Exploring the Factors behind Nurses' Decision to Leave Clinical Practice: Revealing Causes for Leaving and Approaches for Enhanced Retention

Exploring Nurses' Quit Intentions: A Structural Equation Modelling and Mediation Analysis Based on the JD-R and Social Exchange Theories

BACKGROUND/OBJECTIVES

Understanding how work environments affect nurses' turnover intentions is crucial for improving retention and organizational stability. Research on factors influencing nursing turnover intentions in Italy is limited despite its significant impact on healthcare sustainability today.

AIM

This study aims to identify the individual, interpersonal, and job-related factors influencing quit intentions among nurses, examining the mediating role of job satisfaction.

METHODS

Guided by the Job Demands-Resources (JD-R) theory and Social Exchange Theory (SET), this cross-sectional study applied structural equation modelling (SEM) to analyse theoretical relationships. Researchers collected data between August 2022 and December 2023 via an online survey sent to nurses in different settings across Italy. This study tested a hypothesised mediation model using SEM analysis, demonstrating good fit indices.

RESULTS

A total of 1745 nurses responded. The findings reveal that high job demands-physical, mental, and emotional workloads-were significantly associated with increased dissatisfaction and quit intentions. Conversely, job resources, including decision-making autonomy, inspiring leadership, and positive leader-member exchanges, were linked to greater job satisfaction and retention. Contrary to expectations, work satisfaction did not mediate the relationship between job demands/resources and turnover intentions. This could be explained by the strong direct effect of job satisfaction on turnover intentions. Additionally, younger nurses were more likely to report higher turnover intentions.

CONCLUSIONS

Identifying potential quitters at an early stage is essential for the sustainability of healthcare organizations. Understanding the factors contributing to nurse turnover is crucial for developing effective retention strategies. This study emphasizes the need for healthcare organizations to prioritize supportive work environments to enhance nurse job resources, well-being, and retention.

Job satisfaction among hospital nurses: An updated literature review

BACKGROUND

Nurses' job satisfaction has long been a global concern because of the critical significance it holds on nurse turnover and the quality and safety of patient care.

OBJECTIVES

To perform an updated literature review of the newly emerging studies on job satisfaction among hospital nurses.

DESIGN

Literature review.

DATA SOURCES

Ten electronic database (PubMed, Web of Science, Embase, CINAHL, PsycINFO, Applied Social Sciences Index, CNKI, SinoMed, CQVIP, WanFang) were searched for studies published between September 2018 and May 2024.

REVIEW METHODS

Studies were included if they published in English or Chinese and focused on job satisfaction of qualified general nurses working in acute care hospitals. Data extraction, synthesis and content analysis were performed.

RESULTS

Of the 28,584 studies originally identified, 52 studies were included in the final review. Thirty-eight influencing factors and twenty-nine predictors of nurses' job satisfaction across the domains of demographic characteristics, individual cognition and behaviors, and working environment and management were newly added in this updated review. Sixty-five factors, which were further grouped into eight subcategorizations: demographic characteristics, personality traits, emotion, behaviors, psychological and cognitive factors, organizational climate, leadership and management, were additionally identified as related factors of nurses' job satisfaction. Factors relating to nurses' individual cognition and behaviors mainly played mediating roles in the mediating pathways linking various factors with job satisfaction.

CONCLUSIONS

This review provides improved understanding of nurses' job satisfaction. Future studies could further explore the mechanisms by which factors relating to working environment and management predict or affect nurses' job satisfaction. The newly identified intrinsic factors from the mediating or moderating pathways offered valuable intervention insights for the improvement of nurses' job satisfaction.

Identifying the Barriers to Acceptance of Blockchain-Based Patient-Centric Data Management Systems in Healthcare

A number of recent studies have shown that wastage and inefficiency are a significant problem in all global healthcare systems. One initiative that could radically improve the operational efficiency of health systems is to make a paradigm shift in data ownership-that is, to transition such systems to a patient-centric model of data management by deploying blockchain technology. Such a development would not only make an economic impact, by radically cutting wastage, but would deliver significant social benefits by improving patient outcomes and satisfaction. However, a blockchain-based solution presents considerable challenges. This research seeks to understand the principal factors, which act as barriers to the acceptance of a blockchain-based patient-centric data management infrastructure, in the healthcare systems of the GCC (Gulf Cooperation Council) countries. The study represents an addition to the current literature by examining the perspectives and views of healthcare professionals and users. This approach is rare within this subject area, and is identified in existing systematic reviews as a research gap: a qualitative investigation of motivations and attitudes among these groups is a critical need. The results of the study identified 12 key barriers to the acceptance of blockchain infrastructures, thereby adding to our understanding of the challenges that need to be overcome in order to benefit from this relatively recent technology. The research is expected to be of use to healthcare authorities in planning a way forward for system improvement, particularly in terms of successfully introducing patient-centric systems.