Work Satisfaction within Community Pharmacy Professionals

Work is a profession, a craft, or an activity in which man produces something central to his life. The job satisfaction is reflected simultaneously on the worker and the functioning of organizations. Workers more satisfied with their work have higher productivity levels, higher subjective well-being and well-being with life in general. Community pharmacy professionals are categorized in three professional categories: pharmacists, pharmacy technicians and technical pharmacy assistants. Work satisfaction was previously associated with gender, age, job category, years of service, remuneration, security concerning the future of the profession, relationships with colleagues and satisfaction with the professional category. The objectives of this study are to evaluate the satisfaction level of community pharmacy professionals and to identify associated factors. These professionals have revealed, in general, a level of moderated satisfaction. There were no significant differences between job satisfaction and gender, age, years of service, professional category and remuneration.


Introduction
Work is considered important to people's lives, having been studied for many authors [1][2][3][4][5][6][7][8] over time. Work has always been part of the lives of human beings and is a profession, a craft, or an activity in which man produces something paramount to their life [9]. This generates knowledge, personal satisfaction and economic development, which is why it has always been valued in all societies [10].
Job satisfaction began to be studied in the early twentieth century, but it was only given importance by the end of this century [1].
According to Locke (1976) [9], job satisfaction can be defined as the positive state or pleasure, resulting in the positive evaluation of the work by the individual. In other words, this is regarded as a pleasant emotional state from the evaluation of a work position [9]. All workers need to be satisfied with their work in order to contribute to the success of organizations [11].
One of the characteristics of job satisfaction is the relationship it has with health, decreasing the occurrence of serious diseases and increasing overall well-being. Indeed job satisfaction is reflected simultaneously on the worker and on the functioning of the organizations [12]. More satisfied workers present higher productivity, higher levels of subjective well-being and well-being with life in general [13]. Rather, dissatisfaction may trigger consequences as absenteeism or, at a more critical, the abandonment of the organization [1].
The community pharmacy is an important place of health care, particularly pharmacotherapy assistance to the population, since the pharmacy professionals are a more affordable healthcare for the general population which often resorted to their services. It is a place for the provision of health care, developing activities as drug preparation and patient assistance, always with the aim of serving the population with the highest quality [14].
In Portugal, community pharmacy professionals are grouped in three professional categories, including pharmacists and pharmacy technicians (both with bachelor degree in pharmaceutical sciences and pharmacy, respectively) and technical pharmacy assistants. It is important to refer that the legal status of such categories might differ from a country to another (i.e. in some countries there is no legal status of the pharmacy technicians and in some countries a pharmacy assistant means pharmacy technician) and accordingly the definitions may vary. At community level, pharmacists and pharmacy technicians are professionals whose responsibilities consist of the preparation of medicines, as well as participation in all stages of its circuit, ie, the acquisition, the receipt, storage and distribution of medicines and other pharmaceutical products, as well as advice users and other health professionals about drugs. In addition, they can still participate in prevention and health promotion, research and teaching. However, contrary to pharmacy technicians, pharmacists have special features like the fact that his presence is required in pharmacies and can acquire the position of technical director [15]. On the other hand, the technical pharmacy assistants cannot legally carry qualified functions of dispensing medications to the public, these being functions reserved to pharmacists and pharmacy technicians. For this, they have to be titled with the respective professional license or at least recorded in Infarmed (National Authority of Medicines and Health Products) or in ASCC (Central Administration of the Health System of the Health Ministry), according to the legislation of pharmaceutical practice [16]. In short, although they are distinct categories, all these contribute to professional advice and information about drugs and pharmaceuticals, to enhance the quality of life of patients and to ensure a rational, safe and effective medication [14].
Work satisfaction in these professionals seems to be associated with a wide range of variables, such as gender, age, job category, years of service, remuneration, security concerning the future of the profession, relationships with colleagues and satisfaction with the professional category, an important factor for a good performance [1][2][3][4][5][6][7][8].
Some studies about satisfaction among physicians, showed that these had a high job satisfaction, increasing with age, but also have a high level of satisfaction with career, years of service and gender (greater satisfaction in males), presenting, in general satisfaction [1,2]. A study on job satisfaction of Technical Diagnostics and Therapeutics also revealed that most were, in general, satisfied [3]. On the other hand, the study in Ethiopia indicated that practitioners felt mostly unsatisfied [4].
Another study on the satisfaction of nurses showed that they were satisfied in relation to the interpersonal relationship. On the other hand, the salary compensation contributed to dissatisfaction, occurring in the same professional group of health centers [5,6].
In relation to community pharmacy professionals, a study of pharmacists in the state of Rio de Janeiro as pointed that the more satisfied professionals were the ones with more years of service and an advanced age, however, salary compensation contributed to the professional dissatisfaction [7].
A study in Portugal with professionals from the community pharmacy, demonstrated that they were satisfied regarding the the professions' future and their profession in general, revealing dissatisfaction in the relationship with colleagues in respect of various professions. Pharmacists and pharmacy technicians showed the same level of satisfaction regarding the recognition of their work performance by others, unlike the technical pharmacy assistants. In the relationship with colleagues pharmacists have a lower level of satisfaction, unlike the pharmacy technicians who possessed a higher level of satisfaction [8].
Job satisfaction has attracted much interest from researchers, becoming a topic increasingly relevant and current, but due to its complexity, since it is a multidimensional concept and by being associated with various aspects of work and the various methodologies used to make its measurement, there has been no consensus among various researchers.
This research project has as its theme the professional satisfaction of community pharmacy, because it is a topic not yet explored. In addition, work satisfaction is reflected in the personal well-being, quality of services, as well as the proper functioning of the community pharmacy.
As such, the objectives of this work were to evaluate the degree of satisfaction of the community pharmacy professional and identifying associated factors.

Materials and Methods
This cross-sectional study was based on a non-probability sample consisting of 54 community pharmacy professionals (pharmacists, pharmacy technicians and technical pharmacy assistants), from community pharmacies in the North of Portugal, district of Viana do Castelo (Monção, Valença and Vila Nova de Cerveira) and the municipality of Bragança (Bragança city).

Instrument of Data Collection
For data collection, a questionnaire was structured in two parts. The first part included questions socio demographic and professional characterization questions and the second was the "Scale of Satisfaction with the work" developed by Pais-Ribeiro & Maia (2002) [17]. This scale consisted of 24 items, later added in six dimensions, namely, 1) Security for the future of the profession, 2) Support the hierarchy, 3) Recognition of the work done by others, 4) Physical conditions of work, 5) Relationship with colleagues and 6) Satisfaction with the profession (Table 1). For each item the respondent used a Likert scale ranging from 1 (Strongly disagree) to 6 (totally agree). To classify the level of job satisfaction in each dimension were used cutoff points by dimension. The cutoff points were calculated taking into account the number of items constituting each dimension and the midpoint (3.5) of the scale 1-6 likert used as a response option for each item of the questionnaire (Table 1).

Procedures
The questionnaires were given to professionals from community pharmacies in the District of Viana do Castelo (Monção, Valença and Vila Nova de Cerveira) and the District of Bragança (Bragança city), In Bragança, questionnaires were delivered by mail along with a written request, referring the importance, the objectives of the study and highlighting the voluntary nature of their participation, ensuring anonymity and data processing in an aggregate form.
The study included professionals from community pharmacy (pharmacists, pharmacy technicians and technical pharmacy assistants) who agreed to participate voluntarily. Individuals in clinical teaching and pharmacists who were both directors and owners of the pharmacy were excluded.
Regarding the collection of data, this took place in the period from January to March 2013. Data have been statistical analyzed, including descriptive statistics to characterize the sample, statistical tests for the correlation of variables, and internal consistency, using for this purpose, SPSS 20.0. Another analysis was made of the internal consistency of the responses of the respondents, ie, analysis of the proportion of the variability in responses by calculating Cronbach's Alpha (α).
To study the correlation of satisfaction with years of service, the Spearman correlation test was used. To verify the correlation of satisfaction dimensions with each other and with age, the R-Pearson correlation was used. The Student-t test was used to identify differences in overall satisfaction considering gender and locality. A one-way Anova allowed the verification of differences in overall satisfaction by professional category and remuneration. For all statistical tests was considered a significance level of 5%.

Results
A total of 69 questionnaires were collected 54, registering a response rate of 78.3%. Of all the professionals, 56.6% (30) were pharmacists, 37.7% (20) were technical pharmacy assistants and 5.7% (3) were pharmacy technicians (Figure 1). Regarding gender, 72.2% (39) were female and 27.8% (15) were male ( Figure 2). Advances in Pharmacology and Pharmacy 2(1): [6][7][8][9][10][11][12]2014 Respondents were aged between 25 and 64 years with an average of 36 years (SD ± 9.6) ( Figure 3). Regarding years of service it was observed an average of 13 years (SD ± 10.6), with a minimum of 1 year and a maximum of 42 years of service ( Figure 4).  In what concerns to salary, 64.6% (31) earned a monthly remuneration exceeding € 1,000, 29.2% (14) between 700 and 1000 € and 6, 3% (3) less than 700 € ( Figure 5). The internal consistency of the six dimensions, concerning satisfaction of the professional community pharmacy, presented a Cronbach alpha of 0.901, classifying as a very good consistency, since it is higher than 0.9. The Cronbach alpha values were between 0.659 and 0.927, so that the internal consistency is acceptable in all sizes, ranging from weak to very good.
With regard to the level of job satisfaction, respondents showed a moderate satisfaction in the "Security in the future of the profession" (Mean = 12.0, SD ± 2.96) and "Satisfaction with the profession" (Mean = 21.6, SD ± 5.04) and a high satisfaction in "Support of the hierarchy" (Mean = 13.8, SD ± 3.14), in "Recognition of the work done by others" (Average = 22 9, SD ± 3.59), in "Physical conditions of work" (Mean = 13.8, SD ± 3.19) and in "Relationship with colleagues" (Mean = 21.3, SD ± 3.00 ) ( Table 2). Respondents according to level of satisfaction with work have revealed, in general, a moderate level of satisfaction (Mean = 105.4, SD ± 15.6) ( Table 3). The distribution of respondents by level of satisfaction was as follows: 50% (27) showed a high level of satisfaction, 42.6% (23) have shown to have a moderate level of satisfaction and 7.4% (4) expressed a level of reduced satisfaction ( Table 3).
The test t-Student showed there are no statistically significant differences between the levels of satisfaction by gender (p value=0.266>0.05) ( Table 3).
With regard to age and years of service (with a p value of 0.786 and 0.706 respectively), these are not statistically significant regarding job satisfaction since these values are 0.05. Thus, job satisfaction is independent of age and service time (Table 4). With regard to job satisfaction and professional categories, it is not possible to establish a relationship between these variables as the p value was 0.287 (p value >0.05), with no statistically significant correlation. The same happens with pay (p=0.101), and there is therefore a correlation between pay and job satisfaction (Table 4). By analyzing the results of the Student's t-test, it was found that only two of the dimensions of job satisfaction showed no statistically significant differences, these being the "Relationship with colleagues" (p value= 0.874 >0.05) and "Recognition of the work done by others" (p value=0.120 >0.05). In other words, the location of the respondents (Viana do Castelo and Bragança) does not influence the relationship with colleagues or recognition of the work done by others (Table 5). For other dimensions, where statistically significant differences (since the p values were less than 0.05), it was found that professionals in Viana do Castelo were the most satisfied, since the averages were all higher than averages of professionals in Bragança (Table  5).   Table 6 show the items in which participants showed low and high satisfaction levels. The analysis was performed by calculating the midpoint Likert scale, which is 3.5, since this scale is composed of six dimensions. As such, all values below 3.5 are low levels of satisfaction and all values greater than or equal to 3.5 levels of satisfaction are moderate or high.

Discussion and Conclusion
During the study, some limitations have emerged, namely the distribution of the questionnaires. Indeed, about 22% of people did not accept to complete the questionnaire, despite the confidentiality and anonymity of the data, partly due to the fact that they have been delivered to the technical directors of pharmacies and subsequently distributed to workers. This reduced the size of the sample that became very small and compromised the results.
This study had the advantage of using a previously validated scale, it was not necessary to make a new scale that needed to be validated, thus proceeding directly to data collection.
This study showed no association between job satisfaction and gender, age, years of service, remuneration and professional category, in contrast to studies by other investigators [1,2,5,6,8].
However, the professional community pharmacy has revealed, in general, a moderate level of satisfaction (mean = 105.4, SD ± 15.6). This result is similar to the study of Diagnosis and Therapy Technicians in that, in general, they are presently satisfied [3]. However, the same was not true in the study done in Ethiopia, where unsatisfied professionals are revealed [4].
With regard to the location of these professionals, it was found that only two of the dimensions of job satisfaction showed no statistically significant differences, these being the "Relationship with colleagues" and "recognition of the work done by others." In relation to other dimensions it was found that professionals in Viana do Castelo are more satisfied.
Through this study, it was found that the respondents had a high level of satisfaction in the items "My relationship with my colleagues is good", "I like the people I work with" and "Treatment of my colleagues," unlike other study carried out in Portugal for Pharmacy Professionals [14], so good relationships with colleagues seems to be an important factor in job satisfaction. So ti should not be underestimated and is indeed necessary to establish a good work environment in the pharmacy, like any other organization in order to increase the satisfaction of the employees.
Moreover, the items that contributed to the dissatisfaction were "The progress in my career is very slow," "My profession is a profession with security for the future", "The kind of work gives few opportunities to progress" and "my job gives me opportunities to promote" mixed results with regard to the study conducted in Portugal in pharmacy professionals 14 that demonstrated satisfaction with the profession's future. These results reveal that the community pharmacy professionals feel insecure regarding their professional life, which reflected in their level of satisfaction. These results may be related also to the financial and economic situation of the country and the community pharmacies.
In summary, it can be said that the implementation of measures by the community pharmacy responsible, such as focusing on a good interpersonal relationship and motivating their employees with promotions, improves the quality of work as well as contributes to and enhances personal and organizational success.