Sunhee Park; Taewha Lee

doi:10.11111/jkana.2018.24.2.139

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Park and Lee: Factors Influencing Korean Nurses’ Intention to Stay: A Systematic Review and Meta-analysis

Original Article

J Korean Acad Nurs Adm 2018;24(2):139-148.

Published online: 17 March 2018

DOI: https://doi.org/10.11111/jkana.2018.24.2.139

Factors Influencing Korean Nurses’ Intention to Stay: A Systematic Review and Meta-analysis

Sunhee Park, Taewha Lee

¹Graduate School, College of Nursing, Yonsei University

²College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University

Corresponding author: Lee, Taewha, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodamun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3305, Fax: +82-2-392-5440, E-mail: twlee5@yuhs.ac

Received 20 November 2017 Revised 24 January 2018 Accepted 4 February 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:

To systematically review research articles that examined factors affecting Korean clinical nurses' intention to stay in their jobs.

Methods:

Articles related to Korean clinical nurses and published both in Korean and English languages were retrieved from computerized databases using a manual search. Data extraction, quality assessment, and analysis including meta-analysis were completed.

Results:

The review included 15 studies. There was strong evidence for the effects of 19 factors on Korean clinical nurses’ intention to stay. Factors were categorized into three major categories; demographic, extrinsic, and intrinsic factors. In the meta-analysis of 10 articles, career experience of more than 6 years was the main factor that led to high intention to stay (OR=-0.5, p<.001). Job performance related factors (28.1%) and nursing work environment or organizational climate for caring (21.9%) were studied as the main extrinsic factors. Job related attitude (28.1%) including job satisfaction and organizational commitment and nursing value (15.6%) were studied as the main intrinsic factors.

Conclusion:

Expert nurses are more likely to retain their current positions as well as quality workplace environments or psychological capitals. Healthcare organizations must be responsible for improving professional and psychological capital of beginner nurses and affecting change for a warm organizational environment.

Keywords: Nurse, Intention to stay, Systematic review, Meta-analysis

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Figure 1.

Nurse experience comparison outcome of intention to stay.

Table 1.

General Characteristics of Reviewed Articles (N=15)

No	Author(s) (year)	Survey region	Sample size	Design	Analysis	Intention to stay M±SD/ Total or % or core category
1	Kwon et al. (2009)	Seoul, Gyeonggi	329	Descriptive survey	Multiple regression	28.69±9.04 / 48
2	Kwon et al. (2010)	Seoul, Gyeonggi	206	Descriptive survey	Hierarchical multiple regression	38.41±7.97 / 48
3	Kim & Hwang (2011)	Nationwide	119	Descriptive survey	Multiple regression	32.80%
4	Sung & Choi (2012)	Pusan, Gyeongnam	220	Descriptive survey	Stepwise multiple regression	4.87±1.48 / 8
5	Choi & Kim (2013)	Seoul	270	Descriptive survey	Pearson's correlation coefficients	3.21±0.78 / 5
6	Lee et al. (2012)	p city	365	Descriptive survey	Logistic regression	70.40%
7	Lee et al. (2014)	Seoul, Gyeonggi, Chungnam	217	Descriptive survey	Multiple regression, path analysis	2.81±0.69 / 5 (Female)
8	Lee et al. (2014)	Nationwide	1,143	Focus group interview & descriptive survey	Pearson's correlation coefficients	2.66±0.26 / 4
9	Park J.H. (2016)	Gyeonggi	230	Descriptive survey	Multiple regression	4.47±1.56 / 8
10	Park & Jung (2016)	Pusan	199	Descriptive survey	Stepwise multiple regression	5.50±1.36 / 8
11	Park H.S. (2016)	D and 3 Ciities more	177	Descriptive survey	Stepwise multiple regression	34.98±8.95 /48 (Female)
12	Han & Choi (2017)	Nationwide	136	Descriptive survey	Stepwise multiple regression	3.39±075 / 5
13	Kwon & Lee (2017)	B city	199	Descriptive survey	Pearson's correlation coefficients	5.21±1.36 / 8
14	Gong & Kim (2017)	J city	229	Descriptive survey	Hierachial multiple regression	4.72±1.41 / 8
15	Park et al. (2014)	Seoul, Chungchung, Jeonnam	10	Qualitative study	Contents analysis and ground theory	Following a stable

Table 2.

Major Variables and Measurement Tools

Domain	Variables	n (%)	Instrument (original developer, year)	n	Cronbach's ⍺	Sources number of Table 1	Significant relationship with Intention to stay
Intention to stay	Intention to stay	14 (100.00)	Nurses' Retention Index, NRI (Cowin,2002)	10	.78~.92
	Yes/No questionnaires Nurses' Retention Index, NRI (Mobley,1982)	2 1	* *
			Development	1	.91
Demographics	Length of career (ys)	10 (71.40)				1,2,4,5,7,9,10,11,12,13	positive
	Education Payment	6 6 (42.90) (42.90)				1,2,5,8,9,13 4,5,10,12,13,14	positive positive/negative
Job Related factors	Nursing perfomance	5 (15.60)	Six dimension scale of nursing performance (Schwirian,1978)	3	.90~.97	1,2,4	positive
	Quality of nursing	1 (3.13)	Nursing performance (Lee,1983)	1	.97	5
	Emotional labor Work demand	1 1 (3.13) (3.13)	Nursing performance (Park, 1988) Quality of nursing scale (Aiken,2002)	1 1	.91	13 6	positive
	Accreditation	1 (3.13)	Modified emotional labor measurement (Morris & Feldman,1996)	1	.72	9	negative
	Subtotal	9 (28.12)	Tasks of QI nurses (Hwang & Kim, 2003)	1		3	negative
			Perception of international hospital accreditation (Choi, 2011)	1	.92	13	positive
Nursing Environmental factors	Work Environment	3 (9.36)	PES-NWI (Lake,2002)	2	.63~.91	6,9	positive
	Organizational fairness	1 (3.13)	Working environment scale-10, WES-10 (Friis,1981)	1	.59~.72	12
	Motivation	1 (3.13)	Organizational fairness scale (Price & Mueller, 1986)	1	.69~.79	7	positive
	Manager caring behavior Peer group caring behavior	1 1 (3.13) (3.13)	Motivation measurement tool (Kim, 2013) Organizational climate for caring scale, OCCS (Hughes, 1998)	1 1	.82 .98	7 14	positive positive
	Subtotal	7 (21.88)	Peer group caring interaction scale, PGCIS, (Hughes, 1998)	1	.91	14	positive
Attitude or response to the job	Job satisfaction	4 (12.50)	The index of work satisfaction (Slavitt et al,1978)	1	.88	1	positive
	Organizational Commitment Job Engagement	3 1 (9.36) (3.13)	Job satisfaction scale (Hwang & Chang, 2008) Job satisfaction scale (Park,2011)	1 1	.76~.86	3 7
	Job Stress	1 (3.13)	Minnesota satisfaction questionnaire (1967)	1	.88	10
	Subtotal	9 (28.12)	Organizational commitment questionnaire (Mowday,1979) Organizational commitment scale (Meyer et al.,1993)	2 1	.87~.91 .57~.87	3,10 6	positive
			Engagement scale (Schaufeli, 2002)	1	.85	6	positive
			Stress scale for nurses (Kim & Gu, 1984)	1	.96	5	negative
Nursing value	Professionalism Self-concept	2 2 (6.25) (6.25)	Professionalism inventory scale (Hall,1968) Nurse self-concept questionnaire, NSCQ (Cowin,2006)	2 1	.69~.85 .98	1,2 13	positive positive
	Calling	1 (3.13)	Self-concept measurement (Arthur,1990)	1	.87	4
	Subtotal	5 (15.63)	Calling and vocational questionnaire (CVQ) (Steger,2008)	1	.83	10	positive
Psychological capital	Self-efficacy	1 (3.12)	Self-efficacy measurement scale (Sherer&Adams,1983)	1	.88	12	positive
	Self-leadership Subtotal	1 2 (3.13) (6.25)	Self-leadership questionnaire (Manz,1983)	1	.86	11	positive
Total		32 (100.00)

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