Reinforcing factors
Factors that lead to the pursuit of stress control strategies, good job performance and provide continuous motivation, reward, and encouragement to maintain them.
Superior Support: It was found that managers and superiors can reduce the stress and mental pressure of HCWs and increase job motivation by encouraging, providing facilities and trusting in the health care worker’s abilities. A HCW who was monitored several times by the ministry said:
When they come from the ministry to inspect, the manager can be effective in reducing stress. For example, our manager comforted us and said: “don’t worry, you are doing your work very well”. (P10)
According to the participants, HCWs’ motivation to correct job weaknesses increased when supervisor support and encouragement was felt in their monitoring feedback. In addition, it was reported that providing opportunities for HCWs to express their demands and supporting them in work and non-work problems and concerns creates a pleasant feeling of security and peace for HCWs.
In contrast, a supervisor said about the need for a responsible person to support employees who are in trouble:
We had a HCW who was involved in a serious insurance problem. She even thought of killing herself and her child. She had referred to the central office many times, but nothing was done for her…, she said: “there was no one to hear my words …” (FGF)
Social Support: Most of the participants mentioned the importance of emotional support from colleagues and family in facing job pressures. It was also mentioned that when the volume of work is high, the participation of colleagues is an important source of support, and occasionally this support has two-way effects. A foreman said about the consequences of helping her colleague in a critical situation:
Every day, she leaves a note on my desk: “Thank you for being you, you are the best”, I kept all those notes, those notes have positive energy and give me motivation and peace. (P16)
Health care workers described positive feedback from clients as one of the motivating factors at work. One of the HCWs said:
I feel that when the client is satisfied, as much as she says one word: “Have a good future”, I feel very satisfied. (P15)
Internal Reinforcement following Optimal Job Performance: All HCWs experienced a pleasant feeling of satisfaction and peace after solving clients’ health problems or performing their job duties satisfactorily. A HCW said of her feelings:
When a mother can’t breastfeed her baby, the baby rejects the mother’s breast, and I help the baby to accept the mother’s breast. It’s really an excellent feeling for me and the mother because I managed to save the mother from anxiety and discomfort. (P5)