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Li M, Wang W, Zhang J, Zhao R, Loban K, Yang H, Mitchell R. Organizational culture and turnover intention among primary care providers: a multilevel study in four large cities in China. Glob Health Action 2024; 17:2346203. [PMID: 38826145 PMCID: PMC11149567 DOI: 10.1080/16549716.2024.2346203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/18/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Primary health care plays an important role in providing populations with access to health care. However, it is currently facing unprecedented workforce shortages and high turnover worldwide. OBJECTIVE This study examined the relationship between organizational culture and turnover intention among primary care providers in China. METHODS A cross-sectional survey was administered in four large cities in China, Tianjin, Jinan, Shanghai, and Shenzhen, comprising 38 community health centers and 399 primary care providers. Organizational culture was measured using the Competing Value Framework model, which is divided into four culture types: group, development, hierarchy, and rational culture. Turnover intention was measured using one item assessing participants' intention to leave their current position in the following year. We compared the turnover intention among different organizational culture types using a Chi-square test, while the hierarchical logistic regression was used to examine the relationship between organizational culture and turnover intention. RESULTS The study found that 32% of primary care providers indicated an intention to leave. Primary care providers working in a hierarchical culture reported higher turnover intention (43.18%) compared with those in other cultures (p < 0.05). Hierarchical culture was a predictor of turnover intention (OR = 3.453, p < 0.001), whereas rational culture had a negative effect on turnover intention (OR = 0.319, p < 0.05). CONCLUSIONS Our findings inform organizational management strategies to retain a healthy workforce in primary health care.
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Affiliation(s)
- Mengyao Li
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Wenhua Wang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Jinnan Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Ruixue Zhao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Katya Loban
- Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada
| | - Huiyun Yang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Rebecca Mitchell
- Health and Wellbeing Research Unit (HoWRU), Macquarie Business School, Macquarie University, Sydney, Australia
- Newcastle Business School, University of Newcastle, Newcastle, Australia
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Lee T, Kim E, Ji Y. The mediating effect of transition shock on the relationship between readiness for practice and turnover intention of new graduate nurses in South Korea: A longitudinal study. NURSE EDUCATION TODAY 2024; 143:106394. [PMID: 39265275 DOI: 10.1016/j.nedt.2024.106394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 08/29/2024] [Accepted: 09/04/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Nurses' turnover intention has garnered significant global attention due to the shortage of the nursing workforce. New graduate nurses encounter challenges as they transition from students to professional nurses. Many new graduate nurses have experienced transition shock, which impacts their turnover intention. Researchers show that undergraduate readiness for practice is linked to transition shock and turnover intention, but there is a lack of longitudinal studies investigating their associations and causality. OBJECTIVES To explore the longitudinal factors affecting turnover intention among new graduate nurses, as well as the mediating role of transition shock in the relationship between readiness for practice and turnover intention. DESIGN A retrospective longitudinal design. SETTINGS This study was conducted in 54 nursing schools in South Korea. PARTICIPANTS A total of 232 new graduate nurses who participated in the New Nurse e-Cohort Panel Study as students and have continued working at the same hospital since graduation were included. METHODS Surveys were conducted during three periods: two months before graduation (T0), six months after graduation (T1), and one year after graduation (T2). Hayes' PROCESS macro Model 4 was utilized to analyze the mediating effect of transition shock (T1) on the relationship between readiness for practice (T0) and turnover intention (T2) among new graduate nurses. RESULTS Readiness for practice (β = -0.140, p = 0.028) and transition shock (β = 0.259, p < 0.001) were significantly associated with turnover intention. Transition shock acted as a mediator between readiness for practice and turnover intention (β = -0.165, 95 % confidence interval -0.311 to -0.051) among new graduate nurses after controlling for work experience, working in desired units, and completion of internship before nursing school graduation. CONCLUSIONS This study explored the causal relationships among readiness for practice, transition shock, and turnover intention of new graduate nurses. The findings suggest that higher readiness for practice decreases transition shock and influences the intention to leave. To retain a valuable nursing workforce, nursing schools should strive to create a supportive learning environment that prepares students with a high level of readiness for practice. Additionally, hospitals' nursing managers and administrators should implement a structured adaptation program for new graduate nurses to facilitate a smooth transition into the profession.
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Affiliation(s)
- Taewha Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
| | - Eunkyung Kim
- College of Nursing, Eulji University, Uijeongbu-si, Gyeonggi-do, South Korea.
| | - Yoonjung Ji
- College of Nursing, CHA University, Pocheon-si, Gyeonggi-do, South Korea
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3
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Yuan D, Hu M, Yao N, Zhong H, Xiao Y, Zhou X, Zhang R, Zhang Y. Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model. BMC Public Health 2024; 24:1198. [PMID: 38685094 PMCID: PMC11059584 DOI: 10.1186/s12889-024-18654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Healthcare staff in China, especially females, work in a high-pressure, high-load, and high-risk environment, which affects the physical and mental health, the efficiency and quality of work, and increases turnover intention. The present study investigated the relationship between perceived stress and turnover intention in female healthcare staff, and the effects of future-oriented coping and work-family balance on this relationship. METHODS Four hundred thirty-five female medical workers were recruited to perform a perceived stress scale, future-oriented coping inventory, work-family balance scale and turnover intention scale. Meanwhile, serial multiple mediation analysis was performed using PROCESS. RESULTS 1) Perceived stress positively predicted the level of turnover intention in female healthcare staff; 2) Preventive coping and proactive coping showed mediation effects on the relationship between perceived stress and turnover intention, and preventive coping positively related to proactive coping; 3) The work-family balance also showed mediation effects on the relationship between perceived stress and turnover intention; 4) Preventive coping, proactive coping and work-family balance showed a serial multiple mediation on the relationship between perceived stress and turnover intention in female healthcare workers. CONCLUSIONS Perceived stress affects the level of turnover intention in female healthcare staff through preventive coping, proactive coping, and work-family balance. In addition, the sequential model of future-oriented coping was validated among female healthcare staff.
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Affiliation(s)
- Dongling Yuan
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China
| | - Muli Hu
- Department of Human Resources, the Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Na Yao
- Department of Human Resources, the Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Huiyuan Zhong
- Department of Human Resources & Office of Talents Recruitment and Development of Central, South University, Changsha, 410011, China
| | - Yinghong Xiao
- Central South University Education Foundation, Changsha, 410011, China
| | - Xiao Zhou
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China
| | - Ruoyi Zhang
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China
| | - Yi Zhang
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China.
- Medical Psychological Institute, Central South University, Changsha, 410011, China.
- National Clinical Research Center On Mental Disorders (Xiangya), Changsha, 410011, China.
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Xiao Q, Iftikhar Q, Spaeth K, Zhang C, Liang XC, Klarin A, Liu L. The relationship between servant leadership and nurses' in-role performance: The sequential mediating effects of job autonomy and emotional exhaustion. J Adv Nurs 2024; 80:1440-1451. [PMID: 37962237 DOI: 10.1111/jan.15930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
AIMS Drawing on the conservation of resources theory, this study examines the underlying process through which servant leadership is associated with nurses' in-role performance. Specifically, we test the indirect effect of servant leadership on in-role performance via a sequential mediating mechanism of job autonomy and emotional exhaustion. DESIGN A time-lagged design was implemented using data gathered from two-wave online surveys (1 week apart) of registered nurses from Jiangsu Province, China. METHODS Between September 2022 and February 2023, we used Wenjuanxing and Credma, which are two powerful and user-friendly data collection platforms, to distribute online surveys to potential participants. We received a total of 220 usable responses and employed the PROCESS Model 4 and Model 6 to assess our proposed hypotheses. RESULTS Our proposed model was supported. Servant leadership has a positive indirect effect on nurses' in-role performance through job autonomy and emotional exhaustion. Job autonomy has a negative effect on emotional exhaustion. Additionally, job autonomy mediates the negative relationship between servant leadership and emotional exhaustion. CONCLUSION The present research extends existing nursing studies by unravelling the complex mechanisms underlying the relationship between servant leadership and nurses' in-role performance. Our study also identifies the underlying mechanism of how servant leadership mitigates emotional exhaustion by supporting nurses' job autonomy. IMPACT The sequential mediation results provide us with a more fine-grained understanding of the relationship between servant leadership and nurses' in-role performance. It further promotes job autonomy and decreases emotional exhaustion, which supports the UN Sustainable Development Goal #3 (Good Health and Well-being). PATIENT OR PUBLIC CONTRIBUTION This study addresses the UN Sustainable Development Goal #3: 'To ensure healthy lives and promote well-being for all at all ages' and the healthcare providers will benefit from our study. Therefore, the study contributes to a more sustainable organization and society.
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Affiliation(s)
- Qijie Xiao
- Department of Management, Monash Business School, Monash University, Melbourne, Victoria, Australia
- Suzhou lndustrial Park Monash Research Institute of Science and Technology, Suzhou, China
| | - Qudsia Iftikhar
- Department of Management, Monash Business School, Monash University, Melbourne, Victoria, Australia
- Department of Management, Deakin University, Melbourne, Victoria, Australia
| | - Katharina Spaeth
- Department of Management, Melbourne University, Melbourne, Victoria, Australia
| | - Chunyu Zhang
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | | | - Anton Klarin
- School of Management and Marketing, Curtin University, Bentley, Western Australia, Australia
| | - Liping Liu
- School of Economics and Management, Guangxi Normal University, Guilin, China
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Salaten EFMM, Zakaria AM, Ibrahim IA. The role of professional identity and job satisfaction in paediatric nurses' intention to remain employed amidst the COVID-19 pandemic. Int J Ment Health Nurs 2024; 33:114-124. [PMID: 37732543 DOI: 10.1111/inm.13229] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
The COVID-19 pandemic has significantly affected nursing, as nurses are crucial in providing healthcare services. Understanding the factors influencing nurse retention is essential for maintaining a strong and long-lasting workforce because nurse retention is becoming increasingly complex. This study aimed to investigate the influence of professional identity and job satisfaction on the intention to remain employed while also evaluating the levels of professional identity, job satisfaction, and intention to stay among paediatric nurses amidst the COVID-19 pandemic. This correlational and descriptive study included a stratified sample of 257 paediatric nurses and was guided by the STROBE checklist. Data were collected through valid and reliable questionnaires, which included a nurses' professional identity scale, job satisfaction survey, intention to stay scale, and a demographic questionnaire. Data collection was conducted from January to April 2022. The study was approved by the ethical research committee at the Nursing Faculty - Mansoura University, ensuring adherence to the Helsinki Declaration. The paediatric nurses reported elevated professional identity, moderate job satisfaction, and moderate intention to stay employed with mean scores of 80.35 ± 13.22, 113.70 ± 19.58, and 8.40 ± 3.55, respectively. Multiple regression explained 13.0% of the variation in paediatric nurses' intention to remain employed (F = 18.50, p < 0.001). Professional identity positively correlated with the intention to stay (β = 2.69, p = 0.008). Job satisfaction also had a positive relationship with the intention to stay (β = 3.49, p < 0.001). Healthcare managers should focus on professional identity strategies such as supportive work environments, growth opportunities, and valuing paediatric nurses' contributions. Implementing interventions such as fair compensation, support, and rewards can enhance paediatric nurses' retention and quality of patient care.
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Affiliation(s)
| | - Abeer Mohammed Zakaria
- Nursing Administration Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Ibrahim Abdullatif Ibrahim
- Nursing Administration Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Shaqra City, Saudi Arabia
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Chang HY, Lee IC, Tai SI, Ng NY, Shiau WL, Yu WP, Cheng TCE, Teng CI. Professional engagement: Connecting self-efficacy to actual turnover among hospital nurses. J Adv Nurs 2023; 79:4756-4766. [PMID: 37334431 DOI: 10.1111/jan.15737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/08/2023] [Accepted: 06/01/2023] [Indexed: 06/20/2023]
Abstract
AIMS To examine how nurses' self-efficacy impacts professional engagement (professional opportunities exploration and workplace improvement participation), nurses' turnover intention and further on actual turnover. BACKGROUND The problem of nursing shortage has become a common global issue. Nurses' self-efficacy could reduce nurses' turnover intention. However, whether professional engagement could connect nurses' self-efficacy and their actual turnover remains unknown. DESIGN This study adopts a three-wave follow-up design. METHODS This study uses proportionate random sampling to survey nurses in a large medical centre in Taiwan. Totally, 417 participants were enrolled from December 2021 to January 2022 (first wave) and followed up from February 2022 to March 2022 (second wave). The data of nurses' actual turnover (or not) were traced in May 2022 (third wave). STROBE statement was chosen as the EQUATOR checklist. RESULTS Self-efficacy was positively linked to outcome expectation, which is positively linked to professional opportunities exploration. Self-efficacy was positively linked to career interest and workplace improvement participation. Professional engagement was negatively linked to nurses' intention to leave the target hospital, which was positively linked to actual turnover. CONCLUSION This study uniquely finds that professional engagement is the key to the mechanism underlying the influence of nurse' self-efficacy on their actual turnover. IMPACT Our findings impact nursing management that professional engagement is as well important as nurses' self-efficacy, with an aim to maintain the professional nursing workforce. PATIENT OR PUBLIC CONTRIBUTION Nurses complete the questionnaires, return them to the investigators and permit investigators to check their personnel data.
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Affiliation(s)
- Hao-Yuan Chang
- School of Nursing, National Taiwan University, Taipei, Taiwan
| | - I-Chen Lee
- Department of Industrial and Business Management, Chang Gung University, Taoyuan City, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
- Department of Business and Management, Ming Chi University of Technology, Taipei, Taiwan
| | - Shih-I Tai
- Graduate Institute of Management, Chang Gung University, Taoyuan City, Taiwan
| | - Nga Yan Ng
- Department of Industrial and Business Management, Chang Gung University, Taoyuan City, Taiwan
| | - Wen-Lung Shiau
- Department of Information Management, Chang Gung University, Taoyuan City, Taiwan
| | - Wen-Pin Yu
- Department of Nursing, Chang Gung Medical Foundation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - T C E Cheng
- Faculty of Business, Department of Logistics and Maritime Studies, The Hong Kong Polytechnic University, Hong Kong SAR, PRC
| | - Ching-I Teng
- Department of Business and Management, Ming Chi University of Technology, Taipei, Taiwan
- Graduate Institute of Management, Chang Gung University, Taoyuan City, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
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Cha C, Lee M. High-Risk Symptom Cluster Groups for Work-Life Quality and Turnover Intention among Nurses. West J Nurs Res 2023; 45:192-200. [PMID: 35876028 DOI: 10.1177/01939459221113511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This cross-sectional study aims to identify high-risk symptom cluster groups for assessing the quality of nursing work life (QNWL) and turnover intention among Korean nurses who have experienced workplace violence. Nurses were recruited for an online survey in May 2021 (n = 203). The following four symptom clusters are extracted: (a) depression-anxiety, (b) shame-somatization, (c) nightmare-loss of appetite, and (d) anger-shock. Three symptom cluster groups were identified. Group 1 had the highest score for the anger-shock symptom cluster, as well as the highest symptom scores and turnover intention. Group 2 had the highest score for the nightmare-loss of appetite symptom cluster and the lowest QNWL. Group 3 had a similar symptom cluster pattern to Group 1 but lower scores for all symptom clusters. Symptom monitoring and programs tailored to symptom cluster groups at the institutional level could be useful for managing QNWL and turnover intention.
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Affiliation(s)
- Chiyoung Cha
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, South Korea
| | - Miran Lee
- Department of Nursing, Kwangju Women's University, Gwangju, South Korea
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Zhang M, Zheng X, Chen C, Fang J, Liu H, Zhang X, Lang H. Role of patient safety attitudes between career identity and turnover intentions of new nurses in China: A cross-sectional study. Front Public Health 2022; 10:981597. [PMID: 36408031 PMCID: PMC9667691 DOI: 10.3389/fpubh.2022.981597] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Patient safety is a key priority for healthcare systems, which is not only about the safety and quality development of health care but also about the safety of patients' lives. However, there has been little research exploring the relationship between new nurses' willingness to leave, patient safety culture, and professional identity. This study was to explore patient safety for new nurses, examine the relationship between professional identity, patient safety culture, and turnover intentions of newly recruited nurses in China, and validate the mediating role of patient safety culture. Methods From August 2019 to September 2021, we collected data from newly recruited nurses in 5 large tertiary public hospitals in Anhui Province, China using a questionnaire survey. Descriptive analysis, a univariate analysis, Pearson correlation analysis, and mediated regression analysis were used to estimate the current status of patient safety attitudes and the effect of safety culture on career identity and turnover intentions among newly recruited nurses. Results The turnover intention of 816 newly recruited nurses was 14.16 ± 3.14%. Patient safety culture was positively associated with career identity (r = 0.516, P < 0.01) and negatively associated with turnover intentions (r = -0.437, P < 0.01), while patient safety was also a partial mediator between career identity and turnover intentions. Conclusions The results showed that the low patient safety attitudes of new nurses in China should not be ignored. The impact of professional identity on patient safety has important practical implications for promoting a culture of safety among new nurses and reducing turnover rates.
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Affiliation(s)
- Man Zhang
- School of Nursing, Yan'an University, Yan'an, China
| | - Xutong Zheng
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Changchang Chen
- Department of Nursing, Air Fourth Military Medical University, Xi'an, China
| | - Jiaxin Fang
- Department of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Huan Liu
- Department of Hemodialysis, The First Affiliated Hospital of Wan'nan Medical College, Wuhu, China
| | - Xiancui Zhang
- Medical Examination Center, The First Affiliated Hospital of Wan'nan Medical College, Wuhu, China
| | - Hongjuan Lang
- Department of Nursing, Air Fourth Military Medical University, Xi'an, China,*Correspondence: Hongjuan Lang
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Huang TL, Wu CN, Lee IC, Wong AMK, Shyu YIL, Ho LH, Liao GY, Teng CI. How robots impact nurses' time pressure and turnover intention: A two-wave study. J Nurs Manag 2022; 30:3863-3873. [PMID: 35862237 DOI: 10.1111/jonm.13743] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 12/30/2022]
Abstract
AIMS To examine the relationships among effort ensuring robots' smooth operation (EERSO), time pressure, missed care, and nurses' turnover intention, and how robot performance moderates such relations. BACKGROUND Robots may reduce nurses' workload but typically still require some effort of nurses for robots' smooth operation. However, the negative impact of EERSO on nurses' workplace outcomes is unknown. METHODS This study used a two-wave follow-up design. Data were collected in a medical center in Taiwan, with first wave collected in 2019 and second wave collected between 2019 and 2020. A total of 331 participants were followed through the two waves. RESULTS EERSO is positively linked to missed care and time pressure. Time pressure is also positively linked to missed care and turnover intention. Positive robot performance weakens the positive link between EERSO and time pressure. CONCLUSION Using robots may help reduce nurses' workload, but it also requires nurses' efforts to maintain robots' continuous operation, that is, EERSO. It may adversely impact nursing professional workplaces. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers should reduce nurses' time pressure whilst suggest hospital managers to seek robots that require minimal EERSO.
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Affiliation(s)
- Tzu-Ling Huang
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan
| | - Chieh-Ni Wu
- Department of Industrial and Business Management, Chang Gung University, Taoyuan, Taiwan
| | - I-Chen Lee
- Department of Industrial and Business Management, Chang Gung University, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | | | | | - Lun-Hui Ho
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan.,Adjunct Lecturer, Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Gen-Yih Liao
- Department of Information Management, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
| | - Ching-I Teng
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Business and Management, Ming Chi University of Technology, Taiwan
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Alilyyani B, Kerr MS, Wong C, Wazqar DY. The influence of authentic leadership on nurses' turnover intentions and satisfaction with quality of care in Saudi Arabia: A structural equation modelling study. J Nurs Manag 2022; 30:4262-4273. [PMID: 36326612 DOI: 10.1111/jonm.13895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/01/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
AIM(S) The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care. BACKGROUND Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions. METHOD(S) A non-experimental, cross-sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included. RESULTS Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care. CONCLUSION(S) Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments. IMPLICATIONS FOR NURSING MANAGEMENT Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses.
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Affiliation(s)
- Bayan Alilyyani
- Nursing Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Michael S Kerr
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Carol Wong
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Dhuha Y Wazqar
- Oncology Nursing and Palliative Care at Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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Kueakomoldej S, Liu J, Pittman P, Turi E, Poghosyan L. Practice Environment and Workforce Outcomes of Nurse Practitioners in Community Health Centers. J Ambul Care Manage 2022; 45:289-298. [PMID: 36006387 PMCID: PMC9429595 DOI: 10.1097/jac.0000000000000427] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The nurse practitioner (NP) workforce in community health centers (CHCs) increases access to primary care for underserved populations. Working with medically complex patients, high workloads, and low resources in the CHC setting, CHC NPs may be susceptible to poor workforce outcomes. This study uses NP survey data collected from 6 US states to describe and assess the relationship between CHC NP practice environment and burnout, job satisfaction, and turnover intention. CHC NPs rated their practice environments favorably, and more than 89% of CHC NPs reported satisfaction with their job. Better rating of NPs' relationship with CHC administration was associated with improved job satisfaction and decreased turnover intention.
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Affiliation(s)
- Supakorn Kueakomoldej
- Center for Healthcare Delivery Research & Innovations (Dr Poghosyan), School of Nursing (Mss Kueakomoldej and Turi and Dr Liu), Columbia University, New York, New York; Health Workforce Research Center, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia (Dr Pittman); and Mailman School of Public Health, Columbia University, New York, New York (Dr Poghosyan)
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Pham TTL, Huang TL, Chung KP, Shyu YIL, Wong MK, Ho LH, Teng CI. Do temperament and character make sense in reducing nurse turnover? The role of professional capabilities improvement. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2079805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Tzu-Ling Huang
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Piao Chung
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - May-Kuen Wong
- Taoyuan Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Lun-Hui Ho
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-I. Teng
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan
- Department of Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Business and Management, Ming Chi University of Technology, Taipei, Taiwan
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Chang HY, Huang TL, Wong MK, Shyu YIL, Ho LH, Chen LC, Cheng TCE, Teng CI. Relationship between Psychological Ownership of the Nursing Profession and Turnover Intention: A Correlational Survey among Taiwanese Nurses. J Nurs Manag 2022; 30:2927-2936. [PMID: 35560968 DOI: 10.1111/jonm.13670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine the relationship between psychological ownership of the nursing profession and turnover intention. BACKGROUND There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated. METHODS This study adopted a cross-sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical center in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self-Efficacy Scale, and developed Having a Place Scale. RESULTS Psychological ownership comprises three dimensions: self-efficacy, nurse identity, and "having a place" in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self-efficacy and "having a place" are negatively related to nurses' intention to leave a hospital (r=-.23 and -.31, p<.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r=-.38, p<.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r=.76, p<.001). CONCLUSION The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management Nurse managers can enhance nurses' self-efficacy and sense of "having a place" to retain nurses in hospitals, while enhance nurse identity to retain nurses in the profession.
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Affiliation(s)
| | - Tzu-Ling Huang
- Graduate Institute of Management, Chang Gung University, Taiwan
| | - May-Kuen Wong
- Taoyuan Branch, Chang Gung Memorial Hospital, Taiwan
| | - Yea-Ing Lotus Shyu
- International Nurse Researcher Hall of Fame, Honor Society of Nursing, Sigma Theta Tau International, & Professor, Department of Nursing, Chang Gung University, Taiwan
| | - Lun-Hui Ho
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan, & Adjunct Lecturer, Department of Nursing, Chang Gung University of Science and Technology, Taiwan
| | - Li-Chen Chen
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan, & Adjunct Lecturer, Department of Nursing, Chang Gung University of Science and Technology, Taiwan
| | - T C E Cheng
- Department of Logistics and Maritime Studies, The Hong Kong Polytechnic University
| | - Ching-I Teng
- Department of Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan, & Adjunct Professor, Department of Business and Management, Ming Chi University of Technology, Taiwan
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Hu H, Wang C, Lan Y, Wu X. Nurses' turnover intention, hope and career identity: the mediating role of job satisfaction. BMC Nurs 2022; 21:43. [PMID: 35144604 PMCID: PMC8830989 DOI: 10.1186/s12912-022-00821-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
Background A high turnover rate has become a critical issue in the field of nursing and how to tackle the problem of nursing turnover has received increased attention worldwide. Hope, career identity, job satisfaction may be useful for reducing turnover. The aim of this study is to explore the relationships among career identity, hope, job satisfaction, and the turnover intention of nurses, and to test the mediating role of job satisfaction on the associations of hope and career identity with turnover intention. Methods A descriptive cross-sectional design was used. A total of 500 nurses were recruited from five comprehensive tertiary hospitals using convenience sampling. The questionnaire included items about sociodemographic information as well as the Adult Dispositional Hope Scale, Nursing Career Identity Scale, Job Satisfaction Index Scale, and Nurse Turnover Intention Scale. Pearson’s correlation, multiple linear regression, and structural equation modeling were used to analyze the data. We describe the study in accordance with the STROBE statement. Results Hope (r = − 0.227, p < 0.001) and career identity (r = − 0.342, p < 0.001) were negatively correlated with turnover intention. Job satisfaction played a completely mediating role on the associations of hope and career identity with turnover intention (β1 = − 0.09, β2 = − 0.33). Conclusions Job satisfaction mediated the associations of career identity and hope with turnover intention. Thus, effective measures can be taken to enhance nurses’ hope and career identity in order to improve their job satisfaction and thereby reduce their turnover intention. Providing nurses with more support, helping them find a spiritual foundation, and holding mindful activities that stimulate positive emotions are helpful. In addition, colleges should pay more attention to instilling nursing students with career identity and nursing values.
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Affiliation(s)
- Huiling Hu
- School of Nursing, Peking University, Beijing, 100191, P.R. China
| | - Chongkun Wang
- School of Nursing, Peking University, Beijing, 100191, P.R. China
| | - Yue Lan
- School of Nursing, Peking University, Beijing, 100191, P.R. China
| | - Xue Wu
- School of Nursing, Peking University, Beijing, 100191, P.R. China.
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Chang WP, Wang CH. Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts. J Clin Nurs 2021; 31:3573-3583. [PMID: 34957611 DOI: 10.1111/jocn.16184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/24/2021] [Accepted: 12/10/2021] [Indexed: 01/19/2023]
Abstract
AIMS AND OBJECTIVES To investigate whether the sleep quality and fatigue of female nurses working rotating shifts could be used to predict future turnover status. BACKGROUND Female nurses working rotating shifts often suffer from sleep problems and fatigue, and the turnover rates of nurses are generally higher than those of other hospital personnel. DESIGN A prospective study. METHODS We recruited a total of 198 female nurses working rotating shifts from December 2017 to March 2019. The nurses completed the Checklist Individual Strength (CIS) scale and wore an actigraph for seven consecutive days in order to collect their sleep parameters. Their turnover status was tracked until 31 May 2021 at which time 55 participants (27.8%) had resigned. The Cox proportional hazard model was used to analyse the factors influencing turnover. In addition, the study adhered to the STROBE checklist. RESULTS The results revealed significant differences between the nurses in the still-working group and the resigned group in terms of the sleep quality parameters sleep efficiency (SE) and wake after sleep onset (WASO) as well as CIS scores. WASO was significantly correlated with intensity of fatigue, and fatigue was common among all of the nurses working rotating shifts. As time progressed, the sleep quality parameter WASO and CIS scores could be used to predict turnover status after 2.4 years. CONCLUSION The results of this study indicated more sleep fragmentation and poor sleep efficiency in the resigned group. Sleep fragmentation was highly correlated with fatigue, and sleep fragmentation and fatigue could be used to predict turnover status. RELEVANCE TO CLINICAL PRACTICE We suggest that relevant hospital management pay more attention to the sleep conditions and fatigue of female nurses working rotating shifts when arranging personnel and schedules and offer them more understanding.
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Affiliation(s)
- Wen-Pei Chang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hui Wang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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