International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 The Effect of Motivation.
Workload and Work Stress on Employee Performance Mediated by Work Satisfaction: The Case of RSUD Dr.
(HC) Ir.
Soekarno Bangka Belitung Island Province Yusi Afserinta.
Abid Djazuli.
Choiriyah Universitas Muhammadiyah Palembang Corresponding Author: yusi.
afserinta@gmail.
Article Information:
Received: June 04, 2025.
Accepted: June 12, 2025.
Published: July 03, 2025 Abstract The study examines the effect of motivation, workload and workstress on employee performance which is mediated by work satisfaction on employee performance at RSUD Dr.
(HC) Ir.
Soekarno Bangka Belitung Island Province.
This research is also verification research .
ausal stud.
This research involves variables consisting of three independent variables, one dependent variable, and one intervening variable.
The independent or exogenous variables contained in this study include work motivation .
, workload .
, and work stress .
The dependent or endogenous variable is employee performance .
At the same time, the intervening variable is job satisfaction .
The population used in this study were all employees at Dr.
(H.
) Ir.
Soekarno Hospital has 320 permanent employees, excluding medical personnel.
The number of samples in this study was 160 permanent employees.
The sampling technique above used a probability sampling technique with accidental sampling.
The analysis model used in this study was Structural Equation Modeling (SEM).
The result reveals that the motivation, workload and workstress on employee performance which is mediated by work satisfaction on employee performance at RSUD Dr.
(HC) Ir.
Soekarno Bangka Belitung Island Province.
Keywords: motivation, workload, work stress, work satisfaction, employee performance Published by:
Page Human resource management (HRM) is one of the most crucial aspects of an organization in today's era of globalization, as the efficient use of human resources enables the company's survival and sustainable economic growth.
Therefore, it is essential to manage human resources effectively in order to maximize their knowledge and productivity in achieving organizational One of the factors that executives in their organizations must pay attention to is the performance of their employees.
According to Busro .
, performance is the work results that can be achieved by employees, both individuals, and groups, in an organization, in accordance with the authority and responsibility given by the organization in an effort to achieve the vision, mission, and goals of the organization concerned by including ability, perseverance, independence, the ability to solve problems according to the time limit given Introduction International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 legally, not violating the law and in accordance with morals and ethics.
Factors that influence employee performance are crucial aspects that must be considered to ensure optimal performance.
According to Kasmir .
, factors that can affect performance, both in terms of work results and behavior, include ability and expertise, knowledge, work design, personality, work motivation, leadership, leadership style, organizational culture, job satisfaction, work environment, loyalty, commitment, and work discipline.
Several factors affect performance, namely personal factors such as skills, competence, motivation, and individual commitment.
leadership factors such as the quality of encouragement, guidance, and support from managers and teams.
team factors such as the quality of support from organizational colleagues.
system elements such as work systems and facilities provided by the situational factors such as high levels of pressure and changes in the internal and external environment.
According to Busro .
, job satisfaction is one of the internal factors that affects employee performance.
Satisfied employees will consistently strive to enhance their abilities and work results to deliver their best performance.
Dissatisfaction among employees can lead to increased errors, which can harm the company.
Companies must make more effort to improve job satisfaction to encourage better performance.
Job satisfaction is one of the key factors that influence performance.
According to Sinambela .
, stress can cause absenteeism, excessive use of alcohol or other drugs, poor performance, or even poor health.
Stress is the body's response to the pressure it is When stress occurs at work, its impact becomes a significant problem for both the Published by:
Page According to Hughes et al.
, several factors influence job satisfaction, including individual perceptions of tasks at work, salary, opportunities for promotion or career advancement, supervision, coworkers, and workload.
An unbalanced workload has a significant impact on feelings of stress, especially when it exceeds capacity, resulting in job dissatisfaction, which ultimately leads to reduced motivation.
So, workload can affect job satisfaction.
Furthermore, according to Sinambela .
, stress can cause a lack of absenteeism, excessive use of alcohol or other drugs, poor performance, or even feeble health.
Stress is the body's response to the pressure it is subjected to.
When stress occurs at work, the impact of the stress According to Suswati .
, several factors that can drive employee performance include employee work motivation.
Work motivation can drive employee performance by satisfying employees' psychological needs.
Motivation is a determinant of performance, based on the assumption that without encouragement, work becomes uninspiring and unengaging.
So, work motivation also affects performance.
Herzberg's two-factor theory, also known as Herzberg's hygiene motivation theory, focuses on sources of motivation related to work completion (Andjarwati, 2.
This two-factor theory consists of hygiene factors and motivator factors.
Herzberg stated that the two factors do not coexist with each other.
He argued that if there is a high motivator factor, it will lead to high satisfaction.
conversely, if the hygiene factor is high, it will cause workers to be dissatisfied (Andjarwati, 2.
So, work motivation also affects job According to Ekawarna .
, workload has a significant impact on employee A high workload and a low workload are both correlated with low performance.
An increase or decrease in workload causes a reduction in performance.
however, an increase in the workload curve is more sensitive to having a negative impact on employee performance.
Therefore, the higher the workload, the lower the performance.
So, workload also affects International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 Published by:
Page One of the government agencies that pays attention to the performance of its employees is the Dr.
(HC.
) Regional General Hospital (RSUD).
Ir.
Soekarno.
Bangka Islands Province.
Soekarno.
Bangka Islands Province.
The study took the State Civil Apparatus (ASN) as the object of research at Dr.
(HC.
) Ir.
Soekarno Regional Hospital.
Soekarno Regional Hospital.
Dr.
(HC.
) Ir.
Soekarno Regional Hospital is a hospital owned by the Bangka Belitung Islands Province Regional Government, which is legally based on Regional Regulation Number 3 of 2013 concerning the Organization and Work Procedures of the Bangka Belitung Islands Province Regional General Hospital and Bangka Belitung Islands Governor Regulation Number 60 of 2013 concerning the Description of Duties and Functions of the Bangka Belitung Islands Province Regional General Hospital.
Dr.
(HC.
) Ir.
Soekarno Regional Hospital is a type B referral hospital in the Bangka Belitung Islands Province.
Dr.
(HC) Ir.
Soekarno Regional Hospital has the vision to be the best and most affordable referral center for the people of the Bangka Belitung Islands Province, prioritizing holistic, interprofessional, collaboration-based In realizing the vision as a regional apparatus within the Bangka Belitung Islands Provincial Government.
Dr.
(HC) Ir.
Soekarno Regional Hospital strives to optimize the achievement of performance targets as stated in the Regional Development Plan (RPJMD) of Dr.
(HC) Ir.
Soekarno Regional Hospital of the Bangka Belitung Islands Provincial Government for 2023-2026.
The results of the evaluation of the achievement of performance indicators, objectives, targets, and results .
of the Strategic Plan (RENSTRA) are obtained through the assessment of the achievement of the Regional Apparatus Performance Plan (RKPD) up to the year (N-.
, evaluation of the contribution of outputs .
from all activities/sub-activities up to the year (N-.
in achieving results .
, strategic issues related to the field of affairs and main tasks and functions of regional apparatus, national policies, regulations or laws and regulations, suggestions and/or input from stakeholders .
of regional development.
Based on the results of the target measurement, it can be concluded that several performance indicators have been achieved according to the set However, there are 2 .
performance indicators that have not been completed, namely the value of the Government Agency Performance Accountability System (SAKIP) of regional apparatus and the percentage of service facilities for facilities, infrastructure, and health equipment according to hospital classAievaluation of the SAKIP value of Dr.
(HC) Ir.
The inspection at Soekarno Hospital was conducted by the Inspectorate of the Bangka Belitung Islands ProvinceAithe achievement of the 2023 SAKIP value, compared to the target of 66%.
The SAKIP value of 51.
45, with the predicate CC, indicates that the implementation of performance accountability is adequate but still requires significant improvement, particularly in performance accountability within work units.
The percentage of achievement of service facilities for facilities, infrastructure, and health equipment according to hospital class is 94%.
Several facilities and infrastructures are not yet in place, including the hospital's blood bank individual employee and the organization in which they work.
Too much stress can reduce a person's performance and lead to unproductivity, but a moderate level of stress can help a person focus their attention and improve their performance.
So, work stress also affects performance.
Psychological factors are one of the fators that influence job satisfaction.
Work stress, a factor related to the employee's mental well-being, can manifest in various ways that impact job performance and satisfaction.
For instance, when employee experiences work stress, they may struggle to concentrate, make more mistakes, or feel less motivated, all of which can impact their work.
In terms of psychological symptoms, stress can lead to feelings of dissatisfaction and disengagement, thereby impacting job satisfaction.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 room and its equipment, as well as the pharmacy room, which lacks a consultation or counseling The achievement of the public satisfaction index in terms of service performance has indeed met the target.
However, according to the Public Satisfaction Survey Report for Semester II of 2023.
Dr.
(HC) Ir.
Soekarno, there are still some improvements that need to be made in several areas according to respondents' suggestions, such as the implementation of the slogan "smile, greet, and say hello" so that patients feel happy and more appreciated, improving room cleanliness, providing complete medicine, adding air conditioning to inpatient rooms, improving supporting facilities such as toilets, bedpans, dispensers, enhancing security and monitoring of security guards in the corridors and patient rooms, and implementing an online information system to reduce queues.
These areas for improvement present an opportunity for the hospital to enhance its performance and patient satisfaction.
The audience, as stakeholders in healthcare, plays a crucial role in this process, instilling a sense of empowerment and responsibility in them.
Published by:
Page Another problem that affects employee work motivation is the completeness of facilities, infrastructure, and equipment that support their work.
For employees who serve patients directly, such as nurses, the lack of facilities, infrastructure, and equipment will negatively impact the quality of service provided to patients.
The next phenomenon observed is the issue of workload, specifically employees performing tasks that are not aligned with their primary responsibilities .
ain task and functio.
Additional main task and function outside the main main task and function often take up work time.
Too many main task and function become an employee's workload.
Several employees who work as nurses stated that the large number of patients was not balanced with the number of human resources and hospital facilities and This condition causes the volume of work to increase, resulting in extra time required to complete work tasks.
Employees with high workloads often miss breaks and struggle to think clearly due to the large amount of work that must be completed.
Another The phenomenon related to performance problems found that some employees do not create work plans and schedules to complete their tasks, and as a result, they often postpone work.
This causes the work not to be completed on time.
Especially if employees are faced with several tasks at the same time.
Nurses have various duties, including caring for and monitoring patient conditions, completing medical documentation, administering medication and therapy, ensuring patient comfort and safety, and communicating with doctors and other medical teams to ensure patients receive the best possible care.
However, there are still nurses who cannot complete their work on time, for example, due to delays in recording medical information about patients, such as their medical history, test results, and drug prescriptions.
Another phenomenon is that some employees are unable to complete tasks without direct supervision.
If they encounter obstacles while on duty, employees are not yet able to recognize and fix the problem Employees stated that they need help and guidance from others to carry out their work functions effectively.
The next phenomenon found by researchers is the problem of work Employees who perform well often do not receive the full range of awards and Furthermore, there are no additional incentives for employees who work in risky In fact, providing incentives, prizes, and rewards is crucial for increasing work Additionally, some employees argue that the distribution of service fees is unfair and that it is delayed.
Service fees are additional to meet the needs of employee families.
Some employees also complained that an unsupportive and unconducive work environment influenced their work motivation.
Uncomfortable and unsupportive working conditions and atmosphere will affect employee motivation in carrying out their duties effectively.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 condition related to workload is that employees feel a lack of support from their superiors and a lack of cooperation between coworkers in completing tasks.
Another phenomenon found by researchers is related to work stress.
A number of employees also admitted to experiencing fatigue, frequent headaches, stomach acid disorders, and sleep Additionally, several employees reported experiencing difficulty concentrating and unstable emotions while at work.
Some employees became forgetful and lazy in completing This has an impact on suboptimal patient service, decreased work quality, and incomplete work on time.
According to employees, the work stress they experienced was a result of excessive workload, an unfavorable work environment, inadequate facilities and infrastructure, and a lack of support from superiors.
Another phenomenon found by researchers is related to job satisfaction.
Several employees stated that the service received did not match the workload and there was no reward for performance achievement.
This condition causes employees to work as well as they can without making a total commitment.
Employees also often feel a lack of support from their superiors while working, which reduces their enthusiasm for the job.
In group dynamics, there are team members who are apathetic, less agile in their work and want to win alone without appreciating the work of their coworkers.
This condition causes miscommunication between coworkers.
Inadequate work environment, infrastructure, and work facilities are also employee complaints.
This condition causes work to be incomplete, work targets to be unmet, and patient complaints to increase.
Job satisfaction will be used as an intervening variable in this study to determine the role of job satisfaction in mediating the influence of work motivation, workload, and work stress on employee performance.
Literature Review Published by:
Page Effect of Workload on Performance.
Workload also affects performance.
According to Ekawarna .
, workload has a significant impact on employee performance.
A workload that is either too high or too low is correlated with low performance.
An increase or decrease in workload causes a reduction in performance.
however, an increase in the workload curve is more sensitive to having a negative impact on employee performance.
Therefore, the higher the workload, the lower the performance.
Research conducted by Rusmiati et al.
and Aldin The Influence of Work Motivation on Performance.
Work motivation is one of the things that affects performanceAiboth work results and behavior.
According to Kasmir .
, work motivation affects work results and behavior.
If employees have a strong drive from within themselves or from outside sources, they will be stimulated to perform well.
The results of research by Adetola et al.
Ardita and Suwandana .
Buabeng and Afari .
, and Abimanyu and Mukhroji .
show that motivation has a significant positive effect on This differs from the results of research by Jamal and Pradana .
, which stated that work motivation does not have a significant impact on employee performance.
The phenomenon of work motivation problems was found in this study.
Employees who perform well often do not receive the awards and rewards they deserve.
Employees working in highrisk environments do not receive additional incentives.
In fact, providing incentives, prizes, and rewards is crucial for increasing work motivation.
The next employee complaint is unfair service distribution, late service delivery, and an unsupportive and unconducive work The completeness of facilities, infrastructure, and work equipment that support work also affects motivation.
A lack of facilities, infrastructure, and equipment will negatively impact the quality of service to patients.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 .
showed that workload has a positive and significant effect on the performance of hospital In contrast to the results of research by Wulandari and Digdowiseiso .
, which states that workload has an insignificant positive effect on employee performance.
Furthermore, research by Hafizah et al.
concluded that workload has an adverse, yet negligible, impact on the performance of hospital employees.
The phenomenon of workload problems was found in this study.
Several employees admitted that their work tasks did not align with their primary tasks and functions .
upoksi =Main duties and authoritie.
Too many tupoksi become a burden on employees' work.
Employees stated that the number of human resources and hospital infrastructure did not balance the large number of patients, resulting in an increase in work volume and requiring extra time to complete tasks.
Employees with a high workload often miss breaks and struggle to think clearly.
Employees also stated that they lacked support from superiors and experienced difficulties due to a lack of cooperation between coworkers in completing tasks.
Published by:
Page The Influence of Job Satisfaction on Performance.
One of the factors that influences performance is job satisfaction.
According to Busro .
, job satisfaction is one of the internal factors that influences employee performance.
Satisfied employees will consistently strive to enhance their abilities and work results to deliver their best performance.
Dissatisfaction felt by employees will increase errors that can harm the company.
Therefore, companies must make a greater effort to enhance job satisfaction in order to encourage improved performance.
Research conducted by Prasetya et al.
Ananta .
, and Wulandari and Digdowiseiso .
shows that job satisfaction has a significant effect on the performance of hospital employees.
In contrast to research conducted by Tarjo .
, this study found that job satisfaction has no significant impact on employee performance.
The phenomenon of job satisfaction was found in this study.
Several employees stated that the service received did not match the workload and there was no reward for performance achievement.
This condition allows employees to work as they please without total commitment.
Employees also feel that they do not receive sufficient support from their superiors while working, which reduces their enthusiasm for their work.
group dynamics, there are team members who are apathetic, less agile in their work and want to win alone without appreciating the work of their coworkers.
This condition causes The Effect of Work Stress on Performance.
Work stress also affects performance.
According to Sinambela .
, stress can cause a lack of absenteeism, excessive use of alcohol or other drugs, poor performance, or even feeble health.
Stress is the body's response to the pressure it is subjected to.
When stress occurs at work, its impact becomes a significant problem for both the individual employee and the organization in which they work.
Too much stress can reduce a person's performance and lead to unproductivity, but a moderate level of stress can help a person focus their attention and improve their performance.
Research conducted by Megawati and Supriyatin .
shows that work stress has a positive and significant effect on the performance of hospital employees.
Meanwhile, research conducted by Ardita and Suwandana .
shows that work stress has a negative and significant impact on employee performance.
This is different from the results of research by Gabriela & Haryani .
stated that work stress did not affect employee performance.
The phenomenon of work stress problems was found in this study.
A number of employees admitted to experiencing fatigue, frequent headaches, stomach acid disorders, and sleep disorders.
Additionally, several employees reported experiencing difficulty concentrating and unstable emotions while working.
Some employees become forgetful and lazy in completing tasks.
This has an impact on suboptimal patient service, decreased work quality, and incomplete work on time.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 miscommunication between coworkers.
Inadequate work environment, infrastructure, and work facilities are also employee complaints.
Work is not being completed, work targets are not being met, and patient complaints are increasing.
The Effect of Job Stress on Job Satisfaction.
According to the two-factor theory developed by Herzberg, satisfaction and dissatisfaction are part of different groups of variables, namely motivators and hygiene factors.
Motivator factors can spur someone to work better and more Published by:
Page The Effect of Workload on Job Satisfaction.
According to the two-factor theory developed by Herzberg, satisfaction and dissatisfaction are part of different groups of variables, namely motivators and hygiene factors.
Hygiene factors, according to Herzberg in Andjarwati .
, are factors whose presence does not increase work motivation, but their absence will cause Hygiene factors affect humans through their feelings of satisfaction or dissatisfaction with their work, as they concern the work environment.
Additionally, it is also related to work policies and administration, supervision, working conditions, relationships between personnel, status, compensation, and security.
Hygiene factors cannot directly increase productivity or work results, but they are maintenance factors because they contribute to maintaining job satisfaction.
However, if this factor is reduced, it can result in decreased productivity, which in turn can negatively impact employee performance.
In this study, the hygiene factor is workload.
Research conducted by Nst et al.
concluded that workload has a positive and significant effect on job satisfaction.
Research by Salsabilla et al.
concluded that workload has a negative and significant impact on job satisfaction.
The phenomenon found in this study was that employees who performed well had not been fully appreciated and rewarded.
The next employee complaint was the unfair distribution of service fees, late distribution of service fees, and an unsupportive and conducive work environment.
The completeness of facilities, infrastructure, and work equipment that support work also affects motivation.
A lack of facilities, infrastructure, and equipment will negatively impact the quality of service to patients.
The Influence of Work Motivation on Job Satisfaction.
Herzberg's Two Factor Theory, also referred to as the Motivator-Hygiene Theory, is a motivation theory proposed by American psychologist Frederick Herzberg in 1959, which examines variables considered desirable for achieving goals and undesirable conditions that must be avoided.
Based on this research.
Herzberg then developed a theory that a person's job satisfaction depends on two types of factors: satisfaction factors .
otivator or satisfier factor.
and dissatisfaction factors .
ygiene or dissatisfaction factor.
, which are referred to as Herzberg's Two Factor Theory.
The presence of motivator factors will cause employees to work harder.
These motivational factors can be found in the work itself.
Examples include work performance, recognition, the nature of the work itself, responsibility, and opportunities for growth.
According to Herzberg, the absence of this motivator factor will not result in significant job dissatisfaction.
however, the presence of a motivator factor will provide high job satisfaction for employees.
The results of research by Candra et al.
and Salsabilla et al.
indicate a positive and significant relationship between motivation and job satisfaction among hospital employees.
This finding contrasts with the results of research by Pratiwi et al.
, who concluded that work motivation does not significantly affect employee job satisfaction.
The phenomenon observed in this study is that employees who perform well often do not receive adequate awards and rewards.
The unfair distribution of service fees, late distribution of service fees, an unsupportive and uncooperative work environment, and the completeness of facilities, infrastructure, and work equipment also affect motivation.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 The fulfillment of this factor causes people to feel satisfied.
however, if it is not fulfilled, it will not result in satisfaction.
Motivational factors influence humans through feelings of pleasure and displeasure at work and can either decrease or increase work productivity, thereby affecting employee performance.
In addition, satisfaction also concerns the work itself, including success, achievement, challenges, increased responsibility, growth, and development.
These motivating or intrinsic factors, when present in the work environment, can foster strong motivation, resulting in enhanced employee performance.
In this study, work stress is a motivating factor because it is inherent in each individual.
Research by Kuncorowati et al.
indicates that work stress has a positive and significant impact on the job satisfaction of hospital employees.
Meanwhile, research by Prasetya et al.
and Salsabilla et al.
indicates that work stress has a significant negative impact on job satisfaction.
contrast, research by Aprilianti et al.
suggests that work stress has no substantial effect on job satisfaction.
The phenomenon found in this study was that employees often experience fatigue, headaches, stomach acid disorders, and sleep disorders.
Some employees have difficulty concentrating and are emotionally unstable while working.
Some employees' behavior becomes forgetful, causing delays in completing tasks.
This has an impact on suboptimal patient service, decreased work quality, and incomplete work on time.
Research Method Page The first research object is the Regional General Hospital (RSUD) Dr.
(H.
C).
Ir.
Soekarno.
Bangka Belitung Islands Province, located at Jalan Zipur.
Air Anyir Village.
Merawang District.
Bangka Regency.
Bangka Belitung Islands Province.
Postal Code 33712.
This research is also verification research .
ausal stud.
This research involves variables consisting of three independent variables, one dependent variable, and one intervening variable.
The independent or exogenous variables contained in this study include work motivation .
, workload .
, and work stress .
The dependent or endogenous variable is employee performance .
the same time, the intervening variable is job satisfaction .
The key performance indicators are quality, quantity, punctuality, and independence.
The indicators of motivation are recognition from superiors, working conditions, and work facilities.
The indicators of workload include work conditions, the use of working time, and targets to be achieved.
The indicators of work stress encompass psychological, physical, and behavioral aspects.
The indicators of job satisfaction are supervision, rewards, and coworkers.
The population used in this study were all employees at Dr.
(H.
) Ir.
Soekarno Hospital has 320 permanent employees, excluding medical The number of samples in this study was 160 permanent employees at Dr.
(H.
) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province.
The sampling technique above used a probability sampling technique with accidental sampling.
The primary data collection method used in this study was a questionnaire.
The primary data collected in this study pertained to nurses' perceptions regarding the research variables.
The analysis model used in this study was Structural Equation Modeling (SEM).
Published by:
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 Figure 1.
Structural Equation Modeling Figure 1.
Structural Equation Modeling Published by:
Page E 2 = .
endogenous latent variable of performance = .
direct relationship of exogenous variables to endogenous variables = .
error in the equation is between exogenous variables and/or endogenous variables to endogenous variables.
= .
direct relationship of endogenous variables to endogenous variables OI = .
, measurement error of exogenous variables yuoyuo = (Ps.
, how to show covariance or correlation matrix between a set of constructs A = .
, measurement error of exogenous variable indicators = (Lambd.
, relationship between exogenous and endogenous latent variables to their 1 = .
exogenous latent variable of work motivation 2 = .
exogenous latent variable of workload 3 = .
exogenous latent variable of work stress E 1= .
endogenous latent variable of job satisfaction International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 X1.
X2.
X3 = indicators for exogenous variables of work motivation X4.
X5.
X6 = indicators for exogenous variables of workload X7.
X8.
X9 = indicators for exogenous variables of work stress Y1.
Y2.
Y3 = indicators for endogenous variables of job satisfaction Y4.
Y5.
Y6.
Y7 = indicators for endogenous variables of performance Findings and Discussions Based on the Figure, it can be seen from the results of the Confirmatory Factor Analysis (CFA) test that the value of all Standardized Factor Loading construct variables is greater than the Error value.
This shows that the CFA test at the initial stage in the figure meets the criteria for further testing.
Published by:
Page Figure 2.
Confirmatory Factor Analysis International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 The Goodness of Fit Test (GOF) aims to determine whether the structural model in this study is suitable for the facts or empirical data .
oodness of fi.
The structural model is indicated as appropriate or fit if it meets at least three types of goodness-of-fit tests (GFT).
Table 1.
Goodness of Fit Result
Measurement Cut-off
Estimate Value Evaluation Result
GFI
> 0,90
0,967
Good Fit
RMSEA
< 0,08
0,107
Bad Fit
ECVI
The lowest
6,64
Good Fit
TLI/NNFI
> 0,90
0,971
Good Fit
NFI
> 0,90
0,921
Good Fit
AGFI
> 0,90
0,961
Good Fit
IFI
> 0,90
0,981
Good Fit
CFI
> 0,90
0,981
Good Fit
CMIN/DF
< 2,00
0,820
Good Fit
Critical N > 200
700,06
Good Fit The model is effective because it includes nine types of Goodness-of-Fit-Test (GOF) with the 'Good Fit' category.
The model testing carried out provided good confirmation of the factor dimensions and causal relationships between factors, indicating that the model can be accepted.
Figure 3.
Structural Equation Modeling Result Published by:
Page Figure 4.
t-values International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 Published by:
Page The effect of workload on performance.
Based on the test results, the t-values were 4.
71 > 1.
with a coefficient value of 0.
, indicating that workload has a positive and significant effect on employee performance at Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province.
These results suggest that if the workload is adjusted to be more manageable, there will be an increase in employee performance.
conversely, if the workload worsens, there will be a corresponding decrease in employee performance.
This explains that the research results, which prove a workload effect on employee performance, are theoretically supported.
The results of this study are supported by research conducted by Rusmiati et al.
and Aldin .
, which demonstrate that workload has a positive and significant effect on hospital employee performance.
This differs from the research results of Wulandari and Digdowiseiso .
, which stated that workload has an insignificant positive impact on employee The effect of work motivation on performance.
Based on the test results, the t-value was 2.
96, with a coefficient value of 0.
, indicating that work motivation has a positive and significant effect on employee performance.
These results suggest that an increase in work motivation is likely accompanied by an increase in employee performance and vice versa.
work motivation decreases, it is expected to be followed by a decrease in employee These results align with Handoko .
, which identifies several factors that influence performance, including motivation, job satisfaction, stress levels, work conditions, compensation systems, and job design.
This explains that the study's results, which demonstrate a theoretical effect of work motivation on employee performance, are supported.
The results of this study align with those of previous studies conducted by Adetola et al.
Ardita and Suwandana .
Buabeng and Afari .
, and Abimanyu .
, which demonstrate that motivation has a significant positive effect on performance.
However, this study differs from the results of Jamal and Pradana .
study, which stated that work motivation does not have a significant effect on employee performance.
The reason this study differs from Jamal and Pradana .
study is that several aspects are considered.
Firstly.
Sampling was carried out using the saturated sampling method, with a total of 45 respondents.
This study, on the other hand, employed the accidental sampling technique, using a sample of 160 respondents.
Based on the respondents' answers, it, is evident that there are problems, particularly in the statements denied by the respondents, as follows: a.
There are still employees who have achieved notable accomplishments but have not received awards, which can help increase the work motivation of other employees.
There are still facilities and workspaces available in quantities that do not meet the needs.
There are still facilities and work areas that are not well-maintained, making them unusable for work.
As a result, this problem has an impact on employee performance, as there are still employees who are unable to carry out their work functions independently without seeking help from others.
A lack of appreciation for high-achieving employees, inadequate facilities and infrastructure, and poorly maintained facilities and infrastructure have reduced employee work motivation, making it difficult for them to carry out their work functions independently.
As a practical implication, the researcher suggests that the leadership of Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province, offers awards and appreciation to high-achieving employees, thereby motivating them to maintain good performance and encouraging the motivation and performance of other employees.
Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province, should pay attention to the needs and adequacy of work facilities, including facilities, infrastructure, medical equipment, and nonmedical equipment, as well as the maintenance process and periodic inspections.
Repairs can be made immediately if damage is found in the inspection results.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 Published by:
Page The effect of work stress on performance.
Based on the test results, the t-values were 2.
96, with a coefficient value of 0.
Therefore, it can be concluded that work stress has a positive and significant effect on employee performance at Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province.
These results suggest that effective management of work stress can lead to improved employee performance, while ineffective management can result in decreased employee performance.
These results align with Handoko .
, which suggests that several factors influence performance, including motivation, job satisfaction, stress levels, work conditions, compensation systems, and job design.
This explains that the study's results, which demonstrate a theoretical effect of work stress on employee performance, are supported.
The results of this study align with those of Megawati and Supriyatin .
, which indicate that work stress has a positive and significant impact on the performance of hospital employees.
This differs from the research conducted by Gabriela & Haryani .
, which found that work stress does not affect employee performance.
The reason this study differs from Gabriela & Haryani .
is because of the differences in the number of samples and sampling techniquesAithe sampling technique used by researchers Gabriela & Haryani .
use a nonprobability sampling technique with a quota sampling method.
the number of samples taken is all nurses totaling 127 respondents, while this study uses a probability sampling technique with an accidental sampling technique with 160 employee respondents.
Based on the results of the respondents' answers, problems were found, especially in the statements denied by the respondents as follows: a.
There are still employees who feel tired because of the amount of There are still employees who feel stiff in the neck and back muscles while working.
As a result of these problems, employee performance is impacted, as employees are unable to fully carry out their work functions independently without seeking assistance from others, and In contrast, the research of Hafizah et al.
concluded that workload has a negative and negligible effect on hospital employee performance.
The reason this study differs from Wulandari and Digdowiseiso .
is that several aspects are considered.
The research population consisted of all non-medical employees, with a research sample of 65 individuals.
This study employed the accidental sampling technique, using a sample of 160 respondents.
Based on the results of the respondents' answers show that there are problems, especially in the statements denied by the respondents as follows: a.
There are still employees who find it challenging to complete their work on time because the ratio of employees to work is not There are still additional duties beyond the primary responsibilities that often consume work time.
As a result, this problem has an impact on employee performance, as there are still employees who are unable to complete several tasks simultaneously and cannot carry out their own work without seeking help from others.
As a practical implication, the researcher suggests that the leadership of Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province, assigns consistent duties without adding additional responsibilities that are not within the employees' purview.
Suppose additional duties must be given due to limited human In that case, the superior must immediately communicate the work to be appropriately done to his team and provide an opportunity to consult if there are difficulties in The superiors can encourage their team to manage their time carefully, create a work schedule, and prioritize tasks according to the level of urgency.
The condition of an increasing workload on employees, followed by strong efforts from employees to improve services, can produce optimal performance.
The workload assigned must be carried out in accordance with the provisions set by the hospital leadership.
So that employee performance increases in line with the fulfillment of standards and tasks assigned to them.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 they struggle to complete multiple tasks simultaneously.
As a practical implication, the researcher suggests that the leadership of Dr.
(HC) Ir.
Soekarno Bangka Belitung Islands Province pays attention to the mental health of employees at work.
Leaders should be able to adjust the amount of work according to the reasonable capacity that employees can handle.
Leaders can also encourage employees to balance their office and personal activities, allowing them to spend more time with their families without overexertion on office matters.
Furthermore, leaders can also provide opportunities for refreshing.
Published by:
Page The effect of workload on job satisfaction.
Based on the test results, the t-values were 2.
96 with a coefficient value of 0.
, indicating that workload has a positive and significant effect on employee satisfaction at Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province.
These results suggest that if the workload is adjusted to be more manageable, there will be an increase in employee job satisfaction, and vice versa: if the workload worsens, there will be a decrease in employee job satisfaction.
These results align with Herzberg's theory The effect of work motivation on job satisfaction.
Based on the test results, the t-values were 99 > 1.
96 with a coefficient value of 0.
, indicating that work motivation has a positive and significant effect on employee satisfaction at RSUD Dr.
(HC) Ir.
Soekarno.
Bangka Belitung Islands Province.
These results suggest that an increase in work motivation is likely accompanied by an increase in employee job satisfaction and vice versa.
If work motivation decreases, it is expected to be followed by a decrease in employee job satisfaction.
These results align with Herzberg's theory in 1959, which posits that a person's job satisfaction depends on two types of factors: motivation and hygiene factors.
This explains that research results, which prove a theoretical effect of work motivation on employee job satisfaction, are supported.
The results of this study align with those of Candra et al.
and Salsabilla et al.
, which demonstrate that work motivation has a positive and significant impact on employee job In contrast to research conducted by Pratiwi et al.
, which concluded that work motivation does not affect employee job satisfaction.
The reason this study differs from Pratiwi et al.
is that it is based on several aspects.
There is a difference in the sample used by Pratiwi et al.
, which consisted of as many as 107 respondents, including both medical and non-medical personnel.
In contrast, this study used a sample of 160 employees, comprising health workers and non-health workers, but excluding medical personnel.
Based on the results of the respondents' answers, problems were found, especially in the statements denied by the respondents as follows: a.
There are still employees who have achieved achievements but have not received awards to increase the work motivation of other employees.
Work facilities and facilities are available in quantities that do not match the needs.
Work facilities and equipment are not well maintained, so they are not ready for use.
As a result of these problems it has an impact on employee job satisfaction.
The results of this study indicate that employees are dissatisfied with the service distribution system, and the services they receive do not align with their workload.
As a practical implication, the researcher suggests that employee motivation be considered by the leadership of Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province, particularly regarding awards for high-achieving employees and the availability and adequacy of facilities and workspaces.
Leaders should provide awards to highachieving employees to motivate their peers.
Leaders should prioritize the procurement of work facilities and infrastructure necessary for employees, ensuring that work is not hindered and becomes more efficient.
Leaders should regularly monitor the maintenance of facilities and workspaces to ensure they are always ready for use by employees.
If these improvements are made, it can lead to increased employee job satisfaction.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 Published by:
Page The effect of job satisfaction on performance.
Based on the test results, the t-values were 3.
96, with a coefficient value of 0.
Therefore, the analysis shows a positive and significant effect of job satisfaction on employee performance at Dr.
(HC) Ir.
Soekarno Regional Hospital.
Bangka Belitung Islands Province.
These results suggest that job satisfaction increases are likely to be accompanied by improved employee performance, and vice versa: if job satisfaction decreases, it is expected to be followed by a decline in employee performance.
These results align with Handoko .
, which suggests that several factors influence performance, including motivation, job satisfaction, stress levels, work conditions, compensation systems, and job design.
This explains that the research results, which prove a theoretical effect of job satisfaction on employee performance, are supported.
The results of this study are supported by research conducted by Prasetya et al.
Ananta .
, and Wulandari and Digdowiseiso .
, which demonstrate that job satisfaction has a positive and significant impact on employee performance.
However, the results of this study differ from those of Tarjo .
, which found that job satisfaction has no significant effect on employee The reason this study differs from Tarjo .
is that it is based on several Specifically.
Tarjo .
employed the multiple linear regression analysis method using the SPSS application, whereas this study utilized the Structural Equation Model (SEM) with the LISREL application.
The sampling method used by Tarjo .
was proportional random sampling, with a sample of 74 respondents, whereas this study employed the accidental (Andjarwati, 2.
, which posits that job satisfaction is influenced by hygiene factors, particularly the workload carried out by employees.
This explains that the study's results, which demonstrate a theoretical effect of workload on employee job satisfaction, are supported.
The results of this study align with the research conducted by Nst et al.
, which found that workload has a positive and significant effect on employee job satisfaction.
Based on the results of the respondents' answers, problems were found, especially in the statements denied by the respondents as follows: a.
There are still employees who find it challenging to complete their work on time because the ratio of employees to work is not balanced.
There are still additional duties beyond the primary responsibilities that often consume work time.
As a result, this issue affects employee job satisfaction.
The results of this study indicate that employees are not satisfied with the services they receive.
The services received are considered not in accordance with their workload.
As a practical implication, the researcher suggests that Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province, pays attention to the division of workload and additional dutiesAithe management of Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province, determines consistent responsibilities to employees.
Suppose additional duties must be assigned due to limited human resources.
In that case, the superior should clearly communicate the work to be done to their team and provide an opportunity to consult if there are difficulties in completing the task.
Management should encourage employees to manage their time carefully, create effective work schedules, and prioritize tasks according to their level of urgency.
The condition of an increasing workload on employees, accompanied by strong efforts from employees and support from management, can impact job The workload assigned must be carried out in accordance with the provisions set by the hospital management.
This ensures that employee satisfaction increases alongside the fulfillment of standards and tasks assigned to employees.
Periodic analysis of employee workload should also be carried out, considering both the working hours allocated and the level of task difficulty.
This aims to ensure that the workload assigned is ideal, neither too heavy nor too light.
International Journal of Marketing & Human Resource Research e-ISSN: 2746-4040 Vol.
06 No.
July 2025 sampling technique with a sample of 160 respondents.
Based on the results of the respondents' answers, problems were found, especially in the statements denied by the respondents as follows: a.
There are still employees who feel that the service distribution system is not clear.
There are still employees who feel that the service received is not in accordance with the As a result of this issue, it affects employee performance.
Employee performance is not optimal because they are faced with inconsistent work and work that exceeds their capacity.
As a practical implication, the researcher suggests that the leadership of Dr.
(HC) Ir.
Soekarno Bangka Belitung Islands Province pays attention to the service distribution system.
The distribution of services should take into account the workload of employees.
The decision of the hospital leadership regarding the distribution of services should be communicated well and openly to all employees so that they understand and there is no misperception.
If these improvements are made, it is expected to improve employee performance.
Conclusion It can be concluded that motivation, workload and work stress affect employee performance which is mediated by work satisfaction.
The Dr.
(HC) Ir.
Soekarno Regional Hospital.
Bangka Belitung Islands Province, needs to improve employee work motivation.
some things that need to be enhanced are awards and appreciation for employees who excel, provision of more adequate work facilities and infrastructure, and improvement of maintenance of work facilities and infrastructure so that they are always ready to be used when employees need them.
The Dr.
(HC) Ir.
Soekarno Regional Hospital.
Bangka Belitung Islands Province, needs to address the problem of employee workload.
some things that need to be improved are adjusting the ratio of the number of employees to the amount of work assigned to be more balanced so that work can be completed on time according to the deadline, in addition, there needs to be a determination of consistent duties and functions without adding other duties that are not the responsibility of Suppose additional duties and functions must be assigned due to limited human In that case, the superior must immediately communicate the extra work to their team and provide an opportunity to consult if there are difficulties in performing the work.
Leaders should encourage employees to manage their time carefully, create work schedules, and prioritize tasks according to their level of urgency.
Periodic analysis of employee workload should also be carried out, considering both the working hours allocated and the level of task difficulty, to ensure the workload is ideal, neither too heavy nor too light.
Dr.
(HC) Ir.
Soekarno Hospital.
Bangka Belitung Islands Province, needs to overcome the problem of employee work the things that need to be improved are limiting the amount of work according to the reasonable capacity that employees can do, providing opportunities for employees to refresh so that they can restore their physical condition, encouraging employees to balance between office and personal activities so that employees do not have to spend too much time with office matters and can spend time with their families.
References