A Study On The Correlation Between Psychological Contract,job Satisfaction And Turnover Intention Of Medical Care Workers

Objective:To understand the status quo of the psychological contract,job satisfaction and turnover intention and to explore the interaction between the the above three variables of medical care workers.Analyze the impact on medical care The factors of nurses’resignation willingness provide a theoretical basis for reducing the resignation willingness of medical nurses,stabilizing the team of medical nurses,and adopting targeted human resource management measures.Methods:This study consisted of two parts.The first part is a study about the current situation and interaction between the psychological contract,job satisfaction and turnover intention of medical care workers.This part adopted the questionnaire survey method,a group of 448medical care workers from 4 tertiary A hospitals in Taiyuan City were selected to conduct an electronic questionnaire survey.The questionnaire included the general information,psychological contract scale,MSQ job satisfaction scale and turnover intention scale.Understand the status quo of medical nurses’psychological contract,job satisfaction and turnover intention,analyze the influencing factors of medical care workers’turnover intention,and test whether it is a mediator of job satisfaction.The second part is a qualitative study on the turnover intention of medical care workers.This part used phenomenological research methods to conduct semi-structured interviews with 13medical care workers.Aims to understand the psychological experience of medical care workers’turnover intention,and to further explore the relationship between medical care workers’psychological contract,job satisfaction and turnover intention.Analyze and summarize the quantitative and qualitative research results,put forward countermeasures and suggestions for effective management of the medical care worker team.Results:Part 1 Quantitative Research1.The results of the current situation analysis show that the psychological contract score was（160.27±24.53）,the job satisfaction score was（78.19±16.54）,and the turnover intention score was（12.29±3.63）.In terms of psychological contract,organizational responsibility score was higher than employee responsibility score;in terms of job satisfaction,internal satisfaction score was higher than external satisfaction score.The score in all dimensions of turnover intention ranged from high to low were III（4.99±1.68）,I（4.21±1.24）and II（3.09±1.53）.2.Correlation analysis results show that the scores of psychological contract and job satisfaction of medical care workers were correlated with turnover intention and each factor（P<0.01）.Among them,psychological contract of medical care workers was positively correlated with job satisfaction（r=0.707）.Both of the above,the variables were negatively correlated with turnover intention（r₁=-0.409;r₂=-0.424）.3.Influencing factors of turnover intention（1）The univariate analysis showed that turnover intention of medical care workers was statistically difference among the family’s per capita monthly income,work experience,training objectives,training requirements compliance level,continuing training willingness,employment years,employment objectives,labor contracts,insurance,the importance of social insurance,total monthly income,and regular specialized training of departments（P<0.05）.（2）The results of multiple stepwise regression analysis showed that:external job satisfaction,organizational standard responsibilities,years of employment,total monthly income,and the purpose of participating in training are important factors that affect turnover intention of medical care workers（R²=0.319,P<0.001）.4.The results of the mediation effect test of job satisfaction show that the confidence intervals of the mediation effect and the direct effect are[-0.048,-0.009]and[-0.051,-0.014],respectively,which do not contain 0,indicating that the mediation effect and the direct effect are both significant.Job satisfaction is a partial mediating variable among psychological contract and turnover intention,and the mediating effect accounts for46.37%of the total effect.Part 2 Qualitative ResearchSemi-structured interview subject analysis extracted three themes:feedback incentives,fairness perception related to organizational normative responsibility;organizational support,respect and identification related to organizational interpersonal responsibility;organizational support,respect and recognition related to external satisfaction.Conclusion:1.The psychological contract and job satisfaction of medical care workers are at a medium level,which still needs to be further improved;the turnover intention of medical care workers is relatively high,nursing managers need to pay attention.2.There are significant differences between different characteristics of turnover intention and its dimensions,which are related to external job satisfaction,organizational standard responsibilities,years of employment,total monthly income,and the purpose of participating in training.Nursing managers should take corresponding measures from the above aspects,and decrease the turnover intention of medical care workers.3.Both psychological contract and job satisfaction of care workers can negatively affect turnover intention.Psychological contract itself can have a significant impact on turnover intention,but there are still some effects on turnover intention by affecting job satisfaction.4.When the psychological contract organization responsibility is insufficiently fulfilled,medical nurses will perceive insufficient feedback incentives,unfair distribution,poor working environment and lack of organizational care.In addition,lack of organizational support and lack of respect and recognition will reduce the external satisfaction of medical care workers.Ultimately affect the willingness of medical nurses to leave.It is suggested that managers should take effective measures in establishing incentive mechanism,focusing on job optimization,strengthening continuous training and increasing psychological care,so as to improve the job satisfaction of medical nurses and reduce turnover intention.