Abstract
Introduction
Professional satisfaction among nurses is a critical factor in ensuring the highest quality of clinical care. In the Democratic Republic of Congo (DRC), operational and working conditions for nursing personnel remain structurally deficient. However, there is a pronounced lack of analytical studies identifying the exact organizational and clinical determinants of nurses’ job dissatisfaction in this territory, presenting an important gap in health services literature.
Purpose
This study aimed to identify the micro-level and macro-level organizational determinants influencing job dissatisfaction among nurses in the Kongo Central province of the DRC.
Methods
A multi-center, cross-sectional analytical quantitative design was deployed in two referral hospitals within the Kongo Central province. Utilizing an exhaustive census sampling methodology, 90 registered nurses were enrolled. Data collection was performed via a secure, structured digital questionnaire utilizing KoboCollect. Statistical analyses comprised descriptive metrics, bivariate analysis (p < 0.05), and a multivariate logistic regression model to isolate independent predictors of professional dissatisfaction.
Results
The descriptive analysis revealed an overall job dissatisfaction rate of 64.4% (yielding a satisfaction rate of only 35.6%). Bivariate analyses identified several operational factors significantly associated with professional dissatisfaction: lack of open communication (p = .020), unmanageable workload (p < .001), insufficient rest periods (p < .001), low workplace autonomy (p < .001), weak institutional leadership (p = .014), disregard for nurses’ opinions (p = .001), inadequate nursing staff numbers (p < .001), workplace safety deficits (p < .001), and poor physical environmental conditions (p < .001). The multivariate logistic regression model isolated four primary independent determinants of job dissatisfaction: insufficient rest periods (OR = 21.99; 95% { CI } [3.45, 140.12]; p = .001), unmanageable patient volume (OR = 20.35; 95% { CI } [3.11, 133.05]; p = .002), excessive physical/mental workload (OR = 6.16; 95% { CI } [1.41, 26.90]; p = .015), and lack of management consideration for nurses’ professional opinions (OR = 14.03; 95%{ CI } [1.46, 134.84]; p = .022).
Conclusion
The primary determinants of job dissatisfaction among nurses are fundamentally rooted in remediable organizational and structural factors. These findings highlight an urgent need for strategic healthcare policy modifications in the DRC, including the formal regulation of shift schedules, mandatory minimum rest allocations, workload balancing, and the integration of participatory governance systems.
References
Alrawahi, S., Sellgren, S. F., Altouby, S., Alwahaibi, N., & Brommels, M. (2020). The application of Herzberg’s two-factor theory of motivation to job satisfaction in clinical laboratories in Omani hospitals. Heliyon, 6(9), e04829. https://doi.org/10.1016/j.heliyon.2020.e04829
Alzoubi, F. A., Jaradat, D., & Abu Juda, A. (2021). Verbal abuse among newly hired registered Jordanian nurses and its correlate with self-esteem and job outcomes. Heliyon, 7(4), e06929. https://doi.org/10.1016/j.heliyon.2021.e06929
Bohm, J. (2012). Two-factor theory – at the intersection of health care management and patient satisfaction. ClinicoEconomics and Outcomes Research, 4, 277–285. https://doi.org/10.2147/CEOR.S29347
Bourque, J., Doucet, D., LeBlanc, J., Dupuis, J., & Nadeau, J. (2019). L’alpha de Cronbach est l’un des pires estimateurs de la consistance interne : Une étude de simulation. Revue des sciences de l’éducation, 45(2), 78–99. https://doi.org/10.7202/1067534ar
Carthon, J. M. B., Travers, J. L., Hounshell, D., Udoeyo, I., & Chittams, J. (2021). Disparities in nurse job dissatisfaction and intent to leave: Implications for retaining a diverse workforce. The Journal of Nursing Administration, 51(6), 310–317. https://doi.org/10.1097/NNA.0000000000001019
Chen, C., & Jamiat, N. (2023). A quantitative study on the effects of an interactive multimodal application to promote students’ learning motivation and comprehension in studying Tang poetry. Frontiers in Psychology, 14, 1189864. https://doi.org/10.3389/fpsyg.2023.1189864
Chen, , Chien, T.-W., Chen, L., Yeh, Y.-T., Ma, S.-C., & Lee, H.-F. (2022). An app for predicting nurse intention to quit the job using artificial neural networks (ANNs) in Microsoft Excel. Medicine, 101(11), e28915. https://doi.org/10.1097/MD.0000000000028915
Cho, M.-K., & Kim, M. Y. (2019). Outcomes and influential factors applying flipped learning methods in a clinical adult nursing practicum. International Journal of Nursing Practice, 25(2), e12724. https://doi.org/10.1111/ijn.12724
Cortés Borra, A., Jaén Ferrer, P., Gea-Caballero, V., Martín García, S., Martínez Estalella, G., & Martínez Riera, J. R. (2025). Leadership by nurse managers and its impact on humanization: A descriptive analysis based on the perception of care nurses. Investigación y Educación en Enfermería, 43(3), e03. https://doi.org/10.17533/udea.iee.v43n3e03
Côté, C. (2022). Cartographie conceptuelle de l’engagement professionnel auprès des infirmières de la relève [Master's thesis, Université Laval]. Corpus. https://hdl.handle.net/20.500.11794/104165
Fallahnezhad, T., Aghaie, B., Norouzadeh, R., Ebadi, A., & Abbasinia, M. (2023). The challenges of nursing presence at the patient’s bedside from the perspective of nurses: A qualitative study. Ethiopian Journal of Health Sciences, 33(2), 281–290. https://doi.org/10.4314/ejhs.v33i2.13
Genet, B., Cohen-Bittan, J., Bonnetain, R., Amal, A., Royer, L., Rollet, M.-E., Glasman, P., Bergeot, A., Nicolas, M., Cadwallader, J.-S., Boddaert, J., & Zerah, L. (2025). Empowering orthopedic nurses’ and nurse’s aides through a multimodal geriatric mobile team: A mixed methods study. BMC Nursing, 24, 694. https://doi.org/10.1186/s12912-025-03410-4
Gustafsson, T., & Hemberg, J. (2022). Compassion fatigue as bruises in the soul: A qualitative study on nurses. Nursing Ethics, 29(1), 157–170. https://doi.org/10.1177/09697330211003215
Huang, L., Liu, M., Wang, X., & Hsu, M. (2024). Interventions to support the psychological empowerment of nurses: A scoping review. Frontiers in Public Health, 12, 1427234. https://doi.org/10.3389/fpubh.2024.1427234
Hudays, A., Gary, F., Voss, J. G., Zhang, A. Y., & Alghamdi, A. (2023). Utilizing the social determinants of health model to explore factors affecting nurses’ job satisfaction in Saudi Arabian hospitals: A systematic review. Healthcare, 11(17), 2394. https://doi.org/10.3390/healthcare11172394
Kawabata, E., Major-Smith, D., Clayton, G. L., Shapland, C. Y., Morris, T. P., Carter, A. R., Fernández-Sanlés, A., Borges, M. C., Tilling, K., Griffith, G. J., Millard, L. A. C., Smith, G. D., Lawlor, D. A., & Hughes, R. A. (2024). Accounting for bias due to outcome data missing not at random: Comparison and illustration of two approaches to probabilistic bias analysis: A simulation study. BMC Medical Research Methodology, 24, 278. https://doi.org/10.1186/s12874-024-02382-4
Kutney-Lee, A., Carthon, J. M. B., Sloane, D. M., Bowles, K. H., McHugh, M. D., & Aiken, L. H. (2021). Electronic health record usability: Associations with nurse and patient outcomes in hospitals. Medical Care, 59(7), 625–631. https://doi.org/10.1097/MLR.0000000000001536
Lasater, K. B., Brom, H., Aiken, L. H., & McHugh, M. D. (2025). Are minimum nurse-to-patient staffing ratios needed in hospitals? An observational study in British Columbia, Canada. BMJ Open, 15(7), e099358. https://doi.org/10.1136/bmjopen-2025-099358
Lee, B., Lee, C., Choi, I., & Kim, J. (2022). Analyzing determinants of job satisfaction based on two-factor theory. Sustainability, 14(19), 12555. https://doi.org/10.3390/su141912555
Li, J. Z., Chen, M., Lao, Y., & Hu, W. (2025). How does job dissatisfaction fuel nurse exit, voice, loyalty, and neglect (EVLN) behaviours? Insights from dynamic game theory and a cross-sectional survey. Nursing Open, 12(10), e70313. https://doi.org/10.1002/nop2.70313
Marc, T. B., Michel, T. P., Florence, M., Tousaint, M., Serge, K., Chadrack, B., Roly, K., Gédéon, D., Brady, M. M., & Erick, K. N. (2023). Hospital survival of patients with pulmonary embolism in a country with limited resources: Case of the city of Kinshasa. BMC Cardiovascular Disorders, 23, 439. https://doi.org/10.1186/s12872-023-03467-6
Muamba, D. (2024). Valeurs de référence de quelques paramètres hématologiques chez les femmes enceintes : Étude transversale analytique multicentrique à Kinshasa, République Démocratique du Congo. Annales Africaines de Médecine, 17(1), e5. https://doi.org/10.4314/aamed.v17i1.5
Nantsupawat, A., Kunaviktikul, W., Nantsupawat, R., Wichaikhum, O.-A., Thienthong, H., & Poghosyan, L. (2017). Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. International Nursing Review, 64(1), 91–98. https://doi.org/10.1111/inr.12342
Nikpour, J., & Brooks Carthon, J. M. (2023). Characteristics, work environments, and rates of burnout and job dissatisfaction among registered nurses in primary care. Nursing Outlook, 71(4), 101988. https://doi.org/10.1016/j.outlook.2023.101988
Nsimba, D. N., Ngoma, O. M., Ngbolua, J.-P. K.-T.-N., Imani, B. E. R., Katuasi, D. I., Mabakutuvangila, S.-D. N., & Mukandu, F. B. (2025). Determinants of the poor quality of professional life among nurses in six hospitals within the Kongo-Central province of the DRC. Orapuh Journal, 6(1), e359. https://orapuh.org/ojs/ojs-3.1.2-4/index.php/orapj/article/view/359
Nzuanda, D. N., Ramazani, B. E. I., Basua, F. M., & Ntela, S.-D. M. (2025). Regard croisé sur les lacunes perçues dans les politiques d’accompagnement institutionnel des infirmiers et les réponses possibles. Revue des Sciences Infirmières et Techniques de Santé, 4(2), 45–56. https://revues.imist.ma/index.php/RSITS/article/view/61003
Schwalbe-Koda, D., Govindarajan, N., & Varley, J. B. (2025). Comprehensive sampling of coverage effects in catalysis by leveraging generalization in neural network models. Digital Discovery, 4(1), 234–251. https://doi.org/10.1039/D4DD00328D
Taylor-Clark, T. M., Swiger, P. A., Anusiewicz, C. V., Loan, L. A., Olds, D. M., Breckenridge-Sproat, S. T., Raju, D., & Patrician, P. A. (2022). Identifying potentially preventable reasons nurses intend to leave a job. The Journal of Nursing Administration, 52(2), 73–80. https://doi.org/10.1097/NNA.0000000000001106
Turnbach, E., Coates, L., Vanek, F., Cotter, E., Pogue, C. A., Clark, R. R. S., & Aiken, L. H. (2024). Emergency nurses’ wellbeing in Magnet® hospitals and recommendations for improvements in work environments: A multi-center cross-sectional observational study. Journal of Emergency Nursing, 50(1), 153–160. https://doi.org/10.1016/j.jen.2023.06.012
Valdes, E. G., Douglas, L., Oliveira, J., & Sadler, F. (2022). Determining the impact of best fit for newly licensed nurses. Journal for Nurses in Professional Development, 38(3), E27–E31. https://doi.org/10.1097/NND.0000000000000763
Weiser, N., Dissanayake, M., Santiago, C., Harrington, F., Benny Gerard, N., Dimmock, S., Canzian, S., & Topolovec-Vranic, J. (2024). The Registered Practical Nurse (RPN) role in an academic acute care hospital: A mixed method study of the barriers and facilitators to practice. Journal of Nursing Management, 2024, e7309242. https://doi.org/10.1155/2024/7309242
World Medical Association. (2025). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human participants. JAMA, 333(1), 71–74. https://doi.org/10.1001/jama.2024.21972

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