| [Objectives]The shortage of nursing is a global problem,which can lead to a decline in quality of care,prolonged hospitalization and increased medical expense.The theories of"psychological capital" and "job embeddedness" were applied to analyze the retention topic in nurses.The scales of psychological capital and "job embeddedness" would be revised in order to adapt to the sample of nurses.Quantitative study was used to analyze the relevance of psychological capital,job embeddedness,job satisfaction and intention to stay.Path analysis was used to explore the interaction model of psychological capital,job embeddedness,job satisfaction and intention to stay.To investigate the deeply reason why nurses intention to stay or to leave,qualitative interview was implemented.Suggestions will be provided to nursing managers to based on the results from quantitative and qualitative studies to improve nurses' work enthusiasm and intention to stay.[Methods]Quantitative interview and qualitative study were both used.With the methods of literature research,open questionnaire survey,experts consultation,pre and formal investigation,job embeddedness scale for nurses in china was revised.By convenient sampling method,nurses from 5 Tertiary Hospitals in Hangzhou were investigated with Job Embeddedness Questionnaire,Psychological Capital Questionnaire,Job Satisfaction Questionnaire and Nurses' Intention to Stay Questionnaire,then the interaction model was explored by path analysis.Statistical methods including descriptive analysis,Pearson correlation analysis,independent samples T test,variance analysis,multiple stepwise regression and structural equation modeling were used to analyze by SPSS17.0 and Amos21.0.The qualitative study enrolled 9 nurses by convenient sampling from the 5 Tertiary Hospitals.Semi-structure interview were conducted to explore the whole idea about nursing,measures of improving work enthusiasm,reasons to stay or leave,et al.After converting record data into a text form,the thematic analysis method was used to encode and induce the data.[Results]The revision of Nurses' job embeddedness scale:The revised version of Nurses' job embeddedness scale was formed through expert consultation,item analysis,exploratory factor analysis and confirmatory factor analysis,which included 20 items and could be divided into four dimension(organization fit,community harmony,organization emotion,occupation sacrifice).The Cronbach a coefficient was 0.848 in the whole scale and ranged from 0.771 to 0.865 in four dimensions.The split half reliability was 0.838.So the reliability and validity of revision version of Job Embeddedness Scale was acceptable.The scores of psychological capital,job embeddedness,job satisfaction and intention to stay in nurses:The score of psychological capital in nurses is medium,and the score of self-efficacy is the highest but the lowest is the hope dimension.Nurses with characteristics such as age 30 to 36 years old,tenure of 5.1 to 15 years,the primary title,no duty,shorter night shift interval,work more than 45 hours per week will have lower level of psychological capital(P<0.05 or P<0.01).Marital status,degree and type of contact can't influence the psychological capital.The score of job embeddedness in nurses is medium and the score of organization emotion is the highest.Nurses with age 30 to 36 years old,tenure of 5.1 to 15 years,unmarried,no duty,shorter night shift interval,45 hours work time per week will have lower level of job embeddedness(P<0.05 or P<0.01).The number of children,degree,type of contact,title can't influence the job embeddedness.The score of intention to stay in nurses is medium.Nurses with age 30 to 36 years old,tenure of 2.1 to 5 years,unmarried,primary title,no duty,staffing type,shorter night shift interval,45 hours work time per week will have lower level of intention to stay(P<0.05(P<0.01).The degree can't influence the intention to stay.The relevance of nurses' psychological capital,job embeddedness,job satisfaction and intention to stay:The psychological capital and its four dimensions including self-efficacy,optimism,hope and resilience were all positively correlated with intent to intention(P<0.01).The job embeddedness and its four dimensions including organization fit,community hannony,organization emotion and occupation sacrifice were all positively correlated with intention to stay(P<0.01).The psychological capital and its four dimensions including self-efficacy,optimism,hope and resilience are all positively correlated with job embeddedness and its three dimensions including organization fit,community harmony and organization emotion(P<0.001).The intention to stay of nurses as dependent variable,demographic variables,four dimensions of psychological capital,four dimensions of job embeddedness and job satisfaction as independent variables for multiple regression analysis,there were 8 factors to enter into regression equation.These factors were tenure,working hours per week,job satisfaction,three dimensions of job embeddedness(organization fit,community harmony and organization emotion),two dimensions of psychological capital(hope,optimism),which explains 36.9%variation of intention to stay.The results of structural equation modelBy the structural equation model,it showed that psychological capital had both direct effect(path coefficient=0.248)and indirect effect through job satisfaction(path coefficient = 0.220)on job embeddedness.Job satisfaction had only direct effect(path coefficient = 0.506)on job embeddedness.Psychological capital hadn't direct impact on intention to stay,but had indirect effect through three paths(psychological capital-job embeddedness-intention to stay,psychological capital-job satisfaction-intention to stay,psychological capital-job satisfaction-job embeddedness-intention to stay)with path coefficient = 0.238.Job satisfaction had both direct effect(path coefficient = 0.285)and indirect effect through job embeddedness(path coefficient = 0.123)on job embeddedness.Job embeddedness had only direct effect on intention to stay(path coefficient = 0.242).The result of Qualitative studyThe three top causes of nurses' intent to leave were work load,family reasons and nursing occupation characteristics.The three top causes of nurses' intention to stay were good working atmosphere,stability of nursing work and security of the salary.[Conclusions]The revision version of job embeddedness scale has acceptale reliability and validity,which can be used to measure the level of nurses' job embeddedness.The scores of nurses' psychological capital,job embeddedness,job satisfaction and intention to stay are medium.Nurses' psychological capital,job embeddedness,job satisfaction and intention to stay are significantly positively related.The variables including tenure,working time per week,job satisfaction,three dimensions of job embeddedness(organization fit,organization emotion and occupation sacrifice),two dimensions of psychological capital(hope,optimism),explain 36.9%variation of intention to stay.Psychological capital has direct and indirect effect through job satisfaction on job embeddedness.Job satisfaction can only directly impact job embeddedness.Psychological capital only indirectly impact intention to stay through job embeddedness and job satisfaction.Job satisfaction can direct and indirect impact through the job embeddedness on intention to stay.Job embeddedness only directly impact intention to stay.[Suggestions]Creating a good working atmosphere and developing organizational emotion.Establishing a scientific and humane nurses scheduling system not only to meet the needs of patients but also focusing on nurses.According to the career planning theory,enhancing nurses' career benefit in each stage.Based on the intervention model of psychological capital,Constracting nurses positive psychological line of defense;.Paying attention to the influence of off-the-job factors and establishing a service guarantee system for nurses. |
PDF Full Text Request