Influence of Nurses' Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention of Nurses in Long Term Care Hospitals

Hyun Suk Joo; Won Hee Jun

doi:10.11111/jkana.2018.24.4.265

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Joo and Jun: Influence of Nurses' Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention of Nurses in Long Term Care Hospitals

Original Article

J Korean Acad Nurs Adm 2018;24(4):265-275.

Published online: 17 January 2018

DOI: https://doi.org/10.11111/jkana.2018.24.4.265

Influence of Nurses' Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention of Nurses in Long Term Care Hospitals

Hyun Suk Joo, Won Hee Jun

College of Nursing, Keimyung University

Corresponding author: Jun, Won Hee, College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3916, Fax: +82-53-580-3954, E-mail: jwh917@hanmail.net

Received 12 March 2018 Revised 21 March 2018 Accepted 21 March 2018

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

The study was undertaken to investigate influence of nurses' work environment, organizational commitment, and nursing professionalism on turnover intention of nurses working in long term care hospitals.

Methods:

The study was cross-sectional study. Participants were 199 nurses working in one of 7 long term care hospitals. Data were collected from May 1 to June 30, 2016 and analysed using two stage hierarchial regression analysis with SPSS 22.0.

Results:

There was a statistically significant difference in turnover intention according to age (F=6.23, p<.001), present work career (t=-2.11, p=.036), frequency of night duty (t=-3.53, p=.001), and present position (t=-4.07, p<.001). The significant predictors of turnover intention were attachment (β=-0.29, p=.005), nursing professionalism (β=-.21, p=.030), identification (β=-.21, p=.014), continuance (β=-.19, p=.008), collegial nurse-physician relations (β=-.16, p=.039), and originality of nursing (β=.16, p=.014). These factors explained 50.4% of the variance.

Conclusion:

The results suggest that several points need to be considered in order to reduce turnover intention in long term care hospital nurses. These points include building work environments to improve collegial nurse-physician relations, promoting recognition of nurses' organizational commitment, nursing professionalism and the political efforts of organizations supporting nursing originality.

Keywords: Nurses, Nursing work environment, Organizational commitment, Nursing professionalism, Turnover intention

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Table 1.

General Characteristics of the Participants (N=199)

Characteristics	Categories	n (%)
Gender	Male	1 (0.5)
	Female	198 (99.5)
Age (year)	20~29	20 (10.0)
	30~39	87 (43.5)
	40~49	60 (30.4)
	50~59	32 (16.1)
Marital status	Married	151 (75.9)
	Unmarried	48 (24.1)
Religion	Yes	129 (64.8)
	No	70 (35.2)
Educational	College	173 (86.9)
background	University, master	26 (13.1)
Clinical career (year)	＜3	77 (38.7)
	≥3	122 (61.3)
Number of night	≤5	148 (74.4)
duties/month	≥6	51 (25.6)
Position	Charge nurse	14 (7.0)
	Staff nurse	185 (93.0)
Type of duty	Day duty	34 (17.1)
	3 shifts, night duty	165 (82.9)
Monthly income	≤200	42 (21.1)
	＞200	157 (78.9)
Salary satisfaction	Mostly satisfied	13 (6.5)
	Moderate	72 (36.2)
	Mostly dissatisfied	114 (57.3)

Table 2.

Nursing Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention Level of the Participants (N=199)

Characteristics	M±SD	Min	Max	Possible range
Nurses' work environment	2.46±0.29	1.52	3.33	1~4
Collegial nurse-physician relations	2.69±0.42	1.67	4.00	1~4
Nursing manager's, leadership and support for nurses	2.55±0.40	1.25	3.75	1~4
Nursing foundations for quality of care	2.48±0.39	1.33	3.44	1~4
Staffing and resource adequacy	2.38±0.43	1.25	4.00	1~4
Nurse participation in hospital affairs	2.35±0.34	1.22	3.11	1~4
Organizational commitment	3.10±0.40	1.46	4.73	1~5
Attachment	3.18±0.43	1.67	5.00	1~5
Continuance	3.13±0.60	1.33	5.00	1~5
ldentification	3.01±0.42	1.33	4.67	1~5
Nursing professionalism	3.41±0.40	2.23	4.45	1~5
Originality of nursing	3.57±0.65	1.00	5.00	1~5
Roles of nursing service	3.56±0.52	2.20	5.00	1~5
Professionalism of nursing	3.52±0.57	2.00	5.00	1~5
Self-concept of the profession	3.48±0.47	2.22	4.89	1~5
Social awareness	3.08±0.49	1.50	4.75	1~5
Turnover intention	3.30±0.45	2.00	4.67	1~5

Table 3.

Differences in Turnover Intention by General Characteristics (N=199)

Characteristics	Categories	Turnover intention
Characteristics	Categories	M±SD	t or F (p) Scheffé
Age (year)	20~29^a	3.27±0.38	6.23 (＜.001)
	30~39^b	3.36±0.37	d＜b, c
	40~49^c	3.39±0.44
	50~59^d	3.01±0.59
Marital status	Married	3.32±0.47	1.08 (.280)
	Unmarried	3.24±0.37
Religion	Yes	3.33±0.47	1.34 (.182)
	No	3.24±0.41
Educational background	College	3.31±0.46	-0.61 (.543)
	University, master	3.25±0.43
Clinical career (year)	≥3	3.22±0.44	-2.11 (.036)
	＜3	3.35±0.45
Number of night duties/month	≤5	3.24±0.46	-3.53 (.001)
	≥6	3.47±0.39
Position	Charge nurse	2.85±0.55	-4.07 (＜.001)
	Staff nurse	3.34±0.43
Type of duty	Day duty	3.19±0.50	1.64 (.103)
	3 shifts, night duty	3.32±0.44
Monthly income	＞200	3.19±0.50	-1.80 (.074)
	≤200	3.33±0.44
Salary satisfaction	Mostly satisfied	3.17±0.61	1.01 (.368)
	Moderate	3.27±0.48
	Mostly dissatisfied	3.33±0.39

Table 4.

Correlations between Nursing Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention (N=199)

Variables	Nursing work environment	Organizational commitment	Nursing professionalism	Turnover intention
Variables	r (p)	r (p)	r (p)	r (p)
Nursing work environment	1
Organizational commitment	.40 (＜.001)	1
Nursing professionalism	.55 (＜.001)	.47 (＜.001)	1
Turnover intention	-.38 (＜.001)	-.11 (＜.111)	-.15 (＜.027)	1

Table 5.

Factors Influencing Turnover lntention (N=199)

Step	Variables	Categories	B	β	t	p
Step 1	Age (year)	20~29	0.22	.15	1.91	.058
		30~39	0.33	.37	3.89	＜.001
		40~49	0.37	.39	4.36	＜.001
		50~59
	Clinical career (year)	≥3
		＜3	-0.08	-.08	-1.22	.224
	Number of night duties/month	≤5
		≥6	0.18	.18	2.65	.009
	Position	Staff nurse
		Charge nurse	-0.43	-.24	-3.63	＜.001
			R²=.206, Adjusted R²=.182, F=8.37, p＜.001
Step 2	Age (year)	20~29	0.08	.05	0.75	.454
		30~39	0.24	.27	3.27	.001
		40~49	0.22	.22	2.82	.005
		50~59
	Clinical career (year)	≥3
		＜3	-0.03	-.04	-0.65	.518
	Number of night duties/month	≤5
		≥6	0.14	.14	2.34	.020
	Position	Staff nurse
		Charge nurse	-0.09	-.05	-0.84	.400
	Nursing work environment
	Nurse participation in hospital affairs		0.08	.06	0.69	.493
	Nursing foundations for quality of care		-0.02	-0.02	-0.16	.872
	Nursing managers' ability, leadership and support of nurses		-0.07	-.06	-0.80	.427
	Staffing and resource adequacy		0.12	.12	1.82	.070
	Collegial nurse-physician relations		-0.18	-.16	-2.08	.039
	Organizational commitment
	Attachment		-0.30	-.29	-2.86	.005
	ldentification		-0.22	-.21	-2.49	.014
	Continuance		-0.14	-.19	-2.67	.008
	Nursing professionalism
	Self-concept of the profession		0.09	.10	1.17	.242
	Social awareness		0.07	.08	1.01	.313
	Roles of nursing service		0.15	.17	1.73	.078
	Professionalism of nursing		-0.17	-.21	-2.19	.030
	Originality of nursing		0.11	.16	2.48	.014
			R² (∆R²)=.504(.298), Adjusted R² (∆R²)=.475 (.293),
			F=10.41, p＜.001

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