Job satisfaction in the health professions: The role of affective temperaments

1 Introduction

Job satisfaction is the multidimensional psychological response to work experience [1]. Workers can have many attitudes toward their jobs and the tasks they perform. These attitudes vary according to the many dimensions of the job itself and include the purpose, specificity, intensity, salience and stability of the job. Professional satisfaction is also a feeling that encompasses both the cognitive and affective components of workers towards their work. Within this context, affective dispositions can influence how individuals evaluate work information along with the related emotional experience which, in turn, can impact on cognitive appraisals of events and work experiences [2]. Thus, satisfaction deriving from work and work-related behaviors may affect emotional states and interpersonal relationships [3, 4]. Within the medical field, job satisfaction has been recognised as an essential factor for healthy and effective teamwork, since it has been found to significantly affect quality of care, patient satisfaction and turnover of health workers, whereas job dissatisfaction was related with poor patient-worker relationships, longer waiting times, and staff burnout [5]. Weiss and Cropanzano [6] showed the role of affective temperament in influencing the experience of emotionally significant events at work and this, in turn, has repercussions on job satisfaction. Although temperaments are conceptualized as stable throughout life, it is almost accepted that they can be shaped by experience and learning [7], and influence personal skills and style of functioning both in social relationships and in professional choices [8, 9]. Additionally, affective temperament can characterize a tendency to perform certain jobs [10].

Kraepelin identified four types of temperament: depressive, hyperthymic, cyclothymic and irritable temperaments [11]. Akiskal [12], starting from Kraepelin’s theory, proposed the current concept of affective temperaments, that additionally includes the anxious temperament, by adding clinical observations from his experience with patients and healthy family members. In Akiskal’s conceptualization, the depressive temperament is characterised by a consistently low mood, a tendency towards introversion, low energy levels, and an excessive need for sleep. People with depressive temperament have low confidence in their means and abilities and tend to rumination and worries [12, 13]. The hyperthymic temperament is characterised by expansive mood, high energy levels and a low need for sleep; it is a temperamental disposition that enables a person to be active, extroverted, warm and cheerful, productive, sociable, self-confident, risk-taking, and strong willed. The cyclothymic temperament consists of rapid and repeated fluctuations in mood, energy levels and sleep-wake rhythms. These fluctuations can be either spontaneous or derived from external events which the subject perceives as stressful. This excessive lability of mood to external events is a typical trait of cyclothymia. Irritable temperament, on the other hand, finds its main feature in the tendency to be aggressive and quarrelsome; people identified as irritable are complaining, restless, dysphoric and react with irritability to external events. Finally, the anxious temperament is characterised by shyness, dependency, insecurity, hypervigilance, tension, somatic symptoms, and by the inability to relax [14].

According to Akiskal, affective temperaments play a significant role in emotional communication and job satisfaction. It has been observed that job satisfaction, shaped by emotional states and cognitive appraisals, has a significant influence on workplace and teamwork atmosphere [3, 4]. As shown by recent studies, subjects belonging to different professions have different profiles in terms of temperament, with those employed in stressful professions showing higher levels of emotional stability that allow them to perform well in difficult scenarios [15].

Since the objective of this study involved health professionals, it should be stressed that helping professions are considered at high risk for lower quality of life, mental health and job satisfaction. As a matter of fact, a study aimed at evaluating affective temperaments in different professions (physicians, lawyers, managers, industrialists, architects, and artists) evidenced that physicians, along with lawyers, had higher levels of dysthymic and obsessional traits and lower levels of cyclothymic and hyperthymic traits when compared to other groups [16]. Overall, different temperament profiles were related with distinct advantages to each of the professions, with a significant role of cyclothymia in creative professions, such as art and architecture, whereas hyperthymic traits, higher in industrialists and managers/executives, seemed to promote better adaptation to work stress and more efficient cognitive performance as opposed to depressive traits which resulted in poorer job performances.

Jaredić [5] observed that hyperthymic temperament correlated with optimism and self-confidence, whereas cyclothymic temperament showed less predictive power, despite rapid mood swinging. Results from a study by Deguchi et al. [17] aimed at evaluating the effects of temperaments on occupational stress in a sample of Japanese day-shift workers in local government showed that hyperthymic temperament was a protective factor and irritable and anxious temperaments were risk factors for occupational stress. In a further study assessing different levels of work-related stress in subjects who had both managerial and non-managerial roles, it was found that depressive temperament was negatively related with avoidant coping style, irritable temperament was positively correlated with stress caused by frequent travel, and cyclothymic temperament was positively related with organisational work stress. It is therefore important in the work environment to recognise how an individual manages work dynamics through their temperamental dispositions [18].

Based on the few studies in the literature, our work was aimed at investigating possible associations between specific of affective temperament traits and job satisfaction in the health professions.

2 Methods

3 Results

The 294 subjects enrolled (72.8% females) were characterised by a mean age of 35.9 years (±S.D. = 12.4) and an education level equal to or greater than a three-year degree in 90.4% of the cases. Concerning to health professions, the most represented category was rehabilitation therapists (38.1%), followed by physicians (26.4%), nurses (18.4%), health technicians (14.3%), and social workers (2.7%).

Table 1 shows ProQOL descriptive statistics in total sample divided by gender; results evidenced moderate scores on the subscales “Compassion satisfaction” (39.66±6.5) and “Burnout” (28.12±4.4), and low scores on the subscale “Secondary traumatic stress” (19.15±6.0); no statistically significant gender differences emerged.

Afterwards, ProQOL subscales “Compassion satisfaction”, “Burnout”, “Secondary traumatic stress”, as dependent variables, and TEMPS-A factors “Cyclothymic”, “Depressive”, “Irritable”, “Hyperthymic” and “Anxious”, as independent variables, were analysed in three linear regression models, in order to evaluate possible associations among affective temperamental dimensions and professional quality of life (Table 2). Results showed that the models accounted for 27.5%, 5.8% and 20.7% of the total variance for “Compassion satisfaction” (F = 10.714; df = 5; p < 0.0001), “Burnout” (F = 1.746; df = 5; p = 0.128), and “Secondary traumatic stress” (F = 7.373; df = 5; p < 0.0001), respectively. Moreover, regression analysis evidenced that Depressive temperament was predictor of the “Secondary traumatic stress” (β= 0.879; p = 0.004), Irritable temperament was a negative predictor of “Compassion satisfaction” (β= –1.289; p = 0.001), Hyperthymic temperament was predictor of “Compassion satisfaction” (β= 1.062; p < 0.0001) and “Burnout” (β= 0.366; p = 0.029), and Anxious temperament predicted “Secondary traumatic stress” (β= 1.241; p = 0.013); conversely, the “Cyclothymic” temperament do not make a significant contribution to the prediction of professional quality of life dimensions.

This study aimed at evaluating possible influences of affective temperaments on job satisfaction. According to the literature, hyperthymic temperament is predictive of compassion satisfaction and low levels of burnout. Studies have shown that hyperthymic subjects employed in stressful occupations show higher levels of emotional stability that allows them to appropriately perform in highly-demanding and anxiogenic environments [15]. In addition, nurses with hyperthymic temperament have been shown to experience low levels of burnout while maintaining the ability to feel satisfied. People with this temperament are often referred to as resilient because of their ability to react positively to adverse events and to be able to reorganise their lives, using difficulties as new experiences [12, 14]. However, increased adaptation at work may lead to “over-adaptation” about the intensity of stress experienced at work, with a consequent rebound effect [23]. In further studies [15, 24] depressive and anxious temperaments have been found to correlate with poorer job performances, especially in those professionals who may experience “secondary traumatic stress” [25] or are directly exposed to traumatic events. Professionals with these qualities tend to care more about their own health and safety than to keep others as safe as possible. In addition, depressive temperament could be related to worse cognitive functioning with consequent negative effects both on health and job performance [26]. In a sample of workers in a Japanese company, the level of anxious temperament was correlated with greater secondary traumatic stress and a lower ability to benefit from social support in the workplace [23]. In our study on health professions, irritable temperament was a negative predictor of “Compassion satisfaction”; one possible explanation is that irritable subjects may be more prone to develop emotional stress. In our sample, no relationships were found between cyclothymic temperament and job satisfaction; this result is quite contrasting with the existing literature that suggested that cyclothymic temperament may promote a more negative evaluation of work-related events, making professionals more prone to stress [22, 27]. The results, although interesting, must be interpreted with caution due to several limitations. First, the small, heterogeneous sample size, mainly consisting of women. A second limitation is that the specific aspects of working environment and conditions were not investigated; subjects were not differentiated by department and/or unit in which they worked. Furthermore, the study was conducted on an Italian sample, and differences in national healthcare systems have to be considered, as care models and policies are different for each Country. Furthermore, the study was performed during the pandemic period, and this may have affected self-evaluation of job satisfaction. Finally, self-report measures may be vulnerable to the effect of several other factors, such as filtered and subjective perceptions, social desirability, and “halo effect”, namely the lack of ability in discriminating among behaviors [28].

5 Conclusions

Despite the limitations, results from the present study research show that temperaments influence the way work situations are perceived and, thus, job satisfaction. Subjects with a depressive, irritable, anxious, and hyperthymic temperament will have a higher risk of developing burnout or secondary traumatic stress in the presence of subclinical aspects that may generate job difficulties and low personal satisfaction. Consequently, the identification of workers’ affective temperamental assets, as indicators of liabilities that may lead to professional dissatisfaction, may favour corrective actions and targeted interventions. Furthermore, recognizing the role of individual temperamental features in job satisfaction would allow the reinforcement of rewarding aspects through preventive and protective strategies, such as supportive interventions, psycho-educational activities, stress management programmes including relaxation and self-observation also aimed at preventing or addressing excessive dedication to work usually associated to an extreme need for control, together with techniques for the management of conflicts in work environments.

Conflict of interest

The authors have disclosed no potential conflicts of interest in researching, authoring and/or publishing this article.