Occupational stress, distributive justice and turnover intention among public hospital nurses in China: A cross-sectional study

AIM

To examine the mediating role of distributive justice on the relation between occupational stress and turnover intention, and the regional role in moderating the relationship between distributive justice and turnover intention.

BACKGROUND

Turnover intention is an effective indicator of job departure and has been widely studied. Identification of methods to reduce turnover intention among nurses is a focus of the new round of medical and health system reform in China and in the realization of the "Healthy China 2030" policy. However, few studies have examined the present situation of Chinese nurse's turnover intention and corresponding influencing factors.

METHODS

Data were collected on-site by using questionnaires designed by anonymous researchers. A total of 718 effective questionnaires were allocated from representative public hospitals. Data were collected for the "Challenge and Hindrance-Related Self-Reported Stress Scale", "Distributive Justice Scale" and "Turnover Intention Scale".

RESULTS

Challenge stress was significantly inversely correlated with turnover intention, while hindrance stress was significantly positively correlated with turnover intention. Moreover, there was a significant inverse correlation between the two types of occupational stress and distributive justice and an inverse correlation between distributive justice and turnover intention. Regional role had a moderating effect on the correlation between distributive justice and turnover intention.

CONCLUSIONS

Chinese nurses' turnover intention is directly or indirectly influenced by occupational stress and distributive justice. Managers should set reasonable goals to cope with challenging stress. Proper intervention measures should be designed such as reducing barrier pressure, increasing remuneration, and promoting the matching between workload and job value to reduce the turnover intention. Finally, balancing the treatment towards nurses in different regions may help achieve relative fairness.

Public service motivation as a mediator of the relationship between job stress and presenteeism: a cross-sectional study from Chinese public hospitals

BACKGROUND

Job stress is a strong indicator of presenteeism, but few studies have examined its diverse effects and mediators on presenteeism. This study explored the relationships between job stress, public service motivation (PSM) and presenteeism and how job stress and PSM influence presenteeism in a large national sample of Chinese healthcare workers.

METHODS

A cross-sectional survey including 1392 healthcare workers from 11 Class A tertiary hospitals in eastern, central and western China was used in the analysis. Descriptive statistical analysis, correlation analysis and structural equation modeling were used to test the research hypothesis.

RESULTS

Hindrance stress was inversely associated with PSM (β = - 0.27; P < 0.001) but significantly positively associated with presenteeism (β = 0.35; P < 0.001). PSM was directly inversely associated with presenteeism (β = - 0.35; P < 0.001). PSM partially mediated the relation of hindrance stress with presenteeism.

CONCLUSIONS

The findings suggest that efforts to prevent presenteeism among healthcare workers in China should emphasize PSM improvement and reduction of hindrance stress.

How job stress influences job performance among Chinese healthcare workers: a cross-sectional study

Objectives

Public service motivation refers to the idea of commitment to the public service, pursuit of the public interest, and the desire to perform work that is worthwhile to society. This study investigates how challenge stress and hindrance stress influence job performance among healthcare workers in Chinese public hospitals. It has also examined the mediating effect of public service motivation.

Methods

Data of 1594 healthcare workers were obtained from typical public hospitals in eastern, central, and western China. To test our hypotheses, we used descriptive statistical analysis, correlation analysis, structural equation modeling, and subgroup analysis to investigate the sample.

Results

Challenge stress and hindrance stress were strongly correlated among healthcare workers in Chinese public hospitals (β = 0.59; p < 0.001). Challenge stress was significantly positively associated with public service motivation (β = 0.14; p < 0.001) and job performance (β = 0.13; p < 0.001). Hindrance stress was significantly negatively associated with public service motivation (β = − 0.27; p < 0.001) and job performance (β = − 0.08; p < 0.05). Public service motivation was directly positively associated with job performance (β = 0.58; p < 0.001), and it indirectly mediated the association between job stress and job performance.

Conclusions

This study provides important empirical evidence on the effects of job stress and public service motivation on job performance among healthcare workers in Chinese public hospitals. Job performance may be raised by limiting hindrance stress, which provides moderate challenge stress and increases public service motivation.

Challenge or hindrance: Does job stress affect presenteeism among Chinese healthcare workers?

Background:

We examined the effects of challenge stress and hindrance stress on general health and presenteeism among Chinese healthcare workers.

Methods:

Structural equation modeling was used to evaluate data from a national hospital survey in China (n = 1392). Job stress, general health, and presenteeism were measured by the Perceived Ability to Work Scale, the 8-item Short-Form Health Survey, and the Challenge- and Hindrance-Related Self-reported Stress Scale.

Results:

Challenge stress and hindrance stress were significantly positively correlated (β = 0.62, SE = 0.021; p < 0.001). Challenge stress was directly negatively associated with presenteeism (β = -0.05, SE = 0.037; p < 0.001), while hindrance stress was positively associated with presenteeism (β = 0.25, SE = 0.040; p < 0.001). These associations with presenteeism were partially mediated by health.

Conclusions:

Hospital managers should provide healthcare workers with an appropriate level of challenge, but employee health is the most important consideration. Further efforts targeting job stress and health of junior healthcare workers are required.