, Bahun M, Lobe B. How nurses’ job characteristics affect their self-assessed work environment in hospitals: Slovenian use of the practice environment scale of the nursing work index. BMC Nurs. 2023;22(1):100.
19. 19. Boev C. The relationship between nurses’ perception of work environment and patient satisfaction in adult critical care. J Nurs Scholarsh. 2012;44(4):368-75.
20. 20. Lake ET, Riman KA, Sloane DM. Improved work environments and staffing lead to less missed nursing care: A panel study. J Nurs Manag. 2020;28(8):2157-65.
21. 21. Emiralioğlu R, Sönmez B. The relationship of nursing work environment and innovation support with nurses’ innovative behaviours and outputs. J Nurs Manag. 2021;29(7):2132-41. doi: 10.1111/jonm.13349.
22. 22. Liu Y, While A, Li SJ, Ye WQ. Job satisfaction and work-related variables in Chinese cardiac critical care nurses. J Nurs Manag. 2015;23(4):487-97. doi: 10.1111/jonm.12161.
23. 23. Van der Mark C, Bitter J, Hendriks PHJ, Vermeulen H, van Oostveen CJ. The nurse perceived adequacy of staffing scale for general hospital wards: A development and psychometric validation study. Int J Nurs Stud Adv. 2023;5:100138.
24. 24. Oweidat I, Abu Shosha G, Al-Harazneh R, et al. Nurses’ perceptions of job security and performance: A comparative study between governmental and private hospitals. PLoS One. 2025;20(3):e0318412.
25. 25. Kalisch BJ. Nurse and nurse assistant perceptions of missed nursing care: What does it tell us about teamwork? J Nurs Adm. 2009;39(11):485-93.
26. 26. Flynn L, Liang Y, Dickson GL, Aiken LH. Effects of nursing practice environments on quality outcomes in nursing homes. J Am Geriatr Soc. 2010;58(12):2401-6.
27. 27. Aiken LH, Sermeus W, McKee M, et al. Physician and nurse well-being, patient safety and recommendations for interventions: Cross-sectional survey in hospitals in six European countries. BMJ Open. 2024;14(2):e079931.
28. 28. Boudreau C, Rhéaume A. Impact of the work environment on nurse outcomes: A mediation analysis. West J Nurs Res. 2024;46(3):210-8. doi: 10.1177/01939459241230369.
29. 29. Alasad JA, Ahmad MM. Patients’ satisfaction with nursing care in Jordan. Int J Health Care Qual Assur. 2003;16(6):279-85. doi: 10.1108/09526860310509276.
30. 30. Rosenbaum KEF, Lasater KB, McHugh MD, Lake ET. Changes in patient care experiences and the nurse work environment: A longitudinal study of US hospitals. Med Care Res Rev. 2024;81(6):444-54. doi: 10.1177/10775587231197471.
31. 31. Li LZ, Yang P, Singer SJ, Pfeffer J, Mathur MB, Shanafelt T. Nurse burnout and patient safety, satisfaction, and quality of care: A systematic review and meta-analysis. JAMA Netw Open. 2024;7(11):e2443059. doi: 10.1001/jamanetworkopen.2024.43059.
32. 32. Alkhameeas AA, Madani YA, Aldailej SA, et al. The impact of nurse staffing on patient outcomes: A comprehensive review. Int J Innov Res Med Sci. 2024;12(6):IJIRMPS2406231491.
33. 33. Dwinijanti L, Adhikara MF, Kusumapradja R. Job satisfaction and turnover intention among public sector nurses: Is workload and burnout the issue? JEMA. 2020;17(1):67-79.
34. 34. Yeşilyurt T, Göktepe N, Türkmen E, Yalçın B. The relationship between nurses’ individual, work-related variables, colleague solidarity, and work engagement: A cross-sectional study. J Nursology. 2023;26(4):246-52. doi: 10.5152/JANHS.2023.23547.