A Study On The Turnover Intention And Its Influencing Factors Of Emergency Doctors Based On The Structural Equation Model

Objective: To investigate the status and individual influencing factors of turnover intention among emergency doctors in Chongqing.The structural equation model(SEM)was used to build an interpretation model of turnover intention,in order to explore the influence of perceived organizational support,work stress,occupational burnout and job satisfaction on turnover intention and to comprehensively analyze the internal relationship among various factors.So as to provide scientific references for improving emergency doctors' enthusiasm for work,reducing turnover intention on them,and maintaining the stability of the talent team of emergency departments.Methods: 1.Using a multi-stage sampling method,a total of 56 hospitals with independent emergency departments were selected in Chongqing,and a total of 366 emergency doctors were included as survey samples according to the inclusion and exclusion criteria.2.The perceived organizational support scale(POSS),work stress scale,Maslach burnout inventory(MBI-HSS),job satisfaction scale and turnover intention scale(TIS)as research tools to investigate the status of perceived organizational support,job stress,burnout,job satisfaction and turnover intention of 366 emergency doctors in Chongqing.3.Using SAS 9.4 for descriptive analysis,univariate survival analysis,exploratory factor analysis and Spearman correlation analysis.And using AMOS 24.0 to build structural equation models to explore the relationship among perceived organizational support,work stress,occupational burnout,job satisfaction and turnover intention.Results: The score of perceived organizational support score was 4.10±1.04,which was slightly higher than the median of the seven-point scale(4 points).The work stress of emergency doctors was high,which score is 3.38 ± 0.60(ranging 1-4).The MBI-HSS score was 3.18 ± 0.95,and the emotional exhaustion score was the highest in all dimensions(3.68 ± 1.41),which were slightly lower than the median of the seven-point scale(4 points).The job satisfaction score was 3.94 ± 0.84,and the score of satisfaction for salary and benefits was the lowest(3.72±1.05)in each dimension,which was lower than the median of the seven-point scale(4 points).The turnover intention score was 2.59 ± 0.52,and the probability of getting a new job in each dimension was the highest(3.02 ± 0.54).Based on the criterion of mean scores >2.5,56.83% of the doctors had high level of turnover intention.Perceived organizational support and job satisfaction are negatively correlated with turnover intention,while work stress and occupational burnout are positively correlated with turnover intention.The structural equation model shows that perceived organizational support,occupational burnout and job satisfaction have direct effects on turnover intention,accounting for 28.9% of the overall variance of turnover intention.Among them,the direct effect of job satisfaction is the largest,and the path coefficient is-0.247.The total effect of perceived organizational support on turnover intention was the largest(-0.466),its direct effect on turnover intention was-0.172,and its indirect effect on turnover intention by affecting work pressure,job burnout and job satisfaction was-0.294.The indirect effect of job stress on turnover intention was 0.125 by affecting burnout and job satisfaction.Conclusion: Doctors of Eds in Chongqing have a medium level of perceived organizational support,a low level of job satisfaction,and a higher levels of work pressure and turnover intention than expected.The increase of turnover intention is related to the decrease of organizational support and job satisfaction,as well as the increase of work tress and occupational burnout.It is also associated with working years in emergency departments and workplace violence.Therefore,organizations need to strengthen their care and support for the work and life of emergency doctors,improve their compensation and welfare and career development,reduce the workload,ensure the safety of emergency doctors at work,reduce work stress and increase job satisfaction.Which has important implications for retaining doctors who have not left and reducing the mobility of emergency doctors.