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Kim JS, Kim S, Chung HIC. Male nurses' adaptation experiences after turnover to community institutions in Korea: A grounded theory methodology. PLoS One 2024; 19:e0302819. [PMID: 38713684 DOI: 10.1371/journal.pone.0302819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 04/14/2024] [Indexed: 05/09/2024] Open
Abstract
We aimed to develop a substantive theory according to the associations between adaptation experience-related factors identified in male nurses after turnover to community institutions. From April through August 2019, data were collected through direct observations and in-depth interviews of 22 male nurse participants who were recruited purposively and analyzed simultaneously with the method proposed by Strauss and Corbin. Furthermore, 29 subcategories were derived from 11 categories, including: (1) leaving the clinical sector and changing jobs, (2) shaking while settling, (3) characteristics of the new job, (4) personal disposition, (5) support system, (6) finding my place, (7) solidifying my place, (8) demonstrating my professional competence, (9) stable settlement in my place, (10) preparing for a better future, and (11) still confused. The core category was identified as "putting down roots in another place for myself." The verification of this theory in this study's results indicates a need for research into the evaluation and development of professional development programs and related policies to provide support to male nurses who are pursuing opportunities in community institutions to maintain their nursing identity and further their efforts for developing a nursing specialty.
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Affiliation(s)
- Ja-Sook Kim
- Department of Nursing, Kunsan National University, Gunsan, Jeollabuk-do, Republic of Korea
| | - Suhyun Kim
- Department of Nursing, Mokpo National University, Gwangju, Republic of Korea
| | - Hyang-In Cho Chung
- College of Nursing, Chonnam National University, Gwangju, Republic of Korea
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Berthelsen C, Hansen CA. SHOULD I STAY OR SHOULD I GO-A rapid qualitative study of principal deteriorating factors experienced by nurses relating to their intentions to leave their current position in a medical hospital department. Scand J Caring Sci 2024. [PMID: 38533749 DOI: 10.1111/scs.13246] [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: 10/25/2023] [Revised: 01/04/2024] [Accepted: 02/04/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND High nurse turnover in hospitals is a worldwide problem with dire consequences for patient care such as increased mortality and a decrease in patient safety. A specific effort to retain nurses is urgently needed due to the many vacant nursing positions, especially across the Medical hospital departments. AIM To identify the principal deteriorating factors experienced by nurses relating to their intentions to leave the medical department at a university hospital. METHODS A rapid qualitative research methodology was used. Participants comprised 22 registered nurses employed in five university hospital medical department units. The Rigorous and Accelerated Data Reduction (RADaR) technique was therefore used for data collection through qualitative semi-structured interviews and analysis. COREQ was used for reporting the study. RESULTS The RADaR analysis detected a downward spiral of five principal deteriorating factors influencing nurses' intentions to leave their position in the medical department. The factors were resignations from several nursing colleagues combined with too few and inexperienced nurses present during shifts, additional tasks assigned, a management refraining from improving the problematic issues, leading to decisive consequences for patient care and a declining feeling of professional care. CONCLUSIONS The lack of nurses in the department caused missed nursing care, which affected the nurses' job satisfaction and intentions to leave their positions. Future research initiatives must focus on evaluating successful interventions to maintain the nurses in the positions. Further knowledge, is also needed, to investigate how we can change the downward spiral to a story of retention success.
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Affiliation(s)
- Connie Berthelsen
- Department of Medicine, Zealand University Hospital, Køge, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Carrinna Aviaja Hansen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark
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Al-Otaibi AG, Alyousef SM, Alhamidi SA, Almoammar DN, Alanazi NH. Exploring Nurse perceptions of structural empowerment in midwifery practice in Saudi Arabia: A qualitative study. Health Care Women Int 2024:1-15. [PMID: 38335006 DOI: 10.1080/07399332.2024.2312955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
Perceptions and experiences of midwives regarding structural empowerment during practice in Saudi Arabia were explored using a qualitative, constructive, descriptive design. Data was gathered using individual semi-structured interviews with ten midwives employed in delivery rooms, and prenatal and postnatal units of governmental hospitals in Saudi Arabia's eastern province. Data was analyzed with assistance of NVivo software, Version 12. Five themes emerged from our study: the meaning of structural empowerment, ambiguous hospital policies, the insufficient numbers of midwives, midwife-physician dynamics, and continuing education and training. Structural empowerment of midwives in maternity units may be useful in improving midwifery services in Saudi Arabia and worldwide.
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Affiliation(s)
- Areej Ghalib Al-Otaibi
- Fundamental of Nursing Department, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Seham Mansour Alyousef
- Community and Psychiatric Department, Nursing College Chairman of Community and Psychiatric Department, King Saud University, Riyadh, Saudi Arabia
| | - Sami Abdulrahman Alhamidi
- Department of Maternal and Child Health, Nursing College Vice Dean of postgraduate and research center, King Saud University, Riyadh, Saudi Arabia
| | - Danah Nasser Almoammar
- Department of Psychiatric and Mental Health Care, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Naif H Alanazi
- Medical-Surgical Department, College of Nursing, King Saud University, Riyadh City, Kingdom of Saudi Arabia
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Wu F, Lao Y, Feng Y, Zhu J, Zhang Y, Li L. Worldwide prevalence and associated factors of nursing staff turnover: A systematic review and meta-analysis. Nurs Open 2024; 11:e2097. [PMID: 38268271 PMCID: PMC10802134 DOI: 10.1002/nop2.2097] [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: 10/12/2021] [Revised: 02/10/2022] [Accepted: 12/25/2023] [Indexed: 01/26/2024] Open
Abstract
AIMS To systematically assess the worldwide prevalence of nurse turnover and discuss its influencing factors. DESIGN Systematic review and meta-analysis. METHODS PubMed, the Cochrane Library, Web of Science, CINAHL, China Knowledge Resource Integrated Database, Wanfang Database were searched from their commencement date to 25 March 2021. Two authors independently reviewed the studies. Stata 15.0 software package was used for statistical analysis, with estimates of data on the prevalence of nurse turnover using a random-effects model. This review was performed according to the Joanna Briggs Institute (JBI) manual for evidence synthesis and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement. PROSPERO Registration Number:CRD42020208873. RESULTS A total of 15 studies covering 852,317 nurses were included in the analyses. The pooled prevalence of nurse turnover was 18% (95% CI: 11% to 26%, I2 = 99.86%, p < 0.0001). Geographic regions (Asia), published years (2001 to 2010) and respondents (new nurses) were significantly associated with the prevalence of nurse turnover. Additionally, several risk factors for turnover were identified in the literature, involving demographic factors (young, single, have short working hours, lower level of education and male nurses), organizational factors (small-scale hospitals, low salary levels, larger workload, developed region and absence of labour union), satisfaction (dissatisfaction with organization, profession, job and competence).
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Affiliation(s)
- Feixia Wu
- Hangzhou Hospital of Traditional Chinese MedicineHangzhouChina
| | - Yuewen Lao
- Sir Run Run Shaw Hospital, Zhejiang University School of MedicineHangzhouChina
| | - Ying Feng
- Hangzhou Hospital of Traditional Chinese MedicineHangzhouChina
| | - Jiaqing Zhu
- Hangzhou Hospital of Traditional Chinese MedicineHangzhouChina
| | - Yating Zhang
- Hangzhou Hospital of Traditional Chinese MedicineHangzhouChina
| | - Liuyan Li
- Hangzhou Hospital of Traditional Chinese MedicineHangzhouChina
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Alanazi R, Bahari G, Alzahrani ZA, Alhaidary A, Alharbi K, Albagawi BS, Alanazi NH. Exploring the Factors behind Nurses' Decision to Leave Clinical Practice: Revealing Causes for Leaving and Approaches for Enhanced Retention. Healthcare (Basel) 2023; 11:3104. [PMID: 38131992 PMCID: PMC10743077 DOI: 10.3390/healthcare11243104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/24/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023] Open
Abstract
Nursing turnover has emerged as an urgent concern with a substantial influence on the financial efficiency and quality of care in healthcare frameworks worldwide. This study determined important factors associated with nurses' intentions to leave and what would bring them back. This was a cross-sectional, multisite study of nurses in three public hospitals. Convenience sampling was used to recruit 205 nurses from the selected hospitals. A questionnaire was used to measure demographic and professional background information, current job satisfaction, and the intention to leave work and return. Bivariate and multivariate analyses were run using SPSS. This study revealed that both job satisfaction (M = 47.26, SD = 11.59, range: 19-76) and intent to leave a current job (M = 14.18, SD = 4.36, range: 4-20) were reported at moderate levels. There were significant differences reported between the scores of nationality and job satisfaction (p < 0.05) and between the means of income level and intention to leave (p < 0.05). There was also a significant, negative association between satisfaction and intention to leave (r = -0.551, p < 0.05). In regression, income level (β = 0.159, p = 0.021), incentives (β = 0.186, p = 0.002), hospital type (β = 0.189, p = 0.005), and intention to leave (β = -0.454, p < 0.001) significantly influenced satisfaction. Gender (β = -0.122, p = 0.037) and nationality (β = -0.210, p = 0.007) were found to influence the intention to leave among participants significantly. In conclusion, this study indicated that job satisfaction and intention to leave are important factors affecting nurses' enthusiasm. Incentives also had a positive impact on increasing nurses' satisfaction levels. Future research studies should investigate what factors might lead to improved monthly salaries and provide more incentives among nurses.
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Affiliation(s)
- Raeed Alanazi
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia; (R.A.); (K.A.)
| | - Ghareeb Bahari
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia; (R.A.); (K.A.)
| | - Zahra Ali Alzahrani
- Nursing Administration, King Faisal Hospital-Makkah, Makkah 24236, Saudi Arabia;
| | - Abdulelah Alhaidary
- Nursing Administration, King Saud University Medical City, Riyadh 11472, Saudi Arabia;
| | - Kholoud Alharbi
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia; (R.A.); (K.A.)
| | - Bander Saad Albagawi
- Medical Surgical Department, College of Nursing, University of Hail, Hail City 2440, Saudi Arabia;
| | - Naif H. Alanazi
- Medical Surgical Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia
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Ofei AMA, Poku CA, Paarima Y, Barnes T, Kwashie AA. Toxic leadership behaviour of nurse managers and turnover intentions: the mediating role of job satisfaction. BMC Nurs 2023; 22:374. [PMID: 37817145 PMCID: PMC10563277 DOI: 10.1186/s12912-023-01539-8] [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: 11/27/2022] [Accepted: 09/26/2023] [Indexed: 10/12/2023] Open
Abstract
INTRODUCTION Globally, hospitals are confronted with major challenges of turnover of nurses. Knowledge of the factors that account for the turnover of nurses will aid in creating strategies that will enhance nurse managers' leadership behaviour and job satisfaction to reduce turnover. The study, therefore, investigated the mediating role of job satisfaction on toxic leadership and turnover intentions of nurses. METHODS A multi-centre cross-sectional study was undertaken to assess 943 nurses using the Toxic-leadership Behaviour of Nurse Managers scale, Minnesota Satisfaction Questionnaire and Turnover Intention scale. Descriptive statistics was used to assess the prevalence of toxic leadership, job satisfaction and turnover and Pearson's correlation examined the relationships between the variables. Hayes' PROCESS macro approach of mediation was used to determine the effect of toxic leadership behaviour on the turnover intention on the possible influence of job satisfaction. RESULTS The response rate for the study was 76.0%. Mean scores for turnover intentions and toxic leadership behaviour were 3.71 and 2.42 respectively. Nurses who work with toxic managers showed a higher propensity to leave their jobs. Job satisfaction acted as a mediator between the toxic leadership practices of managers and turnover intentions. The total effect of toxic leadership behaviour on turnover intention comprised its direct effect (β = 0.238, SE = 0.017, 95% CI [0.205, 0.271]) and its indirect effect (β = -0.020, SE = 0.017). CONCLUSIONS Job satisfaction acted as a mediating factor for toxic leadership behaviour and nurses' turnover intentions. As part of nurse retention initiatives, avoiding toxic leadership behaviours will be the ultimate agenda. Nurse administrators should recognize the value of excellent leadership and develop a structured training programme through the use of evidence-based professional development plans for nurse managers.
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Affiliation(s)
| | - Collins Atta Poku
- School of Nursing and Midwifery, University of Ghana, Legon-Accra, Ghana.
- Department of Nursing, Kwame Nkrumah University of Science and Technology, PMB, University Post Office, Kumasi, Ghana.
| | - Yennuten Paarima
- School of Nursing and Midwifery, University of Ghana, Legon-Accra, Ghana
| | - Theresa Barnes
- School of Nursing and Midwifery, University of Ghana, Legon-Accra, Ghana
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Hudays A, Gary F, Voss JG, Zhang AY, Alghamdi A. Utilizing the Social Determinants of Health Model to Explore Factors Affecting Nurses' Job Satisfaction in Saudi Arabian Hospitals: A Systematic Review. Healthcare (Basel) 2023; 11:2394. [PMID: 37685428 PMCID: PMC10487519 DOI: 10.3390/healthcare11172394] [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: 07/11/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
The purpose of this systematic review was to explore factors affecting nurses' job satisfaction in Saudi Arabian hospitals by utilizing the social determinants of a health model. We conducted a systematic review using three databases (PubMed, PsychINFO, and CINAHL) following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A total of 235 studies were screened. Of these studies, nine met the inclusion criteria. The studies were appraised using the Joanna Briggs Institute checklist tool. The majority of studies reported that salary, years of experience, nationality, and marital status were factors affecting nurses' job satisfaction. Gender and educational level did not impact job satisfaction for male and female nurses. Overall, the review highlighted some knowledge gaps in the assessment of the impact of social determinants of health regarding gender and educational level on nurses' job satisfaction. Further research is needed to address this knowledge gap.
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Affiliation(s)
- Ali Hudays
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (F.G.); (J.G.V.); (A.Y.Z.)
- Community, Psychiatric, and Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh 11437, Saudi Arabia;
| | - Fay Gary
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (F.G.); (J.G.V.); (A.Y.Z.)
| | - Joachim G. Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (F.G.); (J.G.V.); (A.Y.Z.)
| | - Amy Y. Zhang
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (F.G.); (J.G.V.); (A.Y.Z.)
| | - Alya Alghamdi
- Community, Psychiatric, and Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh 11437, Saudi Arabia;
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Bae SH. Comprehensive assessment of factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals: a systematic review. BMC Nurs 2023; 22:31. [PMID: 36739408 PMCID: PMC9899133 DOI: 10.1186/s12912-023-01190-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/24/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the demand for nursing care increased, making the retention of nurses even more important. Among staff nurses, it is reported that the turnover rate of newly licensed registered nurses is higher. However, no systematic reviews have focused on the factors that influence newly licensed registered nurses' turnover. Additionally, because newly licensed registered nurses are a major source of the supply of nurses, it is critical to retain them to meet patient needs. Therefore, this study aimed to systematically synthesize the factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals. METHODS CINAHL, Cochrane Library, DBpia, EBSCO, PubMed, PsycINFO, RISS, and Web of Science were searched for studies published between January 2000 and June 2021. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Ten articles from 9029 were included in this review. All studies used a longitudinal design. The annual turnover rates of newly licensed registered nurses ranged from 12 to 25%. Health status, including sleep and healthy lifestyles, were significant factors affecting turnover. Most studies focused on work environment factors, and emotional exhaustion, job satisfaction, peer support, and intent to leave, were significantly associated with newly licensed registered nurses' turnover. Small hospitals located in nonmetropolitan areas were at risk of high turnover of newly licensed registered nurses. CONCLUSIONS Turnover is inevitable in the process of employment, but high turnover can be prevented. Through reviewing ten articles, significant contributing factors for newly licensed registered nurses' turnover included personal factors of health status; work environment factors of physical exhaustion, emotional exhaustion, depersonalization, occupational injuries, income, intent to stay, job satisfaction, and peer support; and hospital factors of hospital size, location, and unionization. Most existing studies focus on work environment factors, which reflects the significance of fostering healthy work conditions to prevent high turnover. These findings can be used to develop strategies and policies for work environment to reduce high turnover of newly licensed registered nurses, and support high-risk groups, such as small hospitals located in nonmetropolitan areas with high levels of nurses' turnover.
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Affiliation(s)
- Sung-Heui Bae
- grid.255649.90000 0001 2171 7754College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Helen Hall #204, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760 Republic of Korea
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Sato A, Sato Y, Sugawara N, Shinozaki M, Okayasu H, Kawamata Y, Tokumitsu K, Uchibori Y, Komatsu T, Yasui‐Furukori N, Shimoda K. Predictors of the intentions to leave among nurses in an academic medical center. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e48. [PMID: 38868654 PMCID: PMC11114313 DOI: 10.1002/pcn5.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 06/14/2024]
Abstract
Aim Nurses are an essential human resource for the healthcare system. However, high turnover of nurses is a current issue. Reducing the high turnover of nurses is crucial for facilitating the sustainable provision of care in hospitals. The purpose of this study was to explore the factors affecting nurses' intentions to leave among nurses in an advanced medical center. Methods Using a cross-sectional design, we conducted a questionnaire survey of nurses working at an academic medical center in August 2020. Of the 1063 distributed questionnaires, there were 821 (77.2%) valid responses. The questionnaire included items on the Kessler 6 (K6), New Brief Job Stress Questionnaire (New BJSQ), Organizational Justice Questionnaire (OJQ), and intention to leave a hospital job. Results Overall, the mean age of the nurses was 34.3 ± 10.1 years and 87.8% (721/821) of them were female. Among respondents, 19.5% (160/821) had a strong intention to leave. After adjusting for all the variables, a logistic regression analysis revealed that longer working hours, job rank (staff nurse), work-self-balance positive (imbalance), workplace harassment (no bullying), and interactional justice (unfair supervisor) were determinants associated with strong intentions to leave. Conclusions Approximately one-fifth of nurses working at advanced medical center had a strong intention to leave. However, our findings can help managers predict the turnover of nurses by understanding occupational characteristics. Managing work-self-balance and treating staff fairly could improve work environments. Further research focusing on the outcome of actual turnover rather than intention to leave is needed.
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Affiliation(s)
- Aoi Sato
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
| | - Yoshiteru Sato
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
| | - Norio Sugawara
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
- Health Services Center for Students and StaffDokkyo Medical UniversityTochigiJapan
| | - Masataka Shinozaki
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
| | - Hiroaki Okayasu
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
| | - Yasushi Kawamata
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
| | - Keita Tokumitsu
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
| | - Yumiko Uchibori
- Department of NursingDokkyo Medical University HospitalTochigiJapan
| | - Tomie Komatsu
- Department of NursingDokkyo Medical University HospitalTochigiJapan
| | - Norio Yasui‐Furukori
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
| | - Kazutaka Shimoda
- Department of PsychiatryDokkyo Medical University School of MedicineTochigiJapan
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Alilyyani B, Kerr MS, Wong C, Wazqar DY. The influence of authentic leadership on nurses' turnover intentions and satisfaction with quality of care in Saudi Arabia: A structural equation modelling study. J Nurs Manag 2022; 30:4262-4273. [PMID: 36326612 DOI: 10.1111/jonm.13895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/01/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
AIM(S) The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care. BACKGROUND Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions. METHOD(S) A non-experimental, cross-sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included. RESULTS Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care. CONCLUSION(S) Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments. IMPLICATIONS FOR NURSING MANAGEMENT Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses.
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Affiliation(s)
- Bayan Alilyyani
- Nursing Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Michael S Kerr
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Carol Wong
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Dhuha Y Wazqar
- Oncology Nursing and Palliative Care at Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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Mariano MEM, Woodman A, Al Zahrani EM, Al Naam Y, Farrelly RR, Al‐Jamea LH, Al Mutair A, Al‐Ansari R, Quiambao JV, Balilla J. Turnover-attachment motive of Saudi Arabia nursing workforce: A Cross-Sectional study. Nurs Open 2022; 10:988-997. [PMID: 36109849 PMCID: PMC9834159 DOI: 10.1002/nop2.1366] [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: 04/20/2022] [Revised: 08/08/2022] [Accepted: 08/30/2022] [Indexed: 01/16/2023] Open
Abstract
AIM This study aimed to explore the association of turnover-attachment motive with socio-demographic data among Saudi and foreign nurses in a hospital in the Eastern Province of Saudi Arabia. METHODS A cross-sectional correlation study was conducted among n = 180 registered Saudi and foreign nurses working at a private tertiary hospital in the Eastern Province, Saudi Arabia. The turnover-attachment motive survey was used to evaluate the eight motivational forces. Data were analysed using JASP version 16 statistical software and Orange 3 version 3.26.0. The data were subjected to correlation analysis and multiple linear regression. RESULTS Only 8% of participants were identified with a high intention to leave driven by alternative, behavioural, normative and constitutive forces. Younger healthcare workers tend to have higher intentions to quit the job; the 29-33 age group has a statistically significant negative effect, increasing intention to leave. It was found that those with 5-6 years of clinical experience at Dr. Sulaiman Al Habib Hospital, Al Khobar and no experience abroad had statistically significantly lower intention to leave. CONCLUSION This study presented the factors influencing nursing staff to stay or leave work in a hospital in the Eastern Province of Saudi Arabia that can be a basis for reviewing existing policies and procedures to improve nurses' working conditions.
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Affiliation(s)
- Maria E. M. Mariano
- Nursing Department, Prince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Alexander Woodman
- Vice Deanship of Postgraduate Studies and ResearchPrince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Eidan M. Al Zahrani
- Biomedical Technology DepartmentPrince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Yaser A. Al Naam
- Department of Clinical Laboratory SciencesPrince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Rory R. Farrelly
- Nursing Administration DepartmentDr. Sulaiman Al Habib HospitalDhahranSaudi Arabia
| | - Lamiaa H. Al‐Jamea
- Department of Clinical Laboratory SciencesPrince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Abbas Al Mutair
- Nursing Department, Prince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Rehab Y. Al‐Ansari
- Internal Medicine DepartmentKing Fahad Military Medical ComplexDhahranSaudi Arabia
| | - Jenifer V. Quiambao
- Vice Deanship of Postgraduate Studies and ResearchPrince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Jeffhraim Balilla
- Institutional Assessment, Effectiveness & Research Advancement UnitBulacan State UniversityBulacanPhilippines
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12
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Al Sabei SD, Labrague LJ, Al-Rawajfah O, AbuAlRub R, Burney IA, Jayapal SK. Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout. Nurs Forum 2022; 57:568-576. [PMID: 35152423 DOI: 10.1111/nuf.12706] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/20/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Sulaiman D Al Sabei
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al-Rawajfah
- Department of Adult and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
- Department of Adult, College of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda AbuAlRub
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Ikram A Burney
- Medical Oncology, Women's Health Program, The Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman
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13
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Bae SH. Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. Int Nurs Rev 2022; 69:392-404. [PMID: 35654041 PMCID: PMC9545246 DOI: 10.1111/inr.12769] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/16/2022] [Indexed: 11/29/2022]
Abstract
AIM To examine and synthesize the noneconomic and economic impacts of nurse turnover in acute hospitals. BACKGROUND Nurse turnover occurs when nurses leave their jobs or the profession and is a major concern for the healthcare industry. Many studies have investigated the determinants of nurse turnover. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was utilized in the current review. Article search was conducted in June 2021. Research articles published since January 2000 were included. Eight databases (e.g., CINAHL, PubMed, PsycINFO, and Web of Science) were used. The following eligibility criteria were applied for inclusion: Articles that (1) were nonexperimental quantitative studies, (2) examined the impact of actual nurse turnover in acute hospitals, (3) were a peer-reviewed original research article, and (4) were written in English or Korean. RESULTS Among 9,041 searched articles, 16 were included in the review. Seven studies investigated the association of nurse turnover with processes and outcomes (workgroup processes, nurse staffing, nurse outcomes, and patient outcomes), and partially supported the negative impact of turnover. Nine studies found that nurse turnover is very costly. CONCLUSION Most studies investigated the turnover cost, which is costly. The negative noneconomic impact of nurse turnover was partially supported. IMPLICATIONS FOR NURSING PRACTICE AND NURSING POLICY To prevent the adverse noneconomic and economic impacts of nurse turnover and retain nurses, healthcare organizations, nurse managers, and hospital staff nurses need to develop and implement prevention strategies and policies to address nurse turnover. Efforts to address nurse turnover can increase hospital competency to improve the quality of nursing care services and patient safety.
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Affiliation(s)
- Sung-Heui Bae
- Associate Professor, College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
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14
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Al Otaibi SM, Amin M, Winterton J, Bolt EET, Cafferkey K. The role of empowering leadership and psychological empowerment on nurses’ work engagement and affective commitment. INTERNATIONAL JOURNAL OF ORGANIZATIONAL ANALYSIS 2022. [DOI: 10.1108/ijoa-11-2021-3049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose
This study aims to investigate to role of empowering leadership and psychological empowerment on nurses' work engagement and affective commitment.
Design/methodology/approach
Self-administered questionnaire data from 231 nurses working in a university hospital in Saudi Arabia were analysed using a cross-sectional research design using structural equation modelling (SEM) to assess the relationship between empowering leadership (EL), affective commitment (AC) and work engagement (WE) while testing for the mediating role of psychological empowerment (PE).
Findings
SEM analysis demonstrated that EL significantly relates to AC. AC similarly significantly relates to WE. Further, the results showed that PE substantially mediates the relationship between EL and WE. There is no significant direct relationship found between EL and WE.
Practical implications
The study findings are essential for nursing managers. They illustrate that nurses become more committed to their organisation and, in return, more engaged with their work when they receive EL. Therefore, nursing managers could train their leaders to practice EL as increased WE has been found to result in other positive work attitudes such as reduced turnover intention.
Originality/value
This study corroborates the relationships between EL, AC and WE, as well as the mediating role of PE. However, this research is unique as the long-established relationship between EL and WE was not supported. It shows that the propositions of leader-member exchange theory may not hold for unique non-Western contexts, in this case, Saudi Arabia.
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15
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Organizational Commitment and Intention to Leave of Nurses in Portuguese Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042470. [PMID: 35206656 PMCID: PMC8878484 DOI: 10.3390/ijerph19042470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 12/31/2022]
Abstract
Intention to leave is influenced by the commitment and individual and structural factors. It is a critical dimension in health systems due to the shortage of professionals and the potential impact on the quality of care. The present paper: (i) characterizes organizational commitment and intention to leave; (ii) analyzes the relationship between structural factors (such as, work environment and nurse staffing), individual factors (age), and nurses’ organizational commitments and intention to leave; and (iii) analyzes the differences in the intention to leave and in the organizational commitment according to service specialty, nurses’ specialization, and contractual relationship in Portuguese public hospitals. A cross-sectional study was conducted with a sample of 850 nurses from 12 public hospitals units. The results show a high affective and continuance commitment of nurses with the hospital, and a reduced tendency of the intention to leave. A significant positive association was also found between the intent to leave and individual/structural factors. Organizational commitment and intention to leave levels are satisfactory, despite the influence of several factors, such as nurse staffing, work environment, or other opportunities for professional development. The results identify particularly sensitive areas that, through adequate health and management policies, can reduce nurses’ intentions to leave and promote the sustainability of the health system.
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16
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Al Muharraq EH, Baker OG, Alallah SM. The Prevalence and The Relationship of Workplace Bullying and Nurses Turnover Intentions: A Cross Sectional Study. SAGE Open Nurs 2022; 8:23779608221074655. [PMID: 35097205 PMCID: PMC8796075 DOI: 10.1177/23779608221074655] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/01/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction: Sustaining a healthy work environment is a major challenge for health care organizations worldwide. Nursing professionals are often exposed to workplace bullying, which imposes serious challenges to nursing retention. Objectives: To determine the prevalence of workplace bullying and turnover intention among nurses, and to investigate the relationship between workplace bullying and nurse turnover. Methods: A cross-sectional correlational design. Convenience sampling was applied, whereby 347 nurses working in a tertiary medical city in Riyadh, Saudi Arabia, were recruited. Data were collected using the Negative Acts Questionnaire and the Anticipated Turnover Scale. Results: The rate of workplace bullying was high, bullying occurred at a cumulative rate of 33.4% (n = 116). Work related bullying behaviors formed the most common bullying acts with (34.5%) followed by personal bullying with (31.1%) meanwhile physical intimidating accounted by (25.6%). Among the participants, 31.7% exhibited a high turnover intention. The demographic variable age was revealing an inverse correlation with workplace bullying. There was a positive significant correlation between workplace bullying and turnover intentions (r = .24, p < 0.01). Conclusion: The alarming prevalence of both bullying and turnover intention among participants confirms that when nurses are exposed to workplace bullying, they are more likely to demonstrate an increased intention for turnover. Managers are urged to use proper enforcement of anti-bullying policies along with education and training to create a healthy environment and mitigate workplace bullying.
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Affiliation(s)
| | - Omar G. Baker
- Community, Psychiatric & Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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17
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Lee J. Nursing home nurses' turnover intention: A systematic review. Nurs Open 2021; 9:22-29. [PMID: 34811952 PMCID: PMC8685779 DOI: 10.1002/nop2.1051] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/04/2021] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
Aim This review aimed to examine and describe the published research on nursing home (NH) nurses' turnover intentions in their workplace. Design This study is a systematic review following PRISMA guidelines. Methods An electronic search was conducted for English and Korean articles to identify research studies published between 2009–2019 using CINAHL, PubMed, Cochrane Library, PsycINFO, RISS, and DBpia. Results A total of six studies met the inclusion criteria and revealed NH nurses' turnover intentions. The factors influencing NH nurses' turnover intentions were identified and classified as individual and organizational factors. Among the various factors above, this study found that job satisfaction was the most influential factor in nurses' turnover intentions. Therefore, further efforts are required to increase NH nurses' job satisfaction to decrease turnover intention.
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Affiliation(s)
- Jiyeon Lee
- College of Nursing, Catholic University of Pusan, Busan, Korea
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18
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Alanzi T. Prospects of Integrating Gig Economy in the Saudi Arabian Health-care System from the Perspectives of Health-care Decision-makers and Practitioners. J Healthc Leadersh 2021; 13:255-265. [PMID: 34703350 PMCID: PMC8526949 DOI: 10.2147/jhl.s323729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background Gig economy is an approach in the labor market which is characterized by the prevalence of short-term contracts or freelance work in contrast to permanent jobs. The gig workers are independent workers or temporary contract workers who enter into formal/informal agreements with on-demand companies to provide their services. Rather than employing full-time/permanent employees companies may utilize gig workers as per the demand and work burden, which can minimize the costs incurred in managing permanent employees. However, there is a lack of research on using gig economy in health care, its prospects and the issues involved. Purpose The purpose of this study is to identify and evaluate various prospects in integrating gig economy with the Saudi health-care system. Methods An online survey questionnaire instrument including 22 prospects under three categories including organizational competitiveness, resource management, and sustainable development was used for collecting data from 712 health-care decision-makers and practitioners in Saudi Arabia. Findings were analyzed using the statistical means and standard deviations for each item in the questionnaire for analyzing the role of each factor in depth, and t-tests were used for comparing the responses between the groups. Results T-tests revealed no significant differences among the experts and health-care workers in relation to organizational competitiveness and resource management; however, significant differences in opinions were identified in relation to sustainable development. Individual factors including motivation for Saudization program (mean=4.5, SD=1.15) and creating employment opportunities in rural areas (mean=4.5, SD=1.08), growth in economy (mean=4.4, SD=1.43), increased opportunities for women and disabled (mean=4.4, SD=1.28), and growth in employment (mean=4.3, SD=1.68) were the major prospects identified in relation to the use of gig economy in the Saudi Arabian health-care system. Conclusion Gig economy may offer a wide range of benefits in health care, especially sustainable development, effective resource management, and organizational competitiveness.
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Affiliation(s)
- Turki Alanzi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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19
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Falatah R. The Impact of the Coronavirus Disease (COVID-19) Pandemic on Nurses' Turnover Intention: An Integrative Review. NURSING REPORTS 2021; 11:787-810. [PMID: 34968269 PMCID: PMC8715458 DOI: 10.3390/nursrep11040075] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has increased the demand and workload on nurses. In addition, the number of critical cases, the uncertainty about the disease, and the incidence rate of death from the disease impose a psychological stress on nurses. Considering the alarming issues of stress, burnout, and turnover among nurses even before the pandemic, the pandemic might have amplified such issues. Thus, the impact of the COVID-19 pandemic on nurses' turnover and turnover intention warrants investigation. The aim of this review is to appraise and integrate the current pre- and post-coronavirus disease (COVID-19) literature on nurse turnover, published between 2016 and 2021. Forty-three studies on nurses' turnover intention were appraised and synthesized. The reviewed literature suggested that nurses' turnover intention increased significantly after the COVID-19 pandemic. Post-COVID-19-pandemic studies focused more on predicting nurses' turnover intention through the pandemic's negative impact on the nurses' psychological wellbeing. The findings of this review should be considered by nurse managers and leaders in the development of policies and programs to reduce the negative impact of COVID-19 on nurse retention.
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Affiliation(s)
- Rawaih Falatah
- College of Nursing, King Saud University, Riyadh 11362, Saudi Arabia
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20
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Alreshidi NM, Alsharari AF. Work-life balance of expatriate nurses working in acute care settings. Nurs Open 2021; 8:3201-3211. [PMID: 34378347 PMCID: PMC8510717 DOI: 10.1002/nop2.1033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/25/2021] [Indexed: 11/09/2022] Open
Abstract
Aim To examine the quality of work life of acute care expatriate nurses in multiple regions of Saudi Arabia. Methods A country‐wide cross‐sectional survey was carried out between June–August 2020 using the Brooks' quality of nursing work‐life questionnaire. Results The range of quality of nursing work‐life scores (80 to 245) was moderate, with an overall mean score of 175.3 (± 23.1). Only 723 (42.4%) of the nurses experienced a high quality of nursing work life. Multivariable regression analysis showed that 21 to 40 years' age group, being a Filipino or Indian nurse and working in the northern region were the independent predictors of low quality work life. Conclusion Most expatriate nurses were not satisfied with their quality of work life. Hospital administrators should take initiatives to enhance the quality of expatriate nurses' work life towards improving their productivity and quality of patient care.
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Affiliation(s)
- Nashi M Alreshidi
- Nursing Administration Department, General Directorate of Health Affairs, Ministry of Health, Hail Region, Saudi Arabia
| | - Abdalkarem F Alsharari
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
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21
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Alanzi TM. Gig Health vs eHealth: Future Prospects in Saudi Arabian Health-Care System. J Multidiscip Healthc 2021; 14:1945-1953. [PMID: 34326645 PMCID: PMC8315780 DOI: 10.2147/jmdh.s304690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction The number of gig workers has been rising across the world, reflecting the growing trend toward the gig economy, which is already functioning in various sectors, such as transport(eg, Uber), technology (eg, Appen), and others (eg, Upwork). However, application of gig economy in health care is underresearched, especially in areas of eHealth that can facilitate various online activities and be outsourced. Purpose The purpose of this study was to investigate the gig economy and eHealth in terms of prospects for future health care in Saudi Arabia. Methods Analysis of data collected using online semistructured interviews with 19 experts, including executives from ministries of health and information and communications, physicians, and health-care administrative managers was conducted and new empirical insights are offered. Results A lack of legal and regulatory frameworks and integrating gig culture into the eHealth system were identified to be the major challenges. Improved operational efficiency of health care, reduced costs, and positive societal impact were identified to be the opportunities and benefits of using the gig economy and eHealth in Saudi Arabia. A strategic framework and an effective regulatory framework are essential for integrating the gig economy into the eHealth system in Saudi Arabia and improving future health care by adopting innovative artificial intelligence and machine-learning technologies. Conclusion eHealth has major scope for future health-care operations in Saudi Arabia and use of the gig economy in eHealth may lead to effective management of eHealth operations. More studies are required to evaluate the idea of integrating the gig economy and eHealth and analyze its impact.
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Affiliation(s)
- Turki M Alanzi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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22
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Challenges Facing the Nursing Profession in Saudi Arabia: An Integrative Review. NURSING REPORTS 2021; 11:395-403. [PMID: 34968216 PMCID: PMC8608082 DOI: 10.3390/nursrep11020038] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/11/2022] Open
Abstract
There is a paucity of recent literature identifying the issues facing the nursing profession in Saudi Arabia. The aim of this integrative review is to highlight the ongoing challenges facing the nursing profession in Saudi Arabia despite attempts to make a difference and suggests recommendations for the future. Literature published from 2000 to 2020, inclusive, relevant for nursing challenges in Saudi Arabia was accessed and reviewed from multiple sources. In Saudi Arabia, inadequate numbers of Saudi nurses have prompted an increase in recruitment of expatriate nurses. This has created its own issues including, retention, lack of competency in English and Arabic, as well as Arabic cultural aspects, insufficient experience, and a high workload. The result is job dissatisfaction and increased attrition as these nurses prefer to move to more developed countries. For national nurses, the issues are the need to recruit more and retain these nurses. There are a range of cultural factors that contribute to these issues with national nurses. There is a need to improve the image of nursing to recruit more Saudi nurses as well as addressing issues in education and work environment. For expatriate nurses there is a need for a better recruitment processes, a thorough program of education to improve knowledge and skills to equip them to work and stay in Saudi. There is also a need for organizational changes to be made to increase the job satisfaction and retention of nurses generally. Healthcare in Saudi Arabia also needs leaders to efficiently manage the various issues associated with the nursing workforce challenges.
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23
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Abstract
Nurses’ turnover is a major global problem with significant service and cost implications. Although sizeable research inquiries have been made into the antecedents, the dynamics, and the consequences of nurses’ turnover, there is still a lack of fine-grained understanding of the psychological states that reflect the cumulative impact of different antecedents and immediately precede nurses’ intentions to quit either from their unit/organization and/or their profession. This paper introduces and develops a meaning-based view of nurses’ turnover. This perspective distinguishes between meaning in work (based on the nurses’ relationship with their work) and meaning at work (based on the nurses’ relationship with their work environment) and explain the implications of high/low meaning in and at work on nurses’ turnover. This meaning-based view of nurses’ turnover offers nurses, administrators and policy makers a deeper and a more nuanced understanding of turnover and promises more tailored remedies for the turnover problem.
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Affiliation(s)
- AR Elangovan
- Gustavson School of Business, University of Victoria, Victoria, BC, Canada
| | - Anirban Kar
- Beedie School of Business, Simon Fraser University, Burnaby, BC, Canada
- Anirban Kar, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada.
| | - Claudia Steinke
- Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
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24
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Alreshidi NM, Alrashidi LM, Alanazi AN, Alshammri EH. Turnover among foreign nurses in Saudi Arabia. J Public Health Res 2021; 10. [PMID: 33849251 PMCID: PMC8054764 DOI: 10.4081/jphr.2021.1971] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Globally, nursing turnover has become a contemporary concern that significantly influences the financial proficiency of healthcare systems. Not only costs, but healthcare accessibility and quality also reverberate the consequence of the phenomenon. Design and methods: The study explores the factors that attribute to turnover among foreign registered nurses working in Saudi Arabia. A quantitative-based cross-sectional descriptive study design that uses survey data to make statistical inferences about foreign nurse turnover in Saudi Arabia, was conducted to ascertain factors influencing the termination of foreign nurses working with the Ministry of Health (MOH) hospitals. Results: Factors influencing turnover were categorized into 9 dimensions, professional growth and development, leadership style, management, wage and benefits, workload, interpersonal relationship, housing facilities and services, hospital facilities and intent to stay and turn-over intention, of which the professional growth (4.1±0.7) and development had the highest mean agreement scores (4.0±1.1), whereas housing (2.3±1.3) and hospital facilities (2.1±1.0) showed the lowest mean scores. Conclusions: Wage benefits and workload factors were found to be the most significant causes of expatriate nursing turnover, closely followed by inadequate housing and hospital facilities. Recommendations from nursing staff on how to improve retention were also noted. Significance for public health The nursing workforce is considered the backbone of the healthcare delivery system. In Saudi Arabia, foreign nurses employ a large percentage of human resources required in healthcare institutions. Thus, foreign nurses’ increasing turnover rates remain a significant problem affecting healthcare institutions across the country. Staff turnover rate is the prime source of workforce shortage that impacts the operational domain, thereby negatively affecting productivity and revenues. The high turnover rates negatively impact organizational in quality of care and resources to recruit and train new staff, prompts many scholars to investigate possible causes, and to develop a comprehensive staff retention strategies. Determining associated factors on staff turn-over, provides insights that will guide facility policy makers and stakeholders to keep pace with the demand of public health system.
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Affiliation(s)
- Nashi Masnad Alreshidi
- Continuing Nursing Education Director, Nursing Administration in Hail Region, Hail City.
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25
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Alluhidan M, Tashkandi N, Alblowi F, Omer T, Alghaith T, Alghodaier H, Alazemi N, Tulenko K, Herbst CH, Hamza MM, Alghamdi MG. Challenges and policy opportunities in nursing in Saudi Arabia. HUMAN RESOURCES FOR HEALTH 2020; 18:98. [PMID: 33276794 PMCID: PMC7716289 DOI: 10.1186/s12960-020-00535-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/10/2020] [Indexed: 05/29/2023]
Abstract
BACKGROUND The Kingdom of Saudi Arabia's (KSA) health sector is undergoing rapid reform in line with the National Transformation Program, as part of Saudi's vision for the future, Vision 2030. From a nursing human resources for health (HRH) perspective, there are challenges of low nursing school capacity, high employment of expatriates, labor market fragmentation, shortage of nurses in rural areas, uneven quality, and gender challenges. CASE PRESENTATION This case study summarizes Saudi Ministry of Health (MOH) and Saudi Health Council's (SHCs) evaluation of the current challenges facing the nursing profession in the KSA. We propose policy interventions to support the transformation of nursing into a profession that contributes to efficient, high-quality healthcare for every Saudi citizen. Key to the success of modernizing the Saudi workforce will be an improved pipeline of nurses that leads from middle and high school to nursing school; followed by a diverse career path that includes postgraduate education. To retain nurses in the profession, there are opportunities to make nursing practice more attractive and family friendly. Interventions include reducing shift length, redesigning the nursing team to add more allied health workers, and introducing locum tenens staffing to balance work-load. There are opportunities to modernize existing nurse postgraduate education, open new postgraduate programs in nursing, and create new positions and career paths for nurses such as telenursing, informatics, and quality. Rural pipelines should be created, with incentives and increased compensation packages for underserved areas. CONCLUSIONS Critical to these proposed reforms is the collaboration of the MOH with partners across the healthcare system, particularly the private sector. Human resources planning should be sector-wide and nursing leadership should be strengthened at all levels.
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Affiliation(s)
- Mohammed Alluhidan
- Saudi Health Council, Riyadh, Saudi Arabia.
- Lancaster University, Lancashire, UK.
| | - Nabiha Tashkandi
- Saudi Commission for Health Specialities, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | | | - Tagwa Omer
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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26
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Stefanovska-Petkovska M, Stefanovska VV, Bojadjieva S, Bojadjiev MI. Psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses. Health Serv Manage Res 2020; 34:92-98. [PMID: 33156712 DOI: 10.1177/0951484820971444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Addressing the worldwide challenge of shortage of nurses contributes to the national and international efforts to enhance the health and well-being of the global population. The main aim of this research is to investigate the level and the relationship between psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses in public and private practices while accounting for their socio-demographic characteristics. This was a cross sectional study of 173 primary health care nurses. The Oldenburg Burnout Inventory and General Health Questionairre-12 were used to assess burnout and psychological distress among nursing staff. High psychological distress was present in 21.38% of all respondents and was significantly related to intention to quit. The results indicated a mean job satisfaction score of 3.54 with higher job satisfaction among private vs. public sector nurses. Furthermore, nurses with higher burnout levels and lower job satisfaction were more likely to consider leaving the profession compared with those with lower burnout and higher job satisfaction. The study provides valuable insight for managers of general healthcare practice and healthcare policy makers in effectively managing and retaining primary healthcare nurses.
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Affiliation(s)
- Miodraga Stefanovska-Petkovska
- School of Business Economics and Management, University American College Skopje, Skopje, The former Yugoslav Republic of Macedonia
| | - Vesna Velikj Stefanovska
- Medical Faculty, Ss Cyril and Methodius University, Skopje, The former Yugoslav Republic of Macedonia
| | - Sonja Bojadjieva
- Medical Faculty, Ss Cyril and Methodius University, Skopje, The former Yugoslav Republic of Macedonia
| | - Marjan I Bojadjiev
- School of Business Economics and Management, University American College Skopje, Skopje, The former Yugoslav Republic of Macedonia
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27
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Majeed N, Jamshed S. Nursing turnover intentions: The role of leader emotional intelligence and team culture. J Nurs Manag 2020; 29:229-239. [PMID: 32881098 DOI: 10.1111/jonm.13144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 12/17/2022]
Abstract
AIM To explore the influence of leader emotional intelligence on the working culture prevailing in teams that ultimately impacts nurses' intent to leave the job. BACKGROUND Global shortages of nursing professionals have been concerning issues of extreme vitality in the delivery of superior services. Though the state-of-the-art system provides relief, the hospital management continued worrying about losing highly skilled nursing professionals due to a higher level of emotional exhaustion exhibiting progressive turnover. METHODS A survey technique was employed for data collection from nurses. Further data were analysed by structural equation modelling in the light of 313 substantial responses by using SmartPLS. RESULTS The findings revealed that leader emotional intelligence impulses critical constructive effects by fulfilling the needs of nurses and has an impact on their turnover intentions simultaneously. CONCLUSION The research provides an empirical lens of leadership and culture, which noticeably explain turnover intention. This study affirmed solid connections amongst the leader emotional intelligence, team culture and turnover intentions. IMPLICATIONS FOR NURSING MANAGEMENT The study provides valuable insight for health management organisations to focus on factors that decrease the turnover intention of nurses. Considering a global shortage of nurses, nursing management must consider crucial aspects of the work environment and plan interventions to restrain nursing turnover intentions.
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Affiliation(s)
- Nauman Majeed
- Department of Business Strategy and Policy, Faculty of Business and Accountancy, University of Malaya, Kuala Lumpur, Malaysia
| | - Samia Jamshed
- Department of Business Strategy and Policy, Faculty of Business and Accountancy, University of Malaya, Kuala Lumpur, Malaysia.,Department of Business Administration and Management Sciences, Superior University, Lahore, Pakistan
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28
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Anthony D, Alosaimi D, Dyson S, Korsah KA, Saleh M. Development of nurse education in Saudi Arabia, Jordan and Ghana: From undergraduate to doctoral programmes. Nurse Educ Pract 2020; 47:102857. [PMID: 32846338 DOI: 10.1016/j.nepr.2020.102857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 07/28/2020] [Accepted: 08/13/2020] [Indexed: 11/24/2022]
Abstract
Doctoral programmes in nursing have a long history in the US where traditional research based PhDs and more clinically based doctoral programmes are common. In the rest of the world PhDs are better accepted though professional doctorates with a thesis component are common in the UK. In countries with newly established or planned doctoral programmes in nursing the research PhD seems the degree of choice. Here we discuss developments in Jordan, Saudi Arabia and Ghana. This study used official documents, strategic plans, curriculum developments and other documentary evidence from Saudi Arabia, Jordan and Ghana. We compared doctoral programmes and development with other countries by reference to the literature. We offer the example of public health and non-communicable diseases in particular as one area where doctorally trained nurses applying international standards in collaboration internationally may be of benefit.
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Hølge-Hazelton B, Berthelsen CB. Leading unique cultures in departments with low turnover of nurses. A positive deviance approach study. J Nurs Manag 2020; 28:1207-1214. [PMID: 32492225 DOI: 10.1111/jonm.13061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2020] [Indexed: 12/01/2022]
Abstract
AIM To investigate nurse leaders' experiences and strategies for turnover in relation to culture and work environment in hospital departments with low nurse turnover. BACKGROUND Nursing shortage is a global problem, and numerous turnover strategies have been utilized to attempt to address this shortage. DESIGN/METHODS Four regional hospital departments with the lowest nurse turnover were included. Data were constructed with nine nurse leaders through individual interviews and were analysed using directed content analysis. RESULTS The findings presented in two categories, 'The culture is unique' and 'Maintaining, protecting or re-establishing a unique culture', summarize how leaders navigated authentically in different contexts, operationalizing clear values and visions both for their departmental culture and in turnover strategies. CONCLUSION Even though all the nurse leaders interviewed were concerned about the current recruitment situation, they were confident in their leadership roles, targeted towards supporting the unique culture in their departments. IMPLICATIONS FOR NURSING MANAGEMENT Leaders with clear cultural awareness and visions for the context in which they operate may be positively associated with lower turnover of nurses. Including the perspectives of leaders from departments with low turnover of nurses has the potential to create new knowledge about improving nurse retention.
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Affiliation(s)
- Bibi Hølge-Hazelton
- Zealand University Hospital, Roskilde, Denmark.,Institute of Regional Studies, University of Southern Denmark, Odense, Denmark
| | - Connie B Berthelsen
- Zealand University Hospital, Roskilde, Denmark.,Institute of Regional Studies, University of Southern Denmark, Odense, Denmark
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Alshareef AG, Wraith D, Dingle K, Mays J. Identifying the factors influencing Saudi Arabian nurses' turnover. J Nurs Manag 2020; 28:1030-1040. [PMID: 32277535 DOI: 10.1111/jonm.13028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 03/19/2020] [Accepted: 03/31/2020] [Indexed: 11/28/2022]
Abstract
AIMS This study identifies and analyses the risk factors contributing to nursing turnover in Saudi Arabia and identifies practical solutions to decrease turnover and encourage nurses to stay in their jobs. BACKGROUND Saudi Arabia has a unique nursing profile, as the majority of the nursing workforce are expatriates. The Saudi health care system relies on contracted expatriate nurses to provide most of the direct patient health care. For nurses from other countries, Saudi Arabia can be a challenging place to work due to a range of factors including personal, policy and organisational variables. There is a high turnover of expatriate nurses, and this has been long-standing problem for the Saudi Arabian health care system. METHOD A cross-sectional survey design among nurses in Saudi Arabia including 502 nurses, of whom 83.7% are female. Structural equation modelling is used to examine the relationships between the study variables. Confirmatory factor analysis is used to create and validate the measurement models for variables. RESULTS The analysis of the survey data identifies that Filipino nurses are more likely to intend to leave their current position than other expatriates, including Malaysian, Pakistani, Indian or local Saudi nurses. Many expatriates identify discrimination as an important contributing factor for their intention to leave, citing that the national salary remuneration for nurses should be based on competency and delivery of care. Furthermore, several independent variables are found to be significant predictors of anticipated turnover, including discrimination; social support from immediate supervisor; organisational commitment; and autonomy. CONCLUSIONS This study provides the most comprehensive information available to date about the factors that influence nurses' desire to leave their current job and provides evidence for better health workforce planning in Saudi Arabia. This study strongly indicates that the main factor related to turnover is the unfair and unequal salaries paid to nurses of different nationalities in Saudi Arabia. IMPLICATIONS FOR NURSING MANAGEMENT The findings relating to both Saudi and foreign nurse employment could be helpful to policymakers and the Ministry of Health in Saudi Arabia.
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Affiliation(s)
| | - Darren Wraith
- School of Public Health & Social Work, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Kelvin Grove, Qld, Australia
| | - Kaeleen Dingle
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove Campus, Kelvin Grove, Qld, Australia
| | - Jennifer Mays
- Social Work & Human Services, Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Qld, Australia
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Banaser M, Ghulman F, Almakhalas H, Alghamdi M. Nurses' job satisfaction during the mass gathering of the Hajj 2018 in Saudi Arabia. Int Nurs Rev 2020; 67:372-379. [PMID: 32441322 DOI: 10.1111/inr.12590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses' job satisfaction and inform future healthcare provision and policy. BACKGROUND Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There was a paucity of evidence regarding nurses' experiences during Hajj. This gap in knowledge needed to be addressed. METHODS A cross-sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24-item Nurses' Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co-workers. RESULTS Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items 'multiple policies and procedures that were perceived as complicating nursing work', 'incompetence of other people they work with' and 'too much burden at work'. CONCLUSION Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology. IMPLICATIONS FOR NURSING POLICY AND PRACTICE Hajj-specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses' work during Hajj. Improvements to the nurse work environment should focus on evidence-based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide.
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Affiliation(s)
- Manal Banaser
- Research and Practice Development Division, Nursing Affairs General Department, MOH Agency for Therapeutic Services, Riyadh, Saudi Arabia
| | | | - Hadi Almakhalas
- Nursing Affairs General Department, MOH Agency for Therapeutic Services, Riyadh, Saudi Arabia
| | - Mohammad Alghamdi
- Human Recourses Division, Nursing Affairs General Department, MOH Agency for Therapeutic Services, Riyadh, Saudi Arabia
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Chang H, Huang T, Wong AM, Ho L, Juan Y, Chen Y, Teng C. How career facilitators and barriers influence nurses’ professional turnover intention. J Adv Nurs 2019; 75:3577-3587. [DOI: 10.1111/jan.14191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/06/2019] [Accepted: 08/28/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Hao‐Yuan Chang
- School of Nursing College of Medicine National Taiwan University Taipei Taiwan
- Department of Nursing National Taiwan University Hospital Taipei Taiwan
| | - Tzu‐Ling Huang
- Graduate Institute of Business and Management Chang Gung University Taoyuan City Taiwan
| | | | - Lun‐Hui Ho
- Department of Nursing Chang Gung Memorial Hospital Linkou Taiwan
| | - Yeh‐Chun Juan
- Department of Industrial Engineering and Management Ming Chi University of Technology New Taipei City Taiwan
- Department of Industrial and Business Management Chang Gung University Taoyuan City Taiwan
| | - Yi‐Fang Chen
- Department of Industrial and Business Management Chang Gung University Taoyuan City Taiwan
| | - Ching‐I Teng
- Graduate Institute of Business and Management Chang Gung University Taoyuan City Taiwan
- Department of Rehabilitation Chang Gung Memorial Hospital Linkou Taiwan
- Department of Business and Management Ming Chi University of Technology New Taipei City Taiwan
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Zhan Y, Kim SK, Zhou L, Xie B, Li Y, Wen B, Nie L. Patient violence and health professionals’ occupational outcomes in China: A time-lagged survey study. Int J Nurs Stud 2019; 94:120-130. [DOI: 10.1016/j.ijnurstu.2018.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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Falatah R, Conway E. Linking relational coordination to nurses’ job satisfaction, affective commitment and turnover intention in Saudi Arabia. J Nurs Manag 2019; 27:715-721. [DOI: 10.1111/jonm.12735] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 11/14/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Rawaih Falatah
- Department of Nursing Administration and Education, College of Nursing King Saud University Riyadh Saudi Arabia
| | - Edel Conway
- Dublin City University Business School Dublin City University Dublin Ireland
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