Effects of work environment and job characteristics on the turnover intention of experienced nurses: The mediating role of work engagement.

To assess turnover intention among experienced nurses and explore the effects of work environment, job characteristics and work engagement on turnover intention. The nursing shortage is an urgent concern in China. A high turnover rate of experienced nurses could have serious effects on the quality of care, costs and the efficiency of hospitals. It is crucial to explore the predictors of turnover intention and develop strategies tailored to experienced nurses. A descriptive, cross-sectional survey design. A total of 778 experienced nurses from seven hospitals was surveyed on their work engagement, job characteristics, work environment and turnover intention in March-May 2017. Structural equation modelling was used to test a theoretical model and the hypotheses. The results showed that 35.9% of experienced nurses had high-level turnover intention. The final model explained 50% of the variance in experienced nurses' turnover intention and demonstrated that: (1) work environment was positively associated with higher work engagement and lower turnover intention and work engagement partially mediated the relationship between work environment and turnover intention; and (2) job characteristics were positively related to higher work engagement and lower turnover intention and work engagement fully mediated the relationship between job characteristics and turnover intention. The study confirms the intrinsic and extrinsic motivators on work engagement posited by job demands-resources model. Theory-driven strategies to improve work environment, enhance job characteristics and promote wok engagement are needed to address the nursing shortage and high turnover intention among experienced nurses.

Wan Q ，Li Z ，Zhou W ，Shang S ... -  《-》

Factors predicting Registered Nurses' intentions to leave their organization and profession: A job demands-resources framework.

To develop a comprehensive model of nursing turnover intention by examining the effects of job demands, job resources, personal demands and personal resources on burnout and work engagement and subsequently on the intention to leave the organization and profession. The ageing population and a growing prevalence of multimorbidity are placing increasing strain on an ageing nursing workforce. Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention. A cross-sectional survey design. Data were collected in 2014-2015 via an e-survey from 2,876 RNs working in New Zealand. Data were analysed with structural equation modelling. Higher engagement results in lower intention to leave the organization and profession. Burnout has significant effects on intentions to leave through lower engagement. While most of the demands and resources' variables (except professional development) have effects on intentions to leave, greater workload and greater work-life interference result in higher burnout and are the strongest predictors of intentions to leave. Greater emotional demands (challenges) and greater self-efficacy also have strong effects in lowering intentions to leave through higher engagement. Employee burnout and work engagement play an important role in transmitting the impacts of job demands, job resources, personal demands and personal resources into RN intention to leave the organization and profession. Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention.

Moloney W ，Boxall P ，Parsons M ，Cheung G ... -  《-》

The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction.

Nurses' voluntary turnover is a worrying global phenomenon which affects service quality. Retaining nursing staff within a hospital is important to eliminate the negative influence of voluntary turnover on the quality of care and organisation costs. This research helps explain nurses' voluntary turnover by analysing the role of self-efficacy, agentic capacities, job satisfaction, and work engagement on hospital turnover intention, and to study the relationships between these variables and patient satisfaction. This study gathered data from 194 nurses and 181 patients from 22 inpatient wards at two hospitals in southern Italy. Correlation analysis revealed that job satisfaction, work engagement, self-efficacy and agentic capacities were positively interrelated and negatively correlated with turnover intention. Path analysis showed that self-efficacy, some agentic capacities (anticipation and self-regulation), job satisfaction, and work engagement had direct or indirect effects on nurses' turnover intention, and that job satisfaction exerted a stronger effect on turnover intention. Also, patient satisfaction was positively correlated with nurses' job satisfaction, work engagement, self-efficacy, self-regulation and anticipation and negatively correlated with nurses' turnover intention. Results highlighted the importance of implementing actions (for example through feedforward methodology and the goal setting technique) to improve self-efficacy, self-regulation skill, work engagement and job satisfaction in order to reduce nurses' turnover intention and increase patient satisfaction with nursing care.

De Simone S ，Planta A ，Cicotto G 《-》

Effects of nurse work environment on job dissatisfaction, burnout, intention to leave.

The nursing shortage is a critical issue in many countries. High turnover rates among nurses is contributing to the shortage, and job dissatisfaction, intention to leave, and burnout have been identified as some of the predictors of nurse turnover. A well-established body of evidence demonstrates that the work environment for nurses influences nurse job dissatisfaction, intention to leave, and burnout, but there never has been a study undertaken in Thailand to investigate this relationship. To investigate how work environment affects job dissatisfaction, burnout, and intention to leave among nurses in Thailand. The study used a cross-sectional survey to collect data from 1351 nurses working in 43 inpatient units in five university hospitals across Thailand. The participants completed the Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory, and measures of job dissatisfaction and intention to leave. Logistical regression models assessed the association between work environment and nurse-reported job dissatisfaction, burnout, and intent to leave. Nurses working in university hospitals with better work environments had significantly less job dissatisfaction, intention to leave, and burnout. The nurse work environment is a significant feature contributing to nurse retention in Thai university hospitals. Improving the work environment for nurses may lead to lower levels of job dissatisfaction, intention to leave, and burnout. Focusing on these nurse outcomes can be used as a strategy to retain nurses in the healthcare system. Addressing the challenges of poor work environments requires coordinated action from policymakers and health managers.

Nantsupawat A ，Kunaviktikul W ，Nantsupawat R ，Wichaikhum OA ，Thienthong H ，Poghosyan L ... -  《-》

The impact of work environment on workplace violence, burnout and work attitudes for hospital nurses: A structural equation modelling analysis.

We aimed to test a model examining the direct and indirect effects of the work environment on workplace violence, nurse burnout and work attitudes of Chinese hospital nurses. Work environment is a key factor related to nurses' work attitudes. There has been limited information about how the work environment influences nurses' work attitudes. This was a cross-sectional study that included 1,517 hospital nurses in 111 medical/surgical units in 23 hospitals from Guangdong province, China. Structural equation modelling was used to test a hypothesized model that supposed work environment has both direct and indirect effects on work attitudes (e.g. job satisfaction and intention to leave) through workplace violence and nurse burnout. Better work environment was related to higher job satisfaction and lower intention to leave both directly and indirectly through two mediators: workplace violence and burnout. Burnout mediated the association of workplace violence with job satisfaction and intention to leave. Improving work environment would promote nurse safety and subsequently contribute to stabilize the nurse workforce. To help nurses achieve safety and improved work attitudes, nurse managers should build a positive work environment and help nurses who have experienced workplace violence relieve their burnout.

Wu Y ，Wang J ，Liu J ，Zheng J ，Liu K ，Baggs JG ，Liu X ，You L ... -  《-》