The Independent Associations of Professional Autonomy, the Work Environment, and Role Ambiguity with Job Satisfaction...

Background/Objectives: Korean hospitals have deployed nurses in physician-support roles since 1997, and more so since the physicians' collective action in 2024, yet the role lacked a clear legal definition until the Nursing Act and its enforcement rule provided one. This study asked which of professional autonomy, the work environment, and role ambiguity remains independently associated with job satisfaction when the three are considered together. Methods: A total of 130 nurses in these roles at two Korean university hospitals completed a cross-sectional survey in July-August 2025, before that rule took effect, using Korean versions of the Dempster Practice Behaviors Scale, Nurse Practitioner Primary Care Organizational Climate Questionnaire, Role Ambiguity Scale, and Job Satisfaction Scale for Clinical Nurses. Results: Means were 3.40/5 (professional autonomy), 2.61/4 (work environment), 2.98/5 (role ambiguity), and 3.56/5 (job satisfaction), and the first three correlated with job satisfaction (r = 0.67, 0.67, and -0.51; all p < 0.001). Adjusted for six covariates, professional autonomy (β = 0.42) and the work environment (β = 0.37; both p < 0.001) remained independently associated with job satisfaction, explaining 55.6% of the variance, whereas role ambiguity did not (β = -0.11, p = 0.135). Conclusions: Professional autonomy and the work environment were the constructs independently associated with job satisfaction once the three were considered together. Attention should therefore focus on the institutional conditions that widen these nurses' discretion over their own work and on their relationships with administrators, the lowest-scoring domain of the work environment. Longitudinal research is required to establish whether these associations are causal.