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The Relationship Between Counselor Satisfaction and Extrinsic Job Factors in State Rehabilitation Agencies

Originally Published:
Key Point Summary
Key Concepts/Context

Maintaining employee satisfaction is fundamental to the success of healthcare organizations. It is hardly imaginable that dissatisfied staff can deliver high quality care. Further, dissatisfaction among healthcare staff may lead to high turnover rate, which is a significant problem in healthcare because of the amount of resources needed in recruiting and training new staff. In recent years, healthcare organizations have emphasized improving job satisfaction and staff retention in order to reduce staff turnover rate and improve quality of care.

Both intrinsic job factors (e.g. work itself, recognition, and achievement) and extrinsic factors (e.g. work conditions, coworker relationship, and compensation) may significantly impact job satisfaction. As an extrinsic factor, physical environment is one component of healthcare organizations’ efforts in improving job satisfaction. Research in various healthcare settings has found that: environmental factors (such as daylight, patient room occupancy, and noise) impact job satisfaction; staff members’ subjective ratings of the physical environment are positively related to their satisfaction with work.


The purpose of the study was to examine the relationship between rehabilitation counselors’ perception of physical environment and their job satisfaction level.


In this correlational study, a 50-item questionnaire instrument was created based on literature analysis and expert review. The questionnaire contained 20 questions related to the physical environment, each of which focused on one environmental aspect (e.g. attractiveness, cleanliness, and being well maintained) and asked for respondent’s rating of the quality (on 5-point Likert scale) and importance (on 3-point Likert scale) of that environmental aspect. The 20 environmental aspects were clustered into six groups (i.e. environmental factors) labeled Location, Safety, Healthy Environment, Facility Space, Comfort, and Professional Nature. The questionnaire also included other questions used to measure job satisfaction (adopted from an existing questionnaire) and to collect demographic information. A total of 380 questionnaires were mailed to counselors working at randomly selected state rehabilitation facilities (with equal numbers of counselors from small and large facilities) in 16 U.S. states, followed by two follow-up mail reminders. Correlational and multiple regression analyses were conducted to identify environmental factors that were strongly related to job satisfaction.

Design Implications
The design of rehabilitation facilities should take into account the preferences of various staff members in order to increase job satisfaction. The needs of staff at a specific facility may be different from staff of other facilities and should be evaluated to customize building design. 

A total of 315 rehabilitation counselors returned the questionnaire. Among the respondents, only 25% were certified rehabilitation counselors. Overall, a high level of job satisfaction was reported. All six environmental factors were significantly correlated with the job satisfaction. However, in stepwise regression analysis, only two environmental factors--Healthy environment and Safety—remained significant predictors of job satisfaction after adjusting for other factors. There was no relationship found between staff demographics and job satisfaction. Gender differences were found with respect to the quality and importance ratings of certain environmental factors.


There were several limitations of this study: 

  • The article included limited information about the validity and reliability of the questions developed and used in the survey (i.e. the questions around perception of physical environment). Further, there was no description about how the 20 questions related to the environment were grouped into six environmental factors. The probable biases in measuring and calculating the scores of the six environmental factors may threat the validity of results.
  • The sample size might have been too small for regression analysis including a large number of potentially contributing factors. Differences were likely existing among the 315 respondents from multiple facilities in 16 states on some contributing factors not collected in the study.
Outcome Category
Staff satisfaction|Job satisfaction|Perception of physical environment
Primary Author
Andrew, J. D.