Magnitude of job satisfaction and intention to leave their present job among nurses in selected federal hospitals in Addis Ababa, Ethiopia

Nurses intention to stay in the nursing profession and associated factors in Ethiopia: a systematic review and meta-analysis

INTRODUCTION

The persistent attrition of nurses from the profession is a significant challenge for both healthcare policymakers and administrative bodies within numerous low-income countries. In Ethiopia, various cross-sectional studies have been conducted regarding nurses' intention to stay in the nursing profession; however, the results have demonstrated inconsistency. Hence, this study aims to pool the level of nurses' intention to persist in the nursing profession.

METHODS

In our systematic review and meta-analysis, targeted findings were searched from a variety of electronic databases; including Pub Med, Google Scholar, African Journal Online, the Cochran Library, and Science Direct. To determine the pooled prevalence and associated factors of intent to stay in nursing profession among nurse in Ethiopia, all the necessary data was extracted by using a standardized data extraction format. We analyzed the data by using Stata 17 statistical software. Heterogeneity between the primary studies was assessed by I-square tests. A random-effect model was applied to estimate the pooled intention of nurses to continue within the nursing profession.

RESULT

We included a total of 12 full-text studies in our analysis. The findings of this meta-analysis revealed that the pooled prevalence of nurses' intention to stay in nursing profession among Ethiopian nurses was 45.57% (95% CI; 38.43, 52.72). The subgroup analysis data revealed that the highest pooled prevalence of intention to stay was reported in the Tigray region which is 56.1% (95% CI 52.24, 59.96). In contrast the lowest prevalence was documented in Addis Ababa city administration which was 19.4% (95% CI 15.56, 23.24). Factors such as job satisfaction (OR = 2.69, 95% CI = 1.11 - 6.53), professional development (OR = 2.49, 95%CI = 1.27- 4.9), level of education (OR = 2.7, 95% CI = 1.92-3.8), payment and benefit (OR = 1.9, 95%CI = 1.15- 3.19) all were the significant determinants of nurses' intention to continue in the nursing profession.

CONCLUSION

The results of our investigation suggested that the degree of intention to continue in the nursing profession among Ethiopian nurses was inadequate. The nurses' intention to depart from the nursing profession is an alarming. Therefore, it's imperative for healthcare policymakers and stakeholders to prioritize on retention strategies encompassing job satisfaction, recognition, incentives, career opportunities, professional support, and autonomy were necessary.

Voices From the Frontline: A Reflexive Thematic Analysis Illuminating Perioperative Practice Realities in Southern Ethiopian Teaching Hospitals

Despite national efforts, gaps persist in Ethiopian perioperative care. This reflexive thematic analysis aimed to investigate the contextual challenges faced in delivering perioperative care. In-depth interviews were conducted with 20 healthcare professionals, including anesthetists, nurses, and surgeons, to gain a frontline perspective of perioperative practice realities. The analysis revealed eight interconnected themes: systemic infrastructure vulnerabilities, workforce expansion uncertainties, workforce demoralization, fragile perioperative safety culture, hierarchical structures and communication barriers, financial barriers to care, fragmented information systems, and fragile governance with sociopolitical instability. Local deficiencies in resources and equipment were amplified by global challenges, creating a precarious care environment. While workforce numbers increased, concerns persisted about competency and training quality. Systemic pressures and unmet professional needs contributed to staff demoralization. Inconsistent safety practices and top-down quality improvement initiatives hindered sustainable progress. Rigid hierarchies and departmental silos impeded effective teamwork and resource coordination. Financial constraints created significant barriers to care access and ethical dilemmas for providers. Incomplete digitalization and inconsistent documentation practices compromised continuity of care and data-driven improvements. Overarching sociopolitical instability and weak governance cascaded into healthcare system disruptions. The findings underscore the need for a multifaceted approach to strengthen perioperative care, including improving infrastructure, enhancing workforce development, fostering a culture of safety, breaking down hierarchical barriers, addressing financial accessibility, implementing robust information systems, and building resilient governance structures amidst adversity.

Pathways among the nursing practice environment, job burnout, and job satisfaction to intention to leave: a cross-sectional study conducted in Taiwan

OBJECTIVE

The purpose of this study was to explore the pathways among the practice environment, job burnout, and job satisfaction and their relationships with the intention to leave among clinical nurses.

METHOD

A cross-sectional survey was administered to 310 nursing staff members working in regional teaching hospitals in southern Taiwan. The instruments used included the practice environment, job satisfaction, job burnout, and sociodemographic characteristics questionnaires.

RESULTS

Structural equation modeling indicated that job satisfaction (β = -0.167) and job burnout (β = 0.361) were significantly and directly associated with the intention to leave, whereas the practice environment was significantly and directly associated with job satisfaction (β = 0.447). The practice environment (βindirect = -0.075) and job burnout (βindirect = 0.060) were significantly and indirectly associated with the intention to leave through job satisfaction.

CONCLUSION

Job burnout and job satisfaction are directly associated with the intention to leave. Therefore, improving the practice environment and subsequent job burnout could be strategies to improve job satisfaction and decrease the intention to leave.

Perioperative capacity and contextual challenges in teaching hospitals of southern Ethiopia: explanatory sequential mixed-methods research

BACKGROUND

Previous Ethiopian literature on surgical capacity and challenges has focused on quantitative investigations, lacking contextual understanding. This explanatory sequential mixed-methods research (MMR) aimed to assess perioperative capacity and contextual challenges at three teaching hospitals in southern Ethiopia.

METHODS

A quantitative survey assessed workforce, infrastructure, service delivery, financing, and information systems. The survey findings were explained by qualitative semi-structured interviews of twenty perioperative providers. Descriptive statistics were integrated with qualitative thematic analysis findings using the narrative waving approach. Key findings from both datasets were linked using a joint display table.

RESULTS

The survey revealed shortages in the specialist workforce (with a ratio of 0.58 per 100,000 population), surgical volume (at 115 surgeries per 100,000 population), equipment, supplies, financing, and perioperative data tracking. Hospitals' radiology services and blood products were only available 25-50% of the time, while anesthetic agents and essential laboratory services were often available 51-75% of the time. Perioperative management protocols were used rarely (1-25% of the time). Over 90% of patients lack health insurance coverage. Qualitative data also revealed scarcity of perioperative resources and equipment; unaffordable perioperative costs, lack of health insurance coverage, and unforeseen expenses; poor patient safety culture and communication barriers across the perioperative continuum of care; workforce shortages, job dissatisfaction, and concerns of competence; and weak national governance, and sociopolitical turmoil, and global market volatility exacerbating local challenges. These challenges are linked to risks in quality of care and patient safety, according to clinicians.

CONCLUSION

The study identifies deficiencies in the health system and sociopolitical landscape affecting safe surgery conduct. It highlights the need for comprehensive health system strengthening to expand workforce, upgrade facilities, improve safety culture, resilience, and leadership to ensure timely access to essential surgery. Exploring external factors, such as the impact of national governance and sociopolitical stability on reform efforts is also essential.

Professional quality of life and job satisfaction among nurses working at tertiary hospitals in central Ethiopia

BACKGROUND

Professional quality of life is a crucial aspect of healthcare professionals' well-being and job satisfaction. Job satisfaction, on the other hand, encompasses fulfillment of desired needs within the work environment, happiness or gratifying emotional response towards working conditions, and job values or equity. Existing literature tends to address job satisfaction and professional quality of life separately, overlooking their interconnectedness, especially within the unique context of Ethiopia. This study aimed to assess nurses' professional quality of life and job satisfaction.

METHODS

A descriptive cross-sectional study was conducted from September 1-30 2023 among 420 nurses using a structured questionnaire. The study participants were recruited by simple random sampling. Multiple linear regressions were used to identify factors associated with outcome variables.

RESULTS

The study involved 420 nurses, with 407 completing the questionnaire, yielding a 96.68% response rate. The findings revealed varying levels of professional quality of life. Specifically, 258 participants (63.4%) exhibited low compassion satisfaction, while 271 (66.6%) and 266 (65.4%) experienced average levels of burnout and secondary traumatic stress, respectively. Job satisfaction was moderate to high for 55% of the participants. As the finding of this study indicates, there is a positive correlation between compassion satisfaction and job satisfaction in nursing. The study also identified predictors for job satisfaction, compassion satisfaction, and compassion fatigue, such as marital status, education, and experience.

CONCLUSION

The majority of participants reported a medium level of compassion satisfaction, with a significant proportion experiencing moderate to high levels of compassion fatigue. Although more than half of the participants had moderate to high job satisfaction, there were still low levels of satisfaction. The study recommends developing targeted training programs, implementing workplace policies, and designing initiatives to enhance education, experience, and compassion satisfaction.

Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Nurses turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability. In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. Hence, the objectives of this systematic review and meta-analysis were to determine the pooled proportion ofturnover intention among nurses and to identify factors associated to it in Ethiopia.

METHODS

A comprehensive search carried out for studies with full document and written in English language through an electronic web-based search strategy from databases including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online. Checklist from the Joanna Briggs Institute (JBI) was used to assess the studies' quality. STATA version 17 software was used for statistical analyses. Meta-analysis was done using a random-effects method. Heterogeneity between the primary studies was assessed by Cochran Q and I-square tests. Subgroup and sensitivity analyses were carried out to clarify the source of heterogeneity.

RESULT

This systematic review and meta-analysis incorporated 8 articles, involving 3033 nurses in the analysis. The pooled proportion of turnover intention among nurses in Ethiopia was 53.35% (95% CI (41.64, 65.05%)), with significant heterogeneity between studies (I2 = 97.9, P = 0.001). Significant association of turnover intention among nurses was found with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) and promotion/development (OR: 0.67, C.I: 0.46, 0.89).

CONCLUSION AND RECOMMENDATION

Our meta-analysis on turnover intention among Ethiopian nurses highlights a significant challenge, with a pooled proportion of 53.35%. Regional variations, such as the highest turnover in Addis Ababa and the lowest in Sidama, underscore the need for tailored interventions. The findings reveal a strong link between turnover intention and factors like autonomous decision-making and promotion/development. Recommendations for stakeholders and concerned bodies involve formulating targeted retention strategies, addressing regional variations, collaborating for nurse welfare advocacy, prioritizing career advancement, reviewing policies for nurse retention improvement.

Analysis of the inhibitory effect of a refined human resources salary system on job transfer and transfer tendency of nurses

To evaluate the impact of a refined human resources salary system on job transfer and transfer tendency. From January 2019 to December 2019, a refined human resources salary system reform was implemented at the Tangshan Workers' Hospital in Hebei Province, and the job transfer and transfer tendency of clinical nurses was assessed using the nurse job transfer tendency scale before and 1 year after the intervention. A total of 640 nurses completed the intervention and evaluation. The results showed that the job transfer rate following the intervention reduced to 0.22%. The total score of clinical nurse job transfer tendency was (10.80 ± 3.23) before the intervention and (9.66 ± 3.58) after 1 year of intervention, which was substantially lower (P < .001). The satisfaction scores of nurses on performance-based salary increased significantly from (67.83 ± 18.54) before the intervention to (80.66 ± 15.87) after intervention, with varying degrees of increase observed in each dimension (P < .001). The refined human resources salary system effectively reduced job transfer and transfer tendency of clinical nurses in hospital nursing management, and can be widely promoted and applied.

Turnover Intention and Associated Factors Among Midwives in Jimma, Southwest Ethiopia

Background

Midwife turnover is a major problem and challenge for health-care leaders in Ethiopia. However, to date, little has been documented on turnover intention and its associated factors among midwifery professionals in southwest Ethiopia. Therefore, this study was conducted to fill the information gap on turnover intention and the factors influencing turnover intention among midwives in southwest Ethiopia.

Objective

This study aimed to determine the turnover intention and associated factors among midwives, southwest Ethiopia/2022.

Methods and Materials

An institutional-based cross-sectional study design was conducted among one hundred twenty one (121) midwives using structured self-administered and a pre-tested questionnaire from May 19/2022-June to 6/2022. Data were entered into Epi-data 4.4.2.1 edited, coded, categorized and entered into the data analysis. Data were analyzed using the statistical package for social science (SPSS) version 24, and the results are presented using figure, tables, and statements. Bivariate and multivariate logistic regression analyses were conducted to determine the factors associated with turnover intention at significance level of 0.25 and 0.05, respectively.

Results

In this study, from 121 midwives included in the analysis, approximately 48.76% (95% CI: 39.86-57.74) of midwives had a turnover intention from their current health-care institution, and 53.72% (95% CI: 44.68-62.52) of midwives did not have job satisfaction. Being male (AOR: 2.9 (95% CI: 1.14-7.39)), working in Health center (AOR: 0.20 (95% CI: 0.06-0.70)) and not having mutual support (AOR: 0.17 (95% CI: 0.07-0.44)) were associated factors of turnover intention among midwives.

Conclusion and Recommendation

In this study, the turnover intention among midwives was higher than that among other local and national figures. Gender, mutual support and type of working institution were factors associated with turnover intention among midwives. Therefore, public health organizations should review their maternity staff to establish teamwork and mutual support.

A survival analysis approach to determine factors associated with non-retention of newly hired health workers in Iran

BACKGROUND AND AIM

One of the main tasks of the healthcare human resource management is to maintain and retain professional staff. The high level turnover of professional staff may reduce the quality of healthcare service delivery. Therefore, this study investigated the factors associated with the turnover of the newly recruited healthcare professionals using survival analysis method in Iran.

MATERIALS AND METHODS

This historical cohort analysis comprised 6811 employees who began working at Mashhad University of Medical Sciences between 2005 and 2020. Employees recruited at any of the university's units between the years 2005 to 2019 were included. We used appropriate descriptive indices and Log-rank test and the Cox proportional-hazards model to assess the staff turnover. A significance level of 0.05 was used for all tests.

RESULTS

The findings of the survival analysis showed that the probability of turnover in one year, two years, and five years of employment were 0.12, 0.16, and 0.27. Based on the findings of the Log-rank test, the probability of turnover in entire of the study period was not statistically different between male and female (p = 0.573), and likewise between employees with healthcare occupations and non-healthcare occupations (p = 0.351). Employees whose current workplace and birthplace were not similar had a significantly higher probability of turnover (p < 0.001). Accordingly, the Cox regression result showed, the risk of turnover for the singles was 1.22 times higher than the married. For the Ph.D degree was 3.23 times higher compared to those with a diploma or an associate degree, and for a bachelor's or master's degree was 2.06 times more likely to change their workplace than those with a diploma or an associate degree.

CONCLUSION

Policies promoting the recruitment of native-born professionals, given priority to the married candidates than single ones, and/or recurring candidates to pledge to stay in the locality of recruitment site can increase the staff retention and reduce the costs of staff turnover including re-hiring, initial and on-the-job training, accommodation, and other extra living consumptions away from home and family.