CH1.docx · Introduction, Amis and Thesis Summary 1.1 My Role in studying the relationship between job satisfaction, autonomy and self-efficacy among school nurses in Bahrain.( nurses working in the school) Comment by user: 1200 words plz · talk about the History of school nurses( nurses working in the school)in Bahrain · when it was started in Bahrain · what it is reached till this day and how do nurses( nurses working in the school)in working in the school operate in the school · why this study needed to be done about the school nurse( nurses working in the school)in in Bahrain , and why nobody has done this study before · why it is needed to use 3 kinds of tools ( job satisfaction tool , autonomy scale and self-efficacy scale) to do this study · the impartments to use them (the 3 scales) together · what kind of result hoped to gain from all the scales used to gather · Why it is need to know about the relationship between job satisfaction, autonomy and self-efficacy among school nurses ( nurses working in the school)in in Bahrain. · what the researcher is looking to get for this study · full description of the study 1.2 Aims and Objectives Comment by user: 1000 words plz · The significant of the study ( the most important point is to talk about student benefit then the nurses working in the schools · aims · analysis 1.2.2 Questions 1.2.3 Overall aim of thesis 1.2.4 Specific objectives of the thesis 1.2.4.1 Primary objective 1.2.4.2 Secondary objective 1.3 Thesis summary · Background · Method · Result · Conclusion Study_P.docx 1. Introduction This proposal outlines a research study investigating the factors influencing job satisfaction among school nurses in Bahrain and the importance and significance in filling this research gap.Bringing fresh primary research to an underexplored area that has a limited amount of empirical evidence is urgently required. 2. Study Aim To investigate the factors influencing job satisfaction among school nurses in Bahrain. 3. Study Objectives 3.1. Primary Objective To investigate the factors associated with job satisfaction among school nurses. 3.2. Secondary Objectives 1. To create a profile of school nurses in Bahrain; 2. To explore the scope of the role of school nurses in Bahrain; and 3. To examine the relationship between job satisfaction, autonomy, and self-efficacy among school nurses in Bahrain. 4. Study Background Job satisfaction is regarded as a complex concept that is described as an inner feeling that contains individual meaning and is capable of impacting numerous dimensions within a specific work environment (Giallonardo, Wong, and Iwasiw, 2010). Job satisfaction has an effect on productivity, absenteeism, recruitment, retention, patient care and satisfaction, and organizational commitment (Sypniewska, 2014). Top and Gider (2013) further state that job satisfaction has been subject to broad scholarly research and is correlated with improved performance of organi ...

1. CH1.docx
· Introduction, Amis and Thesis Summary
1.1 My Role in studying the relationship between job
satisfaction, autonomy and self-efficacy among school nurses in
Bahrain.( nurses working in the school) Comment by user:
1200 words plz
· talk about the History of school nurses( nurses working in the
school)in Bahrain
· when it was started in Bahrain
· what it is reached till this day and how do nurses( nurses
working in the school)in working in the school operate in the
school
· why this study needed to be done about the school nurse(
nurses working in the school)in in Bahrain , and why nobody
has done this study before
· why it is needed to use 3 kinds of tools ( job satisfaction tool ,
autonomy scale and self-efficacy scale) to do this study
· the impartments to use them (the 3 scales) together
· what kind of result hoped to gain from all the scales used to
gather
· Why it is need to know about the relationship between job
satisfaction, autonomy and self-efficacy among school nurses (
nurses working in the school)in in Bahrain.
· what the researcher is looking to get for this study
· full description of the study
1.2 Aims and Objectives Comment by user: 1000 words plz
· The significant of the study ( the most important point is to
talk about student benefit then the nurses working in the
schools
· aims
· analysis
1.2.2 Questions

2. 1.2.3 Overall aim of thesis
1.2.4 Specific objectives of the thesis
1.2.4.1 Primary objective
1.2.4.2 Secondary objective
1.3 Thesis summary
· Background
· Method
· Result
· Conclusion
Study_P.docx
1. Introduction
This proposal outlines a research study investigating the factors
influencing job satisfaction among school nurses in Bahrain and
the importance and significance in filling this research
gap.Bringing fresh primary research to an underexplored area
that has a limited amount of empirical evidence is urgently
required.
2. Study Aim
To investigate the factors influencing job satisfaction among
school nurses in Bahrain.
3. Study Objectives
3.1. Primary Objective
To investigate the factors associated with job satisfaction
among school nurses.
3.2. Secondary Objectives
1. To create a profile of school nurses in Bahrain;
2. To explore the scope of the role of school nurses in
Bahrain; and
3. To examine the relationship between job satisfaction,
autonomy, and self-efficacy among school nurses in Bahrain.
4. Study Background

3. Job satisfaction is regarded as a complex concept that is
described as an inner feeling that contains individual meaning
and is capable of impacting numerous dimensions within a
specific work environment (Giallonardo, Wong, and Iwasiw,
2010). Job satisfaction has an effect on productivity,
absenteeism, recruitment, retention, patient care and
satisfaction, and organizational commitment (Sypniewska,
2014). Top and Gider (2013) further state that job satisfaction
has been subject to broad scholarly research and is correlated
with improved performance of organizations and outcomes for
employees.
Numerous definitions of job satisfaction are now available in
healthcare. Pomirleanu and John (2015) indicate that job
satisfaction means the degree to which an employee likes the
job. Hosie, Jayashree, Tchantchane, and Lee (2013), on the
other hand, describe job satisfaction as the level of positive
effect the components of the job, or the job itself, have on the
employee. Hackman and Oldham (1976) show that autonomy,
including core job dimensions, such as task significance and
feedback, promotes outcomes on such job aspects as “positive
motivation, performance, satisfaction, absenteeism, and
turnover” (P. 162). Another study indicated that there is a
significant relationship between job satisfaction, stress,
collaboration, and autonomy among nurses (Zangaro & Soeken,
2007). Furthermore, Hayes et al. (2010) found that coping
strategies, coworker interaction, autonomy, provision of
adequate resources, and education opportunities are some of the
primary job satisfaction factors.
Scholars have identified autonomy as the main significant factor
that contributes to job satisfaction and retention among nurses
(Luszczynska, Scholz, and Schwarzer, 2005). Self-efficacy can
be described as the process by which individuals are able to
exercise control over demands that affect them due to their
beliefs (Luszczynska, Scholz, & Schwarzer, 2005). Autonomy
and self-efficacy are believed to be inherent in job satisfaction
among school nurses, and both autonomy and self-efficacy

4. affect job performance among nurses.
According to Schwarzer and Jerusalem (1999), individual self-
efficacy can be described as the self-confidence an individual
has when coping with different situations in life. General self-
efficacy (GSE) can be described as the process by which people
in different environments use various domains to achieve their
goals (Scholz et al., 2002). It has been argued that autonomy
and self-efficacy contribute to job satisfaction. Moreover,
employees with high degrees of self-efficacy have relative
strength in their fields, resulting in patient outcomes that are
positive and that raise job satisfaction for employees (Shu-Fang
et al., 2012). It is likely that higher self-efficacy beliefs will
have direct implications on the capacity of a nurse to cope with
a myriad of challenging demands. Furthermore, employment
satisfaction is of particular interest in nursing given the
demanding work environment to which nurses are exposed and
nurses’ significant role in patient care (Salsgiver, 2011). Job
satisfaction is therefore a complex construct that requires
consideration of a myriad of factors for analysis.
Bahrain’s Education Ministry and Ministry of Health have
adopted the policy to which you are referring in terms of the
direction and need for school-based health programs in public
and private Bahraini schools. School nurses in Bahrain offer
health education by directly providing health information to
individual learners, groups of learners, or classes. Also, they
offer guidance concerning health education programs that
encourage sequential, comprehensive, and age-accurate
information (Uys and Gwele, 2004).
4.1. Research Questions
· What are the factors associated with job satisfaction among
school nurses in Bahrain?
· What is the scope of the role of school nurses in Bahrain?
· What is the relationship between job satisfaction, autonomy,
and self-efficacy among school nurses in Bahrain?
5. Methodology
5.1. Study Design

5. The study adopts a mixed-methods design with both qualitative
and the quantitative aspects. A mixed-methods design was
chosen because of the capability to triangulate the sources, as in
public versus private settings, and methods, as in qualitative
and quantitative data, to increase both the validity and the
reliability of the findings. The results would have aspects of
generalization and contextualization.
· Quantitative aspect
Involving administration of questionnaires to 150 nurses, which
is the total population of private and public school nurses in
Bahrain.
· Qualitative aspect
Involving semi-structured interviews for 30 school nurses, 15
private and 15 public.
5.2. Study Subjects
All the nurses working in public and private schools in Bahrain
will be invited to take part in this study.
The criteria for inclusion are as follows:
· The participant is a registered nurse;
· The participant works in an educational institution as a full-
time employee; and
· The participant has worked within the institution as a school
nurse for more than one month.
The criteria for exclusion will be:
· The participant is not a registered nurse;
· The participant does not work within an institution of learning
or is not a full-time employee;
· The participant has worked within the institution for a period
that is less than one month; and
· The participant qualifies to be part of the study but does not
consent to participate in the study.
5.3. Sample Size and Pilot Study
The survey uses a mixed-methods design.
5.3.1. Quantitative Aspect
For this aspect of the study, a total population sampling
technique will be utilized. Total population sampling is a

6. common technique where the overall size of the population is
small (Ellstrand and Diane, 1993). The total population of
school nurses in Bahrain is relativity small. The total population
is 150 and includes 85 nurses in private schools and 65 in
public schools. The researcher will invite all school nurses to
participate in the study as further division of the population
would lead to results that are not robust enough. This is based
on the advice of RCSI Biostatistics Consulting and Support
Services (BCSS).
5.3.2. Qualitative Aspect
For the qualitative research, a nonprobability of approximately
30 participants will be chosen, 15 from private and 15 from
public schools. The sampling technique will be purposeful or
judgmental, a method which aims to target those best placed to
answer the research questions. According to advice from BCSS,
in this instance, 30 is considered a reasonable number to archive
data saturation.
5.4. Ethical Issues
5.4.1. Recruitment
Consent will be sought from the RCSI Ethics Review
Committee, the Ministry of Health Ethics Review Committee,
and the Ministry of Education Ethics Review Committee, in that
order. The consent of the three committees will allow the study
and the researcher to access all schools and nurses in Bahrain.
5.4.2. Quantitative Aspect
Once consent from the ethics committees and access have been
granted, the researcher will meet the gatekeeper (the headmaster
of each school) to provide the three ethics committee approval
letters, and the gatekeeper will approach the school nurses, give
information about the study, and provide the researcher with the
school nurses’ emails so that each school nurse can receive the
study questionnaire with the participant information pack. A
school nurse’s completion and return of the questionnaire will
be taken as consent to participation in the study.
5.4.3. Qualitative Aspect
Through the gatekeeper, the researcher will approach school

7. nurses with a view to participating in the qualitative aspect of
the study through interviews. The nurses will also be told that
they must sign the ethical consent form in order to take part in
the study.
The researcher will be expected to take full responsibility for
the research conducted, and, as such, a verification process
must be in place to ensure that ethical guidelines are followed
5.5.1. Ethical Principles
The study follows three ethical principles and guidelines:
informed consent, voluntary participation, and nondisclosure
.Ethical standards require research participants to give valid
consent freely and without pressure, such as coercion, threats or
persuasion. Voluntary participation requires that people not be
coerced into participating in research. Closely related to the
notion of voluntary participation is the requirement of informed
consent. Making sure that participants in research not only give
consent but give informed consent is critical to ensuring that
consent is truly given freely and that a participant is knowingly,
and thus voluntarily, participating in the stud. The other ethical
standard is the privacy of research participants. Almost all
research guarantees the participant’s confidentiality. The
participant is assured that identifying information will not be
made available to anyone who is not directly involved in the
study. The stricter standard is the principle of anonymity, which
essentially means that the participant will remain anonymous
throughout the study, even to the researchers (Trochim and
William, 2006).
In the case of quantitative data, the participant’s completion of
the required study questionnaire will be considered his or her
consent. The researcher will then be responsible for ensuring
that the participant’s information is kept confidential. Such
information includes anything that may lead someone to identify
the participant. The researcher will not require the participants
to indicate their names or personal identification numbers.
Notably, the study will enable the participants to remain
autonomous. Autonomy will also be achieved by analyzing the

8. quantitative data and reporting the results in the form of
summaries.
In the case of qualitative data, consent will be obtained before
recording each participant’s interview. The researcher will keep
participants’ respective institutions confidential. All study data
(such as consent forms, participant leaflets, and approval
letters) will be scanned, encrypted, and saved onto the “RCSI
V:” drive. Data will be stored in this location for five years.
5.5.2. Data Protection
As aforementioned, the researcher will ensure that the
respondents have the maximum level of confidentiality possible
(Ivey, 2015). This confidentiality will be partly ensured through
the protection of the participants’ data (Snowden, 2014).
Firstly, given that participants have the right to such protection,
the researcher will make it known to the participants that all the
information they provide will be treated as confidential.
However, the details of how the data will be kept will only be
revealed to the participants who seek such information.
Secondly, the data protection is the researcher’s mandate, and,
before research can begin, the ethics review committees must
have determined that the researcher has an adequate plan to
ensure the protection of data. The study data will be securely
stored and encrypted within the researcher’s” unique project
folder located within the “RCSI V:” drive. All study data (such
as consent forms, participant leaflets, and approval letters) will
be scanned, encrypted and saved onto the “RCSI V:” drive. Data
will be stored in this location for five years.
The data will be protected as follows:
• Data in soft copy will be password protected.
• All study data (such as consent forms, participant leaflets,
and approval letters) will be scanned, encrypted, and saved onto
the “RCSI V:” drive. Data will be stored in this location for five
years.
• Analyzed data (quantitative) will be presented in
summarized form.
• Analyzed data (qualitative) will be submitted in general

9. form, but when a particular quote is referred to, the participant
will then be mentioned, provided that his or her name will be
replaced with a number and without reference to the institution
with which the participant is affiliated.
0. 3. Data Collection
For the quantitative aspect of this research, permission has been
granted to use instruments that have been used in previous
studies. The Measure of Job Satisfaction (MJS), the Hampton
Peterson Scale, the Factual Autonomy Scale (FAS), and the
General Self-Efficacy Scale (GSE) questionnaires will be used.
(Appendices 1, 2 and 3).
For the qualitative aspect of this research, the researcher will
require the participants to sign the consent forms before taking
part in the interviews (Appendix 5), which will be semi-
structured.
5.6. Instrument
5.6.1. Demographic Data in Quantitative Data Collection
Before the respondents fill in the answers to the questions
concerning different measures, the researcher will require the
respondents to indicate their demographic attributes (see
Appendix 1).
5.6.2. Measure of Job Satisfaction (MJS)
The construction of the MJS emanated from literature and
discussions with key informants (Traynor and Wade, 1993). The
dimensions of the MJS were identified through the use of the
principal component analysis with varimax rotation. The five
dimensions included personal satisfaction, job satisfaction, and
satisfaction with professional support, workload, training, and
pay. The scale was administered to nurses in a longitudinal
study (Traynor and Wade, 1993). The results of the factor
analysis indicate positive factor loadings of greater than 0.3 for
the five subscales, with the correlations between the factor
scores and the raw scores being between 0.88 and 0.93. It was
established that the scale had a high level of internal
consistency, discriminatory and concurrent validity, and test
and retest reliability (see Appendix 1).

10. 5.6.3. Factual Autonomy Scale (FAS)
The first trial regarding the formulation of a more factual scale
of control was in Spector (1987) (Spector and Fox, 2003).
Following the administration of the scale, the correlations were
0.25 with a single measure of job satisfaction and 0.12 with a
single dimension of job satisfaction. There were complaints that
participants had difficulty choosing from the options provided
in some questions because more than one option applied. This
scale became the foundation of the FAS. There are about seven
items that were included in the evaluation of autonomy, after
two items were added and others, which overlapped with other
constructs, were deleted. The FAS was developed for the
purpose of reducing subjectivity and has a high level of
discriminant and convergent validities. It also significantly
correlates with the measures of job performance (Spector and
Fox, 2003).
5.6.4. General Self-efficacy Scale (GSE)
The GSE has become popular in the measurement of general
self-efficacy (Luszczynska, Gutiérez-Doña, and Schwarzer,
2005; Jian-Feng, Ze-Wei, and Xue-Ting, 2015). It helps in the
evaluation of a wide and stable sense of personal competence
that enables one to deal effectively with situations that are
stressful. The scale comprises ten items rated from not at all
true (1) to exactly true (4) (Bonsaksen, Kottorp, Gay,
Fagermoen, and Lerdal, 2013). An overall score on the scale is
calculated through the summation of the scores, ranging from
lowest (10) to highest (40), of each item. The scale has been
used among cohorts, students, and clinical populations. Its use
among school nurses should therefore be valid. Moreover, the
scale has been found to have total item correlations ranging
from 0.25 to 0.63 and factor loadings ranging from 0.32 to 0.74.
Moreover, Schwarzer, Mueller, and Greenglass (1999) found the
internal consistency of the scale to be 0.82.
5.6.5. Qualitative
The interviews will be semi-structured (Appendix 4). Thus, they
will consist of closed-ended and open-ended questions. The

11. semi-structured nature of the interviews will allow the
emergence of new evidence and will permit the clarification of
questions and answers. The interviews will be conducted at the
convenience of the interviewees and at interviewees’ preferred
times and venues. The interviews will be audio recorded and
will then be transcribed verbatim. The audio records and the
transcriptions will be securely stored and encrypted within the
researcher’s unique project folder located within the “RCSI V:”
drive for future reference.
1. Data Analysis
0. Analysis of Demographic Attributes Using Descriptive
Statistics
All quantitative data analysis will be carried out in SPSS. After
data are collected, the demographic attributes will be
summarized using pie charts, bar graphs, and frequency tables.
For continuous variables, the mean and standard deviation will
be calculated. Thus, the data will be analyzed using descriptive
statistics.
The summarization of the data will enable the researcher to
compare the data and, with the advice of the BCSS, to have a
complete view of the characteristics that relate to testing the
relationship between the data relating to public school nurses
and the data relating to private school nurses.
0. Relationships between the Data
The relationships between the data will be tested using
correlational statistics. Total scores from each instrument will
be used to investigate relationships between the concepts of
interest—i.e., job satisfaction, autonomy, and self-efficacy—
using Spearman’s correlations. Investigation of differences
between groups will be carried out using Chi-squared tests. This
is in line with the advice provided by the BCSS.
0. Analysis of Qualitative Data
The qualitative data that will be obtained from 30 interviews
will be analyzed using the 14 stages proposed by Burnard
(1991). The stages include note-taking; immersion of the
researcher in the data; open coding; reducing and refining the

12. data; checking, reading, and categorizing the data; and
rearranging the data. Moreover, the stages also involve
checking the data analyzed by the informants and making
preparations toward writing and finally reporting the results as
well as linking them to literature.
The first stage will involve audio recording and then
transcribing each interview to enable the categorization of the
data at a later time. The data will be analyzed using the Burnard
process of thematic analysis. Thus, the researcher will cover the
following steps: familiarization with the data, coding, searching
for themes, reviewing the themes, defining and naming the
themes, and production of the report.
0. Expected Outcome and Benefits
Given that the study will look into the factors that contribute to
job satisfaction of nurses, the results established will be
recommended to the Ministry of Health and the Ministry of
Education for purposes of improving the working environment
of school nurses in Bahrain. Research indicates that a satisfied
employee is less likely to be absent, has a lower intent of
leaving employment, and has a greater level of involvement
with the organization or the unit with which the employee is
affiliated. In this case, the organization is the school at which
the school nurse works. For this reason, the school will benefit
from decreased human resource problems arising from
dissatisfaction, such as conflict with others.
Additionally, the literature indicates that job satisfaction of
nurses may lead to improved patient care (Top and Gider,
2013). This means that the students served by the school nurses
may benefit from improved care if the recommendations are
implemented. This improved care comes from the provision of
better health services that result in enhanced school attendance,
as well as the prevention and control of communicable diseases.
Lastly, the study will explore the differences and similarities
between private and public school nurses in Bahrain.
Cooperation between learning institutions’ major stakeholders
will have a direct impact on the quality of health care services

13. being rendered by such institutions. Thus, the study should
provide information on which relationships can be forged.
12
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