research methodology in job satisfaction

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• Int J Health Sci (Qassim)
• v.15(4); Jul-Aug 2021

An empirical study on the job satisfaction and turnover intention of health-care professionals: Moderated moderation approach

Ghulam muhammad kundi.

Department of Health Administration, College of Public Health and Health Informatics Qassim University, Al-Bukayriyah, Saudi Arabia

Yasir Hayat Mughal

Fahad albejaidi, syed arif pasha, associated data.

All data sets are available with authors and it will be produced on reasonable request.

The objective of this study was to investigate relationship between job satisfaction and turnover intention of health-care professionals using the moderated moderating approach.

Explanatory sequential research design was applied. Non-probability convenience sampling technique was used to determine the sample size using Weiers formula. Scales adopted in the current study were validated through exploratory and confirmatory factor analysis. To test the hypothesis correlation, the hierarchical multiple regression was used. In the second stage, semi-structured face-to-face interviews from 35 interviewees were conducted and transcribed in Nvivo.

Job descriptive index, cognitive style index (CSI), cognitive style indicator, and turnover intention scales were found to be reliable. Furthermore, correlation analysis shows that the factors of job satisfaction were significantly correlated with turnover intention. In addition, findings of the interviews highlighted the importance of cognitive styles for increasing the job satisfaction of health-care professionals.

Conclusions:

Study concludes that the involvement of health-care professionals in making health-care policies enhances their job satisfaction that also reflected on their performance. Moreover, it also reduces their turnover intention of workforce.

Introduction

Turnover intention is a mental process and it needs a lot of thinking for decision-making. The decision of whether to leave the job or to stay at a job is very difficult.[ 1 , 2 ] There are direct and indirect costs associated with turnover intention. For example, the recruitment and selection process, training, and development process need time and a lot of cost paid by organizations to train new employees.[ 3 ] Meanwhile, it brings a lot of burden to existing employees for replacing the previous employee.[ 4 ] Organizations, especially in health care, are very difficult to retain employee[ 5 ] as it embroils a lot of thinking and decision-making how to reduce turnover intention. Allinson and Hayes[ 4 ] have developed cognitive style index (CSI). They have divided human mind into two parts; one is called left brain it is also called analytical and second part is called intuition or right brain. People with analytical style tend to collect information first and then they make decisions while intuitive people make decision on basis of their experience, judgment, and feelings.[ 6 ] Later on, Cools and Broeck[ 7 ] developed cognitive style indicator (CoSI). She has divided analytical style into three more parts and named those constructs knowing, planning, and creating for making decisions. It is believed that decision-making plays very important role in reducing turnover intention and increasing job satisfaction. Hence, it was very crucial to use a well-reported and validated instrument for decision-making in this study. Job satisfaction is an international phenomenon,[ 8 ] in the 1960s, more than 4000 articles were published on job satisfaction. However, it gains popularity after the theories given by Herzberg two factor theory, Vroom’s[ 9 ] theory, McGregor Theory, Theory X and Theory Y, and job characteristics model by Hackman and Oldham[ 10 ] Spector theory of job satisfaction.[ 11 ] All these researchers confirmed that there are few attributes of job satisfaction that is held constant, for example, salary, supervisor, promotion, colleagues, work, work environment, and job security.[ 12 , 13 ] Later on, researchers added more variables in theories of job satisfaction but for this study, researchers have chosen the above-mentioned variables.[ 7 , 13 ] There is an American researcher named Judge, Klinger, and Simon[ 13 ] conducted and reported many articles on job satisfaction. From the findings of this study, it was indicated from the results that instrument was found reliable and valid.[ 14 , 15 ] CoSI was only related with job and supervisor while CSI was not significantly related with any factor of job satisfaction. In addition, there was moderated moderating effect on satisfaction and salary only but no moderated moderation effect on other variables.[ 16 , 17 ] Themes emerged from qualitative interviews and findings also supported the quantitative findings. Based on the above literature, we hypothesized proposed the following: H 1 : There is a negative relationship between predictors and criterion variables, that is, satisfaction, salary, supervision, promotion, coworkers, work environment, work itself, CSI and CoSI, and turnover intention. H 2 : There is a moderated moderating effect of CSI, CoSI on factors of job satisfaction, and turnover intention.

Explanatory sequential research design

There are six research designs for mixed methods research; however, in this study, explanatory sequential research design is adopted, it has two stages of research. In the first stage, quantitative data were collected and analyzed, while, in the second stage, interviews were conducted for qualitative study and analyzed. Qualitative data were used to supplement, support, and strengthen the quantitative results. For quantitative study, positivism philosophy was employed whereas, for a qualitative study, a phenomenological approach was adopted as recommended by Creswell,[ 18 ] Collis and Hussey.[ 19 ] Pragmatism considers the happening of events to the situation. In a mixed method, the researcher is capable to solve the problem using both methods that help researchers to go deep into the problem or the issue understudy. Smith et al .[ 20 ] suggested the use of at least 10 interviewees for the interpretative phenomenological approach (IPA), however, in the second stage of qualitative analyses, we have used 35 interviewees which is above the Smith threshold, that is, 10 participants. The majority of scientists and researchers have used survey questionnaires for the assessment of behaviors and attitudes of individuals and organizations.[ 21 ] Thus, the survey is a common, popular, and easy method that allows the researcher to collect a very big data in less time and cost, therefore, in this study, survey was employed to collect data.

Population and sampling

The population of the study consisted of health-care professionals in the Riyadh region of Saudi Arabia that included 124 administrative and 23,246 staff members, thus, N of the study was 23,370. Since the population was big so it was impossible to contact every member to obtain their responses, therefore, sampling was essential. Probability and non-probability sampling techniques are given by researchers in health care. Both have their strengths and weaknesses.

In this study, researchers have used simple random stratified sampling, whereas, convenience sampling technique was applied to collect responses from the respondents. Weiers[ 22 ] has developed a statistical formula [SD 2 /((E 2 /Z 2 ) + (SD 2 /N))] for the finite population to determine sample size. Therefore, researchers have employed the Weiers formula. 95% confidence level is suggested by social scientists to determine the sample size for the finite population, which is equal to 1.96 z-value. Table 1 illuminates the procedure to determine the sample size of the study in hand.

Sample size

Measures and procedures

The job satisfaction instrument was adopted from Busari et al .[ 8 ] while turnover intention was taken Mughal et al. ,[ 4 ] and for CoSI, it was adopted from Cools and Broeck.[ 7 ] Therefore, the instrument developed by Cools and Broeck[ 7 ] was used in this study. The questionnaires were administered among administrators and staff. The questionnaire included four sections; first is about job satisfaction, second is about turnover intention, and the third is about the CoSI; all these sections were measured on a 5-point Likert scale. Job satisfaction has seven items, turnover has three items, and CoSI has 18 items, while the fourth section was demographic variables.

Data analysis

SPSS was used for quantitative data analysis. Exploratory factor analysis, bivariate correlation, and hierarchical multiple regression (HMR) were run to investigate the best fit model. Further for moderation, a procedure given by Aiken and West[ 23 ] is used. First, the variables were mean centered to reduce the multicollinearity problem. Then, interaction term was created to test moderation results. Thereafter, all variables were entered into HMR according to theoretical significance. Then, interaction plots were plotted one standard above the mean and one standard deviation below the mean. Nvivo 8 was used for qualitative data analysis; nodes were developed, where from themes emerged [Figures ​ [Figures11 11 and ​ and12]. 12 ]. Template analysis was used to analyze themes. Since, ideas and themes are parcel part of the respondents’ lives. Researchers also focus on the phenomenological flavor of themes. The current study was conducted in 2020.

Word cloud taken from NVIVO

Qualitative model taken from NVIVO

Work environment CoSI, CSI. CSI: Cognitive style index, CoSI: Cognitive style indicator

A total of 301 employees have participated in the current study. There were total 225 male participants, that is, 74.75%, 76 females have participated in the current study, that is, 25.2%. Majority of the participants belong to public sector health-care organization such as 198 (65.7%) while 34.2% belong to private sector organizations. Further analyses of results revealed that most of the professionals were foreigners and belong to India, Pakistan, Egypt, and Sudan, that is, 49% Indian, 33% Pakistani, 9.9% Egyptian, and remaining Sudan. In the first run of exploratory factor analysis, it is necessary to check the sample is adequate for EFA or not? This objective was accomplished by Kaiser-Meyer-Olkin (KMO) of all variables KMO for cognitive style was recorded KMO = 0.7 which is above 0.5 Hair et al .[ 24 ] for job satisfaction KMO = 0.775, for turnover intention KMO = 0.703. Bartlett’s’ test of sphericity for all variables was significant. Promax was used for rotation, as shown in Table 2 .

Factor loading pattern matrix

Table 3 presents the results of the correlation between predicting variables and the criterion variable. As expected, satisfaction is negatively related with turnover intention while positively but weakly related with CoSI and CSI, that is, r = 0.463, P < 0.05 and r = 0.91, r = 0.91, P > 0.05. Further examination of the relationship between salary and turnover intention is found moderate and negative but significant, that is r = −0.502, P < 0.05, but alary is not related to CoSI and CSI.

Correlation matrix

Further examination of results shows that promotion is negatively but significantly related with turnover intention, that is r = −0.332, P < 0.05, but promotion is negatively related with CoSI, that is r = −0.063, P > 0.05 while promotion is positively but insignificantly related with CSI, that is r = 0.028, P > 0.05. In the same way, further examination of correlation results shows that job/work is negative but significant related with turnover intention but also significant related with CoSI but weakly related with CSI, that is r = −0.412, P < 0.05; r = 0.134, P < 0.05; and r = 0.024, P > 0.05. Furthermore, examination revealed that coworkers/colleagues are also negative but significant related with turnover intention but weakly and positively insignificant with CoSI and CSI, that is r = −0.250, P < 0.05; r = 0.070, P > 0.05; and r = 0.050, P > 0.05.

Likewise, results revealed that supervisor is negative and significant but weak related with turnover intention also significant related with CoSI but insignificant related with CSI, that is r = −0.373, P < 0.05, r = 0.112, P = 0.05, and r = 0.012, P > 0.05. Furthermore, work environment is negative and significant with turnover intention but insignificant with CoSI and CSI, that is r = −0.304, P < 0.05; r = 0.105, P > 0.05; and r = 0.035, P > 0.05, so on the basis of discussion from correlation results, it is clear that our hypothesis 1 is substantiated and accepted. This means that there is a significant positive relationship between the predictors and criterion variables of the study, Table 3 .

There is different goodness of fit indices given by Hair et al . [ 24 ] for model fitness. Fit indices and their fitness range values are given in Table 5 .

Model fitness measurement model results

Table 4 and Figure 1 illustrate results for model 1 of the study. AMOS-SEM was used to develop a measurement model. In Figure 1 , measurement model is given. All the factor loadings are higher than 0.5 except one construct, that is, job it is 0.49, two constructs are deleted from analysis because of low factor loadings. All the goodness of fit index values met the required level, that is, Chi-square =2.847, RFI = 0.889, NFI=0.921, TLI = 0.925, CFI = 0.947, and IFI = 0.947, P < 0.01, all the values are in the specified range so the model if fit. Further analysis of results revealed construct reliabilities and average variance extracted values. Construct reliability for job satisfaction and CoSI is 0.786 and 0.706 while AVE value is 0.433 and 0.461 below 0.5 but construct reliability is met criteria, so reliability and validity are established.[ 25 ]

Measurement model. RMSEA: Root mean square error of approximation, GFI: Goodness of fit index, IFI: Incremental fit index, CFI: Comparative fit index, TLI: Tucker Lewis index, NFI: Normed fit index, RFI: Relative fit index. Chi-sq/df: Chi-square/Degree of freedom

Evaluating the model fit to fit before confirmatory factor analysis CFA

Figure 2 was developed for the structural model. In this model, job satisfaction is independent; cognitive style is also independent (moderator is considered independent) and turnover intention is criterion variable. Table 6 shows the goodness of fit indices. It is found that model is fit, and all the goodness of fit indices are in the specified range, that is, χ 2 = 2.847, RFI=0.889, NFI=0.921, TLI=0.925, CFI=0.947, IFI =0.947, and RMSEA=0.078. Further analysis of results revealed that correlation between job satisfaction and cognitive style is r = 0.17, P < 0.01, and impact of job satisfaction on turnover intention is beta β = −0.64, P < 0.05 and β = 0.20, P < 0.05 is also significant and R 2 = 0.41 it means that job satisfaction and cognitive style show variance on turnover intention 41%. It means that there is a negative impact of job satisfaction on turnover intention and the positive impact of cognitive style on turnover intention.

Structural model. RMSEA: Root mean square error of approximation, GFI: Goodness of fit index, IFI: Incremental fit index, CFI: Comparative fit index, TLI: Tucker Lewis index, NFI: Normed fit index, RFI; Relative fit index. Chi-sq/df: Chi-square/degree of freedom

Moderating effects of cognitive style on job satisfaction and turnover intention were also checked in AMOS-SEM. Results are highlighted in Figure 3 , it is found that job satisfaction has a negative impact on turnover intention, that is, β = −0.81, P < 0.05, while cognitive style has positive effect β = 0.10, P < 0.05, an interaction term was created by multiplying job satisfaction and cognitive style β = 0.24, P < 0.05, R 2 = 0.37 it means job satisfaction, cognitive style, and interaction term shows variance on turnover intention 37%. Next HMR is used for testing hypothesis 8, that is, there is moderated moderating effect of CoSI and CSI on job satisfaction factors and turnover intention. This moderated moderation results are also known as three-way interaction. All seven independent variables and their three-way interaction results are presented in Table 7 .

Moderation model

Moderated moderation results

In this study, CoSI is used as a moderator and the CSI is used as a moderated moderator. First examination of three-way interaction done with satisfaction CoSI and CSI and turnover intention. The results revealed that the interaction term is significant and ∆R 2 is also significant it means that there is moderated moderation and CSI does act as a moderated moderator on the CoSI, satisfaction, and turnover intention. Three-way interaction was conducted using the same procedure and found that CSI does not act as a moderated moderator on CoSI, coworkers, and turnover intention, there is no significant interaction term and ∆R 2 is also not significant although there is changed in ∆R 2 is recorded.

Further examination of the results revealed that there is moderated moderation occurs on the relationship between CoSI, promotion, work, work environment, and supervisor because all interaction terms were insignificant and there is no significant change in recorded in ∆R 2 but when CSI is used with salary and turnover and CoSI it does acts as moderator because interaction term is significant and ∆R 2 is also significant so CSI acts as a moderated moderator on CoSI salary and turnover intention so our hypothesis 2 is partially accepted for satisfaction and salary. Table 7 highlights the moderated moderation result of this study.

To interpret the interactions, all three-way interactions were plotted, with cut values of one standard deviation below the mean and one standard deviation above the mean on each moderator variable. Examination of the first plot revealed that the CSI, that is, CSI is acting as a moderated moderator on CoSI, that is, COSI.

From the plot, it is also revealed that low CoSI and high CSI interact with high CoSI and high CSI. Hence, this plot [ Figure 4 ] is consistent with the results shown in Table 3 for satisfaction. Further analysis of results shows that low COSI and low CSI fully moderate the relationship between salary, turnover intention, and CoSI. Hence, this plot [ Figure 5 ] is consistent with the results shown in Table 7 for salary.

Satisfaction CoSI, CSI. CSI: Cognitive style index, CoSI: Cognitive style indicator

Salary CoSI, CSI. CSI: Cognitive style index, CoSI: Cognitive style indicator

Similarly, examination of the plot [ Figure 6 ] shows that CoSI and CSI interact with each other, but these two variables do not interact with coworker and turnover intention so three-way interaction does not exist in this Figure 6 . Further examination of plot [ Figure 7 ] indicated that high CoSI and high CSI and high CoSI and low CSI interact with promotion and turnover intention but low COSI and low CSI do not interact so there is no three-way interaction exists. Further examination of plots revealed that Figures ​ Figures8 8 - ​ -10 10 also consistent with regression results.

Coworkers CoSI, CSI. CSI: Cognitive style index, CoSI: Cognitive style indicator

Promotion CoSI, CSI. CSI: Cognitive style index, CoSI: Cognitive style indicator

Supervisor CoSI, CSI. CSI: Cognitive style index, CoSI: Cognitive style indicator

Work CoSI, CSI. CSI: Cognitive style index, CoSI: Cognitive style indicator

In this study, we have used 35 interviews, whereas Creswell[ 27 ] Smith et al .[ 29 ] suggested the use of at least 10 interviews for qualitative analysis. Furthermore, Silverman[ 25 ] suggested that in qualitative research, qualitative data must be natural. There should be no coding and the researcher is not allowed to minimize data. Semi-structured interviews are the best source for qualitative study as in this study researchers aimed to understand the phenomena in-depth, additionally; this method allows the interviewees to ponder freely on the issues. In the first instance, researchers got the consent of all the interviewees then an interview guide was provided to them as Rubin and Rubin[ 26 ] considered an interview guide as the scaffolding of the interview. The date and time for the interview were fixed mutually as practiced by Smith et al. ,[ 20 ] and interviews were recorded suggested by IPA. All interviews were transcribed verbatim. As asserted by Remenyi et al. ,[ 27 ] the researcher has read transcription thoroughly and made necessary corrections to make sense of it. Below is the narration and analyses of the interview data. Different questions were asked from interviewees about different attributes of their current job. Interviewees respond in the following manner: “Regarding salary my package is according to government rules and you know in public sector rules are already defined for each cadre and scale. So, salary is not an issue.” Another respondent explained “My package is attractive, and I am happy with this package, but I am not satisfied from the workload in this organization that is beyond the capacity, sometimes, I have to complete the work of my colleagues.” Other interviewees highlighted the issue of inter-relationships. Their concerns are as under “Relationships with colleagues are fine but my senior colleagues are not supportive. If I need equipment and consumable office supplies, I have to wait a few weeks or even a month. Although I know they have their limitations as they have to follow the rules, and they cannot buy from their own money since they have to ask the purchase department to make things available that is why it takes time. Efficiency of work is concerned, comparatively; the progress of work is slower than the private sector.” Other attributes of job satisfaction are highlighted in this way as under: “Work environment is good, yet promotion policies are inflexible, you know you have to fulfill the criteria for promotion, once you fulfill it, then you will get it” one of the respondents discussed about job security that “Job security in the public sector is very high since these are tenured jobs… you can easily work for whole life…. and nobody can disturb you if your conduct is aligning with the rules of business.” Responses of respondents regarding turnover are mentioned below. “I don’t have the intention to leave that job in future I am satisfied with my current job.” Other respondents highlighted their concerns in this way… “Since I am working in public sector organization so I have no intention to leave that job, however, if I get a better opportunity, then I could decide to move.” Cognitive style is used for making decisions. Different cognitive styles were used by researchers to know their role in decision-making, therefore, CSI and CoSI were used in this study. Respondents were of the view that: ”First I try to find the reason of problem… and it is better to know the history and background of the problem then you are better able to find the better solution, so I used to analyze the situation first as you know, we all are human beings and we have emotions and feelings so sometimes we cannot control our feelings and, in such situation, I use to make spontaneous decisions. However, I am intuitive by nature.” This study has some limitations which can affect some potential areas. First, the sample size of this study is small and collected from health-care organizations only and that to in Riyadh region, thus findings of this research could not be generalized to other sectors such as banks and universities, therefore, it will be better if future studies may use large sample size. Second, this study is quantitative; future studies can use mixed methods and longitudinal data for more thought provoking results. The third limitation is methodological limitations. This study has used two moderators, whereas, future studies can use multiple or series of mediators to come up with novel results and findings. Other dimensions of cognition such as feelings, emotions, and judgment can be used in future studies.[ 28 , 29 ]

Conclusions

It is imperative for the health-care organizations to enhance the satisfaction of their professionals by applying different strategies for involving them in decision-making policies, this not only increases their job satisfaction but also reduces turnover intention of workforce. Furthermore, management and leadership of the health-care professionals play very important role in increasing the job satisfaction of their professionals.

Authors’ Declaration Statements

Ethical approval.

The current study was carried out without receiving any funding and was approved by Qassim University Ethical Committee.

Data availability

Authors’ contributions.

G.M.K and Y.H.M participated in manuscript drafting, conceptualization, the idea of study design, and methodology. F.A and S.A.P.: Perform review, editing, formal data analysis, and validation. All authors have read and agreed to the published version of the manuscript.

Acknowledgments

Authors acknowledges to all study subjects for their active participation to complete the study.

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JOB SATISFACTION AND EMPLOYEE PERFORMANCE: A THEORETICAL REVIEW OF THE RELATIONSHIP BETWEEN THE TWO VARIABLES

In today's increasing competitive environment, organizations recognize the internal human element as a fundamental source of improvement. On one hand, managers are concentrating on employees' wellbeing, wants, needs, personal goals and desires, to understand the job satisfaction. And on the other hand, managers take organizational decisions based on the employees' performance. The purpose of this study is to identify the factors influencing job satisfaction and the determinants of employee performance, and accordingly reviewing the relationship between them. This study is an interpretivist research that focuses on exploring the influence of job satisfaction on employee performance and vice, the influence of employee performance on job satisfaction. The study also examines the nature of the relationship between these two variables. The study reveals the dual direction of the relationship that composes a cycle cause and effect relationship, so satisfaction leads to performance and performance leads to satisfaction through number of mediating factors. Successful organizations are those who apply periodic satisfaction and performance measurement tests to track the level of these important variables and set the corrective actions.

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The Relationship Between “Job Satisfaction” and “Job Performance”: A Meta-analysis

• Original Research
• Published: 24 August 2021
• Volume 23 , pages 21–42, ( 2022 )

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• Ali Katebi 1 ,
• Mohammad Hossain HajiZadeh 1 ,
• Ali Bordbar 1 &
• Amir Masoud Salehi 1  

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The purpose of this meta-analytic research is to obtain a clear and unified result for the relationship between job satisfaction and job performance, as previous research has shown contradictions in this regard. A total of 913 articles in both English and Persian languages were obtained from four databases, and finally, 113 articles with 123 independent data were selected and analyzed. The random-effects model was adopted based on results, and the analysis resulted a medium, positive, and significant relationship between job performance and job satisfaction ( r  = 0.339; 95% CI = 0.303 to 0.374; P  = 0.000). Finally, the country of India was identified as a moderator variable. The publication, language, selection, and citation biases have been examined in this study. Increasing and improving the job performance of employees have always been an important issue for organizations. The results of this study can be useful for managers in different industries, especially for Indian professionals in both public and private sectors, to better plan and manage the satisfaction and the performance of their employees. Also, Indian scholars can use these results to localize the global research in this regard.

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Acknowledgements

We would like to express our special thanks and gratitude to prof. Gholamreza Asadollahfardi for sharing his pearls of wisdom and experience with us to improve this research. We are immensely grateful to him for his comments on an earlier version of the manuscript. His insightful comments and suggestions have truly shined a light on our path and helped us to achieve better and brighter intuition.

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Katebi, A., HajiZadeh, M.H., Bordbar, A. et al. The Relationship Between “Job Satisfaction” and “Job Performance”: A Meta-analysis. Glob J Flex Syst Manag 23 , 21–42 (2022). https://doi.org/10.1007/s40171-021-00280-y

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Exploring job satisfaction in fitness franchises: a study from a human talent perspective

• Mario Alberto Salazar-Altamirano 1 ,
• Esthela Galván-Vela 2 ,
• Rafael Ravina-Ripoll 3 &
• Maria Rubi Bello-Campuzano 2  

BMC Psychology volume  12 , Article number:  489 ( 2024 ) Cite this article

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This qualitative study investigates job satisfaction and its impact on the performance of human talent in fitness club franchises in Mexico, based on six semi-structured in-depth interviews conducted in October 2023. The research highlights that internal communication is the primary factor influencing job satisfaction, followed by interpersonal relationships and organisational climate. These findings imply that enhancing internal communication and fostering healthy interpersonal relationships can significantly improve employee well-being and job performance. The study aims to understand job satisfaction from the human talent perspective, focusing on the factors that affect their satisfaction and performance. The insights gained can inform strategies to improve work life quality and industry efficiency in Mexico, serving as a benchmark for future research and a strategic tool for human resource management in similar organisations.

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Introduction

The success of fitness club franchises in Mexico relies on several critical factors, including advanced technology, high-quality facilities, and, crucially, highly trained and satisfied human talent [ 1 ]. Attention to human talent, grounded in ethical, scientific, and human principles, goes beyond technical aspects to foster deep satisfaction among both franchise staff and clients [ 2 , 3 ].

Job satisfaction in Mexican fitness franchises involves a complex interaction between human talent and customers [ 4 ]. As defined by [ 5 ], job satisfaction is inherently linked to the interaction between individuals and their work environment. This 'emotional dance' affects both staff performance perceptions and customer experiences within their daily fitness routines [ 6 ]. The satisfaction level of human talent reflects individual well-being and serves as a crucial indicator of service quality and effectiveness [ 7 ]. However, assessments often prioritise client perceptions, overlooking the significant efforts of staff in maintaining service excellence.

Research highlights the importance of service quality for both customer and staff satisfaction in fitness franchises [ 8 ]. Conversely, other studies indicate rising dissatisfaction among fitness professionals due to a lack of recognition, autonomy, and task overload [ 9 ]. Internationally, job dissatisfaction has increased due to worsening working conditions and higher workloads, with the World Health Organization (WHO) warning of negative impacts, including demotivation and decreased service quality [ 10 ].

In Mexico, labour policies have significantly influenced the fitness industry. Specifically, a lack of human talent planning and labour reforms have led franchises to focus on welfare, often neglecting their responsibility to preserve the health and well-being of their staff [ 11 ]. According to INEGI's MOPRADEF, in 2021, 39.6% of Mexico's adult population reported being physically active, with a notable increase in those using private facilities [ 12 ]. These statistics underscore the relevance of physical activity in the Mexican adult population.

Furthermore, the 2030 Agenda and the Sustainable Development Goals (SDGs) emphasise the urgent need to address human talent well-being [ 13 ]. Job dissatisfaction extends beyond the workplace, leading to burnout, chronic stress, and mental health issues [ 14 ]. Addressing this phenomenon is therefore a moral duty and a social investment in creating a healthier and more productive work environment [ 15 ].

Research objectives

This study aims to explore job satisfaction in fitness franchises in Mexico, focusing on the following objectives:

Understand human talent perceptions and their impact on performance.

Analyse factors influencing job satisfaction.

Provide insights to improve work life quality and industry efficiency in Mexico.

This relationship has been evidenced in previous studies showing that job satisfaction is significantly related to higher employee performance [ 16 ].

Research questions

What factors influence job satisfaction in this environment?

How are professional development opportunities and working conditions linked to job satisfaction?

What challenges or improvements can enhance job satisfaction?

This research serves as a benchmark for future studies and a strategic tool for human resource management by offering a holistic perspective. Despite extensive literature on job satisfaction, this study uniquely focuses on an international fitness club franchise, providing valuable insights into a specialised context. The re-engineering of human resource strategies, including high-performance work practices, is essential for maintaining employee efficiency and well-being during and after the pandemic [ 17 ].

Theoretical framework

Job satisfaction.

Job satisfaction is fundamental to organisational psychology and human resource management [ 18 ]. It refers to the degree of contentment, well-being, and gratification that employees experience in their workplace [ 19 ], encompassing various aspects such as interactions with colleagues and superiors, working conditions, career development opportunities, remuneration, and job security [ 14 ].

Understanding job satisfaction is crucial as it directly impacts multiple organisational aspects [ 1 ]. Satisfied employees are more productive, committed, and loyal to the company [ 20 ]. Additionally, job satisfaction can influence the quality of an organisation's products or services [ 21 ], making it a critical factor for a company's success and effectiveness [ 22 ].

Measuring job satisfaction is essential in human resource research and management. Methods include surveys and questionnaires to obtain quantitative data on aspects such as work environment, interpersonal relationships, and working conditions [ 23 ]. In-depth interviews and direct observations capture subjective dimensions like employees' emotions and personal experiences [ 24 , 25 ]. Combining these approaches allows researchers to gain a comprehensive and contextualised understanding of job satisfaction, crucial for addressing its complexity and effects on employee well-being and organisational performance [ 26 ].

Several authors, such as [ 27 ] and [ 28 ], have highlighted the importance of researching and addressing job satisfaction across different contexts and sectors, as the needs and expectations of employees can vary widely. In the context of fitness club franchises in Mexico, it is essential to consider industry-specific factors, such as the constant demand for specialised services and the importance of maintaining a healthy and motivating work environment [ 29 ].

There is also growing international awareness of the relationship between job satisfaction, strengthening institutions, and the broader economy [ 9 ]. Satisfied employees are more likely to contribute positively to economic productivity and social well-being [ 30 ]. This connection has increased interest in understanding and improving job satisfaction to strengthen institutions and promote sustainable economic development [ 18 ]. Therefore, job satisfaction is a central concept in the workplace, encompassing employee well-being and satisfaction. Its study is essential as it influences productivity, talent retention, and service quality. Moreover, its role in improving institutions and the economy is recognised.

Job satisfaction in fitness club franchises

The analysis of job satisfaction in fitness club franchises is of vital importance due to the unique characteristics of this sector [ 1 ]. These franchises operate in a highly competitive environment, where providing fitness and wellness services requires specialisation and faces constant demand [ 31 ].

Thus, job satisfaction plays a crucial role in customer experience, as there is a direct relationship between employee well-being and the quality of service provided [ 32 ]. Satisfied employees tend to provide a more friendly, committed and high-quality service, directly influencing customer loyalty [ 33 ].

In addition, fitness club franchises face the constant challenge of motivating and retaining their staff in a work environment often characterised by high employee turnover [ 34 ]. To maintain high service standards, human resource management plays a crucial role in implementing policies and practices that promote the satisfaction and well-being of human talent [ 35 ].

In short, job satisfaction in fitness club franchises is essential to ensure quality of service and customer loyalty in a competitive and constantly evolving industry. Understanding and managing job satisfaction in this context is critical to the success of these franchises in the fitness industry.

Contextualisation of job satisfaction for Mexico

Job satisfaction, a concept studied globally, reveals a unique dimension when examined within the specific context of Mexico [ 36 ]. Several economic, cultural, and social factors significantly influence how human talent perceives and experiences job satisfaction in this country [ 37 ]. This contextualised perspective underscores the importance of analysing job satisfaction within Mexico, considering its particularities and dynamics.

One of the main factors influencing job satisfaction in Mexico is the country's economic situation, characterised by significant variations in income levels and wealth distribution across regions and sectors [ 38 ]. This economic disparity directly impacts how employees value their employment and the working conditions they experience. Additionally, Mexico's rich and diverse culture plays a crucial role; values such as the importance of family, community, and personal relationships are fundamental. Loyalty to the company and solidarity among colleagues are highly valued, significantly influencing job satisfaction perceptions [ 39 ].

Moreover, Mexico grapples with distinct labour challenges, such as the prevalence of informal employment, high turnover rates in certain sectors, and the need to balance economic competitiveness with improved working conditions [ 40 ]. These challenges offer fertile ground for research aimed at enhancing job satisfaction within the country. Previous studies in Mexico have laid a solid foundation for understanding the intricate dynamics of job satisfaction. For instance, research by [ 39 ] has identified numerous factors that influence job satisfaction in Mexican firms that adopt work arrangements like telework. These factors encompass job responsibilities, company-provided training, relationships with supervisors, and workplace environmental conditions.

A recent study by [ 41 ] further elucidates job satisfaction in Mexico, demonstrating that human resource development, organisational culture, and leadership style significantly impact employee satisfaction. These factors function both independently and interactively, shaping employees' perceptions of their job satisfaction. This complexity underscores that job satisfaction arises from the dynamic interplay of multiple elements rather than a single factor. Consequently, an effective strategy to enhance job satisfaction must adopt a holistic approach, encompassing both individual and organisational aspects, to address the multifaceted nature of this phenomenon.

Methodology

To conduct this research, a qualitative approach with a phenomenological perspective was adopted to analyse job satisfaction factors in a fitness club franchise in Mexico. The study sample comprised six team members in various roles within the franchise, including six coaches, two front desk professionals, and one unit leader. Despite efforts to engage more participants, only six individuals could be interviewed in-depth, which required multiple attempts over several days in October 2023 at the franchise's premises.

The participants included one front desk professional and five-unit trainers, providing diverse perspectives and enriching the understanding of job satisfaction factors within the fitness franchise. This diversity allowed for a comprehensive exploration of the motivations behind job satisfaction in this context. The group consisted of two women and four men, aged between 25 and 29, reflecting some generational diversity and a predominance of men, hinting at possible gender trends within the workforce.

Data collection was conducted through semi-structured interviews, addressing thirteen key aspects ranging from the work environment to suggestions for improvement. Each interview lasted approximately 35 to 45 minutes, facilitating an in-depth exploration of participants' perceptions and experiences regarding their job satisfaction. The semi-structured interviews consisted of three stages: collecting sociodemographic information, posing introductory questions to ease participants into the discussion, and asking 17 key questions aimed at extracting detailed insights. Examples of these key questions included: ‘’How do you get along with your colleagues and bosses? (Why?)’’, ‘’Do you feel valued or appreciated? (Why?)’’, and ‘’Do you have any ideas or suggestions to make your job at the gym more satisfying?’’

During the interviews, an atmosphere conducive to free and detailed expression was meticulously fostered. The interview structure was flexibly adapted, allowing for adjustments based on the flow of conversation and the participants' willingness to share their insights. Emphasising a strong ethical foundation and strict confidentiality assured participants that their responses would remain anonymous, thereby encouraging honest and confident expressions. In several instances, participants provided concise answers, often limited to simple ‘’yes’’ or ‘’no’’ responses. To enrich these explanations and extract more detailed information, follow-up questions were immediately employed.

The collected information was analysed using ATLAS.ti 23 software, enabling coding and exploration of interview contents. The transcripts of the six interviews were imported into the software, where they underwent thorough analysis and categorisation. This study followed a specific unit of analysis for creating codes, examining the sentences in participants' responses. This methodological approach aligns with the research process proposed by [ 42 ] in 2019, based on Grounded Theory's three steps: open coding, axial coding, and selective coding. Importantly, the coding process was conducted inductively, meaning that codes and categories were derived directly from the data, allowing for a more objective analysis based on participants' responses.

After the data was entered into ATLAS.ti 23, the coding process for the interview segments began. Initially, 327 individual codes were identified. To streamline the organisation and interpretation of the data, ten primary codes were selected to serve as main categories. These categories were then used to classify and structure the related codes. Table 1 provides a detailed breakdown of the number of codes assigned to each primary category.

These categories represent the thematic organisation derived from the interviews, formed after generating and assigning codes to the interview contents. Emerging inductively, these categories reflect recurring themes in the collected data. The broadest category, ‘‘Work-Life Balance’’, encompassed the majority of codes, indicating its prominence in participants' discussions, followed by "Work Stress." Conversely, ‘’Job Experience and Perceived Job Satisfaction’’ had the fewest codes, suggesting this theme was less recurrent in the interviews. The following sections will analyse these categories in detail, providing a deeper understanding of the findings.

Work-life balance

The first segment explored in this analysis refers to the ‘’Work-life Balance’’ of human talent, revealed through the codes summarised in Table 2 within the same category. A prominent finding in this category emerged in response to the question, ‘’How do you balance your personal life with your work at the gym?’’ In this context, one of the interviewees shared her experience by stating, ‘’It is a daily effort; I organise my thoughts and focus on my work, leaving personal concerns aside. Sometimes occupational therapy and immersion in work support me in achieving this balance’’. In addition, it is essential to note that the support of a mental health professional has played a significant role in her search for work-life balance.

Furthermore, the relationship between work-family conflict and job satisfaction has been widely studied. Recent studies, such as [ 43 ], have shown that supervisor support can significantly moderate this conflict, improving employee job satisfaction.

Our analysis of human talent revealed a multitude of influential factors, such as work-life balance, time management, workplace conflict, flexibility, self-evaluation, professionalism, self-improvement, self-confidence, socialisation outside of work, mindfulness, reflection, autonomy, and occupational therapy. These factors align with previous research by [ 44 ] and [ 45 ], as well as the short questionnaire developed by [ 46 ], which incorporates most of these categories.

Work-life balance emerged as particularly significant. Within the fitness club industry, many participants expressed a passion for their work activities, which helps them achieve a harmonious balance between their professional and personal lives. For instance, one participant stated: ‘’It does not affect my life; on the contrary. I like and am passionate about what I do.’’ This sentiment echoes findings by [ 47 ], which highlight that work can significantly impact personal life, especially when it infringes upon free time. Such interference can disrupt the balance between work and personal life, influencing overall job satisfaction.

Moreover, [ 48 ] suggests that flexible working hours enhance autonomy in schedule management, promoting a more effective work-life balance. Conversely, a lack of flexibility can hinder achieving this balance, as evidenced by employees having to leave secondary jobs due to schedule adjustments. This situation underscores the need for employers to provide flexible working hours to support their employees' work-life balance and job satisfaction. To visualise the relationships and flow of categories and codes derived from our coding analysis, a semantic map was created. This map, based on each participant's input during the interviews, graphically represents the interconnectedness and dynamics of the data (Fig. 1 ).

Source: ATLAS.ti 23

Work-Life Balance category

In the analysis of work-related stress, research was conducted to characterise the perceptions and motivations contributing to work-related stress and the coping strategies employed by participants. Four of the six participants interviewed reported experiencing stress, while two reported not feeling stressed in their work environment. These findings are consistent with stress trends in the workplace in Mexico, where the situation is notably concerning.

According to recent studies, 60% of Mexican human talent report significant stress levels, adversely affecting their health and motivation at work. Consequently, Mexico is ranked as the country with the highest levels of work-related stress globally. Authors have noted that 63% of Mexicans have encountered stressful situations in their workplaces over the past two years.

During the interviews, various codes related to stress and the strategies used to manage it were identified. These codes are detailed in Table 3 . Notable terms among the codes include "stress," ‘’psychological therapy’’, ‘’suppression of emotions’’, ‘’absence of stress’’, ‘’self-care’’, ‘’emotional balance’’, ‘’relaxation’’, ‘’self-confidence’’, ‘’sociability’’, ‘’concentration’’, ‘’reflection,’’ and ‘’difficulties at work’’.

In work-related stress, the human talent interviewed presented significant stress levels. When addressing the question, "Do you feel that your daily work generates stress?" most participants answered in the affirmative. A representative example is the participant who shared: ‘’ Yes, I feel stress. There are times when we interact with vulgar people, and although we have to keep a friendly attitude, sometimes absorbing the bad mood and negativity of users affects us’’. In terms of strategies used to cope with work-related stress, some mentioned seeking psychological support to address this specific aspect. Others pointed out that they do not take interactions with users personally and seek to suppress their emotions as an alternative to avoid stress.

Therefore, the importance of addressing job stress in the context of fitness club franchises is highlighted by authors such as [ 49 ] in their work "Theories of Psychological Stress at Work." This chapter discusses various theories related to work stress, most notably the "Work Demand-Control-Support Model", which highlights the relevance of balancing work demands with control and support in the work environment. Finally, a semantic map has been draw to visualise and understand the flow of the category and the codes resulting from the analysis. This map is derived from the intervention and the information provided by each participant in the interviews (Fig. 2 ).

Work-related stress category

Given the significance of this issue and its impact on the health and well-being of human talent, it is crucial to address work-related stress promptly. This approach aligns with the Sustainable Development Goals (SDGs) of the UN 2030 Agenda, which advocate for decent working conditions and employee well-being as part of a sustainable future.

Communication

Effective internal communication is defined as the process of exchanging information, knowledge, and feedback between the unit leader or manager and the employees of the fitness franchise [ 42 , 50 ]. This category aims to understand the impact of internal communication on the organisation's work dynamics. Previous research has shown that effective internal communication can mitigate feelings of loneliness and rejection sensitivity in the workplace, thereby improving job performance and overall job satisfaction [ 51 ].

Table 4 presents the codes identified within the ‘’Internal Communication’’ category. Among the codes collected, the most recurrent was ‘’Lack of Communication’’, which reflects a lack of effective communication between the leadership and the unit's employees. On the other hand, the least mentioned code was "Good Relationship with the Leader", suggesting that the relationship and effective communication with the leader are areas for improvement in this work context.

A representative example of this category emerged when participants were asked, "Does your boss communicate clearly and professionally about what he expects from you and provide useful feedback on your work?" One participant responded, ‘’He does not talk to me, he does not give me feedback, he is freezing. However, I think it is a personal issue, as I notice he is more open with others’’.

When asked if they knew whom to turn to in case of problems or unusual situations, one participant stated, ‘’We can communicate with someone, but we are not sure if we will get a solution. They listen to us, and that is it. If we have a serious problem with our leader, we doubt if anyone can offer us a solution’’.

This scenario reflects the perception of limited effectiveness in problem-solving within the organisation, which could influence job satisfaction and the perception of support from the company. These findings are consistent with previous research by [ 52 ] and [ 38 ], which highlight the correlation between effective internal communication and several critical aspects, such as feedback, problem-solving, and effective leadership. These factors directly influence human talent's perception of their work environment and job satisfaction, underscoring the importance of internal communication in organisations.

Moreover, organisational climate significantly impacts employee satisfaction and overall performance. Effective internal communication is essential for maintaining a positive work environment, facilitating better relationships between employees and management, and resolving conflicts. Research [ 53 ] indicates that emotional intelligence (EI) significantly impacts employee performance and engagement through job satisfaction, acting as a mediator in these relationships. This underscores the importance of EI in fostering a supportive and productive organisational climate. Developing EI within teams can lead to improved job satisfaction and performance, highlighting the need for effective internal communication strategies.

These findings also support the Communication as Management Theory, which considers internal communication a strategic tool for managing organisations. This theoretical approach views internal communication as a means to promote the participation of human talent, improve the work climate, and strengthen organisational culture. To illustrate this, a semantic map was created, based on participant interviews, to graphically represent the interconnectedness and relationships between categories and codes derived from the authors' coding analysis (Fig. 3 ).

Internal Communication category

Work motivation refers to the reasons, desires and needs that drive human talent towards achieving their goals and objectives in the work environment [ 54 , 55 ]. This concept is not limited only to internal or external factors. However, it encompasses an amalgam of elements that impact the commitment, satisfaction and effort employees are willing to invest in their work [ 56 ].

Given the above, within the scope of the work motivation category, six distinct codes have been identified, detailed in Table 5 : demotivation, assertive motivation, lack of leader support, lack of leader recognition, performance appraisal and self-motivation. These codes capture work motivation's complex dynamics, as reflected in the interviews.

When human talent was asked if they felt valued or appreciated in their work environment, two participants felt a lack of value and appreciation. This perception is based on the need for a structured method to evaluate performance and the lack of recognition by their leader or manager. One interviewee ‘’ highlighted the lack of an evaluation process, both internal and external, to track their progress". This response highlights the concern of employees about the lack of recognition and appreciation of their work’’.

On the other hand, when it was explored whether they felt that their team whether colleagues or leader, gave them support and motivated them to improve in their work, 100% of the participants stated that they felt support and encouragement from their team. However, support from their leader was less recurrent, with only 20% of respondents agreeing that they felt this level of support. For example, one participant: ‘’ highlighted that not all colleagues offer the necessary support and some lack support. Despite this lack of support from some peers, those with whom he has good relationships motivate him and assist him to the best of their ability’’ . It underlines the relevance of team support in employee work motivation.

This aspect becomes even more relevant when we link it to the Job Demands-Resources Theory, developed by [ 57 ] in 2014, and more recent research, such as the findings of [ 58 ] in 2020. This widely recognised theory offers an insightful view of how job demands and resources can impact the motivation and, thus, job satisfaction of professionals.

In addition, the absence of an appraisal system that allows employees to measure their performance and compare themselves with their colleagues has contributed to this moderation in motivation. An objective rating system and constructive competition among staff could significantly drive increased motivation in the work environment. This finding highlights the importance of establishing feedback and appraisal systems that empower human talent to reach their full potential and sustain motivation in the workplace. To better visualise and understand the interconnectedness of the categories and the resulting codes, a semantic map was created (Fig. 4 ).

Motivation category

Professional development

Professional development in the workplace can be defined as the process by which employees expand their knowledge, skills and experiences to advance their careers [ 59 ]. This expansion involves acquiring new skills and qualifications and the possibility of achieving higher levels of responsibility and leadership within the organisation.

Then, within the professional development category, several codes were identified that reflect employees' experiences and perceptions (Table  6 ). Among the most recurrent codes are professional growth, occasional training, and personal development, change of location, personalized service and performance appraisal. These elements play a vital role in the perception of development opportunities within the company.

When participants were queried about their perceived opportunities for growth and development within their roles, the responses were notably diverse. Five participants recognised the presence of growth opportunities in their current positions. However, they noted that such prospects could be enhanced if they were open to relocating, either to another city or a different unit within the same city. One participant illustrated this sentiment by mentioning, “The possibility of connecting with other employees or changing location to access new development opportunities”.

Furthermore, when participants were asked about the availability of training or educational opportunities to enhance their job skills, there was a general consensus that such opportunities were provided. However, these were predominantly in the form of virtual courses and training videos. One participant noted, “ That area of opportunity in our area, continuous training, is missing” , underscoring the concern for the quality and relevance of virtual training and the need for more effective training programmes.

These insights align with the notion of providing targeted training to develop specific work-related competencies, as proposed by [ 60 ]. This approach suggests better competence indicators can be obtained by assessing successful life outcomes and the competencies that contribute to achieving them. By identifying relevant criteria, assessing communication skills, and considering both professional and personal success, a holistic and practical view of competence and skills development can be achieved, thereby fostering general growth in both work and life. To map and visualise the relationship and flow of categories and codes effectively, a semantic map was created based on the interview data (Fig. 5 ).

Compensation and benefits

Salary compensation and benefits provided to organisational staff can be defined as the package of financial rewards and employment advantages that employees receive as part of their employment contract [ 61 ]. In this compensation category, six significant codes were identified: financial benefits, job benefits, turnover, working time, social support and quality (Table 7 ).

Therefore, it is essential to highlight that five interviewee’s expressed satisfaction with their salary compensation. They emphasised that, given their five-hour working day, they consider their remuneration fair compared to other fitness clubs. They agreed in response to whether they were happy with their salary and benefits. For example, one participant mentioned: “I think the salary is excellent, given the short working hours, and I have no complaints. I am satisfied in that sense”.

In contrast, the only counter-response came from a participant who said: "Better pay would be better. In a way, this system is designed to benefit both parties. Some may consider it unfair, but if we compare it to other companies or gyms in the same sector, we come out ahead in all aspects. Although it may be 50-50 or maybe not for some people, it seems fair."

In addition, an important finding occurred with two specific responses. One participant indicated that she was satisfied with her compensation but wanted to receive food vouchers or social support as part of her benefits. She commented, “We have a pretty good salary. However, as a franchise, we do not have food vouchers. Other units in Mexico and Monterrey offer food vouchers, which can benefit employees. Things like backpacks, thermoses, anything. We do not have that; that would be perfect”.

At this point, previous research has highlighted the importance of the geographical location in which the job is performed. It has been observed that, in Western countries, wage compensation is not considered a relevant factor influencing job satisfaction. In contrast, in developing countries, this variable is a positive and significant factor in job satisfaction, as evidenced in previous research, such as that carried out by [ 62 ]. These studies highlight how context considerably influences the perception of wage compensation and its relationship with job satisfaction.

Thus, the findings of this research contribute to Herzberg's two-factor motivation theory. This theory holds that there are hygiene factors, such as compensation, which, when absent or inadequate, can cause job dissatisfaction [ 63 ]. On the other hand, motivational factors, such as recognition and career growth, drive job satisfaction and intrinsic motivation. The results of this study support the importance of hygiene factors, as fair wage compensation was identified as a crucial element for employee job satisfaction [ 62 ]. It underlines how adequate compensation can act as a motivating factor and contribute to employee well-being and job satisfaction in the context of this study. Finally, the authors developed a semantic map to visualise and understand the flow of categories and codes resulting from the coding analysis (Fig. 6 ).

Compensation and Benefits Category

Interpersonal relations

“Interpersonal Relationships in the Workplace” refers to the interactions and bonds between individuals in the work environment [ 64 ]. This category encompasses relationships between work colleagues, managing potential interpersonal conflicts, forming friendships in the workplace, effective team collaboration, and employees' interaction with their leaders or superiors [ 65 ].

It is also important to note that these relationships significantly influence job satisfaction and organisational efficiency [ 66 ]. The codes associated with this category, such as “Good relationship between colleagues”, “Interpersonal conflicts”, “Friendship”, “Teamwork", and “Relationship with the leader” (see Table 8 ), summaries and capture the essential dimensions of interpersonal relationships in the work context.

To this end, all participants expressed having positive relationships with their co-workers, although they stressed that this does not apply uniformly to all their colleagues. For example, when asked how they get along with their colleagues and superiors, one participant explained: "I have a good relationship with my leader. I try to distinguish between being a boss and a colleague, as we have had interactions outside of work but in the work environment. Overall, I can say it is good, but to be honest, I do not get along with everyone. If you were to mention a name, I could not stand it at all. There are one or two colleagues in my work group that I do not like, and I have no interest in becoming friends with them."

Similarly, another participant expressed the following in response to the same question: "I try to approach my relationships with co-workers in both a professional and friendly manner to maintain a harmonious balance. However, in terms of 100% of the staff, I think I can get along very well with 80%. However, with the remaining 20%, we have experienced situations that have made it difficult to establish a good professional and personal relationship".

Therefore, it is supported by previous research by [ 67 ], who found that friendships in the work environment significantly positively impact decision-making and motor task performance. This finding underscores the relevance of cultivating friendly relationships in the workplace, as they are significantly correlated with decision-making, as well as with job satisfaction and productivity.

Furthermore, the results obtained in this study can be related to Social Exchange Theory. This theory focuses on social interactions as an exchange process in which people seek to maximise rewards and minimise costs in their interpersonal relationships [ 6 ]. It argues that relationships are maintained when people perceive that they are gaining benefits and broken when they perceive inequalities in these exchanges [ 68 ]. Finally, we drew a semantic map to identify and visualise the flow of categories and codes resulting from the authors' coding analysis (Fig. 7 ).

Category Interpersonal Relationships

Working environment

The work environment or organisational climate in the business environment refers to the set of factors, perceptions and conditions that characterise the work atmosphere within an organization [ 69 ]. In this context, the category of “work environment” has been coded into five (Table 9 ): “work conflicts”, “good work environment”, “uncertainty”, “toxic work environment” and “task overload”.

To explore the work environment category, participants were asked: "How would you describe the atmosphere in the gym?" The findings revealed that five of the six participants mentioned the presence of work conflicts, primarily attributing these conflicts to leadership and personal egos among colleagues. For instance, one participant pointed to "the leader's preference for some employees as a source of tension in the work environment." Another participant expressed uncertainty, noting: " The working environment can be improved; we can all improve it. One can interpret it as an average environment. Sometimes it is nice, and sometimes it is tense. The situation varies, depending on the circumstances."

A notable comment came from a participant who observed: "Preference is only given to certain people, and that is where it falls. Now, we doubt the word of the person who is guiding us. There is a lot to be desired because some demand more from us than others, complicating the environment." This indicates that individuals who do not have a good relationship with the leader are often assigned more tasks. These testimonies highlight several dynamics and challenges influencing the work environment in the gym, emphasising the need to address these aspects to improve job satisfaction and productivity.

Research by [ 70 ] in 2001 supports this principle, finding that project or organisational success is inversely related to staff perceptions of personal and environmental threats. Additionally, specific organisational characteristics such as promoting free expression, encouraging questioning, participation in goal setting, innovation, and intrinsic job satisfaction were positively associated with project success. Conversely, factors such as organisational change and conflict were negatively associated with project success.

Further research on Organisational Climate Theory underscores the impact of employees' collective perceptions of their work environment on their attitudes and behaviours. An organisational climate that fosters employee satisfaction, trust, and a perception of fairness tends to generate greater motivation and commitment among employees [ 21 , 71 , 72 ]. Employees who perceive their work environment as positive, fair, and satisfying are more likely to be motivated and committed to their work.

Also, organisational climate emerges as a significant factor in job satisfaction. The perception of organisational politics can be a major stressor that negatively influences work attitudes, as discussed in [ 73 ]. This study suggests that political skills and work ethics can help mitigate these negative effects, highlighting the importance of developing personal resources to manage internal politics and improve the work environment.

In summary, a work environment characterised by positive and fair perceptions can significantly contribute to the success of a project or organisation. Leadership plays a critical role in shaping, creating, and maintaining this positive work climate. Finally, a semantic map was created to visualise the relationships between the categories and codes derived from the interviews of the participants in our study (Fig. 8 ).

Work environment category

Tasks and responsibilities

The penultimate category, “Task and responsibilities”, delves into the many facets of employees' job responsibilities in their work environment. It is composed of several codes, including "customer service", "responsibility", "equal distribution of tasks", "work", and "contracted service" (Table 10 ). These codes contribute to understanding how job responsibilities impact job satisfaction and dynamics, revealing the relationship between employees' tasks and responsibilities and their organisational experience.

Then, the previously mentioned codes originated from the interview question: "What activities do you carry out in your job daily? In response, participants said, " The activities I carry out in general terms ask us to do customer care. Also, to make corrections to the clients, to see if the client needs a free service offered by the company to attend the client with high satisfaction and they can have a quality, a service well in accordance, what they pay additionally for the personalised ones". Within this response, it is evident that employees are fully aware that customer service is part of their priority responsibilities. In addition, they highlighted the provision of a personalised service that comes at an additional cost to customers.

Finally, when asked if they were satisfied with the tasks assigned to them in their job roles, one participant responded: "Yes, I always feel satisfied with what I am asked to do. Not myself. The job is too easy. The only thing is the recognition that you do it right, or you do it wrong. When it needs to be said , this testimony again highlights the critical role of recognition in the work environment, as despite feeling satisfied with the nature of his work, the participant yearns for more consistent recognition from management, suggesting the importance of valuing and rewarding employee contributions.

However, hhese findings align with Victor Vroom's Theory of Motivation and Expectancy. It is critical to note that while all participants understand their tasks and responsibilities, some express dissatisfaction due to the perception that they are working harder than their peers and lack recognition from their leaders.

Further examination of testimonies revealed that personalised services represent a significant part of their income and are performed outside their five-hour working hours. Notably, the fitness club franchise charges employees a fee for providing one-on-one counselling, causing discomfort among staff. Despite efforts to obtain the exact fee, none of the participants disclosed this information. Consequently, these findings highlight the importance of addressing recognition and additional compensation issues to promote employee satisfaction and motivation. Finally, a semantic map has been developed to visualise the relationship between categories and codes resulting from the coding analysis based on the interviews (Fig. 9 ).

Tasks and responsibilities category

Experience and perceived job satisfaction

The final category, entitled "Experience and Perception of Job Satisfaction", has been categorised based on the following codes: "Job Satisfaction", which reflects employees' happiness and well-being at work; “Job Dissatisfaction”, which denotes discomfort or dissatisfaction; "Social Interaction", which refers to relationships and connections between co-workers and leaders, and "Mixed Job Satisfaction", which encapsulates mixed or ambivalent feelings about work (Table 11 ). These codes represent crucial elements in the perception and experience of job satisfaction.

The categories mentioned above emerged from a question posed to participants: "What has been your work experience at the gym so far?" One participant responded: "So far, my work experience has been pleasant. I like this job very much. It is pretty simple. What I appreciate most is that I enjoy what I do; it is a real passion. Although we sometimes face challenges with complicated clients, we can handle everything. I am satisfied with my work." This response reflects the overall satisfaction and enthusiasm experienced by this participant in his role at the gym.

Moreover, another participant shared his perspective: "So far, my work experience here has been very satisfying. I think a lot of it is because I enjoy what I do. I could not say much more except that I love working here and am passionate. In short, my experience has been positive." This participant also expresses his satisfaction and appreciation for his work at the gym, highlighting the importance of passion in his work experience.

However, it is noteworthy that one participant expressed a variable level of satisfaction, stating: "My work experience so far is pleasant. It is a job that I like. It is a straightforward thing. The simple fact is that I like what I do, and I am passionate about it. Although sometimes there are difficult days, some clients are complex, but nothing that cannot be handled." This employee generally appreciates his work, although he acknowledges occasional challenges and demanding clients in his work experience.

Therefore, these findings align with BF Skinner's "Reinforcement Theory," which focuses on how rewards and punishments shape human behaviour [ 74 ]. In the context of labour relations, we can observe the application of positive reinforcement, negative reinforcement, punishment, and extinction. For example, the lack of recognition by leadership aligns with the concept of extinction, where a previously reinforced behaviour is no longer reinforced, resulting in decreased behaviour.

Furthermore, employees' perception of recognition is directly related to positive reinforcement, as recognition presents a pleasant stimulus after desired behaviour. These findings underscore the importance of understanding how rewards and punishments, in the form of recognition and non-recognition, affect employee satisfaction and behaviour in the work environment. While Reinforcement Theory is not without controversy, its influence endures in management and psychology, offering a valuable lens for analysing and improving work dynamics. Finally, a semantic map has been developed to visualise and understand the relationships between the categories and codes derived from the coding analysis based on participant interviews (Fig. 10 ).

Experience and perceived satisfaction

To culminate and enrich our research, we have included a word cloud (Fig. 11 ). This word cloud plays a crucial role in understanding the categories and codes generated through the three-step grounded theory approach. This visual tool aids in grasping the thematic elements and their interconnections, providing a clearer insight into the qualitative data analysis and enhancing the comprehensiveness of our study.

Cloud of the most representative words in the interviews

Analysis with Artificial Intelligence (AI)

To enhance and evaluate our research, we have utilised Artificial Intelligence (AI), an interdisciplinary field of computer science that develops systems and algorithms to emulate human intelligence, including machine learning and data-driven decision-making [ 75 , 76 ]. AI plays a crucial role in data collection, analysis, and synthesis, enabling a rigorous, data-driven research process [ 60 , 69 ]. This application aligns with contemporary technological trends and enhances our ability to analyse and understand the studied phenomena more deeply and accurately.

Furthermore, leveraging the capabilities of ATLAS.ti 23, we conducted two additional analyses to provide a more thorough exploration of the collected data. These complementary analyses enriched our understanding by allowing a detailed examination of the information. The advanced tools in ATLAS.ti 23 have strengthened the quality and depth of our analysis, offering a more comprehensive perspective of the research data.

Paragraph sentiment analysis

The first of these analyses involved conducting a Paragraph Sentiment Analysis using Artificial Intelligence support. This method allowed us to thoroughly and consistently examine the emotions expressed in each transcribed paragraph of the six interviews conducted. In other words, we assessed the tone or emotional disposition conveyed through the words in these interviews, gaining a deeper and more nuanced understanding of the participants' responses.

Specifically, sentiment analysis was applied to 451 paragraphs extracted from the six interviews using Artificial Intelligence. The results revealed that 253 paragraphs expressed neutral sentiments, 159 reflected negative sentiments, and 39 conveyed positive sentiments (Table 12 ). This approach provides a detailed understanding of the emotions and attitudes in the participants' responses, enriching our research and offering insights into their experiences and perceptions in the studied context.

This overlap with previously established categories and codes supports the validity and relevance of our sentiment analysis. It demonstrates that the emotions and attitudes identified align with the key themes and concepts explored in our study. This alignment strengthens our understanding of participants' work experiences and how they relate to satisfaction, interpersonal relationships, tasks, and responsibilities within the organisational context studied.

Conclusions and discussions

Qualitative research on job satisfaction provides a sophisticated and nuanced understanding of individuals' experiences and perceptions within their work environment. This approach diverges from traditional quantitative methods, allowing for an in-depth exploration of interactions, motivations, frustrations, and aspirations, thus enriching our comprehension of job satisfaction dynamics [ 77 ].

A primary finding from this study underscores the significant impact of internal communication on job satisfaction. Although numerous interviewees highlighted inadequacies in communication from their leaders, some observed notable improvements. This aligns with the Communication as Management Theory, which posits internal communication as a strategic tool for enhancing organisational management and culture [ 77 ]. Such improvements in communication are aligned with the Sustainable Development Goals (SDGs) of the UN 2030 Agenda, particularly Goal 8, which advocates for sustained, inclusive, and sustainable economic growth, alongside full and productive employment and decent work for all.

Moreover, the organisational climate emerged as a critical factor influencing job satisfaction. While the majority of participants rated the environment as fair, there was a consensus on the need for improvement, especially in leadership management. This finding is in concordance with Organisational Climate Theory, which emphasises the significant role of collective perceptions in shaping attitudes and behaviours within an organisation, thereby promoting employee satisfaction, trust, and fairness [ 71 ]. This supports SDG 8 by underlining the necessity of a positive work environment to foster decent working conditions.

Furthermore, the study highlighted the importance of interpersonal relationships, with participants stressing their relevance to job satisfaction and expressing concerns about managing these relationships within the franchise. This insight aligns with Social Exchange Theory, which underscores the pivotal role of reciprocal social interactions in enhancing motivation and commitment [ 68 ]. Cultivating strong interpersonal relationships at work supports SDG 8 by fostering a collaborative and respectful work culture, essential for sustainable economic growth.

The findings also indicate that work ethic and political skill can buffer the negative effects of perceived organisational politics on job attitudes. Effective management of interpersonal relationships is crucial for maintaining a positive work environment and enhancing employee commitment [ 33 ]. This further emphasises the role of strong interpersonal relationships in job satisfaction, aligning with the need to foster a supportive work culture.

Additionally, effective time management and conflict resolution are fundamental to achieving a work-life balance in Mexican fitness franchises. Addressing work-related stress and providing emotional support are vital for prioritising employees' well-being, which aligns with SDG 3, aiming to ensure healthy lives and promote well-being for all at all ages.

Furthermore, motivation, both positive and negative, was found to significantly influence job satisfaction, with a notable emphasis on the role of leadership in fostering motivation and providing support. Professional development and growth opportunities were also highlighted, with participants valuing face-to-face training and personal development initiatives. These findings underscore the necessity for continuous skills improvement and career advancement, aligning with SDG 4, which promotes inclusive and equitable quality education and lifelong learning opportunities.

Compensation and benefits were also crucial factors, with participants appreciating financial and employment benefits but suggesting improvements in working hours. Fair compensation directly impacts financial well-being and job satisfaction, contributing to employee retention. This aligns with SDG 10, which aims to reduce inequality within and among countries by ensuring fair wages and benefits.

In summary, this research aimed to understand how employees in Mexican fitness franchises perceive their job satisfaction and its impact on performance. The findings highlight the essential roles of internal communication, leadership, and the work environment. Enhancing these areas can significantly boost job satisfaction and performance.

Aligning these insights with the UN 2030 Agenda's Sustainable Development Goals (SDGs) demonstrates how improving job satisfaction supports global sustainability objectives. This study underscores the critical connection between workplace well-being and broader social goals, emphasising the importance of strategic management practices in fostering a supportive and productive work environment.

.Notes: No experimental tests were carried out with humans in this article. The research subjects consented to the use of their information.

Practical implications

The findings from this research offer several practical implications for improving job satisfaction within fitness club franchises in Mexico.

First, enhancing internal communication is essential. Improving communication from leaders and ensuring transparency in decision-making processes can foster trust and mutual respect, which significantly enhances job satisfaction. Employees need regular feedback and clear information about their roles and organisational changes to feel valued and engaged [ 47 ].

Second, leadership training is crucial. Providing training focused on empathy, communication, and team building can address issues of ineffective leadership and improve overall employee motivation and support. Effective leaders can create a more supportive and motivating work environment, crucial for maintaining high levels of job satisfaction.

Third, offering career development opportunities is vital. Establishing clear career pathways and providing regular training and development programs help employees feel valued and invested in the organisation. This approach not only improves job satisfaction but also contributes to higher retention rates and a more skilled workforce.

Fourth, promoting work-life balance is important. Implementing flexible work schedules and allowing employees to take time off as needed supports their overall well-being, leading to higher productivity and engagement. A healthy work-life balance ensures that employees are not overwhelmed and can maintain their personal lives alongside their professional responsibilities.

Fifth, addressing compensation and recognition is necessary. Regularly reviewing compensation packages to ensure they reflect employees' contributions and market standards can address financial dissatisfaction. Additionally, recognising and appreciating employees' efforts, both formally and informally, can boost morale and motivation.

Sixth, improving the work environment is critical. Promoting a culture of fairness and inclusivity where all employees feel valued and respected can reduce conflicts and enhance job satisfaction. Implementing policies that encourage ethical behaviour and teamwork can help cultivate a positive work atmosphere.

Lastly, utilising AI for continuous improvement can be highly effective. Using AI tools for regular employee feedback and sentiment analysis can provide ongoing insights into job satisfaction. This real-time data can help organisations proactively address issues and continuously improve the work environment.

In summary, these practical steps enhancing communication, improving leadership, offering career development opportunities, promoting work-life balance, addressing compensation and recognition, improving the work environment, and utilising AI—can significantly enhance job satisfaction, motivation, and productivity within fitness club franchises in Mexico, benefiting both employees and the organisation.

Limitations and directions for future research

Limitations.

This study has several limitations that should be acknowledged. Firstly, the sample size is relatively small, consisting of only six participants from a single fitness club franchise in Mexico. This limited sample size may not fully capture the diversity of experiences and perspectives across the entire industry. Consequently, the findings may not be generalisable to all fitness club franchises in Mexico or other countries.

Secondly, the study relies on qualitative data collected through semi-structured interviews. While this approach provides in-depth insights into participants' experiences and perceptions, it may be subject to biases such as social desirability bias, where participants provide responses, they believe are expected rather than their true feelings. Additionally, the qualitative nature of the study makes it difficult to quantify the extent of the issues identified or compare them statistically across different groups.

Thirdly, the research focuses primarily on the perspectives of employees, with less emphasis on the views of management or customers. This narrow focus may overlook important factors influencing job satisfaction, such as organisational policies, customer interactions, and market conditions.

Directions for future research

Future research should address these limitations by adopting a more comprehensive approach. Firstly, expanding the sample size and including participants from multiple fitness club franchises across different regions of Mexico would provide a more representative and generalisable understanding of job satisfaction in this industry. Including a broader demographic range and varying levels of employment within the sample could also offer deeper insights.

Secondly, incorporating quantitative methods alongside qualitative approaches could help quantify the prevalence of identified issues and enable statistical comparisons. Surveys or questionnaires could be used to collect data from a larger number of participants, providing a more robust analysis of job satisfaction factors.

Thirdly, future research should consider the perspectives of management and customers to gain a more holistic view of job satisfaction. Understanding the challenges and expectations from multiple stakeholders can provide a more comprehensive framework for improving job satisfaction.

Additionally, longitudinal studies tracking changes in job satisfaction over time would be valuable. These studies could assess the long-term impact of implemented improvements and identify evolving trends and new challenges in the industry.

Finally, exploring the impact of cultural and economic factors unique to Mexico on job satisfaction could provide valuable context-specific insights. Comparative studies between different countries or regions within Mexico could also highlight how varying socio-economic conditions influence job satisfaction.

Availability of data and materials

Data is provided in the manuscript, If you need the complete interviews, please request us.

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Conceptualization, M.A.S.A.; methodology, E.G.V.; software, M.A.S.A and E.G.V..; validation, M.R.B.C..; formal analysis, M.A.S.A and E.G.V.; investigation, M.A.S.A., E.G.V., M.R.B.C. and R.R.R.; interviews: M.R.B.C and R.R.R.; resources, M.R.B.C. and R.R.R.; data curation, E.G.V. and M.A.S.A.; writing—original draft preparation, M.A.S.A..; writing—review and editing, E.G.V. and R.R.R.; visualization, E.G.V. and M.R.B.C.; supervision, E.G.V. and R.R.R.; project administration, E.G.V. and R.R.R.; funding acquisition, R.R.R. All authors have read and agreed to the published version of the manuscript.

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Salazar-Altamirano, M.A., Galván-Vela, E., Ravina-Ripoll, R. et al. Exploring job satisfaction in fitness franchises: a study from a human talent perspective. BMC Psychol 12 , 489 (2024). https://doi.org/10.1186/s40359-024-01855-x

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Securing human resources for Japan’s aging population: a mixed methods study of job satisfaction and well-being among Southeast Asian long-term care workers in Japan

• Niaya Harper Igarashi 1 ,
• Junko Kiriya 1 ,
• Rogie Royce Carandang 1 , 2 ,
• Ken Ing Cherng Ong 1 , 3 ,
• Akira Shibanuma 1 &
• Masamine Jimba 1  

BMC Health Services Research volume  24 , Article number:  1134 ( 2024 ) Cite this article

Metrics details

Japan is one of the countries experiencing a “super-aged society.” The government has looked to Southeast Asia for recruiting workers to fill the demand for long-term care (LTC) workers. However, migrant LTC workers have faced many job-related stressors. This study aimed to examine the factors associated with job satisfaction and subjective well-being among Filipino, Indonesian, and Vietnamese LTC workers in Japan and explore the specific factors behind what makes them satisfied in their jobs.

A convergent mixed methods study was conducted. The workers were recruited through snowball and convenience sampling and completed a self-administered questionnaire for the quantitative part. The association of the work environment with the workers’ job satisfaction and subjective well-being were analyzed using multiple linear regression analysis. An interpretive phenomenological approach was used to conduct in-depth interviews of the workers, which were analyzed using a deductive and inductive approach for the qualitative part. Quantitative and qualitative results were integrated and interpreted to expand on the findings with new insights.

In the final analysis, 122 workers were included (20 Filipino, 43 Indonesian, and 59 Vietnamese). In the quantitative part, having the necessary tools/equipment (Unstandardized Coefficient [B] = 16.1, 95% Confidence Interval [CI] = 6.8, 25.3) and support from work (B = 18.1, 95% CI = 8.6, 27.6) were associated with a higher level of job satisfaction. Having experienced harassment on the job was associated with a lower level of job satisfaction (B = -18.2, p  = 0.007, 95% CI = -28.5, -7.8). There is no strong evidence for the association with subjective well-being. In the qualitative part, prominent themes emerged related to cultural sensitivity and an inadequate knowledge of caring for older adults living with dementia. The integrated findings suggested inadequate and unequal Japanese language training across the facilities. Moreover, the importance of human relations in the workplace emerged, with some workers desiring a deeper connection with their Japanese coworkers.

Conclusions

A supportive and culturally sensitive work environment may bring about more motivated employees and increase employee retention from migrant LTC workers. Government and facilities should consider policies supporting a culturally sensitive work environment and more equitable Japanese language training across all facilities.

Peer Review reports

Introduction

Today, people are living longer, and the population aged 60 and over is growing faster than all other age groups. By 2030, 1 in 6 people worldwide will be 60 or older [ 1 ]. Japan is experiencing what is known as a “super-aged society,” with 30% of its population already aged 60 and above, making it the country with the largest proportion of this age group in the world [ 2 ].

The shift in the aging demographics and changes in the structure of family households in Japan has created many challenges in securing the human resources to care for older adults [ 3 ]. Due to geographical constraints, work demands, or raising children, many families can no longer care for an aging family member, thus resulting in a substantial growth in the need for long-term care and an increased demand for long-term care (LTC) workers [ 4 , 5 ]. Like many other high-income countries, Japan has a labor shortage of LTC workers. As the population grows older in Japan, the Ministry of Health, Labour and Welfare (MHLW) estimates that by 2040, there will be a need for 2.8 million LTC workers, leaving an additional 690,000 LTC workers needed to fill the labor gap [ 6 ].

To mitigate the labor shortage of LTC workers, the Japanese government has implemented several policies for accepting migrant LTC workers. Since 2008, Japan has received nursing and LTC work candidates through the Economic Partnership Agreement (EPA) from Indonesia, the Philippines, and Vietnam [ 7 ]. The EPA permits candidates for LTC work to enter and stay in Japan for up to four years for training to obtain the national care worker certification. Upon receiving the qualification, candidates can live and work in Japan indefinitely. In contrast, candidates who are unsuccessful in passing the exam will be required to return to their home country [ 8 ].

However, there have been some challenges for the workers, such as passing the exam, which is in Japanese. The government has since made several modifications to the exam to make passing it more achievable for migrant workers. Several reforms have also been implemented to expand the systems through which migrant workers can come to Japan to work in LTC [ 9 , 10 ]. There are four systems for employing migrant LTC workers: through the EPA, graduating from a certified care worker training school and obtaining care worker qualification in Japan, through the Technical Intern Training program, and Specified Skilled Worker status of residence [ 11 ].

While passing the national care worker certification exam is one challenge, many workers have also reported negative experiences on the job. One study that surveyed 146 EPA nurse and LTC worker candidates from Indonesia, the Philippines, and Vietnam showed that dissatisfaction with their job was significantly associated with returning to their home country [ 12 ]. In other studies, migrant workers cited dissatisfaction with working conditions such as the long hours, physical health concerns, and coworker relationships, as well as stressors such as language barriers, workplace discrimination, and cultural differences [ 13 , 14 , 15 ].

The Range of Affect Theory (1976) is a job satisfaction model developed by Edwin A Locke. This theory proposes that an individual’s job satisfaction depends on the workers’ expectations from the job and if the expectations are met. Further, the theory states that how much the worker values any given part of the job (autonomy, coworker relationships, organizational culture, management practices, etc.) determines their satisfaction or dissatisfaction when expectations are met or not met [ 16 ].

With the growing demand for qualified migrant LTC workers in Japan, the government must study all aspects of the human resources shortage and turnover among migrant LTC workers. Previous literature on migrant LTC workers in Japan primarily focused on the stressors and dissatisfaction of the workers who were mainly part of the EPA system and working as nurses. Little research to date has investigated the factors associated with satisfied migrant LTC workers and the association between their work environment with their job satisfaction and well-being. By understanding what makes migrant LTC workers satisfied and happy in their jobs, new methods and strategies can be employed to modify the work environment, reduce employee turnover, and optimize retention among this group of workers. Figure  1 illustrates the conceptual framework used in this study.

Conceptual framework

This study had two objectives: to examine the factors associated with job satisfaction and subjective well-being among migrant LTC workers in Japan and to explore the factors behind what makes the workers satisfied with their jobs.

A convergent mixed methods study was conducted across all 47 prefectures (administrative regions) in Japan. The convergent mixed methods design was employed to meet the needs of the objectives and to be able to examine the situation of the workers from different angles and within the study’s timeline. The convergent design allowed quantitative and qualitative data to be collected in parallel but analyzed independently [ 17 ].

Quantitative study design and participants

Participants of this study included Filipino, Indonesian, and Vietnamese LTC workers who were either certified or trainees working in an LTC facility, excluding daycare centers and in-home care services. The workers were at least 20 years of age. This population was selected as it represents the three main countries from which the majority of migrant LTC workers are recruited and where Japan holds EPA Agreements.

A minimum sample size of 350 was calculated using OpenEpi software, taking the mean difference in job satisfaction from the bivariate analysis of a study on job satisfaction and associated factors among healthcare professionals in Ethiopia [ 18 ]. The significance level was 5%, with a statistical power of 80%.

The workers for this study were recruited by employing both a convenience sampling and snowball sampling method through social media groups and with the cooperation from non-governmental organizations (NGOs), LTC facilities, and supervising organizations that support migrant workers in Japan.

Variables and assessment

Exposure variables, work environment.

The work environment was assessed by asking the following “Yes” or “No” questions, “My workplace provides me with the necessary tools/equipment to perform my job,” “I have experienced harassment or discrimination in my workplace,” and “There are enough staff in my workplace to provide the necessary care for the users.” Social support at work was assessed by asking, “Is there someone at work to talk to about understanding a situation or any problems.”

Outcome variables

• Job satisfaction

The workers’ job satisfaction was measured using the Job Satisfaction Survey (JSS) developed by Paul Spector. Spector’s JSS was based on Locke’s (1976) job satisfaction theory [ 19 ]. The workers responded based on a 6-point Likert scale ranging from 1 “disagree very much” to 6 “agree very much” with scores ranging from 36 to 108 interpreted as “dissatisfied,” whereas scores of 144 to 216 interpreted as “satisfied” [ 20 ]. The questionnaire also consists of nine subscale domains (pay, promotion, supervision, fringe benefits, contingent rewards, operating conditions, coworkers, nature of work, and communication). The JSS has adequate reliability with Cronbach’s alpha score that averages 0.7 for all nine subscales, making it a reliable tool for evaluating job satisfaction [ 21 ]. The JSS has been translated into 27 languages and has been used in studies worldwide, demonstrating the instrument’s acceptability across cultures [ 22 ].

Subjective well-being

The WHO-5 Well-being Index (WHO-5) was used to measure the workers’ subjective well-being. Responses to this questionnaire are based on a 6-point Likert scale ranging from 0 “none of the time” to 5 “all of the time,” with a total score of 25 representing the “best imaginable well-being” while scores below 13 indicate “poor well-being”. The WHO-5 has been translated into over 30 languages and due to the diversity of its application, the WHO-5 instrument has shown to be successful across different regions of the world [ 23 ].

Translated and validated versions of previous studies’ JSS and WHO-5 questionnaires were used for Filipino and Vietnamese workers. There were no translated versions of the JSS or WHO-5 for Indonesian workers, so for this study, a forward–backward translation from English to Indonesian was performed by a researcher fluent in both languages and with a background in health science. The primary researcher conducted face and content validity and pre-testing on a sample of six Indonesian LTC workers to assess the understanding of each questionnaire for linguistic and cultural validation. Pre-tests were also conducted on a small sample of two Filipino and five Vietnamese workers before the start of the study. Cronbach’s alpha was calculated to check internal consistency, which came out to α = 0.93 for the JSS and α = 0.90 for the WHO-5.

Confounders

Potential confounders of this study are length of time living in Japan, Japanese language proficiency, being a certified care worker, number of years of LTC work, living situation, and work location.

Covariates of this study are background-related factors of the workers, which included age, sex, nationality, weekly working hours, and monthly income.

Data collection

A 58-item web-based, anonymous, self-administered questionnaire was created in the native language of the workers, Tagalog, Indonesian, and Vietnamese, and distributed online using the Google Forms platform. A paper-based questionnaire was also made available if needed. Quantitative data were collected from mid-May to mid-October 2021.

Data analysis

Descriptive statistics were used to summarize the characteristics of the workers. The mean scores of the JSS nine subscales were calculated to examine the specific job domains in which workers are satisfied or dissatisfied. One-way Analysis of Variance (ANOVA) was conducted to test the differences in the JSS subscale mean scores among the nationalities.

Multiple imputation was performed for variables with missing data. Multiple linear regression analyses were performed to identify the association of the work environment with job satisfaction and subjective well-being. The variance inflation factor (VIF) was calculated to check the multicollinearity, and values below 5, suggesting a moderate correlation, but not severe enough to warrant corrective measures, remained in the model [ 24 ]. The level of statistical significance was set at p  < 0.05. All analyses were performed using Stata/SE 16 (StataCorp, College Station, TX, USA).

Qualitative study design and participants

For the qualitative part of the study, an interpretive phenomenological approach was employed to explore further and interpret the workers’ perceived experiences at work and in life and identify the factors behind what makes them satisfied in their jobs. Eligible workers who completed the questionnaire were recruited from the quantitative part of the study. An estimated sample size of 20 eligible workers (10 "satisfied” and 10 “dissatisfied”) were purposively selected and screened before sending a formal invitation to collect and compare workers at both ends of the satisfaction spectrum. The nationality of the workers was also considered to include a balanced number of workers from all three nationalities included in the study.

In-depth interviews were conducted using a semi-structured approach with guided questions developed for this study. The primary researcher and an interpreter (research assistant speaking the local language of the worker) interviewed the workers on the Zoom online platform, where workers chose a convenient private location. Informed consent was taken verbally on the day of the interview before starting. The workers were given ID codes in place of their names during the Zoom interview to confirm their identity and stay anonymous. Questions asked in the interview were framed around their (1) background, (2) work environment, (3) social support, and (4) unique behaviors (Appendix A). Qualitative data were collected from August to mid-October 2021. Data saturation was checked and discussed after each interview.

All transcripts not in English or Japanese were translated by the interpreter and analyzed by the primary researcher using a deductive and inductive thematic approach in parallel with another researcher trained in qualitative interviewing. Each researcher independently coded the transcripts and met to discuss their codes, which were then grouped into more conceptual categories and themes. Lastly, to minimize researcher bias, themes included in the final analysis were mutually agreed upon through peer debriefing with a third external researcher. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was completed for this study. MAXQDA 2020 (VERBI Software, 2019) qualitative data analysis software was used to manage and code the data.

Integration

The data from the quantitative and qualitative parts were collected in parallel and analyzed independently. The results were then merged and interpreted. Significant findings that confirm the results in both parts or expand on the results by providing new insights were organized and presented as joint displays showing both quantitative and qualitative findings side-by-side. Meta-inferences were drawn to describe new findings obtained from the integration.

Quantitative part

In total, 124 workers completed the survey. After data cleaning, it was found that two entries were missing substantial data and were excluded from further analysis. The final analysis included 122 workers from 31 prefectures (Appendix B). The calculated estimated sample size in this study was not met due to challenges in recruiting participants during the COVID-19 pandemic, and given the time limitation, it was decided for the data collection to stop at 124 workers. However, the statistical power for each significant outcome variable in the regression analysis of this study was sufficient.

Sociodemographic characteristics of the workers

Table 1  shows the sociodemographic characteristics of the workers, 20 Filipino, 43 Indonesian, and 59 Vietnamese. Their mean age was 27.9 years (SD 6.1), and most were women (79.5% vs. 20.5%). Most workers (79.8%) had a monthly income of JPY 200,000 (USD 1,900) or less. 34.4% were employed through EPA, followed by Specified Skilled Worker (23.8%) and Technical Intern Trainee (21.3%). Concerning their Japanese language proficiency, 70.5% of the workers self-rated their Japanese speaking proficiency as working-level or greater.

Overview of the Job Satisfaction (JSS) and the WHO-5 subjective well-being (WHO-5) scores

Table 2 shows the JSS subscale mean scores for each of the nine subscale domains. The mean scores of the subscale domains: “nature of their work” (17.6), “communication” (17.1), “supervision” (17.0), and “coworkers” (16.7) all suggest a higher level of satisfaction. The results from ANOVA showed no significant differences among the nationalities (Appendix C). The WHO-5 mean scores were calculated at 12.9 points, indicating poor well-being. The Cronbach’s alpha of the JSS scale used for this study was α = 0.92 for Tagalog, α = 0.93 for Indonesian, and α = 0.91 for Vietnamese. The Cronbach’s alpha of the WHO-5 scale used for this study was α = 0.91 for Tagalog, α = 0.90 for Indonesian, and α = 0.93 for Vietnamese.

The association of the work environment with job satisfaction and subjective well-being

Table 3  shows the results of the multiple linear regression analysis for the association of the work environment with job satisfaction. Workers that reported having the necessary tools/equipment (Unstandardized Coefficient [B] = 16.1, p  = 0.007, 95% CI = 6.8, 25.3) and support from work (B = 18.1, p  = 0.006, 95% CI = 8.6, 27.6) were significantly associated with having a higher level of job satisfaction compared with workers who did not. Workers who have experienced harassment or discrimination at work (B = -18.2, p  = 0.007, 95% CI = -28.5, -7.8) were significantly associated with a lower level of job satisfaction compared with workers who have not.

Table 4  shows the results of the multiple linear regression analysis for the association of the work environment with subjective well-being. Although the WHO-5 mean scores were calculated at 12.9 points, indicating poor well-being, strong enough evidence for the association between work environment with subjective well-being was not found. However, based on the value of the coefficients and the confidence interval, the following variables could be potential factors contributing to subjective well-being. Being a certified care worker (B = 3.1, p  = 0.097, 95% CI = -0.8, 7.0), Filipino worker (B = 2.4, p  = 0.130, 95% CI = -1.1, 5.9), working 30 hours or less in a week (B = 2.3, p  = 0.089, 95% CI = -0.5, 5.1), and having support from family and friends (B = 2.1, p  = 0.101, 95% CI = -0.6,4.8) might be important factors that contribute to a higher level of subjective well-being.

Qualitative part

Out of the 76 contacted workers, 16 interviews were successfully arranged. Table 5  shows the sociodemographic characteristics of the workers who participated in the interviews: 2 Filipino, 8 Indonesian, and 6 Vietnamese, with a mean age of 28.3 years (SD 4.6).

Two main themes emerged from the qualitative findings: unique behaviors of the workers and positive factors of their work environment. Table  6 summarizes the themes, sub-themes, and descriptions from the findings.

Unique behaviors of the workers

Religious beliefs and practices.

Religion was mentioned by many of the workers from Indonesia and the Philippines. The workers talked about their religious practices, with several stating religion as a strong factor in their motivation for continuing their work and dealing with stressors related to work or daily life.

“Just staying motivated in that work because I’m a Christian, that is my motivation to do a job. And then even if the situation is very hard, so you need to be focused and you need to stay motivated in that job, because of our God.” ( Filipino, female, 30 s, works in Aichi)

Community participation

Some of the workers discussed their involvement in community activities. Community participation or volunteering has been associated with migrant workers feeling more connected to Japan [ 25 ].

“There are some Japanese people more like a mother figure that are around me who I know from the cultural center. There’s a space to meet and study Japanese and exchange culture and there are many older Japanese ladies that also visit and or work there and I often talk with them.”  (Indonesian, female, 20 s, works in Aichi)

Cultural adaptability

While many workers highlighted cultural differences as challenges within the workplace, some talked about having more of an ability to quickly adapt and integrate due to previous education or interest in Japanese culture and language.

“There are some points that I am accustomed to, and others are still shocking to me. Before coming to Japan, I was able to learn about Japanese culture and manner, so it was easy to get use to the differences.”  (Indonesian, female, 20 s, works in Aichi)

Knowledge of care for older adults (users) living with dementia

Workers who have been working in LTC for some years or who are certified in Japan mentioned being more familiar with the varying behaviors of dementia among older adults. In comparison, recently employed workers talked about their shock and challenges with how to care for the users in their facility who are living with dementia.

“There are some users that are suffering from dementia and there are many different stages so there can be users who can go on a rampage wanting to return back to their home… I was surprised, during my training there was no mention of this…I never thought [of it] until experiencing this at the facility.”  (Indonesia, female, 20 s, works in Aichi)

Positive factors of the work environment

Leadership and development opportunities.

Some workers spoke enthusiastically about leadership opportunities. Providing opportunities for the workers to be more involved in taking ownership of responsibilities other than their daily tasks can empower them to be more motivated. It may also create a more inclusive working environment for the migrant workers to feel equal to Japanese workers.

“There is a [training] program here, every month we discuss about an issue for example diseases infection prevention, how to improve quality of the patient’s condition…The training can develop into a career. I have worked already as a floor leader position and team leader.”  (Indonesian, male, 30 s, works in Tokyo)

Japanese language training

Although all the workers are required to meet a minimum intermediate level of Japanese language requirement [JLPT N3] for working as an LTC worker, the majority stated having insufficient language ability to perform their duties confidently and spoke about Japanese language being one of the significant challenges at work. Furthermore, many workers talked about the need for self-study or paying for lessons independently. In contrast, others mentioned that Japanese language support or even allowance for study time was provided within their facilities.

“My facility also facilitated me to learn Japanese, the sensei [language instructor] comes to my facility… Two hours, every week.”  (Indonesian, female, 20 s, works in Gifu)

“Before the exam [National care worker certification exam] they will give us 40 days, we can study at any day. We will still have to go to the facility, but it won’t be to work, but just to study, during that time.” (Vietnamese, female, 20 s, works in Tokyo)

Cultural sensitivity

When bringing other nationalities and cultures into the workplace, it is essential to have an awareness and understanding of the different cultures of the workers [ 26 ]. Those workers in facilities where the management understood the importance of accepting the workers’ cultural and religious practices shared how lucky they felt to work in such a facility.

“I discussed this [my religion] with the facility management prior to joining in the interview. I explained that it was necessary for me to pray five times a day and they were understanding about it…and are flexible with giving me time off for religious obligations as well. I am very appreciative of this.”  (Indonesian, male, 20 s, works in Gunma)

Social support

Coworker support has been associated with a more positive work environment, higher job satisfaction, and lower turnover intentions [ 27 ]. Additionally, it helps to build human relationships and skill sharing. For migrant workers, many are here in Japan alone, and some may have no other support system apart from support from their facility.

“The positive point for me, the director is easy-going; they support learning, study time, teachers, books, a lot. Plus, we’ve had a raise recently.”  (Vietnamese, female, 20 s, works in Tokyo)

Two new findings were brought to light after integrating the quantitative and qualitative data results. The first integrated finding in Table  7 shows that while Japanese language proficiency was not significantly associated with job satisfaction in the quantitative part, in the qualitative part, almost all the workers mentioned that speaking and or writing in Japanese remained a significant challenge for them.

The second integrated finding that emerged relates to workplace human relations. Based on the JSS total subscale mean scores in the quantitative findings, the workers were satisfied with the domains: “nature of their work” (17.6), “communication” (17.1), “supervision” (17.0), and “coworkers” (16.7). The results in Table 8  show comparable responses from the qualitative findings, where workers shared about their “friendly environment” and “helpful coworkers.” While most of the workers noted a high level of social support in the workplace, some also mentioned wanting a deeper connection with Japanese coworkers.

This study aimed to examine the factors associated with the job satisfaction and the well-being among migrant LTC workers in Japan and to explore the unique behaviors of those workers who are satisfied in their jobs. Four main findings emerged from this study. First, it highlights the importance of cultural sensitivity among management and staff in the facilities as an important factor for many workers, particularly when it involves understanding religious practices. Second, having the necessary tools, equipment, and social support in the facility was positively associated with the level of job satisfaction; conversely, facing discrimination and harassment in the facility was negatively associated with the level of job satisfaction. Third, some of the workers felt that their knowledge and level of training in caring for older adults living with dementia was inadequate. Fourth, in the integrated findings, a divergent finding emerged that although the association of Japanese language level was not found statistically significant with the workers’ job satisfaction or well-being, Japanese language is an ongoing challenge for many of the workers, and that there are disproportionate levels of training across facilities. Furthermore, the importance of social support and human relations at work was confirmed in the integrated findings.

The importance of cultural sensitivity and acceptance of cultural practices in the workplace

In this study, religion was found to be an important factor for many of the workers. Many of the Muslim workers talked about the cultural barriers they have faced when it comes to their religious obligations of daily prayers. On the other hand, some of the Muslim workers expressed how “ lucky ” they felt to work for a facility that respected their culture and religious practices. Muslims are required by their faith to observe five daily prayers at set times, usually at dawn, mid-day, mid-afternoon, sunset, and nighttime. One study in Malaysia highlighted the impact that daily prayers had on Muslim workers’ motivation to work hard in their organizations [ 28 ]. Christian workers also spoke about religion as a motivating factor for dealing with daily stressors and for their resilience to continue even when work gets demanding.

Furthermore, the increase in migrant LTC workers from Southeast Asia brings a new cultural diversity to many of the facilities, with workers who hold different beliefs, values, and behaviors from the Japanese workers. Facility management should consider implementing cultural sensitivity practices in their facilities, as it has been found to be a strong predictor of job satisfaction and employee retention [ 29 , 30 ].

The association of the work environment with job satisfaction

Workers at facilities with the necessary tools/equipment and support from work were associated with a higher level of job satisfaction compared with workers who do not. Many of the workers interviewed in this study who expressed their satisfaction with their job also mentioned that they received support from their coworkers or supervisors in dealing with issues in their daily lives. It is beneficial for management and staff to have healthy interactions, such as sharing resources and information. Past studies have found a link between support from supervisors or coworkers and job satisfaction [ 31 , 32 , 33 ]. In the case of migrant LTC workers, most of the workers come to work in Japan alone, so they do not necessarily have the same level of support outside of work as their Japanese coworkers. This places even more importance on the level of support provided by the facility to the workers. The integrated findings in this study also highlighted how significant social support and human relations at work are for the workers, with many workers also expressing wanting to have a deeper connection with the Japanese workers in their facility.

Workers who have experienced harassment or discrimination at work were associated with a lower level of job satisfaction compared with workers who have not. Previous studies highlight the impact experiences of harassment and discrimination, such as being undervalued, ignored for promotion, and excessive discipline by supervisors, have on job satisfaction and well-being [ 34 , 35 , 36 ]. For example, one qualitative study on migrant care workers in Japan, which was used as the basis of this study, found discrimination as one of the stressors LTC workers face in Japan [ 15 ]. Migrant and minority workers are most at risk of harassment or discrimination on the job and suffer more adverse health outcomes in comparison to the majority demographic group of the country in which they are living [ 37 ]. The quantitative findings in this study support how among all the other factors how much facing harassment or discrimination at work negatively impacts the level of job satisfaction.

Inequalities in the level of training across long-term care facilities

Many workers spoke about the on-the-job training they receive at their facilities, which includes the physical care and support training required for daily work. Having the knowledge and understanding of caring for older adults living with dementia was one part of the job that some of the workers felt inept in handling. Workers who have been working longer in LTC in Japan had a better understanding of dementia. In contrast, workers who have recently started working spoke about the challenges they faced when caring for users in their facility living with dementia. This finding suggests that among migrant LTC workers, there is a need for more awareness, knowledge, and training on caring for older adults living with dementia. Based on 2020 projections, over the next 25 years in Japan, dementia in people older than 65 years is projected to exceed 25% nationwide [ 38 ].

It also emerged that some workers want to have a deeper connection with their coworkers. Language could be a potential barrier to forming a deeper connection. While the workers are expected to have a minimum level of Japanese language requirement, many expressed a lack of confidence in speaking and writing in Japanese at work. Some workers mentioned that their facilities provide free Japanese language training for them on-site. In contrast, others talked about having to supplement their Japanese language learning through their own financial means.

The integrated findings of this study suggest that the current amount of Japanese language support provided is insufficient. In the quantitative findings, although there was no significant association between Japanese language proficiency and job satisfaction, in the qualitative part, most of the workers discussed the challenges and barriers that remained with speaking and writing Japanese at work, with one worker stating difficulties with the Japanese language, “sometimes makes me want to quit”. This finding corroborates with past literature where it was found among migrant nurses and care workers that Japanese language, especially understanding kanji and writing incident reports in Japanese, remained difficult [ 39 , 40 ].

Ensuring equitable access to language training across facilities nationwide can enable workers to form a deeper connection with coworkers and establish a better relationship with the facility’s users. Moreover, given the pass rate of the national care worker certification exam for migrant workers, having the necessary Japanese language training to pass the exam and get certified is important for retaining migrant workers for the future.

Strengths and limitations

The mixed methods approach in this study utilized the strengths of both quantitative and qualitative findings. However, there were three limitations to address. First, only a small sample size was attained, and the estimated sample size for this study was not achieved, limiting the study’s representativeness and generalizability. This study was conducted during the peak of the COVID-19 pandemic, limiting the accessibility of workers at the time, however, having more authority through government agency with support for recruitment methods may have had a better response, in addition to having an incentive for the facility management to encourage the participation of their employees. Second, multiple imputation was used for the data missing at random, which can reduce the study’s statistical power. Therefore, a statistical power calculation was performed for the variables that showed significance and were all sufficient at over 80%. Third, most of the workers who participated in the interviews had a high level of satisfaction based on their JSS mean score, resulting in possible selection bias. There was an effort to reduce this bias in the beginning by purposively selecting workers who were both satisfied and dissatisfied to compare. However, those workers who were less satisfied were not as responsive, and many could not be interviewed.

Despite such limitations, this study benefits from several strengths. This study examines the experiences and positive factors of migrant LTC workers in Japan from all four government employment systems and across 31 out of 47 prefectures working in both urban and rural settings. The mixed methods design of this study further strengthens the findings. For instance, the qualitative interpretive approach allowed the primary researcher to examine the experiences of the workers from their perspective, which brought to light many significant findings that could not be seen in the quantitative part, such as the importance of cultural sensitivity and the need for more knowledge and training in caring for older adults living with dementia. Future research could explore the experiences and challenges of employing migrant LTC workers from the LTC facilities and management perspective.

With Japan’s aging population and labor shortage in long-term care, workers from Southeast Asia are an important pool of future human resources to hold the industry together. Therefore, policies and interventions should be implemented to promote cultural sensitivity training for all employees in LTC facilities while also allowing flexibility and accommodations for workers with specific religious or cultural obligations. Moreover, facilities and supervising organizations should focus on more education and training on caring for older adults living with dementia and Japanese language. Providing a culturally sensitive working environment and sufficient and equitable training and support are some of the ways to create a more encouraging workplace and improve employee retention.

Availability of data and materials

The datasets used and analyzed during this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to acknowledge the following organizations and researchers who provided their industry expertise and support for this study: Gaikokujin Gino Jisshu no Kai, Indonesian Community in Japan (ICJ), KALAKASAN Migrant Women Empowerment Center, Kokoro Medical, NPO Foreign Residence Support, Onodera User Run, Professor Akiko Asai, Professor Yuko Hirano, and SETIA Management. In addition, the authors would like to acknowledge, Kathleen Soriano, Truong Quy Quoc Bao, Do Dang An, Ahmad Junaedi, and Cindy Rahman Aisyah who assisted with the translation and interpretation during the data collection of this study. Appreciation should also go to all the long-term care workers from Indonesia, the Philippines, and Vietnam for their time and cooperation to participate in this study.

This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan

Niaya Harper Igarashi, Junko Kiriya, Rogie Royce Carandang, Ken Ing Cherng Ong, Akira Shibanuma & Masamine Jimba

Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, 06030, USA

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Contributions

NHI and JK together conceived the design, while JK supervised the study. NHI mobilized collaborators, implemented the study, and conducted data collection. NHI, AS, RRC analyzed and interpreted the data. KICO contributed as an external researcher for peer debriefing of the data analysis and interpretation. NHI drafted the manuscript. MJ reviewed and provided input for the finalization of the manuscript.

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Correspondence to Niaya Harper Igarashi .

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This study was approved by the Research Ethics Committee of The University of Tokyo (Reference Number: 2021023NI). Participation in this study was voluntary. Workers were notified of the objective and practical issues of the study, the right to withdraw or terminate from participating at any time, and the protection of privacy. Informed consent was obtained from all workers prior to conducting the study. The confidentiality of the workers was maintained, and the data collected for the quantitative and qualitative parts were securely stored on two USB drives and locked in a private desk. No information revealing the identity of any worker in this study shall be included during the dissemination of findings.

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Igarashi, N.H., Kiriya, J., Carandang, R.R. et al. Securing human resources for Japan’s aging population: a mixed methods study of job satisfaction and well-being among Southeast Asian long-term care workers in Japan. BMC Health Serv Res 24 , 1134 (2024). https://doi.org/10.1186/s12913-024-11572-1

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Received : 29 May 2024

Accepted : 10 September 2024

Published : 27 September 2024

DOI : https://doi.org/10.1186/s12913-024-11572-1

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