The Relationship between Job Satisfaction and Mental Workload

Among Health Workers During the COVID-19 Pandemic in the

Abiansemal District

Putu Dahlia Eka Patni

1 a

, I Kadek Nuryanto

3 b

, I Nengah Adiana

4 c

Ni Luh Putu Inca Buntari Agustini

4 d

and Ni Made Dewi Wahyunadi

5 e

Student of Master of Nursing Program, Faculty of Health, Institute of Technology and Health Bali, Bali, Indonesia

Puskesmas Petang, Badung, Bali, Indonesia

Master of Nursing Program, Faculty of Health, Institute of Technology and Health Bali, Bali, Indonesia

3,4

Bachelor of Nursing Program, Faculty of Health, Institute of Technology and Health Bali, Bali, Indonesia

Keywords: Mental Workload, Job Satisfaction, Health Worker, Covid-19, Pandemic.

Abstract: Mental workload is workload due to the activity of using the human brain or mind. Job satisfaction is a

person's emotional state after comparing their perceived performance and results with their expectations.

Health workers are at the frontline in providing services during the COVID-19 pandemic. Mental workload

is an important factor affecting the services provided by health workers. This study aimed to examine the

relationship between the mental workload and job satisfaction of health workers during the COVID-19

pandemic in the Abiansemal district, Bali. This was a quantitative study using a correlation cross-sectional

design. A total of 83 health workers were selected through stratified sampling. Data were collected using an

online questionnaire. Data collection was conducted in May 2022. Data were analyzed using descriptive

statistics to measure the job satisfaction and mental workload of health workers during the COVID-19

pandemic. A Chi-square test was conducted to analyze the relationship between job satisfaction and mental

workload. The results showed that the majority of health workers had moderate (50.6%) and heavy (49.4%)

mental workloads. It also showed a significant relationship between job satisfaction and mental workload (p

= 0.004). Job satisfaction is a very important aspect that needs to be improved to reduce mental workload,

which can be done by providing rewards and supporting facilities and infrastructure for health services.

1 INTRODUCTION

Coronavirus disease 2019 (COVID-19) is an

infectious disease caused by a coronavirus. COVID-

19 was the number one cause of death in the world

from 2020 to May 2021, and has affected the socio-

economic status of communities and areas affected by

the virus (Kemenkes, 2021). COVID-19 spreads very

quickly through small droplets from the nose or

mouth that spread when someone coughs or exhales.

The total distribution of COVID-19 cases in Bali has

a cumulative number of 44,671 cases as of September

https://orcid.org/0000-0001-7629-594X

https://orcid.org/0000-0001-5617-792X

https://orcid.org/0000-0002-6451-9827

https://orcid.org/0000-0003-3327-3817

https://orcid.org/0000-0002-9697-3821

2021 (Indonesian Ministry of Health, 2021). Health

workers are the front line in dealing with COVID-19.

Data from the Badung District Health Office shows

the number of health workers exposed to COVID-19

was 700 people.

The policy created by the government to counter

the increasing number of health workers dying due to

COVID-19 exposure was to reduce health workers’

workload in three ways. First, reduce working hours

to prevent fatigue in medical personnel. Second,

increase the number of shifts for health workers for

more frequent staff changes. Third, categorize

patients to reduce workload (Candra, 2020).

Patni, P., Nuryanto, I., Adiana, I., Agustini, N. and Wahyunadi, N.

The Relationship Between Job Satisfaction and Mental Workload Among Health Workers During the COVID-19 Pandemic in the Abiansemal District.

DOI: 10.5220/0011950200003576

In Proceedings of the 2nd Bali Biennial International Conference on Health Sciences (Bali BICHS 2022), pages 82-87

ISBN: 978-989-758-625-5

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

The phenomenon that occurs in the field is that

there are no additional health personnel, especially in

the most basic health service centers such as primary

healthcare centers. Ruiz-Frutos et al., (2022) found

that there was an imbalance of health workers in big

cities and remote areas during the COVID-19

pandemic. For 1.5 years, health workers had not been

able to take leave, which caused their workload

during the pandemic to be high. Nurses' workload

during the COVID-19 pandemic consisted of caring

for and serving infected (positive) patients. The study

used the NASA-Task Load Index (NASA-TLX) and

found that during the COVID-19 pandemic, the

majority of health workers’ mental workload was

very high at 88.2% (Novira, dkk., 2021)

Another study stated that the mental workload of

male nurses was considered high (Susanti, S., dkk.,

2017). However, no study has specifically identified

how the mental workload experienced by health

workers at primary healthcare centers in terms of the

age, gender, and length of work characteristics.

Physical work environment factors around the

workplace are some of the factors that affect a

person's mental workload (Simanjuntak, R. A., &

Situmorang, 2010). Furthermore, job satisfaction

greatly affects health workers’ workload, as seen

from Christi's (2015) research showing job

satisfaction is influenced by workload. Health

workers’ mental workload is relatively heavy. This is

especially true during pandemic conditions like this,

with the increasing number of COVID-19 cases

adding to the workload; both physical and mental

workloads can cause work stress (Wihardja, dkk.,

2021). At the time of this study, no research has been

found on health workers’ mental workload in Bali,

though it is very important to systematically review

health workers’ mental workload during the COVID-

19 pandemic.

2 METHOD

This was a correlative analytic study with a cross-

sectional correlation approach. This study was

conducted to examine the relationship between job

satisfaction and health workers’ mental workload in

dealing with the COVID-19 pandemic in Abiansemal.

The sample in this study were health workers at the

Abiansemal District Health Center who met the

inclusion criteria, totaling 83 people. The sampling

method in this study was probability sampling with a

stratified-simple random sampling technique where

the determination of the sample used a random

system (Hariyati & Safril, 2018). The sample criteria

was split in two, namely inclusion criteria and

exclusion criteria, where the two criteria determined

whether the sample could be used. The inclusion

criteria in this study were health workers who worked

at the Abiansemal District Health Center, health

workers who had active STR, were willing to be

respondents, and had signed an informed consent.

The exclusion criteria in this study were health

workers who were in self-isolation and health

workers who were on leave or study assignments.

The instrument used in this study was a questionnaire.

The questionnaire was filled out by respondents

through a Google Form that met the inclusion criteria.

Research was carried out at the Abiansemal District

Health Center in May 2022. The data collection in

this study was carried out through administrative

procedures and implementation procedures. The data

analysis technique used in this research was the

bivariate analysis.

3 RESULT

The table below describes health workers’ general

characteristics, job satisfaction, and mental workload

while facing the COVID-19 pandemic. Respondents’

general characteristics consisted of age, gender,

education, work unit, years of service, marital status,

and place of residence. Table 1 shows the distribution

of respondents' characteristics

Table 1: Respondents’ Characteristics.

Variable f %

Age (years)

Adults

Not adults

84.3

15.7

Gender

Male

Female

15.7

84.3

Education

Diploma 3 in Health

Bachelor/Maste

57.8

42.2

Work Unit

COVID

Non-COVID

61.4

38.6

Length of Work (years)

≤ 10 years

>10

ears

60.2

39.8

Marital Status

Married

Not marrie

88.0

10.0

Residence

Rural

Urban

81.9

18.1

The Relationship Between Job Satisfaction and Mental Workload Among Health Workers During the COVID-19 Pandemic in the

Abiansemal District

The majority of respondents were in the adult

category, totaling 70 respondents (84.3%). The

majority were female with a total of 70 respondents

(84.3%). The majority of respondents had a Diploma

3, with as many as 48 respondents (57.8%). The

majority of respondents’ length of work was less than

or equa to 10 years with as many as 50 respondents

(60.2%). Judging from marital status, as many as 73

respondents were married (88%). Finally, as many as

68 respondents lived in rural areas (81.9%).

This study also looked at health workers’ mental

workload and job satisfaction in dealing with the

COVID-19 pandemic. Figure 1 and Figure 2 below

describe the details of the data obtained in this study

Figure 1: The Proportion of Health Workers’ Mental

Workload in Facing the COVID-19 Pandemic at the

Abiansemal District Health Center (n = 83).

Figure 1 and Figure 2 show that most of the

respondents, namely 42 respondents (50.6%), had

moderate mental workloads. It is also evident that the

majority of respondents, namely 44 respondents

(53%), had good job satisfaction.

Figure 2: The Proportion of Health Workers’ Job

Satisfaction in Facing the COVID-19 Pandemic at the

Abiansemal District Health Center (n = 83).

A bivariate analysis was conducted to determine

the relationship between the independent variable and

the dependent variable. The Chi-square test was used

in conducting the bivariate analysis in this study, with

the total percentage being in each independent

variable’s row. Table 2 shows an analysis of one

variable relationship, namely between job satisfaction

and hrealth workers’ mental workload in the face of

the COVID-19 pandemic.

The results showed that most health workers had

a moderate mental workload (50.6%), with the rest

having a heavy mental workload (49.4%). The results

from testing the relationship between job satisfaction

and mental workload showed a significant

relationship (p < 0.004) where 65.9% of respondents

with good job satisfaction had light/moderate mental

workload.

Table 2: Bivariate results of the relationship between job

satisfaction and mental workload.

Job Satisfaction * Mental Workload Crosstabulation

Mental Workload Total

P-

Value

Moderate Heav

(

)

(

)

Job

Satisfaction

Good 29

(65.9)

(34.1)

0.004

Sufficient/

less

(

33.3

)

(

66.7

)

Total 42

(

50.6

)

(

49.4

)

4 DISCUSSION

The measurement results of health workers’ mental

workload at the Abiansemal District Health Center

showed that the majority had a mental workload in

the medium and heavy categories. These results

indicate that the majority of health workers at the

Abiansemal District Health Center had a good

maximum capacity for individual mental loads. This

is shown by health workers providing an assessment

of their mental workload during the COVID-19

pandemic season as a mental burden in the moderate

category. However, 49.4% of all respondents reported

a heavy mental burden.

The research results presented by (Z. Fikri, 2020)

show that the majority of nurses at the Labuan Baji

Makassar Hospital during the COVID-19 pandemic

season also reported a mental workload in the

moderate category. A study was also done on nurses

at the Kondosapata' Hospital in Balla District, where

the majority of health workers reported a moderate

mental workload during the COVID-19 pandemic

(Nikeghbal, et al., 2021). Mental workload is defined

as the difference between the demands of the

workload and an individual’s maximum mental load

capacity in a motivated condition. An increase in

workload can occur due to a lacking workforce and

health workers’ insufficient abilities to meet the job’s

demands. If mental workload arises due to a lack of

energy, an additional amount of energy is needed to

Bali BICHS 2022 - The Bali Biennial International Conference on Health Sciences

overcome the problem. Meanwhile, if the mental

workload occurs because of health workers’ lack of

ability, capacity building through education and

training is the path to overcoming it.

Primary healthcare centers in Badung, especially

in Abiansemal, had met the minimum number of

health workers on duty based on Indonesian Ministry

of Health Regulation Number 75 of 2014 concerning

the Public Health Centers. Health workers at the

Badung District Health Center also had relatively

extensive work experience, allowing health workers

to better manage tasks during the COVID-19

pandemic. Based on the analysis results, 41% of the

Badung District Health Center health workers had

more than 10 years of work experience. These results

show that these health workers already had a lot of

experience. This will affect their ability or capacity to

manage their mental workload. During the pandemic,

there was a surge in patients accompanied by the

submission of reports and personnel confinement due

to COVID-19 infection. However, health workers

who already have extensive work experience will be

able to manage their work and tasks at the Badung

District Health Centers, one of which is the

Abiansemal District Health Center. The majority of

these experienced workers should have a mental

workload in the medium category. Their ability to

analyze situations and manage work stress should be

much better than novice health workers who have less

than two years of experience.

The results of the research analysis found as much

as 53% of health workers at the Abiansemal District

Health Center expressed job satisfaction in the good

category, and the remaining 47% in the sufficient/less

category. These results indicate that the Abiansemal

District Health Center’s health workers are satisfied

with their work and their work needs have been met.

These research results are supported by previous

cognate research. (Hariyati & Safril, 2018) found that

many nurses at a hospital expressed job satisfaction

during the COVID-19 pandemic. In line with these

results, nurses at the Idaman Hospital in Banjarbaru

City were also reported to have job satisfaction in the

good category (M. K. Fikri, Rizany, & Setiawan,

2022). Similar results were also conveyed by

(Apriliani & Hidayah, 2020), who found that most

nurses at PKU Muhammadiyah Gamping

Hospitalwere satisfied in job satisfaction indicators

(88.62%). This study’s research results as well as

previous studies’ results show that during the

COVID-19 pandemic, nurses generally had job

satisfaction in the satisfied or good category. This is

believed to be because support for health workers in

providing services came from various parties and

sectors, both private and government. This resulted in

a mismatch between expectations and the reality for

health workers, especially those on duty at the

Abiansemal District Health Center.

Job satisfaction is defined as an individual's

positive feelings towards their job and the extent to

which their needs can be met by the job. Satisfaction

in general can also be defined as a match between an

individual’s expectations and reality. Nurses’ job

satisfaction can have a relationship with social

support received at work, which can come from

superiors, friends or work teams, and family (Novira

et al., 2021). Based on research instrument results, it

is believed there has been good team performance as

well as communication between fellow nurses and

other health workers in providing services during the

COVID-19 pandemic. This is also supported by the

discovery of good work environment data for health

workers at the Abiansemal District Health Center. In

addition, good work motivation was also reported to

form nurses’ job satisfaction (Hariyati & Safril,

2018). Good work motivation will encourage health

workers to be able to work optimally, enabling nurses

to feel satisfied with the reality of their work. A

relationship between work motivation and job

satisfaction was also presented by (M. K. Fikri et al.,

2022), wherein the results of the research conveyed

that there was a statistically significant relationship

between work motivation and job satisfaction for

nurses at Idaman Hospital, Banjarbaru City.

During the COVID-19 pandemic, job satisfaction

was also associated with the receipt of remuneration

by health workers in charge of providing services.

The Indonesian government, through Ministry of

Health Decree Number 447 of 2020 concerning

Provision of Death Incentives and Compensation for

Health Workers Handling COVID-19, has regulated

the mechanism and number of incentives for health

workers during the pandemic. This study not conduct

in-depth research on the number of incentives

received by health workers, but it is believed that the

incentives received in providing services during the

pandemic season will be able to shape health

workers’ job satisfaction. Previous study results also

discovered that remuneration for nurses had a direct

effect on job satisfaction during the COVID-19

pandemic (Apriliani & Hidayah, 2020). This implies

that the Abiansemal District Health Center’s health

workers would have had job satisfaction in the good

category.

Health worker job satisfaction was found to have

a statistical relationship with mental workload (p <

0.004). Job satisfaction is conveyed as a match

between health workers’ expectations and realityin

The Relationship Between Job Satisfaction and Mental Workload Among Health Workers During the COVID-19 Pandemic in the

Abiansemal District

providing services during the COVID-19 pandemic.

Health workers at the Abiansemal District Health

Center mostly had a job satisfaction score in the good

category, indicating that their expectations fit their

reality. High job satisfaction will help workers view

work not as a burden, but as a task or obligation that

must be done. This will shape their perception to be

able to carry out their duties as well as possible

without considering the pandemic condition as an

additional mental workload in providing services.

In line with this study’s results and analysis,

(Inegbedion, et al., 2020) stated that there is a causal

relationship between job satisfaction and workload.

These two variables can influence each other.

Workload can shape job satisfaction and vice versa.

Rhythmic results were also presented by (Holland, et

al., 2019), where it was conveyed that there was a

relationship between workload and job satisfaction,

where a significant increase in workload can be the

reason someone leaves their job. In line with these

results, (Goh, et al., 2020) also stated that there is a

relationship between job satisfaction and workload.

The results of previous studies found a causal

relationship between workload and job satisfaction;

in this study, it was found that nurses who had less

job satisfaction tended to experience an increase in

mental workload.

This study had its limits in that the questionnaire

was filled out via Google Form and no assistance was

provided during the process of filling out the

questionnaire, thus allowing misunderstandings to

occur presenting the risk of missed questions by the

selected respondents, thus causing bias in data

collection. Extreme values forced a change in each

variable’s categories from three to two categories to

allow for a decrease in the quality of data differences

that cause the analysis results to be less than optimal.

5 CONCLUSION

The majority of respondents experienced a

light/moderate mental workload in the face of the

COVID-19 pandemic at the Abiansemal District

Health Center (50.6%). The majority of respondents

also reported good job satisfaction (53%). There was

a significant relationship between health workers’ job

satisfaction and mental workload. Job satisfaction

was the most dominant factor influencing health

workers’ mental workload in the face of the COVID-

19 pandemic. Job satisfaction has a very important

role and needs to be improved to reduce mental

workload by providing awards and supporting

infrastructure for health services.

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The Relationship Between Job Satisfaction and Mental Workload Among Health Workers During the COVID-19 Pandemic in the

Abiansemal District