Extrinsic motivation affects the job satisfaction of nurses at Rantauprapat Hospital

 Corresponding author: Rayuani Sipahutar Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Extrinsic motivation affects the job satisfaction of nurses at Rantauprapat Hospital Rayuani Sipahutar *, Chrismis Novalinda and Johannes Bastira Ginting Master of Public Health Study Program, Faculty of Dentistry and Health Sciences (FKKGIK) Universitas Prima Indonesia, Medan, Indonesia. World Journal of Biology Pharmacy and Health Sciences, 2025, 21(01), 408-415 Publication history: Received on 12 November 2024; revised on 07 January 2025; accepted on 09 January 2025 Article DOI: https://doi.org/10.30574/wjbphs.2025.21.1.1055 Abstract Job satisfaction, including nurses at Rantauprapat Hospital, is crucial in improving employees' performance and welfare. This study aims to analyze the influence of extrinsic motivational factors of supervision, wages, work environment, and position status on the job satisfaction of nurses at the hospital in 2024. The method used was non-experimental quantitative research with a descriptive approach and associative analysis involving 175 nurses as a sample. Data were collected through observation, interviews, and questionnaires and analyzed using the Chi-Square test and multiple logistic regression. The analysis showed that supervision, wages, and work environment had a significant relationship with the job satisfaction of nurses, with values of p=0.020, p=0.000, and p=0.013, respectively. According to the UMR (regional minimum wage), good supervision and wages significantly increased job satisfaction, while job status did not show a significant relationship. This study concludes that extrinsic motivational factors, especially wages, play an essential role in determining the level of job satisfaction of nurses, which in turn can improve the quality of health services at Rantauprapat Hospital. Keywords: Job satisfaction; Extrinsic motivation; Supervise; wages; Work environment 1. Introduction Job satisfaction is an important aspect that contributes to the performance and well-being of nurses (Sulaeman & Sugiarto, 2022). Nurses who feel satisfied tend to be more motivated, productive, and loyal, which positively impacts the quality of health services. In addition, job satisfaction is also related to emotional well-being, reducing stress, and improving the mental health of nurses (Sumanta et al., 2023). In hospitals, nurses' job satisfaction dramatically affects the quality of service and patient experience (Jatmika et al., 2024). Satisfied nurses are more committed to providing quality care and improving operational efficiency (Huda, 2023). Intrinsic and extrinsic motivation plays a key role in job satisfaction (Jumani & Rianto, 2023). Intrinsic motivation comes from within the individual, while extrinsic motivation is influenced by external factors such as financial rewards and recognition (Samosir et al., 2023). Both contribute to the level of job satisfaction of nurses (Sutedi et al., 2021). Previous research has shown a significant relationship between salary, working conditions, and job satisfaction, but there is no relationship between responsibility and job satisfaction (Pangulimang et al., 2019). Aswata (2023) found that intrinsic, extrinsic, and transformational leadership styles significantly affect employee job satisfaction. This shows the importance of leadership in improving these three factors (Aswara, 2023). Many nurses in hospitals are still dissatisfied with their jobs, with factors that affect satisfaction divided into intrinsic factors (achievement, working conditions, promotion, safety) and extrinsic factors (salary, supervision, colleagues, work environment) (Fitnanto et al., 2021). At Rantauprapat Hospital, evaluating motivational factors that affect nurses' job satisfaction is paramount, especially considering the challenges faced in this profession. This study aims to analyze the impact of extrinsic motivation on nurses' job satisfaction in 2024. The study results are expected to provide insight into the elements that World Journal of Biology Pharmacy and Health Sciences, 2025, 21(01), 408-415 409 affect job satisfaction and become the basis for developing strategies to improve the quality of work and welfare of nurses in hospitals. 2. Research methods This study is a non-experimental quantitative study with a descriptive approach (cross-sectional survey) and associative analysis carried out at Rantauprapat Hospital in September 2024. The study population included 302 implementing nurses, with a sample of 175 respondents using the Slovin formula and a margin of error (e) of 0.05. The sample was taken through purposive sampling with the criteria of active nurses (permanent or contract employees), at least one year of experience, working in units that interact directly with patients, and not on sabbatical or pregnant. Data collection was carried out through observation, interviews, and questionnaires. The variables studied include extrinsic motivation (supervision, wages, work environment, status) and job satisfaction as dependent variables. Data analysis was carried out univariately and bivariate using the Chi-Square test and multivariate using multiple logistic regression. The validity test used Pearson Correlation on 30 respondents, with the question declared valid if r calculated > r table at a significance of 0.05. This study aims to understand the influence of extrinsic motivation on job satisfaction among implementing nurses at Rantauprapat Hospital. 3. Research results Table 1 Overview of Respondent Characteristics of Extrinsic Motivational Factors Towards Job Satisfaction of Nurses at Rantauprapat Hospital in 2024 Category Sub-Category n Percentage Gender Male 83 47% Woman 92 53% Total 175 100% Age < 30 Years 108 62% >30 Years 67 38% Total 175 100% Education D3 117 67% S1 58 33% Total 175 100% Supervise Ada 169 97% None 6 3% Total 175 100% Wages According to UMR 162 93% Not following UMR 13 7% Total 175 100% Work Environment Comfortable 151 86% Uncomfortable 24 14% Total 175 100% Status There is a position 31 18% No Position 144 82% Total 175 100% Job Satisfaction Satisfied 161 92% World Journal of Biology Pharmacy and Health Sciences, 2025, 21(01), 408-415 410 Category Sub-Category n Percentage Dissatisfied 14 8% Total 175 100% Table 1 describes the characteristics of respondents related to extrinsic motivation factors and job satisfaction of nurses at Rantauprapat Hospital in 2024. Most respondents are female (53%) and under 30 years old (62%), showing the dominance of the younger generation. Most nurses (67%) have a D3 educational background, while 33% have an S1 education. 97% of respondents reported supervision support, and 93% felt that the wages received followed the UMR. The comfort of the work environment is also high, with 86% of respondents feeling comfortable. Although the majority (82%) do not have a formal position, indicating limited career development, 92% of respondents are satisfied with their jobs. These findings show that extrinsic motivational factors, such as intense supervision, appropriate wages, and a comfortable work environment, play an essential role in increasing the job satisfaction of nurses at Rantauprapat Hospital. Overall, the majority of respondents tend to feel satisfied with their jobs thanks to positive motivational factors. Table 2 Bivariate analysis of the Chi-Square test of variable X and Y Extrinsic Motivation Factors on Job Satisfaction of Nurses at Rantauprapat Hospital in 2024. Variable Sub-Category Job Satisfaction df p-value Satisfied Dissatisfied Total Supervise Ada 157 12 169 1 0.020 90% 7% 97% None 4 5 9 2% 3% 5% Total 161 17 178 92% 10% 102% Wages According to UMR 154 8 162 1 0.000 88% 5% 93% Not following UMR 7 6 13 4% 3% 7% Total 161 14 175 92% 8% 100% Work Environment Comfortable 142 9 151 1 0,013 81% 5% 86% Uncomfortable 19 5 24 11% 3% 14% Total 161 14 175 92% 8% 100% Status There is a position 30 1 31 1 0.280 17% 1% 18% No Position 131 13 144 75% 7% 82% Total 161 14 175 92% 8% 100% World Journal of Biology Pharmacy and Health Sciences, 2025, 21(01), 408-415 411 Table 2 presents the bivariate analysis results with the Chi-Square test regarding the relationship between extrinsic motivational factors and the job satisfaction of nurses at Rantauprapat Hospital in 2024. Of the 169 nurses who worked under supervision, 157 (90%) were satisfied, with a p = 0.020 value indicating a significant association. In contrast, only 4 out of 9 unsupervised nurses were satisfied. For the wage variable, 154 out of 162 nurses who received wages according to the UMR (88%) were satisfied, with p = 0.000, also significant. On the work environment variable, 142 of the 151 nurses who felt comfortable (81%) were satisfied, with p = 0.013, indicating a significant relationship. However, for the status of the position, no significant relationship was found (p = 0.280). Variables feasible for further analysis are supervision, wages, and work environment. Table 3 Multivariate analysis of multiple logistic regression tests of the Enter method of extrinsic motivational factors on job satisfaction of nurses at Rantauprapat Hospital in 2024 Variable B S.E. Forest df Mr. Exp(B) 95% C.I.for EXP(B) Lower Upper Supervise 1.776 1.023 3.014 1 0.083 5.904 0.795 43.826 Wages 2.583 0.715 13.062 1 0.000 13.241 3.262 53.745 Work Environment 0.699 0.713 0.960 1 0.327 2.011 0.497 8.131 Constant -8.253 1.615 26.128 1 0.000 0.000 Table 3 presents a multivariate analysis with multiple logistic regression tests to identify the influence of extrinsic motivation on the job satisfaction of nurses at Rantauprapat Hospital in 2024. The wage variable showed the highest Exp(B) value, which was 13.241, which means that nurses who received wages according to the UMR were 13.241 times more likely to be satisfied than those who did not. This shows that wages are the extrinsic motivational factor that influences nurses' job satisfaction most, exceeding the influence of supervision and work environment. 4. Discussion 4.1. The relationship of the supervision variable to the job satisfaction of nurses at Rantauprapat Hospital in 2024 The results of this study show that supervision has a significant impact on nurses' job satisfaction. Most nurses under supervision are satisfied (90%), while only 7% are not. This indicates that good supervision can significantly increase job satisfaction, with guidance and emotional support that makes nurses feel valued. A p-value of 0.020 confirms that the relationship between supervision and job satisfaction is significant, indicating a real correlation. Supervision creates a structured and positive work environment, contributing to job satisfaction. In contrast, only 2% of nurses without supervision are satisfied, indicating that the absence of supervision can reduce job satisfaction. These findings are in line with previous research that shows a positive relationship between supervision and job satisfaction (Dian Ariani, 2020); (H. S. Siagian et al., 2020); (Nurhidayati et al., 2023). Adequate supervision, through support, guidance, and clear communication, helps nurses understand job expectations and complete tasks well. Fair treatment from supervisors also contributes to job satisfaction. Therefore, hospital managers need to pay attention to the role of supervision in improving nurse satisfaction and performance by providing adequate support to create a productive and harmonious work environment (Tarigan et al., 2021). 4.2. The relationship of wage variables to job satisfaction of nurses at Rantauprapat Hospital in 2024 The results of this study show that wages are the main factor affecting nurses' job satisfaction. Of the 162 nurses who received wages according to the UMR, 154 people (88%) were satisfied, while only 8 (5%) were dissatisfied, with a value of p = 0.000, which showed a significant relationship. In contrast, among the 13 nurses who did not receive wages according to the UMR, only seven people (4%) were satisfied, and 6 (3%) were dissatisfied. This finding is in line with the research of Muti (2020) and Pangulimang (2019), which showed a relationship between wages and job satisfaction of nurses (Muti, 2020); (Pangulimang et al., 2019). As per Maslow's theory of needs, adequate wages meet basic physiological needs, allowing employees to focus on higher needs (Fajar, 2023). Based on Herzberg's theory of Two Factors, wages are an essential hygienic factor in preventing dissatisfaction, although they do not directly increase job satisfaction. In the context of justice theory, appropriate wages are considered fair, increase satisfaction, reduce financial stress, and improve general well-being (Rahadi & Rozikan, 2024). World Journal of Biology Pharmacy and Health Sciences, 2025, 21(01), 408-415 412 Multivariate analysis using multiple logistic regression showed the highest Exp(B) value in the wage variable, which was 13.241. This means nurses who received wages according to the UMR were 13.241 times more likely to be satisfied with their jobs. These findings confirm that wages are the most significant extrinsic motivational factor influencing nurses' job satisfaction, greater than supervision and work environment. Therefore, hospitals must ensure that nurses' wages meet or exceed market standards to maintain their satisfaction and motivation (Abrori, 2024); (Musmiler et al., 2020). 4.3. The relationship of work environment variables to job satisfaction of nurses at Rantauprapat Hospital in 2024 The results showed that of the 151 nurses who worked in a comfortable environment, 142 people (81%) were satisfied with their jobs. In contrast, nine people (5%) were dissatisfied, with a p = 0.013 value indicating a significant relationship. Of the 24 nurses who felt the work environment was uncomfortable, 19 (11%) were satisfied, and 5 (3%) were dissatisfied. This finding is in line with the research of Marliani (2023) and Nahardian (2021), which also found a relationship between the work environment and nurses' job satisfaction (Marliani et al., 2023); (Nahardian, 2021). The work environment significantly affects nurses' job satisfaction through several aspects, including physical conditions, work culture, and workload management. Good facilities and a clean environment increase comfort and safety, while a positive work culture and effective communication reinforce motivation and reduce conflict. Balanced workload management and support for coping with stress prevent dissatisfaction, while professional training and development opportunities increase a sense of appreciation and satisfaction. Equitable management and leadership qualities also contribute to job satisfaction (Hassira & Kasmiruddin, 2023). Good physical condition, such as adequate medical facilities, helps nurses carry out their duties more efficiently and safely, reducing the risk of injury and improving well-being. A positive work culture, open communication, and team support also increase motivation and reduce conflict (Pebriyanti & Rinaldi, 2024). Opportunities for training play an essential role in increasing satisfaction, with nurses who feel valued tend to be more satisfied. Overall, a supportive and positive work environment contributes to the physical and emotional well-being of nurses and increases their job satisfaction (Tuahuns et al., 2023). 4.4. The relationship of status variables to job satisfaction of nurses at Rantauprapat Hospital in 2024 The study's results showed that of the 31 nurses with positions, 30 people (17%) were satisfied, while one person (1%) was not. On the other hand, of the 144 nurses who did not have a position, 131 people (75%) were satisfied, and 13 people (7%) were dissatisfied. The p = 0.280 indicates no significant relationship between job status and satisfaction. This finding aligns with the Studyninglias (2023) study, which found a negative and insignificant influence between the position status and job satisfaction of non-civil servants at Dr. Soedono (Studyninglias et al., 2023). The absence of this significant relationship shows that the difference in positions in hospitals does not significantly impact the job satisfaction level of nurses. In other words, nurses in high positions are not always more satisfied than their peers in lower positions. Other factors, such as work environment, supervision, and compensation, seem to influence nurses' job satisfaction more, as explained by Krisman Silaen et al. (2020) (Krisman Silaen et al., 2020). This may be due to the similarity of duties and responsibilities between nurses in various positions, so the difference in position status does not have a significant effect. In addition, working conditions, managerial support, and compensation significantly impact job satisfaction. Nurses' perception of fair treatment and flexibility in their roles can also reduce the effects of job disparities. Thus, job satisfaction is more influenced by more consistent factors across positions, such as the work environment and the support received (Hardiman, 2023). 5. Conclusion The study's conclusion at Rantauprapat Hospital in 2024 shows that supervision, wages, and work environment significantly correlate with nurses' job satisfaction. Good supervision increases job satisfaction with a value of p = 0.020, as it provides the necessary support. 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