Motivation of health professionals and associates to perform daily job activities

Introduction: Motivation is one of the most complex elements of human behavior, it is the subject of debates by which we answer to the question of why someone behaves in a certain way. The aim of this study wasto examine the factors of motivation for health workers and staff in working with diffi cult patients in intensive care units and to evaluate implementation of motivation factors by managers in their daily work with a team of health professionals.Methods: The study was designed as prospective. It was conducted on 27 employees who work in intensive care units in Clinical Center of Sarajevo University. The survey questionnaire was used with a clear andconcise questions , aimed at testing the factors of motivation for daily work with diffi cult patients, as well as implementation of motivational factors by managers in the organizational unit (OU).Results: Respondents indicated that motivates them, good organization of work - 10 of them (37%), while 26% of respondents indicated that they are motivated by fi nancial gain. In our study 21 (77%) of respondentssaid that their managers infuenced the motivation for a better job. Mobbing at the workplace did not had 80% of respondents, while 8% of respondents stated that they had some form of mobbing, and 12% of respondents give partial response.Conclusions: The survey showed that most respondents have a good motivation factors for the performance of daily activities to work with diffi cult patients. As the main motivating factors respondents reportedgood organization of work, as well as positive examples of their managers.


Introduction
Motivation is one of the most complex elements of human behavior, it is the subject of debates by which we answer to the question of why someone behaves in a certain way.By this response,people are devising events in their environment, satisfy their curiosity, discover the initiators of changes, willing elements of human behavior.Motivation is one of the explanations used to explain the variability of behavior.Terms such as initiators, goals, needs, clarify the appearance of confl icts which indicate that in identical situations, there are large diff erences in human behavior (1).By the motives we mean those driving forces of the human body aimed to satisfy specifi c needs.Th e concept of motivation today has a number of synonyms for terms that basically have identical meanings: desire, will, preference, and need (1).Motivation is the internal incentive why people behave -just the way they behave.Someone can make that people behave irrationally and unpredictably.However, if we would be able to "peek" into their past and their emotional mechanism, we would understand that human behavior is logical and predictable.Knowing these facts, with great certainty we are able to predict how some people react to criticism, or to request to stay to work in the offi ce aft er business hours.Th e reasons for such diff erent behavior for the same incentives lie in the uniqueness of each individual.Th at uniqueness gives the stamp the parents, home education, education, social life, works experience etc. Th e sooner managers realize and accept the fact that they are communicating with people who are unique, which are very diff erent among themselves and who have brought with them all their previous experience , they will be much easier manage them and will have before it opened the way for a successful career (2).It is important that managers their subordinates and their colleagues are seen as individuals who have their own unique needs and the need to respect and to be consistent with these fi ndings on behavior -the way to help them to meet those needs.Managers are, thanks to their function and authority, oft en in a position to infl uence the satisfaction of these needs.In this way they are in a position to infl uence the satisfaction and motivation of their subordinates, they will certainly return them in the best way -through the good achieved results and objectives.For some of these needs managers cannot infl uence directly.Oft en the question is salary, bonus awards and other outside their competence, but as we know -it is not all in cash.Th e fact is that money is a big motivation, because it represents a means to satisfy a variety of other needs -from basic needs, increase living standards and the needs for esteem and reputation in society, but we know that there are organizations in which the fi nancial burden is not the primary, and where there is high motivation and job satisfaction.When viewed from the side, in these organizations there is an "irrational" loyalty to the company, a lot of overtime and new taken responsibilities of employees, without the simultaneous material compensation.Th ese are environments in which management respects their subordinates and their needs, and where the recognition, praise and "applause" are an everyday occurrence (1).According to William Glasser, an American psychiatrist and a leading representative of the relative treatment and control theory, person has fi ve requirements.As he says, they are powerful forces that are constantly forcing us to satisfy them.Th ey are: the need for survival and reproduction, the need for belonging, loving, giving and sharing, the need for entertainment, the need for power and the need for freedom (2).Th e goals of this study were: to examine the factors of motivation for health workers and staff in working with diffi cult patients in inten-sive care units and to assess the application of the factors of motivation by managers in their daily work with a team of health professionals.

Sample
Th e study was designed as a prospective.It was conducted on 27 employees who work in intensive care units in Clinical Center of Sarajevo University.In research participated 17 health care workers with secondary education, 4 healthcare workers with university degrees and 3 support staff (workers on maintaining cleanliness and physical workers).

Methods
Th e survey questionnaire was used with a clear and concise questions, aimed at testing the factors of motivation for daily work with diffi cult patients, as well as the application of the factors of motivation by managers in the organizational unit (OU).Th e survey was anonymous, did not contain questions which would revealed the identity of respondents.Th e study was conducted during January 2012.

Data processing
Survey results were analyzed in Microsoft Access database, presented as charts and tables.

Discussion
Th e survey was conducted among 27 employees who work in the Intensive Care Unit of the Clinical Center of Sarajevo University.Looking at the distribution of respondents by sex, was observed higher number of women 24 (89%), while the number of male respondents was 3 (11%).Most of the respondents belonged to age group 20-35 years -20 (74%), while 7 (26%) of respondents belonged to age group 35-45 years.In the study there were no respondents who belong to other age groups.When we observe the structure by it shows that majority are health care workers with secondary education -20 (74%), small number of subjects had a university degree 4 (15%) of respondents, while 3 (11%) respondents was physical workers.Respondents indicated that motivates them to work is good organization of work -10 of them (37%), while 26% of respondents indicated that they are motivated by fi nancial gain.Managers (heads, managers) should directly affect on more eff ective work of their employees, especially by their good practices.In our study 21 (77%) of respondents said that their managers aff ect the motivation for a better job.A large number of respondents 24 (88%) said that the managers reward them for successful work, such as a day off , going to seminars, conferences, fi nancial incentives, etc. Th e study showed that managers respect the opinion of their employees in full 22 (81%), only a small number said that their opinion is not respected -2 (7%).Mobbing at the workplace did not had 80% of respondents, while 8% of respondents stated that they had some form of mobbing, and 12% of respondents give partial response.Managers sometimes from preoccupation with work commitments do not manage the problems of interest to employees.Employees sometimes because of personal problems (disease, illness, family member, etc.) are not able to adequately respond to business tasks, and there is necessity for support by OU managers and other supervisors, which has a positive eff ect for the employees, including health care users.Looking at the respondents answers about their managers understanding of personal problems it can be seen that the greater number of respondents stated that their superiors have an understanding of absence from work -25 (93%) with a small number of respondents who said that their personal problems are not respected 2 (7%) .Research has shown that a larger number of respondents want to improve motivation to work through the increase of wages, respect for opinions and frequent rewards for a job done.

Conclusions
Th e survey showed that most respondents have a good motivation factors for the performance of daily activities to work with diffi cult patients.As the main motivating factors respondents reported good organization of work, as well as positive examples of their managers.Most respondents indicated that their managers respect their opinions and reward them in certain ways.Th e organizational unit for intensive care requires the maximum involvement of employees, so it is necessary to motivate employees in certain ways to work.Teamwork and good communication in the team are prerequisite for the good operation of the organizational unit.

Competeing interests
None to declare.

TABLE 1 .
Suggestions for improving the motivation to work FIGURE 5.The infl uence of superiors on the job motivation FIGURE 6. Rewarding for work by superiors FIGURE 7. Respecting opinions and suggestions by the managers (head, chief nurse) FIGURE 8.The presence of mobbing at work 9.Understanding of the organizational unit's managers -supervisors for unpredicted situations of the employee (illness, family member illness, exams, etc.)