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

Turnover intention and influential factors among primary healthcare workers in Guangdong province, China: a cross-sectional study

OBJECTIVES

Primary health workers are crucial to the healthcare system, yet China experiences a notable shortage driven by high turnover rates. This study aimed to investigate the prevalence and determinants of turnover intention among primary health workers.

DESIGN

Cross-sectional study.

SETTING

Primary healthcare facilities across 21 cities in Guangdong province, China.

PARTICIPANTS

Online questionnaires (SurveyStar, Changsha Ranxing Science and Technology) were administered to 16 573 primary health workers in September and October 2022.

PRIMARY AND SECONDARY OUTCOME MEASURES

Variables measured included demographics, work-related factors, job satisfaction, emotional exhaustion and turnover intention. Comparisons of turnover intention were made across different categorical groups, and hierarchical regression analysis was used to pinpoint influencing factors.

RESULTS

The average turnover intention score among participants was 10.49±2.93. Notable positive correlations included those with male gender, single marital status, leadership positions and roles as public health physicians. Emotional exhaustion correlated positively (β=0.108), while job satisfaction showed a significant negative correlation (β=-0.154). Other negative influential factors were observed with tenure lengths of 6-10 years, 11-15 years and ≥16 years, as well as with senior professional titles, lower salary levels and perceptions of fair compensation.

CONCLUSIONS

Turnover intention is notably prevalent among primary healthcare workers, with emotional exhaustion and job satisfaction identified as primary determinants. Salary, payment justice in compensation and tenure also significantly influence turnover intention. Based on the above analysis, a series of intervention measures can be expectedly unveiled to reduce the turnover intention of primary health workers and maintained the steady development of basic medical resources.

The impact of job stress on job satisfaction and turnover intentions among bank employees during the COVID-19 pandemic

Objective

The main objective of this study is to explore the relationships among job stress, job satisfaction, and turnover intentions among bank employees during the COVID-19 pandemic, with a focus on variations across different demographic characteristics.

Methods

A cross-sectional design was employed, and data were collected from 501 bank employees using the Job Stress Questionnaire (JSQ), the Simplified Minnesota Satisfaction Questionnaire (MSQ), and the Intention to Leave Scale (ILS). Descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple regression analyses were used to test the research hypotheses.

Results

The findings show that job stress is significantly negatively correlated with job satisfaction and positively correlated with turnover intention. Interpersonal relationship stress emerged as the strongest predictor of turnover intention, while job autonomy stress significantly influenced job satisfaction. Demographic factors, including age, income, and education level, moderated these relationships, with younger, higher-income, and more educated employees reporting lower stress and higher satisfaction. Employees with dependents reported higher stress levels, lower job satisfaction, and greater turnover intentions compared to those without dependents.

Conclusion

This study underscores the importance of managing workplace stress and enhancing job satisfaction to reduce turnover intention, particularly during the COVID-19 pandemic. Interventions focused on improving interpersonal relationships and providing targeted support for older and lower-income employees are recommended to mitigate stress and improve retention rates.

Testing a chain mediation model of effort-reward imbalance, Confucian values, job satisfaction, and intention to quit among Chinese vocational education teachers

Context

This research delves into the significant impact of Confucian Values on the societal fabric of China, particularly in the realm of vocational education. In this setting, these principles are instrumental in guiding both educators and students. The study employs the Culture-Value Structure (CVS) model to dissect the intricate dynamics between Confucian Values, the Effort-Reward Imbalance (ERI), educators' job satisfaction, and their inclination toward leaving the profession. Teachers in vocational education, who are often regarded as moral guides, play a pivotal role in the ethical and social upbringing of students. Adopting Confucian values not only promotes academic success but also nurtures all-round development, equipping students for conscientious societal roles. In the backdrop of Confucian influence, these educators face substantial stressors in the workplace due to varied demands. The ERI model, proposed by Siegrist, serves as a tool to comprehend the stress experienced when there is a disproportion between efforts and rewards. This study delves into how ERI correlates with job satisfaction among vocational education teachers, with a focus on the modifying effect of Confucian values. Additionally, it examines the potential role of job satisfaction in mediating the relationship between ERI and the tendency to consider leaving the job. The research illuminates the complex interrelation of cultural values, occupational stress, job contentment, and career decision-making in the context of vocational education in China.

Methodology

The research involved a group of 332 Vocational education teachers from diverse Chinese institutions. Through thorough statistical analysis, the study validated the model's effectiveness, notably indicating a substantial direct impact of ERI on the Intention to Quit.

Findings

The investigation pinpointed Factors I (Integrity), II (Confucian Ethos), and IV (Moderation) as key determinants of job satisfaction. Notably, an increase in job satisfaction was found to inversely relate to the likelihood of leaving the profession, implying it could lessen the propensity to resign. The research applied a Chain Mediation Model to elucidate the influence of ERI on the decision to quit, mediated by various factors. The findings highlight the complex interaction of elements influencing teachers' decisions to leave, showcasing the utility of sophisticated statistical methodologies in decoding complex social dynamics.

Behavioral intentions and perceived stress under isolated environment

BACKGROUND

Isolation is a special environment that will affect the mental health and behavior of individuals. The current study was to explore the relationship between behavior intention (BI) and perceived stress in isolated environment during Shanghai Omicron pandemic.

METHODS

A cross-sectional study was conducted between April 8 and 14, 2022. Three self-reported questionnaires were used to evaluate quarantine duration, stress perception, and BI. A total of 1042 participants in Shanghai under quarantine at home were included by random sampling. Logistic regression and one-way variance analysis were used to determine the risk factors related to BI.

RESULTS

The finding implicated negative BI was more reported by the population of males, with lower educational background, with jobs, and youngers. A negative association existed between perceived stress and BI (B = -1.004, p = .003, OR = 0.367, 95% CI = .191-.703). The proportion of positive BI decreased with quarantined duration, whereas the negative BI seemed vibrate upward then downward.

CONCLUSION

There existed a significant effect of quarantined days on perceived stress with different BIs. High perceived stress was a risk factor of positive BI. This preliminary study has significance to understand the effect of compulsory measures on BI and for policies makers to take a psychosocial perspective to consider the effective pandemic intervention strategies.

The impact of meaning in life and professional happiness on the turnover intention of health care workers: a cross-sectional study from China

INTRODUCTION

The turnover and shortage of health care workers (HCWs) have been a worldwide problem for healthcare organizations. The primary aim of this study was to identify the factors influencing the intention of Chinese HCWs to leave their job, especially meaning in life and professional happiness.

METHODS

This observational cross-sectional study, conducted among 1125 full-time HCWs, assessed demographic variables, meaning in life, professional happiness, and turnover intention by a survey. The survey was distributed to HCWs in three tertiary hospitals. The data were analyzed by T-tests, ANOVA, Kruskal-Wallis tests and hierarchical linear regression model.

RESULTS

There were statistically significant differences in turnover intention of HCWs by gender, age, role, educational level, years in practice, and number of monthly night shifts. HCWs' meaning in life and professional happiness were negatively associated with the turnover intention. Furthermore, after controlling for other factors, meaning in life explained 3.7% of the turnover intention and professional happiness explained 13.4%.

CONCLUSION

In our study, positive psychological factors were related to turnover intentions. Professional happiness was the strongest predictor. Thus, health human resource managers should foster positive psychology among HCWs to reduce their turnover.

Chronic stress and turnover intention of resident physicians after experiencing COVID-19

BACKGROUND

Previous studies have explored the stress and turnover intention of healthcare workers, but as important backup talents in the healthcare system, resident physicians have received little attention from researchers, especially after experiencing COVID-19. Therefore, this study aims to evaluate the chronic stress and turnover intention of resident physicians after experiencing COVID-19.

METHODS

From June to August 2022, we conducted a questionnaire survey on resident physicians in the Children's Hospital of Hebei Province through the online platform (Wenjuanxing) to evaluate their chronic stress and turnover intention after experiencing COVID-19. For the collected data, we used frequency and percentage to make the statistical description, the Chi-square test to make a univariate analysis on the scores of chronic stress and turnover intention scale, and binary logistic regression analysis to explore the influencing factors of turnover intention.

RESULTS

Out of 143 respondents, we finally received 127 questionnaires, with a response rate of 88.81%. Among 127 respondents, 80.31% of resident physicians experienced varying degrees of chronic stress (mild: 36.22%, moderate: 35.43%, severe: 8.66%), and 74.80% of resident physicians showed varying degrees of turnover intention (mild: 23.62%, moderate: 37.79%, severe: 13.39%). Moreover, age (OR = 0.772, P = 0.042), identity (OR = 8.648, P = 0.021), and chronic stress levels (mild: OR = 6.938, P = 0.003; moderate: OR = 44.049, P < 0.003; severe: OR = 46.141, P = 0.004) can significantly affect turnover intention.

CONCLUSION

In this study, we reported a relatively high proportion of resident physicians with high chronic stress and high turnover intention after experiencing COVID-19. We suggest that the relevant departments should pay more attention to the resident physicians' group and formulate corresponding measures to solve the problems faced by the resident physicians and ensure the stability of the health human resources.

Work-family conflict and its related factors among emergency department physicians in China: A national cross-sectional study

Background

Work-family conflict is common among emergency department physicians. Identifying the factors associated with work-family conflict is key to reducing its negative impact on mental health and work attitudes. However, the work-family conflict of Chinese emergency department physicians and the related factors have been scarcely studied.

Objective

This study aimed to investigate the current status and related factors of work-family conflict among Chinese emergency department physicians.

Methods

A national cross-sectional study was conducted among emergency department physicians in China from June 2018 to August 2018. A standard questionnaire was used to investigate the demographic characteristics, work-related factors, and work-family conflict of emergency department physicians. The generalized linear regression analysis was used to identify the related factors of work-family conflict.

Results

A total of 10,457 licensed emergency department physicians participated in the study. The average score of work-family conflict among the enrolled emergency department physicians was 19.27 ± 3.94, and the prevalence of high levels of work-family conflict was 69.19%. The multivariable regression analysis showed that emergency physicians who were female (linear regression coefficient, −0.25; SE, 0.08; P = 0.002), older than 40 years (linear regression coefficient,−0.53; SE, 0.14; P &lt; 0.001), and earning more than 4,000 CNY per month (e.g., 4,001~6,000 vs. ≤4,000 CNY: linear regression coefficient, −0.17; SE, 0.09; P = 0.04) had lower work-family conflicts. However, emergency department physicians who were married (linear regression coefficient, 0.37; SE, 0.11; P &lt; 0.001), highly educated (linear regression coefficient, 0.46; SE, 0.10; P &lt; 0.001), had a high technical title (e.g., intermediate vs. junior technical title: linear regression coefficient, 0.61; SE, 0.09; P &lt; 0.001), worked in a high-grade hospital (e.g., tertiary hospital vs. emergency center: linear regression coefficient, 0.38; SE, 0.11; P &lt; 0.001), had a higher frequency of night shifts (e.g., 6~10 night shifts per month vs. 0~5 night shifts per month: linear regression coefficient, 0.43; SE, 0.10; P &lt; 0.001), self-perceived shortage of physicians in the department (linear regression coefficient, 2.22; SE, 0.08; P &lt; 0.001), and experienced verbal abuse (linear regression coefficient, 1.48; SE, 0.10; P &lt; 0.001) and physical violence (linear regression coefficient, 0.84; SE, 0.08; P &lt; 0.001) in the workplace had higher work-family conflict scores.

Conclusion

Most emergency department physicians in China experience a high-level work-family conflict. Hospital administrations are recommended to develop family-friendly workplace policies, establish a scientific shift system, and keep the number of emergency department physicians to meet the demand to reduce work-family conflict.

Using EMA and Physiological Data to Explore the Relationship between Day-to-Day Occupational Stress, Musculoskeletal Pain and Mental Health among University Staff: A Study Protocol

Exposure to work-related stressors is associated with poor physical and mental health outcomes for workers. The role of chronic stressors on health outcomes has been explored, but less is known about the potential role of exposure to day-to-day stressors on health. This paper describes the protocol for a study that aims to collect and analyze day-to-day data on work-related stressors and health outcomes. Participants will be workers engaged in predominantly sedentary work at a university. Self-report data on work-related stressors, musculoskeletal pain, and mental health will be collected three times per day for 10 work days through ecological momentary assessment via online questionnaires. These data will be combined with physiological data collected continuously via a wristband throughout the working day. The feasibility and acceptability of the protocol will be assessed via semi-structured interviews with participants and adherence to the study protocol. These data will inform the feasibility of using the protocol in a larger study to investigate the relationship between exposure to work-related stressors and health outcomes.