How Perceived Quality of Care and Job Satisfaction Are Associated with Intention to Leave the Profession in Young Nurses and Physicians

Abstract

German hospitals are now confronted with major challenges from both shortages and fluctuations in the numbers of physicians and nurses. This makes it even more important that physicians and nurses do not prematurely leave patient care. The objective of the present study was to improve our understanding of the factors that trigger intentions to leave the profession. For this purpose, data from 1060 young physicians and nurses in hospital care were analysed. Intentions to leave the profession was assessed with the Copenhagen Psychosocial Questionnaire (COPSOQ). In the first step, the association was determined between intention to leave the profession and the factors of perceived quality of care and job satisfaction. In a second step, a mediation analysis was performed to determine the effect of perceived quality of care after correction for the possible mediator of job satisfaction. There were statistically significant negative associations between perceived quality of care and intention to leave the profession (beta: −2.9, 95% CI: −4.48-−1.39) and job satisfaction and intention to leave the profession (beta: −0.5, 95% CI: −0.64-−0.44). The effect of perceived quality of care on intention to leave the profession was partially mediated by job satisfaction. Thus, high perceived quality of care and high job satisfaction are both important factors that tend to prevent young physicians and nurses from leaving their professions.for this include overtime, psychosocial stress, burnout, career aspects and particularly, a low level of job satisfaction [2][3][4][5][6]. In order to improve their balance between work and family, some physicians switch to nontherapeutic work or emigrate, in the hope of finding better working conditions in other countries [7].Although the absolute number of all physicians in Germany has been constantly increasing over the years [8], it is still justified to discuss a "relative lack of physicians" or a "lack of medical working hours". The reasons for this include the relatively high number of hospital beds (in comparison with other European countries), the imbalanced distribution between conurbations and rural areas, the fact that many physicians are very highly specialized, and finally the entry of more women into medicine [9]. At the end of 2018, it was found that women made up 47% of physicians registered at the German Medical Association [10]. This proportion is increasing, as is the proportion of female physicians who work part-time.The position was similar for nursing staff. Even during training, 20-30% of trainees were considering not remaining in the profession for more than 5 years [11]. Systematic reviews have proposed a wide variety of reasons that trained nursing staff may consider leaving the profession. These include inadequate earnings, lack of personnel, lack of autonomy and high stress at work [12][13][14]. At the individual level, these factors lead to low job satisfaction, which is also empirically associated with thoughts of leaving the profession [15][16][17][18][19][20][21]....

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