Relationship between work-family conflict and turnover intention in nurses: A meta-analytic review

The Specialist Nurse in European Healthcare 2030: ESNO Congress 2024 Highlights

The European Specialist Nurses Organization (ESNO), after a series of congresses in Brussels, organised its 6th International Congress in Milan, Italy. The ESNO Congress 2024 focused on "The Specialist Nurse in European Healthcare 2030", addressing the evolving roles and increasing importance of specialist nurses. The event featured keynote presentations and discussions on enhancing clinical practice through advanced education, bridging policy-practice gaps, and improving working conditions. The ESNO Declaration emphasised lifelong learning, harmonised qualification recognition, and interdisciplinary collaboration. A dynamic hackathon preceded the congress, generating innovative solutions to pressing nursing challenges. New inductees of the ESNO Fellowship Program were celebrated. The congress highlighted critical advancements and set a strategic roadmap for the future of specialist nursing in Europe.

'Breakdown and healing' - adaptation experiences of postpartum nurses returning to work: a descriptive phenomenological study

BACKGROUND

Promoting the work adaptation of nurses returning to work after childbirth is key to improving their physical and mental health and ensuring the quality of nursing care. Although postpartum nurses have reported high work stress and poor adaptation after returning to work, little is known regarding the experiences, problems and further needs. This study aimed to explore the adaptation experiences of postpartum nurses returning to work.

METHODS

This was a qualitative study with descriptive phenomenological approach. Individual semi-structured interviews were conducted between March and May 2023 in four tertiary hospitals in Changsha, mainland China, which were selected using convenience sampling. A total of 16 postpartum nurses returning to work within one year were recruited using purposive sampling and maximum variation sampling. The interviews were analysed using the Colaizzi's 7-step method.

RESULTS

'Breakdown and healing' is a strong thread in postpartum nurses' work adaptation. It links 13 subthemes in the interview data, which can be grouped under three overarching themes: (a) changes and challenges of multiple roles; (b) self-coping and social support; and (c) further needs after returning to work. The phrase 'breakdown and healing' reflects the mutual relationship between stress and coping among postpartum nurses. The changes and challenges associated with being required to fulfil multiple roles of mothers, wives and nurses make the subjects feel on the verge of 'breakdown'. When returning to work, most of them move slowly towards 'healing' through positive self-management and support from their partners, families, supervisors and colleagues. Moreover, their ongoing demands and unsolved problems - such as their desire for a workplace that is friendly and serves their needs - were generated by the constant process of 'breakdown and healing'.

CONCLUSIONS

Understanding how postpartum nurses returning to work perceive adaptation experiences is essential for nursing managers, who can use the findings to implement targeted measures to shorten postpartum nurses' maladaptation period after returning to work and promote their work adaptation. This study underscores the critical importance of personalized return-to-work training, flexible work arrangements, support from colleagues and managers, well-established maternal facilities and services, and targeted policy efforts in enhancing postpartum nurses' work adaptation.

Chinese Rural Kindergarten Teachers' Work-Family Conflict and Their Turnover Intention: The Role of Emotional Exhaustion and Professional Identity

The loss of rural kindergarten teachers has become a common social concern in China, which is of great importance to the development of preschool education. This study conducted a survey of 2944 kindergarten teachers in mainland China, to explore the relationship between work-family conflict and turnover intention, the mediating effect of emotional exhaustion, and the moderating effect of professional identity. The study used the work-family conflict questionnaire, the emotional exhaustion scale, the turnover intention questionnaire, and the professional identity questionnaire. The results showed that (1) work-family conflict significantly predicted turnover intention; (2) emotional exhaustion played a mediating role between work-family conflict and turnover intention; and (3) professional identity moderated the latter half path of the mediation model, that is, strong professional identity alleviated the indirect predicting effect of work-family conflict on turnover intention through emotional exhaustion. The results clarified the influencing mechanism of work-family conflict on turnover intention, which could help improve rural preschool teachers' positive emotions and reducing turnover.

Validation of the Hungarian version of the 6-item turnover intention scale among elderly care workers

This research examines the psychometric characteristics and reliability of the 6-item turnover intention scale (TIS-6) by Bothma and Roodt (SA J Hum Resour Manag 11:a507, 2013) on a Hungarian sample. The internal validity of the TIS-6 was assessed using data from 269 Hungarian elderly care institution workers. Confirmatory factor analysis was performed to analyse the structural validity. Convergent and discriminant validity were examined with questions on job characteristics and using the Maslach Burnout Inventory and Effort-Reward Imbalance Scale. IBM SPSS 28.0 software was used for the statistical analysis, and the results were considered significant at p < 0.05. The internal consistency of the questionnaire's scale proved to be acceptable (α = 0.826). Convergent validity was confirmed by the relationships between the components of the questionnaire and burnout (rs = 0.512; p < 0.001; rs = 0.419; p < 0.001) and workplace stress (rs = 0.565; p < 0.001; rs = 0.310; p < 0.001). There were significant differences between the TIS-6 scores among the groups with different degrees of burnout (p < 0.001), which indicated adequate discriminant validity of the questionnaire. The structural validity of the questionnaire was acceptable, and the scale questions fit well. The Hungarian version of the TIS-6 scale is a valid and reliable tool for assessing turnover intention among elderly care institution workers in Hungary.

Uneven distribution of stressful working conditions among Japanese nurses: a secondary analysis of nurses with and without children

Supportive measures for employees raising children may have increased workloads on other nurses, causing psychological stress. This study aimed to clarify the differences in working conditions and psychological status among female Japanese nurses based on child-rearing attributes. We used data from 1,600 female nurses at 10 Japanese hospitals collected by the study of the Work Environment for Hospital Nurses in Japan conducted in 2016. The variables included work conditions (number of night shifts per month, daily overtime, number of paid holidays per year, and social support received), psychological status (sense of coherence, emotional exhaustion, and work engagement), and sociodemographic characteristics. An analysis of covariance was performed on the differences between the three groups (without children, with preschool-age children, and with children of other ages groups). The group without children had a relatively higher workload (p<0.01) and lower social support (p<0.01 and p<0.05). Additionally, they had higher emotional exhaustion and lower work engagement (p<0.01). This study confirmed the uneven distribution of work environment by work-life balance measures.

Factors influencing the thriving of emergency department nurses in China

INTRODUCTION

Thriving is a positive feeling arising from nurses' work and is increasingly valued by managers. Given their demanding workloads and various duties, it is necessary to research the determinants of ED nurses' thriving. This study aimed to investigate the factors influencing thriving and the mechanisms of interaction between the factors among ED nurses.

METHODS

380 ED nurses from six tertiary hospitals in Shandong Province, China, participated in this cross-sectional study. The instruments used were the General Information Questionnaire, Challenge-Hindrance Stressors Scale, Psychological Detachment Scale, and Thriving at Work Scale. Data analysis methods included univariate analysis, Pearson correlation, PROCESS 4.0, and hierarchical multiple regression.

RESULTS

Weekly working hours affected nurses' thriving. Challenge stressors and psychological detachment were positively related to thriving. Hindrance stressors had a negative link with thriving. Psychological detachment suppressed the relationship between challenge stressors and thriving; however, it mediated the relationship between hindrance stressors and thriving.

CONCLUSION

Challenge-hindrance stressors and psychological detachment are significant elements influencing ED nurses' thriving. Nursing administrators should help ED nurses properly address stressors with different attributes and adopt appropriate strategies to improve nurses' thriving by enhancing psychological detachment.

How is work-family conflict linked to nurse-assessed patient safety among intensive care unit nurses? A serial multiple mediation analysis

AIM

The aim of this study was to test whether rumination and negative affectivity mediate the relationship between work-family conflict and nurse-assessed patient safety among intensive care unit nurses.

BACKGROUND

Most intensive care unit nurses experience work-family conflicts that jeopardise patient safety. Although prior studies have explored the effect of work-family conflict on patient safety, few have investigated whether work-family conflict is associated with patient safety through rumination and negative affectivity among intensive care unit nurses.

DESIGN

Cross-sectional study.

METHODS

This study included 209 intensive care unit nurses from five general hospitals. The Work-Family Conflict Scale, the Ruminative Response Scale, the Positive and Negative Affect Schedule-Negative Affectivity, and three items indicating nurses' perception of overall patient safety were used to gather data. Associations between work-family conflict, rumination, negative affectivity, and nurse-assessed patient safety were assessed using correlation and serial multiple mediation analysis.

RESULTS

Work-family conflict, rumination, negative affectivity, and nurse-assessed patient safety were significantly correlated (p < 0.01). Work-family conflict can have not only a direct negative impact on the nurse-assessed patient safety (effect = -0.0234; standard error [SE] = 0.0116; 95% confidence interval [CI]: lower limit [LL] = -0.0464, upper limit [UL] = -0.0005) but also an indirect impact on nurse-assessed patient safety through three paths: the independent mediating role of rumination (effect = -0.0118; SE = 0.0063; 95% CI: LL = -0.0251, UL = -0.0006), the independent mediating role of negative affectivity (effect = -0.0055; SE = 0.0039; 95% CI: LL = -0.0153, UL = -0.0001), and the chain-mediating role of rumination and negative affectivity (effect = -0.0078; SE = 0.0031; 95% CI: LL = -0.0152, UL = -0.0027).

CONCLUSION

Our findings indicated that work-family conflict could influence nurse-assessed patient safety through increasing rumination and negative affectivity among intensive care unit nurses. Based on the results, interventions aimed at decreasing work-family conflict would be beneficial for intensive care unit nurses' emotional stability and patient safety.

Work-family conflict categories and support strategies for married female nurses: a latent profile analysis

Objective

To clarify subgroups of married female nurses experiencing work-family conflict (WFC), explore the factors associated with the subgroups, and determine how desired support strategies differ among the subgroups.

Methods

Data was collected from a sample of 646 married female nurses from public hospitals in Zhejiang Province, China, in December 2021. Latent profile analysis was used to group the participants, and multiple logistic regression was used to identify factors associated with higher WFC. The STROBE criteria were used to report results.

Results

According to latent profile analysis, there were three distinct profiles of WFC among married female nurses: "low-conflict type," "work-dominant-conflict type," and "high-conflict type." These profiles differed in the number of children, night shifts, family economic burden, childcare during working hours, family harmony, colleague support, and nurse-patient relationships. Nurses with multiple children, higher pressures in childcare during working hours, heavier family economic burdens, lower family harmony, lower colleague support, and poorer nurse-patient relationships are more likely to be classified as "high-conflict type" nurses.

Conclusion

This study found that married female nurses experience different types of WFCs. The structure of these WFCs and their associated factors suggests that customized intervention strategies can be developed to address the specific needs of married female nurses.

Predicting post-traumatic stress disorder: The complex relationship between burnout, intentions to leave and emotional support among health care professionals

BACKGROUND

Health care professionals working in delivery rooms often encounter stressful situations. Understanding their challenges and the support they receive is essential for improving their well-being and consequently patient care.

PURPOSE

Examining the relationship between burnout, intentions to leave, post-traumatic stress disorder (PTSD) symptoms, and complex PTSD among health care professionals, and identifying their predictors.

METHODS

A mixed methods design, including a survey among 196 midwives and gynecologists assessing burnout, intentions to leave, exposure to negative work experiences and PTSD, as well as 15 semi-structured interviews.

DISCUSSION

Most participants experienced multiple difficult events in the delivery room, reporting insufficient emotional support. Burnout and lack of emotional support were significant predictors of PTSD symptoms. Participants expressed a need for emotional support to cope with complex situations.

CONCLUSION

Burnout among midwives must be addressed through prevention and intervention programs. Emotional support is essential in mitigating PTSD symptoms among midwives and gynecologists, enhancing their resilience and well-being.

The relationships between work-family conflict and life satisfaction and happiness among nurses: a moderated mediation model of gratitude and self-compassion

Background

Researchers and practitioners are concerned with the impact of work-family conflict on the well-being of workers, including those in the health care sector, and previous research suggested that nurses were experiencing a range of negative outcomes.

Aim

To investigate the potentially mediating role of self-compassion and moderating role of gratitude in the relationships between work-family conflict and both life satisfaction and happiness among Saudi nurses.

Method

A cross-sectional survey was conducted with 368 nurses (men age = 35.18, SD = 6.67, 70.65% of females). Nurses were recruited via social media using convenience sampling techniques. They completed the Satisfaction with Life Scale, the Subjective Happiness Scale, the Gratitude Questionnaire-6, the Self-Compassion Scale, and the Work-Family Conflict Scale, as well as a set of demographic questions. The data were analyzed using PROCESS MACRO model 4 and 8, and the reporting followed STROBE checklist.

Results

As expected, the study found a negative relationship between work-family conflict and both life satisfaction and happiness. These relationships were mediated by self-compassion. For the relationships between work-family conflict and life satisfaction and happiness, and between family-work conflict and happiness, this mediation was moderated by gratitude.

Conclusion

This study built on positive psychology and demonstrated that the positive personality traits of self-compassion and gratitude can engender enhanced life satisfaction and happiness among Saudi nurses.

Nurses' perceived health and occupational burnout: A focus on sleep quality, workplace violence, and organizational culture

AIM

This study investigates the mediation of sleep quality between perceived health and occupational burnout in hospital nurses, considering the moderation of workplace violence and organizational culture.

BACKGROUND

Occupational factors lead to physical and mental distress, burnout, and sleep issues in nurses. Approximately two-thirds of nurses experience burnout, impacting patient care quality and safety. Cultivating a positive organizational culture is essential for nursing workforce stability.

METHODS

This cross-sectional study employed convenience sampling to recruit 346 nurses from a teaching hospital in southern Taiwan in July-August 2020 (response rate: 87.3%). Self-administered questionnaires containing validated instruments were employed, including an adapted occupational burnout scale, the Chinese version of an organizational culture scale, a Perceived Health Questionnaire, a Workplace Violence Experience Scale, and the CPSQI; all instruments were reliable and valid. The analysis involved descriptive statistics, linear regression, and the Johnson-Neyman technique.

RESULTS

Nurses with better perceived health exhibited significantly lower occupational burnout (p < 0.001). Perceived health indirectly impacted burnout through sleep quality (p < 0.01) with organizational culture as a partial moderator. Bureaucratic organizational culture exacerbated this relationship. Additionally, decreased workplace violence moderated the connections among perceived health, sleep quality, and occupational burnout among nurses.

CONCLUSIONS

Given the inverse correlation between nurses' perceived health and occupational burnout and considering factors such as workplace violence, organizational culture, and sleep quality, healthcare institutions can proactively take steps to enhance nurses' overall well-being and mitigate burnout.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

By implementing wellness programs, mental health support, security training, robust reporting, and a zero-tolerance approach to violence, healthcare stakeholders can foster a safe and supportive work environment for nurses, thus improving well-being, patient outcomes, and healthcare quality.

Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study

The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, "Whether living with relatives" and "Monthly income" had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = -0.459) and job satisfaction (r = -0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.

Turnover intention of nurses in public hospitals and its association with quality of working life: a cross-sectional survey in six provinces in China

Objectives

High turnover intention can exacerbate the workforce shortage of nurses. This study aimed to determine the level of turnover intention of public hospital nurses in China and its associated factors.

Methods

A cross-sectional questionnaire survey of 2,863 nurses was conducted in 48 public hospitals across six provinces in mainland China, measuring the sociodemographic (gender, age, marital status, and monthly basic salary) and work characteristics (professional title, workload, night sleep deprivation, and workplace violence) of respondents, their quality of working life (QWL), and turnover intention. Multivariate logistic regression models were established to determine the association between QWL and turnover intention after adjustment for variations of the sociodemographic and work characteristics.

Results

Overall, 42.8% of respondents reported turnover intention. Higher QWL scores (AOR = 0.824 for job and career satisfaction, p < 0.001; AOR = 0.894 for professional pride, p < 0.001; AOR = 0.911 for balance between work and family, p < 0.05) were associated with lower turnover intention. Workplace violence was the strongest predictor of higher turnover intention (AOR = 3.003-4.767) amongst the sociodemographic and work characteristics, followed by an age between 30 and 40 years (AOR = 1.457 relative to <30 years), and night sleep deprivation (AOR = 1.391-1.808). Senior professional title had a protective effect (AOR = 0.417 relative to no title) on turnover intention.

Conclusion

High levels of turnover intention are evident across China in nurses employed by public hospitals, in particular in those aged between 30 and 40 years. Low QWL and poor work environment are significant predictors of turnover intention.

Quitting one's job or leaving one's profession: unexplored consequences of workplace violence and discrimination against health professionals

BACKGROUND

Although workplace violence and discrimination against healthcare workers are global and universal phenomena, and violence at work is recognized as a serious and growing problem, in Switzerland, hardly anything is known about the related consequences on job changes and career endings, which are two major staffing challenges present in the notoriously understaffed healthcare sector.

METHOD

Data collected from a written survey conducted among 1,840 hospital employees, of which 1,441 were health professionals, were used to evaluate and estimate the prevalence and impact of specific and cumulated forms of workplace violence and discrimination on the work climate and particularly on subsequent turnover intentions and career endings. Established multi- and single-item measures were used as predicting, intervening and outcome variables. Relative frequencies stratified for nurses, physicians and therapists were calculated to estimate and differentiate the size of the phenomena under study. Furthermore, crosstabulations, as well as multivariate regression analyses, were performed to explore the associations of interest.

RESULTS

Every fifth to sixth nurse and every seventh to eighth physician reported having had intentions to change jobs or leave the profession within the past year. These intentions become much more prevalent across all health professions when one or even two or more different forms of violence and/or discrimination at work are experienced and reported. Accordingly, the relative risks for intending to quit one's job or leave one's profession increase significantly and steadily with a growing number (1, 2 +) of different experienced forms of violence and/or discrimination at work compared to the reference group of those who are nonaffected (aOR from 2.5 up to 5.4). This fairly strong association was only slightly reduced (aOR from 2.1 to 4.0) when work climate was additionally taken into account as a potential intervening variable. Although work climate only partly accounted for the association under study, a poor work climate was an additional strong predictor and independent risk factor for intentions to turnover (aOR = 6.4) or leave the profession (aOR = 4.2).

CONCLUSIONS

Experiences of workplace violence and discrimination and the resulting poor work climate both together and independent of each other seem to be important causes of job changes and career endings among healthcare workers in Switzerland.

Influence of job demands on implicit absenteeism in Chinese nurses: mediating effects of work-family conflict and job embeddedness

Purpose

It has been widely noted that implicit absenteeism is common among nurses, with job demand influencing it. Theoretically, work-family conflict and job embeddedness may help link job demands to implicit absenteeism. However, the mediating effects of the two on the association between job demands and implicit absenteeism remain unclear. Thus, this study aims to explore the association between nurses' job demands and implicit absenteeism, and the chain mediating effect of work-family conflict and job embeddedness in this relationship.

Patients and methods

Data were collected from 1,420 nurses from five tertiary public hospitals in China. They were asked to respond to a questionnaire asking about job demands, implicit absenteeism, work-family conflict, and job embeddedness. The data were coded and analyzed using IBM SPSS version 21.0. Descriptive analysis, t-test, one-way ANOVA, hierarchical multiple regression analysis, and bootstrapping were used to analyze the extracted data.

Results

The mean score for implicit absenteeism was 17.75 ± 5.60. There was a significant correlation (p < 0.05) between nurses' job demands, work-family conflict, job embeddedness, and implicit absenteeism. Nurses' job demands directly influenced implicit absenteeism and indirectly influenced implicit absenteeism through the mediating effects of work-family conflict and job embeddedness. Furthermore, work-family conflict and job embeddedness have a chain effect on the association between job demands and implicit absenteeism.

Conclusion

The study found that nurses' job demands directly and positively influence implicit absenteeism, and indirectly influence implicit absenteeism through single and chain mediating effects of work-family conflict and job embeddedness.

The effect of psychological contract on turnover intention among nurses: a meta-analytic review

BACKGROUND

The turnover intention (TI) of nurses is common, posing a threat to modern healthcare organizations. Psychological contract (PC) is a predictor of TI, affecting significantly nurse's TI. However, the extent of the association between PC and nurse's TI is unknown. We performed a meta-analysis to quantitatively analyze the relationship between PC and nurse's TI.

METHODS

We searched nine electronic databases from inception to July 2023. Observational studies were included using a retrieval strategy related to PC and TI. Meta-analyses of common effect and random effect models were performed using R software with Spearman or Pearson correlation coefficients. Meta-regression, subgroup analysis, publication bias, and sensitivity analysis were also carried out .

RESULTS

Eighteen studies including 8,908 nurses were identified. Based on various PC-related perspectives, 16 studies explored nurses' TI in terms of the content and three-dimensional structure of PC. Of these, 9 studies reported the negative direction of the correlation between PC and TI (r ranged from - 0.20 to -0.45), whereas 7 studies reported the positive direction of the correlation between PC and TI (r ranged from 0.32 to 0.50). The PC total and its dimensions were found to have moderately significant associations with TI, with the exception of the PCE and PCE-I. Additional, 2 studies reported the relationship between the outcome of PC and TI, the PCF, PCB, and PCV were powerful predictors of nurses' TI. Meta-regression and subgroup analysis found that only nurses working in specialized departments might be the source of heterogeneity.

CONCLUSIONS

To our knowledge, this was the first meta-analysis to quantitatively examine the relationship between PC and TI among nurses. The findings reaffirmed the necessity for healthcare administrators and the medical profession to valued nurse' good interpersonal, social support, humanistic environment, and meet nurses' psychological and spiritual needs in addition to their material demands. Moderators of the connection between PC and TI, based on meta-regression and subgroup analyses, should be carefully explored as they may aid in identifying nurses' TI. Additional, longitudinal research, as well as mixed research, should be conducted to more comprehensively explore the relationship between PC and TI.

Nursing students' academic conditions, psychological distress, and intention to leave school: A cross-sectional study

BACKGROUND

Psychological distress and intention to leave school are highly prevalent among nursing students. Academic conditions, including psychosocial stressors and school-work-life conflicts, could contribute to psychological distress and intention to leave school.

OBJECTIVE

To explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

DESIGN

Cross-sectional correlational design.

SETTINGS

Data collection was performed in February and October 2021 in two nursing schools in Canada: Cegep (publicly funded college, technical degree) and university (bachelor's degree).

PARTICIPANTS

230 nursing students (Cegep 131, university 99).

METHODS

A self-administered online questionnaire assessed academic conditions (psychosocial stressors (Demand-Control-Support, Effort-Reward Imbalance and Overcommitment scales) and school-work-life conflicts (single item)), psychological distress (Kessler-6 scale), intention to leave school, and several covariates. Poisson robust multivariate regression models were built to explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

RESULTS

A large proportion of participants experienced high efforts, school-work-life conflicts, overcommitment, and psychological distress (49.5-84.7 %). One out of five participants had had intention to leave school "many times" (Cegep 20.61 %; university 22.22 %). In adjusted analysis, overcommitment and school-work-life conflicts were associated with a higher prevalence of psychological distress (Prevalence ratio = 2.10; 95 % Confidence Intervals = 1.15-3.84 and Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.24-4.32, respectively). Adverse associations were observed between effort-reward imbalance (Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.09-4.94) as well as school-work-life conflicts (Prevalence ratio = 2.40; 95 % Confidence Intervals = 1.05-5.45) and intention to leave school.

CONCLUSIONS

Academic conditions might be risk factors for psychological distress and intention to leave school among nursing students. Interventions targeting modifiable academic conditions might improve nursing students' mental health and retention.

Identifying work-related factors associated with work-family conflict of care workers in nursing homes: A cross-sectional study

AIMS

To investigate which work-related factors are associated with work-family conflict of care workers in nursing homes, this study aimed to: (a) describe the prevalence of work-family conflict of care workers in nursing homes and (b) assess the association of work-related factors with work-family conflict.

DESIGN

Cross-sectional multicentre sub-study based on data from the Swiss Nursing Homes Human Resources Project 2018.

METHODS

Data were collected between September 2018 and October 2019. Work-family conflict of care workers was assessed with the Work-Family Conflict Scale (range 1-5). Prevalence was described in percentages. We used multilevel linear regression to assess the association of time-based factors (working overtime or during one's free time, employment percentage, presenteeism, shift working) and strain-based factors (staffing adequacy, leadership support) with work-family conflict.

RESULTS

Our study sample consisted of 4324 care workers working in a total of 114 nursing homes. Overall, 31.2% of respondents stated to have experienced work-family conflict (>3.0 on the Work-Family Conflict Scale). The overall mean score of the study sample for work-family conflict was 2.5. Care workers experiencing presenteeism 10 or more days per year showed the highest scores for work-family conflict (mean: 3.1). All included predictor variables were significant (p < .05).

CONCLUSION

Work-family conflict is multifactorial. Possible intervention points to tackle work-family conflict could be strengthening care workers' influence in planning work schedules, enabling flexible planning to ensure adequate staffing, lowering presenteeism and implementing a supportive leadership style.

IMPACT

Care workers' jobs become less desirable when workplace demands interfere with family life. This study highlights the multifaceted nature of work-family conflict and suggests intervention options to prevent care workers from experiencing work-family conflict. Action is needed at nursing home and policy level.

Effects of work-family conflict on turnover intention among primary medical staff in Huaihai Economic Zone: a mediation model through burnout

Background

Countries worldwide face the challenge of how medical personnel manage conflicts between work and family. Especially after the challenge of the COVID-19 epidemic, it is necessary to explore the possible mechanisms of work-family conflict, burnout, and turnover intention among primary medical staff.

Objectives

This study aims to observe the turnover intention of Chinese primary medical staff and explore the relationship between work-family conflict, burnout, and turnover intention.

Methods

A cross-sectional study included a turnover intention questionnaire, the Maslach Burnout Inventory-General Survey (MBI-GS), and the Work-Family Conflict Scale (WFCS) to understand turnover intention, burnout, and work-family conflict among primary medical staff in four cities (Xuzhou, Linyi, Huaibei, and Shangqiu cities) within the Huaihai Economic Zone. Spearman correlation analysis and hierarchical multiple regression analysis were used to examine the related factors of turnover intention. Structural equation modeling (SEM) was used to study the mediating role of burnout between work-family conflict and turnover intention.

Results

In this study, there is a positive correlation between work-family conflict and turnover intention (P < 0.01). Demographic characteristics, work-family conflict, and burnout explained 2.3%, 20.3%, and 8.8% of the incremental variances, respectively. Burnout mediated the association between work-family conflict and turnover intention.

Conclusions

Burnout can be regarded as a mediator between two different variables: work-family conflict and turnover intention. Improving work-family conflict and alleviating burnout may play a key role in reducing the willingness of primary medical staff to resign. Corresponding measures can be taken to balance the conflict between work and family, alleviate burnout, reduce turnover rates, and build a primary medical staff team with higher medical service quality and stability.

Factors Associated with Turnover Intentions of Nurses Working in Japanese Hospitals Admitting COVID-19 Patients

Three years after the outbreak of the coronavirus disease (COVID-19) pandemic, turnover among frontline nurses has increased. The participants of this study were nurses at two general hospitals in Ishikawa, Japan, receiving COVID-19 patients. An original self-report questionnaire was created based on previous research. The questionnaire was distributed to 400 nurses, and responses were received from 227 nurses (response rate: 56.8%). The factors influencing turnover intention at the facilities were having less time to relax (odds ratio [OR]: 2.88, 95% confidence interval [CI]: 1.12-7.41) and wanting to receive counseling (OR: 5.21, 95% CI: 1.30-20.91). As a strategy to prevent turnover, nurse managers should provide opportunities for nurses to receive counseling during normal working hours and pay particular attention to changes in nurses' daily lives, such as changes in the time available for relaxation.

How work-family conflict influences emergency department nurses' turnover intention: The mediating role of positive and negative affect

BACKGROUND

Turnover has significant impact on nursing management and nursing safety. Nurses working in the Emergency Department are especially vulnerable to high turnover intention because of their increased risk of work-family conflict associated with the work characteristics.

OBJECTIVE

This study aimed to investigate the effects of work-family conflict on emergency nurses' turnover intention and the role of positive and negative affect between work-family conflict and turnover intention.

METHODS

A cross-sectional study. Data were collected from 17582 nurses working in emergency department in China. We employed a standardized questionnaire to collect sociodemographic information and target work-family conflict, affect and turnover intention. Mediation analyses were performed for the data analyses.

RESULTS

On turnover intention, work-family conflict exerted both direct effect and indirect effect. The results also indicated that positive and negative affect partially mediated the effect of work-family conflict on turnover intention, and that 35.7% of this effect could be explained by mediating effects totally.

CONCLUSIONS

The findings highlight positive and negative affect concern during the process of nursing management and nursing managers should take active measures to reduce negative affect and improve positive affect in order to reduce turnover intention and maintain the stability of the emergency nursing workforce.

The Effect of Risk Propensity on Family-Work and Work-Family Conflicts in Jordanian Nurses: Does Gender Matter?

INTRODUCTION

Work and family duties may be in conflict, which can cause a problem faced by nurses and lead to significant physical and mental health risks. This study examined whether gender moderated the relationship between risk propensity with work-family and family-work conflicts in Jordanian nurses.

METHOD

A cross-sectional study was conducted to collect data from 206 nurses currently employed in two major referral hospitals. Data analysis was performed using the Macros process and correlations.

RESULTS

The bivariate correlations showed that family-work conflict was significantly correlated with depression, stress, and risk propensity. Work-family conflict was only correlated with depression and stress. Macros process results showed that gender moderated the relationship between risk propensity and family-work conflict. These results showed that the risk propensity significantly affected family-work conflict in male but not female nurses.

DISCUSSION

The results showed that gender moderated the relationship between risk propensity and family-work conflict but not between risk propensity and work-family conflict.

Factors related to turnover intention among emergency department nurses in China: A nationwide cross-sectional study

BACKGROUND

Turnover intention among nurses is high, especially in the emergency department. However, factors that are associated with Chinese emergency department nurses' turnover intention have been scarcely studied.

AIMS

The present study examined relationships between turnover intention and demographic characteristics, job-related factors, depressive symptoms, and organizational commitment among emergency department nurses.

STUDY DESIGN

A cross-sectional study of emergency department nurses was conducted in China between July and August 2018. The questionnaire included demographic characteristics (age, gender, level of education, and self-rated health status), job-related factors (qualification title, job seniority, night shifts, and workplace violence), depressive symptoms, organizational commitment, and turnover intention. A hierarchical linear regression model was used to identify factors that are associated with turnover intention among emergency department nurses.

RESULTS

A total of 17 582 emergency department nurses participated in the study. The response rate was 68.9%. The findings indicated that poor self-rated health status (β = 0.25, p < .001), working more than 11 night shifts per month (β = 0.14, p < .01), experiencing workplace violence in the past year (β = 0.08, p < .05), and higher depressive symptom scores (β = 0.07, p < .001) positively correlated with turnover intention. More years of service (β = -0.38, p < .001) and higher organizational commitment scores (β = -0.45, p < .001) negatively correlated with turnover intention.

CONCLUSIONS

Health status, job seniority, night shift frequency per month, workplace violence, depressive symptoms, and organizational commitment were significantly associated with emergency department nurses' turnover intention.

RELEVANCE TO CLINICAL PRACTICE

To reduce turnover intention in the emergency department nurses, hospital administrators and managers should implement measures to improve their physical and mental health, increase organizational commitment, develop staff acceptable shift schedules, and reduce incidences of workplace violence.

Effects of work-family conflict and anxiety in the relationship between work-related stress and job burnout in Chinese female nurses: A chained mediation modeling analysis

BACKGROUND

Job burnout among nurses has been a challenging problem in recent years globally and in China. Work-related stress, work-life interference and mental health have been shown to be associated with nurse job burnout. However, the underlying mechanisms remain not fully understood. This study aims to examine the complex relationships linking work-related stress to nurse burnout among Chinese nurses.

METHODS

Study data were collected from female nurses (n = 2172) in cities of Wuhan, Shiyan and Jingzhou, Hubei Province of China. Job burnout was used as outcome variable, work-related stress was the predictor, work-life interference and anxiety symptoms were mediators. Mediation and chained mediation modeling analysis were used for data analysis.

RESULTS

The association between work-related stress and job burnout was significantly mediated by work-family conflict (indirect effect[95%CI] = 0.05[0.05,0.06]) and anxiety symptoms (indirect effect = 0.42[0.36,0.49]), respectively. Further, a chained mediation mechanism was observed with work-family conflict and anxiety symptoms consecutively mediated the relationship between work-related stress and job burnout (indirect effect = 0.02[0.01,0.02]).

LIMITATIONS

The data were collected in one province in central China, so it needs caution when generalizing the study findings to other regions within or outside of China.

CONCLUSION

Work-related stress exerts effects on job burnout through work-family conflict and anxiety symptoms among female nurses in China. Work-related stress-based burnout prevention must consider both work-family conflict and mental health problems.

The Effect of Work Engagement and Perceived Organizational Support on Turnover Intention among Nurses: A Meta-Analysis Based on the Price–Mueller Model

Aim. To elaborate on the relationship between work engagement, perceived organizational support, and the turnover intention of nurses by analysing some potential moderators. Background. Nurses’ turnover intention is negatively impacted by their level of work engagement and perceptions of organizational support. However, it is challenging to reach a consistent conclusion. Methods. Data were acquired from six electronic databases. Each study was evaluated using the quality assessment tool for cross-sectional studies of the Agency for Healthcare Research and Quality (AHRQ). STATA 15.0 was used to analyse the data, and a random effects model was used. The groups that included two or more studies were added to the moderator analysis. Results. A total of 40 study articles involving 23,451 participants were included. The turnover intention of nurses was inversely associated with work engagement (coefficient: −0.42) and perceived organizational support (coefficient: −0.32). A substantial moderating role was played by cultural background, economic status, working years, and investigation time ( $P<0.05$ ). Conclusion. Work engagement and organizational support significantly reduced turnover intention among nurses. Considering the acute shortage of nurses worldwide, nurses with lower wages, fewer working years, and lower levels of work engagement should be given more attention and support from their organizations. Implications for Nursing Management. The meta-analysis suggested that managers should give their employees a more organizational support and promote their work engagement to motivate nurses’ retention intention and maintain a stable workforce with little employee turnover.

A systematic review and meta-analytic synthesis of the relationship between compulsory citizenship behaviors and its theoretical correlates

Background

Compulsory citizenship behaviors (CCBs) are increasingly endorsed and expected of workers in contexts where managerial worker protections are low and performance demands on workers are high. Although studies on compulsory citizenship behaviors have shown a significant increase in recent years, the literature still lacks a comprehensive meta-analysis. To fill this gap the purpose of this study is to synthesize the collective outcomes of prior quantitative research on CCBs with the objective of identifying the factors linked to the concept and offering a primary reference for future researchers.

Methods

Forty-three different correlates with CCBs were synthesized. The dataset of this meta-analysis consists of 53 independent samples with a sample size of 17.491, contributing to 180 effect sizes. PRISMA flow diagram and PICOS framework were used for the study design.

Result

Results showed only gender and age were significant among demographic characteristics related to CCBs. Correlates between CCBs and counterproductive workplace behaviors, felt obligation, work-family conflict, organizational-based self-esteem, organizational cynicism, burnout, anger toward the organization, and work alienation were found as large. We also found turnover intention, moral disengagement, careerism, abusive supervision, citizenship pressure, job stress, facades of conformity, and feeling trusted to be moderately related to CCBs. Next, there was a small relationship between CCBs and social loafing. On the other hand, LMX, psychological safety, organizational identification, organizational justice, organizational commitment, job satisfaction, and job autonomy were found as significant deterrents of CCBs. These results suggest that CCBs flourish in contexts with low levels of worker protection and low road practices to people management.

Conclusion

In sum, we found solid cumulative evidence that CCBs are a harmful and undesirable phenomenon for employees and organizations. Also, positive correlations of felt obligation, feeling trusted, and organization-based self-esteem with CCBs, showed that, contrary to general acceptance, positive factors could also cause CCBs. Lastly, we found CCBs as a dominant phenomenon in eastern culture.

Influence of the Clinical Nurse's Self-Acceptance and Experiential Acceptance on Leadership Versatility

Introduction

This study identifies how the self-acceptance and experiential acceptance of nurses working in hospitals influences leadership versatility to utilize the information as basic data for developing strategies for improving nursing quality through effective manpower management.

Objective

This study aims to identify the relationships of nurses' self-acceptance, experiential acceptance, and leadership versatility and verify the influence of experiential acceptance and self-acceptance on leadership versatility.

Methods

This study used a descriptive design. The convenience subjects were 100 nurses at the one territory hospital in Korea. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regressions.

Results

There were significant positive correlations between self-acceptance and leadership versatility (r = .39, p < .001). Among predictors, self-acceptance had statistically significant influences on leadership versatility (β = 0.35, p < .001). Self-acceptance indicated an explanation power of 24.0% of the total variance and was shown to be statistically significant (F = 6.89, p < .001).

Conclusions

Self-acceptance and experiential acceptance and factors according to nurses' clinical experience and position should be identified in depth, and subsequent studies on factors related to this should be conducted.

The effect of sleep disturbance on the association between work-family conflict and burnout in nurses: a cross-sectional study from South Korea

BACKGROUND

Sleep disturbances can lead to work-family conflicts and affect the mental health of nurses. This study aimed to investigate the mediating effect of sleep disturbance on the association between work-family conflict (WFC) and burnout in nurses.

METHODS

Responses to a questionnaire from 156 nurses working in a hospital in South Korea were analyzed. Multiple linear regression analysis and PROCESS Macro Model 4 were used to analyze the mediating effect of sleep disturbance on the relationship between WFC and burnout. A bootstrapping approach was used to test the statistical significance of the indirect parameter effects.

RESULTS

The WFC of nurses had a positive correlation with sleep disturbance and burnout. Moreover, sleep disturbance completely mediated the association between WFC and burnout.

CONCLUSIONS

Nursing administrators should pay careful attention to WFCs that interfere with nurses' sleep and reduce their sleep quality, and design suitable working schedules that minimize the effects of WFC. In addition, hospital administrators should improve shift scheduling to ensure good sleep quality and reduce the health effects of WFC among nurses.

How do compulsory citizenship behaviors affect moral disengagement in organizations? Significance of anger toward the organization during the COVID-19 pandemic

Background

With the COVID-19 pandemic, healthcare professionals, especially nurses, are confronted with an intensified workload. The literature on compulsory citizenship behaviors and their consequences is still far from explaining the cognitive and emotional mechanisms that underlie this relationship.

Methods

Drawing on the resource depletion theory, we unpack the mechanism by which compulsory citizenship behaviors influence moral disengagement with the mediation effects of anger toward the organization. We are reporting a cross-sectional survey of nurses (n = 294) in private and public hospitals in Istanbul, Turkey. The data analysis involved structural equation modeling and Bayesian mediation.

Results

The study revealed that compulsory citizenship behaviors positively influenced anger toward the organization and moral disengagement. Further, anger toward the organization mediates the link between compulsory citizenship behaviors and moral disengagement. Likewise, the Bayesian mediation analysis indicated that the proportion mediated (PM), which ensures a prediction of the extent to which the pathway explains the total effect through the mediation effect, was 33.74%.

Conclusion

The findings show that exposure to compulsory citizenship behaviors lead to negative emotional (anger toward to organization) and cognitive (moral disengagement) consequences in nurses.

Practical implications

Hospital managers should not force nurses to display discretionary work tasks outside their job descriptions. Providing an organizational milieu where voluntarily extra-role behaviors are encouraged may help reduce nurses' moral disengagement and, in turn, ease their anger toward the organization.

Work-family and family-work conflict and stress in times of COVID-19

This study aims to investigate the spillover impact of work-family/family-work conflict and stress on five major industrial sectors (education, textile, hospitals, banks, and retail stores), during the first wave of Covid-19. The purpose of this cross-sectional study is twofold; firstly, to test a hypothesized model where work-family/family-work conflicts are related to stress and where stress could exert a mediating role in such relationships. Secondly, we seek to explore the presence of these conflicts and stress in each of the five major industrial sectors and evaluate if there are significant differences between them, identifying the sociodemographic characteristics associated. Two questionnaires were applied to 748 employees from the selected industries. According to our results, stress predicts both types of conflict and also exerts a mediator role. It was primarily found that the five sectors are significantly different regarding the work-family/family-work conflicts and stress. Findings and implications are discussed.

Counterintuitive consequences of COVID-19 on healthcare workers: A meta-analysis of the relationship between work engagement and job satisfaction

Background

Studies conducted in the health sector have determined a positive relationship between job satisfaction and work engagement. However, this paper reveals that this relationship turns into a negative or non-significant relationship during the COVID-19 pandemic. We explore the reasons for inconsistency in research findings in this critical period through a meta-analysis.

Methods

This study was conducted according to the PRISMA guidelines and PICO framework. Online databases including Web of Science, Scopus, PubMed, ProQuest, Google Scholar, and additional records from other databases were searched without any time limitation, and all studies published in English that reported the correlation between work engagement and job satisfaction were included in the analysis. In total, 36 individual correlation coefficients were synthesized. R statistical language was used to analyze the data.

Result

A total of 36 studies with a sample size of 16,087 were synthesized. The overall effect size was found as r = 0.57 (95% CI [0.50-0.64]). While the moderating effect of national culture was not statistically significant, presence of COVID-19 as the significant moderator explained 37.08% of effect size heterogeneity. Such that the presence of COVID-19 has transformed the positive relationship between work engagement and job satisfaction into a negative but statistically non-significant relationship.

Conclusion

This study empirically challenges the existing assumptions about the positive link between work engagement and job satisfaction. The results of the research can be a guide for managers and policymakers. Specifically, based on these results, different mechanisms can be put in place to support work engagement and, in turn, job satisfaction in the COVID-19 process.

Testing the validity and reliability of a Turkish version of the social cyberloafing scale

PURPOSE

This paper aims to evaluate the validity and reliability of the Turkish version of the social cyberloafing (SC) scale as an important predictor of the mental health of healthcare employees.

METHODS

The data for this descriptive cross-sectional study was obtained from 202 Turkish healthcare employees. We followed Dima's 6-step protocol for validation.

FINDINGS

The one-dimensional structure of the scale was found to be homogenous (H = 0.54) and reliable (α = 0.87). The CFA demonstrated that the 7-item and one-factor construct was a valid instrument to measure the SC (GFI = 0.98, CFI = 0.98, TLI = 0.95, SRMR = 0.03, RMSEA = 0.09).

PRACTICAL IMPLICATIONS

These results demonstrated that the Turkish version of the SC scale is an accurate measurement tool.

A systematic review and meta-analytical synthesis of the relationship between work engagement and job satisfaction in nurses

PURPOSE

This study aimed to clarify the mixed conclusions regarding work engagement and job satisfaction in the nursing research literature by conducting a systematic review and meta-analysis.

DESIGN AND METHODS

This meta-analytic review synthesized 15 independent studies published between 2007 and 2021.

FINDINGS

An overall effect size of random-effect model was calculated as r = 0.47 (k = 15, N = 3,818, 95% confidence interval [0.43;0.51]). Data collection method and presence of control variable, as significant moderators, accounted for 43.6% and 43.8%, respectively, of the effect size heterogeneity.

PRACTICE IMPLICATIONS

While the positive relationship between work engagement and job satisfaction was higher in studies using the face-to-face data collection method, it was lower in studies using the control variable in their research models.

A global overview of healthcare workers' turnover intention amid COVID-19 pandemic: a systematic review with future directions

BACKGROUND

Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic.

METHODS

A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute's Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically.

RESULTS

Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia-Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support.

CONCLUSIONS

A wide range of factors influence healthcare workers' turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.

Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout

BACKGROUND

Reducing nurse turnover is a top priority for nursing management globally. While evidence has demonstrated that working in a favorable environment with greater interprofessional teamwork is essential in increasing nurse retention, few studies have explored the mechanism underlying this relationship.

AIM

To examine the direct and indirect effects of interprofessional teamwork on nurses' intentions to leave their jobs via the intermediary roles of job satisfaction and burnout.

METHODS

A cross-sectional study was conducted to collect data from 2113 nurses working in 21 hospitals in Oman. Data were collected using a survey questionnaire measuring teamwork, job satisfaction, burnout, and intention to leave. Logistic regression was used to investigate the direct effect of teamwork on intent to leave. A sequential mediation model was conducted to examine the mediating role of job satisfaction and burnout.

RESULTS

Interprofessional teamwork was directly associated with nurses' intentions to leave. The influence of teamwork on intention to leave was indirectly mediated by both job satisfaction and job burnout.

CONCLUSION

Findings illustrate the potential benefits of enhancing interprofessional teamwork in reducing nurses' intentions to leave. Interventions intended to foster teamwork could create satisfying workplaces, reduce perceived burnout, and ultimately contribute to organizational strategy for reducing nursing shortages.

How Work-Family Conflict and Work-Family Facilitation Affect Employee Innovation: A Moderated Mediation Model of Emotions and Work Flexibility

This paper aims to verify the effects of work-family conflict and work-family facilitation on employee innovation in the digital era. Based on resource conservation theory, this study regards the work-family relationship as a conditional resource. Employees who are in a state of lack of resources caused by work-family conflict will maintain existing resources by avoiding the consumption of further resources to perform innovation activities; employees who are in a state of sufficient resources are more willing to invest existing resources to obtain more resources. In this study, 405 employees from enterprises in the Chinese provinces of Jiangsu, Anhui, Sichuan, and Guangdong, and in the municipality of Tianjin were selected as the research object. These enterprises are knowledge-based companies, and their employees frequently transfer knowledge at work. We collected questionnaires from the frontline employees of these companies. The results show that negative and positive emotions mediate the effect of work-family conflict and work-family facilitation on employee innovation. Moreover, work flexibility has a significant moderating effect on the mediating role of emotions between work-family facilitation and employee innovation behavior. In the digital era, when facing different work-family situations, employees need to pay attention to and dredge their negative emotions to avoid reducing their innovative behaviors due to self-abandonment; in parallel, they need to guide their positive emotions toward innovation, so as to promote their innovative consciousness and behavior. This paper expands the research perspective of employee innovation behavior.

Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts

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.