Influence of Psychosocial Risk Factors on Job Satisfaction among the Employees 

of the National Hospital Insurance Fund in Kenya 

 

 

 

 

Mureithi Reginah Wanjira 

17/00537 

 

 

A Thesis Submitted in Partial Fulfilment of the Requirements for the Degree of 

Masters of Arts in Counselling Psychology 

 

Tangaza University College 

Catholic University Of Eastern Africa 

 

 

Nairobi 

September 2020 

 



ii 
 

DECLARATION 

I, the undersigned declare that this report is my own work and not a product of 

anything done in collaboration or presented in any other institution. All sources cited 

herein are duly acknowledged. 

Name of Student: Mureithi Reginah Wanjira 

Registration No. 17/00537 

Signature of the Student: …………………………………………………. 

Date: ………………………………………………………………………. 

 

We certify that this thesis report is an original piece of work and fulfils all requirements 

Name of the Supervisor: Dr Lucy Njiru 

Signature: ………………………………………………………………. 

Date: ……………………………………………………………………. 

 

Name of the Supervisor: Dr Josephine Muthami 

Signature: ………………………………………………………………. 

Date: ……………………………………………………………………. 

 

 

DEDICATION 



iii 
 

This study is dedicated to my two lovely children Delfine Charity and Melvin Macharia. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACKNOWLEDGEMENTS 



iv 
 

 I am especially grateful to my supervisors, Dr Lucy Njiru and Dr.Josephine 

Muthami for accepting to supervise this research. Their consistent encouragement, 

suggestions and constructive criticism directed this study. I do not really have the right 

words to thank them, may the Almighty God shower blessings on them. 

To my two lovely children, Delfine and Melvin for persevering and creating a 

conducive environment of understanding during the time of the study. Not to forget my 

colleagues at Tangaza University College, Institute of youth studies who helped me in 

many ways in the course of my study. Their encouragement and support provided me 

with the atmosphere for academic work. May the almighty God from whom all good 

things come reward and bless them abundantly. 

To all National Hospital Insurance Fund staff members who agreed to 

participate in this study without whose contribution, this study would not be possible 

to reach the instrumental stage; may God continue to bless you. 

 

 

 

 

 

 

 

 

ABSTRACT 



v 
 

Psychosocial risk factors potentially impact the employee interactions with their work, 

their colleagues, supervisor and other elements of the organizational context. The study 

assessed the influence of psychosocial risk factors on job satisfaction among employees 

at the National Hospital Insurance Fund (NHIF) in Kenya. In particular, the study 

sought to establish the influence of social support on employee job satisfaction, 

determine the influence of psychological demand on employee job satisfaction, and 

define the influence of job control on employee job satisfaction. The study was pegged 

on the psychological demands-control-support model and the two-factor theory. An ex-

post-facto research design was adopted and all the 1918 employees at NHIF were 

targeted for this study. Using a stratified random sampling technique, 330 respondents 

were obtained from the study population. To collect primary data on psychosocial risk 

factors, the study used the demand-control-support questionnaire while job satisfaction 

was measured using the Warr-Cook-Wall questionnaire. While 330 questionnaires were 

distributed, only 301 questionnaires were duly filled and returned. Descriptive and 

inferential statistics encapsulated the analyzed data and the findingswere presented in 

the form of tables. Analysis of the data was done through the use of SPSS version 22. 

The findings of the study showed that the regression analysis revealed that 

psychological demand and social support had a statistically significant influence on job 

satisfaction at NHIF Kenya (p<0.05). The study recommends that future researchers 

should conduct a similar study targeting other public sector organizations in Kenya.  

 

 

 

 

 

 

TABLE OF CONTENTS 

DECLARATION ........................................................................................................... ii 



vi 
 

DEDICATION ............................................................................................................... ii 

ACKNOWLEDGEMENTS ..........................................................................................iii 

ABSTRACT .................................................................................................................. iv 
TABLE OF CONTENTS ............................................................................................... v 

LIST OF TABLES ......................................................................................................viii 

LIST OF FIGURES ...................................................................................................... ix 

LIST OF ABBREVIATIONS AND ACRONYMS ...................................................... x 
OPERATIONAL DEFINITION OF TERMS .............................................................. xi 

CHAPTER ONE: INTRODUCTION ............................................................................ 1 

1.1 Introduction .......................................................................................................... 1 

1.2 Background of the Study ..................................................................................... 1 
1.3 Statement of the Problem ..................................................................................... 5 

1.4 Purpose of the Study ............................................................................................ 6 

1.5 Research Questions .............................................................................................. 6 

1.6 Objectives of the Study ........................................................................................ 6 
1.6.1 General Objective ......................................................................................... 6 

1.6.2 Specific Objectives ....................................................................................... 6 

1.7 Significance of the Study ..................................................................................... 7 

1.8 Scope and Delimitations of the Study .................................................................. 8 
1.9 Assumptions of the Study .................................................................................... 8 

1.10 Summary ............................................................................................................ 9 

CHAPTER TWO: LITERATURE REVIEW ................................................................ 9 

2.1 Introduction ........................................................................................................ 10 

2.2 The Concept of Psychosocial Risk Factors ........................................................ 10 
2.3 Review of empirical studies ............................................................................... 12 

2.3.1 Psychological demands ............................................................................... 12 

2.3.2 Job control ................................................................................................... 13 

2.3.3 Social support.............................................................................................. 14 
2.3.4 Job satisfaction ............................................................................................ 17 

2.4 Theoretical Literature Review ........................................................................... 18 

2.4.1 Psychological Demands-Control-Support (DCS) model ............................ 19 

2.4.2 The two-factor theory ................................................................................. 24 
2.5 Conceptual Framework ...................................................................................... 27 

2.6 Research Gap ..................................................................................................... 28 

2.7 Chapter Summary .............................................................................................. 29 



vii 
 

CHAPTER THREE: METHODOLOGY .................................................................... 30 

3.1 Introduction ........................................................................................................ 30 

3.2 Research Design................................................................................................. 30 
3.3 Location of the Study ......................................................................................... 31 

3.4 Target Population ............................................................................................... 32 

3.5 Sampling Frame ................................................................................................. 32 

3.6 Sampling Size Determination ............................................................................ 33 
3.7 Sampling Technique .......................................................................................... 33 

3.8 Research Instruments ......................................................................................... 34 

3.8.1 Demand-Control-Support Questionnaire .................................................... 35 

3.8.2 Warr-Cook-Wall Questionnaire .................................................................. 35 
3.9 Validity and Reliability ...................................................................................... 36 

3.10 Data Collection Procedures .............................................................................. 37 

3.11 Data Analysis ................................................................................................... 38 

3.12 Ethical Considerations ..................................................................................... 39 
3.13 Debriefing ........................................................................................................ 39 

3.14 Chapter Summary ............................................................................................ 39 

CHAPTER FOUR: RESULTS .................................................................................... 40 

4.1 Introduction ........................................................................................................ 40 
4.2 Response Rate .................................................................................................... 40 

4.3 Socio-Demographic Information of Respondents ............................................. 41 

4.3.1 Gender of Respondents ............................................................................... 41 

4.3.2 Years worked in the Organization .............................................................. 42 

4.3.3 Highest Level of Education Attained .......................................................... 42 
4.3.4 Level of Work ............................................................................................. 43 

4.4 Psychosocial Risk Factors.................................................................................. 44 

4.4.1 Psychological Demands .............................................................................. 44 

4.4.2 Job Control .................................................................................................. 46 
4.4.3 Social Support ............................................................................................. 48 

4.5 Job Satisfaction .................................................................................................. 50 

4.6 Influence of Psychosocial Risk Factors on Job Satisfaction .............................. 53 

4.6.1 Collinearity Diagnostics.............................................................................. 53 
4.6.2 Regression Analysis Results ....................................................................... 54 

4.7 Limitations of the Study..................................................................................... 57 

4.8 Chapter Summary .............................................................................................. 58 



viii 
 

CHAPTER FIVE: DISCUSSION ................................................................................ 58 

5.1 Introduction ........................................................................................................ 58 

5.2 The Influence of Psychological Demand on Job Satisfaction ........................... 58 
5.3 The Influence of Job Control on Job Satisfaction .............................................. 59 

5.4 The Influence of Social Support on Job Satisfaction ......................................... 61 

5.5 Summary ............................................................................................................ 62 

CHAPTER SIX ............................................................................................................ 63 
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS................................ 63 

6.1 Introduction ........................................................................................................ 63 

6.2 Summary of Findings ......................................................................................... 63 

6.2.1 The Influence of Psychological Demands on Job Satisfaction ................... 64 
6.2.2 The Influence of Job Control on Job Satisfaction ....................................... 64 

6.2.3 The Influence of Social Support on Job Satisfaction .................................. 65 

6.3 Conclusions ........................................................................................................ 65 

6.4 Recommendations of the Study ......................................................................... 66 
6.5 Suggestions for Further Research ...................................................................... 67 

REFERENCES ............................................................................................................ 68 

APPENDICES ............................................................................................................. 74 

Appendix I: Consent Form for Participants ............................................................. 74 
Appendix II: Socio-demographic Questionnaire ..................................................... 76 

Appendix III: Demand-Control-Support Questionnaire .......................................... 77 

Appendix IV: Warr-Cook-Wall (WCW) Job Satisfaction Questionnaire Scale ...... 79 

Appendix V: Debrief Form. ..................................................................................... 80 

Appendix VI: University Research Authorization Letter ........................................ 83 
Appendix VII: NACOSTI Permit Letter.................................................................. 85 

Appendix VIII: Ministry of Education Authorization Letter ................................... 86 

Appendix IX: County Commissioner Authorization Letter..................................... 88 

Appendix X: NHIF Authorization Letter ................................................................. 89 
Appendix XI: NHIF Branch Network ...................................................................... 90 

Appendix XII: Plagiarism Report ............................................................................ 91 

 

LIST OF TABLES 

Table 3.1: Sampling Frame .......................................................................................... 32 



ix 
 

Table 3.2: Distribution of Sample Size ........................................................................ 34 
Table 4.1: Response Rate ............................................................................................. 40 
Table 4.2: Gender distribution of Respondents ........................................................... 41 
Table 4.3: Years worked in the Organization .............................................................. 42 
Table 4.4: Highest Level of Education Attained ......................................................... 42 
Table 4.5: Work Level ................................................................................................. 43 
Table 4.6: Psychological Demands .............................................................................. 44 
Table 4.7: Degree of Psychological Demand .............................................................. 45 
Table 4.8: Job Control.................................................................................................. 46 
Table 4.9: Degree of Job Control ................................................................................. 48 
Table 4.10: Social Support ........................................................................................... 48 
Table 4.11: Level of Social Support ............................................................................ 50 
Table 4.12: Job Satisfaction ......................................................................................... 50 
Table 4.13: Level of Job Satisfaction .......................................................................... 52 
Table 4.14: Multicollinearity Test ............................................................................... 53 
Table 4.16: Model Summary ....................................................................................... 54 
Table 4.17: Analysis of Variance................................................................................. 55 
Table 4.18: Coefficient Table ...................................................................................... 55 
 

 

 

 

 

 

 

 

 

 

LIST OF FIGURES 

Figure 2.1: Influence of psychosocial factors on job satisfaction ................................28 



x 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIST OF ABBREVIATIONS AND ACRONYMS 



xi 
 

DCS:  Demand Control Support 

EAP:   Employee Assistance Programs  

NACOSTI:   National Commission of Science, Technology and Innovation  

NHIF:  National Hospital Insurance Fund  

SPSS:  Statistical Package for Social Scientists 

WCW:  Warr-Cook-Wall  

 

 

 

 

 

 

 

 

 

 

 

 

 

OPERATIONAL DEFINITION OF TERMS 



xii 
 

Job Control Refers to the authority extent that an employee has to 

make decisions and use skills for the job. 

Job Satisfaction Describes an employee’s feelings towards the job. 

Psychological demand Refers to job aspects that are physical, social, 

psychological, or organizational that required 

physical and psychological effort to be sustained. 

Social support The support that employees perceive that they receive 

from their colleagues and supervisors. 

PsychosocialRisk 

Factors 

Work aspects in organizations that are designed and 

constructed by human beings; and have the potential 

to cause physical or psychological harm. 

 

 

 

 



1 
 

CHAPTER ONE: INTRODUCTION 

1.1 Introduction 

This chapter provides the background and the problem statement of the study. 

The purpose and the objectives of the study are also provided as well as the research 

questions, scope, and assumptions of the study. 

1.2 Background of the Study 

       Theoretical and empirical factors have led to a myriad of researches in a bid to 

comprehend the psychosocial risk factors that are found in the workplace (Burke & 

Richardsen, 2014). There is a consensus among scholars that work is good for an 

individual. According to Shimazu, Nordin, Dollard, and Oakman (2016), the Seoul 

Declaration on Safety and Health at work indicates that it is a fundamental human right 

to have access to safe and healthy workplaces.  To ensure that this fundamental human 

right is upheld, essential consideration has to be made on risk factors present in the 

workplace.  These factors affect the organization and management of work which 

involves aspects of work that are social and relational. These social and relational 

aspects affect the employees psychologically and emotionally. 

Employees are the most vital asset for an organization to achieve its goals. Their 

performance is directly dependent on their economic, political and social well-being. 

In the modern society, employees are faced with issues such as terror attacks, social, 

economic and political challenges that would create an imbalance in their profession 

and their physical and psychological wellbeing (Burke & Richardsen, 2014). 

Organizations, therefore, have to understand the dynamics of employees, their work 

and environment and the interaction of this triad in affecting the outputs of the 

employees, their psychological wellbeing and the organizational wellbeing. 



2 
 

Changing work environments lead to changes in the understanding of health and 

safety measures as well as aspects of the performance of work. Different organizations, 

whether in the public or private spheres, exist for a reason. The organizations are made 

up of different individuals from diverse backgrounds seeking to solve a common 

problem. Interrelations of individuals are most likely to lead to a number of work-

related stresses (Whitfield & Cachia, 2015). The work environment, on a global 

platform, has increased the demands on workers due to the aforementioned reasons, 

coupled with the economic and market crises.  There are increased levels of pressure 

and stress among employees. Whitfield and Cachiainsist that even though some stresses 

in the workplace are good and lead to increased performance, some have negative 

results such as lack of motivation and even burnout; which adversely affect the 

emotional, mental and psychological wellbeing of the employees which ultimately 

affects the performance of the organization. 

Psychosocial risk factors point to work aspects in organizations that are 

designed and constructed by human beings; and have the probability to cause physical 

or psychological harm (Shimazu et al., 2016).  The International Labor Association 

views psychosocial risk as an interaction that involves work content, organization and 

management, conditions in organizations and environment, and the skills and needs of 

the workers (Fernandes & Pereira, 2016). These social interactions have different 

psychological and physiological impacts on the employees’ health as they experience 

the effects in different ways.  

In developed countries, work processes are more mechanized and the 

consideration of employees in the workplace is far beyond what is found in the 

developing countries. The introduction and spread of globalization have led to many 

forms of interactions on global contexts which identify labour and psychological 



3 
 

demands, workplace values, and social relationships. Different awareness and 

understanding exist among countries on the psychosocial aspects of work in 

organizations. In the United States of America, Sauter et al., (2012)noted that there is a 

realization in many American organizations that the work environment can pose threats 

to the mental health of employees. A comparison of American companies in the 1990s 

and today shows that there have been rapid changes in the work and workforce fabric 

and aspects such as job stress have increased. The downsizing of modern corporations 

has led to retrenchment, forced early retirement and firing of the majority of employees. 

This has psychological and emotional effects on the employee. 

In Europe, the European Agency for Safety and Health at Work (2015) cites that 

about half of the European workers are faced with psychosocial risk factors which result 

to stress and burnout in which the employees are psychologically affected and thereby 

reduced satisfaction in the job undertaken. The results are increased job turnover and 

reduced work productivity. Many European organizations recognize the increasing 

pressures by cause of changing demands in the workplace and many employers have 

instituted voluntary measures for the promotion of mental and psychological well-being 

of the employees. In a specific focus, Belgium realized the effects of psychosocial 

factors in the 1990s and laws and regulations were enacted to ensure the wellbeing of 

employees across the countries. Measures dealing with psychosocial risk factors have 

since then advanced to ensure absolute prevention of psychosocial risk aspects of work 

(OECD, 2013). 

In the Asia Pacific, while there is a growing realization of the psychosocial 

effects in organizations, gaps still exist in dealing with related risk factors. In Japan and 

Korea, there are laws and regulations that organizations use to address work-related risk 

management. However, in China, a lack of concentration on psychosocial risk 



4 
 

management exists even though the effects are well known and have been well 

documented (Shimazu et al., 2016). 

In Africa, there is a lack of understanding and also an awareness of the 

affiliation that is there between the work environment and the psychological wellbeing 

of employees. In Nigeria, Omoegun, Nwadinigwe, and Ahimie (2018) acknowledge 

that organizations in the country especially the government organizations do not pay 

much attention to certain organizational factors such as psychosocial factors. This 

means that remedies such as counseling services to enhance the psychological 

wellbeing of the employees are not provided in the organization. The study further 

postulates that the lack of attention leads to the devastating performance of the 

government organizations. 

In South Africa, government organizations such as the security forces are faced 

with high-stress environments presenting psychosocial risk factors in the work 

environment (Mlangeni, 2016). There are no or limited working policies that augment 

the social and psychological wellbeing of the employees. However, there is an 

acknowledgement that some advances have been made to deal with the psychosocial 

risk factors in some organizations. For instance, there are programs such as the 

Employee Assistance Programs (EAPs) to assist the employees in their wellbeing. 

In Kenya, there has been awareness and understanding, albeit minimal, on the 

psychosocial risk factors and how they affect organizations. Charllotte (2018) asserts 

that the psychosocial environment in Kenya has impacts that can be highly felt. This 

has led to the introduction of Employee Assistance Programs especially in government 

institutions which help to identify and resolve the social and psychological concerns of 



5 
 

employees that may affect their performance (Kwasira, 2018). However, the EAPs are 

limited in their formulation and implementation in most public service departments. 

1.3 Statement of the Problem 

Over the years, psychosocial risk factors have been seen to affect employees 

engaged in more labour-intensive activities such as construction. This is because many 

studies have focused on the physiological concerns of the employees neglecting the 

psychological, emotional and mental wellbeing. According to Kisilu (2018), the 

thinking of many academic scholars is always focused on psychosocial risk factors 

resulting in physical health issues such as musculoskeletal disorders which result from 

labour-intensive activities conducted in the organization. This thinking leads to a gap 

in which focus is only on the physical aspects of psychosocial risk factors leaving a gap 

of knowledge on the emotional, psychologicaland social facets of the employees.  

The present study sought to recognize the psychological, emotional and social 

factors that affect employee job satisfaction. According to Finne, Christensen, and 

Knardahl (2016) psychological and mental wellbeing of an employee determine their 

job performance and job satisfaction. Psychological and social work factors affect the 

mental states of the employees in both positive and negative ways.  

Additionally, employees in the civil service are among the least interviewed on 

psychosocial risk factors. Review on psychosocial risk factors by Fernandes and Pereira 

(2016) specify that of the working population in the literature, 33% of the respondents 

were from the healthcare system and 48% were from the construction sector. The civil 

servants were quite limited. It is therefore quite evident that little attention is focused 

on psychosocial risk factors on the employee in public organizations. Therefore, there 

is a disconnect from limited empirical studies conducted focusing on the public service 



6 
 

sector. To fill in this gap, this study sought to understand the influence of psychosocial 

risk factors on job satisfaction focusing on the National Hospital Insurance Fund which 

is in the public service sector. 

1.4 Purpose of the Study 

This study aimed to assess the influence of psychosocial risk factors on job 

satisfaction among the employees at the National Hospital Insurance Fund (NHIF) in 

Kenya. 

1.5 Research Questions 

i. What is the influence of psychological demand on job satisfaction among the 

employees at NHIF in Kenya? 

ii. What is the influence of job control on job satisfaction among the employees at NHIF 

in Kenya? 

iii. What is the influence of social support on job satisfaction among the employees at 

NHIF in Kenya? 

1.6 Objectives of the Study 

1.6.1 General Objective 

To understand the influence of psychosocial risk factors on job satisfaction 

focusing on the National Hospital Insurance Fundin Kenya. 

1.6.2 Specific Objectives 

i. To determine the influence of psychological demand on job satisfaction among the 

employees at NHIF in Kenya 

ii. To define the influence of job control on job satisfaction among the employees at 

NHIF in Kenya 



7 
 

iii. To establish the influence of social support on job satisfaction among the employees 

at NHIF in Kenya 

1.7 Significance of the Study 

The study’s findings are projected to be of significance to the government since 

they may result in positive changes in dealing with social and psychological issues and 

provision of management and assessment measures which lead to improvement of 

working conditions of workers.   

This study will also be of significance to the human resource managers who will 

be able to understand psychological, emotional and social support the employees need. 

This will enhance the importance of safety and health while considering the job 

performed by the employees and how these can help to ensure job satisfaction. The 

human resource manager will also be better placed in the understanding of policy 

formulation for the organization. 

Employees spend most of their time in a day performing work-related activities 

which create a workplace environment. This study will be of significance to individual 

employees who will gain profound discernment on their contribution to dealing with 

psychosocial risk factors at their place of work. This discernment will lead to a change 

in the thinking of the benefits of mental wellbeing which improves job fulfillment and 

ultimately the functioning of the organization. 

For counseling psychologists, the findings will provide insights of expansion of 

policies by employers to cover not only physiological wellbeing but also psychological 

and emotional well beings of employees. This will help in the provision of groups and 

individual counseling so as to help them achieve satisfaction in their workplaces. 



8 
 

Finally, this study’s findings will motivate and rejuvenate the thinking of future 

scholars and researchers who have an interest in further enquiring into the field of 

psychosocial risk factors and job satisfaction through adding on to the body of literature 

for future reference. 

1.8 Scope and Delimitations of the Study 

This study addressed the influence of psychosocial risk factors on job 

satisfaction among the employees at the National Hospital Insurance Fund in Kenya. 

The foremost focus of the study was on social support, psychological demand, and job 

control. The target population was all the 1918 employees of National Hospital 

Insurance Fund in Kenya. On the geographic scope, the study took place in two regional 

stations, Nairobi and Rift valley Region. The study was limited to NHIF employee 

experiences who had been in service of the organization for at least six months. This 

was to help have a rich and reliable source of data from people with long engagements 

with the organizations. The study was expected to take place between August and 

October 2019. 

1.9 Assumptions of the Study 

In the study, three main suppositions were made. The first assumption was that 

psychosocial risk factors are present among the employees at the NHIF. Secondly, those 

psychosocial risk factors had an effect on job satisfaction. Finally, the study assumed 

that the responses that were provided by the respondents were true reflections of what 

is on the ground and as such, the respondents did not give responses on basis of fear of 

retribution from the authorities. To ensure the free and open provision of responses, 

confidentiality and anonymity were observed. 



9 
 

1.10 Summary 

It is evident that there is a need to explore the state of mental health among 

various employees of all organizations whether public or private. The focus on N.H.I.F 

will go a long way in painting a picture of how much psychosocial risk factors affect 

employee performance. The lack and subsequent demand of sufficient local empirical 

literature will further be seen in the next chapter, where the study explores various 

supporting theories that guide the formulation of the research objectives while also 

comparing best practice globally, regionally and locally. 

 

 

 

 

 

 

 

 

 

 

 

CHAPTER TWO: LITERATURE REVIEW 

 



10 
 

2.1 Introduction 

This chapter depicts the literature on the influence of psychosocial risk factors 

on job satisfaction. The chapter encompasses a theoretical and empirical literature 

review on the study of the variables. Based on these reviews, the research gap will be 

identified and a conceptual framework designed to graphically represent the connection 

between psychological risk factors and job satisfaction. 

2.2 The Concept of Psychosocial Risk Factors 

Psychosocial risk factors focus on employee interactions with their workplace 

environment and their psychological demands. These interactions lead to the 

satisfaction of the employee at their place of work. For instance, if employees feel that 

they do not have the right psychological fit for their job position they become stressed. 

This leads to the poor physical and mental health of the employees. According to 

Auspice Safety (2018), any workplace has to have psychosocial risk factors since the 

factors are developed through the culture, social attitudes, policies and expectations 

found in the organization. Therefore, those at risk include those working in all sorts of 

the environment such as customer care, health industry, construction, among others. 

The psychosocial risk factors range from job characteristics such as job control, support 

and demands. When these factors are too much for a worker to handle, stress is 

experienced.   

The importance of assessing risk factors in the workplace environment cannot 

be overemphasized. A study by Auspice Safety (2018) in Canada shows that among the 

locals, 47% view work to be the most stressful part of their day, 19% have quit work 

because of stress, 12% have called in sick because of stress. On the flip side, 23% of 

the employees are comfortable enough with their employer to communicate 



11 
 

psychological health issues. On average, there is decreased work morale, workvalue, 

and productivity of employees. 

On the analysis of the nature of the psychosocial work environment, it is visible 

that the environment is more structural than the individual. Dynamic work 

environments mean that continuous assessments should be undertaken to uncover 

changing psychosocial risk factors that produce effects such as ill-health (Kwasira, 

2018). To get a clear understanding of the psychosocial risk factors, objectivity is 

required. That is probably a reason, Fernandes and Pereira (2016) insinuated that 

quantitative methods of analysis are used. 

As a structural phenomenon, psychosocial risk factors result in different 

individual responses. The individuals may experience behavioural responses where 

they may begin to avoid work or show frustration in carrying activities using a lot of 

force. Psychological responses are how positively or negatively an individual can 

perceive the stress. Physiological responses show the body’s natural response to stress 

(Auspice Safety, 2018). 

Furthermore, psychosocial factors lead to a variety of health-related issues. A 

report by Lee et al. (2016) analyzed the Korean Working Conditions Survey in which 

data 33,569 workers were included. The shows that the risk factors result in adversative 

health consequences such as coronary heart diseases, depression, musculoskeletal 

diseases and suicide attempts. The study also indicates that apart from the specific 

diseases, the focus is also on the health status in the daily wellbeing. 



12 
 

2.3 Review of empirical studies 

This subsection discusses past studies that have been conducted on psychosocial 

risk factors. The study has three main objectives which are psychological demands, job 

control, and social support which are herein discussed.  

2.3.1 Psychological demands 

Psychological demands refer to job aspects that are social, physical, or 

organizational required for psychological and physical efforts to be sustained. A study 

by Sutherland (2014) on Trends and interrelations in the workplace in Britain suggests 

that psychological demands refer to the employment conditions related to how hard an 

employee works. In other words, psychological demand is all about work intensity. 

High and excessive psychological demands can strain the employee in such a way that 

they are unable to perform their work well. This leads to dissatisfaction in their 

performance and productivity. Research on psychological demands suggests that high 

psychological demands on employees lead to strain in the workplace.  This leads to a 

lack of confidence in their functioning in terms of abilities and skills (Burke & 

Richardsen, 2014). This current research also negates the fact that work under-load can 

also have the same effect on abilities and skills. Work overload has an association with 

employee dissatisfaction. 

Employees are always trying to find the meaning of work so that they can be 

satisfied and content with what they are about to endeavour in. In Denmark, a 

correlational study by Burr, Albertsen, Rugulies, and Hannerz (2010) used a cohort 

method to study 3552 employees in the period 2000 to 2005. The study emphasized 

that psychological demands involve emotional demands. While the nature presented by 

Burr et al. (2010) is complex, there are still connotations that psychological demands 



13 
 

present stressors that have a negative impact on the employees. An exhaustive literature 

review on the nursing profession by Bani-Hani, Hamdan-Mansour, Atiyeh, and 

Alslman (2016) considered psychological demands to include physical, emotional, 

workload, and work shift demands. 

Nonetheless, the employees have to be clear on their role in the organization. 

Role ambiguity has a negative impact on job satisfaction. Based on their study, Burr et 

al. (2010) allude that role ambiguity can lead to exhaustion in the tasks undertaken. This 

leads to burnout and ultimately an employee is no longer satisfied with their work and 

also with the organization. Based on survey data focused on Britain by Sutherland 

(2014) there is an indication that over time, lowered levels of role ambiguity lead to an 

increased level of job and professional fulfilment. Having a variety of tasks to be 

performed can lead to conflicting demands. The psychosocial factors are correlated to 

emotional and psychological demands. These demands can create development 

opportunities such as responsibility and at the same time, the demands can create 

hindrances in growth and achievement such as role ambiguity and insecurities. 

2.3.2 Job control 

 Sutherland (2014) indicated that there are a number of ways in which job control 

can be interpreted. One interpretation is in the aspect of job autonomy in which an 

individual effectively has total control over the job. Another one is in the amount of 

influence that an individual has over the job that they do. A third one comes from the 

extent of job discretion that the individual possesses. Therefore, it is easy to predict that 

job control indicators always lead to different outcomes.  

Different authors have attempted to provide the job control indicators and while 

the outcomes have been different, some commonalities exist.  Lindley (2015) in her 



14 
 

study on the gender pay gap in the United Kingdom cited that there are variations of 

job control in aspects of gender whereby, women are seen to have more control over 

job execution than men.  

On the other hand, in the United States of America, Blanch (2016) studied 281 

administrative and technical workers. The study intimated that qualifications and 

supervisory position enhance job control in that those with higher qualifications or 

supervisory positions have more job control than those without. Additionally, 

Sutherland (2014) cited that the scope for job control is higher in the public sector. 

 Job control helps the worker to exert a certain degree of influence over any 

given environment so that it becomes less threatening and more rewarding. In support 

of the concept, Blanch (2016) empirically showed that there is an association between 

the integration of the authority of employees to make decisions with their job skills. 

The applications of workplace control include scheduling work activities including 

leaves, off duties the working methods and the supervisory positions. 

A degree of control that is high provides employees with a chance to influence 

their work environment and their satisfaction in the job. In Kenya, Kagwi (2018) 

conducted a descriptive study of 48 employees at the Huduma Centre in Nyeri County. 

The study asserts that having a climate that is participative in terms of control helps 

employees to deal with intensive work. It promotes a culture that can separate work and 

home life and bring about satisfaction. 

2.3.3 Social support 

 Organizational psychology has for long investigated organizational aspects 

such as bases of job fulfilment and productivity. In Norway, a study on psychological 

and social work factors using 3644 employees from 48 organizations by Finne, 



15 
 

Christensen, and  Knardahl (2016) proposed that social support from fellow employees 

and supervisors is likely to be influenced by the work environment. Workplace 

environments are different and this is driven by the culture of the organization.  

Workplaces where the colleagues and supervisors are supportive to each other help to 

reduce psychological and mental issues. This also protects any traumatic stressors that 

come from work demands.  

A cross-sectional study by Pohl and Galletta (2017) focusing on 323 Belgian 

nurses showed that perceived social support is attained from the degree to which 

employees believe that their supervisors and fellow employees care about them and 

value the contribution they make to work outcomes. Psychological and mental 

wellbeing is a predator for job performance and job satisfaction. The study by Finne et 

al. (2016) elucidated that there are relationships that exist between psychological work 

factors and the mental states of employees.  

When employees perceive that they lack social support from their organization, 

there arise issues such as increased turnover, increased absenteeism, and lack of job 

satisfaction. On the other side of the coin, where there is social support, employees feel 

that they have greater job commitment and satisfaction. There is a desire to remain with 

the organization over time and the job performance is increased. A study by Lee et al. 

(2016)exhibited a significant association between the psychosocial risk factors and the 

satisfaction of employees. Theirstudy compared European and Korean workers and 

revealed that in Korea, the workers experienced poor psychological wellbeing as 

compared to the European workers. That was due to factors such as cultural difference 

and support received from their work colleagues and supervisors. 



16 
 

Perceived support by supervisors is abasis of job satisfaction and the supervisors 

influence the emotional reaction of employees. Empirical findings by Pohl and Galletta 

(2017) showed that employees who obtain high emotional backing from their 

supervisors are prospective to face high levels of correspondence between their goals 

and their abilities. This is because the support received is either emotional or 

instrumental to help in upholding emotional intelligence and provision of work-related 

information and feedback. Pohl and Galletta viewed supervisors’backing as a 

moderator for satisfaction at the individual level.  

Similarly, perceived social support from bosses and coworkers creates a positive 

environment for the achievement of the organization’s goals and objectives. In a study 

on 255 Romanian bank employees, Roxana (2013) reveals that perceived social support 

leads to a supportive climate which is connected to lowered stress levels, turnover 

intentions and overall job satisfaction. Employees who support each other most likely 

like each other and this is shown in their relationship with each other. This is a predictor 

for job satisfaction. In the study, social support also considers the personal development 

of the employee which is brought about through appraisal of experiences and skills. 

Supervisors are given the duty and responsibility of forming and leading 

workgroups in organizations. In Kenya, a descriptive study by Charllotte (2018) studied 

the psychosocial environment in the Kenyan Prison system at UasinGishu County. The 

study indicated that supervisors have an interpersonal role to play so as to increase 

positive relations among the employees. This in return helps to increase the 

satisfactionlevels. Therefore, immediate supervisors are advocates for the employees 

and ensure that the latter are well supported in their activities. They ensure that the 

environment is conducive to uphold psychological wellbeing.  



17 
 

2.3.4 Job satisfaction 

            Employees are said to have satisfaction at their workplace when there is an 

affective attachment to the job that they do or from the evaluation of their job 

experiences (Lee et al., 2016). Focusing on the Psychological demands-resources 

theory, psychosocial factors often lead to a variety of wellbeing outcomes. Fila (2016) 

indicated that among the outcome variables, job satisfaction is most important as it 

shows the overall attitude that employees have in the performance of their work. This 

can lead to poor or good results depending on the various factors such as work 

environment and motivation. 

Job satisfaction describes an employee’s feelings towards the job and it is 

viewed by many scholars as an organizational output (Shimazu et al., 2016; Sutherland, 

2014). Much attention has been focused on the two-faceted variable which consists of 

inherent and extrinsic satisfaction from the job. A study on 118 elementary schools in 

Israel by Bogler & Nir (2015) indicated that intrinsic satisfaction focuses on the 

accomplishments and self-fulfilment while extrinsic satisfaction focuses on job 

conditions such as the social aspects of work and job security. Job satisfaction in many 

cases involves intrinsic satisfaction whereby the employee gains joy from the work that 

they do. 

Employees also gain support from others and this provides them with 

satisfaction (Blanch, 2016). From a supervisor’s perspective, when the employee is 

satisfied in the job that they are performing, this can translate to increased job 

performance and profits for the organization. Job satisfaction is also perceived in terms 

of high levels of work performance which leads to self-fulfillment from carrying out 

activities on a daily basis. In the public sector context, job satisfaction is a critical 

element which is affected by psychosocial factors in the organization. 



18 
 

According to Roxana (2013), job satisfaction is a variable that has practical 

importance since in a general sense, it affects the overall performance of the 

organization. The study stipulated that there is anoptimistic association between 

satisfaction and the support of coworkers and supervisors. Motivated employees have 

advanced heights of satisfaction. The level of satisfaction varies from employee to 

employee and from organization to organization due to personal characteristics, values, 

needs, and expectations. In this study, however, job satisfaction will be focused as an 

organizational outcome which is dependent on the psychosocial risk factors. 

Job satisfaction results in successful and happy employees. In this state of mind, 

they are assets for the organization, its survival and success in a competitive global 

market. Shimazu et al. (2016) emphasized that the psychological and mental wellbeing 

of employees increases the productivity of their organization irrespective of whether 

the organization is in the public or private sector. Job satisfaction is a constructive 

emotional state which shows the connection between what an employee requires from 

a job and what they think it is offering. 

 

 

2.4 Theoretical Literature Review 

This study was pegged on two main theories. The psychological demands-

control-support (DCS) model which was first formulated in the 1990s by Karasek and 

Theorell (Lee et al., 2016). This theory was supported by the two-factor theory which 

was developed by the psychologist, Fredrick Herzberg in 1959 (Alshmemri et al., 2017) 



19 
 

The choice of the theories was because they provide insights into the 

interconnection between psychosocial risk factors and job satisfaction which ultimately 

leads to organizational performance. This was the aim of the current study.  

2.4.1 Psychological Demands-Control-Support (DCS) model 

The DCS model provides three main dimensions; demands, control and support. 

It postulates that demanding work needs control over processes in the working 

environment as well as support in the workplace so as to attain wellbeing of employees 

which concerns employee job satisfaction and ultimately, performance (Fila, 2016). 

According to Lee et al. (2016), many studies that have viewed the psychosocial 

risk factors use the psychological DCS model so as to identify the psychological 

demands, job control, and support as important job characteristics that influence the 

wellbeing of employees. Job control denotes the authority extent that an employee has 

for decision-making and skill-usage in the job. Support in the context of this model 

refers to the interrelationships with supervisors and coworkers. The synergy between 

psychological demands, control and support help in understanding strains that an 

employee undergoes that they cannot attain satisfaction in their work. 

The model view demands as psychological stressors which are part of the 

process of accomplishing workload which involves the performance of the unexpected 

task. When this occurs, the employee tends to strain in order to attain what they were 

supposed to attain. In comparison to psychological demands, job control provides an 

opportunity to the employees to use the specific skills that they have to accomplish 

tasks and use their autonomy to make decisions on how to perform the tasks at hand 

(Fila, 2016). It is therefore quite likely that job control can be used to deal with strains 



20 
 

in dealing with the tasks, thus, creating an environment that fosters the satisfaction of 

the employee in the performance of the task. 

The type of job control to be used depends on the psychological demands placed 

on an employee. For instance, challenges such as workload can be dealt with to provide 

opportunities for personal growth whereas hindrances such as role ambiguity are 

unmanageable and they hinder personal growth (Dawson et al., 2016a). Job control and 

support are valuable resources which enhance and protect resources from situations that 

may be threatening or conflicting such as an employee have to perform different roles. 

In this case, the employee who has control chooses where and when to perform the 

work. This way, the situation becomes less conflicting and threatening. 

The support that an employee receives from supervisor and coworkers cannot 

be underestimated. According to Dawson et al. (2016), depending on the work 

environment, the support of coworkers and supervisors can be seen as a buffer against 

stressful conditions and situations. The support received influences the performance of 

the worker. It is considered that support from a coworker may be more influential since 

they are regarded as equals as compared with the support received from the supervisor. 

However, Finne et al. (2016) suggest that supervisor support is more attributed to other 

job characteristics such as job satisfaction and commitment. Motivation is an important 

aspect of the support relationship. In fact, this current study viewed motivation as a 

mediating factor between psychosocial factors and job satisfaction. 

 Subsequently, Fila (2016) notes that this model by Karasek and Thoerell has 

been criticized for focusing on cardiovascular diseases and work strain which leaves 

other aspects of job characteristics such as satisfaction in the background. Furthermore, 

Fila recommend that future studies should focus on other occupations that empirical 

researches neglect such as the public service sector. This current study sought to bring 



21 
 

job satisfaction to the limelight by presenting the mediating variable of public service 

motivation. 

Some literature found that there were shortcomings in the DCS theory. This led 

to Bakker and Demerouti (2017) developing the jobs demands-resources which gained 

footing and application in various organization and empirical findings. The theory has 

been used mainly in government agencies and regulators the United Kingdom, 

Australia, and Canada for the formulation of psychosocial education activities, policies, 

and risk assessment approaches (Bakker &Demerouti, 2017). The psychological 

demands-resources theory identifies two broad categories of the work environment 

which are the psychological demands and job resources.  

Even though all organizations are different in their workings and general 

outlook of practices, policies and processes, the work environments can be easily 

characterized by demands that are psychologicaland resources in the job. Psychological 

demands refer to job aspects that are physical, social, and psychological which require 

physical and psychological effort to sustain. Examples include working under very high 

pressure and engaging with client interactions that are demanding emotionally. The 

resources in the job are the social, psychological, physical and organizational facets of 

a job which help in goal achievement. The job resources help to deal with the strains of 

the job. These resources include control, skill variety, social support, growth and 

development opportunities.  

The impact of psychological demands-resources theory on the wellbeing of 

employees is quite unique. According to the psychological demands-resources theory, 

different processes are involved. These include health impairment and motivational 

processes (Sutherland, 2014). Psychological demands uniquely predict exhaustion 



22 
 

which can undermine both intrinsic and extrinsic satisfaction and performance of a job 

task. On the other hand, job resources predict engagement which leads to satisfaction 

through the satisfaction of employees (Burke & Richardsen, 2014). 

A review of literature by Bakker (2015) in the Netherlands used the 

psychological demands-resources theory to illustrate motivation in public service. 

Public service motivation refers to aspects that motivate an employee to serve the 

people in the nation. Motivation determines how they deal with the demands of their 

jobs and resources every day. The study indicated that when the public servants are 

highly motivated, they can deal with the demands at work and prevent exhaustion. 

These employees also used their job resources to stay engaged so as to produce 

satisfactory results. However, for the sake of this study, it is notable that motivation in 

lieu of psychosocial factors is not an easy predictor.  

Generally, in the psychosocial environment, psychological demands and 

resources interact so as to predict the wellbeing of an employee (Bakker &Demerouti, 

2017). The job resources cushion the strains of psychological demands which have 

negative and undesirable effects. Therefore, social support can help to deal with 

demands of a job task which lead to stress, burnout and other health problems that 

greatly affect the satisfaction of the employee in the work setup. It is then clear to depict 

that job challenges strengthen the impact of job resources on a positive wavelength; as 

complex tasks boost the engagement of job resources. To this end, complex tasks 

engage the employees to exhibit high levels of energy and dedication to use resources 

in an optimal way so as to ensure that work that needs to be done gets done and the 

employee is satisfied with their work (Bakker, 2015). 

Congruence of theory to Study objectives 



23 
 

Advantages 

1. The theory is able to elaborate on how psychological demands influence job 

satisfaction. This is seen where the aspect of having psychological demands is well 

highlighting that employees have more needs that are not necessarily relieved through 

rewards but by having these psychological needs being met. Therefore their ability to 

achieve this becomes the core reason for either working harder or not based on whether 

the output they produce is of value to them as well. 

2. Further through the psychological demands control support theory, we are able 

to understand the influence of providing job control to workers and the impact this has 

on their stress levels. According to the psychological Demands-Control model, job 

stress increases when there in an increase in job demands but when there is job control, 

there is likely to be a decrease in work stress. 

According to Selye (1976), the DCS model is in alignment with the stress and 

adaptation model which presents that when there are high levels of job demands, there 

is also an increase in stress which brings about increased adrenalin levels. Karasek 

(1979) was further in support of this explaining that when the job control level is high, 

stress levels can be counterbalanced by having coping mechanisms. However, when the 

demand is high and control is low, then the outcomes are likely to show the prevalence 

of poor health.  

The outcomes of stress in this theory show that the theory is well in support of the 

study’s objective to define the influence of job control on job satisfaction among the 

employees at NHIF in Kenya which include several mental and physical outcomes such 

as depression and life satisfaction which are thought to happen when perceived stressors 

bring about actual stress. The psychological demands-control-support model does not 



24 
 

provide a foundation for understanding job satisfaction and this gap is filled by the two-

factor theory. 

2.4.2 The two-factor theory 

This theory was developed in 1959 by Herzberg as an augmentation of the 

hierarchy of needs theory by Maslow. The two-factor theory is pegged on the ideology 

that individuals will always seek satisfaction from their work which goes beyond 

remuneration and pleasant work environments. These factors are however important for 

satisfaction but they are considered as lower-order needs (Alshmemri et al., 2017). 

Individuals seek higher-level psychological needs which focus on characteristics such 

as responsibility, recognition, advancement and achievement. When one of these 

characteristics occur, the result is job satisfaction while separate characteristics result 

in dissatisfaction. Therefore, as indicated by Holmbergr Caro and Sobis (2018), 

dissatisfaction and satisfaction are two independent variables which cannot be placed 

on a continuum. They proposed that if an individual is satisfied, then they are not 

dissatisfied. 

The two-factor theory includes the motivation and hygiene aspects which 

impact the attitudes of persons towards work. The motivation factors are focused on 

individual need for growth which on the needs hierarchy can be equated to self-

actualization (Alshmemri et al., 2017). The motivation factors emanate from intrinsic 

characteristics which include achievement, recognition, the possibility for growth and 

advancement, as well as the nature of the work itself. These give rise to positive 

satisfaction. Diversely, hygiene aspects include salary, remuneration, status, and job 

security which are mainly maintenance factors and are extrinsic to work (Alshmemri et 

al., 2017). These factors result in dissatisfaction in the workplace which can have an 

effect on the psychological and mental wellbeing of the employees. 



25 
 

The two-factor theory, therefore, concentrates on the difference between 

motivation and hygiene factors which are inherent and extrinsic respectively. 

Motivational factors lead to satisfaction in the job and in their absence, job 

dissatisfaction. Conversely, poor hygiene factors result in job dissatisfaction but this 

does not mean that better hygiene factors lead to job satisfaction. The two factors do 

not operate on a continuum (Holmberg et al., 2018). 

The application of the two-factor theory has been widely used in a variety of 

organizations. In the public sector, the theory has been found to be very useful. 

According to Hur (2018), the two-factor theory is promising when applied to public 

employees. In his study, Hur found out that motivators have a positive effect on public 

managers’ satisfaction in their jobs and the satisfaction was not affected by the hygiene 

factors. This is just as projected by Herzberg. In the same vein, Alshmemri et al., (2017) 

postulate that the two-factor theory has been empirically proven to be the most effective 

need-satisfaction model in healthcare organizations. These postulations, therefore, 

provide a basis for this study to adopt the two-factor theory as it is set upon the context 

of the public sector and healthcare. 

 

Linkage to objectives 

The theory was particularly useful in this study in exploring the study’s third 

objective which is to establish the influence of social support on job satisfaction among 

the employees at NHIF in Kenya. Work relationships form a crucial part of the day to 

day operations of each worker as man is a social being and thus these relationships play 

a huge role in the psychological states of employees. 

How effective these relationships are to ensuring that one is satisfied at work 

can be assessed. The hierarchical relationship too can be understood using this theory 



26 
 

as it implies that the level of trust will be shown by the degree of job control one is 

accorded to make decisions on their own that are well respected. The top-down and 

bottom-up relationships will thus be explored in the study. 

Secondly, in regards to establishing determine the influence of psychological 

demand on job satisfaction among the employees at NHIF in Kenya, which is the prime 

objective of the study, the two-factor theory is able to substantiate that there are other 

factors outside of the rewards system that also impacts the level of job satisfaction 

individuals derive from their work.  

Lawler (1967), a proponent of this theory, was very much in agreement with the 

above sentiments, suggesting that man’s Path-goal attitudes towards what factors 

influence the rewards he receives, combined with his job satisfaction levels are key to 

understanding the employee’s motivation to perform effectively. This study attempts to 

explore these factors. 

Critics to theory 

Despite having a strong argument on the effects of extrinsic factors, the effects 

of other sources of stress that have nothing to do with work can also have similar effects 

on the job satisfaction of workers. For instance, loss and grief, domestic violence among 

others can affect the emotional aspect of an employee. These factors are not factored in 

this theory which can affect employee psychologically hence reduced job satisfaction. 

Being a work-related study in focus, looking at the effects of policy and 

operations as intrinsic factors, then the study seems to be focused on intrinsic factors 

more than the extrinsic and psychological factors when using this theory. As such it 

does only fill in one gap identified. 

Wolf (1970) further views this theory as a complicated version of understanding 

Maslow’s hierarchy of needs which basically explains what brings about the 



27 
 

psychological demands in people which in turn determine satisfaction and/or 

dissatisfaction. 

 

 

 

 

 

 

 

 

 

 

 

2.5 Conceptual Framework 

This section presents a diagrammatical illustration of study variables and the 

perceived relationship between them (Kumar, 2019). The framework is depicted in 

Figure 2.1. 

 

 

 

 

 

 

 

 

Independent Variables 

Psychological Demands 

-Job Requirements 

-Time to carry out tasks 

-Conflicting work demands 

 

Job Control 

-Opportunity to learn 

-Task Variety 

-Task autonomy  

Job Satisfaction 

-Intrinsic Satisfaction 

-Extrinsic Satisfaction 

 

Dependent Variable 

Social Support 

  



28 
 

 

 

 

 

Figure 2.1: Influence of psychosocial factors on job satisfaction  

Source: (Researcher, 2019) 

 As shown in Figure 2.1, the conceptual framework indicates that the 

independent variables predict the dependent variables. There are also moderating 

factors which aid this process. The independent variable comprised psychosocial risk 

factors which were operationalized as social support. This sought to explain the 

relationship of employees with their supervisors and their coworkers as well as their 

personal development. The psychological demands underlined the job requirements, 

time used to carry out tasks and the conflicting work demands. Job control was 

measured by seeking to understand the opportunity to learn, task variety and task 

autonomy.  

On the other hand, the dependent variable was job satisfaction which was 

measured by understanding the intrinsic and extrinsicsatisfaction of the employees. The 

moderating variables were the characteristics of the respondents whose indicators are 

age, gender, years in service, level in job undertaken and education level. Each of the 

stated measurable indicators further helped to provide animprovedcomprehension of 

the connection between psychosocial risk factors and job satisfaction. 

2.6 Research Gap 

In this section, various studies have been systematically reviewed and found 

evidence that the aspects of psychosocial risk factors and job satisfaction have received 



29 
 

much attention from scholars and researchers. For this reason, the gaps identified for 

this study go beyond methodological and contextual gaps to encompass practical 

interventions. Some studies discussed indicate reviews that are mainly theoretical and 

not empirical, therefore, there are no hard facts presented on psychosocial risk factors.  

In this vein, a practical intervention cannot be relied upon as the scientific evidence 

available are an amalgamation of other studies thus they lack robust design. 

Most of the studies on psychosocial risk factorsfocus on health outcomes. With 

a wide range of psychosocial working conditions, there is a need to understand the 

wellbeing of employees in a wholesome manner. This involves organizational 

outcomes which include characteristics such as job satisfaction; so that achievement of 

organizational goals and objectives is realized. Also, there is a need to investigate the 

psychological and emotional wellbeing of the employees in their jobs which undercut 

the understanding of job satisfaction. 

The view that psychosocial risk factors are moderators to health outcomes or 

job performance is quite evident in the reviewed literature. This provides limitations in 

understanding the causality effects of the psychosocial risk factors. There is also a lack 

of focus on different types of occupations in empirical studies on psychological risk 

factors and job satisfaction. Empirical review on public service is quite limited thus 

revealing a gap in occupational focus. This study, therefore, wanted to understand the 

influence of psychological risk factors on job satisfaction. 

2.7 Chapter Summary 

In this chapter different literature exists on the various theories hovering around 

issues of job satisfaction and the psychological needs of workers. Being human, we are 

further reliant on our relationships formation and the effects they have on us including 



30 
 

in a working environment. The two theories of the two-factor theory and the 

psychological Demands-/control support theories can complement each other and give 

the study validity. In the next chapter, we focus on the designing of the study and the 

procedural steps that guided the researcher. 

 

 

 

 

 

 

CHAPTER THREE: METHODOLOGY 

3.1 Introduction 

The research methodology adopted aimed at achieving the stipulated goals for 

the study. The chapter organization includes the designof the research, location of the 

study, population and sampling design, data collection instrument and procedure, and 

data analysis method. 

3.2 Research Design 

This study used anex-post-facto design because the phenomenon under study 

has already taken place. Kumar (2019) stated that a research design is a strategy that 

helps to shape the research study. An ex-post-factoresearch design was deemed to fit 

this study as it was able to show the cause and effect of the study variables. 

Additionally, the ex-post-facto research design focuses on empirical inquiry that is 

conducted in a systematic manner and the control over independent variables is not up 



31 
 

to the researcher as the variables have already occurred and can therefore not be 

manipulated.  

This study’s research questions were: What is the influence of psychological 

demand on job satisfaction among the employees at NHIF in Kenya? Does job control 

influence job satisfaction among the employees at NHIF in Kenya?, and Does social 

support influence job satisfaction among the employees at NHIF in Kenya? 

The use of anex-post-facto research design envisions gaining answers to the 

aforementioned research questions without any alterations to gain insights into the 

influence of the psychosocial risk factors as they had occurred. The study was 

undertaken over three months adopting a quantitative approach in which numerical data 

was collected. 

3.3 Location of the Study 

The National Hospital Insurance Fund is a government institution that was 

established in 1966 by an Act of parliament and given the mandate of providing medical 

cover to its members. During its establishment, the fund was only a department in the 

ministry of health (Moraa& Datche, 2019). Changes in the needs of people as pertains 

to healthcare services led to the Act being reviewed and amended. This led to a 

transition of the fund into a State Parastatal which sought to achieve efficiency and 

effectiveness. 

Currently, the NHIF is governed by the NHIF ACT of 1998. Its mandate is the 

provision of medical insurance both inpatient and outpatient cover to its members, their 

spouses and their children under the age of 18 years. The fund has 97 branches including 

satellite offices in the country (Moraa & Datche, 2019) which need proper coordination 

from Nairobi head office where strategic planning is done. Besides, in support of the 



32 
 

implementation of Kenya’s Big Four agenda, the government has come up with 

programs which the NHIF is tasked to foresee running as expected. These include and 

are not limited to Linda mama, Innuajamii for over seventy plus and Eduafya for all 

government secondary schools. These added tasks and expansion of its services has 

increased the psychological demand of employee affecting their psychological and 

mental wellbeing. The focus of this study was on all the employees of the National 

Hospital Insurance Fund (NHIF).The study was carried out in two regional stations, 

Nairobi and Rift valley Region this eliminated the logistical limitations of accessing the 

entire network of stations. Furthermore, the Nairobi office being the national 

headquarters gave a good measuring stick of how work policies replicated countrywide 

affect employee performance and job satisfaction.The map of the location study is 

indicated in Appendix VIII. 

3.4 Target Population 

Target population refers to all elements, individuals, subjects or entities that 

have a similar and related character which are being investigated (Quinlan et al., 2019). 

In this study, 1918 employees working at the National Hospital Insurance Fund were 

the target population. This comprised of the management, operation and support staff.  

3.5 Sampling Frame 

This is an extensive list of entities, individuals or subjects from which a sample is taken. 

In this regard, all the 1918 employees working at NHIF are as illustrated in Table 3.1. 

Table 3.1: Sampling Frame 

NHIF Staff Level            Number of Employees 

Management 148 

Operation 1528 



33 
 

Support Staff 242 

Total 1918 

 

3.6 Sampling Size Determination 

Sampling ensures that the respondents that are chosen are representative of the 

total population (Quinlan et al., 2019). This study’s target population was all the NHIF 

employees. The sample size was achieved through the Yamane’s 1967 Formula which 

is used in a finite population as below: 

                                        n = N/ [1+N (e2)] 

Where N is the population, n is the sample size and e is the level of precision or the 

error margin (0.05) 

Applying the formula:  

                                     n = 1918/ [1+1918(0.052)] 

 𝑛𝑛 = 330 

Therefore, a sample size of 330 respondents was used for this study. 

3.7 Sampling Technique 

Sampling technique is the procedure used to gain the sampled respondents from 

the sampling frame. In respect to this, the current study will focus on a probability 

sampling in which stratified random sampling will be used. According to Kumar 

(2019), stratified random sampling is used as it is fair and allows the respondents an 

equal possibility of participation in the study. At the NHIF, staff members vary across 

management levels.  To ensure a finite population, the respondents were divided into 



34 
 

homogenous groups placed in three strata which take in the management staff, the 

support staff,andthe operational staff. 

The strata were divided into a finite population according to the formula provided by 

Pedhazur and Schmelkins in 1991 which is as follows 

r= (c × s)/ p 

Where r is the number ofrespondentsgotten from a stratum  

c is the population’sstratum(category)  

s is the desired size (330) 

p is the total population (1918) 

From the formula, the strata size was as indicated in Table 3.2 

Table 3.2: Distribution of Sample Size 

Strata 
Stratum Population Size 

(r= (c × s)/ p) 
Sample Size 

Management Staff 148 26 

Operational Staff 1528 262 

Support Staff 242 42 

Total 1918 330 

 

3.8 Research Instruments 

Research instruments are tools used to facilitate the collection of data in any 

given study (Quinlan et al., 2019). Every researcher should ensure that the instrument 

used answers the research questions to realize the goal of the study. For this study, a 



35 
 

questionnaire gathered primary data from the respondents. The questionnaire was 

structured and self-administered. First, the demographic characteristics of the 

respondents which include gender, length of service in the organization, level of 

education and level of staff management were assessed.  

3.8.1 Demand-Control-Support Questionnaire 

The study assessed the psychosocial risk using the DCS questionnaire which is 

based on the DCS model by Karasek and Theorell and was developed in 1990 (Mauss 

et al., 2018). The DCS questionnaire has been widely used in understanding the 

psychosocial risk factors in organizations. In the questionnaire, 17 items were 

presenting the three variables which were expressed as a statement in which through a 

Likert scale with fivepoints, the levels of agreement or disagreement were given by the 

respondents.  

This study made use of a DCS questionnaire in which the items already exist 

and have been validated in several languages such as Swedish, German, Finnish and 

English (Mauss et al., 2018). In this study, it could not be established by the researcher 

the use of the DCS questionnaire in researches in Kenya. Therefore, construct validity 

was used to ensure that the instrument captures the concepts as theorized.  

3.8.2 Warr-Cook-Wall Questionnaire 

The dependent variable, job satisfaction, was measured through the use of the 

Warr-Cook-Wall (WCW) job satisfaction questionnaire scale. The instrument was 

established in 1979 by Warr, Cook and Wall and was chosen for this study as it is used 

in association with the psychological wellbeing of individuals (Goetz et al., 2013).  

The reason for choosing this questionnaire is that it is an efficient attitude 

survey, especially when used together with scales such as the Likert scale. Likert (1961) 



36 
 

pointed out that attitude surveys were an important tool for the assessment of the human 

resource of an organization believing that looking at just the effects of an action on one 

type of organizational activity while ignoring the impacts on job satisfaction of 

employees can be a costly type of myopia, 

This scale was a five-point Likert scale with ten. This ensured the objectives of 

the study were achieved. The scale items were scored from very dissatisfied to very 

satisfied. 

The WCW questionnaire has been validated in different countries such as 

Europe, Australia, Asia and the United State of America. In Kenya, the WCW was 

validated by Goetz et al. (2013) who used it in a study on healthcare staff in Kenya. 

This current study also sought to validate the instrument using construct validity. 

Simple language for the statements was therein used for the respondents to fully 

understand the content. 

The study also employed the use of secondary data from the organization’s 

document repository to gain additional information to help in the achievement of the 

study’s objectives. 

3.9 Validity and Reliability 

Sekaran and Bougie (2016) define validity as the magnitude to which a tool of 

research measures the right thing as it ought to measure. They also say that validity is 

determined judgmentally and can be achieved through a panel of people who critic the 

standards of the instrument. In this study, construct validity was observed by having the 

instrument reviewed by the researcher’s supervisors. Their recommendations were used 

to review the instrument. 

Reliability of an instrument mirrors its stability and consistency without bias 

within any given context. Over time, the consistency of the instrument shows the same 



37 
 

results when the trials are repeated(Kumar, 2019). Both the DCS and WCW 

questionnaires have been established as reliable in previous studies conducted (Goetz 

et al., 2013; Mauss et al., 2018). In the context of this present study, internal consistency 

reliability was tested through a pretest which was conducted at NHIF Nyeri Central 

Region from which 10 randomly selected employees were used. The choice of Central 

Region was to ensure that there was no contamination of the responses and data 

provided that may be as a result of using the respondents from the other branches even 

though they may not have participated in the final actual study. 

To this end, Cronbach’s Alpha was used to independently measure a similar 

concept and the answers were correlated with one another. This was established through 

the use of the Cronbach’s alpha coefficient which was achieved when the researcher 

entered some of the items on the answered questionnaires from the pilot study in the 

Statistical Package for Social Scientists (SPSS) computer software. The overall 

Cronbach Alpha Coefficient value for this study was 0.769. When the alpha coefficient 

value is equal to or greater than 0.5, then the questionnaire is reliable (Quinlan et al., 

2019). Therefore, the questionnaire was deemed reliable. 

3.10 Data Collection Procedures 

To carry out the study, permission and authority was sought from the Tangaza 

University College Research EthicsCommittee (TUCREC). A research permit for data 

collection was also sought from the National Commission of Science, Technology and 

Innovation (NACOSTI), the County Commissioner and the County Director of 

Education. After gaining the permits, the researcher then proceeded to the management 

of NHIF to seek permission to carry out the study. When a go-ahead was provided, the 

researcher sampled the respondents then selected those to participate in the study after 

which consent was sought to administer the questionnaire.  Due to the differences in 



38 
 

distance, the researcher used emails and drop and pick method in which the 

questionnaires were collected after one week to give the respondents ample time to 

answer the questionnaire. The researcher thereby followed up through telephone calls 

to ensure that the respondents filled in the questionnaires before they were picked.  

3.11 Data Analysis 

The collected data was first screened through to ensure that the questionnaires 

were duly filled according to the instructions provided. This helped in minimizing any 

outliers and removal of questionnaires that are not properly answered. Descriptive and 

inferential analyses were steered using the Statistical Package for Social Sciences 

(SPSS) Version 24. Descriptive statistics were analyzed using percentages and 

frequencies. Inferential Statistics were analyzed using multiple linear regression to 

determine the relationship between the dependent (job satisfaction) and independent 

variables (psychological demands, control and social support). The following 

regression model was employed; 

Y = b0 + b1x1 + b2x2 + b3x3+ b3x3+ε  

Where: Y = Job Satisfaction 

x1= Psychological demands 

x2 = Job Control 

x3 = Social support 

ε = Error term 

b0 = Constant Term;  

b1, b2, andb3 = Beta coefficients 



39 
 

3.12 Ethical Considerations 

The researcher made sure that the ethical, legal and professional research 

standards are applied in carrying out the proposed study. For this reason, the 

participation in the study for the respondents was voluntary and if one did not want to 

continue with the study at any one point, they were free to pull out. There was no 

coercion for the respondents to participate in the study. 

 The respondents were also guaranteed that the information that they provided 

would be confidential. This was assured by telling the respondents not reveal their 

identity on the questionnaire, for example by writing their names, to safeguard the 

responses by making them anonymous thus upholding confidentiality. After data 

collection, a debriefing was done on the respondents to ensure that no physical, 

emotional or psychological harm came to the respondents as a result of participating in 

the study. 

3.13 Debriefing 

Upon completion of the study, the participants were handed a debriefing form 

(See Appendix V), as well, the researcher discussed with them the study’s aim, its 

questions and the aims of conducting the study. The debriefing was done after the data 

had been collected and involved a Question and Answer session to inform as well as 

deal with any queries that arose from the respondents. 

3.14 Chapter Summary 

The procedural aspects being in line, we canview how the study was conducted 

in-line with recommended practice. Further, we canunderstand as to what reason, the 

study was designed as ex-post-facto research as opposed to other quantitative means of 



40 
 

carrying out research. With all boxes checked the submission of this report should give 

leeway for collection, analysis and interpretation of findings. 

 

 

 

 

 

 

 

CHAPTER FOUR: RESULTS 

4.1 Introduction 

Presented in this chapter are the analysis, findings of the data and results. The 

data was entirely gathered utilizinga structured questionnaire which was answered by 

selected employees from the National Hospital Insurance Fund (NHIF). The study 

aimed to assess the influence of psychosocial risk factors on job satisfaction among the 

employees at the National Hospital Insurance Fund (NHIF) in Kenya.  

4.2 Response Rate 

The researcher gave out 330 questionnaires and 302 questionnaires were 

returned. During the process of cleaning and coding data, it was found out that one 

questionnaire was unduly completed. These findings are as recorded in Table 4.1. 

Table 4.1: Response Rate 

Category Frequency Per cent 



41 
 

Fully filled and returned 302 91.5 

Incomplete or unreturned 1 8.5 
Total 301 100.0 

 

As indicated in Table 4.1, only 301 questionnaires were used for this study, 

contributing to 91.5% (n=301) response rate. As asserted by Mugenda & Mugenda 

(2012) a response rate that is more than 50% is ideal to make generalizations for a study. 

In this case, a 91.5% response rate was deemed to be adequate to make generalizations 

based on the findings of this study. 

4.3 Socio-Demographic Information of Respondents 

The socio-demographic questionnaire used presented the gender of the 

respondents, years in the organization, the highest level of education and the 

respondents’ work level in the organization. 

4.3.1 Gender of Respondents 

The gender distribution was tabulated and the findings were indicated in Table 

4.2  

Table 4.2: Gender distribution of Respondents 

Gender Frequency Percent 

Male 159 52.8 

Female 142 47.2 
Total 301 100.0 

  

As indicated in Table 4.2, 52.8% (n=159) of the respondents were males while 

47.2% (n=142)were female. There is a show of marginal discrepancy in the distribution 

of respondents. For this study, the low gender disparity was an indication that the 



42 
 

responses that were provided considered the male and female perspectives; thereby 

providing a balance in the points of view based on the gender of the respondents. 

4.3.2 Years worked in the Organization 

The number of years worked by the respondents in the organization is recorded 

in Table 4.3.  

Table 4.3: Years worked in the Organization 

Number of Years Frequency Per cent 

3 years and Below 38 12.6 
4-7 Years 104 34.6 
8-11 Years 43 14.3 
12 Years and Above 116 38.5 
Total 301 100.0 

The results on Table 4.3 show that 38.5% (n=116) of the respondents had 

worked in the organization for 12 years or more, 34.6% (n=104)had worked for 4-7 

years, 14.3% (n=43)had worked for 8-11 years, and 12.6% (n=38)of the respondents 

had worked for 3 years or belowin the organization. These findings show that most of 

the respondents had worked in the organization for more than ten years. As such, they 

were conversant with the operations of the organization. Further, these findings are an 

indication that the respondents had a good comprehension of the psychosocial risk 

factors and job satisfaction in the organization. 

4.3.3 Highest Level of Education Attained 

The results on the highest level of education that the respondents had completed 

are indicated in Table 4.4.  

Table 4.4: Highest Level of Education Attained 

Level of Education Frequency Per cent 

College Diploma 142 47.2 



43 
 

Undergraduate Degree 139 46.2 

Master’s Degree 19 6.3 

PhD 1 .3 

Total 301 100.0 

 

As recorded in Table 4.4, 47.2% (n=142)of the respondents had attained college 

diplomas, 46.2% (n=139)had attained undergraduate degrees, and 6.3% (n=19)had 

attained a Master’s degree, while 0.3% (n=1)of the respondents had a PhD. For this 

study, the level of education was important as it was aimed to measure literacy and 

being that all the respondents had attained at least a college diploma meant that they 

were able to understand and provide responses as required for the study. The education 

aspect was also important as the respondents had to fill in the questionnaires by 

themselves.   

4.3.4 Level of Work 

The results on the level of work that the respondents work in are indicated in 

Table 4.5.  

Table 4.5: Work Level 

Management Level Frequency Per cent 

Management Staff 24 8.0 

Operational Staff 236 78.4 

Support Staff 41 13.6 

Total 301 100.0 

 

As indicated in Table 4.5, most of the respondents (78.4%; n=236) were 

operational staff, 13.6% (n=41)of the staff were support staff, while 8.0% (n=24) of the 



44 
 

respondents were management staff. This shows that majority of the respondents were 

operational staff and this is important for this study as this category of employees is 

mainly focused on the operations of the organization and are likely to face different 

aspects of psychosocial risk factors. 

4.4 Psychosocial Risk Factors 

In order to measure the psychosocial risk factors, a demand-control-support 

questionnaire as designed by Karasek and Theorell (1990) was used. The results are 

presented in the subsequent subsections.  

4.4.1 Psychological Demands 

The study’sfirst objective was to determine the influence of psychological 

demand on job satisfaction among the employees at NHIF in Kenya.  Descriptive 

statistics were conducted using percentages and the findings are recorded in Table 4.6.  

Table 4.6: Psychological Demands 

Psychological 

Demands 

Strongly 

Disagree 

Disagree Neutral Agree Strongly 

Agree 

Total 

My job requires me 

to work very fast 

10.3% 12.3% 18.6% 19.3% 39.5% 100% 

The work I do is 

quite intense 

11.6% 2.3% 24.3% 38.5% 23.3% 100% 

The work I do 

requires a lot of 

effort 

6.6% 12.0% 20.6% 24.9% 35.9% 100% 



45 
 

I have sufficient 

time to perform all 

my work tasks 

5.0% 10.6% 27.2% 40.5% 16.6% 100% 

There are 

conflicting 

demands that often 

occur in my work 

9.6% 5.6% 35.5% 34.6% 14.6% 100% 

 

As indicated in Table 4.6, 39.5% strongly agreed that their jobs required them 

to work fast and only 10.3% strongly disagreed. Additionally, 38.5% of the respondents 

agreed that their work was quite intense and only 2.3% disagreed with the statement. 

On whether their work required a lot of effort, 35.9% strongly agreed while 6.6% 

strongly disagreed with the statement. Also, 40.5%agreed that they had sufficient time 

to perform all their work tasks and only 5.0% strongly disagreed. On whether there are 

demands that are conflicting occurring in their work, 35.5%were neutral while 5.6% 

disagreed on this statement. 

The researcher thereafter sought to understand the degree of psychological 

demands on the employees at NHIF Kenya. Through a dummy variable created by 

adding the items under psychological demand in the questionnaire, the degree of 

psychological demands was analyzed and recorded in Table 4.7. The degree of 

psychological demand was determined as either low, moderate or high. The findings 

show that there is a high degree of psychological demand (55.5%). 

Table 4.7: Degree of Psychological Demand 



46 
 

Degree of Psychological 

Demand 

Frequency Percent 

Low 56 18.6 

Moderate 78 25.9 

High 167 55.5 

Total 301 100.0 

 

4.4.2 Job Control 

This study’s second objective was to define the influence of job control on job 

satisfaction among the employees at NHIF in Kenya.  Descriptive statistics were 

conducted using percentages and the findings are recorded in Table 4.8.  

 

 

Table 4.8: Job Control 

Job Control  Strongly 
Disagree 

Disagree Undecided Agree Strongly 
Agree 

Total 

I have an 
opportunity to 
learn new things 
at work 

7.0% 7.3% 13.6% 32.2% 39.9% 100% 

My work requires 
a high skill level 

0% 17.3% 22.6% 38.2% 21.9% 100% 

My job requires 
creativity 

4.0% 3.7% 27.6% 41.9% 22.9% 100% 

My job requires 
doing the same 
tasks over and 
over again 

5.0% 11.0% 27.2% 22.6% 34.2% 100% 



47 
 

I have the 
freedom to decide 
for myself how to 
carry out my 
work 

19.3% 15.6% 9.6% 19.6% 35.9% 100% 

I have the 
freedom to decide 
for myself what 
should be done in 
my work 

19.3% 11.3% 15.0% 36.2% 18.3% 100% 

 

As indicated in Table 4.8, there was a 39.9% agreement that the respondents 

had an opportunity to learn new things at work while 7.0% strongly disagreed. Also, 

38.2% of the respondents agreed that their work requires a high skill level and 17.3% 

disagreed on this statement. On job creativity, 4.0% of the respondents disagreed that 

their job requires creativity however, 41.9% agreed that their job requires creativity. 

Most of the respondents (34.2%) strongly agreed that their job requires doing the same 

tasks over and over again while only 5.0% strongly disagreed.  

On freedom at work, 35.9% of the respondents stated that they have the freedom 

to decide for themselves how to carry out the work required of them while 9.6% were 

neutral on this statement. On the other hand, the respondents were also asked whether 

they had the freedom to decide for themselves what should be done in their work, and 

36.2% agreed while 11.3% disagreed.  

The researcher thereafter sought to understand the degree of job control on the 

employees at NHIF Kenya. A dummy variable which was as a result of the sum of the 

items under the job control variable in the questionnaire was created. The degree of job 

control was analyzed, determined as either low, moderate or high, and recorded in Table 

4.9. The degree of job control was found to be moderate. 



48 
 

Table 4.9: Degree of Job Control 

Degree of job control  Frequency Percent 

Low 76 25.2 

Moderate 137 45.5 

High 88 29.2 

Total 301 100.0 

4.4.3 Social Support 

The study’sfinal objective was to establish the influence of social support on job 

satisfaction among the employees at NHIF in Kenya.  Descriptive statistics were 

conducted using percentages and the findings are recorded Table 4.10.  

 

 

 

Table 4.10: Social Support 

Social Support Strongly 

Disagree 

Disagree Undecided Agree Strongly 

Agree 

Total 

There is a 

pleasant 

atmosphere at my 

place of work 

19.9% 4.3% 21.3% 29.2% 25.2% 100% 

There is a spirit of 

unity among the 

colleagues 

5.0% 2.7% 31.2% 40.2% 20.9% 100% 



49 
 

I receive support 

from colleagues 

7.3% 1.3% 32.6% 33.9% 24.9% 100% 

My colleagues 

are helpful in 

helping me 

perform my work 

duties 

6.0% 5.3% 18.9% 45.8% 23.9% 100% 

I get along well 

with my superiors 

10.3% 1.3% 19.3% 35.5% 33.6% 100% 

I get along well 

with colleagues 

5.0% 2.3% 26.2% 39.2% 27.2% 100% 

 

The results as shownin Table 4.10 indicate that 29.2% of the respondents agreed 

that there is a pleasant atmosphere at their place of work while 4.3% disagreed. Also, 

40.2% agreed that there is a spirit of unity among the colleagues while 2.7% of the 

respondents disagreed. Additionally, 33.9% of the respondents agreed that they 

received support from their colleagues while 1.3% disagreed. The results also indicate 

that 45.8% of the respondents agreed that their colleagues help them perform their 

duties but 5.3% of the respondents disagreed.  

On getting along at the workplace, 35.5% of the respondents agreed that they 

get along well with their superiors while 1.3% indicated that they did not get along well 

with their superiors. On the other hand, well over 39.2% of the respondents positively 

indicated that they get along well with their colleagues while about 5.0 % had a negative 

outlook on getting along with their colleagues, and 26.2% were neutral on getting along 

with their colleagues. 



50 
 

The researcher thereafter sought to understand the degree of job control on the 

employees at NHIF Kenya. A dummy variable which was as a result of the sum of the 

items under the social support variable in the questionnaire was created. The degree of 

social support was analyzed, determined as either low, moderate or high, and recorded 

in Table 4.11. The degree of job control was found to be moderate. 

Table 4.11: Level of Social Support 

Level of Social Support   Frequency Percent 

Low 42 14.0 

Moderate 88 29.2 

High 171 56.8 

Total 301 100.0 

 

. 

4.5 Job Satisfaction 

This study’s dependent variable was job satisfaction which was measured using the 

Warr-Cook-Wall (WCW) Job Satisfaction Questionnaire Scale. Descriptive statistics 

were conducted using percentages and the findings are recorded Table 4.12. 

Table 4.12: Job Satisfaction 

Job Satisfaction Very 
Dissatisfied 

Dissatisfied Neutral Satisfied Very 
Satisfied  

Total 

Freedom to choose 
my own method of 
working 

13.0% 17.9% 14.3% 19.9% 34.9% 100% 

The amount of 
variety in my work 

7.3% 29.6% 14.3% 37.2% 11.6% 100% 



51 
 

The physical 
working conditions 

13.0% 9.6% 24.3% 38.5% 14.6% 100% 

The opportunities 
provided to use my 
abilities 

10.3% 20.6% 10.0% 45.5% 13.6% 100% 

My colleagues and 
fellow workers 

3.3% 10.3% 16.9% 57.5% 12.0% 100% 

The recognition I 
get for good work 

15.0% 12.0% 21.3% 31.2% 20.6% 100% 

The hours I work in 
the organization 

1.3% 10.3% 27.2% 39.9% 21.3% 100% 

My remuneration 25.2% 7.6% 23.3% 29.9% 14.0% 100% 

The amount of 
responsibility that I 
am given at work 

6.6% 13.3% 30.2% 37.2% 12.6% 100% 

How do you feel 
about your work? 

15.3% 8.6% 30.2% 37.5% 8.3% 100% 

  

As shown in Table 4.12, 34.9% of the respondents said that they were satisfied 

with the freedom to choose their own method of working while 13.0% were very 

dissatisfied. The respondents, 37.2%, said that they satisfied with the variety in their 

work while 7.3% were very dissatisfied. There was also an indication of satisfactio