Turnover factors revisited: A longitudinal study of Taiwan-based staff nurses

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Abstract

Background

The relationship between employees’ intent to stay/leave a position and the actual turnover of employees merits further investigation. Most previous studies of this relationship have utilized cross-sectional designs to examine nurse turnover from a fixed point in time. Research using a longitudinal design could increase the ability to predict who will leave, and to identify factors that cause turnover behavior.

Objectives

To investigate whether the same mechanisms and factors that affect employee's turnover intentions can be applied to actual turnover in a longitudinal way in an effort to expose causal relationships.

Design

After a review of existing literature, we collected baseline data on turnover determinants as well as two intervening variables: job satisfaction and intent to stay. Three years later, hospital personnel records were used to identify the actual turnover of nurses who responded in the first wave.

Settings

With its 600 beds and metropolitan site, the target hospital located in Taichung, Taiwan is representative of Taiwan's general hospitals.

Methods

The 412 registered staff nurses (managers excluded) at work in this hospital were reached by a mail questionnaire in the first wave. Three years later, the turnover data collected in wave two had divided the wave one's 308 respondents (74.8%) into 132 leavers (42.9%, coded as “1”) and 176 stayers (57.1%, coded as “0”). The data were then processed by descriptive statistics, exploratory factor analysis, multiple regression, and logistic regression.

Results

As in previous studies of this type, distributive justice, workload, resource inadequacy, supervisory support, kinship support, and job satisfaction were again proven to be highly associated with intent to stay/leave. Nevertheless, with the exception of workload, these indicators worked poorly when predicting the actual turnover.

Conclusions

The study confirms earlier findings on the relationships among turnover determinants, job satisfaction, and intent to stay, and suggests a more comprehensive selection of turnover factors must be taken into account when attempting to explain variations in actual turnover.

Section snippets

What is already known about the topic?

Employee turnover is one of the most significant causes of declining productivity and sagging morale in both the public and private sectors. Experts estimate that the combined total of the three component costs of turnover (i.e. hiring, training, and reductions in productivity) can exceed 5% of the total annual operating budget. Previous studies showed that job satisfaction and intent to stay are widely regarded as key factors in determining the turnover amongst nurses. However, there appears

What this paper adds

The results of this study confirm earlier findings on the interrelationships among turnover determinants, job satisfaction, and intent to stay. Distributive justice, workload, resource inadequacy, supervisory support, kinship support, and job satisfaction are again proven to be highly associated with intent to stay. Nevertheless, with the exception of workload, they work poorly as predictors of actual turnover.

Furthermore, the results of this study suggest a more comprehensive selection of

Determinants of turnover

According to Price (1977), turnover is the movement of members across the boundary of an organization. Most research on turnover has explored voluntary or avoidable turnover, though there has been no systematic empirical evidence existing to support the hypothesized difference between voluntary and involuntary turnover due to the inaccuracy of organizational data (Hayes et al., 2006). There is a vast body of the nursing turnover literature linking job satisfaction, intent to stay and actual

Estimated nursing turnover model

Based on the previously reviewed literature, we tested the model of nursing turnover as illustrated in Fig. 1. Similar to most turnover research, attention was concentrated on the nurses voluntarily leaving the hospital. Ten determinants of turnover were considered in this study: job involvement, positive and negative affectivity, distributive justice, job stress, promotional chances, autonomy, routinization, social support, and pay. As derived from “Reflections on the determinants of voluntary

Site, subjects and procedure

In resemblance to western healthcare industries, Taiwan's healthcare institutions became fiercely competitive after the government implemented the National Health Insurance System in 1995. In addition, most of Taiwan's general hospitals are private, large-sized and located in metropolitan areas (Chu et al., 2003). The target hospital for this study was located in Taichung, Taiwan. With its 600 beds and metropolitan site, this private institution was a suitable representative of Taiwan's general

Results

Of the 412 registered staff nurses who were reached by the first-wave mailed questionnaire 308 (74.8%) responded. The information for actual turnover, as collected in the second-wave, divided the 308 first-wave respondents into 132 leavers (42.9%, coded as “1”) and 176 stayers (57.1%, coded as “0”). They were all females, mostly young (92.5% under the age of 30), short in tenure (96.8% had a tenure less than 5 years), and well-educated (96% had a college degree). This distribution very closely

Discussion and conclusion

Employee turnover is one of the most significant causes of declining productivity and sagging morale in both the public and private sectors (Abbasi and Hollman, 2000). The cost of nursing turnover eats away a hospital's efforts to implement efficient processes and improve patient care (Hayes et al., 2006). Experts estimate that of the three components of turnover costs, i.e. hiring, training, and reduced productivity costs, the magnitude of the turnover cost can climb to at least 5% of the

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      Various studies in this regard like (Griffeth, Hom, & Gaertner, 2000) and (Kinicki, Mckee-Ryan, Schriesheim, & Carson, 2002) also describe this relation between job satisfaction and turnover to be negative, Mobley, Griffeth, Hand, and Meglino (1979) however suggested the relation between the two not very significant. Recently the work of Duraisingam, Pidd, and Roche (2009) and Chen, Chu, Wang, and Lin (2008) concluded that a well-established negative relationship exists between employee job satisfaction and turnover. Job satisfaction is perhaps the most recognized employee job attitude indicator, considered as a consistent mean to assess the judgment made by an individual about his/her experiences in the organization, which is found to have positive impact on commitment, increase in performance and decreases turnover and absenteeism of the subordinates (Rezvani et al., 2016); (Lambert & Paoline, 2008).

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