Factors influencing turnover and absence of nurses: a research review

Why do workers leave geriatric care, and do they come back? A timing of events study

BACKGROUND

In many industrialized countries, demographic change is accompanied by increasing demand for geriatric care workers, which in turn intensifies the need to retain them or to attract them back after leaving. Although much is known about the intention of workers to leave, little is known about how many of them actually do leave and return to geriatric care at a later stage in a comprehensive framework.

OBJECTIVE

To examine and explain how many workers withdraw from geriatric care, take up other occupations, and return to geriatric care at a later stage in their careers, and the reasons behind this.

DESIGN

This study used administrative daily data that cover all workers in Germany who started working in geriatric care in the period 1996 to 2018 and observed their employment biographies for a maximum of 26 years.

METHODS

Kaplan-Meier survival analysis and parametric regression survival-time analysis were used to estimate the survival rates and to estimate individual, workplace and regional determinants of leaving and returning to geriatric care.

RESULTS

Workers in geriatric care were more likely to leave the profession than other workers, two thirds withdrew within five years of first taking up work in geriatric care. If they remained in employment, they generally chose an occupation related to geriatric care. Half of the leavers returned to geriatric care again within eight years. Individual and workplace-related factors, such as age and remuneration, are statistically significant predictors of leaving and returning.

CONCLUSIONS

The findings emphasize how important it is for organizations to keep in touch with geriatric care workers leaving their job, since a substantial share of them returns again.

Precursors and outcomes of work engagement among nursing professionals-a cross-sectional study

BACKGROUND

Health services organizations must understand how best to lower nursing professionals' turnover intentions, and increase their job satisfaction and the quality of care provided to patients. This study aims to examine whether work engagement (WE) is a significant predictor of the achievement of these preferred organizational goals. The study also aims to examine whether organizational culture and organizational climate can manage the WE of nursing professionals and indirectly contribute to the accomplishment of the preferred organizational goals.

METHODS

In detail, a cross-sectional questionnaire survey study was conducted through a convenience sampling of a total of N = 164 nurses, from four Norwegian public hospitals. Structural equation modeling was employed in testing the hypothesis in the conceptual model, using Stata software. Furthermore, mediation analyses were achieved through use of the "medsem" package in the Stata software, in testing whether the proposed direct and indirect effects were statistically significant, and the type of mediation found.

RESULTS

The three key findings from this study are: i) WE of nursing professionals was found to be positively related to service quality of care (β = 0.551) and job satisfaction (β = 0.883). Job satisfaction fully mediates the relationship between WE and turnover intention and in itself explains almost 60% (R² = 0.59) of turnover intention; ii) nursing professionals' perception of organizational culture (β = 0.278) and collaboration climate (β = 0.331) were both directly related to their WE; and iii) WE fully mediates the relationship between organizational culture/climate and service quality of care and job satisfaction. Moreover, WE partially mediates the relationship between collaborative climate and job satisfaction.

CONCLUSIONS

The WE of nursing professionals is highly correlated to their job satisfaction. WE and turnover intentions are (fully) mediated by job satisfaction. Employers should therefore focus on improving the job satisfaction of nursing professionals. The WE of nursing professionals is a common key factor for such improvement. Consequently, leaders and managers should continuously manage nursing professionals' WE, focusing on such areas as organizational culture and climate, because WE is an effective means of enabling multiple desirable outcomes for hospital organizations.

Effects of work environment and job characteristics on the turnover intention of experienced nurses: The mediating role of work engagement

AIM

To assess turnover intention among experienced nurses and explore the effects of work environment, job characteristics and work engagement on turnover intention.

BACKGROUND

The nursing shortage is an urgent concern in China. A high turnover rate of experienced nurses could have serious effects on the quality of care, costs and the efficiency of hospitals. It is crucial to explore the predictors of turnover intention and develop strategies tailored to experienced nurses.

DESIGN

A descriptive, cross-sectional survey design.

METHODS

A total of 778 experienced nurses from seven hospitals was surveyed on their work engagement, job characteristics, work environment and turnover intention in March-May 2017. Structural equation modelling was used to test a theoretical model and the hypotheses.

RESULTS

The results showed that 35.9% of experienced nurses had high-level turnover intention. The final model explained 50% of the variance in experienced nurses' turnover intention and demonstrated that: (1) work environment was positively associated with higher work engagement and lower turnover intention and work engagement partially mediated the relationship between work environment and turnover intention; and (2) job characteristics were positively related to higher work engagement and lower turnover intention and work engagement fully mediated the relationship between job characteristics and turnover intention.

CONCLUSIONS

The study confirms the intrinsic and extrinsic motivators on work engagement posited by job demands-resources model. Theory-driven strategies to improve work environment, enhance job characteristics and promote wok engagement are needed to address the nursing shortage and high turnover intention among experienced nurses.

The effects of psychological capital and work engagement on nurses’ lateness attitude and turnover intentions

Purpose

The purpose of this paper is to investigate work engagement (WE) as a mediator of the influence of psychological capital (PsyCap) on lateness attitude and turnover intentions. It also examines lateness attitude as a mediator between WE and turnover intentions.

Design/methodology/approach

Structural equation modeling was employed to gauge the relationships using data gathered from nurses in public hospitals in Northern Cyprus.

Findings

The results underscore the role WE plays as a mediator between PsyCap and the previously stated outcomes. The results also highlight the role lateness attitude plays as a mediator in the relationship between WE and turnover intentions.

Originality/value

What is known about the effects of PsyCap and WE on nurses’ lateness attitude and turnover intentions is scarce. There is also limited empirical evidence regarding the underlying mechanism linking PsyCap to lateness attitude and turnover intentions.

Factors Related to Successful Transition to Practice for Acute Care Nurse Practitioners

The transition from student to acute care nurse practitioner (ACNP) has been recognized as a time of stress. The purpose of this descriptive, correlational-comparative design pilot study was to examine: (1) the relationships among personal resources, community resources, successful transition, and job retention; (2) the difference between ACNPs with 0 to 4 years and ACNPs with more than 4 years of prior experience as a registered nurse in an intensive care unit or emergency department; and (3) the skills/procedures that ACNPs found difficult to perform independently. Thirty-four participants were recruited from a social media site for nurse practitioners. Organizational support, communication, and leadership were the most important elements of successful transition into the ACNP role. This information can help ACNP faculty and hospital orientation/fellowship program educators to help ACNPs transition into their first position after graduation.

Stress, self-esteem and well-being among female health professionals: A randomized clinical trial on the impact of a self-care intervention mediated by the senses

BACKGROUND

Stress levels are evident among health professionals. However, there are few studies on sensory-based self-care aimed at stress management, self-esteem and subjective well-being in this group of professionals.

OBJECTIVE

To assess the impact of a self-care intervention mediated by the senses on the stress levels, self-esteem and well-being of health professionals in a hospital environment.

METHODS

A total of 93 health professionals participated in an unblinded clinical trial, randomized into four groups: 1) control (no intervention); 2) Monosensory-daily body moisturizing (DBM) with odorless cream; 3) Bisensory-DBM with scented cream; 4) Multisensory-DBM with scented cream associated with audiovisual material. Participants answered specific questionnaires to assess stress, self-esteem and well-being and cortisol samples were collected at baseline, 15 and 30 days following intervention, and at the 30-day follow-up.

RESULTS

Self-care was characterized as neglected, with most participants reporting inadequate hours of sleep (74%), irregular physical activity (68%), and inadequate nutrition (45%). Compared to the other groups, the Bisensory group had lower stress on all three assessments (p = 0.017; 0.012; 0.036), a life satisfaction 8% higher at follow-up than at baseline (95% CI: 2% to 15%, p = 0.016), a 10% increase in positive affect (95% CI: 2% to 19%, p = 0.011) and a 12% reduction in negative affect (95% CI: 3% to 21% less, p = 0.014) after 30 days. The Multisensory group showed improvement in self-esteem (p = 0.012) and reduced cortisol (p = 0.036) after 30 days of intervention. The control group showed no changes in the variables studied, except for cortisol: an increase at the 15-day evaluation (denoting higher risk for stress, p = 0.009) and a reduction at follow-up (p = 0.028), which was nevertheless within normal levels.

TRIAL REGISTRATION

Clinicaltrials.gov NCT02406755.

A World Apart: How Occupational Therapists, Nurses and Care Managers Perceive Each other in Acute Health Care

Multidisciplinary teamwork is one of the key processes through which care is managed in the British National Health Service. Working in a multidisciplinary team requires many skills, which include understanding not only one's own role but also that of other professionals. The aim of this paper is to provide an understanding of occupational therapists', nurses' and care managers' perceptions of each other and how these influence interprofessional relationships.

In total, nine occupational therapists, nine care managers and 19 nurses within an acute physical health care setting were interviewed using the critical incident approach. The findings revealed that the interprofessional relationships between nurses, care managers and occupational therapists were often problematic owing to role confusion and competing priorities, which influenced communication.

To prevent role ambiguity, occupational therapists must define their role clearly. It is suggested that multidisciplinary team members need continuing interprofessional education in order to understand the changing roles in the National Health Service.

The Effects of Top Management Professional Development on Administrator Turnover

This study examines how characteristics associated with professional development of the top management team in 406 nursing homes can affect administrator turnover. Tenure, education, and membership in a professional association are the characteristics investigated. Data used in this investigation came from a survey of nursing facilities and the 1999 On-line Survey, Certification, and Reporting system. Using logistic regression analyses, the effects of the professional development characteristics of the top management team on the turnover of administrators were examined. The average annual turnover rate of administrators was 43%. Controlling for seven organizational factors, the results are generally significant for tenure and membership in a professional association. This study shows that both aggregate and dissimilarity measures of tenure and professional association membership are important influences on administrator turnover. These results suggest that nursing home owners may want to hire top managers with strong professional membership ties or should encourage top managers to make these ties.

Developing nurse and physician questionnaires to assess primary work areas in intensive care units

The objective of the study was to develop instruments for describing and assessing some aspects of design of the primary work areas of nurses and physicians in intensive care units (ICUs). Separate questionnaires for ICU physicians and nurses were developed. Items related to individual- and unit-level design features of the primary work areas of nurses and physicians were organized using constructs found in the literature. Items related to staff satisfaction and staff use of time in relation to primary work area design were also included. All items and constructs were reviewed by experts for content validity and were modified as needed before use. The final questionnaires were administered to a convenience sample of 4 ICUs in 2 large urban hospitals. A total of 55 nurses and 29 physicians completed the survey. The Cronbach α was used to measure internal consistency, and factor analysis was used to provide construct-related validity. Convergent and discriminant validity were assessed through examining bivariate correlations between relevant scales/items. Analysis of variance was used to identify whether the between-group member responses were significant among the 4 units. The Cronbach α values for all except 3 preliminary scales indicated acceptable reliability. Factor analysis indicated that some preliminary scales could be partitioned into subscales for finer descriptions of the primary work areas. Correlational analysis provided strong evidence of convergent and discriminant validity of all the scales and subscales. The significance level of F-statistics showed that the units were significantly different from each other, providing evidence of more between-unit variance than within-unit variance. Therefore, the questionnaires developed in the study offer a promising departure point for rigorous description and evaluation of the primary work areas in relation to staff satisfaction and use of time in ICUs at a time when the importance of such studies is growing.

The role of veterinary team effectiveness in job satisfaction and burnout in companion animal veterinary clinics

OBJECTIVE

To determine the role of veterinary team effectiveness regarding job satisfaction and burnout in companion animal veterinary practice.

DESIGN

Cross-sectional observational study.

SAMPLE

48 companion animal veterinary health-care teams.

PROCEDURES

274 team members participated in an online survey. Overall job satisfaction was evaluated with a 1-item measure, and the 3 dimensions of burnout (exhaustion, cynicism, and professional efficacy) were measured with the Maslach Burnout Inventory-General Survey. Team effectiveness was assessed with a survey developed for this study. Demographic and team effectiveness factors (coordinated team environment, toxic team environment, team engagement, and individual engagement) associated with job satisfaction and burnout were evaluated.

RESULTS

Overall mean job satisfaction score was 5.46 of 7 (median, 6.00); veterinary technicians and kennel attendants had the lowest scores. According to the Maslach survey results, 22.4% of participants were in the high-risk category for exhaustion, 23.2% were in the high-risk category for cynicism, and 9.3% were in the high-risk category for professional efficacy. A coordinated team environment was associated with increased professional efficacy and decreased cynicism. A toxic team environment was negatively associated with job satisfaction and positively associated with exhaustion and cynicism. Individual engagement was positively associated with job satisfaction and professional efficacy and negatively associated with exhaustion and cynicism.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested the effectiveness of a veterinary team can significantly influence individual team members' job satisfaction and burnout. Practices should pay specific attention to the effectiveness with which their veterinary team operates.

Does moonlighting influence South African nurses' intention to leave their primary jobs?

Background

Staff retention and turnover have risen in prominence in the global discourse on the health workforce. Moonlighting, having a second job in addition to a primary job, has not featured in debates on turnover.

Objective

This paper examines whether moonlighting is a determinant of South African nurses’ intention to leave their primary jobs.

Design

During 2010, a one-stage cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses working in critical care, theatre, emergency, maternity, and general medical and surgical wards completed a self-administered questionnaire after giving informed consent. In addition to demographic information and information on moonlighting, the questionnaire obtained information on the participants’ intention to leave their primary jobs in the 12 months following the survey. A weighted analysis of the survey data was done using STATA^® 13.

Results

Survey participants (n=3,784) were predominantly middle-aged with a mean age of 41.5 (SD±10.4) years. Almost one-third of survey participants (30.9%) indicated that they planned to leave their jobs within 12 months. Intention to leave was higher among the moonlighters (39.5%) compared to non-moonlighters (27.9%; p<0.001). Predictors of intention to leave in a multiple logistic regression were moonlighting in the preceding year, nursing category, sector of primary employment, period working at the primary job, and number of children. The odds of intention to leave was 1.40 (95% CI: 1.16–1.69) times higher for moonlighters than for non-moonlighters. The odds ratio of intention to leave was 0.53 (95% CI: 0.42–0.66) for nursing assistants compared to professional nurses and 2.09 (95% CI: 1.49–2.94) for nurses working for a commercial nursing agency compared to those working in the public sector.

Conclusions

Moonlighting is a predictor of intention to leave. Both individual and organisational strategies are needed to manage moonlighting and to enhance retention among South African nurses.

Factors that influence the turnover intention of Chinese village doctors based on the investigation results of Xiangyang City in Hubei Province

INTRODUCTION

This study analyzes the factors that influence the turnover intention of village doctors by investigating village clinic workers in rural areas, particularly in Xiangyang City, Hubei Province.

METHODS

A total of 1184 village clinics were sampled randomly in Xiangyang City. The research assistants distributed 1930 questionnaires to village doctors. This study had a response rate of 97.88%. A total of 1889 village doctors completed the questionnaires.

RESULTS

The results of the investigation conducted in Xiangyang City indicated that 63.2% of the village doctors did not plan to leave the organization where they were currently employed. However, more than one-third (36.8%) of the village doctors considered leaving their posts voluntarily. Some job satisfaction indexes affect their intention to resign. The results showed that income satisfaction and the way organization policies are put into practice, in addition, my pay and the amount of work I do, the chances for advancement on this job and the work conditions are significant factors that contribute to the turnover intention of village doctors.

CONCLUSIONS

This study may interest heath care management administrator and highlight the influence of job satisfaction on turnover intention of village doctors. Our findings outline some issues that contribute to these problems and suggest an approach for health care policy maker to implement a broader national process and organizational strategies to improve the job satisfaction and stability of the village doctors.

Nurses well-being in intensive care units: study of factors promoting team commitment

BACKGROUND

Intensive care units (ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain nurses' enthusiasm and increase job satisfaction.

AIM

The aim of this study was to analyse how nursing work environment factors affect identification and commitment among ICU nurses.

DESIGN

A cross-sectional study was carried out in 12 ICUs from four Italian urban hospitals.

METHOD

A total of 222 nurses participated and completed a self-reported questionnaire.

RESULTS AND CONCLUSION

Results show that nursing work characteristics are directly related to team commitment, and that the nursing work characteristics and team commitment relationship was mediated by both perceived supervisor support and job satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Our findings may concretely contribute to literature and offer additional suggestions to improve nurses' work conditions and patient health in ICUs.

An empirical analysis of nurse retention: what keeps RNs in nursing?

OBJECTIVE

This study investigates the effects of stress, economic factors, altruism, and value congruence on intentions to leave jobs and the nursing profession.

BACKGROUND

Retaining nurses will be critical for healthcare organizations as the demand for nurses increases. Regulation and cost pressures are changing the nursing work environment.

METHODS

We surveyed 861 RNs in the southeastern United States. Structural equation modeling was used to analyze the survey.

RESULTS

Results confirm the importance of stress and salaries and underscore the impact of both value congruence and altruism. Evidence shows a correlation between altruistic desires and intentions to leave the profession.

CONCLUSIONS

Efforts to retain nurses should include matching nurse and organizational values. Initiatives need to be undertaken to increase professional autonomy and provide opportunities for the expression of altruism. Further research is indicated to investigate the unexpected result that highly altruistic nurses are leaving the profession.

The consequences of nursing stress and need for integrated solutions

PURPOSE

In a 2011 survey sponsored by the American Nurses Association (ANA), nurses identified the acute and chronic effects of stress and overwork as one of their two top safety and health concerns.

DESIGN/METHODS

A review of the literature was conducted to investigate the impact that job stress has on the health and safety of nursing professionals and the role that working conditions and job characteristics play in fostering job stress.

FINDINGS

Strong evidence supporting links between job stress, safety and health in general and within different types of nursing populations exists. Working conditions also contribute to the development of job stress.

CONCLUSION

Combining and integrating "person-focused" strategies designed to build nurses' ability to manage stress at the individual level with "organization-focused" strategies that eliminate stressful working conditions is critical to the reduction and prevention of job stress among nursing professionals.

A critical ethnographic look at paediatric intensive care nurses and the determinants of nurses' job satisfaction

The aim of this study is to examine key features within the cultural context in a Canadian Paediatric Intensive Care Unit (PICU) environment as experienced by nurses and to identify what these influences are and how they shape nurses' intentions to remain at critically ill children's bedsides for the duration of their careers. This is a qualitative study which follows a critical ethnographic approach. Over 20 hours of observation and face-to-face semi-structured interviews were conducted. Approximately one third of the nursing population at the research site PICU were interviewed (N=31). Participants describe a complex process of becoming an expert PICU nurse that involved several stages. By the time participants became experts in this PICU they believed they had significantly narrowed the power imbalance that exists between nursing and medicine. This study illuminates the role both formal and informal education plays in breaking the power barrier for nurses in the PICU. This level of expertise and mutual respect between professions aids in retaining nurses in the PICU. The lack of autonomy and/or respect shown to nurses by administrators appears to be one of the major stressors in nurses' working lives and can lead to attrition from the PICU. Family Centred Care (FCC) is practiced in paediatrics and certainly accentuated in the PICU as there is usually only one patient assigned per nurse, who thus afforded the time to provide comprehensive care to both the child and the family. This is considered one of the satisfiers for nurses in the PICU and tends to encourage retention of nurses in the PICU. However, FCC was found to be an inadequate term to truly encompass the type of holistic care provided by nurses in the PICU.

The Australian pharmacist workforce: employment status, practice profile and job satisfaction

OBJECTIVE

The aims were to determine Australian registered pharmacists' current employment status, practice profile and professional satisfaction.

METHOD

A questionnaire was mailed to all registered pharmacists (n=7764) on the Pharmacy Boards of Victoria and South Australia's registers; 19 were returned undeliverable. Quantitative data were entered and analysed using the Statistical Package for Social Sciences Version 17. Qualitative data were subjected to a thematic analysis.

RESULTS

1627 (21%) pharmacists responded: 259 (16%) were registered as pharmacists but no longer worked in the pharmacy profession. A total of 1366 respondents reported still working as pharmacists. Of the 1366, 912 (67%) indicated that they spend most of their time in a clinical area; 233 (17%) spend most of their time in 'non-clinical pharmacist work (i.e. dispensing as technical supply)'; 216 (16%) worked in other non-clinical roles and; 1053 (77%) were professionally satisfied.

CONCLUSION

Measuring the pharmacist workforce based on registration data significantly overestimates the available clinical pharmacist workforce: 708 (44%) respondents were no longer working in the profession, were not mainly involved in clinical practice or were working in non-clinical roles. A significant re-professionalisation program is needed if pharmacists' unique knowledge and skills are to contribute to better healthcare delivery.

Nursing a case of the blues: an examination of the role of depression in predicting job-related affective well-being in nurses

The current study explored the effect of depression, optimism, and anxiety on job-related affective well-being in 70 graduate nurses. It was predicted that depression and anxiety would have a significant negative effect on job-related affective well-being, whereas optimism would have a significant positive effect on job-related affective well-being. Questionnaires were completed online or in hard-copy forms. Results revealed that depression, optimism, and anxiety were all significantly correlated to job-related affective well-being in the expected direction, however, depression was found to be the only variable that made a significant unique contribution to the prediction of job-related affective well-being. Possible explanations for these findings are explored.

The effect of quality circles on job satisfaction and quality of work-life of staff in emergency medical services

INTRODUCTION

Quality circles, as a participatory management technique, offer one alternative for dealing with frustration and discontent of today's workers. This study was conducted to investigate the effect of implementation of quality circles on nurses' quality of work-life and job satisfaction.

MATERIALS AND METHODS

In this study, two emergency medical services (EMS) of Hamedan province were selected and randomly assigned as the experimental and control groups. After the experimental group was trained and quality circles were established in this group, the levels of quality of work-life and job satisfaction were measured in the two groups. Then, the statistical analyses were performed using t-test.

RESULTS

After the intervention, the results showed significant differences between the scores of motivational factors (p=0.001), the total scores of job satisfaction (p=0.003), and the scores of some quality of work life (QWL) conceptual categories including the use and development of capacities (p=0.008), the total space of life (p=0.003), and the total scores of QWL (p=0.031) in the experimental group compared to those in the control group.

CONCLUSION

This study confirms the effectiveness of quality circles in improving quality of work-life and job satisfaction of nurses working in EMS, and offers their application as a management method that can be used by EMS managers.

Why do Australian registered pharmacists leave the profession? a qualitative study

BACKGROUND

Understanding why people choose to leave their professions is important to inform workforce planning to meet community needs. Poor job satisfaction has been linked to health practitioners expressing intentions to leave in other professions such as nursing, occupational therapy and medicine, but little is known about the reasons why pharmacists leave their profession.

OBJECTIVE

To explore reasons why Australian pharmacists leave the profession.

SETTING

As part of a survey of the Australian pharmacist workforce, a questionnaire was mailed to all registered pharmacists (n = 7,764) on the registers of the Pharmacy Boards of Victoria and South Australia; 1,627 (21 %) responded. Participants, who were registered but no longer working as a pharmacist, were asked to provide contact details if they were willing to be interviewed for this study; 89 (5.5 %) pharmacists accepted an invitation. A proportionate sample of 20 was selected for the interview.

METHOD

A semi-structured interview schedule was developed with probe options which encouraged participants to further explore their responses to questions. De-identified audio records of interviews were transcribed verbatim and thematically analysed.

MAIN OUTCOME MEASURE

Reasons why pharmacists leave the pharmacy profession.

RESULTS

Five themes emerged: (1) Dissatisfaction with the professional environment; (2) lack of career paths and opportunities; (3) under-utilisation of pharmacists' knowledge and skills; (4) wanting a change; and (5) staying connected with pharmacy.

CONCLUSION

These findings provide insights to the pharmacy sector, previously unexplored in Australia, and informs future pharmacist workforce planning. To retain experienced, mid-career pharmacists in the profession, strategies to increase opportunities for career progression, better use of pharmacists' knowledge and skills and involvement in patient care are required to increase job satisfaction and improve retention rates.

The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia

Background

Quality of work life (QWL) has been found to influence the commitment of health professionals, including nurses. However, reliable information on QWL and turnover intention of primary health care (PHC) nurses is limited. The aim of this study was to examine the relationship between QWL and turnover intention of PHC nurses in Saudi Arabia.

Methods

A cross-sectional survey was used in this study. Data were collected using Brooks’ survey of Quality of Nursing Work Life, the Anticipated Turnover Scale and demographic data questions. A total of 508 PHC nurses in the Jazan Region, Saudi Arabia, completed the questionnaire (RR = 87%). Descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression were applied for analysis using SPSS v17 for Windows.

Results

Findings suggested that the respondents were dissatisfied with their work life, with almost 40% indicating a turnover intention from their current PHC centres. Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by QWL, p < 0.001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, p < 0.001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables.

Conclusions

Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes.

Thirty years of nursing turnover research: looking back to move forward

Despite the substantial amount of useful prior work on turnover among nurses, our understanding of the causal mechanisms explaining why nurses voluntarily leave their jobs is limited. The purpose of this article is to promote the development of stronger conceptual models of the causes of voluntary turnover among nurses. The author compares the nursing-specific literature to research on voluntary turnover from the general management field over the past 30 years and examines the evolution of key theories used in the nursing literature. Results of this review comparing nursing research with that in the broader field suggest that, over time, nursing research has not kept pace with conceptualizations from general management explaining why people either remain at or quit their jobs. The author argues that conceptual models of turnover among nurses can benefit significantly from drawing more effectively on particular models and concepts available in general management studies of turnover.

Job satisfaction among hospital nurses revisited: a systematic review

BACKGROUND

The current nursing shortage and high turnover is of great concern in many countries because of its impact upon the efficiency and effectiveness of any healthcare delivery system. Recruitment and retention of nurses are persistent problems associated with job satisfaction.

OBJECTIVE

To update review paper published in 2005.

DESIGN

This paper analyses 100 papers relating to job satisfaction among hospital nurses derived from systematic searches of seven databases covering English and Chinese language publications 1966-2011 (updating the original paper with 46 additional studies published 2004-2011).

FINDINGS

Despite varying levels of job satisfaction across studies, sources and effects of job satisfaction were similar. Hospital nurse job satisfaction is closely related to working conditions and the organizational environment, job stress, role conflict and ambiguity, role perception and role content, organizational and professional commitment.

CONCLUSIONS

More research is required to understand the relative importance of the many identified factors relating to job satisfaction of hospital nurses. It is argued that the absence of a robust causal model reflecting moderators or moderator is undermining the development of interventions to improve nurse retention.

Job satisfaction and intention to leave: a questionnaire survey of hospital nurses in Shanghai of China

AIM

To explore nurses' views and experiences regarding job satisfaction and their intention to leave in Shanghai.

BACKGROUND

The widespread nursing shortage and nurses' high turnover rate has become a global issue. Job satisfaction is the most consistent predictor of nurses' intention to leave and has been reported as explaining most of the variance on their intention to leave.

DESIGN

A cross-sectional survey.

METHODS

A convenience sample of nurses was recruited from 19 large general hospitals in Shanghai and the research assistants distributed 2850 questionnaires to nurses. The response rate of this study was 78·95%, and 2250 nurses completed the questionnaire.

RESULTS

Regarding the overall job satisfaction, 50·2% nurses were dissatisfied and 40·4% nurses reported that they had intention to leave the current employment. Respondents' characteristics had an impact on job satisfaction and their intention to leave. The results showed that age, marital status, work experience, overall job satisfaction, job satisfaction: extrinsic rewards, interaction, praise/recognition and control/responsibility were significant factors contributing to nurses' intention to leave.

CONCLUSIONS

The finding may be a cause of concern for hospital management and highlights the importance of the two concepts (job satisfaction and intention to leave) in Shanghai. Innovative and adaptable managerial interventions need to be taken to improve nurses' job satisfaction and to strengthen their intention to stay.

RELEVANCE TO CLINICAL PRACTICE

Our findings outline some issues contributing to these problems and provide nurse administrators with information regarding specific influences on nurses' job satisfaction and intention to leave in Shanghai and innovative and adaptable managerial interventions that are needed. Our findings may also provide direction for nurse managers and healthcare management to implement strategies to improve nurses' job satisfaction and their intention to stay.

Academic job satisfaction questionnaire: Construction and validation in Saudi Arabia

Background:

Colleges and universities are becoming increasingly accountable for teaching outcomes in order to meet rigorous accreditation standards. Job satisfaction (JS) seems more difficult to measure in the academic field in view of the complexity of roles, duties and responsibilities.

Objectives:

To compile and determine the psychometric properties of a proposed Academic Job Satisfaction Questionnaire (AJSQ) suitable for university faculty, and amenable to future upgrading.

Materials and Methods:

A 46-item five-option Likert-type draft questionnaire on JS was distributed for anonymous self-reporting by all the academic staff of five colleges in University of Dammam (n=340). The outcome measures were (1) factor analysis of the questionnaire items, (2) intra-factor α-Coefficient of Internal Consistency Reliability, (3) inter-factor correlations, (4) comparison of psychometric properties in separately analyzed main faculty subgroups.

Results:

The response rate was 72.9 percent. Factor analysis extracted eight factors which conjointly explained 60.3 percent of the variance in JS. These factors, in descending order of eigenvalue, were labeled “Authority”, “Supervision”, “Policies and Facilities”, “My Work Itself”, “Interpersonal Relationships”, “Commitment”, “Salary” and “Workload”. Cronbach's-α ranged from 0.90 in Supervision to 0.63 in Salary and Workload. All inter-factor correlations were positive and significant, ranging from 0.65 to 0.23. The psychometric properties of the instrument in separately analyzed subgroups divided by sex, nationality, college and clinical duties produced fairly comparable findings.

Conclusion:

The AJSQ demonstrated good overall psychometric properties in terms of construct validity and internal consistency reliability in both the overall sample and its separately analyzed subgroups. Recommendation: To replicate these findings in larger multicenter samples of academic staff.

Job satisfaction and turnover intent of primary healthcare nurses in rural South Africa: a questionnaire survey

AIM

This paper is a report of a correlational study of the relationships between demographic variables, job satisfaction, and turnover intent among primary healthcare nurses in a rural area of South Africa.

BACKGROUND

Health systems in Southern Africa face a nursing shortage fuelled by migration, but research on job satisfaction and turnover intent of primary healthcare nurses remains poorly described.

METHOD

A cross-sectional study with survey design was conducted in 2005 in all local primary healthcare clinics, including nurses on duty at the time of visit (n = 143). Scale development, anova, Spearman's rank correlation, and logistic regression were applied.

RESULTS

Nurses reported satisfaction with work content and coworker relationships and dissatisfaction with pay and work conditions. Half of all nurses considered turnover within two years, of whom three in ten considered moving overseas. Job satisfaction was statistically significantly associated with unit tenure (P < 0·05), professional rank (P < 0·01) and turnover intent (P < 0·01). Turnover intent was statistically significantly explained by job satisfaction, age and education (P < 0·001), with younger and higher educated nurses being more likely to show turnover intent. Satisfaction with supervision was the only facet significantly explaining turnover intent when controlling for age, education, years of nursing and unit tenure (P < 0·001).

CONCLUSION

Strategies aimed at improving job satisfaction and retention of primary healthcare nurses in rural South Africa should rely not only on financial rewards and improved work conditions but also on adequate human resource management.

Factors influencing Macao nurses' intention to leave current employment

AIMS

To investigate factors associated with nurses' intention to leave current employment in Macao.

BACKGROUND

The shortage of nursing staff and nurses voluntarily leaving their jobs has continued to be a problem affecting the delivery of health care all over the world. One way to alleviate this shortfall is via recruitment, but this is not always successful. Another way is to reduce the rate at which nurses voluntarily leave their work places.

DESIGN

A descriptive survey was conducted and data were collected using a self-reported structured questionnaire. Nurses were recruited in the Health Bureau and one private hospital in Macao. The status of nurses' intention to leave current employment (yes vs. no) was the dependent variable and nurses' predisposing characteristics, organisational environments and five components on job satisfaction outcomes were independent variables.

RESULTS

Of 426 nurses, 166 (39.0%) indicated an intention to leave current employment. The results showed that age (p < 0.001), work experience (p < 0.001), workplace (p = 0.015) and job satisfaction: pay and benefits (p < 0.001) were significant risk factors to predict nurses' intention to leave current employment.

CONCLUSIONS

More than one-third of the nurses in Macao indicated an intention to leave current employment. This figure may be a cause of concern for the hospital management and highlights the need to implement strategies to improve the communication between nurses and the organisation, to enhance nurse job satisfaction and commitment to the organisation.

RELEVANCE TO CLINICAL PRACTICE

Our findings outline some issues contributing to this problem and provide the nurse manager with information regarding specific influences on nurses' turnover in Macao. Given the complexity of issues outlined in this analysis, nurse managers should assist their nursing staff to deal with those influences, make efforts to address the nursing shortage that will require additional communications and recognise the needs and values of their staff and empower them to create a better work environment. As a consequence, their commitment to the organisation can be fostered.

Registered nurses' perceptions of health and safety related to their intention to leave

This study examined perceptions of general and emotional health among a statewide sample of nurses, and their assessment of employers' workplace health and safety initiatives. These variables and demographic data were then used to model predictors of intention to leave their work positions. A survey was mailed to all registered nurses in one state. Fifty-three percent responded (n = 3,955). Findings suggested marked differences in perception of emotional health by age, with younger nurses reporting less positive perceptions of their emotional health. Perceptions of employers' safety and health initiatives varied by age, setting, and work role. Predictors of intention to leave included lower perceived emotional health among younger nurses and employer safety initiatives for both age groups. This exploratory study suggests a relationship among employer health and safety practices, nurses' emotional health, and intention to leave. Implications for occupational health nurses are detailed.

Registered Nurses' Perceptions of Health and Safety Related to Their Intention to Leave

This study examined perceptions of general and emotional health among a statewide sample of nurses, and their assessment of employers' workplace health and safety initiatives. These variables and demographic data were then used to model predictors of intention to leave their work positions. A survey was mailed to all registered nurses in one state. Fifty-three percent responded ( n = 3,955). Findings suggested marked differences in perception of emotional health by age, with younger nurses reporting less positive perceptions of their emotional health. Perceptions of employers' safety and health initiatives varied by age, setting, and work role. Predictors of intention to leave included lower perceived emotional health among younger nurses and employer safety initiatives for both age groups. This exploratory study suggests a relationship among employer health and safety practices, nurses' emotional health, and intention to leave. Implications for occupational health nurses are detailed.