RELATIONSHIP BETWEEN QUALITY OF WORK LIFE AND NURSEAoS
PERFORMANCE IN EMERGENCY ROOM RSUD KARSA HUSADA BATU
CITY
Jiwani Alvina Dharma Pratiwi1.
Elsa Yosinda Widya Kusuma Putri2.
Department of Health Policy and Administration.
Universitas Airlangga.
Indonesia Faculty of Health Technology and Management.
Bhakti Wiyata Institute of Health Science Corresponding Email: jiwanialvinadp@gmail.
ABSTRACT
Keywords Quality of Work Life (QWL) is an important factor affecting nurse performance, especially in the Emergency Room (ER) with high work This study aims to analyze the relationship between QWL and the performance of ER nurses at RSUD Karsa Husada.
Batu City.
The research design used a quantitative method with a cross-sectional study approach.
The total sampling used involved 17 ER nurses.
QWL measurement was carried out through a structured questionnaire, while nurse performance was measured based on hospital performance evaluation indicators.
The statistical test used was chi-square.
The results showed a significant relationship between QWL and nurse performance with a p-value <0.
005, which was 0.
002 ( = 0.
This indicates that improvements in QWL can contribute positively to improving nurse performance.
These findings provide important implications for hospital management to improve the quality of the nurse work environment to achieve better performance in health services.
INTRODUCTION
Quality of Work Life (QWL) is a concept that has received increasing attention in various health studies because it is considered as one of the important factors that affect the wellbeing and performance of health workers, especially nurses.
In high-pressure work environments, such as the Emergency Department (ED), the role of QWL becomes even more vital.
This is due to the physical and mental challenges faced by nurses in the ED, who often work in emergency conditions, dealing with complex cases, and Emergency room, nurse .
QWL heavy workloads.
Based on research conducted, it was found that QWL has been identified as one of the key determinants of departments (IGD) and has been recognized as an important factor affecting nurse performance, especially in high-stress work departments (IGD) (Satriyanto et al.
, 2.
Previous studies have consistently shown that QWL is a significant predictor of professional practice, professionalism, leadership, legal, and ethical (Satriyanto et International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 2.
August 2025 al.
, 2023.
Wahyuni & Sulistyanto, 2.
study conducted by Chang et al.
, .
found that QWL was positively associated with job satisfaction and negatively associated with burnout among emergency room nurses.
The importance of QWL in the health sector has been emphasized by the Ministry which has launched various initiatives to improve the working conditions and well-being of health professionals (Direktorat Kesehatan dan Gizi Masyarakat, 2.
Despite these efforts from both the public and private sectors.
Indonesian hospitals still face challenges in providing a conducive working environment for their nurses (Afaya et al.
, 2.
This is especially true in the emergency room where the workload is high and the pressure to provide quality health services is intense and continuous.
Several studies have investigated the relationship between QWL and nurse performance in various healthcare settings.
For example, a study by Chang et al.
, .
found that QWL was significantly related to nurses' performance in Taiwanese hospitals with the result that nurses who had high QWL performed better by 25% compared to nurses who had low QWL.
Similarly, another study found that QWL was a significant predictor of job satisfaction and performance among Indonesian nurses, with the result that 80% of nurses who had high QWL also had high job satisfaction (Wahyuni & Sulistyanto, 2.
QWL
dimensions, including work-life balance, fair compensation, a safe working environment, opportunities for professional development, and participation in decisionmaking.
The effective implementation of QWL principles has been shown to enhance job satisfaction, motivation, and healthcare workers' loyalty to their institutions.
Indirectly, this also contributes to increased productivity and improved service quality.
Conversely, poor QWL is associated with high turnover rates, absenteeism, decreased performance, and suboptimal service quality (Diana et al.
, 2.
Based on this background, a study was conducted on QWL in the emergency department of RSUD Karsa Husada Batu City.
This study aims to investigate the relationship between QWL and nurses' performance in the emergency department of RSUD Karsa Husada Batu City, a public hospital in Indonesia that has just changed its status from type C to type B, making it the only hospital with type B in Batu City while other hospitals still have types below The transformation of RSUD Karsa Husada Kota Batu from a type C to a type B hospital has led to increased service As one of the hospital's Emergency Department (ED) faces greater pressure to deliver prompt, accurate, and high-quality In this context, strengthening the Quality of Work Life (QWL) for ED nurses becomes essential to maintain optimal service performance amid increasing workload demands.
However, empirical studies examining the relationship between QWL and nurse performance in hospitals undergoing capacity expansion remain limited, thus highlighting the need for relevant research in this area The literature suggests that QWL is influenced by various factors, including workload, autonomy, and social support (Chang et al.
, 2.
Research in Indonesia on the relationship between QWL and nurse performance remains limited, particularly in high-stress environments such as emergency Given the growing demands placed on healthcare workers and the critical nature of emergency services, understanding International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
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August 2025 how QWL affects nurse performance is essential (Eliyana et al.
, 2.
The theoretical framework for this study is Kanter's Structural Empowerment Theory, which postulates that access to opportunity, information, support, and resources has the potential to empower nurses to perform at peak levels.
Existing nursing literature shows that structural empowerment improves performance on the job, reduces stress, increases intent to stay, and promotes thriving at work, a pathway to better performance and reduced turnover intentions (Al-Otaibi et al.
, 2.
The Job DemandsAeResources (JDR) model elucidates how job resources serve as cushions for high demands in settings like emergency departments and are translated into higher engagement and performance.
Contemporary healthcare research always verifies JD-R processes linking resources and performance/well-being (Nurmeksela et , 2.
This study aims to address that gap by identifying specific QWL-related factors that influence the performance of nurses in the ED.
By emphasizing the importance of QWL as a determinant of performance, this study underscores the need for systemic interventions that prioritize staff well-being as a central In doing so, the study will contribute to both academic understanding and practical efforts to elevate the standards of emergency care in Indonesia.
Recent syntheses of influences on nurses QWL present few.
ED-specific Indonesian capacity/status upgrading hospitals where workload and complexity are on the rise.
Disaggregated proof of what QWL sub .
ompensation, problem-solving, communicatio.
best map to documented performance indicators in an ED environment is still scarce.
This study focuses directly on that gap in RSUD Karsa Husada Batu City during its post-upgrade This study is important because it will provide insight into the factors that influence nurses' performance in a high stress work environment and will provide information on strategies to improve QWL and performance among emergency department nurses, and the emergency department continues to be required to meet hospital expectations so that the quality of the nurses' work environment must always be a special concern for hospital This study will also fill the knowledge gap by investigating the relationship between QWL and nurses' performance in the emergency department of RSUD Karsa Husada Batu City.
To our knowledge, this is the first ED specific analysis in Indonesia conducted in the context of a hospital status transition that .
maps nine QWL sub-dimensions to observed nurse performance categories, .
uses total sampling of all ED nurses on site, and .
identifies a distinctive pattern in which balanced compensation, career problem-solving, communication, but not job security or environmental safety show significant associations with performance .
values reported in Result.
These ED-contextual, sub-dimension-level insights extend recent QWL syntheses and operationalize Kanter/JD-R predictions for a high-demand Indonesian ED.
METHOD
This research is an observational study using a Cross-Sectional design which was conducted from October 2021 to December 2022 at RSUD Karsa Husada Batu City.
East Java.
The independent variable studied was Quality of Work Life (QWL), while the dependent variable was the performance of emergency room nurses.
The independent International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
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August 2025 variables consisted of nurse involvement, balanced compensation, a sense of job security, work environment safety, a sense of pride in the institution, career development, available facilities, problemsolving and communication.
The research sample was 17 emergency room nurses at RSUD Karsa Husada Batu City who met the inclusion criteria.
Sampling was done by total sampling technique, namely all emergency room nurses at RSUD Karsa Husada Batu City who met the inclusion Ethical approval was obtained from the Health Research Ethics Committee with ethical number 139/FTMK/EP/IV/2022.
QWL data were collected using a QWL questionnaire that had been tested for validity and reliability.
Data regarding the performance of emergency room nurses were obtained through the use of emergency room nurse performance evaluation forms.
QWL assessment is categorized based on the QWL score into two categories, namely high if the QWL score is Ou 80 and low if the QWL score is < 80.
Meanwhile, the data on the performance of emergency room nurses obtained from the performance evaluation form of emergency room nurses has a minimum score of 0 and a maximum score The score is then categorized into the performance of emergency room nurses with excellent scores .
core Ou .
, good .
core 80-.
, less good .
core 60-.
, and bad (< Statistical analysis to test the relationship between the independent variable and the dependent variable was performed with the chi-square test at <0.
RESULTS
Table 1.
Frequency Distribution of RespodentsAo Characteristics at RSUD Karsa Husada Batu City Characteristics Age Gender Length of Service Academic Education Employment Status Total Category 20 Ae 30 years 31 Ae 40 years > 40 years Male Female O 5 years 6 Ae 10 years > 10 years Diploma Bachelor Ners Government Employees More Based on the results of the frequency distribution of respondent characteristics at RSUD Karsa Husada Batu City, the majority of respondents were between 20-30 years old .
%), followed by the 31-40 years age group .
%), and only 6% were over 40 years old.
In terms of gender, the proportion of men and women is quite balanced with a slight dominance of men .
%) over women .
%).
Based on length of employment, the majority of respondents had worked for O 5 years .
%), while those who worked for 610 years amounted to 29%, and those who International Journal of Nursing and Midwifery Science (IJNMS).
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%), while 41% were diploma graduates, and no respondents had a bachelor's degree.
For employment status, 41% of respondents were civil servants, while 59% were noncivil servants.
These results show a diverse professional characteristics, but dominated by young nurses with less than 5 years of work experience and the majority of educational levels at the ners level.
Table 2.
Frequency Distribution of Emergency Room Nurse Performance Level at RSUD Karsa Husada Batu City Emergency Room Nurse Performance Indicators Very Good Good Total Less Good Bad Total Based on Table 2 which displays the frequency distribution of the performance level of emergency room nurses at RSUD Karsa Husada Batu City, it is known that the majority of nurses are considered to have good performance with a percentage of 59% .
Meanwhile, 41% of nurses .
were categorized as having poor There are no nurses who are considered to have excellent or poor performance, with each of these categories showing 0%.
From these results, it can be concluded that although most nurses have good performance, there is still a group of nurses with performance that needs to be improved to achieve more optimal results.
Table 3.
Relationship Between Quality of Work ife and Performace of Emergency Room Nurse at RSUD Karsa Husada Batu City Quaity of Work Life Variables Category Low Nurse Engagement High Low Balanced Compensation High Low Job Security High Low Work Environment Safety High Low Sense of Pride in the Institurion High Low Career Development High Low Avalailable Facilities High Low Problem-Solving High Low Communication High Low Total QWL High Nurse Performance Kategory Good Less Good Total P Ae Value 0,015 0,010 0,644 0,304 1,000 0,035 0,603 0,004 0,015 0,002 International Journal of Nursing and Midwifery Science (IJNMS).
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August 2025 Based on the distribution table 3, the relationship between Quality of Work Life (QWL) and nurse performance at RSUD Karsa Husada Batu City, it can be seen that several dimensions of QWL have a In the dimension of nurse involvement, nurses with high involvement tend to have good performance .
5%),
although statistically, this relationship is not significant .
= 0.
On the other hand, balanced compensation had a significant relationship with nurse performance .
= .
, where all nurses who received low compensation were categorized as having poor performance .
2%), while nurses who received high compensation mostly showed good performance .
8%).
Another dimension that showed a development .
= 0.
Nurses who received high career development mostly had good performance .
7%), while those who received low career development tended to have poor performance .
3%).
addition, problem-solving also showed a significant relationship .
= 0.
, where 8% of nurses with high problem-solving ability had good performance, while those with low ability were entirely in the category of poor performance.
The same was also seen in the communication dimension, where nurses with high communication showed more good performance .
than those with low communication .
= Overall, total Quality of Work Life (QWL) had a significant relationship with nurse performance .
= 0.
From this result, 52.
9% of nurses with high QWL showed good performance, while all nurses with low QWL showed poor performance.
These results confirm that improving the quality of work life, especially in the aspects of compensation, career development, problem-solving, and communication, is instrumental in improving the performance of nurses in the emergency room.
Efforts to improve QWL in RSUD Karsa Husada Batu City can be an effective strategy in improving nurse performance and service quality in the emergency department.
DISCUSSION