Job Satisfaction Among Nurses in Hafr Albatin Proposal

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Introduction

Research Topic

Job satisfaction is a subject of great interest to employees and people who conduct studies on workplace settings. According to Trower (2012), occupation contentment is a worker’s sentimental reaction towards a job. It is based on a comparison between actual and expected outcomes. During employment, workers often expect their occupations to grant them different levels of satisfaction, which offer preferential values. The features include incentives and promotion. When the desired expectations are not met, employees’ level of job satisfaction reduces.

Over the past few decades, extensive research has been conducted on this topic. According to the existing literature, job satisfaction is influenced by numerous factors (Boylan 2013). Some of the factors include interpersonal relationships, repetition of duties, and supervision. Other elements that influence contentment include employees’ perceptions of the nature of the work and the quality of the physical environment (Auerbach et al. 2012).

The proposed research will analyze the issue of job satisfaction among nurses in Hafr Albatin. The study will be limited to the factors affecting job satisfaction. Other elements, such as the recruitment criteria and the nurses’ personal lives outside the work setting will not be part of the research. In addition, the research will focus on nurses alone. Other workers in the health sector, such as doctors and administrators, will not be part of the proposed study.

Importance of the Study

Professional fulfillment enhances employee retention and performance. To promote satisfaction, managers are encouraged to focus on a wide range of aspects touching on their organizations. The facets include balanced workload, quality of technical equipment, and physical work environment. Other issues to be taken into consideration include opportunities for professional growth, leadership, team dynamics, and communication. According to Al-Enezi et al. (2009), nurses are patients’ closest friends. Despite their hard work and concern towards the ailing individuals, the caregivers, at times, suffer from high levels of stress. It is one of the reasons why it is important to conduct studies in this field. The reason is that when they are under stress, the spirit of the nurses and their passion for their profession reduces. In addition, stress may lead to burnout, which negatively affects the work environment. According to Bjorka, Samdalb, and Hansen (2007), satisfied employees are more productive, creative, and committed. When nurses are contented, they provide high-quality patient care. Due to this, patients are also satisfied.

The Author’s Engagement with the Topic

The research will be conducted by a nursing student in Hafr Albatin. As such, the proposed study has personal significance to them. As a result of their engagement with the study, the author will identify some of the issues that affect their satisfaction with their chosen line of career. Consequently, they will be well equipped to deal with such issues.

Policies on Job Satisfaction

The proposed study is closely related to policy in the health sector, specifically in the field of nursing. The main reason is that burnout and job satisfaction are interlinked. Board (2012) is of the view that among healthcare professionals, nurses suffer the most from exhaustion. In such situations, the caregivers become inefficient and less dedicated to their work. Various policies have been adopted by governments in the Gulf region to enhance job satisfaction. The findings of the proposed research will inform these guidelines. One of the primary agendas is concerned with the restructuring of pay. The issue of remuneration is one of the major factors affecting job satisfaction. The majority of nurses believe that their efforts and willingness to help the ailing requires better rewards and recognition. Another Saudi Arabia government agenda is the one meant to ensure that healthcare centers do not victimize nurses. Bjorka et al. (2007) argue that nurses require positive working environments. When the atmosphere is positive, workers are more comfortable and motivated to carry out their duties. Governments also strive to ensure that healthcare administrators formulate measures to develop the skills and potential of their employees. According to Boylan (2013), some nurses report job dissatisfaction due to a lack of career growth. The proposed study will highlight most of these issues.

Background to the Study

Search strategy

Nursing catalogs to be used

It is important to note that one of the primary approaches to be employed is the descriptive-correlation research method. In addition, a quantitative non-experimental design will be used. Descriptive correlation methodology is preferred because it allows the collection of data without altering the subject of the study (Ardilly 2006). In addition, the design enables scholars to gather in-depth information on the characteristics of a specific field of study. The descriptive correlation method of research will provide more insight into the level of job satisfaction among nurses in Hafar Al-Batin.

A total of 5 databases will be used to gather relevant information on the level of job satisfaction among nurses in Hafar Al-Batin. They include the following:

  1. National Database of Nursing Quality Indicators (NDNQI).
  2. CINAHL plus.
  3. PubMed.
  4. ProQuest Nursing and Allied Health Source, and
  5. Highwire Press and MedConnect.

The search engines are preferred due to their capability to provide relevant information on healthcare professionals. Most of the catalogs provide access to major news and research publications dating back to the past 10 years (Coomber & Louise 2007).

Search phrases

According to Fitzpatrick (2004), a literature review is a well-planned and organized search for information about a specific topic. Well-structured information exploration is the most effective and efficient mode of locating evidence on a research topic. The facts can be found in books, journals, and government publications. To find the relevant sources, key search terms will be used. They include the following:

  1. Job satisfaction
  2. Job satisfaction among nurses
  3. Nurses in Hafr Al-Batin
  4. Indicators of job satisfaction

The primary phrases applied will be Boolean Operators, truncations, and thesaurus. The three Boolean operators AND, OR, and NOT will be chosen from the drop-down menu adjacent to search boxes. The expressions will be used to link different notions and search terms. In addition, they help to develop complex search mechanisms.

Some phrases have variant endings (Fitzpatrick 2004). Because most of the search terms above are relevant to the study, truncation signs will be entered to give results containing all deviations of a word. Thesaurus will be used in databases to break down broad topics into sub-headings. In addition, the feature will be used to ensure that all entries of a specific subject have standard search phrases assigned to them.

Selection criteria for research articles

The research will focus on articles and books published between 2000 and 2015. Such sources contain information that is up to date (Carver 2010). Articles published in non-academic sources, such as magazines, will be excluded from the research. The research will also limit resources touching on job satisfaction among nurses.

Appraising the articles

CASP will be used to appraise the articles. The tool helps to determine the trustworthiness and relevance of reports in the healthcare sector (Kaspar 2011).

Outcomes of the search

A total of 27 sources will be used in the proposed research. The reason is that it is a manageable size.

Literature Review

Selection of respondents

There are numerous ways of selecting participants for research. Franzosi (2008) notes that the modes used are influenced by the type of study to be carried out. One cannot analyze the whole population in research. To get reliable information, an appropriate sampling procedure will be used in the current study. According to White and McBurney (2010), two primary factors need to be taken into consideration during the selection of participants. One is the heterogeneity of the population. The feature entails analyzing the key characteristics distributed within the study populace. The other aspect is the sample size. Participants dimension involves assessing whether or not the sample size is big enough to avoid errors. Small samples increase levels of ambiguity (Vogt 2010).

Job satisfaction among nurses is a complex phenomenon. Existing literature on studies made in KSA and the Gulf region reveals that various factors, such as work-related stress, are associated with discontent. In addition, more males continue to enter into the nursing profession. In the proposed research, the intrinsic and extrinsic factors that motivate men to join the nursing profession will be analyzed.

Shortage of nurses and job satisfaction in Saudi Arabia

Saudi Arabia faces a severe shortage of nursing staff and high turnover rates. Velayudhan and Veeramani (2013, p. 110) are of the view that expatriate nurses form the largest portion of the workforce in the nation. The high number of foreign professionals is associated with instabilities in the labor market. Nurses of Saudi descent form only 29.1% of the total population. The private sector is worst affected by the problem of nurse shortage. The situation leads to discontentment. Compared to other Middle East countries, such as Kuwait and Bahrain, Saudi Arabia has the lowest number of nurses per population. In the nation, there are 36 nurses per 10,000 citizens (Ray 2010).

Over the years, various measures have been taken to tackle the problem of nurse shortage in Saudi Arabia. Some of the efforts taken by the government include setting up nursing colleges and institutes. In addition, funds are set aside each financial year to facilitate training and scholarship of healthcare personnel abroad (Tourangeau et al. 2010). Despite all the measures, the shortage of nurses and dissatisfaction continue to be a major problem in Saudi Arabia.

Factors affecting job satisfaction in Saudi Arabia

Job satisfaction is an important aspect of any healthcare organization. The reason is that it is used to measure the psychological and physical condition of employees. As a result, leaders and managers should understand the basis of job satisfaction. Discontent impacts negatively on how workers carry out their daily duties (Trower 2012). Saudi Arabia is developing in all fields. One of the sectors experiencing rapid growth in nursing and health. Over the years, the nursing fraternity has been reported to suffer from job discontentment.

Various factors are linked to work satisfaction among nurses in Saudi Arabia. One of the issues is the role of these professionals. Over the past few decades, the duties carried out by nurses have changed significantly. The responsibilities have become more complex than before (Ray 2010). In addition, economic recession, which impacts negatively on most healthcare centers, has affected job satisfaction among nurses in Saudi Arabia.

The aspect of job satisfaction is also linked to the epoch. Aged nurses with more years of experience are highly satisfied with their work (Velayudhan & Veeramani 2013). Studies conducted in the Middle East reveal that nurses who are older than 30 years report higher levels of satisfaction compared to their younger counterparts.

Another factor related to job satisfaction among nurses in Saudi Arabia is shifts. Nurses work on different schedules. Some work during the day, while others operate at night. In addition, there are full-time and part-time nurses. Studies reveal that caregivers who work on night shifts report higher levels of job dissatisfaction. The reason is that nightwork affects sleeping patterns (Ray 2010). The source by Ray (2010) notes this as one of the specific factors affecting job contentment. Consequently, some nurses suffer from sleep-related health complications.

The importance of job satisfaction among nurses

Saudi Arabia and other Middle East nations suffer from the problem of nurse shortage. The primary cause of the problem is low retention rates. Oulton (2006, p. 95) points out that job satisfaction leads to high turnover rates. It is one of the reasons why nurses desire to leave the profession. Satisfied employees play a key role in enhancing the success of an organization. As such, leaders in the healthcare sector need to understand the importance of contentment. Job satisfaction among employees should be monitored regularly (Rajapaksa & Rothstein 2009).

Job dissatisfaction has numerous effects on nurses. Discontentment among caregivers leads to low productivity and commitment to patient care. Trower (2012, p. 107) notes that patients are also affected by the aspect of job satisfaction. When nurses fail to perform as required, patients tend to be displeased with the services provided. It is also important to note that caregivers who lack motivation report high levels of stress. According to Ray (2010, p. 88), pleased workers register low levels of stress associated with their work. In addition, job dissatisfaction among nurses in Saudi Arabia leads to tardiness and absenteeism (Williams 2010).

Knowledge lacuna and research questions

Most studies have established that nursing is a female-dominated profession. It is also known that nurses work under physical, psychological, and emotional stress. However, the issue of job satisfaction among nurses in Hafr Al-Batin is not well known. The proposed research will address this knowledge gap. In light of this, the study will respond to the research questions below:

  1. What is the level of job satisfaction among nurses in Hafr Al-Batin?
  2. What is the relationship between socio-demographic variables and the level of job satisfaction among nurses in Hafr Al-Batin?

Study Design

Overview of the Proposed Study

According to Cox (2012), stakeholders in the healthcare sector have expressed several concerns relating to the productivity of nurses. For example, in Hafr Al-Batin, there have been major concerns regarding the retention and recruitment of healthcare practitioners. The shortage of skilled nurses and high turnover rates within hospitals in this region has led to increased levels of stress and job dissatisfaction. When the size of the task force is small, overworking and overloading tend to occur. In addition, patients do not receive the desired quality of care from healthcare institutions. Al-Enezi et al. (2009) think that there are many factors associated with the shortage of nurses in Saudi Arabia. The issues include a reduction in the number of students wishing to join the field and job discontentment. Dissatisfaction makes caregivers leave the nursing career (Board 2012). In the proposed study, the research will analyze the issue of job satisfaction among nurses working in Hafr Al-Batin. The research will incorporate both qualitative and quantitative research designs. Qualitative information will be gathered using literature review and interviews, while quantitative data will be collected with the help of a questionnaire.

Sampling Techniques and Research Sample

Overview

The study will assess the level of job satisfaction among both Saudi and foreign nurses working in private and public hospitals in Hafar Al-Batin. The research will incorporate such variables as the forms of leadership in healthcare facilities, burnout, and organizational commitment. According to Auerbach et al. (2012), job satisfaction among nurses in Hafr Al-Batin is linked to organizational commitment, rewards, working environment, and hospital policies. Other factors attributed to dissatisfaction include social views, payment, and policies adopted by healthcare facilities.

To carry out the study and get the desired findings, both retrospective and prospective audits will be conducted using a large population sample. According to Ardilly (2006), the assessment procedure entails gathering data about patients during their care. To perform a retrospective audit, an existing set of questions and tools will be used. The reason for this is to save time. However, a few modifications will be made to the pre-existing design. In addition, a small pilot study will be conducted to fine-tune the tool.

Retrospective and prospective audit designs are important in research. The prospective methodology is preferred because it helps one to collect more reliable clinical data. According to Bazeley (2013), the audit system enables scholars to predefine and validate the gathered information. When this happens, any detected errors can be rectified with ease as the data collection process continues. It is one of the reasons why the design will be adopted for this research. However, it is important to note that the design has one primary limitation. The procedure needs to be altered in cases where the nurses and patients discover that they are being observed.

A retrospective audit entails analyzing the records of discharged patients. The procedure will provide vital information on the day-to-day practice of the nurses. Carver (2010) notes that a retrospective audit allows one to highlight the points in time where the patient received poor care from nurses who suffered from burnout and job dissatisfaction. However, like the prospective approach, the procedure has one major disadvantage. It is hard to access a complete set of data regarding the participants taking part in the study.

Research sample

The study will involve assessing the level of job satisfaction among nurses in 5 hospitals and 25 primary healthcare centers in Hafr Al-Batin. To access the target participants, a convenience sampling technique will be employed. The entire population of caregivers in the region is estimated to be 1200. However, the sample size to be used will be 500. The number chosen will comprise both male and female Saudi nationals and expatriate nurses. To get the right participants for the study, various factors will be taken into consideration. Some of the aspects include job ranking, number of years worked in Hafr Al-Batin, and basis of employment.

The final sample size selected for the study will comprise nurses with various demographic characteristics. The primary features to be considered include at least one year of working experience in any hospital in Hafr Al-Batin. Such an engagement should be on a full-time and permanent basis. Participants excluded from the study are head nurses and supervisors. The reason for their elimination is because the nature of their duty varies from that of the ordinary members of staff, who are the target of the research. Head nurses and supervisors do not interact a lot with patients (Bjorka et al. 2007). As a result, they may experience different levels of burnout and job dissatisfaction. New employees in the healthcare centers will also not be included in the research. The reason for this is that they have little experience with the nature of the nursing profession in Hafr Al-Batin.

Convenience sampling is a non-probability approach that entails choosing study subjects based on their accessibility and proximity to the research (Franzosi 2008). In a study, it is best to assess the entire population. The reason for this is to get conclusive and detailed data. However, in most instances, the population is too big. Consequently, it becomes a challenge to include every individual in the study. Convenience sampling is preferred in many studies (Carver 2010). The reason why the design is common is that it is fast and cheap to apply. In addition, the methodology allows scholars to access subjects with ease.

Convenience sampling has various strengths and weaknesses. Advantages of the methodology include fast data collection and ease of research. It is also inexpensive and readily available. As a result of the speedy collection of data, the technique makes it possible to embark on data analysis in good time. According to Thompson (2012), convenience sampling requires little preparation on the part of the individual undertaking the study. As already indicated, the total number of nurses in Hafr Al-Batin is 1200. The technique will be useful in pooling subjects and acquiring the desired number with ease.

With regards to ease of use, convenience sampling can be carried out by developing and distributing questionnaires to the study subjects. As a result, it takes less time to collect the data required. In terms of it being readily available, one does not have to travel long distances to meet their subjects and collect information (Vogt 2010). The reason behind this is that the participants chosen for the study are near the experimenters. The sampling technique is also cheap. The reason is that the methodology does not require an elaborate setup. White and McBurney (2013) think that the sampling technique allows for resources to be distributed to other areas of the study.

Despite the numerous advantages, convenience sampling has various disadvantages. The limitations include biased results, incomplete conclusions, and misrepresentation of data. According to Vogt (2010), biasness arises due to the over or under-representation of specific study groups. The numerous flaws in the methodology may lead to incomplete conclusions.

To estimate the required sample size, a power calculation will be carried out. Thompson (2012) is of the view that before gathering data, there is a need to approximate the sample size required to provide the desired results. Respondents will be recruited for the study through face-to-face interaction with the individuals undertaking the research.

Data Collection

Before taking part in a study, participants should be given a chance to ask any questions regarding the process (White & McBurney 2013). During the research, data will be collected using several strategies. The primary channels to be used include questionnaires, interviews, observation, and literature review.

A questionnaire is a research tool that comprises a set of questions structured systematically. The primary purpose of the instrument is to collect the relevant information from the study participants (Al-Enezi et al. 2009). Various approaches can be used to distribute the questionnaires to the recipients. They include posting and offering them in an interview format. In addition, the tool can be self-administered. To carry out the proposed study, participants will be provided with feedback forms to fill out whenever visits are made to their hospital. When questionnaires are issued, cases of duplication may arise (Bazeley 2013). To ensure that recipients do not fill out two forms, the participants will be marked off the sampling frame. To collect the questionnaires, a central drop point will be created in all the hospitals.

Like other research instruments, questionnaires have both strengths and weaknesses. The advantages include the fact that they are economical. In addition, they are fast and easy to administer. They also provide a wide coverage of the research population. Other pros associated with the tool are anonymity and flexibility (Bazeley 2013).

It is cheap to construct questionnaires. In addition, they save time and effort. For example, to carry out this study, the scholar will not have to visit all the participants in person to administer the questionnaires. The reason is because the tools can be posted. Questionnaires can be received and filled fast (Ardilly 2006). Compared to interviews and observations, the tool helps to reach participants that may be inaccessible. Some will be posted to different hospitals and healthcare centres to allow for a wide coverage. Questionnaires are also flexible and offer anonymity (Auerbach et al. 2012). When filling the forms, recipients are assured that they will not be exposed. Due to this, they are more confident and comfortable when expressing their views. The advantages highlighted above are some of the reasons the tool was selected for this research.

In spite of the numerous advantages, questionnaires also have various weaknesses. They include limited response, lack of personal contact, poor feedback, and unreliability. Other limitations include incomplete and manipulated entries. In terms of limited response, questionnaires can only be used by participants with good reading and writing skills. People with different characteristics are provided with the forms (Carver 2010). Some claim to be busy to complete them, while others are too lazy. In addition, some recipients fail to sign questionnaires because they do not trust the study.

At times, the tool is also administered without personal contact. Guido (2006) notes that some participants may fail to understand the questions. In such scenarios, it becomes a challenge for respondents to fill the forms. Questionnaires are also associated with incomplete entries. According to Franzosi (2008), some participants fill the forms poorly. Others leave too many questions unanswered. The weaknesses are some of the reasons why the research intends to use other tools to complement the questionnaire.

Data Analysis

The structured questionnaires will be made up of open-ended questions (Thompson 2012). The aim is to obtain additional information from the recipients, which is not asked in the standardised queries. Once all the data is collected, it will be computerized and analysed using Statistical Package for Social Sciences (SPSS version 18.0). The software includes marginal trends for the findings and contingency tables. In addition, inferential and descriptive statistics will be used. The two methodologies incorporate percentages, means, frequencies, and standard deviation. They will be used to depict demographic traits and job satisfaction survey (JSS).

The total number of nurses provided with questionnaires will be around 500. In clinical research studies, 80% of participants tend to respond (Oulton 2006). The data in the valid survey instruments will be coded. It will then be keyed into the SPSS program. Various tests will be made to sort out the sample data. The assessments include bivariate analyses between independent and dependent variables. Chi-square will also be used in the evaluation. The research will also make use of binary logistic regression. The correspondence between erratic is computed on interval scale. It will be measured by calculating the product-moment correlation coefficients (Pallant 2010). The analysis will reveal the strength and course of the link between variables. To compare the findings in distinctively, different sets of correlations will be used. To this end, ±1.0 –0.5 will be considered as strong, ±.05-0.4 as modest, while ±0.4-.02 will be treated as weak. In addition, hierarchical regression analysis will be carried out. The aim is to develop models to predict job satisfaction and retention among nurses.

Content analysis will be used to examine some of the collected data. The technique entails systematic examination of written information (Bazeley 2013). The responses of the questionnaires will be categorised using such criteria as favourableness and essential theme. The procedure will be repeated several times to develop sub-groups. The rationale behind this is to ensure that all forms are put in the right cluster. Content analysis is preferred because it combines both qualitative and quantitative designs.

Ethical Aspects of the Research

Before the proposed research project commences, a risk assessment will be carried out. Lo (2010) notes that this evaluation is not just a procedural requirement. The research will focus on three primary questions. The three are harm, risk, and potential benefits associated with the study. When an appraisal is conducted, one is able to determine whether the study is worth conducting or not. In addition, the risks associated with the research are identified. According to Vogt (2010), the test helps study subjects to make informed decisions on whether to take part in the study or not. To address this problem, the participants will be required to sign a consent form before the research starts.

During a research, participants are exposed to various dangers. Risk refers to the probability of harm associated with taking part in the study. The level of injury can be minimal or significant depending on the type of research (Cox 2012). Before carrying out the job satisfaction investigation among nurses in Hafr Al-Batin, the potential risks will be identified. The probable perils include psychological, invasion of privacy, and social and economic harm.

Guido (2006) notes that taking part in a research can lead to undesired changes in recipients’ emotions and thought processes. Some participants have been reported to suffer from hallucination and stress. Others experience loss of self-esteem and depression. The cases are categorised as psychological risks associated with research. The changes in emotions can be recurrent or transitory. However, at times, the spells may be permanent. Psychological risks in the proposed research may arise due to such factors as manipulation of subjects’ environment and guilt associated with talking about one’s own behaviour. According to Boylan (2013), the harm may arise when research involves deception. To alleviate this problem, the scholar will be as honest as possible with the participants (Ker 2012).

Another probable risk to participants in this research is invasion of privacy. Harm may arise when behaviour considered as private is observed without the subjects’ consent (Lo 2010). Social and economic risks are associated with invasion of privacy and breach of confidentiality. Cox (2012) is of the view that such acts may lead to loss of employment or criminal trial. To minimise the harm associated with the research, data will be collected by following standard procedures. According to Franzosi (2008), the strategy will help to address the problem associated with invasion of privacy.

The study on job satisfaction among nurses in Hafr Al-Batin will be conducted after an ethical approval from the College Research Ethics Panel is acquired. In addition, authorisation from the Chief Executive Officer and Deputy Director of Nursing will be sought to conduct the study and interact with nurses in Hafr Al-Batin.

Conclusion

Expected Findings

The majority of respondents are expected to be female nurses. The reason is that they make up 85.5 percent of the entire research population. Male nurses account for 14.5 percent of the total population. If the research works, various findings are expected. The overall level of job satisfaction among nurses in Hafr Al-Batin will be identified. Factors affecting dissatisfaction with work, such as promotion, independence, need for career development, and workplace environment, will be identified. Women tend to be more satisfied with their jobs than men. The research is expected to give similar results. Female nurses are likely to express high levels of satisfaction in comparison to men. The aspect of age will also be linked to job satisfaction. Board (2012) notes that healthcare givers with more than 10 years of experience in the field show more satisfaction in their profession. The research findings will have a significant impact on the way stakeholders understand the nature of the nursing discipline in Hafr Al-Batin and Saudi Arabia in general.

Research Audience

The target audience for the research on job satisfaction among nurses in Hafr Al-Batin includes scholars, healthcare professionals, and other parties interested in gaining an in-depth understanding of the nature of the nursing profession in Saudi Arabia. The research will assume an analytical format. The aim is to provide readers with as much information as possible on the topic.

Resources

The study will take two months. The total number of trips to the hospitals and healthcare centers is expected to be twenty. Questionnaires will be the primary research materials to be used.

Gantt Chart

ActivityWeeks
12345678
Ethics approvalX
RecruitmentXX
Data collectionXX
Data AnalysisXX
Report writingX

References

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Auerbach, D, Staiger, D, Muench, U & Buerhaus, P 2012, ‘The nursing workforce: a comparison of three national surveys’, Nursing Economics, vol. 30, no. 5, pp. 253-260.

Bazeley, P 2013, Qualitative data analysis: practical strategies, SAGE Publications, Los Angeles, Thousand Oaks, California.

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Lo, B 2010, Ethical issues in clinical research: a practical guide, Wolters Kluwer Health/Lippincott William & Wilkins, Philadelphia.

Oulton, J 2006, ‘The global nursing shortage: an overview of issues and actions’, Policy, Politics, and Nursing Practice, vol. 7, no. 3, pp. 345-396.

Pallant, J 2010, SPSS survival manual: a step by step guide to data analysis using SPSS, 4th edn, Open University Press/McGraw-Hill, Maidenhead.

Rajapaksa, S & Rothstein, W 2009, ‘Factors that influence the decisions of men and women nurses to leave nursing’, Nursing Forum, vol. 44, no. 3, pp. 195-206.

Ray, M 2010, Transcultural caring dynamics in nursing and health care, F.A Davis, Philadelphia.

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Williams, C 2010, Gender and sexuality in the workplace, Emerald, Bingley.

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