An Assessment of Job Satisfaction of Janitorial Staff in Two Tertiary Care Hospitals in Kandy District, Sri Lanka

Background: The significance of janitors in elevating the quality of hospital environments is paramount. Assessment of Job Satisfaction among janitorial staff in healthcare institutions is a multifaceted inquiry that encapsulates both the well-being of the workforce and its consequential impact on the quality of healthcare delivery [1] . In the context of two prominent tertiary care hospitals situated in the Kandy District, Sri Lanka, this academic article navigates through the nuanced dimensions of job satisfaction among janitorial staff and its intrinsic relationship with overall hospital performance. Objective: To assess the job satisfaction and performance of janitorial staff in two tertiary care hospitals in Kandy district, Sri Lanka. Methods: The study adopts a robust mixed-methods approach, combining descriptive cross-sectional analysis and qualitative methods, offering comprehensive insights into the nuanced dimensions of janitorial services. The demographic analysis provides a foundation, revealing key factors influencing job satisfaction, including gender distribution, age representation, income categories, and educational background. Results: The detailed statistical analysis, presented in Table 4, uncovers positive perceptions among janitorial staff across various dimensions, such as facilities, colleague support, and overall job satisfaction. Colleague support emerges as a notable strength, contributing to a positive work environment, and indicating potential for enhancing teamwork. The findings not only provide a benchmark for local contexts but also contribute to the global discourse on job satisfaction in healthcare services. The research highlights the significance of addressing unique challenges faced by janitorial staff, filling a crucial gap in the literature. Conclusion: The study offers practical implications for hospital administrators, policymakers, and researchers.


Introduction
The Assessment of Job Satisfaction among janitorial staff in healthcare institutions is a multifaceted inquiry that encapsulates both the well-being of the workforce and its consequential impact on the quality of healthcare delivery [1] .In the context of two prominent tertiary care hospitals situated in the Kandy District, Sri Lanka, this academic article navigates through the DOI: https://doi.org/10.4038/sljma.v24i2.5429nuanced dimensions of job satisfaction among janitorial staff and its intrinsic relationship with overall hospital performance.
Defining job satisfaction within the territory of janitorial services involves an exploration of the elements that contribute to their contentment and fulfilment in their roles [2] .This article delves into the comprehensive definitions of job satisfaction as they apply to janitorial staff in the specific context of healthcare settings.The significance of janitors in elevating the quality of hospital environments is paramount.Beyond their traditional role as custodians of cleanliness, janitorial staff substantially contribute to the creation of a sanitary and organized space, directly influencing the well-being of patients, healthcare professionals, and support staff [3] .This research underscores the importance of recognizing and addressing factors that impact the job satisfaction of janitors, thereby enhancing their performance and, consequently, elevating the overall quality of healthcare services.
Considering the international and local dimensions of job satisfaction among janitorial staff, this study aims to provide a comparative analysis [1][2][3] .By juxtaposing the experiences and satisfaction levels of janitors in the Kandy District with broader international trends, we seek to identify commonalities and distinctive factors that contribute to job satisfaction.This approach enables a holistic understanding of the challenges faced by janitorial staff in both global and local contexts.The justification for this study stems from the imperative to fill the existing gap in the literature on job satisfaction within janitorial services, particularly in the healthcare sector.While numerous studies explore job satisfaction across various professions, the distinct challenges and contributions of janitorial staff remain underexplored.This research seeks to bridge this gap by offering valuable insights that can inform policies and practices to improve the well-being and performance of janitorial staff in tertiary care hospitals in the Kandy District, Sri Lanka, and potentially serve as a reference for similar contexts globally.

General Objective
To assess the job satisfaction and performance of janitorial staff in two tertiary care hospitals in Kandy district, Sri Lanka.

Methodology
The research employs a descriptive crosssectional study design to comprehensively assess the job satisfaction and performance of janitorial staff in two teaching hospitals within the Kandy District, Sri Lanka.This study utilizes a mixed-methods approach, combining both quantitative and qualitative methods to provide a holistic understanding of the subject matter.Given practical constraints and the unique nature of the janitorial workforce, a purposive sampling strategy is employed.The total staff of janitorial services is considered as the sample for this study, ensuring a focused examination of the experiences and perceptions of this essential workforce within the chosen healthcare setting.
These hospitals are selected due to their significance within the healthcare system and the diverse challenges faced by janitorial staff in such complex environments.Data collection comprises a quantitative component involving structured questionnaires tailored for janitorial and nursing staff.Additionally, a qualitative component involves key informant interviews with select janitorial staff members to delve deeper into their experiences.An interviewer guide ensures consistency and coverage of relevant topics during these qualitative interactions.The study utilizes two distinct questionnaires, one for janitorial staff and another for nursing staff, aiming to quantify job satisfaction and performance from different perspectives.An interviewer guide is employed during key informant interviews to maintain consistency and facilitate indepth qualitative data collection.
Quantitative data analysis involves the use of the Statistical Package for the Social Sciences (SPSS) software.Descriptive statistics, such as mean, standard deviation (SD), and p-values, are calculated to quantify the quantitative aspects of job satisfaction and performance.Simultaneously, qualitative data from key informant interviews undergo thematic analysis to identify patterns, themes, and meaningful insights.This methodological framework aims to provide a robust and nuanced exploration of the job satisfaction and performance of janitorial staff in the specified healthcare setting, offering valuable insights for both practical interventions and future research endeavours.

Results
Table 1 displays the number and percentage of janitorial staff across two hospitals: Teaching Hospital Peradeniya (THP) and Sirimavo Bandaranaike Children's Hospital (SBHK).The data reveals that THP has 64 janitorial staff, constituting 64.6% of the total, while SBHK has 35 janitorial staff, representing 35.4%.The total population size of janitorial staff considered in this study is 99, encompassing both hospitals.Table 3 provides a detailed statistical analysis, offering insights into the level of job satisfaction among janitorial staff at Teaching Hospital Peradeniya (THP) and Sirimavo Bandaranaike Children's Hospital (SBHK).The assessment covers various facets of their job, utilizing a rating scale ranging from 1 to 5, where 5 represents "Yes," 4 indicates "Partially Yes," 3 signifies "Average," 2 represents "Rarely," and 1 denotes "No." Facilities for the job garnered a high level of satisfaction at both THP and SBHK, with mean satisfaction levels of 1.022 (SD = 0.128) and 1.008 (SD = 0.170), respectively.This suggests contentment among janitorial staff regarding the facilities provided for their work.In the realm of sanitary equipment, janitorial staff at THP reported a mean satisfaction level of 0.726 (SD = 0.091), while their counterparts at SBHK recorded an M of 0.736 (SD = 0.124).Though indicating a relatively lower satisfaction level, it remains comparable to other aspects.

Discussion
The comprehensive assessment of job satisfaction and performance among janitorial staff in the specified healthcare setting offers valuable insights into the nuanced dynamics of this essential workforce.The multifaceted inquiry addresses the well-being of janitors and its potential impact on the overall quality of healthcare delivery in Teaching Hospital Peradeniya (THP) and Sirimavo Bandaranaike Children's Hospital (SBHK).
Comparing with the other determinants, Demographic factors as presented in Tables 2 and 4, shed light on key factors influencing job satisfaction among janitorial staff.The majority of participants being male, with a substantial representation in the age group 41-60 and an emphasis on the Rs 25001-50000 monthly income category, provide a foundational understanding of the demographic landscape.This demographic context is crucial for interpreting job satisfaction variations and tailoring interventions to address specific needs within this workforce.
The positive perceptions expressed by janitorial staff regarding facilities, sanitary equipment, colleague support, time allocated for meals and tea, welfare facilities, staff support, job appreciation, travel distance, income, and job duties satisfaction underscore the overall contentment within the workforce.The relatively higher satisfaction levels regarding travel distance and income indicate the significance of these aspects in shaping job satisfaction among janitors in the healthcare sector.These insights can inform targeted interventions and policies to sustain and enhance these positive aspects.
Colleague support emerges as a notable strength, contributing to a positive work environment for janitors in both hospitals.This collaborative atmosphere fosters job satisfaction and has the potential to positively impact overall hospital performance.Identifying and leveraging these strengths can be instrumental in designing initiatives to further enhance teamwork and support mechanisms among janitorial staff.
The job satisfaction levels noted in this study provide a benchmark for comparing international trends and local realities.This comparative analysis is crucial for understanding whether the challenges and satisfaction levels among janitorial staff in the Kandy District align with broader global patterns or if there are unique local factors at play.The findings contribute to the global discourse on job satisfaction in healthcare services, offering insights that can be valuable for institutions facing similar challenges worldwide.
The significance of colleague support, high satisfaction levels in critical aspects like travel distance and income, and the positive overall job satisfaction reported in both hospitals point to the resilience and commitment of janitorial staff.These findings contribute to the existing literature on job satisfaction within the healthcare sector, particularly for janitorial services, filling a crucial gap in understanding the unique challenges and contributions of this essential workforce.
The insights gleaned from this study have practical implications for hospital administrators, policymakers, and researchers.
Implementing targeted interventions based on the identified strengths and addressing specific areas for improvement can enhance the well-being and performance of janitorial staff.This, in turn, can positively impact the overall quality of healthcare services provided by these institutions.In essence, the research not only addresses the immediate context of janitorial services in the Kandy District but also contributes to the broader discourse on job satisfaction in healthcare, laying the foundation for further research and practical interventions globally.

Conclusion
As discussed, one key issue was disproportionate staffing also it was found that no proper indicators to monitor and evaluate the process.
In both hospitals we have identified issues with related to Sex, Age and wages as these aspects can demotivate the staff and can affect the, efficiency quality and productivity of work.Though overall job satisfaction is satisfactory, majority draw a low salary with having several dependents in a family.
It was found that though majority of the staff members have a poor education level, but their knowledge on work is satisfactory and was shown difference with regard to knowledge on spreading disease.
When analysing the process and out put the data indicated, tough there is no significant different in between hospitals, in using check lists, both the hospitals were lacking in usage of monitoring tools to assess quality of work and correct use of equipment's which infer those supervisions by the middle and the immediate supervisory staff (NOIC) is low.Employee retention and Pay are key areas that we must consider in strategic Human Resource Management as they contribute to job satisfaction directly or indirectly.

Recommendations
The given content outlines several key recommendations for improving the management of janitorial staff outsourcing in a healthcare setting:

Table 1 : Distribution of the sample according to the hospital
accounting for 10.2% (n=10).Those over 61 years of age make up 11.2% (n=11) of the overall sample.This age distribution is consistent across both hospitals.

Table 3 : Statistics of measuring the level of Job Satisfaction of the Janitorial Staff
M= Median, SD= Standard Deviation