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Nurses’ Intention to Leave the Organization: A Mediation Study of Professional Burnout and Engagement

Published online by Cambridge University Press:  08 August 2018

Alexandra Marques-Pinto*
Affiliation:
Universidade de Lisboa (Portugal)
Élvio Henriques Jesus
Affiliation:
Universidade Catolica Portuguesa (Portugal)
Aida Maria Oliveira Cruz Mendes
Affiliation:
Escola Superior de Enfermagem de Coimbra (Portugal)
Inês Fronteira
Affiliation:
Universidade Nova de Lisboa (Portugal)
Magda Sofia Roberto
Affiliation:
Universidade de Lisboa (Portugal)
*
*Correspondence concerning this article should be addressed to Alexandra Marques-Pinto. Universidade de Lisboa. Faculdade de Psicologia. Centro de Investigação em Ciências Psicológicas (CICPSI). Alameda da Universidade, 1649–013, Lisboa (Portugal).

Abstract

The nature of the turnover process calls for the study of more complex relationships among variables beyond simple bivariate or multiple associations between predictors and turnover intentions. The present article aims to examine the predictive value of job demands and resources in the explanation of nurses’ intention to leave the organization and to test the mediating roles of professional burnout and engagement in these relationships, within a Portuguese nursing population. The research models were tested within the scope of the Registered Nurse Forecasting project. Data included the self-report questionnaires of 2,235 Portuguese nurses from 31 hospitals, collected through stratified random sampling procedures. The statistical analyses of the structural models showed that nurses’ participation in hospital affairs, a job resource at the work organization level, was the only significant predictor of nurses´ intention to leave the organization (β = –.45, p < .001). Analyses of the mediation models revealed that the emotional exhaustion symptoms of burnout (β = –.11, p < .001) and job engagement feelings (β = –.15, p < .001) were both significant mediators between nurses’ decisional involvement and their intentions to leave the organization. Results suggest that including nurses in decision-making processes regarding their professional practice policy and environment, and improving nurses’ professional well-being are two crucial strategies to reduce nurses’ turnover intentions.

Type
Research Article
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2018 

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References

Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., … Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. The BMJ, 344, e1717. https://doi.org/10.1136/bmj.e1717CrossRefGoogle ScholarPubMed
American Organization of Nursing Executives (AONE) (2003). Healthy work environments: Striving for excellence (Vol. 2). Chicago IL: McManis & Monsalve Associates.Google Scholar
Bandalos, D. L. (2014). Relative performance of categorical diagonally weighted least squares and robust maximum likelihood estimation. Structural Equation Modeling, 21(1), 102116. https://doi.org/10.1080/10705511.2014.859510CrossRefGoogle Scholar
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238246. https://doi.org/10.1037/0033-2909.107.2.238CrossRefGoogle ScholarPubMed
Bentler, P. M., & Dudgeon, P. (1996). Covariance structure analysis: Statistical practice, theory, and directions. Annual Review of Psychology, 47, 563592. https://doi.org/10.1146/annurev.psych.47.1.563CrossRefGoogle ScholarPubMed
Brewer, C. S., Chao, Y-Y., Colder, C. R., Kovner, C. T., & Chacko, T. P. (2015). A structural equation model of turnover for a longitudinal survey among early career registered nurses. International Journal of Nursing Studies, 52, 17351745. https://doi.org/10.1016/j.ijnurstu.2015.06.017CrossRefGoogle ScholarPubMed
Demerouti, E., & Bakker, A. B. (2011). The job demands-resources model: Challenges for future research. Journal of Industrial Psychology, 37(2), a974. https://doi.org/10.4102%2Fsajip.v37i2.974Google Scholar
Flinkman, M., Leino-Kilpi, H., & Salantera, S. (2010). Nurses’ intention to leave the profession: Integrative review. Journal of Advanced Nursing, 66(7), 14221434. https://doi.org/10.1111/j.1365-2648.2010.05322.xCrossRefGoogle ScholarPubMed
Garden, A. M. (1987). Depersonalization: A valid dimension of burnout? Human Relations , 40(9), 545559. https://doi.org/10.1177/001872678704000901CrossRefGoogle Scholar
Gilmartin, M. T. (2013). Thirty years of nursing turnover research: Looking back to move forward. Medical Care Research and Review, 70(1), 328. https://doi.org/10.1177/1077558712449056CrossRefGoogle ScholarPubMed
Heinen, M. M., Van Achterberg, T., Schwendimann, R., Zander, B., Matthews, A., Kózka, M., … Schoonhoven, L. (2013). Nurses’ intention to leave their profession: A cross sectional observational study in 10 European countries. International Journal of Nursing Studies, 50(2), 174184.CrossRefGoogle ScholarPubMed
Hom, P. W., Lee, T. W., Shaw, J. D., & Hausknecht, J. P. (2017). One hundred years of employee turnover theory and research. Journal of Applied Psychology, 102, 530545. https://doi.org/10.1037/apl0000103CrossRefGoogle ScholarPubMed
Hu, L.-T, & Bentler, P. M. (1999). Cut-off criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 155. https://doi.org/10.1080/10705519909540118CrossRefGoogle Scholar
Jaafarpour, M., & Khan, A. (2011). The participation of nurses in decision making. Journal of Clinical and Diagnostic Research, 5(1), 1619.Google Scholar
Jesus, E. H., Marques-Pinto, A., Fronteira, I. S. E., & Mendes, A. M. O. C. (2014). Estudo RN4Cast em Portugal: Percepção dos enfermeiros sobre burnout [RN4Cast Study in Portugal: Nurses’ perception of burnout]. Revista Investigação em Enfermagem, 9(2), 4759.Google Scholar
Jourdain, G., & Chênevert, D. (2010). Job demands–resources, burnout and intention to leave the nursing profession: A questionnaire survey. International Journal of Nursing Studies, 47, 709722. https://doi.org/10.1016/j.ijnurstu.2009.11.007CrossRefGoogle ScholarPubMed
Lake, E. T. (2002). Development of the practice environment scale of the Nursing Work Index. Research in Nursing & Health, 25(3), 176188. https://doi.org/10.1002/nur.10032CrossRefGoogle ScholarPubMed
Leone, C., Bruyneel, L., Anderson, J. E., Murrells, T., Dussault, G., de Jesus, É. H., … Rafferty, A. M. (2015). Work environment issues and intention-to-leave in Portuguese nurses: A cross-sectional. Health Policy 119, 15841592. https://doi.org/10.1016/j.healthpol.2015.09.006CrossRefGoogle ScholarPubMed
Little, T. (2013). Longitudinal Structural Equation Modeling. New York, NY: The Guilford Press.Google Scholar
Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002). To parcel or not to parcel: Exploring the question, weighing the merits. Structural Equation Modeling, 9, 151173. https://doi.org/10.1207/S15328007SEM0902_1CrossRefGoogle Scholar
Marques-Pinto, A., Jesus, E. H., Mendes, A. M. O. C., & Fronteira, I. S. E. (2015). Estudo RN4Cast em Portugal: Work Engagement dos enfermeiros [RN4Cast Study in Portugal: Nurses’ Work Engagement]. Revista Investigação em Enfermagem, 10(2), 2637.Google Scholar
Maslach, C., & Leiter, M. P. (1997). The truth about burnout – How organizations cause personal stress and what to do about it. San Francisco, CA: Jossey-Bass Inc.Google Scholar
Mendes, F., & Stander, M. W. (2011). Positive organization: The role of leader behavior in work engagement and retention. South African Journal of Industrial Psychology, 37(1), 113.Google Scholar
Ordem dos Enfermeiros (2014). Relatório de dados e contas de 2013 [2013 Data and account report]. Retrieved from https://www.ordemenfermeiros.pt/arquivo/ordem/Documents/RAC2013_aprovado_03abril2014.pdfGoogle Scholar
Poghosyan, L., Aiken, L. H., & Sloane, D. M. (2009). Factor structure of the Maslach Burnout Inventory: An analysis of data from large scale cross-sectional surveys of nurses from eight countries. International Journal of Nursing Studies, 46(7), 894902. https://doi.org/10.1016/j.ijnurstu.2009.03.004CrossRefGoogle ScholarPubMed
Price, J. L., & Mueller, C. W. (1981). A causal model for turnover for nurses. Academy of Management Journal, 24, 543565. https://dx.doi.org/10.2307/255574Google ScholarPubMed
R Core Team. (2015). R: A language and environment for statistical computing [Computer Software]. R Foundation for Statistical Computing, Vienna, Austria. Retrieved from http://www.R-project.org/Google Scholar
Rosseel, Y. (2012). Lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48(2), 136.CrossRefGoogle Scholar
Schaufeli, W. B., & Bakker, A. (2004). Job demands, job resources, and their relationship with burnout and engagement: A multi-sample study. Journal of Organizational Behavior, 25(3), 293315. https://doi.org/10.1002%2Fjob.248CrossRefGoogle Scholar
Sermeus, W., Aiken, L. H., Van den Heede, K., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., … RN4CAST consortium. (2011). Nurse forecasting in Europe (RN4Cast): Rationale, design and methodology. BMC Nursing, 10(1), 6. https://doi.org/10.1186/1472-6955-10-6CrossRefGoogle ScholarPubMed
Sonnentag, S. (2003). Recovery, work engagement, and proactive behavior. Journal of Applied Psychology, 88(3), 518528. https://doi.org/10.1037%2F0021-9010.88.3.518CrossRefGoogle ScholarPubMed
Van Bogaert, P., Kowalski, C., Weeks, S. M., Van Heusden, D., & Clarke, S. P. (2013). The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey. International Journal of Nursing Studies, 50(12), 16671677. https://doi.org/10.1016/j.ijnurstu.2013.05.010CrossRefGoogle ScholarPubMed
Van Bogaert, P., Meulemans, H., Clarke, S., Vermeyen, K., & van de Heyning, P. (2009). Hospital nurse practice environment, burnout, job outcomes and quality of care: Test of a structural equation model. Journal of Advanced Nursing, 65(10), 21752185. https://doi.org/10.1111/j.1365-2648.2009.05082.xCrossRefGoogle ScholarPubMed
Yu, C. Y. (2002). Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes (Unpublished doctoral dissertation). University of California, Los Angeles, CA.Google Scholar
World Health Organization (2006). The World Health Report 2006 – Working Together for Health. Retrieved from WHO website http://www.who.int/whr/2006/en/Google Scholar