bs_bs_banner

Research into Work Life Experiences

Nurses’ job satisfaction and attitudes towards

people living with HIV/AIDS in Russia
L. Hamama1 PhD, E. Tartakovsky2 PhD, K. Eroshina3 MD, E. Patrakov4
PhD, A. Golubkova5 MD, J. Bogushevich5 MD & L. Shardina5 MD
1 Senior lecturer, Social worker, 2 Senior lecturer, Psychologist, Tel Aviv University, Tel Aviv, Israel, 3 Manager of the Global
Fund Project, Open Health Institute, Moscow, 4 Psychologist, Head of the Social Security Department of Ural Federal
University, Ekaterinburg, 5 Physicians, Urals State Medical Academy, Ekaterinburg, Russia

HAMAMA L., TARTAKOVSKY E., EROSHINA K., PATRAKOV E., GOLUBKOVA A., BOGUSHEVICH J.
& SHARDINA L. (2014) Nurses’ job satisfaction and attitudes towards people living with HIV/AIDS in
Russia. International Nursing Review 61, 131–139

Background: Previous studies internationally have highlighted that working with people living with
HIV/AIDS may lead to nurses’ stress and burnout. However, this topic has not been well explored in Russia, a
country with an exponential growth in HIV/AIDS.
Aim: This study focused on nurses’ job satisfaction and their attitudes towards people living with HIV/AIDS
in centres where nurses regularly treat such patients, and in a general hospital where nurses rarely treat such
patients.
Method: We distributed three self-report questionnaires: demographics, job satisfaction and attitudes towards
people living with HIV/AIDS to nurses working in six HIV/AIDS centres and the largest general hospital in
Ekaterinburg, Russia. Sixty-nine nurses from the HIV/AIDS centres and 66 from the general hospital (about
90% of those approached) completed these.
Results: Nurses who regularly treated people with HIV/AIDS were significantly younger and a greater number
held master degrees than those who rarely treated such patients. No significant differences between the two
settings emerged for job satisfaction but what did emerge were differences in nurses’ attitudes: nurses in
HIV/AIDS centres reported less avoidance than nurses in the general hospital. Regarding empathetic attitudes,
no significant differences emerged, but empathetic attitudes contributed to the explained variance of job
satisfaction.
Conclusion: Although our sample was small, the associations found between avoidant attitudes and job
satisfaction highlight the need for stigma-reduction strategies and increased disease knowledge. Healthcare
managers should consider attitudes towards people living with HIV/AIDS as an important factor in ensuring
adequate care for them and initiate education programmes for nurses, especially programmes dealing with
HIV/AIDS in general hospitals.

Correspondence address: Dr Liat Hamama, Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69970, Israel; Tel: +972-3-9305551; Fax: +972-3-9305551;
E-mail: hamama@post.tau.ac.il.

Funding: This study was funded in part by a Sara Peleg grant from the School of Social Work at Tel Aviv University (grant no.34030000).
Conflict of interest: No conflict of interest has been declared by the authors.

© 2013 International Council of Nurses 131

132 L. Hamama et al.
Implications for nursing and health policy: Support and supervision can be used as a strategy, for
empowering nurses to meet the challenges of working with HIV/AIDS patients.
Keywords: Attitudes, HIV/AIDS, Job Satisfaction, Nursing, Russia
Introduction
Nurses have always been at the forefront of the HIV epidemic;
they are on the frontline of HIV prevention, care and advocacy
(Li et al. 2007; Qu et al. 2010). Working with people living with
HIV/AIDS (PLWHA) may lead to nurses’ stress, burnout and
even dropout, especially when physical contact with HIV/AIDS
patients elicits misunderstandings and avoidance among nurses’
social connections and families (Bride 2007). Although this has
been well studied in the West, this phenomenon has not been
studied in Russia.
In the current study, we aimed to assess the associations
between Russian nurses’ job satisfaction and attitudes towards
PLWHA, in order to inform healthcare policy and identify
training and supervision needs. Specifically, the present study
highlighted the similarities and differences regarding job satis-
faction and attitudes towards PLWHA among Russian nurses
working in two settings that vary in exposure to PLWHA: spe-
cialized HIV/AIDS centres where nurses regularly treat PLWHA
vs. general hospitals where nurses rarely treat PLWHA.
HIV/AIDS continues to be a major public health issue in
Russia (UNAIDS/WHO 2010). The Russian Federation is
experiencing an exponential growth in HIV incidence, as
reflected in an increase in reported cases of new HIV diag-
noses, from less than 40 000 in 2006 to over 60 000 in 2011
(UNAIDS 2012). In Russia, each large city (population over
200 000) has its own HIV/AIDS centre. These centres provide
HIV diagnostics, treatment of opportunistic infections, psy-
chosocial consulting for patients and their families, and infor-
mation dissemination on these issues to mass media and
educational systems (Ekaterinburg Regional Center for
Prophylactics and Treatment of HIV/AIDS 2008). Nurses and
other staff working in HIV/AIDS centres are well informed
about HIV/AIDS, receive specialized training, have close inten-
sive contacts with PLWHA and their families, and accrue sub-
stantial experience in treating these patients (Pankratov &
Peresypkina 2012).
On the other hand, general hospitals in Russia rarely treat
HIV/AIDS patients. Most PLWHA who are treated in general
hospitals either do not know their diagnosis or for some other
reason do not wish to be treated in HIV/AIDS centres. Once
© 2013 International Council of Nurses
hospitalized, patients are diagnosed and they are usually then
referred to a centre for the continuation of treatment. There-
fore, medical staff in general hospitals are often unaware that
they are treating PLWHA and receive very little training and
experience in dealing with PLWHA (Pankratov & Peresypkina
2012).
The present study is the first of its kind to examine the con-
nection between job satisfaction and nurses’ attitudes towards
PLWHA in these two settings.
Job satisfaction
Job satisfaction is a multidimensional construct consisting of
elements essential to the personal fulfilment from one’s job
(Shader et al. 2001). It pertains to how employees feel about
their work environment and about diverse aspects of their
employment (Spector 1997; Thompson & Phua 2012). As such,
job satisfaction is conceived as a reaction to role stressors and as
a predictor of occupational mental health (Sheward et al. 2005;
Tourigny et al. 2010).
Low job satisfaction in nurses has been found to result in
burnout, high turnover, physical and psychological disturb-
ances, higher stress levels and low levels of patient care (Chang
et al. 2010; Mrayyan 2009; Murrells et al. 2008).
Job satisfaction has been studied especially among nurses
working in HIV/AIDS services (Chirwa et al. 2009; Delobelle
et al. 2009). These studies conducted in African countries found
that perceived HIV stigma was the strongest predictor of job
dissatisfaction (Chirwa et al. 2009) and that the work itself was
associated with job satisfaction (Delobelle et al. 2009).
The importance of job satisfaction in the nursing profession
has been linked to positive patient outcomes as rated by
healthcare providers (Aiken et al. 2002) and to a higher quality
of care as perceived by patients (Murrells et al. 2005). Nurses’
personal characteristics, attitudes and behaviours are factors
that may influence their job satisfaction (Hayes et al. 2010;
Utriainen & Kyngas 2009). Moreover, according to a literature
search that was conducted by Hayes et al. (2010), factors associ-
ated with nurses’ job satisfaction can be grouped into
intrapersonal, interpersonal (between the nurse and colleagues
Job satisfaction among nurses in Russia
or patients) and extrapersonal. In the current study, we focused
on the intrapersonal factor, using the attitudes variable.
Attitudes towards PLWHA
Attitude is an internal state generally believed to reflect three
different components: the cognitive component linked to a
person’s beliefs or thinking, the affective component linked to
a person’s values, and the behavioural component linked to a
person’s actions (Smith & Mackie 2007). Thus, attitudes can
significantly affect a person’s choices regarding personal behav-
iour, and in the case of nurses, may have an important impact
on the quality of patient care (Smith & Mathews 2007).
Previous studies showed that higher empathy and compas-
sion among nurses working with PLWHA in particular were
associated with lower feelings of psychological distress (e.g.
Delobelle et al. 2009; Smit 2005). On the other hand, several
studies (Li et al. 2007; Tyer-Viola 2007) have documented nega-
tive attitudes towards HIV/AIDS patients shared by many
healthcare professionals for a number of reasons, including but
not limited to the fear of contracting the disease, a dislike of
working with terminally ill patients, perceptions of personal
risk, an unwillingness to work with certain patient populations
(e.g. intravenous drug users, homosexuals) and concern over
being professionally stigmatized.
Furthermore, researchers assume that increased contact with
PLWH helps healthcare providers increase their knowledge
about HIV transmission and their empathy towards their
patients (Pettigrew & Tropp 2006). These findings are consistent
with Allport’s social psychological theory of intergroup contact
(Allport 1954), which argues that prolonged contact with an
out-group weakens prejudices and leads to a more positive atti-
tude towards the group. The intergroup contact is consequently
understood as both a cognitive process of obtaining more
objective knowledge about the out-group and a behavioural
process of changing attitudes towards the out-group (Pettigrew
and Tropp 2006). With regard to nurses, Chirwa et al. (2009)
found that the perception of stigma related to HIV influences
their job satisfaction significantly.
Notably, these variables were examined among nurses in
South Africa (Chirwa et al. 2009; Delobelle et al. 2009, 2011;
Smit 2005), in Belize (Andrewin & Chien 2008) and in Finland
(Suominen et al. 2010). However, to the best of the authors’
knowledge, Russian HIV/AIDS nurses have not been well
studied regarding their attitudes towards PLWHA in centres and
hospital settings.
Hypotheses
This study investigated the possible differences between job sat-
isfaction and attitudes towards PLWHA of nurses who regularly
© 2013 International Council of Nurses
133
treated PLWHA (working in HIV/AIDS centres) and nurses
who rarely treated PLWHA (working in general hospitals) in
Russia. We predicted that Russian nurses working in HIV/AIDS
centres would reveal lower job satisfaction than those working
in general hospitals due to the uniquely stressful characteristics
of caring primarily for PLWHA in the centres: stigma, discrimi-
nation and overexposure to suffering (Ijumba 2003). We also
predicted that Russian nurses working in HIV/AIDS centres
would reveal lower avoidance attitudes and higher empathetic
attitudes than those working in general hospitals, in line with
Allport’s (1954) social psychological theory positing that inter-
group contact reduces intergroup prejudice, which in turn may
affect attitudes. Thus, nurses with more frequent exposure to
PLWHA should reveal more positive (empathetic) attitudes and
fewer negative ones (avoidant), but also lower job satisfaction.
In sum, the following hypotheses were tested:
1 Nurses who regularly treat PLWHA (in the centres) will
report lower job satisfaction than nurses who rarely treat
PLWHA (in the hospital).
2 Nurses who regularly treat PLWHA will report less avoidant
attitudes and more empathetic attitudes than nurses who rarely
treat PLWHA.
3 Avoidant attitudes will associate with low job satisfaction and
empathetic attitudes will associate with high job satisfaction.
Method
Design
This study used a cross-sectional, quantitative research design.
Sample
The research questionnaires were distributed to the nurses who
worked regularly with PLWHA in six HIV/AIDS centres in
Ekaterinburg, during the centres’ training seminars at a time
when 76 nurses participated in the training seminars (168
nurses employed in all centres, groups of 21–35 nurses in each
centre). The nurses were informed of the purpose of the study
and were assured that the study was confidential and voluntary.
After completing the questionnaires, the nurses sealed them in
an envelope and handed them to the researchers personally or
through the administrative assistant.
The comparison sample of nurses who did not work regularly
with PLWHA was recruited from the largest general hospital in
Ekaterinburg, which runs the largest nursing school in the
region (Sverdlovsk Regional Medical College 2012). In this hos-
pital, 371 nurses are employed. The research questionnaires
were distributed to these hospital nurses during three randomly
selected sessions of a conference held in the hospital to provide
the latest practical nursing information and teach skills for
134 L. Hamama et al.
working with PLWHA. Seventy-five nurses participated in these
selected sessions (groups of 21–29 nurses in each). The hosp-
ital’s nurses were randomly assigned to the sessions; therefore,
the sample obtained was a random representation of the nurses
working in the hospital.
Ethical considerations
The nurses were informed of the purpose of the study and
were assured that the study was confidential and voluntary.
They completed the questionnaires anonymously and returned
them to the researchers in sealed envelopes with a signed,
informed consent form. The study was approved by the Ethical
Commission in the general hospital and the HIV centres in
Ekaterinburg and supervised by Tel Aviv University Research
Ethics Committee.
Data collection
Participants completed three self-report questionnaires. All
questionnaires used in the present study were translated from
English to Russian and back to English by two bilingual transla-
tors. Internal consistency of all the scales in the present study
was similar to that obtained in previous studies applying
English-language scales (for job satisfaction, see: Taber & Taylor
1990; for attitudes towards PLWHA, see: Froman & Owen
1997).
Demographic questionnaire
This self-report related to demographic details of age, sex,
family status, religiosity, health, education, professional experi-
ence and experience in treating PLWHA.
Job satisfaction
Hackman & Oldham’s (1975) 15-item Job Diagnostic Survey
measured workers’ satisfaction with various aspects of their jobs
(e.g. skill variety, task identity, task significance, autonomy).
Previous applications of the Russian version of this scale, in
Russia and other countries of the former Soviet Union, con-
firmed its validity and reliability (see Bondarenko 2010). Par-
ticipants rated their job satisfaction along a 7-point Likert-type
scale ranging from not at all satisfied (1) to completely satisfied
(7), with higher scores indicating higher job satisfaction. Inter-
nal consistency (Cronbach’s alpha) was 0.87. (Internal consist-
encies for the two settings were as follows: regularly treated
HIV/AIDS = 0.88; rarely treated HIV/AIDS = 0.87).
Attitudes towards PLWHA
The 21-item AIDS Attitude Scale questionnaire (Froman et al.
1992) was used to assess two aspects of attitudes towards
© 2013 International Council of Nurses
patients with HIV/AIDS: avoidance (14 items, e.g. ‘Patients who
are HIV positive should not be put in rooms with other
patients’) and empathy (7 items, e.g. ‘Patients with AIDS should
be treated with the same respect as any other patient’). Partici-
pants rated their attitudes towards PLWHA on a 6-point Likert-
type scale ranging from strongly disagree (1) to strongly agree
(6), where higher scores indicated more avoidance attitudes
towards PLWHA. Internal consistency (Cronbach’s alpha) was
0.88. (Internal consistencies for the two settings were as follows:
avoidance: regularly treated HIV/AIDS = 0.87, rarely treated
HIV/AIDS = 0.82; empathy: regularly treated HIV/AIDS = 0.76,
rarely treated HIV/AIDS = 0.80).
Data analysis
To examine the differences between the two groups (nurses who
regularly treated PLWHA and nurses who rarely treated
PLWHA) in job satisfaction and in attitudes towards PLWHA
(avoidance, empathy), we conducted univariate one-way multi-
variate analysis of variance (MANOVAs). In our analyses, we
controlled for the two demographic variables that differed
between the two settings – age and education.
Findings
About 90% of the nurses who were approached in both settings
agreed to participate in the study (in the HIV/AIDS centres –
69; in the general hospital – 66). Participants comprised 135
female nurses in Russia, 69 of whom regularly treated PLWHA
in HIV/AIDS centres, and 66 of whom worked in a general hos-
pital and rarely treated PLWHA. Mean age overall was
41.3 years (SD = 9.88), but the nurses who regularly treated
PLWHA were significantly younger (M = 39.58, SD = 8.61) than
the nurses who rarely treated PLWHA (M = 43.15, SD = 10.81),
t = 2.13, P < 0.05. Nurses had a mean of 19.65 years of profes-
sional experience (SD = 10.00), which did not differ signifi-
cantly between the two groups.
In terms of other demographic variables (see Table 1), only in
education did a significant difference emerge between the two
groups, χ2 = 4.51, P < 0.05. In both groups, the majority of
nurses held a bachelor’s degree (∼80% of the nurses who treated
PLWHA and ∼92% of the nurses who rarely treated PLWHA),
although approximately 20% of the nurses who treated PLWHA
held a master’s degree, whereas only 8% of those in the general
hospitals did. No significant differences were found between the
groups with regard to marital status, religiosity or health.
Validating the hypothesis that nurses working in general hos-
pitals rarely treated PLWHA, only five hospital nurses reported
seeing, at the most, two HIV/AIDS patients during the previous
Job satisfaction among nurses in Russia 135

Table 1 Demographic characteristics for nurses in the two settings

Variable Regularly treated HIV/AIDS Rarely treated HIV/AIDS χ2

– centres (n = 69) – hospitals (n = 66)

n % n %

Marital status Single 30 43.5 20 30.3 0.11

Married 39 56.5 46 69.7
Education BA 55 79.7 61 92.4 4.51*
MA 14 20.3 5 7.6
Religiosity Religious 63 92.3 55 90.2 0.54
Not religious 6 7.7 11 9.8
Health† Healthy 62 91.2 58 92.1 0.85
Not healthy 7 8.8 8 7.9
Total 69 100.0 66 100.0

*P < 0.05.
†There are missing values for health.

Table 2 Means, standard deviations and F and eta squared values for job satisfaction and attitudes in the nurses’ two settings

Variables Regularly treated HIV/AIDS Rarely treated HIV/AIDS F† η2

– centres (n = 69) – hospitals (n = 66)

M SD M SD

Job satisfaction 3.60 0.68 3.50 0.70 0.64 0.00

Attitudes towards PLWHA
Empathy 3.72 0.73 3.54 0.76 1.90 0.01
Avoidance 2.17 0.94 3.41 0.81 62.41*** 0.33

***P < 0.001.

†For job satisfaction: F (2, 126); for attitudes: F (3, 124).
PLWHA, people living with HIV/AIDS.

week. In contrast, for those working in the HIV/AIDS centres,
the mean number of HIV-infected patients seen during the pre-
vious week was 33.6.
Significant differences emerged between the groups only
regarding avoidance attitudes towards PLWHA, F (3, 124) =
62.41, P < 0.001, η2 = 0.33, where the nurses working in HIV/
AIDS centres revealed significantly lower avoidance towards
PLWHA than their counterparts in the general hospitals.
Empathy did not significantly differ between the groups. Like-
wise, the MANOVA comparing the two groups’ rates of job sat-
isfaction yielded no significant difference between the two
settings, F (2, 126) = 0.40, P > 0.05. That is to say, job satisfac-
tion did not significantly differ between nurses who regularly
treated PLWHA and nurses who rarely treated PLWHA. Means,
standard deviations and F values for each measure are presented
in Table 2.
Correlations between the variables
Pearson’s analyses were conducted to examine correlations
between the demographic variables (age, sex, family status,
religiosity, health, education, professional experience and
experience in treating PLWHA) and the study variables. No
demographic variables were found to be linked to the study
variables.
Pearson’s analyses were conducted to examine correlations
among the study variables. Job satisfaction showed a positive

© 2013 International Council of Nurses

136 L. Hamama et al.

Table 3 Hierarchical regression coefficients (β) to explain differences in
job satisfaction (N = 135)
Predictors B SE B β R2
Step 1 0.00
Group 0.08 0.12 0.06
Step 2
Group −0.23 0.14 −0.17
Empathy 0.17 0.08 0.18*
Avoidance −0.23 0.08 −0.36**
*P < 0.05; **P < 0.01; ***P < 0.001.
correlation with empathetic attitudes towards PLWHA
(r = 0.28, P < 0.001) and a negative correlation with avoidant
attitudes towards PLWHA (r = −0.32, P < 0.001). In other
words, nurses with higher empathy towards PLWHA and
with lower avoidant towards PLWHA, reported higher job
satisfaction.
We next conducted a hierarchical regression analysis with job
satisfaction as the dependent variable. The first step assessed the
group (PLWHA-treating nurses vs. general nurses). The second
step assessed the contribution of the two attitude subscales
(avoidance, empathy). As seen in Table 3, these variables
explained 16% of the variance in job satisfaction. The group
(PLWHA-treating nurses vs. general nurses), entered in the first
step, yielded no significant contribution. However, nurses’ atti-
tudes towards PLWHA, entered in the second step, added 16%
to the explanation of the variance. A significant contribution
was made by the attitudes of empathy and avoidance to explain
job satisfaction: nurses with more empathetic and less avoidant
attitudes reported higher job satisfaction.
To examine the differences between the two settings (nurses
working in HIV/AIDS centres and nurses working in general
hospitals) on these correlations, Pearson’s analyses were con-
ducted separately. Significant differences emerged between the
two settings: among nurses working in HIV/AIDS centres, job
satisfaction correlated significantly and positively with empa-
thetic attitudes (r = 0.36, P < 0.001), and correlated significantly
and negatively with avoidant attitudes (r = −0.34, P < 0.001). In
contrast, the nurses working in general hospitals revealed no
significant correlations between job satisfaction and attitudes
(avoidance, empathy).
Discussion
The current study is innovative regarding the comparison
between two settings: nurses who worked in dedicated HIV/
AIDS centres vs. nurses who worked in general hospitals and
rarely treated PLWHA in Russia.
Our findings did not confirm our first hypothesis, which pre-
ΔR2 dicted differences in job satisfaction between nurses who
worked in specialized HIV/AIDS centres and nurses who
worked in general hospitals and rarely treated PLWHA. To the
best of our knowledge, no research has yet been conducted to
0.16***
examine the differences between nurses who work in these two
settings in relation to job satisfaction. Perhaps the current lack
of differences in job satisfaction between the groups can be
related to the methodology of the study, that is, a small sample
size and differences in the characteristics associated with the
work environment rather than the differences associated with
whether or not nurses regularly treated PLWHA (in line with
the fact that only 16% of the variance in job satisfaction was
explained by attitudes). As mentioned previously, nurses’ job
satisfaction is multifaceted, complex and highly subjective
(Hayes et al. 2010). Another explanation can be related to
Hobfoll’s (1989) conservation of resources model. This model
assumes that people consciously and unconsciously utilize the
amount and quality of resources at their disposal. In a stressful
situation, when a specific resource is threatened, people will
‘compensate’ by utilizing a different resource. According to this
model, it seems that nurses from both groups may be efficient at
utilizing their motivation and their intrinsic rewards to help
their patients (HIV/AIDS and non-HIV/AIDS). Moreover,
nurses are expected to give quality care to patients regardless of
diagnosis; they are expected to feel ethically bound to act indis-
criminately towards all patients (Smit 2005).
The second hypothesis, related to nurses’ attitudes towards
PLWHA, did confirm our expectations. Nurses working in HIV/
AIDS centres reported less avoidant attitudes towards PLWHA
than their peers working in general hospitals who experienced
less frequent exposure to PLWHA. Nevertheless, no significant
difference emerged regarding empathetic attitudes; thus, the
second hypothesis was only partially confirmed.
A probable explanation for the less avoidant attitudes
among nurses in the specialized HIV/AIDS centres may be that
their personal contact with PLWHA and their AIDS-specific
training acted to dispel misinformation and decrease stigma
(Brems et al. 2010). In contrast, nurses who work in general
hospitals rarely have contact with PLWHA and may experience
deficiencies in AIDS-specific training, resulting in insufficient
and inadequate knowledge regarding HIV/AIDS care, leading
to avoidant and negative attitudes towards PLWHA (Smit
2005). Further study, including more detailed qualitative and
quantitative reports about nurses’ interactions with PLWHA in
both settings, specifically in the Russian context, is needed to
validate this speculation, which coincides with Allport’s social

© 2013 International Council of Nurses

Job satisfaction among nurses in Russia
psychological theory of intergroup contact (Allport 1954). In a
meta-analytic test of intergroup contact theory, Pettigrew &
Tropp (2006) found that intergroup contact typically reduces
intergroup prejudice. Thus, nurses who work in general hospi-
tals and rarely treat PLWHA may be flooded with anxiety over
their safety practices and fears of occupational contagion,
which may evoke avoidant attitudes towards PLWHA.
Regarding the third hypothesis, the correlation between lower
job satisfaction and nurses’ greater avoidance towards PLWHA
was confirmed only among nurses who worked in HIV/AIDS
centres. As mentioned above, direct contact with PLWHA may
produce anxiety over safety practices and fears of occupational
contagion, which may be very stressful for AIDS caregivers
(Gueritault-Chalvin et al. 2000). Further study is needed to vali-
date this speculation and to also consider as a whole the infor-
mation about job satisfaction for nurses in Russia.
Study limitations
This study had several limitations that should be noted. First,
literature is scarce on the cultural aspects that may influence the
study variables; therefore, special care should be taken in the
future to examine the possible effects of such cultural issues and
to untangle the specifics of the healthcare system, specifically
the HIV/AIDS system, in the Russian Federation.
Second, it was a convenience sample and the sample size
restricted usage of structural equation modelling; therefore, we
could not conduct an assessment of generalizability. Third, the
study was of a cross-sectional nature, which allowed us to estab-
lish associations but not causal relationships.
Fourth, the present self-report survey responses were subject
to common method variance bias. Nurses’ job satisfaction is
multifaceted, complex and highly subjective (Hayes et al. 2010).
Therefore, researchers would do well to collect complementary
objective data on the actual work environment, to confirm
current outcomes. In addition, the current quantitative design
should be complemented in the future by qualitative methods
that give voice to the unique perspectives on job satisfaction
among nurses. That is to say, interpersonal (between the nurse
and colleagues or patients) and extrapersonal (those external to
the nurse; Hayes et al. 2010; Utriainen & Kyngas 2009).
Implications
The associations found between avoidant attitudes and job sat-
isfaction highlight the need for stigma-reduction strategies and
increased disease knowledge. Stigma and discrimination repre-
sent not only human rights violations, but also violations of the
ethical principles on which the healthcare system is based
(Brems et al. 2010). A recent study by Collani et al. (2010)
showed that a reduction in the stigmatization faced by AIDS
© 2013 International Council of Nurses
137
victims is likely to be marginal if the reduction plan focuses
solely on educating healthcare professionals about false beliefs.
They found it necessary to change general dispositions for
prejudice, a much more difficult task. Thus, healthcare manag-
ers should augment education programmes for nurses, espe-
cially programmes dealing with HIV/AIDS in general hospitals.
They must consider attitudes towards PLWHA as an important
factor in ensuring adequate care for PLWHA. Moreover, nurses
and healthcare professionals who work with HIV/AIDS patients
should be encouraged to stay current on changing issues relat-
ing to HIV/AIDS, and to understand that the disease process
has already helped to start a social reconstruction of HIV as a
chronic illness (Qu et al. 2010). From these changes, both an
oppressed client population and the nurses who have an obliga-
tion to provide the best care possible are likely to benefit. Thus,
these changes might contribute to enhancing the job satisfac-
tion of nurses and other healthcare professionals.
Given the fact that nursing is a highly stressful profession
with severe concern regarding retention issues (Curtis 2007),
results of this study may assist in developing practical
organizational strategies to increase workers’ job satisfaction.
Further research should investigate the similarities and differ-
ences between these two settings with respect to physical, social
and organizational work–environment characteristics.
Furthermore, the results of this study have theoretical impli-
cations. The study expanded knowledge about attitudes towards
PLWHA among nurses in two different health settings and their
associations with job satisfaction. It also extended intergroup
contact theory to Russian nurses who work in specialized HIV/
AIDS centres vs. nurses who worked in general hospitals and
rarely treated PLWHA.
Nurses and heath providers are part of the general society,
and their perceptions and attitudes towards HIV/AIDS are
expected to be influenced by societal norms and attitudes.
If AIDS were viewed as a normal disease in society, the health
providers could feel more comfortable when they treat
AIDS patients. Thus, HIV education might be a necessary
intervention component to maintain a healthy psychological
state among nurses and health providers and to increase their
productivity.
Implications for health and nursing policy
From a health policy perspective, the Russian political system is
shaped by its Soviet institutional legacy. That is to say, the state
still plays a large part in Russian health, education and the
economy. Private health facilities exist, but the vast majority of
Russians continue to receive health care through the state
system (Pankratov & Peresypkina 2012; Wallander 2005).
Hence, to be able to meet the challenges of their profession and
138 L. Hamama et al.
work with HIV/AIDS patients, nurses need to perceive them-
selves as being empowered. Support and supervision can be
used as a strategy for commitment and involvement when pro-
viding care for people with HIV/AIDS (McGlynn et al. 2012).
Because of the lack of research focusing on nurses’ experi-
ences of HIV/AIDS-related job satisfaction and attitudes in
Russia, similar studies should be conducted at other hospitals
and HIV/AIDS centres to ascertain whether the findings can be
replicated. The greater understanding gained by such studies
could inform social policies and programmes dealing with HIV/
AIDS-related care in Russia.
Acknowledgements
We wish to thank all nurses who participated and collaborated
in this study whose contribution enabled the production of this
paper.
Author contributions
Liat Hamama: study conception, data analysis, drafting of
manuscript, critical revisions for important intellectual content;
Eugene Tartakovsky: study design, data analysis, drafting of
manuscript, critical revisions for important intellectual content;
Ksenia Eroshina: study design, drafting of manuscript, adminis-
trative support; Eduard Patrakov: study design, data collection,
drafting of manuscript, critical revisions for important intellec-
tual content; Alla Golubkova: study conception, data collection,
critical revisions for important intellectual content, material
support; Julia Bogushevich: study conception, data collection,
drafting of manuscript, administrative support. Loubov
Shardina, data collection; drafting of manuscript; material
support.
References
Aiken, L.H., et al. (2002) Hospital nurse staffing and patient mortality,
nurse burnout, and job dissatisfaction. Journal of the American Medical
Association, 288 (16), 1987–1993.
Allport, G.W. (1954) The Nature of Prejudice. Addison Wesley, Reading,
MA.
Andrewin, A. & Chien, L. (2008) Stigmatization of patients with HIV/AIDS
among doctors and nurses in Belize. AIDS Patient Care and STDS, 22
(11), 897–906. doi: 10.1089/apc.2007.0219.
Bondarenko, I.N. (2010) Adaptation of the job satisfaction scale of
Hackman and Oldham to the Russian population. Psikhologicheskii
Zhurnal, 31 (3), 109–124.
Brems, C., Johnson, M.E., Warner, T.D. & Roberts, L.W. (2010) Health care
providers’ reports of perceived stigma associated with HIV and AIDS in
rural and urban communities. Journal of HIV/AIDS & Social Services,
9 (4), 356–370.
Bride, B.E. (2007) Prevalence of secondary traumatic stress among social
workers. Social Work, 52 (1), 63–70.
© 2013 International Council of Nurses
Chang, Y.H., Li, H., Wu, C.M. & Wang, P.C. (2010) The influence of per-
sonality traits on nurses’ job satisfaction in Taiwan. International Nursing
Review, 57, 478–484.
Chirwa, M.L., et al. (2009) HIV stigma and nurse job satisfaction in five
African countries. Journal of the Association of Nurses in AIDS Care, 20,
14–21. doi: 10.1016/j.jana.2008.10.001.
Collani, G.V., Grumm, M. & Streicher, K. (2010) An investigation of the
determinants of stigmatization and prejudice toward people living
with HIV/AIDS. Journal of Applied Social Psychology, 40 (7),
1747–1766.
Curtis, E.A. (2007) Job satisfaction: a survey of nurses in the Republic of
Ireland. International Nursing Review, 54 (1), 92–99.
Delobelle, P., et al. (2009) HIV/AIDS knowledge, attitudes, practices and
perceptions of rural nurses in South Africa. Journal of Advanced Nursing,
65 (5), 1061–1073. doi: 10.1111/j.1365-2648.2009.04973.x.
Delobelle, P., et al. (2011) Job satisfaction and turnover intent of primary
healthcare nurses in rural South Africa: a questionnaire survey. Journal of
Advanced Nursing, 67 (2), 371–383. doi: 10.1111/j.1365-2648.2010
.05496.x.
Ekaterinburg Regional Center for Prophylactics and Treatment of HIV/
AIDS (2008) Service Center. Available at: http://www.livehiv.ru/
index.php?page=about&pid=4 (accessed 1 May 2013).
Froman, R.D. & Owen, S.V. (1997) Further validation of the AIDS Attitude
Scale. Research in Nursing & Health, 20 (2), 161–167. doi: 10.1002/
(SICI)1098-240X(199704)20:2<161:AID-NUR8>3.0.CO;2-I.
Froman, R.D., Owen, S.T. & Daisy, C. (1992) Development of a measure of
attitudes toward persons with AIDS. Image, 24, 149–152.
Gueritault-Chalvin, V., Kalichman, S.C., Demi, A. & Peterson, J.L. (2000)
Work-related stress and occupational burnout in AIDS caregivers: test of
a coping model with nurses providing AIDS care. AIDS Care, 12 (2),
149–161. doi: 10.1080/09540120050001823.
Hackman, J. & Oldham, R. (1975) Development of the job diagnostic
survey. Journal of Applied Psychology, 60 (2), 159–170.
Hayes, B., Bonner, A. & Pryor, J. (2010) Factors contributing to nurse job
satisfaction in the acute hospital setting: a review of recent literature.
Journal of Nursing Management, 18, 804–814.
Hobfoll, S.E. (1989) Conservation of resources: a new attempt at conceptu-
alizing stress. American Psychologist, 44, 513–525.
Ijumba, P. (2003) ‘Voices’ of primary health care facility workers. In South
African Health Review 2002 (Ijumba, P., ed.). Health Systems Trust,
Durban, South Africa, pp. 186–200.
Li, L., et al. (2007) Stigmatization and shame: consequences of caring for
HIV/AIDS patients in China. AIDS Care, 19 (2), 258–263. doi: 10.1080/
09540120600828473.
McGlynn, K., Griffin, M.Q., Donahue, M. & Fitzpatrick, J.J. (2012) Regis-
tered nurse job satisfaction and satisfaction with the professional prac-
tice model. Journal of Nursing Management, 20, 260–265.
Mrayyan, M. (2009) Job stressors and social support behaviors: comparing
intensive care units to wards in Jordan. Contemporary Nurse, 31 (2), 163–
175.
Murrells, T., Clinton, M. & Robinson, S. (2005) Job satisfaction in nursing:
validation of a new instrument for the UK. Journal of Nursing Manage-
ment, 13 (4), 296–311.
Job satisfaction among nurses in Russia
Murrells, T., Robinson, S. & Griffiths, P. (2008) Job satisfaction trends
during nurses’ early career. BMC Nursing, 7 (7), 1–13.
Pankratov, L.E. & Peresypkina, N.A. (2012) Prophylactics of HIV infection
among medical workers in a health organization. Social Work and Social
Education: Challenges of Interaction. Conference Proceedings, 97–101.
(Russian). Available at: http://www.rsvpu.ru/filedirectory/6415/
Socialqnaya-rabota-i-socialqnoe-obrazovanie.pdf#page=98 (accessed 29
September 2013).
Pettigrew, T.F. & Tropp, L.R. (2006) A meta-analytic test of intergroup
contact theory. Journal of Personality and Social Psychology, 90 (5), 751–
783. doi: 10.1037/0022-3514.90.5.751.
Qu, B., Zhang, Y., Guo, H. & Sun, G. (2010) Relationship between HIV/
AIDS knowledge and attitude among student nurses: a structural equa-
tion model. AIDS Patient Care and STDS, 24 (1), 59–63. doi: 10.1089/
apc.2009.0190.
Shader, K., et al. (2001) Factors influencing satisfaction and anticipated
turnover for nurses in an academic medical center. Journal of Nursing
Administration, 31 (4), 210–216.
Sheward, L., et al. (2005) The relationship between UK hospital nurse staff
and emotional exhaustion and job dissatisfaction. Journal of Nursing
Management, 13 (1), 51–60.
Smit, R. (2005) HIV/AIDS and the workplace: perceptions of nurses in a
public hospital in South Africa. Journal of Advanced Nursing, 51 (1),
22–29.
Smith, D.M. & Mathews, W.C. (2007) Physicians’ attitudes toward homo-
sexuality and HIV: survey of a California medical society – revisited
(PATHH-II). Journal of Homosexuality, 52 (3–4), 1–9.
Smith, E.R. & Mackie, D.M. (2007) Social Psychology. Psychology Press,
London.
Spector, P.E. (1997) Job Satisfaction: Application, Assessment, Cause and
Consequences. Sage, Thousand Oaks, CA.
Suominen, T., et al. (2010) Nurses’ knowledge and attitudes to HIV/AIDS:
an international comparison between Finland, Estonia and Lithuania.
© 2013 International Council of Nurses
139
International Journal of Nursing Practice, 16, 138–147. doi: 10.1111/
j.1440-172X.2010.01822.x.
Sverdlovsk Regional Medical College (2012) About the College. Available at:
http://www.somkural.ru/about/ (in Russian) (accessed 17 November
2013).
Taber, T.D. & Taylor, E. (1990) A review and evaluation of the psychomet-
ric properties of the job diagnostic survey. Personnel Psychology, 43, 467–
500. doi: 10.1111/j.1744-6570.1990.tb02393.x.
Thompson, E.R. & Phua, F.T.T. (2012) A brief index of affective job satis-
faction. Group & Organization Management, 37 (3), 275–307. doi:
10.1177/1059601111434201.
Tourigny, L., Baba, V.V. & Wang, X. (2010) Burnout and depression among
nurses in Japan and China: the moderating effects of job satisfaction and
absence. International Journal of Human Resource Management, 21 (15),
2741–2761.
Tyer-Viola, L. (2007) Obstetric nurses’ attitudes and nursing care inten-
tions regarding care of HIV-positive pregnant women. Journal of
Obstetric, Gynecologic & Neonatal Nursing: Clinical Scholarship
for the Care of Women, Childbearing Families & Newborns, 36 (5),
398–409.
UNAIDS (2012) World AIDS Day Report. Available at: http://
www.unaids.org/en/media/unaids/contentassets/documents/
epidemiology/2012/gr2012/JC2434_WorldAIDSday_results_en.pdf
(accessed 7 October 2013).
UNAIDS/WHO (2010) AIDS epidemic update. Global report. Geneva.
Utriainen, K. & Kyngas, H. (2009) Hospital nurses’ job satisfaction:
a literature review. Journal of Nursing Management, 17 (8),
1002–1010.
Wallander, C.A. (2005) The politics of Russian AIDS policy. PONARS
Policy Memo No. 389. Center for Strategic and International Studies,
141–147.
Copyright of International Nursing Review is the property of Wiley-Blackwell and its content
may not be copied or emailed to multiple sites or posted to a listserv without the copyright
holder's express written permission. However, users may print, download, or email articles for
individual use.