TURNOVER INTENTION AND CORONAPHOBIA AMONG FRONTLINE NURSES DURING THE SECOND SURGE OF COVID-19: THE MEDIATING ROLE OF SOCIAL SUPPORT AND COPING SKILLS

Novice nurses' transition shock and professional identity: The chain mediating roles of self-efficacy and resilience

AIMS AND OBJECTIVES

The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self-efficacy and resilience among Chinese novice nurses.

BACKGROUND

Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self-efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources.

DESIGN

A cross-sectional survey.

METHODS

The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self-Efficacy Scale and the Connor-Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent-sample t-tests and a one-way ANOVA. Structural equation modelling was used to detect the mediating effects of self-efficacy and resilience.

RESULTS

Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self-efficacy and resilience mediated the complete chain relationship between transition shock and professional identity.

CONCLUSION

To our knowledge, this study is the first to explore the mediating effect of self-efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self-efficacy and resilience.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system.

PATIENT OR PUBLIC CONTRIBUTION

Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self-report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process.

The association between school educational atmosphere, learning engagement, and professional commitment of nursing students, and learning engagement as the mediator

BACKGROUND

The current shortage and loss of nurses has become a significant problem in healthcare systems around the world. Professional commitment is essential to prevent the loss of nursing staff and stabilize the nursing workforce.

OBJECTIVES

This study aimed to explore the unique relationship between school educational atmosphere, learning engagement, and professional commitment, and whether learning engagement would mediate the relationship between educational atmosphere and professional commitment.

DESIGN

A cross-sectional study design was used.

SETTINGS

The participants came from six schools in four cities in Hubei Province, China.

PARTICIPANTS

A total of 1009 nursing students above the first year of undergraduate studies were included by convenient sampling method.

METHODS

Data were collected using the Educational Climate Inventory, the Utrecht Work Engagement Scale-student, and the Professional Commitment Scale. Pearson correlation was used to examine the relationship between educational atmosphere, learning engagement, and professional commitment. Mediation analysis was used to test whether learning engagement mediated the relationship between educational atmosphere and professional commitment.

RESULTS

A positive educational atmosphere was associated with a high level of learning engagement, which was associated with a higher level of professional commitment. Learning engagement mediated the relationship between educational atmosphere and professional commitment.

CONCLUSIONS

The findings provide empirical evidence for promoting professional commitment in nursing students. Learning engagement is an important mediating variable connecting educational atmosphere and professional commitment. In order to stabilize the career choices of nursing students, it is necessary to take measures to improve their learning engagement during school.

Linking COVID-19 stress and Chinese nurses' life well-being: The influence of work-family conflict and work centrality

The COVID-19 pandemic has placed enormous stress on health workers, exposing them to high levels of work-family conflict (WFC), which in turn affects their life well-being（LWB). To date, whether WFC is involved in the association between COVID-19 stress and the well-being of life has not been investigated. The purpose of this paper was to explore the connection between COVID-19 stress and LWB in Chinese nurses and to analyse the mediating role of WFC and the moderating effect of work centrality. The link between COVID-19 stress and LWB was examined by performing multiple regression analysis, common method bias analysis, and confirmatory factor analysis on data for 227 nurses.COVID-19 stress exerted a remarkable direct impact on nurses' LWB, and WFC mediated the link between COVID-19 stress and nurses' LWB. Work centrality moderated the link between COVID-19 stress and nurses' WFC. COVID-19 stress decreases nurses' LWB and increases their WFC, which also decreases their LWB. For nurses with higher work centrality, the connection of COVID-19 stress to work-family conflict was stronger. Hospital managers should focus on nurses' work-family balance and pay particular attention to the work-family balance of work-centered nurses to avoid compromising their LWB.

The mediating and moderating role of recovery experience between occupational stress and turnover intention in nurses caring for patients with COVID-19

AIM

This study aimed to investigate the relationships among occupational stress, recovery experience and turnover intention among nurses caring for patients with coronavirus disease 2019 (COVID-19).

BACKGROUND

The high turnover intention among nurses affect patient safety quality of patient care.

DESIGN

The cross-sectional study design was used. This study was guided by STROBE.

METHODS

Convenience sampling identified 202 registered nurses working in the COVID-19 wards of three tertiary general hospitals in two cities in South Korea. The collected data were analysed using SPSS version 26.0, and the PROCESS macro in SPSS was employed to estimate path coefficients and assess the adequacy of the model. The moderating effects of recovery experience on the pathway in which occupational stress of the participants affects turnover intention were verified using model 1 of the SPSS PROCESS macro proposed by Hayes.

RESULTS

The recovery experience did not significantly mediate the relationship between occupational stress and turnover intention. However, it had significant moderating effect on the relationship between occupational stress and turnover intention (β = .005, 95% CI [.001, .010]). The effect of occupational stress on turnover intention was dependent on recovery experience.

CONCLUSION

The results revealed that occupational stress among nurses caring for patients with COVID-19 affect the turnover intention and the level of recovery experience moderates this relationship. Thus, not only during the COVID-19 pandemic but also during challenging times of various infectious disease outbreaks, hospitals can enhance the health and well-being of nurses and promote the retention of nursing staff.

IMPLICATIONS FOR THE PROFESSION

During the COVID-19 pandemic, nurses have been exposed to understaffing and overwhelming workloads. However, policies for nurses' welfare and benefits are still insufficient, even as the pandemic comes to an end. The results of this study indicate that sufficient rest and appropriate nursing personnel are of utmost importance to nurses.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The global outbreak of COVID-19 has brought to light the profound impact that large-scale disease outbreaks can have on healthcare systems and the dedicated professionals who serve within them. It becomes increasingly important to explore strategies for retaining nurses and physicians within hospital settings during such challenging times. This paper aims to investigate the determinants of retention among nurses and physicians during the COVID-19 pandemic.

METHOD

A systematic review of other potential determinants impacting retention rates during the pandemic was carried out. Secondly, a meta-analysis on the prevalence of intention to leave for nurses and physicians during the COVID-19 pandemic.

FINDINGS

A comprehensive search was performed within four electronic databases on March 17 2023. Fifty-five papers were included in the systematic review, whereas thirty-three papers fulfilled the eligibility criteria for the meta-analysis. The systematic review resulted in six themes of determinants impacting intention to leave: personal characteristics, job demands, employment services, working conditions, work relationships, and organisational culture. The main determinants impacting the intention to leave are the fear of COVID-19, age, experience, burnout symptoms and support. Meta-analysis showed a prevalence of intent to leave the current job of 38% for nurses (95% CI: 26%-51%) and 29% for physicians (95% CI: 21%-39%), whereas intention to leave the profession for nurses 28% (95% CI: 21%-34%) and 24% for physicians (95% CI: 23%-25%).

CONCLUSION

The findings of this paper showed the critical need for hospital managers to address the concerning increase in nurses' and physicians' intentions to leave during the COVID-19 pandemic. This intention to leave is affected by a complex conjunction of multiple determinants, including the fear of COVID-19 and the confidence in and availability of personal protective equipment. Moreover, individual factors like age, experience, burnout symptoms, and support are maintained in this review. Understanding the influence of determinants on retention during the COVID-19 pandemic offers an opportunity to formulate prospective strategies for retaining nurses and physicians within hospital settings.

Prevalence and influencing factors of PTSD symptoms among healthcare workers: A multicenter cross-sectional study during the surge period of the COVID-19 pandemic since December 2022 in the Chinese mainland

BACKGROUND

China has experienced a surge period of COVID-19 pandemic since December 2022. Healthcare workers (HCWs) were exposed to huge workload under high risk of being infected, and significant levels of trauma, which might cause Post-traumatic Stress Disorders (PTSD) symptoms in HCWs.

OBJECTIVES

To identify the prevalence of PTSD symptoms among HCWs in the Chinese mainland during the surge period of the COVID-19 pandemic; to explore their psycho-social factors of PTSD symptoms.

METHODS

A multicenter cross-sectional study was conducted among HCWs in Chinese mainland from January 5 to February 9, 2023, covering seven geographical regions. 6552 participants were recruited by convenience sampling. Data were collected on demographic characteristics, work-related factors, and psychological factors by online questionnaires. Univariate analysis and binary logistic regression were used to determine the influencing factors of PTSD symptoms.

RESULTS

The prevalence of PTSD symptoms among HCWs was 37.49 %. A higher level of mindfulness, resilience, and perceived social support were protective factors. Female gender, nurses, higher educational attainment, married status, more working years, higher perceived risk of contracting COVID-19 due to work, and higher perceived work intensity were risk factors.

CONCLUSION

High prevalence of PTSD symptoms among HCWs necessitates psychological interventions. Tailored interventions, designed by professional psychiatrists, should be tailored to address the stressors. A comprehensive approach, incorporating mindfulness, resilience-building, and perceived social support enhancement, is vital to bolster the mental well-being of HCWs exposed to traumatic events, thus mitigating the impact of PTSD effectively. Additionally, it is essential to provide support to HCWs with other potential risk factors.

Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study

Background

The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover.

Objective

This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism.

Methods

In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between.

Results

Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect).

Conclusion

Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.

A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review

The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.

Intention to leave, depersonalisation and job satisfaction in physicians and nurses: a cross-sectional study in Europe

The European healthcare sector faces a significant shortage of healthcare workers. Assessing the prevalence of this issue and understanding its direct and indirect determinants are essential for formulating effective recruitment programs and enhancing job retention strategies for physicians and nurses. A multicentric cross-sectional study was conducted, involving 381 physicians and 1351 nurses recruited from eight European hospitals in Belgium, the Netherlands, Italy, and Poland. The study focused on assessing turnover intentions among healthcare workers based on the Job Demands-Resources model, using an online questionnaire. Structural equation models were employed to test the data collection questionnaires' construct validity and internal consistency. The turnover intention was assessed by agreement with the intention to leave either the hospital or the profession. Among physicians, 17% expressed an intention to leave the hospital, while 9% intended to leave the profession. For nurses, the figures were 8.9% and 13.6%, respectively. The internal consistency of the questionnaires exceeded 0.90 for both categories of health workers. Depersonalization and job dissatisfaction were identified as direct determinants of turnover intention, with work engagement being particularly relevant for nurses. We found a higher intention to leave the hospital among physicians, while nurses were more prone to leave their profession. To mitigate turnover intentions, it is recommended to focus on improving job satisfaction, work engagement and fostering a positive working climate, thereby addressing depersonalisation and promoting job retention.

Enhancing nurses' perceptions of having a place to reduce turnover intentions

AIM

To investigate whether education, tenure, being an advanced practice nurse, skill level, and time pressure impact perceptions of "having a place" and, further, turnover intentions.

BACKGROUND

Nursing shortages persist worldwide. Nurses' turnover intentions are negatively related to their perceptions of "having a place" (i.e., the feeling that the nursing workplace is their territory). However, the sources of nurses' perceptions of the perception of "having a place" remain unknown.

METHODS

Our research employed a cross-sectional and correlational design. This research was conducted at a large-scale hospital in northern Taiwan from December 2021 to January 2022. We used personnel data pertaining to 430 nurses as well as scales for time pressure, "having a place" and turnover intentions to assess nurses' intention to leave their place of employment. The inclusion criteria focused on full-time nurses who worked for the hospital under investigation. Most of our participants were women. The STROBE statement was used as the EQUATOR checklist (supplemental file).

RESULTS

"Having a place" was positively related to educational level, tenure, and skill level, while being an advanced practice nurse was negatively associated with perceptions of "having a place," which in turn were negatively related to turnover intention among nurses.

CONCLUSION

Our study is the first to examine the antecedents of nurses' perceptions of "having a place," which include education, tenure, and skill level.

IMPLICATIONS FOR NURSING POLICY

Nursing policymakers could encourage nurses to pursue higher degrees and update their nursing skills while instilling perceptions of "having a place" in nurses with a brief tenure and advanced practice nurses.

Professional engagement: Connecting self-efficacy to actual turnover among hospital nurses

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.

Effects of Career Adaptability and Self-Efficacy on Transition Shock Among Newly Graduated Nurses During the COVID-19 Pandemic: A Survey Conducted in China

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak has increased the work pressure of nurses worldwide, and managers must provide support and assistance for the transition period of newly graduated nurses.

METHOD

A cross-sectional design was adopted to collect a sample of 318 newly graduated nurses from six hospitals in China during the COVID-19 pandemic. Data were collected using a questionnaire that consisted of a demographic questionnaire, the Transition Shock Scale (2015), the Career Adapt-Ability Scale (2012), and the General Self-Efficacy Scale (2001).

RESULTS

The transition shock of newly graduated nurses was 3.77 ± 0.48 in China. Regression analysis showed that transition shock among newly graduated nurses was predicted by career adaptability, general self-efficacy, living with one's parents, and education level, which accounted for 37.7% of the variance in transition shock.

CONCLUSION

Newly graduated nurses experienced a relatively high level of transition shock in China during the COVID-19 pandemic. Managers may offer continuing education to reduce the transition shock of newly graduated nurses based on the factors that affect their transition shock. [J Contin Educ Nurs. 2023;54(11):524-532.].

Day to Day and Environmental Risk Factors for Psychological Distress Among Healthcare Workers: A Mixed Methods Analysis

OBJECTIVE

Despite a growing literature on mental health among clinical staff during COVID-19, factors shaping distress for nonclinical staff are understudied and may be driven by inequalities at work. We aimed to discuss the role of workplace factors in shaping psychological distress for a diverse group of clinical, nonclinical, and other health and hospital workers (HHWs).

METHODS

This convergent parallel mixed-methods study with HHWs in a US hospital system included an online survey ( n = 1127) and interviews ( n = 73) collected from August 2020 to January 2021. We thematically analyzed interviews; findings informed log binomial regression estimating risk factors for severe psychological distress (Patient Health Questionnaire - 4 item version [PHQ-4] scores of 9 or greater).

RESULTS

Qualitatively, day-to-day stressors fostered fear and anxiety, and concerns about work environments manifest as betrayal and frustration with leadership. Distress was associated with burnout, financial concerns, and feeling betrayed or unsupported by the institution and leadership. Staff in service versus clinical roles had higher risk for severe distress (adjusted prevalence ratio = 2.04, 95% confidence interval = 1.13-2.66); HHWs receiving workplace mental health support had lower risk (adjusted prevalence ratio = 0.52, 95% confidence interval = 0.29-0.92.

CONCLUSIONS

Our mixed-methods study underscores how the pandemic brought inequalities to the surface to increase distress for vulnerable HHWs. Workplace mental health activities can support HHWs now and during future crises.

Teaching behaviours of clinical teachers and professional commitment among nursing students: A moderated mediation model of optimism and psychological well-being

BACKGROUND

Understanding the paths that influence professional commitment among nursing students is important for helping students continue the nursing profession after graduation. The paths between the teaching behaviours of clinical teachers (TBCT) and professional commitment were unknown.

OBJECTIVES

This study aimed to examine whether psychological well-being mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Moreover, we investigated whether the mediating effects of psychological well-being were moderated by optimism.

DESIGN

A cross-sectional design was conducted.

SETTING AND PARTICIPANTS

A total of 318 students from 24 hospitals in 13 cities in northern, north-eastern, and eastern China were included in the study.

METHODS

The instruments used in this study included the scale of teaching behaviours of clinical teachers, a brief inventory of thriving (measuring psychological well-being), a life orientation test (measuring optimism), and a professional commitment scale. The PROCESS macro for SPSS was used to perform mediation analysis and moderated mediation analyses.

RESULTS

Psychological well-being of nursing students partially mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Also, optimism moderated the indirect effect of this mediation model. The indirect effect of clinical teachers' teaching behaviours was stronger for nursing students with low levels of optimism.

CONCLUSION

The findings suggest that the teaching behaviours of clinical teachers and psychological well-being promote professional commitment. In addition, the mediation of psychological well-being between the teaching behaviours of clinical teachers and professional commitment was conditional on different levels of optimism. Clinical teachers should pay special attention to students with low levels of optimism because teaching behaviours of clinical teachers exert more influence on those students' professional commitment.

Staff quality of working life and turnover intentions in municipal nursing care and social welfare: a cross-sectional study

BACKGROUND

Nurses and social workers are two common professions with a university degree working within municipal nursing care and social welfare. Both groups have high turnover intention rates, and there is a need to better understand their quality of working life and turnover intentions in general and more specifically during the Covid-19 pandemic. This study investigated associations between working life, coping strategies and turnover intentions of staff with a university degree working within municipal care and social welfare during the Covid-19 pandemic.

METHODS

A cross-sectional design; 207 staff completed questionnaires and data were analyzed using multiple linear regression analyses.

RESULTS

Turnover intentions were common. For registered nurses 23% thought of leaving the workplace and 14% the profession 'rather often' and 'very often/always'. The corresponding figures for social workers were 22% (workplace) and 22% (profession). Working life variables explained 34-36% of the variance in turnover intentions. Significant variables in the multiple linear regression models were work-related stress, home-work interface and job-career satisfaction (both for the outcome turnover intentions profession and workplace) and Covid-19 exposure/patients (turnover intentions profession). For the chosen coping strategies, 'exercise', 'recreation and relaxation' and 'improving skills', the results (associations with turnover) were non-significant. However, comparing the groups social workers reported that they used 'recreation and relaxation' more often than were reported by registered nurses.

CONCLUSIONS

More work-related stress, worse home-work interface and less job-career satisfaction together with Covid-19 exposure/patients (Covid-19 only for turnover profession) increase turnover intentions. Recommendations are that managers should strive for better home-work interface and job-career satisfaction, monitor and counteract work-related stress to prevent turnover intentions.

Seasonal Influenza Vaccine Intention among Nurses Who Have Been Fully Vaccinated against COVID-19: Evidence from Greece

Seasonal influenza continues to be a significant public health issue causing hundreds of thousands of deaths annually. Nurses are a priority risk group for influenza vaccination and a high vaccine uptake rate among them is crucial to protect public health. Thus, the aim of our study was to estimate the levels of influenza vaccine acceptance, as well as its determinants, among nurses for the 2022/2023 season. We conducted a cross-sectional study with a convenience sample in Greece. We collected data via an online survey in September 2022. Most of the nurses in the study possessed a MSc/PhD diploma (56.2%) and had previously been infected by SARS-CoV-2 (70.3%). Among nurses, 57.3% were willing to accept the influenza vaccine, 19% were hesitant, and 23.7% were unwilling. Older age, higher levels of perceived support from significant others, and higher COVID-19-related physical exhaustion were positively related to influenza vaccination intention. In contrast, more side effects because of COVID-19 vaccination and higher levels of exhaustion due to measures taken against COVID-19 were negatively associated with vaccination intention. Since the influenza vaccination acceptance rate among nurses was moderate, policymakers should develop and implement measures tailored specifically to nurses in the context of the COVID-19 pandemic to decrease vaccine hesitancy.

Social Support Mediates the Relationship between COVID-19-Related Burnout and Booster Vaccination Willingness among Fully Vaccinated Nurses

COVID-19 booster doses for high-risk groups such as nurses are necessary to reduce the impacts of the pandemic and promote public health. We examined the relationship between COVID-19-related burnout and booster vaccination willingness among nurses, and we assessed whether social support can buffer this relationship. We conducted a cross-sectional study with 963 fully vaccinated nurses working in healthcare settings in Greece. We used the multidimensional scale of perceived social support to measure social support and the COVID-19 burnout scale to measure COVID-19-related burnout. We measured vaccination willingness with a scale from 0 (extremely unlikely to take a booster dose) to 10 (extremely likely). Among nurses, 37.1% reported being very likely to be vaccinated, 34.4% reported being uncertain about their likelihood of vaccination, and 28.6% reported being very unlikely to be vaccinated with a booster dose. We found that COVID-19-related burnout reduced vaccination willingness, while social support functioned as a partial mediator of this relationship. In conclusion, nurses who experienced burnout were less likely to accept a booster dose. Furthermore, increasing nurses' social support reduced the negative effects of burnout, resulting in improved booster vaccination willingness. Immunization awareness programs should be implemented in order to address nurses' concerns and support booster doses.

The effect of macro-control and organizational support perception on nurses and physicians intention to quit during the COVID-19 pandemic

AIM

The aim of this study is to determine the effect of organizational support and COVID-19 macro-control perception levels on intention to quit in physicians and nurses.

BACKGROUND

During the pandemic process, healthcare workers faced great health risks and workloads. Many health workers are considering quitting their job.

METHOD

A cross-sectional and explanatory research. The sample of the study consisted of 300 nurses and 73 physicians. To collect data, COVID-19 perception of macro-control, perceived organizational support, and intention to quit scales were used. Structural equation modeling was used.

RESULTS

COVID-19 macro-control perception and perceived organizational support have a negative effect on the intention to quit. The perceived organizational support has a partial mediating role, on the COVID-19 macro-control perception and the intention to quit.

CONCLUSION

This study demonstrated that the macro measures taken against the pandemic and the organizational support received by the nurses and physicians, who are the main actors in the fight against the epidemic, negatively affected their intention to leave.

IMPLICATIONS FOR NURSING PRACTICE AND CLINICAL RELEVANCE

To reduce the intention to quit health workers during the COVID-19 pandemic, scientific-based macro-control measures should be taken, and organizational support should be provided.

Factors Influencing Turnover Intention among Nurses and Midwives in Ghana

BACKGROUND

Nurse turnover intention, defined as a measure of nurses' desire to leave their positions, is a global public health issue with a grave impact on the healthcare workforce. However, literature on it is limited in sub-Saharan Africa, an at-risk region. This study aimed to determine the predictors of turnover intention among nursing staff at a tertiary hospital in Kumasi, Ghana.

METHODS

This was an institution-basedcross-sectional study conducted among 226 randomly selected nurses and midwives working at a tertiary healthcare center in Kumasi, Ghana. Data were collected by using a structured questionnaire. Significant predictors of turnover intention were analyzed by using multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p value <0.05 was used.

RESULTS

The prevalence of turnover intention among study participants was 87.2% (197/226). About two-thirds (61.5%, 139/226) of the participants were exposed to a high level of workplace hazards. Management support (AOR = 3.09, 95% CI = 1.09-8.75), salary (AOR = 0.07, 95% CI = 0.01-0.46), inadequate number of staff on duty per shift (AOR = 3.36, 95% CI = 1.08-10.47) and participants' rank (AOR = 6.81, 95% CI = 1.18-39.16) were significantly associated with turnover intention.

CONCLUSION

Overall, the turnover intention was high. Hence, there is a need for policymakers, health administrators, and nurse managers to implement strategies such as increasing staff strength, providing adequate support, incentives, and other forms of motivation for nurses and midwives to help reduce the rate of turnover intention.

Stressors, coping strategies and intention to leave the nursing profession: A cross-sectional nationwide study in China

AIMS

This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses.

BACKGROUND

Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large-scale study has been conducted on these associations in China yet.

METHOD

A cross-sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported.

RESULTS

Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse-patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on-the-job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect.

CONCLUSIONS

Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China.

IMPLICATIONS FOR NURSING MANAGEMENT

Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress.

How robots impact nurses' time pressure and turnover intention: A two-wave study

AIMS

To examine the relationships among effort ensuring robots' smooth operation (EERSO), time pressure, missed care, and nurses' turnover intention, and how robot performance moderates such relations.

BACKGROUND

Robots may reduce nurses' workload but typically still require some effort of nurses for robots' smooth operation. However, the negative impact of EERSO on nurses' workplace outcomes is unknown.

METHODS

This study used a two-wave follow-up design. Data were collected in a medical center in Taiwan, with first wave collected in 2019 and second wave collected between 2019 and 2020. A total of 331 participants were followed through the two waves.

RESULTS

EERSO is positively linked to missed care and time pressure. Time pressure is also positively linked to missed care and turnover intention. Positive robot performance weakens the positive link between EERSO and time pressure.

CONCLUSION

Using robots may help reduce nurses' workload, but it also requires nurses' efforts to maintain robots' continuous operation, that is, EERSO. It may adversely impact nursing professional workplaces.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers should reduce nurses' time pressure whilst suggest hospital managers to seek robots that require minimal EERSO.

Primary care provider's job satisfaction and organizational commitment after COVID-19 restrictions ended: A mixed-method study using a mediation model

Objectives

More and more countries have decided to cancel most or even all COVD-19 restrictions. However, it is unclear how ending of restrictions will affect primary care providers' job satisfaction and organizational commitment. Our objectives are to explore the current status and possible change in primary care providers' job satisfaction and organizational commitment after massive restriction policies ended in China.

Methods

This was a mixed-method study that utilized structured questionnaires and semi-structured qualitative individual interviews. The 20-item Minnesota Satisfaction Questionnaire (MSQ) and 25-item organizational commitment survey were adopted to assess job satisfaction and organization commitment. Descriptive statistics and mediation models, as well as inductive thematic analysis, were used to analyze quantitative and qualitative data.

Results

A total of 18 interviews and 435 valid survey responses were included in our analysis. The average scores for job satisfaction and organizational commitment were 80.6 and 90.8. The thematic analysis revealed one major theme: ethical and moral responsibility to provide care as primary care providers, on which we established a mediation model. The mediation analysis revealed that normative commitment could positively affect the other four dimensions of organizational commitment and job satisfaction. The direct effect of affective commitment on job satisfaction was significant (LLCI = 0.11, ULCI = 0.31), and the mediators were identified to have a partial mediating effect instead of a total mediating effect.

Conclusion

After COVID-19 restrictions end, the job satisfaction and organizational commitment of primary care providers will return to levels before the pandemic and during this estimated process, a brief rise in resignation is predictable. The normative commitment positively affects the other four dimensions of organizational commitment and job satisfaction for primary care providers, which suggests a possible way to motivate primary care providers when restrictions end.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Relationship between Psychological Ownership of the Nursing Profession and Turnover Intention: A Correlational Survey among Taiwanese Nurses

AIMS

To examine the relationship between psychological ownership of the nursing profession and turnover intention.

BACKGROUND

There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated.

METHODS

This study adopted a cross-sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical center in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self-Efficacy Scale, and developed Having a Place Scale.

RESULTS

Psychological ownership comprises three dimensions: self-efficacy, nurse identity, and "having a place" in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self-efficacy and "having a place" are negatively related to nurses' intention to leave a hospital (r=-.23 and -.31, p<.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r=-.38, p<.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r=.76, p<.001).

CONCLUSION

The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management Nurse managers can enhance nurses' self-efficacy and sense of "having a place" to retain nurses in hospitals, while enhance nurse identity to retain nurses in the profession.