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      Job burnout and turnover intention among Chinese primary healthcare staff: the mediating effect of satisfaction

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          Abstract

          Objectives

          Although China has done a lot in strengthening the primary healthcare system, the high turnover intention is still a social problem to be reckoned with. The objective of this study is to explore the mediating effect of satisfaction between job burnout and turnover intention.

          Design

          Cross-sectional study.

          Methods

          A cross-sectional study was conducted to make sense of the job burnout, satisfaction and turnover intention among primary healthcare workers in central China. Structural equation modelling (SEM) was performed to study the mediating effect of satisfaction between job burnout and turnover intention with maximum likelihood estimation. The mediation effect test was carried out by using the bootstrap method.

          Results

          SEM showed that job burnout was positively related to the turnover intention with the standard path coefficient of 0.845 (C.R.=34.055, p<0.001). The partial mediating effect of satisfaction was 0.047, making up 5.32% of the total effect. The goodness-of-fit was acceptable (Goodness of Fit Index=0.947, Comparative Fit Index=0.975, root mean square error of approximation=0.067, Non-Normed Fit Index=0.971, Incremental Fit Index=0.975). Age, education level, monthly income, hire form and night shift were also found significantly correlated with turnover intention, and no difference was found between physicians and nurses.

          Conclusions

          The turnover intention is significantly affected by job burnout, satisfaction and demographical characteristics including age, education level, monthly income, hire form and night shift. Satisfaction can be regarded as a mediator between job burnout and turnover intention. Relative measures can be taken to promote enthusiasm and satisfaction thus decreasing the turnover rate.

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          Most cited references34

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          A three-component conceptualization of organizational commitment

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            The primary health-care system in China

            China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes). As China deepens its health-care reform, it has the opportunity to build an integrated, cooperative primary health-care system, generating knowledge from practice that can support improvements, and bolstered by evidence-based performance indicators and incentives.
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              A nursing shortage - a prospect of global and local policies

              The article addresses selected determinants of the nursing shortage in Poland and other countries in the face of employee ageing.
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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
                2020
                7 October 2020
                : 10
                : 10
                : e036702
                Affiliations
                [1 ]departmentDepartment of Occupational and Environmental Health, School of Health Sciences , Wuhan University , Wuhan, China
                [2 ]departmentDepartment of Health Management , Huangpi People’s Hospital , Wuhan, China
                [3 ]departmentDepartment of Health Managment , Health Committee of Huangpi District of Wuhan , Wuhan, China
                [4 ]departmentSchool of Nursing , Wuchang University of Technology , Wuhan, China
                Author notes
                [Correspondence to ] Dr Xiaodong Tan; 00300469@ 123456whu.edu.cn ; Dr Ruihua Duan; 854757230@ 123456qq.com
                Author information
                http://orcid.org/0000-0002-2802-5547
                Article
                bmjopen-2019-036702
                10.1136/bmjopen-2019-036702
                7542935
                33033013
                f92bdaf7-8648-4efa-9541-f0b848c36443
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 02 January 2020
                : 26 August 2020
                : 08 September 2020
                Categories
                Health Services Research
                1506
                1704
                Original research
                Custom metadata
                unlocked

                Medicine
                burnout,job satisfaction,turnover intention,mediating effect,healthcare
                Medicine
                burnout, job satisfaction, turnover intention, mediating effect, healthcare

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