Relationships among Quality of Nursing Work Life, Nurses’ Intention to Leave and Nurses''Turnover
方法：在2012年及2013年於臺灣中部七家急性醫院，以立意取樣的方式選擇研究對象。樣本納入條件是所有輪三班執行第一線臨床照護的護理人員，排除對象是試用期內的新進護理人員及護理長以上的護理管理階層及非輪三班單位的護理人員，人數共1,283位，一年後追蹤人數為1,231位，流失率為4.1 %。研究工具共有四種：第一種是中文版護理工作生活品質量表；第二種是護理人員離職傾向量表；第三種是護理人員實際去留狀況紀錄表；第四種是護理人員個人屬性變項與工作相關變項。以IBM SPSS 20.0英文版統計軟體分析，以描述性統計呈現個人屬性變項與工作相關變項、護理工作生活品質、離職傾向、離職發生的分布情形，再以卡方檢定及t檢定、二元邏輯斯迴歸分析、累積邏輯斯迴歸模型檢驗護理工作生活品質、離職傾向與離職間的關係。
Background: In a 2009 study by the International Council of Nurses that examined nurses’ expectations and needs globally, the proportion of nurses in Taiwan who believed that nursing work environment was getting worse. The getting worse work environment will lead to nurses highly turnover. The annual turnover rate in Taiwan is 20 %. Quality of work life (QWL) plays a significant role in nurse turnover. However, very limited attention has been given to exploring the direct and indirect relationships between QWL and nurses turnover.
Aims: The purposes of this study were that (1) to explore the direct relationships between QWL and three-type nurses turnover of that to leave units, leave the organization and leave nursing profession, and (2) to explore the indirect relationships among three-type nurses’ intention to leave, which are intention to leave units, intention to leave the organization and intention to leave nurse profession, QWL and three-type nurses turnover.
Designs: The study design was a longitudinal and correlational study. To follow up the same nurses turnover one year latter.
Methods: Participants were recruited using purposive sampling from seven acute care hospitals in central Taiwan at 2012 and 2013. Inclusion criteria were nurses who provided bedside care and worked on three rotating shifts; exclusion criteria were nurses who were still in the probation period. A total of 1,283 questionnaires were delivered to nurses, and 1,231 nurses were follow-up after one year. The loss rate was 4.1 %. Four questionnaires—the Chinese version of the Quality of Nursing Work Life scale, a Intention-to-leave questionnaire, the records of nurses turnover and a demographic questionnaire for individual- and work-related variables—were used for collecting the data. All analyses were conducted with IBM® SPSS® English version 20. We used descriptive analyses to examine individual- and work-related variables, QWL, intention to leave and turnover measures. We performed chi-square tests, t-tests, binary logistic regression and cumulative logistic regression to assess the relationships among QWL, nurses’ intention to leave and nurses turnover.
Results: The mean age of nurses was 29.2 years old (SD = 4.94), with an average service length of 6.57 years (SD = 4.94). The top three ranking of mean of QWL were “friendships with my co-workers are important to me”, “I feel like I belong to the work team”, and “I feel that there is teamwork in my work setting”. The lowest three ranking of mean of QWL were “I have to participate in many lectures which occupy my after work time in my work setting”, “I experience many interruptions in my daily work routine”, and “It difficult for me to arrange my holidays in my work setting”. Nurses’ intentions to leave units, the organization and nursing profession were 45%, 51.8%, 58.5%, and nurses turnover rates were 8.7%, 7.6% and 2.5% after one year, respectively. Total QWL and the QWL of work life/ home life balance can predict nurses leave the units after one year. Total QWL can predict nurses leave the organization after one year. The “milieu of respect and autonomy” QWL can predict nurses leave nursing profession after one year. The mediating effects of intention to leave the units were in the relationships between total QWL, the six QWL dimensions of “supportive milieu with security and professional recognition”,” work arrangement and workload”,” work/ home life balance”,” head nurse’s/ supervisor’s management style”,” nursing staffing and patient care”, and “milieu of respect and autonomy” and nurses leave the units. The mediating effects of intention to leave the organizations were in the relationships between the four QWL dimensions of “work arrangement and workload”,” head nurse’s/ supervisor’s management style”,” nursing staffing and patient care”, and “milieu of respect and autonomy” and nurses leave the organizations. The mediating effect of intention to leave nursing profession was in the relationship between the “milieu of respect and autonomy” QWL dimension and nurses leave nursing profession.
Conclusions and Suggestions: There were direct relationships between QWL and nurses turnover, and there were also mediating effects among QWL, nurses’ intention to leave and nurses turnover. Further researches can be seen QWL as independent variable or the outcome variable to improve the work environment or explore the relationships between QWL and patients care outcomes.
|Appears in Collections:||護理學系所|
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.