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      Predictors of nursing workers’ intention to leave the work unit, health institution and profession* Translated title: Preditores da intenção de trabalhadores de enfermagem em deixar a unidade de trabalho, instituição de saúde e profissão Translated title: Predictores de la intención de los trabajadores de enfermería de dejar la unidad de trabajo, la institución de salud y la profesión

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          Abstract

          Objective:

          to identify the factors related to the nursing workers’ intention to leave the work unit, health institution and profession.

          Method:

          cross-sectional study with quantitative approach was carried out with 267 nursing workers from seven emergency units in Brazil. For data collection, we used the Questionnaire of socio-demographic, life style and work and health aspects as well as the Work Ability Index, Workplace violence questionnaire, questions about intention to leave and the Turnover Intention Scale. The predictors of intentions to leave were evaluated through Poisson regression models.

          Results:

          workplace violence increased and better satisfaction with current job decreased the probability of greater intention to leave the unit, institution and profession. Better work ability decreased the probability of greater intention to leave the unit and profession. The more qualified workers and those who had been working in the institution longer was more likely to greater intention to leave the profession.

          Conclusion:

          promoting job satisfaction, work ability and a violence-free environment is possible to decrease the workers’ intention to leave the job or profession, but nursing managers need to understand the three phenomena of intention to quit individually for retention strategies.

          Translated abstract

          Objetivo:

          identificar os fatores relacionados à intenção de trabalhadores de enfermagem em deixar a unidade de trabalho, instituição de saúde e profissão.

          Método:

          estudo transversal, com abordagem quantitativa, realizado com 267 trabalhadores de enfermagem de sete unidades de emergência no Brasil. Para coleta de dados, utilizou-se o Questionário de aspectos sociodemográficos, estilo de vida, trabalho e saúde, bem como o Índice de Capacidade para o Trabalho, questionário sobre violência no local de trabalho, questões sobre intenção em deixar e a Escala de Intenção de Rotatividade. Os preditores de intenção em deixar foram avaliados por meio de modelos de regressão de Poisson.

          Resultados:

          violência no trabalho aumentou e melhor satisfação com o emprego atual diminuiu a probabilidade de maior intenção em deixar a unidade, instituição e profissão. Melhor capacidade para o trabalho diminuiu a probabilidade de maior intenção em deixar a unidade e profissão. Os trabalhadores mais qualificados e aqueles que trabalhavam na instituição há mais tempo estavam mais propensos a maior intenção em deixar a profissão.

          Conclusão:

          com a promoção da satisfação no trabalho, da capacidade para o trabalho e de um ambiente livre de violência é possível diminuir a intenção de trabalhadores em deixar o emprego ou profissão, mas os gerentes de enfermagem precisam compreender os três fenômenos de intenção em sair individualmente para propor estratégias de retenção.

          Translated abstract

          Objetivo:

          identificar los factores relacionados con la intención de los trabajadores de enfermería de dejar la unidad de trabajo, la institución de salud y la profesión.

          Método:

          se realizó un estudio transversal con enfoque cuantitativo con 267 trabajadores de enfermería de siete unidades de emergencia en Brasil. Para la recopilación de datos, utilizamos el Cuestionario de aspectos sociodemográficos, de estilo de vida y de trabajo y salud, así como el Índice de Capacidad para el Trabajo, el Cuestionario de violencia en el trabajo, las preguntas sobre la intención de dejar y la Escala de Intención de Rotación. Los predictores de intenciones de dejar fueron evaluados a través de modelos de regresión de Poisson.

          Resultados:

          la violencia en el trabajo aumentó y una mejor satisfacción con el trabajo actual disminuyó la probabilidad de una mayor intención de dejar la unidad, la institución y la profesión. Una mejor capacidad para el trabajo disminuyó la probabilidad de una mayor intención de dejar la unidad y la profesión. Los trabajadores más calificados y aquellos que han trabajado en la institución por más tiempo tenían más probabilidades de una mayor intención de dejar la profesión.

          Conclusión:

          promoviendo la satisfacción laboral, la capacidad para el trabajo y un ambiente libre de violencia es posible disminuir la intención de los trabajadores de dejar el trabajo o la profesión, pero los gerentes de enfermería deben comprender los tres fenómenos de intención de dejar individualmente para estrategias de retención.

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          Most cited references54

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          Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio

          Background Cross-sectional studies with binary outcomes analyzed by logistic regression are frequent in the epidemiological literature. However, the odds ratio can importantly overestimate the prevalence ratio, the measure of choice in these studies. Also, controlling for confounding is not equivalent for the two measures. In this paper we explore alternatives for modeling data of such studies with techniques that directly estimate the prevalence ratio. Methods We compared Cox regression with constant time at risk, Poisson regression and log-binomial regression against the standard Mantel-Haenszel estimators. Models with robust variance estimators in Cox and Poisson regressions and variance corrected by the scale parameter in Poisson regression were also evaluated. Results Three outcomes, from a cross-sectional study carried out in Pelotas, Brazil, with different levels of prevalence were explored: weight-for-age deficit (4%), asthma (31%) and mother in a paid job (52%). Unadjusted Cox/Poisson regression and Poisson regression with scale parameter adjusted by deviance performed worst in terms of interval estimates. Poisson regression with scale parameter adjusted by χ2 showed variable performance depending on the outcome prevalence. Cox/Poisson regression with robust variance, and log-binomial regression performed equally well when the model was correctly specified. Conclusions Cox or Poisson regression with robust variance and log-binomial regression provide correct estimates and are a better alternative for the analysis of cross-sectional studies with binary outcomes than logistic regression, since the prevalence ratio is more interpretable and easier to communicate to non-specialists than the odds ratio. However, precautions are needed to avoid estimation problems in specific situations.
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            Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study

            Background Variation in post-operative mortality rates has been associated with differences in registered nurse staffing levels. When nurse staffing levels are lower there is also a higher incidence of necessary but missed nursing care. Missed nursing care may be a significant predictor of patient mortality following surgery. Aim Examine if missed nursing care mediates the observed association between nurse staffing levels and mortality. Method Data from the RN4CAST study (2009–2011) combined routinely collected data on 422,730 surgical patients from 300 general acute hospitals in 9 countries, with survey data from 26,516 registered nurses, to examine associations between nurses’ staffing, missed care and 30-day in-patient mortality. Staffing and missed care measures were derived from the nurse survey. A generalized estimation approach was used to examine the relationship between first staffing, and then missed care, on mortality. Bayesian methods were used to test for mediation. Results Nurse staffing and missed nursing care were significantly associated with 30-day case-mix adjusted mortality. An increase in a nurse’s workload by one patient and a 10% increase in the percent of missed nursing care were associated with a 7% (OR 1.068, 95% CI 1.031–1.106) and 16% (OR 1.159 95% CI 1.039–1.294) increase in the odds of a patient dying within 30 days of admission respectively. Mediation analysis shows an association between nurse staffing and missed care and a subsequent association between missed care and mortality. Conclusion Missed nursing care, which is highly related to nurse staffing, is associated with increased odds of patients dying in hospital following common surgical procedures. The analyses support the hypothesis that missed nursing care mediates the relationship between registered nurse staffing and risk of patient mortality. Measuring missed care may provide an ‘early warning’ indicator of higher risk for poor patient outcomes.
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              Effects of nurse work environment on job dissatisfaction, burnout, intention to leave.

              The nursing shortage is a critical issue in many countries. High turnover rates among nurses is contributing to the shortage, and job dissatisfaction, intention to leave, and burnout have been identified as some of the predictors of nurse turnover. A well-established body of evidence demonstrates that the work environment for nurses influences nurse job dissatisfaction, intention to leave, and burnout, but there never has been a study undertaken in Thailand to investigate this relationship.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                05 December 2019
                2019
                : 27
                : e3219
                Affiliations
                [1 ]Universidade Federal da Fronteira Sul, Curso de Enfermagem, Chapecó, SC, Brazil.
                [2 ]Scholarship holder at the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) - Grant # 2016/06128-7, at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) - Grant # 162825/2014-5 and at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Grant # 01-P-3481/2014, Brazil.
                [3 ]Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil.
                Author notes
                Corresponding author: Maiara Bordignon. E-mail: bordignonmaiara@ 123456gmail.com
                Author information
                http://orcid.org/0000-0001-7766-4612
                http://orcid.org/0000-0002-6004-8378
                Article
                00400
                10.1590/1518-8345.3280.3219
                6896814
                31826161
                32ccff24-4ff3-4329-86b3-b1d0d9f12f02
                Copyright © 2019 Revista Latino-Americana de Enfermagem

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 December 2018
                : 19 August 2019
                Categories
                Original Article

                intention,employment,occupations,nursing,nurses,workplace violence,intenção,emprego,ocupações,enfermagem,enfermeiras e enfermeiros,violência no trabalho,intención,empleo,ocupaciones,enfermería,enfermeros,violencia laboral

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