Work climate perception and turnover intention among Korean hospital staff

The effect of organizational justice on young nurses' turnover intention: The mediating roles of organizational climate and emotional labour

AIM

This study aims to explore the effect of organizational justice on young nurses' turnover intention and the roles of organizational climate and emotional labour in this relationship.

BACKGROUND

The shortage of nursing resources has become a growing problem in countries worldwide. As the main representatives of the nursing force, young nurses have high turnover intentions, which aggravates the possibility of nursing shortages. As an important variable affecting the turnover intention of young nurses, the mechanism underlying the impact of organizational justice should be studied in depth.

DESIGN

A descriptive cross-sectional design was employed.

METHODS

From November to December 2022, an online questionnaire survey was conducted among 1160 young clinical nurses from 5 hospitals in Henan Province, China. The scales used in this study include the organizational justice scale, the turnover intention scale, the organizational climate scale and the emotional labour scale. AMOS 26.0 was used for model drawing and mediation path testing, and SPSS 25.0 was used for data analysis. This study complies with the STROBE Statement of Observational Studies.

RESULTS

In general, the young nurses surveyed had high turnover intentions (14.82+/-4.44). Organizational justice has a negative predictive effect on young nurses' turnover intention (r = -0.465, P＜0.01). Organizational climate and emotional labour play a chain mediating role in the relationship between organizational justice and young nurses' turnover intention (β = -0.051).

CONCLUSIONS

Organizational justice is significantly related to the turnover intention of young nurses, and organizational climate and emotional labour play a chain mediating role in the relationship between organizational justice and turnover intention. Therefore, nursing managers should pay attention not only to organizational justice but also to the influence of organizational climate and emotional labour on the turnover intention of young nurses.

Invisible Erosion of Human Capital: The Impact of Emotional Blackmail and Emotional Intelligence on Nurses' Job Satisfaction and Turnover Intention

Emotion is a compelling factor in the retention and job satisfaction of professionals, and the impacts of emotional feelings and reactions have become an indispensable issue in the nursing workforce. Drawing on the cognitive theory of emotions, this study bridges the research gap to investigate the relationships among emotional blackmail, emotional intelligence, job satisfaction, and turnover intentions of nurses. A cross-sectional design was used to collect data from a sample of 374 full-time nurses in Northern Taiwan. Hypotheses were tested and analyzed by means of SPSS 22, structural equation modeling (SEM), and PROCESS v3.3. The results revealed the direct relationships between emotional blackmail, job satisfaction, and turnover intentions, and job satisfaction partially mediated the relationship between emotional blackmail and turnover intentions. However, there is no statistical support that emotional intelligence moderates the relationships between emotional blackmail and job satisfaction and turnover intentions. Healthcare organizations must take the initiative and form strategies that will help balance nurses' work stresses. These strategies should aim to reduce unnecessary demands from supervisors, patients, and co-workers, as well as in the socio-emotional domain.

Decision-Making Model to Assess the Organizational Climate in Healthcare Organizations

Organizational climate impacts on the employee’s well-being, commitment and positive behavior. Most studies to assess climate in healthcare organizations use qualitative and/or statistical methods. Here, we propose a general framework, based on a multiple criteria decision making/aid (MCDM / A) method, which considers different objectives in a single problem. Such framework includes internal and external factors to assess organizational climate and presented adequate results when tested in a particular case. To assess the organizational climate, we use the ELECTRE TRI method, an outranking method that combine the decision-maker (DM) preferences and his value judgments. We conclude that MCDM methods can improve agility, provide a systemic vision on organizational climate assessment and contribute to the decision-making process

How Does the Assessment of Work Organization during the COVID-19 Pandemic Relate to Changes in the Well-Being of Health System Workers?

In the case of various emergencies, especially pandemics, healthcare workers are faced with disproportionate pressures. Organizational support plays a significant role in protecting the psychological and physical health of healthcare workers. This interdisciplinary research aims to determine how changes in the physical and psychological well-being of healthcare and pharmacy workers during the first wave of the COVID-19 lockdown are related to work organization factors that support safety and stability. A quantitative research strategy was applied in the research. Data from an electronic survey assessed the changes in the physical and psychological well-being of healthcare and pharmacy workers during the lockdown period and the organizational factors supporting safety and stability. The sample of the quantitative research consisted of 967 employees of healthcare institutions and pharmacies in Lithuania. This research broadens the concept of organizational factors and provides data on their interaction with the changes of employee well-being indicators in a pandemic situation. It was found that positive changes in the evaluation of physical as well as psychological well-being during the COVID-19 lockdown could be consistently predicted by all the analyzed safety and stability supporting organizational factors that were found to be associated with subjective physical well-being and psychological well-being even when adjusting for the effect of socio-demographic factors (gender, age, work field, and specialty). The identification and proper management of organizational factors was significant for the psychological and physical well-being of healthcare workers during the lockdown period. It was found that all estimates of safety and stability supporting organizational factors during the first wave of the COVID-19 pandemic lockdown were positively related and could act as protective factors to the subjective physical and psychological well-being of healthcare and pharmacy workers.

Supportive supervisor to curtail turnover intentions: do employee engagement and work–life balance play any role?

Purpose

The purpose of this paper is to investigate the role of employee engagement and work–life balance in perceived supervisor support and turnover intentions relationship.

Design/methodology/approach

The perception of teachers on the constructs considered has been assessed by a survey using a structured questionnaire. Data were collected from the teachers of private schools of Punjab, India, and 375 were valid number of responses. Parallel multiple mediated regression was used to estimate the direct and indirect effects of perceived supervisor support on turnover intentions mediated through employee engagement and work–life balance.

Findings

The results reveal that the effect of perceived supervisor support on turnover intentions is indirect rather than direct. On the comparison of specific indirect effects, the results demonstrate that employee engagement and two dimensions of work–life balance (work interference with personal life and work–personal life enhancement) act as mediators in the perceived supervisor support and turnover intentions relationship.

Practical implications

School principals need to draft teacher-friendly policies for enhancing work–life balance and employee engagement so that teachers can feel satisfied with their work and can handle work and family demands. In this way, positive perceptions associated with high engagement and work–family balance can take place, which in turn can curtail the turnover intentions of teachers.

Originality/value

The use of employee engagement and work-life balance in the relationship of perceived supervisor support and turnover intentions is unprecedented. The study also considered three different dimensions of work–life balance and tested the model in an integrative manner. Since the study is based on an Indian sample, it also adds to growing literature on turnover intentions in nonwestern countries. The results are of great value to school managements, HR managers and policymakers who are seeking to develop practices that reduce employee turnover at workplaces.

The Italian version of the Work Psychosocial Climate Scale (Escala Clima Psicosocial en el Trabajo)

BACKGROUND

The organizational climate is a quality of the internal environment of an organization that is shared by its members, can be described in terms of the values of the characteristics of an organization, influencing the workers' behaviour. A number of empirical studies have examined the relationship between climate perceptions and a variety of variables such as job satisfaction, performance, psychological well-being, absenteeism and turnover.

OBJECTIVE

The aim of the present study was to verify the psychometric properties of the Work Psychosocial Climate Scale in the Italian context.

METHODS

The participants were 1063 Italian workers. The survey comprised: Work Psychosocial Climate Scale, Majer D'Amato Organizational Questionnaire 10, Work and Organizational Motivation Inventory, Mindfulness Organising Scale, Job Satisfaction Scale, and Organizational outcomes (Turnover intentions, Exit and neglect, Performance).

RESULTS

The results provide evidence for the reliability and validity of the Italian version of the Work Psychosocial Climate Scale, after some modifications of the original version.

CONCLUSIONS

The evaluation of the psychosocial climate in an organization is one of most important steps to recognize the indicators of work-related stress. The Work Psychosocial Climate Scale allows to conduct the evaluation with a reduced number of items.

The Association Between Unit-Level Workplace Social Capital and Intention to Leave Among Employees in Health Care Settings: A Cross-Sectional Multilevel Study

OBJECTIVE

The aim of this study was to investigate the multilevel association between workplace social capital and intention to leave among employees in health care settings in Japan.

METHODS

This study was a secondary data analysis of the cross-sectional data. A sample of 658 Japanese employees in health care settings with 17 facilities were recruited using a self-administered questionnaire. Multilevel linear regression analysis of intention to leave on unit-level workplace social capital (average score for each unit) was conducted.

RESULTS

Among 317 respondents from 49 units, after adjusting for demographic and work-related variables, both unit-level and individual-level workplace social capital were significantly negatively associated with intention to leave (P < 0.001).

CONCLUSIONS

The current study found that there was a significant negative association between unit-level workplace social capital and intention to leave in the health care field.

The Influence of Mistreatment by Patients on Job Satisfaction and Turnover Intention among Chinese Nurses: A Three-Wave Survey

The affective event of mistreatment in the workplace has been recognized as an important factor influencing employee affect and behavior. However, few studies have logically explained and empirically clarified the link between mistreatment by patients and nurses' job satisfaction and turnover intention. The current study aimed to explore the effects of mistreatment by patients on nurses' job satisfaction and turnover intention through work meaningfulness and emotional dissonance, as well as the moderating role of hostile attribution bias. Using three-wave survey data collect from 657 nurses who worked in three hospitals in China, we found that mistreatment by patients had a negative effect on nurses' job satisfaction through work meaningfulness, mistreatment by patients had a positive effect on nurses' turnover intention through emotional dissonance. Furthermore, nurses' hostile attribution bias acted as an effective moderator on the relationship. These findings help uncover the mechanisms and conditions in which mistreatment by patients influences nurses' job satisfaction and turnover intention.

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.

The Relationship of Trust and Intent to Stay Among Registered Nurses at Jordanian Hospitals

AIMS

This study examined the relationship between the level of trust with immediate supervisor and the level of intent to stay at work among registered nurses (RNs) in Jordan and explored if there is a significant difference between RNs working in governmental- and university-affiliated teaching hospitals.

BACKGROUND

Financial retention strategies are not feasible in low- and middle-income countries. This study investigated if the level of trust that RNs hold toward their immediate supervisors could affect their intent to stay at work, so as to be used as a nonfinancial strategy.

METHODS

A descriptive correlational design was used to examine this relationship among a convenience sample of 260 hospital nurses in Jordan. Descriptive and inferential statistics were used to analyze the data.

RESULTS

When the level of trust increased, the level of intent to stay at work also increased. RNs working in governmental-affiliated teaching hospitals reported higher levels of trust and intent to stay at work than those working in university-affiliated teaching hospitals.

CONCLUSION

The findings emphasized the positive effect of trust with immediate supervisor on the level of RNs' intent to stay.

IMPLICATIONS FOR NURSING MANAGEMENT

Building trust between RNs and their immediate supervisors could be an important retention strategy.

How does collegial support increase retention of registered nurses in homecare nursing agencies? a qualitative study

Background

Collegial workplace support has been linked to higher registered nurse (RN) retention in various clinical settings. In Japan, homecare agencies experience high RN turnover. The purpose of this study was to develop a conceptual framework to describe how perceived support from colleagues affects RNs’ decision to remain in an agency.

Methods

A qualitative research method based on grounded theory was used. Participants were RNs with at least 4 years of experience at the same homecare agency. Participants were theoretically sampled via managers of 12 homecare nursing agencies. Semi-structured interviews and supplementary participant observations were conducted. Data were analyzed using a constant comparative technique, and the process of how workplace support affected participants’ decision to remain at their agency was clarified.

Results

In total, 26 RNs were interviewed, 23 of whom were observed in their practice setting. Participants’ perception of support from colleagues was framed as being “encouraged to grow in one’s own way”, which comprised practicing with protected autonomy in an insight-producing environment. Participants reported that they were able to practice with protected autonomy, receiving 1) mindful monitoring, 2) semi-independent responsibility, 3) help as needed, and 4) collegial empathy and validation. RNs also felt supported in an insight-producing environment by 1) enlightening dialogue, 2) being set for one’s next challenges, and 3) being able to grow at one’s own pace. Reportedly, these were defining characteristics in their decision to continue working in their agencies.

Conclusions

For RNs to willingly stay at a homecare nursing agency, it is essential that they are able to practice with protected autonomy in an insight-producing environment that encourages them to grow in their own way. Further research is needed to explore ways to create and enhance such environments to lower RN turnover.

Implementation of a participatory management model: analysis from a political perspective

AIM

To analyse experiences of managers and nursing staff in the implementation of participatory management, specifically processes of decision-making, communication and power in a Canadian hospital.

BACKGROUND

Implementing a Participatory Management Model involves change because it is focused on the needs of patients and encourages decentralisation of power and shared decisions.

METHODS

The study design is qualitative using observational sessions and content analysis for data analysis. We used Bolman and Deal's four-frame theoretical framework to interpret our findings.

RESULTS

Participatory management led to advances in care, because it allowed for more dialogue and shared decision making. However, the biggest challenge has been that all major changes are still being decided centrally by the provincial executive board.

CONCLUSIONS

Managers and directors are facing difficulties related to this change process, such as the resistance to change by some employees and limited input to decision-making affecting their areas of responsibility; however, they and their teams are working to utilise the values and principles underlying participatory management in their daily work practices.

IMPLICATIONS FOR NURSING MANAGEMENT

Innovative management models encourage accountability, increased motivation and satisfaction of nursing staff, and improve the quality of care.

Financial interventions and movement restrictions for managing the movement of health workers between public and private organizations in low- and middle-income countries

BACKGROUND

Health workers move between public and private organizations in both urban and rural areas during the course of their career. Depending on the proportion of the population served by public or private organizations in a particular setting, this movement may result in imbalances in the number of healthcare providers available relative to the population receiving care from that sector. However, both public and private organizations are needed as each sector has unique contributions to make to the effective delivery of health services.

OBJECTIVES

To assess the effects of financial incentives and movement restriction interventions to manage the movement of health workers between public and private organizations in low- and middle-income countries.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (10 November 2012); EMBASE (7 June 2011); LILACS (9 June 2011); MEDLINE (10 November 2012); CINAHL (13 August 2012); and the British Nursing Index (13 August 2012).

SELECTION CRITERIA

Randomized controlled trials and non-randomized controlled trials; controlled before-and-after studies if pre- and post-intervention periods for study and control groups were the same and there were at least two units included in both the intervention and control groups; uncontrolled and controlled interrupted time series studies if the point in time when the intervention occurred was clearly defined and there were at least three or more data points before and after the intervention. Interventions included payment of special allowances, increasing salaries, bonding health workers, offering bursary schemes, scholarships or lucrative terminal benefits, and hiring people on contract basis.

DATA COLLECTION AND ANALYSIS

Two review authors independently applied the criteria for inclusion and exclusion of studies to the titles and abstracts of all articles obtained from the search. The same two review authors independently screened the full reports of the selected citations. At each stage, we compared the results and resolved discrepancies through discussion with a third review author.

MAIN RESULTS

We found no studies that were eligible for inclusion in this review.

AUTHORS' CONCLUSIONS

We identified no rigorous studies on the effects of interventions to manage the movement of health workers between public and private organizations in low- and middle-income countries. Health worker availability is a key obstacle in delivery of health services. Interventions to make the health sector more responsive to the expectations of populations by having more health workers in the sector that serves most people would contribute to the more efficient use of the health workforce. More research is needed to assess the effect of increase in salaries, offering scholarships or bonding on movement of health workers in one sector compared with another.

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.

A systematic literature review of nurse shortage and the intention to leave

AIM

To present the findings of a literature review regarding nurses' intention to leave their employment or the profession.

BACKGROUND

The nursing shortage is a problem that is being experienced worldwide. It is a problem that, left unresolved, could have a serious impact on the provision of quality health care. Understanding the reasons why nurses leave their employment or the profession is imperative if efforts to increase retention are to be successful.

EVALUATION

Electronic databases were systematically searched to identify English research reports about nurses' intention to leave their employment or the profession. Key results concerning the issue were extracted and synthesized.

KEY ISSUES

The diversified measurement instruments, samples and levels of intention to leave caused difficulties in the attempt to compare or synthesize findings. The factors influencing nurses' intention to leave were identified and categorized into organizational and individual factors.

CONCLUSIONS

The reasons that trigger nurses' intention to leave are complex and are influenced by organizational and individual factors. Further studies should be conducted to investigate how external factors such as job opportunities correlate with nurses' intention to leave.

IMPLICATIONS FOR NURSING MANAGEMENT

The review provides insight that can be useful in designing and implementing strategies to maintain a sustainable workforce in nursing.

Understanding nurse anesthetists' intention to leave their job: how burnout and job satisfaction mediate the impact of personality and workplace characteristics

BACKGROUND

The retention of nurse anesthetists is of paramount importance, particularly in view of the fact that the health care workforce is shrinking. Although many health care providers find their work satisfying, they often consider leaving their jobs because of the stress. Are there ways to improve this situation?

PURPOSE

This study investigated how work environment characteristics and personality dimensions relate to burnout and job satisfaction and ultimately to turnover intention among Dutch nurse anesthetists.

METHODOLOGY

An online self-reporting questionnaire survey was performed among Dutch nurse anesthetists. The questionnaire included scales to assess personality dimensions, work climate, work context factors, burnout, job satisfaction, and turnover intention. The research model stated that personality dimensions, work climate, and work context factors, mediated by burnout and job satisfaction, predict turnover intention. Structural equation modeling was used to test the research model.

FINDINGS

Nine hundred twenty-three questionnaires were completed (46% response rate). Burnout mediated the relationship between personality dimensions and turnover intention; job satisfaction mediated the relationship of work climate and work context factors to turnover intention.

PRACTICE IMPLICATIONS

To retain nursing staff and to maintain adequate staff strength, it is important to improve job satisfaction by creating a positive work climate and work context and to prevent burnout by selecting the most suitable employees through personality assessment.

Personality dimensions and their relationship with job satisfaction amongst Dutch nurse anaesthetists

AIM

This study investigates the relationship between personality dimensions and job satisfaction.

BACKGROUND

The shortage of nurses, and those voluntarily leaving their jobs, continues to be a problem affecting the delivery of healthcare all over the world, including anaesthesia. If it is found that nurse anaesthetists with certain personality types have high levels of job satisfaction, the information may be helpful for the retention of nurse anaesthetists.

METHODS

A questionnaire was distributed amongst Dutch nurse anaesthetists. Factor and multiple regression analyses were performed to reveal personality dimensions and their impact on job satisfaction.

RESULTS

Nine hundred and twenty-three questionnaires were completed and analysed (46% response rate). Two personality dimensions -'easy going' and 'orderly'- explained 3.5% of the variance in job satisfaction.

CONCLUSION

Personality dimensions as measured with the Myers-Briggs Type Indicator (MBTI) are only minimally relevant in predicting job satisfaction amongst Dutch nurse anaesthetists.

IMPLICATIONS FOR NURSING MANAGEMENT

Before using personality traits as a selection tool for retaining employees, it is important to understand the relationship of particular personalities to job satisfaction; it is also important to know which combination of personality traits is likely to create a highly cohesive work group.

Burnout, psychosomatic symptoms and job satisfaction among Dutch nurse anaesthetists: a survey

BACKGROUND

To meet the increasing demand for healthcare providers, it is crucial to recruit and retain more nurse anaesthetists (NAs). The majority of NAs in the Netherlands are >45 years old, and retaining them in their jobs is very important. This study investigates the relationships among burnout, physical health and job satisfaction among Dutch NAs.

METHODS

Two thousand NAs working in Dutch hospitals were invited to participate in this online questionnaire. We tested the relationships among burnout, psychosomatic symptoms, sickness absence, perceived general health and job satisfaction.

RESULTS

Nine hundred and twenty-three questionnaires were completed and analysed (46% response rate). Burnout and psychosomatic symptoms were negatively associated with job satisfaction, and predicted 27% of job satisfaction. Perceived general health was positively and sickness absence was negatively related to job satisfaction. Older NAs had a higher incidence of burnout than their younger counterparts.

CONCLUSIONS

The results confirmed the importance of a healthy psychosocial work environment for promoting job satisfaction. To prevent burnout, further research is necessary to determine the factors causing stress. These findings may also apply to anaesthesiologists who share many tasks and work in close cooperation with NAs.