Nurse turnover: A longitudinal survival analysis of the Korea Nurses' Health Study

Kim, Young Taek; Kim, Oksoo; Cha, Chiyoung; Pang, Yan; Sung, Choa

doi:10.1111/jan.14919

Cited by 9 publications

(14 citation statements)

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“…In a previous cross-sectional study, depression was positively associated with turnover intention among nurses [13,51]; however, a longitudinal cohort study found no such association with actual turnover [52]. Likewise, this study found that depression was associated with turnover intention but not with actual turnover.…”

Section: Plos Onecontrasting

confidence: 85%

Health problems, turnover intention, and actual turnover among shift work female nurses: Analyzing data from a prospective longitudinal study

Choi-Kwon

2022

PLoS ONE

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Aims This study investigated health problems, turnover intention, and actual turnover among shift work nurses. While turnover intention is often used as a proxy variable for turnover, the relationship between these variables requires clarification. This study tested for relevant associations using prospective longitudinal data with a time lag of 12 months. We also tested for associations between health problems (sleep disturbance, fatigue, and depression) and turnover intentions/turnover, with a focus on the mediating role of turnover intention. Methods This study conducted a secondary analysis of data from the Shift Work Nurses’ Health and Turnover project, which is a prospective longitudinal cohort study. We analyzed health problems, turnover intention, and actual turnover. The data were analyzed via descriptive statistics, the Pearson’s chi-squared test, independent t-test, univariable logistic regression, multiple logistic regression, and causal mediation. Results Participants included 491 shift work female nurses. Of these, 112 (22.8%) had turnover intention, while 38 (7.7%) left their jobs within the 12-month period of investigation. Of the 112 with turnover intention, 22 left their jobs (OR 5.68. 95% CI 2.84–11.36). The logistic regression analysis showed that sleep disturbance and fatigue were associated with turnover intentions and actual turnover, while depression was only associated with turnover intention. The causal mediation analysis showed that turnover intention mediated the relationship between health problems (sleep disturbance and fatigue) and actual turnover (sleep disturbance OR 1.31, 95%CI = 1.02–1.60; fatigue OR 2.11, 95%CI = 1.50–2.68); sleep disturbance had a natural direct effect on actual turnover (OR 2.66, 95%CI,2.07–3.21). Conclusion Turnover intention strongly predicted actual turnover. Sleep disturbances may result in turnover, even in cases without existing turnover intention. These findings highlight the need for early interventions aimed at preventing and alleviating sleep disturbances for shift work female nurses.

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Section: Plos Onecontrasting

confidence: 85%

Health problems, turnover intention, and actual turnover among shift work female nurses: Analyzing data from a prospective longitudinal study

Choi-Kwon

2022

PLoS ONE

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Section: Discussionmentioning

confidence: 99%

“…The difference may be due to the fact that the job characteristics and shift conditions in their study were different from those in this study. Kim et al (2021) discovered that nurses who had received less education were more likely to resign. However, the results of this study showed no correlation between educational background and future turnover, due perhaps to the different classifications of educational background.…”

Section: Discussionmentioning

confidence: 99%

“…Because only 1 nurse among the 198 nurses working rotating shifts in this study had a master's degree, we placed this nurse in the same group as the university graduates. In contrast, the study conducted byKim et al (2021) involved 33,060 female nurses, among which 3402 (10.3%) had a master's degree. This difference in classification and the number of nurses with a master's degree could explain the variation in the results.With regard to work experience as a nurse, we found lower turnover among female nurses who worked rotating shifts and had more work experience.…”

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confidence: 98%

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Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts

Chang

Wang

2021

Journal of Clinical Nursing

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Aims and objectives: To investigate whether the sleep quality and fatigue of female nurses working rotating shifts could be used to predict future turnover status.Background: Female nurses working rotating shifts often suffer from sleep problems and fatigue, and the turnover rates of nurses are generally higher than those of other hospital personnel.Design: A prospective study. Methods: We recruited a total of 198 female nurses working rotating shifts from December 2017 to March 2019. The nurses completed the Checklist Individual Strength (CIS) scale and wore an actigraph for seven consecutive days in order to collect their sleep parameters. Their turnover status was tracked until 31 May 2021 at which time 55 participants (27.8%) had resigned. The Cox proportional hazard model was used to analyse the factors influencing turnover. In addition, the study adhered to the STROBE checklist. Results:The results revealed significant differences between the nurses in the stillworking group and the resigned group in terms of the sleep quality parameters sleep efficiency (SE) and wake after sleep onset (WASO) as well as CIS scores. WASO was significantly correlated with intensity of fatigue, and fatigue was common among all of the nurses working rotating shifts. As time progressed, the sleep quality parameter WASO and CIS scores could be used to predict turnover status after 2.4 years. Conclusion:The results of this study indicated more sleep fragmentation and poor sleep efficiency in the resigned group. Sleep fragmentation was highly correlated with fatigue, and sleep fragmentation and fatigue could be used to predict turnover status. Relevance to clinical practice:We suggest that relevant hospital management pay more attention to the sleep conditions and fatigue of female nurses working rotating shifts when arranging personnel and schedules and offer them more understanding.

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“…Our results are important to the field considering that few recent studies have reported on the effectiveness of higher education scholarship programs for RNs as a nursing workforce retention strategy; even fewer studies have looked at factors affecting degree completion rate for RNs who enrolled in higher education scholarship programs. The survival analysis approach is relatively novel in the domain of nurse turnover studies (Kim et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Retention in nursing education and scholarship programs: Survival analysis of the Veterans Health Administration National Nursing Education Initiative Data

Toyinbo

Rugs

Nedd

et al. 2023

Journal of Advanced Nursing

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Aims To investigate factors affecting non‐completion by registered nurses (RNs) participating in degree programs supported by the scholarship program of the National Nursing Education Initiative of the United States Veterans Health Administration. Secondarily, to assess overall retention in the scholarship program over time. Design Retrospective longitudinal design using administrative data. Methods Defining retention time as the time elapsed from enrollment date to non‐completion, we performed survival (retention) analysis (i.e.,Kaplan–Meier survival functions, log‐rank tests and Cox regressions) to retrospectively analyzea national sample of RNs (N = 15,908) enrolled in the scholarship program between the United States federal fiscal years 2000 and 2020. Results Nurses' mean age was 44 years (range: 19–71), and 86% were females. Six‐ and 12‐month cumulative educational program retention rates were 92% and 84% respectively. The newest group of enrollees (2016–2020), younger nurses (<50 years), and nurses in traditional degree programtype were more likely to complete their academic programs than the earlier groups, older nurses and nurses in non‐traditional type, respectively. Male nurses who aspired to advanced occupational levels upon completion were more likely to complete their academic programs compared to those who expected no change from their current level of practice. Conclusion Multiple factors affected non‐completion of academic degree programs by RNs enrolled in the scholarship program. More work is needed to examine these plus additional plausible factors and their correlates extensively. Impact Our findings highlighted areas for quality improvement in employee scholarship programs for RNs. The findings are expected to inform tailoring of proactive helpful intervention towards individual needs and prioritization of limited resources to maximize graduation rate from academic programs for scholarship recipients. The study will have impact on nursing workforce policy makers interested in implementing employee scholarship programs, and on their scholarship recipients.

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Nurse turnover: A longitudinal survival analysis of the Korea Nurses' Health Study

Abstract: Aims: To identify factors influencing turnover among Korean female nurses from a longitudinal perspective.

Cited by 9 publications

References 58 publications

Health problems, turnover intention, and actual turnover among shift work female nurses: Analyzing data from a prospective longitudinal study

Health problems, turnover intention, and actual turnover among shift work female nurses: Analyzing data from a prospective longitudinal study

Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts

Retention in nursing education and scholarship programs: Survival analysis of the Veterans Health Administration National Nursing Education Initiative Data

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