The influence of frontline manager job strain on burnout, commitment and turnover intention: a cross-sectional study.

The frontline clinical manager role in healthcare is pivotal to the development of safe and healthy working conditions and optimal staff and patient care outcomes. However, in today's dynamic healthcare organizations managers face constant job demands from wider spans of control and complex role responsibilities but may not have adequate decisional authority to support effective work performance resulting in unnecessary job strain. Prolonged job strain can lead to burnout, health complaints, and increased turnover intention. Yet, there is limited research that examines frontline manager job strain and its impact on their well-being and work outcomes. The substantial cost associated with replacing experienced managers calls attention to the need to address job strain in order to retain this valuable organizational asset. Using Karasek's Job Demands-Control theory of job strain, a model was tested examining the effects of frontline manager job strain on their burnout (emotional exhaustion and cynicism), organizational commitment and ultimately, turnover intentions. Secondary analysis of data collected in an online cross-sectional survey of frontline managers was conducted using structural equation modeling. All 500 eligible frontline managers from 14 teaching hospitals in Ontario, Canada, were invited to participate and 159 responded for a 32% response rate. Participants received an email invitation with a secure link for the online survey. Ethics approval was obtained from the university ethics board and the respective ethics review boards of the 14 organizations involved in the study. The model was tested using path analysis techniques within structural equation modeling with maximum likelihood estimation. The final model fit the data acceptably (χ(2)=6.62, df=4, p=.16, IFI=99, CFI=.99, SRMR=.03, RMSEA=.06). Manager job strain was significantly positively associated with burnout which contributed to both lower organizational commitment and higher turnover intention. Organizational commitment was also negatively associated with turnover intention and there was an additional direct positive relationship between job strain and turnover intention. Preliminary support was found for a model showing that manager job strain contributes to burnout, reduced organizational commitment and higher turnover intentions. Findings suggest that organizations need to monitor and address manager job strain by ensuring managers' role demands are reasonable and that they have the requisite decision latitude to balance role demands.

Wong CA ，Spence Laschinger HK 《-》

The influence of areas of worklife fit and work-life interference on burnout and turnover intentions among new graduate nurses.

To examine the relationships among the overall person-job match in the six areas of worklife, work-life interference, new nurses' experiences of burnout and intentions to leave their jobs. As a large cohort of nurses approaches retirement, it is important to understand the aspects of the nurses work-life that are related to turnover among new graduate nurses to address the nursing workforce shortage. Secondary analysis of data collected in a cross-sectional survey of 215 registered nurses working in Ontario acute hospitals was conducted using structural equation modelling. The fit indices suggested a reasonably adequate fit of the data to the hypothesised model [χ(2)  = 247, d.f. = 122, P = 0.001, χ(2) /d.f. = 2.32, Incremental Fit Index (IFI) = 0.954, Comparative Fit Index (CFI) = 0.953, Root Mean Square Error of Approximation (RMSEA) = 0.06]. Person-job match in six areas of worklife had a direct negative effect on burnout (emotional exhaustion and cynicism), which in turn had a direct positive effect on turnover intentions. Work-life interference also influenced turnover intentions indirectly through burnout. The study findings demonstrate that new graduate nurses' turnover intentions are a recurring problem, which could be reduced by improving nurses' working conditions. Retention of new graduate nurses could be enhanced by creating supportive working environments to reduce the susceptibility to workplace burnout, and ultimately, lower turnover intentions. Managers must employ strategies to enhance workplace conditions that promote a person-job fit and work-life balance to improve retention of new graduate nurses, and, thereby, lessen the nursing shortage.

Boamah SA ，Laschinger H 《-》

The influence of authentic leadership on newly graduated nurses' experiences of workplace bullying, burnout and retention outcomes: a cross-sectional study.

Retaining skilled and engaged nurses is critical during a time of shortage, however growing reports of workplace bullying threaten nurses' health and wellbeing, especially the transition of newly graduated nurses entering the profession. High rates of burnout and turnover among new nurses puts additional strain on limited financial resources in healthcare organizations and can compromise the quality of care provided to patients. The purpose of this study is to test a model linking authentic leadership to new graduate nurses' experiences of workplace bullying and burnout, and subsequently, job satisfaction and intentions to leave their jobs. This study employed a cross-sectional survey design with 342 new graduate nurses (defined as less than two years of practice experience) working in acute care hospitals in Ontario, Canada. Participants completed a questionnaire with measures of authentic leadership, workplace bullying, burnout, job satisfaction and turnover intentions. The model was tested using path analysis techniques within structural equation modeling. The model fit indices suggested that the original hypothesized model did not adequately fit the data (χ(2)=33.59, df=5, p=.000, χ(2)/df=6.72, IFI=.937, CFI=.937, RMSEA=.130), thus an additional theoretically justified direct path from authentic leadership to job satisfaction was added, which improved the fit substantially (χ(2)=5.26, df=4, p=.261, χ(2)/df=1.32, IFI=.997, CFI=.997, RMSEA=.030). Authentic leadership had a negative direct effect on workplace bullying, which in turn had a direct positive effect on emotional exhaustion. Authentic leadership also influenced job satisfaction indirectly through bullying and emotional exhaustion. Authentic leadership, workplace bullying and emotional exhaustion all had significant direct effects on job satisfaction, which in turn, was related to lower turnover intentions. The findings from this study demonstrate the fundamental importance of authentic leadership in creating supportive working environments. An authentic leadership style may reduce the probability of a unit culture of workplace bullying developing, contributing to a nursing workforce that is less burned out, more satisfied with their job, and ultimately, less likely to leave their position.

Spence Laschinger HK ，Wong CA ，Grau AL 《-》

Job demands-resources, burnout and intention to leave the nursing profession: a questionnaire survey.

The aims of the paper are to examine the role of burnout in the relationship between stress factors related to nurses' work and social environment and intention to leave the profession and to investigate the nature of the relationship between burnout and intention to leave the nursing profession. A postulate of the job demands-resources model is that two distinct yet related processes contribute to the development of burnout. The energetic process originates from demands and is mainly centered on emotional exhaustion; the motivational process originates from resources and is mainly centered on depersonalization. Moreover, we postulated that the two components of burnout are linked indirectly to intention to leave the profession via psychosomatic complaints, associated with the energetic process, and via professional commitment, associated with the motivational process. The research model was tested on cross-sectional data collected in 2005 from 1636 registered nurses working in hospitals who responded to a self-administrated questionnaire. Demands are the most important determinants of emotional exhaustion and indirectly induce depersonalization via emotional exhaustion, whereas resources mainly predict depersonalization. Moreover, emotional exhaustion and depersonalization are linked to psychosomatic complaints and professional commitment, which are in turn associated with intention to leave the profession. The results suggest that a dual strategy is needed in order to retain nurses within the profession: a decrease in job demands, coupled with an increase in available job resources. In particular, nurses' tasks and role should be restructured to reduce work overload and increase the meaning of their work.

Jourdain G ，Chênevert D 《-》

Related Factors of Turnover Intention Among Pediatric Nurses in Mainland China: A Structural Equation Modeling Analysis.

Pediatric nurses are at high risk for turnover. Turnover intention strongly predicts the actual voluntary turnover. Currently, no nationwide study has examined turnover intention among pediatric nurses in mainland China since the universal two-child policy implementation. Related factors associated with pediatric nurse turnover intention have not yet been identified. This study aims to understand factors related to turnover intention among pediatric nurses in mainland China. A cross-sectional on-line questionnaire survey was conducted among 6673 pediatric nurses across mainland China. Structural equation modeling (SEM) was used to examine the relationships between job satisfaction, work stress, job burnout, organizational commitment, work-family support and turnover intention. Six hundred and sixty-three (9.93%) nurses reported high turnover intention. Work stress and job burnout were directly and indirectly associated with turnover intention positively. Job satisfaction was related to turnover intention negatively with both direct effect and indirect effect through the mediations of job burnout and organizational commitment. Organizational commitment had a negative direct effect on turnover intention. Work-family support had indirect effects on turnover intention through the mediating role of burnout, job satisfaction, and organizational commitment. Turnover intention among pediatric nurses was associated with job satisfaction, work stress, job burnout, organizational commitment and work-family support. Attention to pediatric nurses' job burnout and work stress is important to improve job satisfaction and organizational commitment and to provide them with support in order to alleviate the turnover intention.

Yang Y ，Chen J 《-》