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146 J Formos Med Assoc | 2009 • Vol 108 • No 2
ORIGINAL ARTICLE
Psychiatric disorders associated with anxiety, de-
pression, sleep disturbances, and related symp-
toms have been reported to be prevalent in the
community and the workplace.1–6 Occupational
mental health has been shown to be significantly
related to productivity and other desired orga-
nizational outcomes such as commitment and
satisfaction. In particular, many studies have found
a close link between mental health and job sat-
isfaction.7–16 Poor mental health impairs job
performance and interpersonal communication.
Therefore, it may have negative effects not only
on job satisfaction but also on the safety and
quality of services.
Relationship Between Mental Health and Job
Satisfaction Among Employees in a Medical
Center Department of Laboratory Medicine
Mo Siu-Mei Lee,1Ming-Been Lee,2* Shih-Cheng Liao,2Fu-Tien Chiang1
Background/Purpose: Mental disorders associated with insomnia, depression and anxiety are common
in the community and the workplace. Many studies have found a close link between mental health and
job satisfaction. The present study investigated the prevalence of psychiatric morbidity and level of job satis-
faction, as well as the relationship between psychological distress and job satisfaction and associated factors,
among nonphysician employees of a laboratory medicine department at a university medical center.
Methods: A cross-sectional descriptive and correlational study design was used. The employees were recruited
and asked to complete a set of questionnaires, including a five-item Brief Symptom Rating Scale (BSRS-5)
and a 40-item Job Satisfaction Questionnaire (JSQ-40). A total of 38 (26.21%) males and 107 (73.79%)
females with a mean age of 40.80 ±7.3 years completed the entire set of questionnaires.
Results: The prevalence of psychiatric morbidity defined by the BSRS-5 was 34.33%, with insomnia rank-
ing the highest (28.36%), followed by depression (25.37%), hostility (24.63%), anxiety (23.13%), and
inferiority (20.15%). Job satisfaction global assessment scores on a scale of 0 to 100 indicated that most
respondents were satisfied with their jobs. In general, subjects with more severe psychological distress re-
ported lower levels of job satisfaction on five dimensions measured by the JSQ-40. Factors related to organi-
zational communication were especially important in overall job satisfaction and severity of psychological
distress.
Conclusion: The prevalence of psychiatric morbidity in the workplace is high. The severity of psychologi-
cal distress is negatively associated with job satisfaction. Early detection of psychiatric morbidity through
self-administered screening questionnaires, as well as implementation of organizational mental-health
promotion programs, is recommended to improve employees’ mental health and job satisfaction. [J Formos
Med Assoc 2009;108(2):146–154]
Key Words: employees, job satisfaction, mental health, psychological distress, workplace
©2009 Elsevier & Formosan Medical Association
.......................................................
Departments of 1Laboratory Medicine and 2Psychiatry, National Taiwan University Hospital and College of Medicine,
Taipei, Taiwan.
Received: October 27, 2008
Revised: November 24, 2008
Accepted: December 1, 2008
*Correspondence to: Dr Ming-Been Lee, Departments of Psychiatry and Social Medicine,
National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.
E-mail: mingbeen@ntu.edu.tw
Mental health and job satisfaction
J Formos Med Assoc | 2009 • Vol 108 • No 2 147
The medical workplace is a complex environ-
ment. Personal, interpersonal and organizational
factors have been found to be involved in job sat-
isfaction, stress and burnout in the medical set-
ting.10,13–16 Most researchers in these areas have
focused more on physicians, nurses, pharmacists
and social workers than on medical technicians
working in clinical laboratories.11–16 Medical error
is attracting increasing attention among medical
professionals as well as the general public. Although
to err is human, most errors in medical laborato-
ries can be avoided. Mistakes resulting from work-
ers’ poor attention and negative behavior caused
by psychological distress or job dissatisfaction can
occur throughout the work process, including dur-
ing performing tests, entering data and writing
reports. An incorrect report of results of an impor-
tant laboratory test can lead to misdiagnosis and
poor treatment decisions by physicians.
The present study was conducted to investi-
gate mental health and its relationship with level
of job satisfaction and to clarify the associated
factors among employees of a medical center de-
partment of laboratory medicine. The ultimate
goal was to provide recommendations for preven-
tion or early identification and treatment of em-
ployees’ psychiatric morbidity, to improve their
job satisfaction and help ensure the quality and
safety of their job performance.
Methods
Subjects and procedures
A cross-sectional study was performed using a
questionnaire-based survey. A set of self-admin-
istered questionnaires, including one on demo-
graphic and basic personal data, a five-item Brief
Symptom Rating Scale (BSRS-5),17 and a 40-item
Job Satisfaction Questionnaire (JSQ-40),18,19 were
distributed directly to all 158 nonphysician em-
ployees in 11 divisions of the laboratory medicine
department of a university hospital in Taiwan. Of
the 158 employees, 145 completed the entire set
of questionnaires, for a response rate of 91.80%,
and were recruited as the study subjects.
Assessment of psychological distress
The BSRS-5, a five-item self-administered ques-
tionnaire in which a higher score indicates worse
mental health, was derived from the Symptom
Checklist-90-Revised (SCL-90R) and BSRS-5017,20–26
and developed to identify psychiatric morbidity.
It contains questions on the following five mea-
sures of psychopathology: (1) feeling tense or
keyed up (anxiety); (2) feeling blue (depression);
(3) feeling easily annoyed or irritated (hostility);
(4) feeling inferior to others (inferiority); and (5)
trouble falling asleep (insomnia). A brief instruc-
tion section before the description of symptoms
was included to guide the respondents to identify
the degree to which they experienced each type of
discomfort during the past week, including the
current day. The subjects were asked to rate their
discomfort for each item on a 5-point Likert-type
scale as follows: 0, not at all; 1, a little bit; 2, mod-
erately; 3, quite a bit; and 4, extremely. A total
score was calculated for each subject. The BSRS-5,
either self-reported or administered by interview-
ers, has been reported to have satisfactory psycho-
metric properties as a screening tool to identify
common psychiatric morbidity such as anxiety, de-
pression and related mental disorders in medical
practice, the workplace and the community.17–26
It has been widely used for various occupational
samples. The cutoff score for screening of psychi-
atric morbidity was set at ≥6.17,24
Measurement of job satisfaction
Two measures were used to assess the level of job
satisfaction. The first was a single-item global
assessment measure in which the subject was
asked to rate his or her degree of job satisfaction
on a scale from 0 to 100. The second measure
was the JSQ-40, which was derived and re-
designed from the Job Descriptive Index.18,19 For
the present study, the authors modified the Job
Descriptive Index and added one more facet of
the health promotion to create five dimensions.
Ultimately, the questionnaire consisted of 40 items
that made up the following five dimensions: (1)
Job Characteristics; (2) Salary and Welfare; (3)
Professional Growth; (4) Health Promotion; and
(5) Interpersonal Support. Each item was rated
according to the degree of satisfaction on a
5-point scale, from 0 (strongly disagree) to 4
(strongly agree). The JSQ-40 has been reported
to have good reliability, indicated by Cronbach’s
α, and construct validity, expressed by factor
analysis.27
Statistical analysis
In addition to descriptive statistics used for de-
mographic and basic personal data variables, the
χ2test was used to compare the rates of BSRS-5-
defined psychiatric morbidity for different gen-
ders and age groups, and the two-tailed ttest and
one-way analysis of variance (ANOVA) were used
to compare the mean BSRS-5 scores and job sat-
isfaction global assessment scores for different
groups. Cronbach’s αvalue was used to estimate
the internal consistency of the BSRS-5 and JSQ-
40. Pearson’s product moment correlation and
multiple stepwise regression analysis were used
to test the association between variables, includ-
ing major demographic and basic personal vari-
ables, the BSRS-5 individual item and total scores,
and the job satisfaction subscale scores and global
assessment score. The level of statistical signifi-
cance was set at p<0.05.
Results
Basic information
The research questionnaires were completed by a
total of 145 subjects, 107 females (73.79%) and
38 males (26.21%), with a mean age of 40.75 ±
7.26 years, and a mean duration of service (sen-
iority) of 12.92 ±8.27 years. Of the 145 subjects,
57.69% had completed college, 23.85% had com-
pleted senior high school or below, and 18.46%
had completed postgraduate school.
Reliability of measurements
For the present study, the internal consistency of
the BSRS-5 and each subscale of the JSQ-40 was
good, with a Cronbach’s αrange of 0.75–0.92
(BSRS-5, 0.92; Job Characteristics, 0.78; Salary and
Welfare, 0.75; Professional Growth, 0.89; Health
Promotion, 0.77; Interpersonal Support, 0.85).
Prevalence of psychiatric morbidity
The prevalence of psychiatric morbidity, defined
as a BSRS-5 score of ≥6, was 34.33% (35.35%
of females and 31.43% of males). A score of ≥2
(moderate or higher degree of distress) was con-
sidered the threshold for individual BSRS-5 items,
and the proportions of subjects meeting this cri-
terion for the individual items were as follows:
28.36% for insomnia, 25.37% for depression,
24.63% for hostility, 23.13% for anxiety, and
20.15% for inferiority. No statistically significant
gender differences were found in the rates of psy-
chiatric morbidity and severity of individual
BSRS-5-defined symptoms.
Job satisfaction levels based on global
assessment and item ratings
For the single-item global assessment of job
satisfaction, on a scale from 0 to 100, the average
score for the subjects was 75.39 ±10.55, with
17.09% indicating dissatisfaction (40–60), 22.22%
indicating low satisfaction (61–70), 38.46% in-
dicating medium satisfaction (71–80), 17.09%
indicating high satisfaction (81–90), and 5.13%
indicating very high satisfaction (91–100). Thus,
approximately 40% of the subjects expressed low
satisfaction or dissatisfaction with their jobs.
The ranking of the JSQ-40 items by the aver-
age score for each item and the correlations of
individual items and dimensions of the JSQ-40
with the job satisfaction global assessment score
and total BSRS-5 score are displayed in Table 1.
Regarding the dimensional scores, Interpersonal
Support ranked highest for satisfaction, with a
mean score of 3.29, followed by Job Characteris-
tics (3.14), Salary and Welfare (2.90), Health Pro-
motion (2.89), and Professional Growth (2.87).
The six highest-satisfaction individual items,
ranked from highest to lowest, were as follows:
(1) item 37, Getting along well with coworkers;
(2) item 36, Colleagues help each other; (3) item
18, Convenient transportation; (4) item 38, Good
interdisciplinary communication; (5) item 4,
M.S.M. Lee, et al
148 J Formos Med Assoc | 2009 • Vol 108 • No 2
Mental health and job satisfaction
J Formos Med Assoc | 2009 • Vol 108 • No 2 149
Table 1. Correlations between JSQ-40 item scores, global assessment of job satisfaction and total BSRS-5 score
Dimensions and individual items of the JSQ-40 Mean Global assessment of Total BSRS-5
(Rank) job satisfaction (r) score (r)
Job Characteristics 3.14 (2) 0.540* −0.295*
1. Comfortable working environment 2.88 (31) 0.402* −0.225*
2. Safe working environment 3.10 (18) 0.445* −0.232*
3. Good medical equipment in the workplace 3.17 (17) 0.150 0.062
4. Reasonable method of working shift 3.39 (5) 0.362* −0.227*
5. Reasonable working hours 3.39 (6) 0.202†−0.155
6. Reasonable workload assigned by my boss 3.28 (11) 0.341* −0.294*
7. Clear definition of job descriptions 3.32 (8) 0.282* −0.099
8. Fits my ability and profession 3.19 (15) 0.449* −0.178†
9. Opportunity to participate in decision making 2.88 (32) 0.445* −0.181†
10. My relatives think I sacrificed too much for my job 2.97 (26) 0.066 −0.186†
11. Too much job stress 2.95 (28) −0.083 −0.024
12. Joyful working experience in the workplace 3.17 (16) 0.535* −0.218*
Salary and Welfare 2.90 (3) 0.439* −0.194†
13. Reasonable bonus for performance 2.45 (39) 0.379* −0.188†
14. Reasonable salary in terms of personal effort and outcome achieved 2.98 (25) 0.292* −0.200†
15. Good welfare systems or facilities 2.69 (36) 0.252* −0.172†
16. Adequate exercise and leisure activities provided by the hospital 3.09 (20) 0.314* −0.065
17. Good-quality dorm or on-duty room 2.14 (40) 0.285* −0.059
18. Convenient transportation to work 3.62 (3) 0.196†−0.196†
19. Reasonable system for time off 3.34 (7) 0.215†−0.015
Professional Growth 2.87 (5) 0.508* −0.234*
20. On-job training meets personal needs 3.06 (23) 0.374* −0.197†
21. Enough opportunity for advanced learning or education 2.79 (34) 0.356* −0.140
22. Fair and reasonable performance assessment systems 2.70 (35) 0.391* −0.157
23. Fair and objective system for promotion or advancement 2.52 (38) 0.389* −0.239*
24. Feelings of achievement from performing the job 3.08 (21) 0.541* −0.209†
25. Current job provides the opportunity for learning and growth 3.10 (19) 0.414* −0.195†
Health Promotion 2.89 (4) 0.438†−0.248*
26. My boss has concern for subordinates’ mental health 2.99 (24) 0.530* −0.298*
27. My hospital promotes diet education and activity 3.06 (22) 0.342* −0.182†
28. My hospital provides adequate exercise space or facility 2.54 (37) 0.416* −0.184†
29. My hospital provides tests and analysis of physical fitness 2.90 (30) 0.324* −0.204†
30. My hospital provides smoking-cessation programs 2.96 (27) 0.075 −0.070
Interpersonal Support 3.29 (1) 0.605* −0.251*
31. My boss has concern for subordinates 3.21 (13) 0.546* −0.264*
32. My boss listens to subordinates’ opinions 3.21 (14) 0.534* −0.244*
33. My boss helps subordinates to resolve work difficulties 3.30 (9) 0.494* −0.244*
34. My boss treats me fairly 3.30 (10) 0.552* −0.184†
35. Satisfied with the leadership style of my boss 3.27 (12) 0.477* −0.224*
36. The colleagues help each other 3.64 (2) 0.314* −0.100
37. Getting along well with coworkers 3.79 (1) 0.345* −0.146
38. Good interdisciplinary communication 3.52 (4) 0.413* −0.204†
39. Good interaction with patients and their families 2.80 (33) 0.088 −0.006
40. Good and open channels of opinion expression 2.90 (29) 0.424* −0.137
Summed score of JSQ-40 122.63 0.617* −0.298*
*Correlation was significant at the 0.01 level (two-tailed); †correlation was significant at the 0.05 level (two-tailed).
M.S.M. Lee, et al
150 J Formos Med Assoc | 2009 • Vol 108 • No 2
Reasonable working shift; and (6) item 5, Rea-
sonable working hours. Most of these items are
related to interpersonal support and fairness in
work situations.
As shown in Table 1, the job satisfaction global
assessment score was significantly correlated with
most items of the JSQ-40. Six items had correla-
tion coefficients >0.5: (1) item 34, My boss treats
me fairly; (2) item 31, My boss has concern for the
subordinates; (3) item 24, Feelings of achievement;
(4) item 12, Joyful working experience; (5) item
32, My boss listens to the subordinates’ opinions;
and (6) item 26, My boss has concern for subor-
dinates’ mental health. Importantly, four of these
six items were related to the boss’ attitudes.
Relationship between job satisfaction and
psychological distress
As Table 2 shows, in the one-way ANOVA for job
satisfaction, global assessment score by BSRS-5
score level (0, 1–9 or 10–20), significant intergroup
differences were found (F[1,2] =7.67; p<0.01).
The post hoc comparison with Bonferroni correc-
tion revealed the following significant differences:
BSRS-5 =0 vs. BSRS-5 =1–9, and BSRS-5=10–20 vs.
BSRS-5 =1–9. The findings indicate that the sub-
jects with higher BSRS-5 score levels expressed
lower job satisfaction.
In general, as shown in Table 3, the total
BSRS-5 score was negatively correlated with the job
satisfaction global assessment score (Pearson’s cor-
relation coefficient =−0.34; p<0.01). The scores for
the five JSQ-40 dimensions were all significantly
correlated with the total BSRS-5 score (Tables 1
and 3). Regarding the correlation between indi-
vidual psychological symptoms and the five JSQ-
40 dimensions, it was noted that insomnia had
a negative correlation only to Job Characteristics
(−0.165); anxiety had the highest negative cor-
relation with Professional Growth (−0.247) and
Health Promotion (−0.212); hostility had the
highest negative correlation with Job Characteris-
tics (−0.210); and depression had the highest nega-
tive correlations with Job Characteristics (−0.248)
and Interpersonal Support (−0.248). The job
Table 2. Association by one-way ANOVA of global
assessment of job satisfaction with the
levels of total BSRS-5 score
Level of Global assessment of
BSRS-5 njob satisfaction score
score (mean ±SD)
0 (A) 34 80.82 ±8.48
1–9 (B) 88 75.53 ±10.23
10–20 (C) 23 68.58 ±10.60
Total 145 75.39 ±10.55
Between-group statistics: df =2; F =7.666; p =0.001. Post hoc
comparison by the Bonferroni method shows significant differ-
ences between groups A and C (mean difference =12.239; SD =
3.130; p =0.01) and groups B and C (mean difference =6.947;
SD =2.563; p =0.028).
Table 3. Correlations between job satisfaction and demographic variables, items of BSRS-5, and total BSRS-5 score
Job satisfaction
Demographic Items of BSRS-5 Total BSRS-5
variables
Age Seniority Insomnia Anxiety Hostility Depression Inferiority
score
Subscales of JSQ-40
1. Job Characteristics 0.036 −0.072 −0.165* −0.170* −0.210* −0.248†−0.110 −0.295†
2. Salary and Welfare 0.268†0.208* −0.081 −0.157 −0.120 −0.135 −0.108 −0.194*
3. Professional Growth 0.084 0.045 −0.116 −0.247†−0.182* −0.197* −0.052 −0.234†
4. Health Promotion 0.211* 0.141 −0.090 −0.212* −0.185* −0.183* −0.113 −0.248†
5. Interpersonal Support 0.132 0.054 −0.072 −0.197* −0.188 −0.248†−0.002 −0.251†
Summed score of JSQ-40 0.165 0.076 −0.149 −0.269†−0.351†−0.364†−0.172* −0.298†
Global assessment of job satisfaction 0.250* 0.204* −0.169 −0.243†−0.329†−0.299†−0.089 −0.340†
*Correlation was significant at the 0.05 level (two-tailed); †correlation was significant at the 0.01 level (two-tailed).
Mental health and job satisfaction
J Formos Med Assoc | 2009 • Vol 108 • No 2 151
satisfaction global assessment score had the high-
est negative correlation with hostility (−0.329),
followed by depression (−0.299) and anxiety
(−0.243).
The correlation coefficient between the job
satisfaction global assessment score and total
BSRS-5 score was −0.340, which was higher than
those of the individual items and five dimen-
sions of the JSQ-40 (Tables 1 and 3). According
to Table 1, the JSQ-40 individual items with the
three highest correlation coefficients with the
total BSRS-5 score were item 26, My boss has con-
cern for subordinates’ mental health (r=−0.298);
item 6, Reasonable workload assigned by my boss
(r=−0.294); and item 31, My boss has concern
for the subordinates (r=−0.264). All of these items
are related to the boss’ attitude.
Other variables associated with job
satisfaction and psychological distress
With respect to the correlation between demo-
graphic variables (age and seniority) and the five
dimensions of JSQ-40, age was positively cor-
related with the dimensional scores of Salary
and Welfare and Health Promotion (Table 3).
The duration of service (seniority) was positively
correlated with the score of Salary and Welfare
(Table 3). Sex and education level were not sig-
nificantly associated with the total BSRS-5 score
or the job satisfaction global assessment score.
As Table 4 shows, in the stepwise multiple
linear regression model for global assessment of
job satisfaction using the individual items of the
JSQ-40, age, education level, seniority and total
BSRS-5 score as independent variables, the final
model contained Division chief treats me fairly
(p<0.001), Joyful working experience in the work-
place (p<0.01), Good interdisciplinary commu-
nication (p=0.03), and Seniority (duration of
service) (p=0.04). In another stepwise multiple
linear regression model for the total BSRS-5 score
using the individual items of the JSQ-40, age, ed-
ucation level and seniority as independent vari-
ables, the final model (Table 5) contained the
significant variables of Reasonable workload as-
signed by my boss (p<0.01), Good interdiscipli-
nary communication (p=0.02), and Good medical
equipment in the workplace (p=0.04).
Discussion
The BSRS-5 is designed for early identification of
common psychiatric disorders associated with
Table 4. Factors related to global assessment of job satisfaction by stepwise multiple regression analysis*†
Independent variable bStandard error tp
1. Division chief treats me fairly 3.919 1.073 3.651 0.000
2. Joyful working experience in the workplace 3.503 1.231 2.847 0.005
3. Good interdisciplinary communication 2.300 1.068 2.155 0.033
4. Seniority 0.182 0.087 2.102 0.038
*Independent variables were sex, age, education level, seniority, and total BSRS-5 score; †adjusted R2of the final stepwise multiple linear
regression model was 0.40.
Table 5. Factors related to total BSRS-5 score by stepwise multiple regression analysis*†
Independent variable bStandard error tp
1. Reasonable workload assigned by the boss −1.425 0.486 −2.936 0.004
2. Good interdisciplinary communication −1.123 0.460 −2.443 0.016
3. Good medical equipment in the workplace 0.832 0.403 2.066 0.041
*Independent variables were sex, age, education level, seniority, and the items of the JSQ-40; †adjusted R2of the final stepwise multiple
linear regression model was 0.13.
depression or anxiety seen in medical practice
and the community.17,25,26 The present study
found that 34.33% of the subjects had psychiatric
morbidity, with predominant features of insom-
nia, depression, hostility and anxiety. Among the
five symptoms measured by the BSRS-5, insomnia
(28.36%) was the most prevalent presentation of
psychological distress. This can be explained by
the fact that insomnia itself is a primary psychiatric
disorder, as well as a common associated feature
of anxiety, depression and hostility. Insomnia has
been reported to be associated with increased feel-
ings of hostility and fatigue and decreased feel-
ings of joviality and attentiveness, and to correlate
negatively with job satisfaction.9In the present
study, we found that insomnia was closely related
to job characteristics (Table 3). Psychiatric mor-
bidity associated with anxiety, depression or hos-
tility has negative effects not only on quality of
life and psychosocial competence, but also on
the productivity and quality of job performance.
Fortunately, insomnia, depression, hostility and
anxiety are all treatable.
Indicators of job satisfaction constitute a mul-
tidimensional psychological response to one’s job.
The indicators have cognitive (evaluative), affec-
tive (emotional) and behavioral components.28
Job satisfaction can be defined in several ways,
including: (1) the degree of personal gratification
received from one’s work; and (2) the pleasure
and feeling of accomplishment derived from
performing a job well.29 Job satisfaction is gener-
ally measured by asking respondents to rate indi-
vidual facets of their work and then aggregating
the responses into a single (global) score.
In general, measures of job satisfaction include
two major types: a single-item global measure (an
overall satisfaction scale), and composite measures
of satisfaction with various job components. Facet
measures are completely different conceptually
from the overall satisfaction measure. Overall sat-
isfaction is essentially the global attitude or feel-
ing an individual has about his/her job as a whole,
and may be related to personality. Composite job
satisfaction measures can provide extensive de-
tailed information to help employees change their
current working situations to increase their over-
all job satisfaction. The present study adopted
both types of measures. As shown in Table 4, the
results using stepwise multiple regression anal-
ysis revealed that 40% of the job satisfaction
global assessment score can be explained by four
variables: (1) the division manager’s attitudes;
(2) joyful working experiences; (3) good inter-
disciplinary communication; and (4) seniority
(duration of service). All of these variables might
be directly or indirectly related to organizational
communication.
Job satisfaction has been associated with a
variety of behaviors relating to communication.
De Nobile and McCormick have identified sev-
eral organizational communication factors that
predicted job satisfaction in a sample of teachers
in a primary school.30 They included downward
supportive communication of supervisors, hori-
zontal communication of colleagues, and vertical
openness of communication with supervisors re-
garding working conditions. Satisfaction levels
can vary markedly across different job facets,
which in turn may be different from an employee’s
overall feeling of job satisfaction. Our study re-
vealed that overall satisfaction was significantly
correlated with all five JSQ-40 dimensions, with
the highest correlation (0.552) with Interpersonal
Support and the lowest correlation with Salary
and Welfare (0.407). In addition, as shown in
Table 4, 40% of the variance in overall satisfaction
was explained by the above-mentioned four
individual items.
A recent study has suggested that the most
important determinants of job satisfaction are
whether an employee finds the job interesting,
has good relationships with managers and col-
leagues, has a high income, is allowed to work
independently, and has clearly defined career-
advancement opportunities.31 All of these factors
were also observed to be significantly correlated
with job satisfaction global assessment in the
present study (Table 1).
The present study demonstrated that psycho-
logical distress is significantly and negatively as-
sociated with job satisfaction among employees.
M.S.M. Lee, et al
152 J Formos Med Assoc | 2009 • Vol 108 • No 2
Subjects who experienced higher psychological
distress tended to have lower job satisfaction rat-
ings. The severity of overall psychological dis-
tress, defined by the total BSRS-5 score, was most
strongly associated with the item “Reasonable
workload assigned by my boss”, followed by
“Good interdisciplinary communication” and
“Good medical equipment in the workplace”.
Faragher and colleagues conducted an analy-
sis of 485 studies with a combined sample size
of 267,995 individuals to evaluate the evidence
linking self-reported measures of job satisfaction
to measures of physical and mental wellbeing.8
They concluded that job satisfaction level is an
important factor in workers’ health. Job satisfac-
tion was strongly related to burnout (corrected
r=0.478), self-esteem (r=0.429), depression (r=
0.428), and anxiety (r=0.490). Our study showed
similar results. Job satisfaction in terms of global
assessment or dimensional scores was significantly
negatively associated with anxiety, depression
and hostility. Moreover, the strongest predictor
of overall job satisfaction was the division man-
ager’s demonstration of fairness. Joyful working
experience, good interdisciplinary communica-
tion, and seniority were also positively correlated
with overall job satisfaction. Employees’ feelings
toward authority figures may play a crucial role
in mental health and job satisfaction among
medical laboratory staff members.
The correlation coefficient between overall
satisfaction and total BSRS-5 score was −0.340,
which was higher than those of the individual
items and five dimensions of the JSQ-40 (Tables 1
and 3). The items with the highest correlations with
the BSRS-5 score were item 26, My boss has con-
cern for subordinates’ mental health (r=−0.298);
item 6, Reasonable workload assigned by my
boss (r=−0.294); and item 31, My boss has con-
cern for the subordinates (r=−0.264). In the pres-
ent study, the organizational communication
factors mentioned above were the strongest pre-
dictors of job satisfaction and severity of psycho-
logical distress. The results suggest that policy
and practice should focus on improved commu-
nication among leaders and colleagues.
Psychiatric morbidity and psychological dis-
tress can be multifactorial in etiology. As Table 5
shows, only 13% of the variance of psychological
distress (BSRS-5 scores) can be explained by the
following three JSQ-40 items: (1) Reasonable
workload assigned by my boss; (2) Good inter-
disciplinary communication; and (3) Good med-
ical equipment in the workplace. Although the
percentage of variance explained in the present
study was not high, as in most of the other re-
search reports, job satisfaction was by far the
highest statistical correlate with mental health in
the workplace.8Recent research has suggested
that effective stress-intervention policies require
good communication between management and
employees.32–34
This study was limited by its cross-sectional
design, which hampered interpretation of a causal
relationship between job satisfaction and psy-
chological distress. From the perspective of men-
tal health, life stressors that lead to psychological
distress and job dissatisfaction are usually impor-
tant stressors among workers. Therefore, efforts
to improve job satisfaction may also help promote
mental health in the workplace. Conversely, from
the perspective of job satisfaction, those with
higher degrees of psychological distress may have
overly negative evaluations of their work envi-
ronment as a result of their psychopathology.
This may result in cognitive bias in responding
to the questionnaires or poor job rewards caused
by functional impairment. In our study, subjects
with severe psychological distress (BSRS-5 score
>9) showed significantly lower job satisfaction
than those without severe psychological distress.
This result partially supports the above-stated hy-
pothesis. Additional prospective studies are needed
to elucidate the detailed relationships between
job satisfaction and psychological distress.
In conclusion, psychological wellbeing and job
satisfaction are linked. In addition to traditional
stress-management techniques, humanized lead-
ership, improved interdisciplinary communica-
tion, and paying increased attention to junior
staff members may be beneficial to workers in
terms of job performance and mental health.
Mental health and job satisfaction
J Formos Med Assoc | 2009 • Vol 108 • No 2 153
M.S.M. Lee, et al
154 J Formos Med Assoc | 2009 • Vol 108 • No 2
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