Research On The Relationship Model Of China Nurses’ Intention To Stay And Influencing Factors

Objectives: The purpose of this study is to investigate the current status and demographic differences of nurses’ intention to stay in tertiary hospitals in China,analyze the quantitative relationship model of nurses’ perceived organizational support,job control,job satisfaction,and intention to stay,and explore the feelings about nurses’ intention to stay by the qualitative interview method.Finally this study constructed a relationship model of nurses’ intention to stay and influencing factors,in order to provide a scientific basis for nursing managers to take measures to improve nurses’ intention to stay and alleviate the shortage of nursing human resources.Methods: Based on the literature review,using the theory of organizational support and job demand-control-support theory as a reference,the hypothetical relationship model of nurses’ intention to stay and its influencing factors were proposed.Using multistage sampling method,a questionnaire survey was used to investigate the general sociodemographic characteristics,perceived organizational support,job control,job satisfaction,and intention to stay of 2352 nurses in 9 tertiary hospitals from the three major economic regions of Chinese east,middle,and west.To explore the current status and sociodemographic differences of nurses’ intention to stay,and the influence of nurses’ perceived organizational support,job control and job satisfaction on their intention to stay.A qualitative interview method was used to interview 13 leaving nurses from 10 tertiary hospitals in Shanghai to dig the action process of influencing factors to nurses’ intention to stay.Finally,combining the results of quantitative and qualitative research,a relationship model of nurses’ intention to stay and its influencing factors was formed.Results: In this study,(1)the average intention to stay of the nurses in the tertiary hospitals participating in the survey was 3.375 ± 0.675;the job satisfaction of the nurses was 3.168 ± 0.816;the perceived organizational support was 3.565 ± 0.840;and the job control was 2.955 ± 0.614.(2)There were statistical differences in nurses’ intention to stay in different ages,job positions,job titles,marital status,employment status,number of night shifts and income.(3)The perceived organizational support,job control,and job satisfaction of nurses had a positive effect on nurses’ intention to stay,which could explain the 39.9% variability of the intention to stay.The perceived organizational support could have a direct effect on the intention to stay(β=0.151,p<0.001),and could also indirectly affect the intention to stay through job control and job satisfaction.The indirect effect accounted for 59.2% of the total effect;job control had a direct effect on the intention to stay(β=0.058,p=0.017),could also indirectly affect the intention to stay through job satisfaction,the indirect effect accounted for 58% of the total effect;job satisfaction had a direct effect on intention to stay(β= 0.491,p<0.001).(4)The results of qualitative interviews showed that the related factors of nurses’ intention to stay included three themes:(1)organizational fairness,management style,respect and attention,and professional development related to the perceived organizational support;(2)remuneration and performance evaluation,job nature,job environment,job settings and responsibilities allocation related to the job control;(3)other job opportunities.Conclusion:(1)The intention to stay,job control and job satisfaction of nurses in tertiary hospitals were at a medium level,there was still room for improvement,and the perceived organizational support was at a moderately high level.(2)There were differences in nurses’ intention to stay in different sociodemographic characteristics.Nursing managers can identify nurses with low intention to stay based on the nurse’s sociodemographic information and implement targeted interventions to improve their intention to stay.(3)The perceived organizational support,job control and job satisfaction of nurses can positively affected the intention to stay,and job control and job satisfaction played a part of the mediating role.In clinical work,the lack of organizational support and job control can reduce the intention to stay of nurses for a variety of reasons.(4)In the conceptual model of nurses’ intention to stay and its influencing factors constructed in this study,perceived organizational support,job control,and job satisfaction are resources at the organizational,job,and personal levels in the medical system,respectively.They can promote the nurses’ intention to stay and keep them in their current jobs.When the resources in the system are insufficient or the resources in the system are inconsistent with personal career development expectations and planning,and their intention to stay is reduced,they will leave or start paying attention to other job opportunities outside the medical system.Other suitable job opportunities will further induce nurses to leave.This suggests that nursing managers can improve the resources in the medical system from multiple levels,fundamentally create a good nursing work environment,increase nurses’ intention to stay,and then alleviate the shortage of nursing human resources.