Stress and turnover intention among healthcare workers in Saudi Arabia during the time of COVID-19: Can social support play a role?

The Effect of Nurses' Perceived Social Support on Job Burnout: The Mediating Role of Psychological Detachment

AIMS

To investigate the impacts of social support and psychological detachment on nurses' job burnout, as well as to validate psychological detachment's mediating effect.

DESIGN

The study was conducted using a questionnaire-based cross-sectional design.

METHODS

From October 2023 to March 2024, convenience sampling was used to distribute electronic questionnaires (including a general information questionnaire, the Maslach Burnout Inventory, the Psychological Detachment Scale, and the Social Support Scale) to investigate the current state of job burnout, psychological detachment, and social support among nurses. A total of 325 nurses were included in the study. The statistical analysis was performed using SPSS 29.0 software and the SPSS Process 4.1 plug-in.

RESULTS

Results showed that both social support and psychological detachment were negatively correlated with job burnout. Excluding general demographic characteristics, social support was negatively associated with job burnout through psychological detachment, where psychological detachment mediated social support and emotionally exhausting job burnout with a mediating effect of 8.93%.

CONCLUSION

Nurses' job burnout can be mitigated by both social support and psychological detachment, with psychological detachment acting as a mediation of the effect of social support.

IMPACT

Nursing managers should take measures to enhance the social support of nurses appropriately. At the same time, it is necessary to arrange work reasonably and establish a solid communication mechanism to improve nurses' psychological detachment and reduce nurses' job burnout.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

Consequences of the Pandemic on Mental Health of Healthcare Workers in the NHS

In recent years, the public health system of the United Kingdom, the National Healthcare System (NHS), has encountered difficulties that have been acknowledged in research studies and public policy discussions, such as resignations and staff shortages. During the COVID-19 pandemic, NHS healthcare workers were confronted with demanding circumstances, exacerbating the constraints of an already struggling system. With this, the authors of this paper aim to better understand the relationships between frustration at work, fear of infection, working hours, and the turnover intention of healthcare workers during the pandemic. This study employed a mixed-methods research approach, as a questionnaire survey was conducted along with an online self-administered interview questionnaire. Using mediation and moderated mediation analyses, it was found that the indirect effect of frustration at work through fear of infection on turnover intention was positively significant. Working hours moderated the mediation effect of fear of infection on the relationship between frustration at work and turnover intention. Surprisingly, the conditional indirect effect of frustration at work on turnover intention through fear of infection was the strongest among those with short working hours. This evidence was supplemented with qualitative results that enhance the understanding of why healthcare workers want to leave the system and the actions that can be taken on the organisational and policy fronts to address this issue.

The effect of incentive factors on turnover intention of PHC workforce in rural China-from the perspective of two-factor theory

OBJECTIVE

The working situation and turnover intention of rural primary healthcare(PHC) workforce have always been of concern. This study aims to explore the effect of different incentive factors on turnover intention of PHC Workforce, with the goal of optimizing health human resources in China.

METHODS

Structured questionnaires were used for data collection, including incentive factors questionnaire based on two-factor theory, turnover intention, perceived social support and job burnout. Multiple linear regression was used to analyze the influence of different incentive factors on turnover intention. Structural equation model was used to explore the effect of motivation factors on turnover intention through different paths of job burnout and social support.

RESULTS

The total number of participants was 1112. PHC Workforce scored higher on hygienic factors than on motivation factors, both of which showed moderate satisfaction levels and the turnover intention level was below average. In regression analysis, the factors related to turnover intention included individual status (B =-0.854), salary (B =-0.610), individual progress (B =-0.628), education level (B = 0.971), monthly income (B =-0.161) and marital status (B = 1.664). The indirect effects of different types of incentive factors through social support were 0.097 (P < 0.001), 0.045 (P < 0.001), and 0.136 (P < 0.001).

CONCLUSION

Different incentive factors may decrease turnover intention of PHC Workforces, which is reflected in three key factors: individual status, salary, and individual progress. The mediating effect of social support is significant, suggesting that managers should prioritize staff mental health and family relationships. Also, implementing diverse incentive strategies and addressing individual needs.

Intersectional employee voice inequalities and culture care theory: the case of migrant palliative care nurses in Saudi Arabia

PURPOSE

This narrative literature review examines intersectional employee voice inequalities in a non-Western, high power distance context to develop a multilevel conceptual framework.

DESIGN/METHODOLOGY/APPROACH

The authors use Leininger's (1997, 2002) culture care model to explore multilevel influences on intersectional voice inequalities. The article applies insights from a review of 31 studies to the specific challenges of migrant palliative care (PC) nurses in Saudi Arabia.

FINDINGS

The themes identified in the review indicate how better transcultural communications might mitigate voice inequalities that influence migrant employee wellbeing and intentions to quit which result from cultural incongruities.

ORIGINALITY/VALUE

The impact of national culture differences and intersectional inequalities on employee voice has largely been ignored in academic research. This paper offers unique insights drawing on culture care theory into intersectional voice challenges from a non-Western perspective in the underresearched setting of Saudi Arabia which is mid-way through a national transformation program. It starkly contrasts policy ambitions for advancing healthcare with discriminatory practices based on conservative attitudes which stifle migrant worker voices.

The Role of Work-Life Balance, Work Stress, and Work-Family Conflict in Creating Job Satisfaction and Their Impact on Turnover Intention in Nurses at Level I Health Facilities Hospital in Karawang

Turnover intention research with the addition of independent variables of work-life balance and work stress in nurses with health backgrounds is rarely found in type c public hospitals in Karawang city, where literature about this research needs to explain it. This research aims to ascertain how work-life balance, workplace stress, and work-family conflict affect nurses' intentions to quit their jobs by using job satisfaction as a mediator. The sampling for this study was carried out using the probability sampling method known as proportionate stratified random sampling. A total of 550 nurses from 4 schools submitted responses. Work-life balance, work-related stress, and job happiness all significantly influence the likelihood of turnover. The desire to increase or reduce hospital turnover is significantly influenced by work-life balance, stress at work, and work-family conflict. This study has limitations that can lead to imperfect conclusions because the sample used is only the nurse division, so this study can only be generalized to some other districts. The variables studied still need to be reviewed to affect turnover intention by mediating job satisfaction.

Factors Associated With Turnover Intention Among Healthcare Providers in Saudi Arabia: A Comprehensive Review

Turnover has a negative impact and can harm businesses, specifically the organizational structure and service delivery. The purpose of this review is to provide policymakers, healthcare administrators, and stakeholders in Saudi Arabia with approaches and strategies for reducing turnover and improving provider retention by synthesizing existing literature and identifying the key variables influencing turnover intention. This study conducted a comprehensive literature review to explore numerous variables associated with medical professional turnover intentions in Saudi Arabia from 2016 to 2024. The librarian assisted with the creation of the query string. The literature search was carried out using PubMed, Web of Science, and Google Scholar. By utilizing the key terms turnover AND healthcare providers AND healthcare facilities AND Saudi*. The authors separately examined and evaluated the risk of bias in each study using Joanna Briggs Institute (JBI) tools. The findings of this review show that all studies were executed using a cross-sectional design, and five studies were published in 2022. According to this review, ten studies were carried out in hospital settings. Ten studies examined elements associated with work. Moreover, five studies were associated with external variables, followed by five studies linked to personal factors. The most common factors for turnover were satisfaction, stress, and work. Turnover-related factors can have an impact on the long-term sustainability of the healthcare system. This review provides crucial information on the factors related to turnover, using the growing body of research in the Saudi context.

The Impact of Social Support on Burnout among Lecturers: A Systematic Literature Review

BACKGROUND

Interest and concern regarding the social support and burnout of college lecturers have grown over the past decades. Maintaining good mental health is critical for university lecturers. Social support has been identified as an effective resource against burnout. However, few studies have comprehensively examined the connection between social support and burnout specifically among college lecturers. Therefore, this review aims to explore how social support influences the burnout of college lecturers.

METHODS

This study employed the systematic literature review (SLR) methodology.

RESULTS

A thorough systematic review of 20 studies was conducted between 2015 and 2024, drawn from five major databases: Web of Science, Scopus, APA PsycINFO, PubMed, and Eric. The review indicates that burnout is measured through the Maslach Burnout Inventory, Maslach Burnout Inventory-Educators Survey (MBI-ES), Maslach Burnout Inventory-General Survey (MBI-GS), Burnout Syndrome Evaluation Questionnaire, Copenhagen Burnout Inventory (CBI), Shirom-Melamed Burnout Measure (SMBM), and the Oldenburg Burnout Inventory (OLBI). While social support is measured through the Multidimensional Scale of Perceived Social Support (MSPSS) and Perceived Organizational Support (SPOS) survey. Individual and occupational factors contribute to lecturers' burnout. This study reveals the association between social support and burnout among lecturers and it emphasizes the multifaceted role of social support in alleviating burnout among lecturers.

CONCLUSIONS

The findings suggest that educational institutions should strengthen support systems and increase the emotional support available among lecturers to relieve burnout.

Why Are Healthcare Providers Leaving Their Jobs? A Convergent Mixed-Methods Investigation of Turnover Intention among Canadian Healthcare Providers during the COVID-19 Pandemic

BACKGROUND

Staffing shortages across the healthcare sector pose a threat to the continuity of the Canadian healthcare system in the post-COVID-19 pandemic era. We sought to understand factors associated with turnover intention as well as Canadian healthcare providers' (HCPs) perspectives and experiences with turnover intention as related to both organizational and professional turnover.

METHOD

A convergent questionnaire mixed-methods design was employed. Descriptive statistics and ordinal logistic regressions were used to analyze quantitative data and ascertain factors associated with turnover intention. Thematic analysis was used to analyze qualitative open-field textbox data and understand HCPs' perspectives and experiences with turnover intention.

RESULTS

Quantitative analyses revealed that 78.6% of HCPs surveyed (N = 398) reported at least a 25% turnover likelihood regarding their organization, with 67.5% reporting at least a 25% turnover likelihood regarding their profession. Whereas regression models revealed the significant impact of years worked, burnout, and organizational support on turnover likelihood for organizations, age, sex, burnout, and organizational support contributed to the likelihood of leaving a profession. Patterns of meaning drawn from participants' qualitative responses were organized according to the following four themes: (1) Content to stay, (2) Drowning and no one cares, (3) Moral stressors, and (4) Wrestling with the costs and benefits.

CONCLUSIONS

Many HCPs described weighing the costs and benefits of leaving their organization or profession during the COVID-19 pandemic. Although challenging working conditions, moral stressors, and burnout may play a significant role in HCPs' experiences of turnover intention, there is ample room to intervene with organizational support.

Middle East Nurses Turnover Intention and its Correlates Amid the COVID-19 Pandemic: A Systematic Review

Global nursing scarcity was more evident during COVID-19. This study investigated the rates and contributing factors of turnover intention in the middle east through meta-analysis. Medline EMCARE, Cochrane, CINAHL, EMBASE, Ovid, Psych Info, PubMed, Science Direct, Scopus, and Web of Science databases searched, Protocol PROSPERO Registration Number was CRD42022337686. The turnover intention rate was 42.3% [CI: 40%, 44.6%]. Working environment, stress, deployment to COVID, fear of infection, long working hours, shift duties, and lack of social support were the major contributing factors.

Work outcomes in public safety personnel after potentially traumatic events: A systematic review

BACKGROUND

It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety.

METHODS

The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of N = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis.

RESULTS

Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across n = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. N = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. N = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization.

CONCLUSIONS

Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.

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.

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.

Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations

BACKGROUND

Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR).

METHODS

We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes.

RESULTS

The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted.

DISCUSSION

PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.

Intention to leave among nurses during the COVID-19 outbreak: A rapid systematic review and Meta-Analysis

AIMS AND OBJECTIVES

The COVID-19 pandemic has caused an increase in the workload of nurses and changes in working conditions. Stress and the increase in workload during the COVID-19 pandemic had a negative effect on nurses' intention to leave. This study aimed to determine the current rate of intention to leave the job among nurses during the COVID-19 outbreak by conducting a rapid systematic review and meta-analysis.

METHODOLOGY/METHODS

The review procedure was conducted by the PRISMA criteria. The researchers searched PubMed and Web of Science databases for studies providing the rate of nurses' intent to leave, published until 31 December 2021. Heterogeneity was assessed using the I2 test, and publication bias was measured by Egger's test.

RESULTS

The estimated overall intent to leave the profession among nurses during the COVID-19 pandemic was 31.7% (95% CI: 25%-39%) with significant heterogeneity (Q test: 188.9; p = 0.0001; I2 : %95.2; Tau2 : 0.225). Additionally, Egger's regression test suggested no publication bias for estimating the pooled rate of nurses' intent to leave during the COVID-19 outbreak.

NO PATIENT OR PUBLIC CONTRIBUTION

Since the research is a meta-analysis study, a literature review model was used. Ethics committee approval was not obtained because the literature review did not directly affect humans and animals.

CONCLUSION

This study showed that approximately one-third of nurses working during the COVID-19 pandemic had thoughts about intending to leave their job. The findings indicate the need for strategies involving precautions and solutions to minimise the psychological impacts of COVID-19 among nurses.

RELEVANCE TO CLINICAL PRACTICE

In this period when the global nurse crisis exists, it is of great importance for institutions to retain their nurse workforce. There is an urgent need to prepare nurses to cope better with COVID-19 pandemic. Identification of risk factors for intention to leave could be a significant weapon giving nurses and healthcare systems the ability to response in a better way against the following COVID-19 waves in the near future.

Internet-Based Trauma Recovery Intervention for Nurses: A Randomized Controlled Trial

Introduction

Nurses, who care for patients with various traumas, may also experience post-traumatic stress disorder due to indirect or direct exposure to traumatic situations. This study examined the effectiveness of an Internet-based trauma recovery intervention for Korean nurses.

Methods

This randomized controlled trial was conducted with 112 nurses aged 23-40 years who were randomly assigned to the intervention (n = 56) or control group (n = 56) from May 7 to December 20, 2020. Nurses in the intervention group attended eight sessions, and the same intervention was administered to the control group. Repeated measures were collected at pre-test, post-test 1 (immediately after the intervention), and post-test 2 (4 weeks after the intervention). A total of 102 nurses (intervention group: n = 49; control group: n = 53) were completed because 10 nurses dropped out before the first session. Data were analyzed using the χ2 test, Fisher's exact test, t-test, Mann-Whitney U test, and repeated measures ANOVA (intention-to-treat and per protocol).

Results

There were significant changes in functional health, resilience, post-traumatic stress, depressive symptoms, state anxiety, and trait anxiety over time and in the group-by-time interactions (intention-to-treat and per protocol). There was a significant difference in social support in the group-by-time interactions, but there were no significant changes between the two groups or over time (intention-to-treat and per protocol).

Conclusion

The Internet-based trauma recovery nursing intervention is effective in clinical and community settings for nurses who cannot participate in fixed-schedule programs due to shift work. This study's findings are relevant for implementing Internet-based trauma recovery programs for nurses and the general population, including survivors and relatives of patients who suffered from COVID-19. This program will also be very useful for people in other high-stress situations. Nurse leaders should consider different populations and situations when offering effective coping strategies suitable for changing environments.

Exploring Job Stress Among Public Health Workforce in Northeastern Malaysia

Introduction Job stress is recognized as a significant concern across various occupational settings which have profound implications for both individuals and organizations. During the COVID-19 pandemic, job stress among the public health workforce (PHW) has been a significant concern, as they face a significantly increased risk of infection and mortality due to excessive COVID-19 exposure. This study presents a descriptive exploration of key job stress-related factors among PHW in Terengganu, Malaysia. Methodology This is a cross-sectional study conducted from May 2022 to April 2023, encompassing all eight District Health Offices (DHO) and government health clinics in Terengganu. Data collection involved a Malay version of the Job Content Questionnaire (M-JCQ), which assesses job characteristics based on Karasek's demand-control-support model and consists of four main domains: decision latitude, psychological job demands, physical job demands, and social support. Data was collected from 1044 participants, and statistical analysis was performed using SPSS version 27 (IBM Corp., Armonk, NY, USA). Findings Of the 1044 participants, 18.9% experienced job stress. The highest percentage of job stress was observed among nurses (24.3%), followed by medical assistants (18.3%) and physicians (16.0%). In contrast, the public health assistant (PKA) group had the lowest rate of job stress. Job types based on Karasek's model also showed variations, with doctors having the highest percentage of active jobs (46.4%), while medical assistants had the highest percentage of low job strain (17.9%), and PKAs had the highest percentage of passive job types (44.7%). Conclusion This study offers significant insights into the work-related challenges faced by the public health workforce in Terengganu, Malaysia, especially during the COVID-19 pandemic. Job stress is a substantial concern, and understanding its underlying factors is essential for improving the well-being of PHWs. Decision latitude, job demands, and social support play critical roles in shaping job stress among PHWs. Strategies and interventions are needed to mitigate job stress, improve working conditions, and enhance the effectiveness of PHWs in public health initiatives. This study highlights the importance of addressing job stress in this sector, with potential benefits for both the mental and physical health of PHW.

Canadian respiratory therapists who considered leaving their clinical position experienced elevated moral distress and adverse psychological and functional outcomes during the COVID-19 pandemic

INTRODUCTION

Respiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttraumatic stress disorder [PTSD] and functional impairment) and consideration of position departure. The purpose of this study was to understand the impact of moral distress and its associated psychological and functional outcomes on consideration to leave a clinical position among Canadian RTs during the COVID-19 pandemic.

METHODS

Canadian RTs (N = 213) completed an online survey between February and June 2021. Basic demographic information (e.g. age, sex, gender) and psychometrically validated measures of moral distress, depression, anxiety, stress, PTSD, dissociation, functional impairment, resilience and adverse childhood experiences were collected.

RESULTS

One in four RTs reported considering leaving their position. RTs considering leaving reported elevated levels of moral distress and adverse psychological and functional outcomes compared to RTs not considering leaving. Over half (54.5%) of those considering leaving scored above the cut-off for potential diagnosis of PTSD. Previous consideration to leave a position and having left a position in the past each significantly increased the odds of currently considering leaving, along with system-related moral distress and symptoms of PTSD, but the contribution of these latter factors was small.

CONCLUSIONS

Canadian RTs considering leaving their position reported elevated levels of distress and adverse psychological and functional outcomes, yet these individual-level factors appear unlikely to be the primary factors underlying RTs' consideration to leave, because their effects were small. Further research is required to identify broader, organizational factors that may contribute to consideration of position departure among Canadian RTs.

Physicians' Turnover Intention During the "Post-COVID-19" Era: Risk and Protective Factors

PURPOSE

This research investigates risk and protective factors affecting physicians' turnover intention during the post-COVID-19 era.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional online survey study of 958 physicians working in Lombardy (Northern Italy) hospitals was conducted.

FINDINGS

In the post-COVID-19 era, burnout significantly increases physicians' turnover intention. The same is true for fear of being infected by COVID-19 (FIC), which indirectly affects turnover intention via burnout. The higher FIC and burnout, the higher intention to leave the job or working unity. Self-efficacy significantly decreases turnover intention by reducing FIC and burnout.

ORIGINALITY/VALUE

Implementing turnover preventive programs in healthcare professionals is essential, mainly reducing BO and promoting physicians' personal resources, such as self-efficacy.

The mediating role of job satisfaction and presenteeism on the relationship between job stress and turnover intention among primary health care workers

BACKGROUND

Turnover problems among primary health care workers are a significant contributor to the shortage of health human resources. This study aims to determine the relationship between job stress and turnover intention among primary health care workers, as well as to examine the mediating effects of job satisfaction and presenteeism on this relationship.

METHODS

Stratified random sampling and quota sampling were used to select 703 primary health care workers in Jilin Province, China in January 2020. Validated scales were used to measure turnover intention, job stress, job satisfaction, and presenteeism among primary health care workers. The study utilized a partial least squares structural equation modeling (PLS-SEM) approach to test the research hypotheses.

RESULTS

The turnover intention score of primary health care workers in Jilin Province was 2.15 ± 1.03, and 19.5% of respondents reported a higher turnover intention. Significant sex and occupation differences were found, with a higher rate of turnover intention for male and doctor groups among primary health care workers. This study also revealed a positive correlation between job stress and turnover intention (β = 0.235, P < 0.001), a significant negative correlation between job satisfaction and turnover intention (β= -0.347, P < 0.001), and a significant positive correlation between presenteeism and turnover intention (β = 0.153, P < 0.001). Moreover, the study revealed a significant indirect effect of job stress on turnover intention which was mediated by job satisfaction (β = 0.183, P < 0.001) and presenteeism (β = 0.078, P < 0.001).

CONCLUSION

We confirmed the positive association between job stress and presenteeism with turnover intention, as well as the negative association between job satisfaction and turnover intention. Moreover, our study confirmed the mediating role of job satisfaction and presenteeism in the relationship between job stress and turnover intention. This study provides scientific evidence to address the turnover problem among primary health care workers.

Impact of psychosocial risk on intention to leave work during COVID-19 in Indonesia: The mediatory roles of burnout syndrome and job satisfaction

The COVID-19 pandemic intensified the complexity of work in the health sector, leading to an increase in the intention to leave work (ITL) in Indonesia. Previous research has revealed a theoretical gap in investigating the roles of burnout syndrome (BS) and job satisfaction (JS) as mediators of the effect of psychosocial risk (PR) on ITL. This research study aimed to fill this gap by examining the effect of PR on ITL during the COVID-19 pandemic, with BS and JS as mediators. Data was collected from 306 health workers in public and private hospitals of Central Jakarta, Indonesia. This data was analyzed as part of a cross-sectional research study involving the partial least square-structural equation modeling (PLS-SEM) method and using SmartPLS software. The questionnaire was based on the Copenhagen Psychosocial Questionnaire (COPSOQ) III short version, the Burnout Assessment Tools (BAT), and a modified Turnover Intention. The findings revealed that, within the direct effect pathways, JS was the highest predictor of health workers' ITL, and workplace PR significantly impacted employees' JS and BS. Another notable finding was related to the research gap vis-a-vis the indirect effect pathways: it showed that JS and BS had partial mediatory power over the relationship between PR and ITL. BS and JS were found to have a high and significant impact on employees' ITL. Therefore, this research study has contributed to the model's novelty in measuring ITL mediated by JS and BS.

Public Health Challenges in Saudi Arabia during the COVID-19 Pandemic: A Literature Review

Similar to most countries, Saudi Arabia faced several challenges during the novel coronavirus disease 2019 (COVID-19) pandemic, some of which were related to the religious position of the country. The main challenges included deficits in knowledge, attitudes, and practices toward COVID-19, the negative psychological impacts of the pandemic on the general population and healthcare workers, vaccine hesitancy, the management of religious mass gatherings (e.g., Hajj and Umrah), and the imposition of travel regulations. In this article, we discuss these challenges based on evidence from studies involving Saudi Arabian populations. We outline the measures through which the Saudi authorities managed to minimize the negative impacts of these challenges in the context of international health regulations and recommendations.

Professional identity, job satisfaction, and intention to stay among clinical nurses during the prolonged COVID-19 pandemic: A mediation analysis

AIM

This study aims to examine the relationship between professional identity and job satisfaction and their impact on intention to stay among clinical nurses in China during the prolonged COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted from April 30 to May 25, 2021, in China. Data were collected using professional identity, job satisfaction, and intention to stay questionnaires from 1425 clinical nurses. A single mediation analysis was utilized to test the interrelationship among the variables, and the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist as a reporting guide.

RESULTS

Nurses indicated a medium level of professional identity, job satisfaction, and intention to stay, with mean scores of 3.85, 3.25, and 3.47, respectively. The professional identity displayed positive indirect effect on nurses' intention to stay through job satisfaction (indirect effect = 0.498, 95% CI [0.439, 0.558]).

CONCLUSION

Cultivating professional identity among nurses can increase their job satisfaction and ultimately enhance the intention to stay in the nursing profession. However, this study also suggests paying more attention to job satisfaction to keep nursing retention. These may be helpful to retain the nursing workforce.

Mediating Effect of Challenges on Demographics and Coping Strategies of Indian Healthcare Workers during COVID-19

Healthcare workers (HCWs) including doctors, nurses and allied workers struggled to cope up with the stressful situation as the COVID-19 pandemic unsettled healthcare systems, including India's. Many factors (commonly called as stressors) acted as major sources of stress and resulted in poor mental health of HCWs. Therefore, this study predicted and explained the mediating effect of challenges on demographic characteristics and coping strategies of HCWs. Data from a cross-sectional study was collected from the district hospital of Rajasthan, India, during the period of August 2022-October 2022. HCW's experience level, shift type and distance of greenspaces from their accommodation were significantly correlated with the challenges they faced at work, specifically societal challenges. Thus, HCWs were more inclined to adopt a meaning-focused coping strategy to retain good mental health during the pandemic. Therefore, these findings call for interventions requiring a layered response, comprising strategies and actions that are structural. At the organizational level, these actions may provide supportive workplace environments.

Evaluation of physical and psychological status of health care workers infected with COVID-19 during a hospital outbreak in Japan

PURPOSE

COVID-19 causes physical and psychological impacts on health care workers (HCWs), especially when it occurs during an outbreak. As there are few reports on outcomes of HCWs infected with COVID-19 during a hospital outbreak, we investigated the physical and psychological impacts on HCWs infected with COVID-19 during an outbreak in our hospital.

METHODS

During the outbreak in our hospital, 231 people were infected with COVID-19 including patients, HCWs and their families. Among them, 83 HCWs were enrolled in this study. Current quality of life (QOL) was assessed with the EuroQol-visual analogue scales (EQ-VAS), and motivation to keep on working was evaluated by a 10-point analogue scale. Physiological recovery rates including return to work (RTW) period were also analyzed.

RESULTS

One nurse quit work due to anxiety regarding re-infection with COVID-19. The median period to RTW from the diagnosis was 14.0 (12.0-17.0) days. Motivation to keep on working was slightly reduced, and the EQ-VAS was 75.0 (65.0-83.6). There were no significant differences in QOL and motivation between male and female HCWs, nurses and other HCWs, treatment and non-treatment group, and supplemental and non-supplemental oxygen group. The most frequent persistent symptoms at 1,3 and 6 months after infection were anosmia followed by fatigue.

CONCLUSION

Although QOL and motivation to keep on working were slightly reduced, only one HCW quit work. No severe persistent symptoms were observed, and the RTW period was relatively short.

Development and Initial Psychometric Validation of the COVID-19 Pandemic Burden Index for Healthcare Workers

BACKGROUND

The burden of COVID-19 on healthcare workers (HCWs) is reported to be increasing, yet the psychometric scales now in use evaluate only single aspects; few measure the pandemic-specific burden on HCWs comprehensively.

OBJECTIVE

To develop a scale to quantify the physical, mental, and socioeconomic burden of the COVID-19 pandemic on HCWs.

DESIGN

Scale development and cross-sectional survey.

PARTICIPANTS

Consenting HCWs aged ≥20.

MAIN MEASURES

Development of an item-list based on literature reviews and HCW panel input, evaluation of content validity and item selection using the Delphi method, psychometric testing conducted on HCWs, validity assessment by factor analyses and hypothesis verification, internal consistency evaluation by Cronbach's alpha, test-retest analysis, and interpretability assessment.

KEY RESULTS

Through the Delphi process, a 29-item pilot scale was generated. In psychometric testing, data from 863 HCWs contributed to the development of the final version of this scale, called Pandemic Burden Index twenty for HCWs (PBI-20), a 20-item scale to measure six domains: fatigue, fear of infection, inadequacy as a medical professional, mental health concerns, prejudice or discrimination, and anxiety about one's livelihood and daily life. Factor analysis showed each factor corresponded to the six domains of this scale. Hypothesis verification showed the PBI-20 total score to be moderately to highly correlated with the Short Form 36 vitality score and mental health score and with intention of turnover. The PBI-20 had good internal consistency (Cronbach's alpha 0.92). Test-retest analysis showed the intraclass correlation coefficient to be 0.70 and the minimal important change to be -7.0.

CONCLUSIONS

The psychometrically sound questionnaire we developed to measure pandemic-specific burdens for HCWs provides an understanding of comprehensive burdens on HCWs and may serve to evaluate interventions to reduce the burdens.

How COVID-19 Perceived Risk Causes Turnover Intention Among Chinese Flight Attendants: A Moderated Mediation Model

Purpose

This study examined the influencing mechanism and boundary conditions underlying the relation between COVID-19 perceived risk and flight attendants' turnover intention by investigating the mediating role of job insecurity and the moderating effect of job crafting.

Methods

 A two-wave survey was conducted with 240 Chinese flight attendants. We used structural equation modeling to test the moderated mediation model.

Results

The results indicated that perceived risk of COVID-19 positively affected flight attendants' job insecurity and turnover intention. Moreover, job insecurity plays a fully mediating role in the relationship between perceived risk and turnover intention. Furthermore, the mediating role of job insecurity was moderated by job crafting; for higher levels of job crafting (opposed to low), the effect of job insecurity on turnover intention was significantly weaker.

Conclusion

 Our findings indicate that dissipating job insecurity and increasing job crafting behavior are critical to employees' work-related attitudes and behavior during the COVID-19 pandemic.

Relationships among Healthcare Providers' Job Demands, Leisure Involvement, Emotional Exhaustion, and Leave Intention under the COVID-19 Pandemic

The COVID-19 pandemic has caused many medical issues. It has tested the impact of healthcare providers' job demands, emotional exhaustion, and other pressures related to the impact on organizational leave intention. Accordingly, the purpose of this study was to verify the relationship between healthcare providers' job demands, leisure involvement, emotional exhaustion, and leave intention under the COVID-19 pandemic. The questionnaire survey was used to address the issue of the present study. Convenience sampling was utilized to recruit 440 healthcare providers with a validity rate of 95%. Collected data were analyzed by structural equation modelling. Results indicated that healthcare providers' job demands do not significantly influence leisure involvement. Job demands significantly influence emotional exhaustion. Job demands significantly influence leave intention. Emotional exhaustion significantly influences leave intention. Emotional exhaustion has a significant mediating effect between job demands and leave intention. Finally, relevant practical suggestions are provided based on the study results.

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.

An investigation of the incidence of post-traumatic stress disorder, turnover intention and psychological resilience among medical staff in a public hospital in China during the outbreak of the omicron variant in the COVID-19 pandemic in 2022

Objective

To investigate the incidence of post-traumatic stress disorder (PTSD), turnover intention and psychological resilience of medical staff during the Outbreak of the Omicron Variant in the COVID-19 pandemic in 2022 and to provide a basis for adopting relevant psychological interventions to reduce medical staff turnover.

Methods

Using the PTSD Checklist-Civilian Version (PCL-C) and a total score ranging from 17 to 85 points, a total score ≥ 38 indicates significant PTSD symptoms and a diagnosis of PTSD. The Chinese version of the Turnover Intention Scale (TIS) has a total score of 6 to 24 points; the higher the score, the stronger the turnover intention. The Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) has a total score of 0 to 100 points, with higher scores indicating a better level of psychological resilience. A total of 443 front-line medical staff working in Chinese public hospitals and still treating all patients normally during COVID-19 were invited via the internet to complete a survey from 15 May to 30 May 2022 in China.

Results

The incidence of PTSD was 14.4%, the total turnover intention score was 13.38 ± 4.08, and the total psychological resilience score was 87.16 ± 18.42. The prevalence of PTSD was higher among medical staff who were married, had children, and were worried about being infected; in addition, the PTSD group had a higher level of education, higher turnover intention, and lower psychological resilience than the non-PTSD group. The total scores for turnover intention and fear of being infected were risk factors for PTSD, while a high total psychological resilience score and high education level were protective factors for PTSD; the differences were statistically significant (all P < 0.05).

Conclusion

Post-traumatic stress disorder among Chinese medical personnel was associated with the marital status, childbirth, education level, turnover intention, and psychological resilience. Among these factors, psychological resilience might be exploited as a protective factor.

Association between Burnout, Job Dissatisfaction and Intention to Leave among Medical Researchers in a Research Organisation in Malaysia during the COVID-19 Pandemic

Employee turnover could affect the organisation's performance. Job dissatisfaction and burnout have been identified as factors influencing the intention to leave. Thus, this study aimed to determine the level of intent to leave, and predictors associated with intention to leave among medical researchers in Malaysia. A cross-sectional, stratified random sampling study was conducted among researchers in a research organisation under the Ministry of Health. Respondents answered an online questionnaire that included sociodemographic information, job dissatisfaction, burnout, and intention to leave. A total of 133 researchers participated. More than one-third (41.4%) of the researchers had a moderate and high level of intention to leave. Burnout and job dissatisfaction were identified as significant predictors. Burnout was noted to have a positive relationship with the intent to leave (β = 0.289, 95% CI (B): 0.287, 1.096). Meanwhile, job satisfaction was found to have a negative relationship with the intention to leave (β = -0.348, 95% CI (B): -0.768, -0.273). Burnout among researchers is quite worrisome as more than two-thirds of the researchers experienced moderate to high burnout. Reducing burnout and job dissatisfaction would increase work performance and produce high-quality research output, hence decreasing the turnover rate.

The Association Between COVID-19 Information Sources and Stigma Against Health Care Workers Among College Students: Cross-sectional, Observational Study

BACKGROUND

The COVID-19 pandemic has triggered stigmatic attitudes against health care workers. Some forms of social media may play a role in disseminating stigmatizing messages.

OBJECTIVE

We aimed to investigate the association between COVID-19 information sources and stigma against health care workers among college students during the pandemic.

METHODS

A cross-sectional, observational study was conducted using a web-based platform in the Tohoku region of Japan. College students aged ≥20 years were asked to complete the questionnaire between August 18 and October 31, 2020. Stigma against health care workers was evaluated using a modified Japanese version of the Social Distance Scale. Participants were also asked to rate their perceived vulnerability to infection using the Japanese version of the Perceived Vulnerability to Disease scale.

RESULTS

A total of 281 students from 8 colleges completed the web-based survey. There were 139 (49.5%) participants who used Twitter, 187 (66.5%) who used news websites, and 46 (16.4%) who used the websites of public health agencies as COVID-19 information sources. After adjusting for age, sex, department, and Perceived Vulnerability to Disease scores, the level of stigma did not differ between students who used Twitter and those who did not. Students who used the websites of public health agencies showed a significantly less stigmatic attitude than those who did not.

CONCLUSIONS

Fact-checking and directing visitors to credible information sources from public health agencies may have prevented the formation of stigmatic attitudes toward health care workers. An effective strategy to enable easy access to information provided by public agencies should be integrated into widespread web-based platforms.

Psychological Safety and Affective Commitment Among Chinese Hospital Staff: The Mediating Roles of Job Satisfaction and Job Burnout

Purpose

The affective commitment of hospital staff is important for human resources management and the sustainable development of hospitals. Psychological safety is an important factor that contributes to an emotional connection to an organization among staff, yet its functional mechanism remains unclear. This study explored how psychological safety influenced affective commitment through the mediating roles of job satisfaction and job burnout.

Methods

A battery of surveys were administered to all medical staff (n = 267) in a local second-grade comprehensive hospital. The surveys included the Psychological Safety Scale, Affective Commitment Scale, Minnesota Satisfaction Questionnaire, Maslach Burnout Inventory–Human Service Survey, and Perceived Organizational Support Scale.

Results

Job satisfaction and job burnout fully mediated the relationship between psychological safety and affective commitment among hospital staff. In addition, perceived organizational support moderated the mediating path via job burnout, and the indirect effect of job burnout decreased when perceived organizational support increased.

Conclusion

Psychological safety may enhance the affective commitment of hospital staff through improving job satisfaction or reducing job burnout. Perceived organizational support may counteract the deleterious effect of job burnout on affective commitment. Effective strategies to improve affective commitment among hospital staff may require consideration of job burnout and job satisfaction.

The Relationship Between Occupational Stress and Turnover Intention Among Emergency Physicians: A Mediation Analysis

Background

There is evidence that occupational stress is a risk factor for turnover intentions. However, the structural relationship between occupational stress and turnover intention among emergency physicians has rarely been studied. This study aimed to examine the pathways of occupational stress on turnover intention through job satisfaction and depressive symptoms among emergency physicians in China.

Methods

A cross-sectional study was conducted in China from July 2018 to August 2018. Data were collected using a structured questionnaire that included demographic characteristics, occupational stress, job satisfaction, depressive symptoms, and turnover intention. Hierarchical linear regression was performed to explore the related factors of turnover intention. Structural equation modeling was used to examine the pathways from occupational stress to turnover intention.

Results

A total of 10,457 emergency physicians completed the questionnaire. The score of turnover intention was 11.34 (SD = 3.25), and the average item score of turnover intention was 2.84 (SD = 0.81). In structural equation modeling, the occupational stress not only had a direct effect on turnover intention (standardized direct effect = 0.311, bias-corrected 95% confidence interval [0.261, 0.361], P < 0.001), but also had an indirect effect through job satisfaction and depressive symptoms (standardized indirect effect = 0.448, bias-corrected 95% confidence interval [0.412, 0.484], P < 0.001). However, the effect of depressive symptoms on turnover intention was weak (standardized coefficient [β] = 0.08, P < 0.001).

Conclusions

Job satisfaction partially mediated the relationship between occupational stress and turnover intention. However, due to the weak effect of depressive symptoms on turnover intention, the mediating role of depressive symptoms between occupational and turnover intention had little practical value. It is recommended that hospital administrators prioritize increasing job satisfaction of emergency physicians to reduce the impact of occupational stress on their turnover intention.

The Intervening Effects of Perceived Organizational Support on COVID-19 Pandemic Stress, Job Burnout and Occupational Turnover Intentions of Collegiate Sport Athlete-Facing Professionals

Already a challenging position in higher education, collegiate sport athlete-facing professionals have been exposed to excessive stress amid the COVID-19 pandemic that can result in emotional exhaustion and a mass exodus of valued employees within collegiate sport organizations. Accordingly, based on COR theory, we aimed to assess the intervening effects of perceived organizational support that can mitigate job burnout and occupational turnover intentions due to pandemic stress. A total of 427 academic support professionals in National Collegiate Athletic Association (NCAA) Division I organizations responded to an online survey measuring pandemic stress, job burnout, occupational turnover intention, and organizational support. Hypotheses were tested through a serial-mediation analysis using the PROCESS macro for SPSS Model 6. Results showed that pandemic stress had a statistically significant effect on occupational turnover through job burnout. It was also confirmed that organizational support fully mediates the relationship between pandemic stress, job burnout, and occupational turnover. Overall, our findings highlight the importance of providing adequate organizational support towards employees under a high level of stress due to the pandemic. As ASPs adapt to the “new normal,” college sport organizations can assist employees by catering the support they provide to meet changing needs, especially by leveraging technologies that have been advanced during the pandemic. Further implications of the findings on collegiate sport organization literature are offered, as are suggestions for future research.

Examining the Relationship between COVID-19 Related Job Stress and Employees' Turnover Intention with the Moderating Role of Perceived Organizational Support: Evidence from SMEs in China

The outbreak of COVID-19 has exerted an enormous impact on society, enterprises, and individuals. It has affected the work attitudes and psychology of employees to a certain extent and their job stress (JS) has also augmented accordingly, leading to increased turnover intention (TI). With the survey responses of 720 employees of small and medium enterprises (SMEs) in China as the sample, we studied the impact of COVID-19 related JS and TI with the moderating effect of perceived organizational support (POS). We utilized linear and multiple regression analysis using Windows SPSS 25. The research findings indicated that the JS caused by COVID-19 in the first affected region (Hubei) was significantly stronger than that in other regions (non-Hubei). JS had a significant positive relationship with employees' TI, while POS had a significant negative connection with employees' TI. We also identified that POS weakened the positive association between JS and employees' TI. These findings are expected to be conducive to and conductive for the upcoming theoretical and empirical investigations as the founding guidelines, as well as for managers in formulating effective policies to curb JS, which would ultimately be helpful in reducing TI.

The magnitude of healthcare professionals' turnover intention and associated factors during the period of COVID-19 pandemic in North Shewa Zone government hospitals, Oromia region, Ethiopia, 2021

Background

Healthcare professional turnover and shortages are perceived as a global issue affecting the performance of healthcare organizations. Studies show that the coronavirus disease has physical and psychological effects on healthcare workers. This study assessed the magnitude of turnover intention and related factors during the COVID-19 pandemic.

Methods

A hospital-based cross-sectional study of 402 healthcare professionals working in the North Shewa Zone was conducted during the COVID-19 pandemic from 1 February to 28 February 2021. The data were collected using a self-managed structure questionnaire, entered into EpiData version 3.1, and exported to SPSS version 25 for further analysis. We performed a logistic regression analysis to identify factors related to healthcare professionals' turnover intention. Finally, the data were displayed in frequency, percentage, and summary statistics.

Result

From the total of 402 study participants, 363 of them were involved in the study with a response rate of 90.3%. The magnitude of healthcare professionals' turnover intention was 56.7%. Single marital status (AOR: 3.926; 95% CI: 1.961; 7.861), completion of obligatory service years (AOR: 0.287; 95% CI: 0.152, 0.542), dissatisfaction with the training opportunities (AOR: 2.407) 95% CI: 1.232, 4.701), having no established family (AOR: 2.184; 95% CI: 1.103, 4.326), dissatisfaction with organizational decisions process (AOR: 0.483; 95% CI: 0.250, 0.932), low continuous organizational commitment (AOR: 0.371; 95% CI 0.164; 0.842), dissatisfaction with professional development opportunities (AOR: 2.407; 95% CI: 1.232-4.701), and a non-conducive work environment (AOR: 2.079; 95% CI: 1.199, 3.607) were independent predictors of turnover intention.

Conclusions

Our study showed that 56.7% of healthcare professionals have turnover intention. Being unmarried, lack of training opportunities, lack of established family, having completed the obligatory service years, non-conducive work environment, low continuous organizational commitment, dissatisfaction with the decision-making of the organization, and dissatisfaction with professional development opportunities of the organization all contributed to a higher rate of healthcare professionals' turnover intention.

Recommendations

Healthcare organizations and other concerned bodies should create strategies that enhance the working environment, foster continuous organizational commitment, improve organizational decision-making, and provide professional development and training opportunities to lower the rate of turnover intention.