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Zhang J, Xia L, Wang Y, Yi T, Wang Y, Zhou E, Dong C. Predictive factors of turnover intention of newly graduated nurses in their first year of employment: a longitudinal study. BMC Nurs 2024; 23:522. [PMID: 39080640 PMCID: PMC11290105 DOI: 10.1186/s12912-024-02205-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The turnover of newly graduated nurses is a severe challenge for healthcare systems, and so it is essential to identify its predictive factors. This study investigates whether professional commitment, career adaptability, career self-efficacy, anxiety, and depression levels before and after internship can predict the turnover intention of newly graduated nurses after one year of employment. METHODS In a longitudinal study, 271 undergraduate nursing students recruited by convenience sampling were surveyed before internship (T1), after internship (T2), and after one year of employment (T3), with all surveys conducted on the Wenjuanxing survey platform ( www.wjx.cn ). Generalized linear models and restricted cubic spline models were used to explore possible linear and nonlinear relationships between turnover intention and the variables of interest. RESULTS Professional commitment both pre-internship (β = -0.060, p = 0.007, 95% CI [- 0.104, - 0.016]) and post-internship (β = -0.053, p = 0.015, 95% CI [- 0.096, - 0.010]) can negatively predict turnover intention. There is also a negative linear relationship between post-internship career self-efficacy and turnover intention (β = -0.308, p < 0.001, 95% CI [- 0.436, - 0.180]). In addition, professional commitment both pre-internship (adjusted R2 = 0.046, p = 0.004) and post-internship (adjusted R2 = 0.068, p < 0.001), career self-efficacy both pre-internship (adjusted R2 = 0.039, p = 0.008) and post-internship (adjusted R2 = 0.116, p < 0.001), career adaptability both pre-internship (adjusted R2 = 0.057, p < 0.001) and post-internship (adjusted R2 = 0.039, p = 0.008), anxiety both pre-internship (adjusted R2 = 0.035, p = 0.014) and post-internship (adjusted R2 = 0.048, p = 0.003), and depression levels both pre-internship (adjusted R2 = 0.031, P nonlinear = 0.021) and post-internship (adjusted R2 = 0.053, p = 0.002) are nonlinearly associated with turnover intention. CONCLUSIONS Nursing educators and clinical care administrators must take action to enhance the professional commitment and career self-efficacy of nursing students during their internship. It is also important to pay attention to their career adaptability, as well as to any anxiety or depression that they may experience during clinical practice. This can help to reduce the turnover intention during the first year of their nursing career.
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Affiliation(s)
- Jingjing Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China
| | - Lin Xia
- School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yuxin Wang
- Publicity Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Ting Yi
- School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yan Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China
| | - Enhong Zhou
- Publicity Department, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China.
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Silver JK, Fleming TK, Ellinas EH, Silver EM, Verduzco-Gutierrez M, Bryan KM, Flores LE, Sarno DL. Individual, organizational, and policy strategies to enhance the retention and a sense of belonging for health care professionals in rehabilitation medicine. PM R 2024; 16:772-778. [PMID: 38494596 DOI: 10.1002/pmrj.13152] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/19/2024]
Abstract
The retention of physicians and other health care professionals in rehabilitation medicine is a critical issue that affects patients' access to care and the quality of the care they receive. In the United States and globally, there are known shortages of clinicians including, but not limited to, physicians, nurses, physical therapists, occupational therapists, and speech-language pathologists. These shortages are predicted to worsen in the future. It is known that attrition occurs in a variety of ways such as a clinician reducing work hours or effort, taking a position at another organization, leaving the field of medicine altogether, stress-related illness, and suicide. Retention efforts should focus on stay factors by creating a positive culture that supports a sense of belonging as well as addressing a myriad of push and pull factors that lead to attrition. In this commentary, we provide a roadmap that includes examples of stay strategies for individuals and organizations to adopt that are aimed at enhancing the retention of rehabilitation medicine professionals.
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Affiliation(s)
- Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Talya K Fleming
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute, Rutgers Robert Wood Johnson Medical School and Hackensack Meridian School of Medicine, Edison, New Jersey, USA
| | - Elizabeth H Ellinas
- Center for the Advancement of Women in Science and Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Emily M Silver
- Department of Psychology, University of Chicago, Chicago, Illinois, USA
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Katherine M Bryan
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura E Flores
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Danielle L Sarno
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, Massachusetts, USA
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Chen Y, Zhou X, Bai X, Liu B, Chen F, Chang L, Liu H. A systematic review and meta-analysis of the effectiveness of social support on turnover intention in clinical nurses. Front Public Health 2024; 12:1393024. [PMID: 38903567 PMCID: PMC11187297 DOI: 10.3389/fpubh.2024.1393024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
Background Nurse turnover has become a salient issue in healthcare system worldwide and seriously compromises patient outcomes. Social support is considered an effective contributor to alleviate nurse turnover intention (TI). However, the degree of correlation between social support and nurse TI remains elusive. Aims This study aims to evaluate the strength of the effectiveness of social support on TI among nurses as well as its potential moderators. Design This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methods To obtained qualified studies, two researchers searched Embase, PubMed, Web of science, CINAHL, CNKI, WanFang, and Chinese Medical Journal Full Text Database from inception to January 6, 2024. Meta-analysis, publication bias, and sensitivity analysis were carried out on the included studies using CMA 3.0 software, and the moderating effect was verified through meta-analysis of variance (ANOVA). Results A total of 38 studies were obtained, involving 63,989 clinical nurses. The comprehensive effect size of the random effect model showed a significant medium negative correlation between social support and TI among nurses (p < 0.001). The sample size and TI measurement tools significantly moderated the correlation between social support and TI (p < 0.050). However, nurse department, gender, data collection time, and social support measurement tools did not moderate the correlation between the two variables. Conclusion Social support is negatively associated with TI in nurses. Nursing administrators and the medical community should fully recognize the importance of social support for nurses and take corresponding measures to enhance it, thereby reducing TI and ensuring the stability of the nursing team.
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Affiliation(s)
- Yan Chen
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiang Zhou
- School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Xue Bai
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Beibei Liu
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fengzhi Chen
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lixia Chang
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hongli Liu
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Zhang X, Zhang C, Gou J, Lee SY. The influence of psychosocial work environment, personal perceived health and job crafting on nurses' well-being: a cross-sectional survey study. BMC Nurs 2024; 23:373. [PMID: 38831334 PMCID: PMC11145890 DOI: 10.1186/s12912-024-02041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/24/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The World Health Organization urged governments to prioritize the health and work well-being of nursing staff by promoting a positive working environment. A safe and healthy physical and psychosocial work environment is a basic human right for nurses. Job crafting is a necessary skill when facing challenging working conditions. OBJECTIVES This cross-sectional correlational research based on the Job Demands-Resources Model aimed to explore the correlation between psychosocial work environment and work well-being among nurses working in the intensive care unit (ICU) and determine whether personal perceived health could mediate the relationship and whether job crafting can moderate the mediating effect. The study hypothesized that: 1. The psychosocial work environment would impact nurses' work well-being; 2. Personal perceived health would play a role as a mediator in the relationship between psychosocial work environment and work well-being; 3. Job crafting would moderate the relationship between personal perceived health and work well-being. METHODS A total of 655 registered nurses (RNs) from 7 ICUs in a teaching hospital in Beijing participated in this study. The RNs completed a battery questionnaire measuring their health, psychosocial work environment, well-being, and job crafting. PROCESS macros analysis was used to test mediating and moderating effects. RESULTS Personal perceived health mediated the relationship between psychosocial work environment and work well-being (b = 0.012, 95% CI [0.008, 0.016]). The moderated mediated analysis revealed that job crafting moderated perceived health's impact on work well-being (b = -0.007, 95% CI [- 0.010, - 0.003]). CONCLUSION A better psychosocial work environment with well-designed work organization and job content through job crafting could positively impact nurses' health and work well-being.
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Affiliation(s)
- Xin Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chen Zhang
- Department of Nursing, Chinese Academy of Medical Sciences & Fuwai Hospital, Beijing, China
| | - Jiayan Gou
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shih-Yu Lee
- School of Nursing, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Taichung, 43302, Taiwan, 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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El-Gazar HE, Taie ES, Elamir H, Abou Zeid MAG, Magdi HM, Zoromba MA. Does the presence of calling relate to career success? The role of strengths use and deficit correction among nurses. Int Nurs Rev 2024. [PMID: 38174920 DOI: 10.1111/inr.12924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The presence of calling has been associated with beneficial outcomes for nurses, yet our understanding of these effects remains limited. Additionally, the mechanisms linking the presence of calling to these outcomes have not been well established in the nursing literature. AIM This study aimed to investigate the relationship between the presence of calling and nurses' career success, mediated by the parallel effects of strengths use and deficit correction. DESIGN A cross-sectional design was used. METHODS Data were collected from December 2022 to April 2023, involving 237 nurses working in six hospitals in Port Said, Egypt. The study utilized the Demographic Information Form, the Presence of Calling Scale, the Strengths Use Scale, the Deficit Correction Scale, and the Career Success Scale. Study hypotheses were evaluated using structural equation modeling. RESULTS Presence of calling positively related to nurses' career success. Furthermore, nurses' strengths use and deficit correction played a mediating role in the relationship between the presence of calling and career success. CONCLUSION Nurses who view their work as a calling are more inclined to utilize their strengths and address their deficits, resulting in a heightened sense of career success. IMPLICATION FOR NURSING POLICYMAKING Emphasising that nursing is a calling should commence during the undergraduate education of nurses, and this concept should be continually cultivated by hospital administrators throughout their professional careers. This approach empowers nurses to leverage their strengths, address their deficits, and ultimately enhance their sense of success in their nursing careers.
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Affiliation(s)
- Heba E El-Gazar
- Nursing Administration Department, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Eman Salman Taie
- Nursing Administration Department, Faculty of Nursing, Helwan University, Cairo, Egypt
| | - Hossam Elamir
- Healthcare Management Consultant, ISQua Expert, Ministry of Health, Safat, Kuwait
| | - Mennat Allah G Abou Zeid
- College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Nursing Administration Department, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Hussein M Magdi
- College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed A Zoromba
- College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
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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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Khattab SMAK, Sorour MS, Abdelaliem SMF. Nurses Job Crafting: Correlation Between Organizational Identification and Workplace Attachment Among Nurses. J Nurs Adm 2023; 53:641-647. [PMID: 37939170 DOI: 10.1097/nna.0000000000001360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
AIM The aim of this study was to investigate the relationship between nurses' job crafting, organizational identification, and work attachment. BACKGROUND Job crafting is a proactive activity in which nurses adapt the physical, cognitive, or social aspects of their jobs to make them more meaningful. Nurses are considered fundamental healthcare stakeholders who are able to transform initiatives implemented by the healthcare organization into valuable work outcomes. Nurses' perceptions of their jobs shape the community's opinion toward an organization. METHODS This is a descriptive correlational study. Two hundred seventy nurses were recruited from 1 governmental hospital in Egypt. Respondents completed the self-administered, printed questionnaires. Measures included job crafting, organizational identification, and work attachment questionnaires. Findings were investigated via descriptive and inferential statistics. RESULTS Over half of the nurses reported a moderate level of job crafting, whereas none of the nurses reported a high level of organizational identification. More than half of the nurses reported low levels of work attachment. CONCLUSION Job crafting is significantly related to nurses' organizational identification and work attachment.
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Affiliation(s)
- Sabrein Mahmoud Ali Khalifa Khattab
- Author Affiliations: Assistant Professor at Nursing Administration Department (Drs Khattab and Abdelaliem), Faculty of Nursing, Alexandria University; Borg Al Arab Technological University, Faculty of Health Sciences Technology (Dr. Khattab); Lecturer of Nursing Administration (Dr Sorour), Faculty of Nursing, Tanta University, Egypt; Faculty of Nursing, New Mansoura University, New Mansoura, Egypt; and Associate Professor at Nursing Management and Education Department (Dr Abdelaliem), College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Lu X, Yang J, Bai D, Cai M, Wang W, He J, Gong X, Hou C, Gao J. The effect of psychological contract on turnover intention among nurses: a meta-analytic review. BMC Nurs 2023; 22:358. [PMID: 37798645 PMCID: PMC10557294 DOI: 10.1186/s12912-023-01496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023] Open
Abstract
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.
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Affiliation(s)
- Xianying Lu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Jing Yang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Dingxi Bai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Mingjin Cai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Wei Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Jiali He
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Xiaoyan Gong
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Chaoming Hou
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
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De Vries N, Lavreysen O, Boone A, Bouman J, Szemik S, Baranski K, Godderis L, De Winter P. Retaining Healthcare Workers: A Systematic Review of Strategies for Sustaining Power in the Workplace. Healthcare (Basel) 2023; 11:1887. [PMID: 37444721 DOI: 10.3390/healthcare11131887] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
The shortage of healthcare workers is a growing concern. The COVID-19 pandemic and retirement wave have accelerated turnover rates. This systematic review aimed to identify and analyse the existing interventions for job retention of healthcare workers, in terms of nurses and physicians, in a hospital setting. A comprehensive search was conducted within three electronic databases, guided by the preferred reporting items for systematic review and meta-analyses (PRISMA) and synthesis without meta-analysis (SWiM) guidelines, this resulted in 55 records that met the inclusion criteria. The intervention outcomes are categorized into substantial themes: onboarding, transition program to a different unit, stress coping, social support, extra staffing, coping with the demands of patient care, work relationships, development opportunities and department resources, job environment, work organization, recruitment approach, and technological innovations. Considering the literature, onboarding programs and mentoring for nurses and physicians are recommended. Additionally, other interventions described in this review could positively affect the retention of nurses and physicians. When selecting an intervention for implementation, managers and human resources should consider the intervention that matches the determinant of intention to leave of their healthcare workers and the hospital's mission, vision, and values. Sharing the success stories of implemented interventions may benefit healthcare organizations.
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Affiliation(s)
- Neeltje De Vries
- Department of Internal Medicine, Spaarne Gasthuis, P.O. Box 417, 2000 AK Haarlem and Hoofddorp, The Netherlands
- Spaarne Gasthuis Academy, P.O. Box 417, 2000 AK Haarlem and Hoofdorp, The Netherlands
| | - Olivia Lavreysen
- Centre for Environment and Health, University of Leuven (KU Leuven), P.O. Box 952, 3000 Leuven, Belgium
| | - Anke Boone
- Centre for Environment and Health, University of Leuven (KU Leuven), P.O. Box 952, 3000 Leuven, Belgium
| | - José Bouman
- Spaarne Gasthuis Academy, P.O. Box 417, 2000 AK Haarlem and Hoofdorp, The Netherlands
| | - Szymon Szemik
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Kamil Baranski
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Lode Godderis
- Centre for Environment and Health, University of Leuven (KU Leuven), P.O. Box 952, 3000 Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, 3000 Leuven, Belgium
| | - Peter De Winter
- Spaarne Gasthuis Academy, P.O. Box 417, 2000 AK Haarlem and Hoofdorp, The Netherlands
- Department of Paediatrics, Spaarne Gasthuis, P.O. Box 417, 2000 AK Haarlem and Hoofddorp, The Netherlands
- Leuven Child and Health Institute, University of Leuven (KU Leuven), P.O. Box 3717, 3000 Leuven, Belgium
- Department of Development and Regeneration, University of Leuven (KU Leuven), P.O. Box 611, 3000 Leuven, Belgium
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Flinkman M, Rudman A, Pasanen M, Leino-Kilpi H. Psychological capital, grit and organizational justice as positive strengths and resources among registered nurses: A path analysis. Nurs Open 2023. [PMID: 37128977 DOI: 10.1002/nop2.1769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 05/03/2023] Open
Abstract
AIM To examine registered nurses' individual strengths (psychological capital and grit) and an organizational resource (organizational justice) as well as associated work-related outcomes. In a time of a global nursing shortage, there is an urgent need to identify strengths and resources that can have a positive impact on the health, well-being and retention of registered nurses. DESIGN A cross-sectional survey. METHODS A nationwide convenience sample of 514 registered nurses responded to a survey. Data were collected using a self-reported questionnaire between March and May 2018. Data were analysed using descriptive statistics and multivariate path analysis. RESULTS Participants rated their psychological capital and grit moderately high. Grit and organizational justice were found to have significant direct effects on psychological capital. Furthermore, psychological capital had positive direct effects on engagement and the perception of well-conducted everyday nursing as well as negative direct effects on burnout, the stress of conscience and the intent to leave the profession. CONCLUSION The results suggest that nurse leaders and managers could consider improving registered nurses' well-being with two complementary approaches. It might be useful to reinforce positive, individual strengths, such as psychological capital, and at the same time create more favourable nursing work environments, for example by strengthening organizational justice. IMPLICATIONS FOR THE PROFESSION Psychological capital and grit are emerging concepts in nursing workforce research. Identifying registered nurses' positive strengths and resources is important for inventing interventions that enhance nurses' engagement and well-being as well as reduce turnover intentions. IMPACT Nurse leaders and managers play crucial roles in managing and developing registered nurses' individual strengths and organizational resources. This has gained even more importance now as the COVID-19 pandemic could have a long-term negative impact on nurses' well-being. REPORTING METHOD The study is reported following STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Mervi Flinkman
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Ann Rudman
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- School of Health and Welfare, Department of Caring Sciences, Dalarna University, Dalarna, Sweden
| | - Miko Pasanen
- Department of Nursing Science, University of Turku, Turku, Finland
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Zhang Y, An Y, Wang L, Zhao Q, Li H, Fan X. Psychosocial factors associated with career success among nurses: A latent profile analysis. J Adv Nurs 2023; 79:652-663. [PMID: 36484162 DOI: 10.1111/jan.15524] [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] [Received: 06/09/2022] [Revised: 10/29/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022]
Abstract
AIM In this study, a person-centred approach was used to analyse career success profiles and explore the associated psychosocial factors among nurses. DESIGN A cross-sectional study was conducted from 15 April to 15 October 2019. METHODS A total of 1155 registered Chinese nurses were recruited from two general hospitals using convenience sampling. Participants completed a printed questionnaire, including the Maslach Burnout Inventory, Stress of Conscience Questionnaire, Practice Environment Scale, and Career Success Scale. Latent profile analysis and multinomial logistic regression were performed. The data were analysed with Mplus 8.3 and SPSS version 26.0. RESULTS Three latent profiles of career success were identified: high, moderate and low. Nurses with lower educational levels, more years of work experience, lower emotional exhaustion, higher personal achievement, lower stress of conscience and higher participation in hospital affairs were more likely to have higher career success than the other profiles. CONCLUSIONS Burnout, stress of conscience, practice environment, educational level and years of work experience were associated with career success among nurses. Targeting interventions may help enhance nurses' career success. Future research should combine subjective and objective indicators (salary, title and so on) to assess career success and explore other determinants for formulating interventions to enhance nurses' career success. IMPACT The heterogeneity and psychosocial factors associated with nurses' career success provide valuable evidence for the formulation of individualized interventions. Nursing managers should understand the importance of career success, develop interventions to reduce nurses' burnout and stress of conscience, and improve the practice environment to enhance their career success. NO PATIENT OR PUBLIC CONTRIBUTIONS This study was designed to examine the psychosocial factors associated with nurses' career success. The study was not conducted using suggestions from the patient groups or the public.
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Affiliation(s)
- Yilin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yan An
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lyu Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Haiying Li
- Qilu Hospital of Shandong University, Jinan, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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de Vries N, Boone A, Godderis L, Bouman J, Szemik S, Matranga D, de Winter P. The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231159318. [PMID: 36912131 PMCID: PMC10014988 DOI: 10.1177/00469580231159318] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The shortage of healthcare workers is a growing problem across the globe. Nurses and physicians, in particular, are vulnerable as a result of the COVID-19 pandemic. Understanding why they might leave is imperative for improving retention. This systematic review explores both the prevalence of nurses and physicians who are intent on leaving their position at hospitals in European countries and the main determinants influencing job retention among nurses and physicians of their respective position in a hospital setting in both European and non-European countries. A comprehensive search was fulfilled within 3 electronic databases on June 3rd 2021. In total 345 articles met the inclusion criteria. The determinants were categorized into 6 themes: personal characteristics, job demands, employment services, working conditions, work relationships, and organizational culture. The main determinants for job retention were job satisfaction, career development and work-life balance. European and non-European countries showed similarities and differences in determinants influencing retention. Identifying these factors supports the development of multifactorial interventions, which can aid the formulation of medical strategies and help to maximize retention.
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Affiliation(s)
- Neeltje de Vries
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands.,Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Anke Boone
- Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium.,IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - José Bouman
- Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Szymon Szemik
- Department of Epidemiology, School of Medinie in Kotawice, Medical University of Silesia, Katowice, Poland
| | - Domenica Matranga
- University of Palermo, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Palermo, Italy
| | - Peter de Winter
- Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands.,Leuven Child and Health Institute, KU Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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14
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Pap Z, Vîrgă D, Lupșa D. Bringing our best selves to work: Proactive vitality management and strengths use predicting daily engagement in interaction. Front Psychol 2022; 13:1015397. [PMID: 36591058 PMCID: PMC9798898 DOI: 10.3389/fpsyg.2022.1015397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
The present research focused on bottom-up, proactive employee behaviors and personal resources that can contribute to more engagement and optimal functioning at work. Based on the Job Demands-Resources (JD-R) and Conservation of Resources (COR) theories, we tested direct and interactive relationships between strengths use (SU), daily proactive vitality management (PVM), and daily work engagement (WE). Eighty-seven (N = 87) employees from a multinational company completed self-reported questionnaires at the beginning of the study and throughout five consecutive workdays (N = 358), yielding a multilevel dataset. We have found a significant daily positive relationship between PVM and WE, which showed significant inter-individual variation and was significantly enhanced by SU at the individual level. This study showed that PVM as employee-initiated proactive behavior and SU as a proactive personal resource facilitate engagement independently but yield the strongest results when used together, suggesting an interactive mechanism between bottom-up effects postulated in the JD-R theory.
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Zhang Y, Yin R, Lu J, Cai J, Wang H, Shi X, Mao L. Association between horizontal violence and turnover intention in nurses: A systematic review and meta-analysis. Front Public Health 2022; 10:964629. [PMID: 36276344 PMCID: PMC9583538 DOI: 10.3389/fpubh.2022.964629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/12/2022] [Indexed: 01/24/2023] Open
Abstract
Background Horizontal violence is common in nurses. Most published studies have focused on horizontal violence and higher turnover rates in nurses; however, it lacks systematic reviews and meta-analyses. The purpose of this review is to quantitatively assess the correlation between horizontal violence and turnover intention in nurses. Methods Systematic review and meta-analysis were performed in accordance with PRISMA guidelines. The relationship between horizontal violence and turnover intention in nurses was obtained by systematically searching related literature in four English databases (Cochrane, PubMed, Embase, and CINAHL) and three Chinese databases (SinoMed, CNKI, and Wanfang) (up to 6 March 2022). The relationship between horizontal violence and turnover intention was evaluated using Fisher's z-value, which was then converted to r. STATA 16.0 was used to perform statistical analysis. The random-effects model was performed to synthesize data. Results A total of 14 studies with 6,472 nurses were included. A low-positive correlation of horizontal violence with turnover intention was found (pooled r=0.32 [0.29-0.34]). Subgroup analysis showed that sample size and quality were not the source of heterogeneity. Measurement tool was the source of heterogeneity. Although geographic region might not be the source of heterogeneity, further subgroup analysis of the country reveals heterogeneity. The funnel plot and Egger's test showed no publication bias. Conclusion Horizontal violence had a low positive correlation with turnover intention in nurses. Nurses who experienced horizontal violence were more likely to leave or change careers than those who did not experience horizontal violence. This finding helps to draw attention to horizontal violence by nursing managers and implement effective interventions for nurses, so as to reduce nurses' turnover.
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Affiliation(s)
- Yue Zhang
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China,School of Nursing, Medical College of Soochow University, Suzhou, China
| | - Rulan Yin
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, China,Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Jing Lu
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China,School of Nursing, Medical College of Soochow University, Suzhou, China
| | - Jianzheng Cai
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haifang Wang
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoqing Shi
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lifen Mao
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China,*Correspondence: Lifen Mao
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