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      Workplace violence, job satisfaction, burnout, perceived organisational support and their effects on turnover intention among Chinese nurses in tertiary hospitals: a cross-sectional study

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          Abstract

          Objectives

          Our aims were to assess the relationship between workplace violence, job satisfaction, burnout, organisational support and turnover intention, and to explore factors associated with turnover intention among nurses in Chinese tertiary hospitals.

          Methods

          The purposive sampling method was used to collect data from August 2016 through January 2017. A total of 1761 nurses from 9 public tertiary hospitals in 4 provinces (municipalities) located in eastern (Beijing), central (Heilongjiang, Anhui) and western (Shaanxi) regions of China completed the questionnaires (effective response rate=85.20%). A cross-sectional study was conducted using the Workplace Violence Scale, Chinese Maslach Burnout Inventory General Survey, Minnesota Job Satisfaction Questionnaire Revised Short Version, Perceived Organizational Support-Simplified Version Scale and Turnover Intention Scale.

          Results

          A total of 1216 of 1706 (69.1%) participants had high turnover intention. During the previous 12 months, the prevalence of physical violence and psychological violence towards nurses was 9.60% and 59.64%, respectively. As expected, the level of turnover intention was negatively correlated with participants’ scores on job satisfaction (r=−0.367, p<0.001) and perceived organisational support (r=−0.379, p<0.001), respectively. Burnout was positively associated with turnover intention (r=0.444, p<0.001). Workplace violence was positively associated with turnover intention (β=0.035, p<0.001) in linear regression analysis. The total effect (β=0.53) of workplace violence on turnover intention comprised its direct effect (β=0.36) and its indirect effect (β=0.17).

          Conclusions

          Perceived organisational support served as a mediator between workplace violence, job satisfaction, burnout and turnover intention, and it had a significantly negative impact on turnover intention. Therefore, nursing managers should understand the importance of the organisation’s support and establish a reasonable incentive system to decrease turnover intention.

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          Most cited references43

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          Perceived organizational support: a review of the literature.

          The authors reviewed more than 70 studies concerning employees' general belief that their work organization values their contribution and cares about their well-being (perceived organizational support; POS). A meta-analysis indicated that 3 major categories of beneficial treatment received by employees (i.e., fairness, supervisor support, and organizational rewards and favorable job conditions) were associated with POS. POS, in turn, was related to outcomes favorable to employees (e.g., job satisfaction, positive mood) and the organization (e.g., affective commitment, performance, and lessened withdrawal behavior). These relationships depended on processes assumed by organizational support theory: employees' belief that the organization's actions were discretionary, feeling of obligation to aid the organization, fulfillment of socioemotional needs, and performance-reward expectancies.
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            Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi

            Background Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. Methods A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher’s perspectives by means of document review and participatory observation. Results Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Conclusions Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change as well as determined commitment and contributions from clients, staff and management.
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              An Alternative Approach: The Unfolding Model of Voluntary Employee Turnover

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                9 June 2018
                : 8
                : 6
                : e019525
                Affiliations
                [1 ] departmentDepartment of Health Management , Harbin Medical University School of Public Health , Harbin, China
                [2 ] departmentDepartment of Neurosurgery , The Second Affiliated Hospital of Harbin Medical University , Harbin, China
                [3 ] departmentDepartment of Medical Education , School of Public Health, Harbin Medical University , Harbin, China
                [4 ] departmentDepartment of Public Health Research , School of Public Health, Qiqihar Medical University , Qiqihar, China
                [5 ] departmentDepartment of Autonomous Protection , Chinese Hospital Association , Beijing, China
                [6 ] departmentDepartment of the Hospital Director, National Center for Children’s Health , Beijing Children’s Hospital Affiliated to Capital Medical University , Beijing, China
                Author notes
                [Correspondence to ] Professor Lihua Fan; lihuafan@ 123456126.com and Prof. Tao Sun; hydsuntao@ 123456126.com
                Article
                bmjopen-2017-019525
                10.1136/bmjopen-2017-019525
                6009508
                29886440
                2a30f7ef-3caa-4393-8544-d34917f224f2
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 08 September 2017
                : 13 March 2018
                : 19 April 2018
                Funding
                Funded by: National Natural Science Foundation of China;
                Categories
                Health Policy
                Research
                1506
                1703
                Custom metadata
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                Medicine
                workplace violence,job satisfaction,burnout,organizational support,turnover intention,nurses
                Medicine
                workplace violence, job satisfaction, burnout, organizational support, turnover intention, nurses

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