Intention to leave profession, psychosocial environment and self-rated health among registered nurses from large hospitals in Brazil: a cross-sectional study

Factors Determining Work Arduousness Levels among Nurses: Using the Example of Surgical, Medical Treatment, and Emergency Wards

Introduction

Staff shortages among nurses have been severely felt in most countries around the world for many years. In Poland, this problem is particularly visible due to the lowest nursing employment rate per 1000 inhabitants among 28 EU states and the high rate of leaving the profession. The average age of Polish nurses has been constantly growing for several years—in 2016 it was 50.79, while in 2008 it was 44.19. These data confirm that young nurses are the first to leave the profession. Diagnosis of the working conditions and psychosocial burden level among nurses should be subject to detailed analysis, so that leaving the profession will not additionally deepen the difficult staffing situation in health care.

Aim

The aim of the study was to identify factors affecting the assessment of work arduousness levels among nursing personnel.

Materials and Methods

The study was conducted among 573 nurses working on surgical, medical treatment, and emergency wards. A standardized job evaluation questionnaire was used to conduct the survey.

Results

(1) Stress levels depended on the ward in which the surveyed person worked. Nurses working in the emergency ward assessed their conditions the best, with the lowest stress. The average general result in this group was 38.1 points versus 46 and 45.7 points in the surgical and medical treatment wards, respectively. (2) At the level of the whole studied group, both the nurses' age and work experience did not differ statistically significantly in the total assessment of working conditions. Differences in the assessment of work arduousness in different age categories occurred at the level of individual wards. In the surgical ward, younger employees were characterized by higher stress levels, especially in the area of arduousness (p=0.0165). In the medical treatment wards, there was a similar age-to-stress ratio for the area of organizational uncertainty (p=0.0063). With age, employees of the emergency ward became more indifferent to stress related to unpleasant working conditions (p=0.0009), while stress related to organizational uncertainty increased (p=0.0495). (3) Nurses working in managerial positions assessed the overall stress related to their job higher than other nurses. They were particularly at risk for burdens related to haste, responsibility, and organizational uncertainty. The average overall assessment of work arduousness for this group was 44.6 points, while for surgical nurses it was 37.2 points. Correlations between the performed function and stress levels were found for almost all of the studied work characteristics (except for hazards). (4) Education had a statistically significant impact on the perception of working conditions in several dimensions. The people with the lowest education evaluated working conditions the best. The difference between people with a higher and those with a secondary education with a specialization was definitely smaller and often nonexistent. Education differentiated the work arduousness assessment depending on the ward. The most statistically significant correlations were obtained in surgical wards, and the least in medical treatment wards.

Conclusions

(1) The study results indicate the need to diagnose problems related to work conditions in the context of occupational stress within individual hospital wards. To limit employee turnover, nursing staff managers should approach the issue of improving working conditions individually for each ward, due to differences in the nature of the work and level of stressogenicity. (2) In each hospital ward, employees at different stages of their career are sensitive to the psychosocial burden resulting from different work characteristics. These areas should be thoroughly diagnosed and the burden minimized to prevent departures from the profession—at early stages of the professional career as well as among experienced personnel. (3) Nurses working in managerial positions should receive the necessary substantive support, due to the higher stress burden associated with greater responsibility.

Predictors of nursing workers' intention to leave the work unit, health institution and profession

OBJECTIVE

to identify the factors related to the nursing workers' intention to leave the work unit, health institution and profession.

METHOD

cross-sectional study with quantitative approach was carried out with 267 nursing workers from seven emergency units in Brazil. For data collection, we used the Questionnaire of socio-demographic, life style and work and health aspects as well as the Work Ability Index, Workplace violence questionnaire, questions about intention to leave and the Turnover Intention Scale. The predictors of intentions to leave were evaluated through Poisson regression models.

RESULTS

workplace violence increased and better satisfaction with current job decreased the probability of greater intention to leave the unit, institution and profession. Better work ability decreased the probability of greater intention to leave the unit and profession. The more qualified workers and those who had been working in the institution longer was more likely to greater intention to leave the profession.

CONCLUSION

promoting job satisfaction, work ability and a violence-free environment is possible to decrease the workers' intention to leave the job or profession, but nursing managers need to understand the three phenomena of intention to quit individually for retention strategies.

Prevalence of bullying in the nursing workplace and determinant factors: a nationwide cross-sectional Polish study survey

OBJECTIVES

In the present study, we aimed to investigate the prevalence of bullying among Polish nurses, and to identify the most common negative acts, as well as individual and work-related risk factors for workplace bullying.

METHODS

Cross-sectional study designed using an online survey. The total study sample was 404 nurses, each having over 6 months of working experience. Data were collected using the Polish version of the Negative Act Questionnaire-Revised. Linear stepwise regression analysis and logistic regression analysis were performed to assess predictors of greater reporting of perceived workplace bullying RESULTS: Bullying was experienced by 65.84% of participants. Perceived workplace bullying was associated with sex (p=0.043), age (p=0.003), seniority (p=0.006), number of working hours per week (p=0.010) and position (p=0.029). Logistic regression analysis with the dependent variable of bullying according to Leymann's rigorous criteria revealed that the model could include four variables: age from 50 to 59, seniority of 11-15 years,>45 working hours per week and a bachelor's degree in nursing.

CONCLUSIONS

An alarming percentage of nurses were victims of bullying. Among all variables included in the regression model, the most significant predictors of perceived workplace bullying were age, seniority, work overtime and bachelor's degree education. Bullying prevention and improvement of well-being at work must be addressed as part of an overall strategy to deal with turnover.

Job satisfaction and associated factors among psychiatric nurses in tertiary psychiatric hospitals: Results from a nationwide cross-sectional study

AIMS

To investigate the job satisfaction among psychiatric nurses in China and to explore its associated factors.

DESIGN

A cross-sectional survey among a nationwide sample from 32 tertiary psychiatric hospitals in 29 provincial capitals in China.

METHODS

Nurses (N = 9.907) were targeted for this survey in December 2017. In all, 8,493 responded (response rate = 85.7%) and 7,881 (79.5%) were included in the analysis. An online questionnaire was used to collect demographics and factors related to the work environment. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Multilevel regression was used to examine the association between job satisfaction and these factors.

RESULTS

The mean job satisfaction score was 73.7. The multiple regression analysis indicated that self-rated health, monthly income, medical liability insurance coverage, perceived respect from patients, social recognition, nurse-physician collaboration, and trust were significantly associated with higher job satisfaction scores, while age, work hours, and directly experiencing patient-initiated violence were negatively associated with job satisfaction (p < .05).

CONCLUSION

Overall, Chinese psychiatric nurses are closer to satisfied than neutral and some demographics and factors related to stressful work environments were associated with nurses' job satisfaction scores.

IMPACT

This study examined factors associated with the job satisfaction of Chinese psychiatric nurses in a nationwide sample and indicated that to improve nurses' job satisfaction, the government and hospital administrators could consider ways to promote nurses' personal health and to modify the stressful work environments, such as improving income, reducing work hours, promoting the psychiatric nursing specialty in ways that increase the public's respect for it, increasing awareness of medical liability insurance coverage, and protecting nurses from patients' violence.

Intention to Leave the Nursing Profession and Its Relation with Work Climate and Demographic Characteristics

BACKGROUND

Because of the importance of staff shortage in health systems, considering the intention to leave the job and its related factors among nurses is very important. The aim of this study was to identify the association between the intention to leave the nursing profession and work climate and demographic characteristics.

MATERIALS AND METHODS

A cross-sectional survey was conducted among 206 nurses, by random sampling method from six hospitals (response rate = 92%). A set of self-administered questionnaires were applied for the evaluation of intention to leave and work climate.

RESULTS

The high level of intention to leave the profession was expressed by 23.70% of the participants; 25.10% of the participants had the moderate intention. Data analysis revealed that work climate, type of employment, marital status, and overtime working were significant predictors of nurses' intention to leave after controlling other independent variables (R2 = 0.10, p < 0.001).

CONCLUSIONS

It was found that work climate and some demographic characteristics can be seen as indicators for intention to leave among nurses; therefore, considering the so-called variables is required. Further studies are needed to identify other aspects of the issue.

Magnitude of Intention to Leave and Associated Factors among Health Workers Working at Primary Hospitals of North Gondar Zone, Northwest Ethiopia: Mixed Methods

Background

Human resource is the most crucial resources for the survival of an organization. Intention to leave is an employee's plan to leave their current job in the near future and is used as a proxy indicator for measuring turnover in cross-sectional surveys. In developing countries human resource shortages are not only due to production of health professionals but also because of employee turnover and instability at health facilities.

Objective

This study aimed to assess the magnitude of intention to leave and associated factors among health workers working at primary hospitals of North Gondar Zone, Northwest Ethiopia.

Methods

Institution based cross-sectional mixed methods' (both quantitative and qualitative) study design was conducted among health workers working at primary hospitals of North Gondar zone. Self-administered standardized structured questionnaires for quantitative and interview guide for qualitative were used for data collection. Variables having p-value less than 0.2 during bivariable analysis were entered into multivariable logistic regression model. Thematic analysis was done for qualitative data analysis.

Results

A total of 382 health workers were participated in the study with a response rate of 93.6%. Overall, 67.8% of them were intended to leave their current organization. Age of participants, 20-29 years (AOR=3.96; 95%CI: 1.04, 15.07), living out of family (AOR= 1.73; 95% CI: 1.23, 3.02), opportunity of other job (AOR= 2.04; 95% CI: 1.21, 3.45), performance appraisal system (AOR= 2.97; 95%CI: 1.64, 5.36), and affective commitment (AOR= 3.12; 95% CI: 1.64, 5.92) were the factors affecting health workers intention to leave current organization.

Conclusion

overall, magnitude of health workers intention to leave their current organization was high. Therefore, healthcare managers, supervisors, and policymakers need to develop and implement retention strategies that aim to improve the retaining of healthcare workers at their working organization such as unifying healthcare providers who are living separately with their families, use evidence-based performance evaluation mechanism, and make efforts to develop a sense of ownership in the health workers, which will reduce health professional's intention to leave their organization.

Health indicators as moderators of occupational commitment and nurses' intention to leave

AIM

This study examined the hypothesis that health indicators moderate the relationship between occupational commitment and intention to leave among nurses, using a large sample in Japan.

METHODS

A self-administered questionnaire was distributed to all registered nurses (N = 11,171) working in group hospitals in western Japan in 2014. The questionnaire evaluated intention to leave, occupational commitment, psychological distress, cumulative fatigue, and demographic variables. After a preliminary analysis of the bivariate and multivariate associations between variables and intention to leave, we tested the interactions between occupational commitment and health indicators on intention to leave.

RESULTS

Of the 5,768 returned questionnaires, data from 5,505 (49.3%) participants were analyzed. Participants' mean age was 36.27 years (SD = 10.37). Most (95.14%) were women. According to a generalized estimating equation, the interaction of continuance occupational commitment and cumulative fatigue was significantly related to intention to leave (b = -0.0055). Additionally, the interaction of affective occupational commitment and psychological distress was significantly related to intention to leave (b = 0.0079).

CONCLUSIONS

This study clarified that the relationship between occupational commitment and intention to leave was robust for nurses in good health. Interventions aimed at reducing fatigue and improving psychological distress should be implemented to prevent the protective effects of occupational commitment on nurses' intention to leave from being compromised.

A Multigroup Analysis of the Effect of Cognitive Appraisal on Nurses' Psychological Distress

BACKGROUND

Cognitive appraisal constitutes an important mechanism in the process of human adaptation to work environment and occupational stress. In this domain, nursing professionals are one of the occupational groups most affected by job stress, suffering high levels of psychological distress.

OBJECTIVES

The aims of this study were to analyze the moderator effect of shift work and the type of job contract on the relationship between work cognitive appraisal and nurses' psychological distress and to explore the interaction effect of the two moderator variables on that relationship.

METHODS

A sample comprised of 2,310 Portuguese registered nurses completed a sociodemographic and professional questionnaire: the Primary and Secondary Cognitive Appraisal Scale and the General Health Questionnaire-12. Data were analyzed through structural equation modeling and multigroup analyses considering the following groups: (a) "shift" versus "nonshift work"; (b) "precarious job contract" versus "nonprecarious job contract"; and (c) "shift and precarious" versus "shift and nonprecarious" versus "nonshift and precarious" versus "nonshift and nonprecarious."

RESULTS

Data confirmed the invariance for the measurement model, but the structural model presented a significantly worse adjustment for all grouping variables, showing the moderator effect of shift work and job contract and of their interaction. Difference tests in structural path coefficients revealed that shift work moderated the relationship between challenge perception and psychological distress-which was stronger for shift work nurses-and that a higher threat perception was related to greater psychological distress, especially in nurses with a precarious job contract. Among the four categories of interaction between job contract and shift work, cognitive appraisal became central in predicting nurses' mental health, explaining more variance in the group that did shift work and had a nonprecarious job contract.

DISCUSSION

The study results highlight the need to develop occupational health intervention programs to promote nurses' mental health, focusing on reducing work perception as a threat and on making nurses' jobs more challenging and controllable.

The Intermediary Role of Burnout in the Relationship Between Self-Compassion and Job Satisfaction Among Nurses

Background

Self-compassion is the process of treating oneself kindly especially when suffering. Self-compassion is associated with decreased symptoms of burnout in nurses such that those high in self-compassion are less likely to report emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment.

Objectives

The purpose of this study was to examine the relationships among self-compassion, burnout, job satisfaction, and sleep quality. Method and Participants: Recruited from MTurk, a final sample of 158 nurses living in the United States (57.6% female) completed indices of self-compassion, burnout, and outcomes of satisfaction and sleep via an online survey.

Results

Self-compassion was positively associated with satisfaction and sleep quality and negatively associated with burnout. In addition, increased burnout was associated with lower satisfaction and poorer sleep quality. Mediational models suggested that the relationships between self-compassion and outcomes were accounted for by the shared variance between self-compassion and burnout.

Conclusions

The results showed the predicted associations among self-compassion, burnout, and outcomes. Importantly, self-compassion was associated with lower burnout that, in turn, was associated with higher job satisfaction and better sleep. Despite the limitations of the study, these results add to the growing literature on the benefits of self-compassion for nurses for preventing and/or ameliorating symptoms of burnout.

Push and pull factors of nurses' intention to leave

AIM

To expand knowledge about the predictive factors of nurses' intention to leave their job and consequently to turnover.

BACKGROUND

Nurse turnover is costly and negatively influences quality of care. Understanding the association between intention to leave and modifiable features of hospital organisation may inform strategies to reduce turnover.

METHODS

A cross-sectional survey of 3,667 medical and surgical nurses was conducted in Italy. Measures included intention to leave; work environment; burnout; job satisfaction; and missed care using the RN4CAST instruments. Descriptive, logistic regression analysis was used.

RESULTS

Due to job dissatisfaction, 35.5% of the nurses intended to leave their current job, and of these, 33.1%, the nursing profession. Push factors included the following: understaffing, emotional exhaustion, poor patient safety, performing non-nursing care and being male. Pull factors included the following: positive perception of quality and safety of care, and performing core nursing activities.

CONCLUSION

The present study expands knowledge about the predictive factors of nurses' intention to leave their job and consequently to turnover, which is one of today's major issues contributing to the shortage of nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurses' intention to leave their job is the consequence of a poor work environment, characterized by factors such as understaffing and performance of non-nursing activities.

Intention to leave and associated factors among psychiatric nurses in China: A nationwide cross-sectional study

BACKGROUND

The retention of psychiatric nurses is an important concern for healthcare administrators in China. However, Chinese psychiatric nurses' intention to leave their jobs and the factors associated with it have been scarcely studied.

OBJECTIVE

To investigate Chinese psychiatric nurses' intention to leave their jobs, and to explore the associations between the intention to leave and individual characteristics, job-related factors and job satisfaction.

DESIGN

A cross-sectional, anonymous survey of a nationwide sample was conducted.

SETTINGS

Thirty-two tertiary psychiatric hospitals in 29 provincial capital cities in China.

PARTICIPANTS

All 9907 nurses in 32 hospitals were targeted for this survey conducted in December 2017; 8493 responded (response rate = 85.7%), and 7933 (without logic errors in the data) were included in the analysis.

METHODS

A questionnaire was used to investigate the respondent's intention to leave their job and to collect data on related factors, including individual characteristics (gender, age, marital status, educational background and self-rated health), job-related factors (professional title, working years, income, work hours, history of patient-initiated violence, perceived respect from patients, social recognition as well as physician-nurse coordination and trust) and job satisfaction. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Chi-square tests and multilevel logistic regression analysis were used to examine associations between an intention to leave and other factors.

RESULTS

Among 7933 respondents, 20.2% reported an intention to leave their current jobs. The multiple regression analysis showed that better self-rated health (i.e. OR = 0.373, 95%CI = 0.308-0.452 for good health, reference: poor health), working more than 20 years (OR = 0.479, 95%CI = 0.389-0.590, reference: 20 years or less), higher monthly income (i.e. OR = 0.521, 95%CI = 0.399-0.680 for 6001-8000 RMBs, reference: 4500 RMB or less), perceived patient respect (OR = 0.727, 95%CI = 0.623-0.849), physician-nurse coordination (OR = 0.549, 95%CI = 0.480-0.629) and being satisfied with one's job (OR = 0.373, 95%CI = 0.308-0.452) were negatively associated with an intention to leave; while those who were male (OR = 1.879, 95%CI = 1.605-2.199), working more than 40 hours per week (OR = 1.584, 95%CI = 1.374-1.825) and experienced patient-initiated violence in the past 12 months (OR = 1.566, 95%CI = 1.376-1.781) had a higher odds of reporting an intention to leave.

CONCLUSIONS

Self-rated health, monthly income, work hours, patient-initiated violence, perceived patient respect, physician-nurse coordination and job satisfaction are significant factors associated with a nurse's intention to quit their job. In order to retain nurses in Chinese tertiary psychiatric hospitals, the government and hospital administrators should consider ways to address these factors.

Psychosocial Hazards in the Workplace as an Aspect of Horizontal Segregation in the Nursing Profession

The purpose of this article was to assess the influence of psychosocial hazards as a factor affecting the presence of men in the nursing profession. The article refers to the topic of particularly low representation of men among nursing staff in Poland, in comparison to what similar statistics show for other countries. The aim of the study was to assess whether the psychosocial hazards in the nursing profession constitute a significant factor in the small number of men present in this occupation. In this article psychosocial hazards are considered as all the aspects of management and work organization that may negatively affect the employee's mental and physical health. The research was conducted from September 2017 to April 2018 in the Podlaskie Voivodeship (Poland). A total of 640 respondents working as nurses in inpatient health care facilities, of which 87% were women and 13% were men, were included in the study. A standardized Work Design Questionnaire for an objective assessment of work stressfulness was used as a research tool. The research has been run by a group of experts, who explained the aim and the meaning of the particular questions to the surveyed group. Afterwards, based on the answers and observations of the responders, the experts filled in the questionnaire. The results of the study show that in almost all the evaluated aspects, the nursing profession was assessed more negatively by surveyed men than women. The most negative aspects reported by women included hazards (a score of 60), complexity (58.3), and haste (50.0), while those reported by men included haste (70.0), complexity (66.7), and hazards (65.0). As a conclusion it has been noticed, that results received from the research confirm that psychosocial hazards may have significant impact on the number of men present in the nursing profession in Poland. This study also suggests that the greater psychosocial hazards experienced by male nurses in the workplace may be an effect of the particularly low representation of men among practicing nursing staff.

Explaining burnout and the intention to leave the profession among health professionals - a cross-sectional study in a hospital setting in Switzerland

Background

Burnout and the intention to leave the profession are frequently studied outcomes in healthcare settings that have not been investigated together and across different health professions before. This study aimed to examine work-related explanatory factors or predictors of burnout and the intention to leave the profession among health professionals in general, and nurses and physicians in particular.

Methods

Cross-sectional survey data of 1840 employees of six public hospitals and rehabilitation clinics recorded in 2015/16 in German-speaking Switzerland were used. Multiple logistic and stepwise linear regression analyses were performed to estimate the relative risks (odds ratios) and standardized effects (beta coefficients) of different workloads and work-related stressors on these outcomes and to study any possible mediation between them.

Results

On average, one in twelve health professionals showed increased burnout symptoms and every sixth one thought frequently of leaving the profession. Temporal, physical, emotional and mental workloads and job stresses were strongly and positively associated with burnout symptoms and thoughts of leaving the profession. However, the relative risks of increased burnout symptoms and frequent thoughts of leaving the profession were highest in the case of effort-reward and work-life imbalances. In fact, these two work-related stress measures partly or even largely mediated the relationships between exposures (workloads, job stresses) and outcomes and were found to be the strongest predictors of all. Whereas a work-life imbalance most strongly predicted burnout symptoms among health professionals (β = .35), and particularly physicians (β = .48), an effort-reward imbalance most strongly predicted thoughts of leaving the profession (β = .31–36). A substantial part of the variance was explained in the fully specified regression models across both major health professions and both outcomes. However, explained variance was most pronounced for burnout symptoms of physicians (43.3%) and for frequent thoughts of leaving the profession among nurses and midwives (28.7%).

Conclusions

Reducing workload and job stress, and particularly reward frustration at work, as well as the difficulties in combining work and private lives among health professionals, may help to prevent them from developing burnout and/or leaving the profession and consequently also to reduce turnover, early retirement, career endings and understaffing in healthcare settings.

Violence-prevention climate in the turnover intention of nurses experiencing workplace violence and work frustration

AIMS

To determine the moderating effect of a violence-prevention climate and the mediating effect of work frustration on the relationship between workplace violence (WPV) and the turnover intention of nurses.

BACKGROUND

To maintain the stability and work quality of nurses, WPV should be studied to provide effective prevention measures.

METHODS

A cross-sectional study with a convenience sample was adopted. Participants were nurses from three hospitals in Taiwan. Of 1,531 questionnaires, 973 were valid for analysis (63.6%).

RESULTS

A total mediating effect of work frustration on nurses' own experiences of WPV increased turnover intention. Witnessing WPV toward coworkers caused a significant partial mediating effect on work frustration that further increased turnover intention. A violence-prevention climate had a significant moderating effect on the work frustration and turnover intention of nurses after they had witnessed violence against others.

CONCLUSION

Effective policies and an incentivized reporting system can foster a safe and friendly work environment not only for nurses who experience violence but also for those who witness violence.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers and leaders must create a positive consultative pipeline to ensure a safe climate and environment for both the victims of WPV and the nurses who witness violence against others.

Job Satisfaction and Associated Factors among Medical Staff in Tertiary Public Hospitals: Results from a National Cross-Sectional Survey in China

Medical staff in China’s tertiary public hospitals are responsible for providing healthcare to a considerable number of patients, and their job satisfaction needs attention. The aim of this study is to investigate the job satisfaction of medical staff in tertiary public hospitals and to explore its associated factors. Based on a national survey conducted in 2016, this study included 43,645 physicians and nurses nested in 136 tertiary public hospitals in 31 provinces of China. Multi-level logistic regression was used to examine job satisfaction and its association with individual characteristics and job-related factors. Results showed that 48.22% respondents were satisfied with their job, and they were least satisfied with their compensation. Individual characteristics including occupation, gender, education background, alcohol drinking and self-reported health status, as well as job-related factors regarding professional title, work years, income, workload, doctor-patient relationship and practice setting were found to be significantly associated with job satisfaction. Given that some of these factors may be amenable to interventions, we suggest that government and hospital administrators could take some measures to promote continuing education, improve personal health, balance workload and compensation for medical staff, in order to improve the job satisfaction of medical staff in tertiary public hospitals.

Job satisfaction of nurses with master of nursing degrees in Poland: quantitative and qualitative analysis

BACKGROUND

Understanding the issue of job satisfaction of nurses with master of nursing degrees may help develop organisational changes necessary for better functioning of health care institutions. This study aimed to evaluate the level of job satisfaction among holders of Masters of Nursing degrees employed at health care institutions and to ascertain its determinants.

METHODS

The cross-sectional study was carried out in randomly selected health care institutions in Poland using the Misener Nurse Practitioner Job Satisfaction Survey and an original survey questionnaire with two open-ended questions. Quantitative data were analysed using descriptive and summary statistics.

RESULTS

The participants gave highest satisfaction ratings to their relationships with direct superiors and other nurses, as well as their social contacts at work. The lowest ratings were given to the pension scheme and factors connected with remuneration. A highly statistically significant relationship was found between the job classification and the level of professional satisfaction (p < 0.001). Qualitative analysis of responses to the two open-ended questions supported Herzberg's Two-Factor theory: internal factors promoted satisfaction, whilst external ones caused dissatisfaction.

CONCLUSIONS

Managers of nurses should strengthen the areas that contribute to higher employee satisfaction, particularly interpersonal relationships, by commendation and recognition of work effects.

Health, workforce characteristics, quality of life and intention to leave: The 'Fit for the Future' survey of Australian nurses and midwives

AIM

To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population; to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave.

BACKGROUND

Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity.

DESIGN

This was a cross-sectional survey conducted in 2014-2015.

METHOD

The "Fit for the Future" electronic survey, delivered to nurses and midwives, examined demographic, work and health-related factors, which were compared with Australian general population normative values for physical and mental components of quality of life (the Short Form-12). Univariate and multivariate logistic regression models assessed associations with workforce intention to leave.

RESULT

Physical and mental component scores, calculated for 4,592 nurses and midwives, revealed significantly higher physical but lower mental component scores than the general population. Physical component scores decreased with increasing age; higher scores were seen in nurses with better health indices and behaviours. Mental well-being scores increased with increasing age; in nurses who reported job satisfaction, no work injury, sleep problems or frequent pain and non-smokers. The odds of intention to leave decreased with increasing mental well-being.

CONCLUSION

Managers and decision-makers should heed study recommendations to implement health promotion strategies for nurses and midwives, aiming to improve mental health, specifically to promote workforce retention.