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Abstract
Purpose
The purpose of this study was to review research papers on structural equation models for hospital nurses' turnover intentions, and to identify the factors that influence these intentions.
Methods
Twenty-four research papers on structural equation models for hospital nurses' turnover intentions were identified for systematic review.
Results
All 24 papers assessed nurses’ turnover intentions in general hospitals and university hospitals. A total of 36 indicators and 105 items were used to measure turnover intention. Turnover intention was positively related with 10 variables, and negatively with 17 variables. Organizational commitment, job satisfaction, job stress, burnout, organizational culture, and empowerment were found to have significant direct and indirect effects on nurses’ turnover intentions. Structural equation models in 23 of the 24 research papers showed high compatibility with the data. The models accounted for 20.1% 68.0% of total variances.
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Table 1.
List of Reviewed Articles (N=24)
Table 2.
Type and Location of Hospitals in Articles by Year (N=24)
Table 3.
Distribution of Number of Nurse Subjects and Hospitals (N=24)
Table 4.
Tools of Turnover Intention (N=24)
| Variables | Developer (year of development) | Modifier (year of modify) | Item | Range | Reliability (Cronbach ⍺) | Mean | Article | |
|---|---|---|---|---|---|---|---|---|
| Author∗ | n (%) | |||||||
| Turnover intention | Bluedorn (1982), | 3 | 1~7 | .88 | 3.76±1.43 | Lee28) | 24 | |
| Lee (2002), Jeong (2006) | (100.0) | |||||||
| Iverson (1996), | 3 | 1~7 | .93 | - | Shin33) | |||
| Lee et al. (2007), | ||||||||
| Seo & Kim (2007) | ||||||||
| Lawler (1983) | Park (2002) | 4 | 1~5 | .89 | - | Kim31) | ||
| 4 | 1~5 | .80 | - | Cho30) | ||||
| 4 | 1~5 | .86 | - | Seok19) | ||||
| Park (2007) | 4 | 1~5 | .89 | 13.75±3.21 | Kim25) † | |||
| Lee (1994) | Lee (2005) | 5 | 1~5 | .89 | 3.29±0.84 | Jeong24) | ||
| Lee (1995) | 2 | 1~5 | .77 | 3.02±1.10 | Koo15) | |||
| Mobley (1982) | Cheon (2005) | 5 | 1~5 | .85 | - | Moon27) | ||
| Kim (2011) | 5 | 1~5 | .97 | - | Han23) | |||
| 5 | 1~5 | .97 | - | Han20) | ||||
| 5 6 | 1~5 1~5 | .88 .77 | 3.08±0.89 3.19±0.62 | An22) Kim26) | ||||
| Mobley (1982), | Kim (2007) | 6 | 1~5 | .82 | 20.16±3.83 | † Lee21) | ||
| Becker (1992) | ||||||||
| Moon (2010) | 5 | 1~5 | .90 | 3.66±0.79 | Kang16) | |||
| Price & Muller (1986) | 4 | 1~5 | .75 | - | Suh18) | |||
| Seashore, Lawler, | 4 | 1~4 | .80 | - | Kim9) | |||
| Mirvis & Cammann (1982) | ||||||||
| Slavittet al. (1978) | Kim (1992) | 4 | 1~5 | .90 | 3.70±0.82 | Kim29) | ||
| Yeun & Kim (2012) | 10 | 1~5 | .81 | 2.95±0.77 | Seo32) | |||
| Park & Lee (2011) | 4 | 1~5 | .87 | 3.38±0.75 | Park13) | |||
| Cho & Kim (2010) | - | 1~5 | - | - | Cho12) | |||
| An & Kang (2008) | 4 | 1~2 | - | - | An11) | |||
| Lee (1998) | 2 | 1~5 | .81 | 5.5±1.9 | Lee17) | |||
| Lee (1995) | 2 | 1~5 | .77 | - | Lee10) | |||
| Job satisfaction | Brief (1998), Park (2005) | 4 | 1~7 | .82 | - | Shin33) | 14 | |
| Han & Oh (1990) | 3 | 1~4 | .87 | - | An11) | (58.3) | ||
| Hingley (1986) | Kim (20041) | 30 | 1~5 | .92 | 2.46±0.65 | Seo32) | ||
| Hwang (2008) | 15 | 1~5 | .91 | 46.77±7.66 | † Kim25) | |||
| Minnesota Satisfaction | Lee (1996) | 20 | 1~5 | .89 | - | Kim9) | ||
| Questionnaire (1967) | 20 | 1~7 | .95 | 4.10±0.91 | Lee28) | |||
| Paula (1978) | Park (1997) | 20 | 1~5 | .77 | 3.19±0.35 | Jeong24) | ||
| Slavitt et al. (1978) | Lee (1993) | 33 | 1~5 | .87 | - | Cho30) | ||
| Han & Park (2006) | 16 | 1~5 | .86 | - | Moon27) | |||
| Park (1994) | 29 | 1~5 | .85 | 2.73±0.42 | Koo15) | |||
| Taylor & Bowers | Lee (1998) | 7 | 1~5 | .83 | - | Kim31) | ||
| Tymon (1988) | 8 | 1~5 | .90 | 3.01±0.70 | Park13) | |||
| Cho & Kim (2010) | - | 1~5 | - | - | Cho12) | |||
| Lee (1995) | 16 | 1~5 | .72 | - | Lee10) | |||
| Organizational commitment | Allen & Mayer (1990) | Park et al. (2009) | 8 | 1~5 | .92 | - | Seok19) | 13 |
| Lee (1997) | 12 | .85 | 42.8±5.9† | Lee17) | (54.2) | |||
| Mowday, Porter, & Steers | Kim (1986) | 15 | 1~5 | .87 | - | Cho30) | ||
| (1979) | 13 | 1~5 | .79 | 3.11±0.40 | Kang16) | |||
| Kim (1986), Park (1997) | 15 | 1~5 | .88 | 3.34±0.47 | Jeong24) | |||
| Kim (2005) | 9 | 1~5 | .89 | - | Moon27) | |||
| Lee (1998) | 15 15 | 1~5 1~5 | .93 .88 | 4.23±1.09 - | Seo32) Kim31) | |||
| Moon & Han (2011) | 9 | 1~5 | .80 | - | Han20) | |||
| Moon (2010) | 9 | 1~5 | .90 | 2.69±0.64 | An22) | |||
| 5 15 | 1~5 1~7 | .84 .94 | - 4.35±1.05 | Suh18) Lee28) | ||||
| 15 | 1~7 | .93 | 4.11±1.01 | Koo15) | ||||
| Emotional labor | Morris & Feldman (1996) | Cha et al. (2009) | 5 | 1~7 | .85 | - | Shin33) | 2 |
| Park (2008) | 9 | 1~5 | .83 | 24.87±4.52† | Kim25) | (8.3) | ||
| Self-efficacy | Bozemanetal (2001), | 4 | 1~7 | .89 | - | Shin33) | 2 | |
| Kim (2009) | (8.3) | |||||||
| Riggs & Knight (1994) | 4 | 1~5 | .81 | 3.68±0.56 | Koo15) | |||
| Personality | Costa & McCrae (1992) | Yoo, Kim, & Hyun(2002) | 17 | 1~5 | .77 | 53.70±5.93† | Kim25) | 2 |
| Goldberg (1992) | Kim (2011) | 30 | 1~5 | .82 | - | Seok19) | (8.3) | |
| Customer orientation | Saxe & Weitz (1982), | 4 | 1~7 | .90 | - | Shin33) | 1 | |
| Franke & Park (2006) | (4.2) | |||||||
| Emotional leadership | Goleman (1998, 2002) | 18 | 1~7 | .96 | 4.68±0.99 | Lee28) | 1 | |
| (4.2) | ||||||||
| Fatigue | Seol (2007) | 19 | 1~5 | .90 | 68.13±9.66† | Lee21) | 1 | |
| (4.2) | ||||||||
| Formal power | Laschinger et al. (1994) | 12 | 1~5 | .77 | 2.96±0.57 | Koo15) | 1 | |
| (4.2) | ||||||||
| Gender stereotype | Kim (1991) | 32 | 1~5 | .92 | 2.14±0.67 | Seo32) | 1 | |
| (4.2) | ||||||||
| Humor | Svebak, Kristoffersen, & | 6 | 1~4 | .72 | - | Kim9) | 1 | |
| Asarod (2006) | (4.2) | |||||||
| Informal powe | r Laschinger et al. (1994) | 19 | 1~5 | .90 | 3.39±0.46 | Koo15) | 1 | |
| (4.2) | ||||||||
| Internal marketing | Lee (2001) | Doo (2004) | 20 | 1~5 | .88 | 3.08±0.45 | Jeong24) | 1 |
| (4.2) | ||||||||
| Job embeddedness | Mitchell et al. (2001) | 18 | 1~5 | .87 | 3.02±0.43 | Kim29) | 1 | |
| (4.2) | ||||||||
| Nursing environment | Lake (2002) | Cho, Choi, Kim, Yoo, | 28 | 1~4 | .89 | - | Kim31) | 1 |
| & Lee (2011) | (4.2) | |||||||
| Nursing performance | VandeVen & Ferry (1980) | Ko (2006) | 17 | 1~4 | .93 | 3.23±0.39 | Jeong24) | 1 |
| Park (1988), Lee (1995), | (4.2) | |||||||
| Lim (2004) | ||||||||
| Organizational cynicism | Atwater, Waldman, Atwater & Cartier (2000) | , Choi (2005) | 6 | 1~5 | .85 | - | Han20) | 1 |
| (4.2) | ||||||||
| Organizational citizenship behavior | Podsakoff, Mackenzie, | Kim (1999) | 24 | 1~5 | .69 | 3.38±0.24 | Kim29) | 1 |
| Moorman, & Fetter (1990) | (4.2) | |||||||
| Organizational identification | Mael & Tetrick (1992) | 5 | 1~5 | .86 | - | Suh18) | 1 | |
| (4.2) | ||||||||
| Organizational performance | Brewer & Selden (2000) | 8 | 1~7 | .88 | 4.46±0.89 | Lee28) | 1 | |
| (4.2) | ||||||||
| Person-job fit | Yang (2009) | 6 | 1~5 | .91 | - | Seok19) | 1 | |
| (4.2) | ||||||||
| Person-organization fit | Jung (2007) | 6 | 1~5 | .88 | - | Seok19) | 1 | |
| (4.2) | ||||||||
| Professional self-concepts | Arthur (1990) | Song & Noh (1996) | 17 | 1~5 | .87 | - | Seok19) | 1 |
| (4.2) | ||||||||
| Relational bonds | Berry & Parasuraman (1991) | ), | 16 | 1~7 | .91 | - | Shin33) | 1 |
| Berry (1995), | (4.2) | |||||||
| Bendapudi & Berry (1997), | ||||||||
| Lin et al. (2003) | ||||||||
| Relationship with senior | Graen & Uhl-Bien (1991) | 7 | 1~5 | .80 | 3.05±0.48 | Kim26) | 1 | |
| (4.2) | ||||||||
| Self-esteem | Rosenberg (1965) | Lee (1993) | 10 | 1~4 | .83 | - | Cho30) | 1 |
| (4.2) | ||||||||
| Work family conflict | Gutek, Searle, & | Kim (2007) | 6 | 1~5 | .85 | 19.13±4.04† | Kim25) | 1 |
| Klepa (1991) | (4.2) | |||||||
Table 5.
Effects of Predictor Variables in Structural Model (N=24)
Table 6.
Fit Statistics for the Measurement Model (N=24)
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