The utility of conceptualisations of place and belonging in workforce retention: A proposal for future rural health research

Malatzky, Christina; Cosgrave, Catherine; Gillespie, Judy

doi:10.1016/j.healthplace.2019.102279

Cited by 34 publications

(45 citation statements)

References 54 publications

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“…In a rural health workforce paper investigating the conceptualisations of place and belonging in workforce retention, the authors argue that an authentic sense of place is experienced when individuals have a sense of belonging-in-place and that 'place' is an intrinsic part of any individual's identity [10]. Other studies have identified that when sense-of-belonging is missing, feelings of loneliness, social isolation and alienation ensue [45].…”

Section: Placementioning

confidence: 99%

“…Similarly, while 'placed-based social processes' have increasingly been recognised as influencing rural health workforce retention, especially for newcomer workers, until fairly recently there was little research undertaken investigating how these operate and influence retention [56]. Research undertaken by Malatzky, Gillespie and myself [10,56] examining the influence of place-based social processes on turnover, argues that operational concepts such as sense of place, place attachment and belonging-in-place offer potential solutions for rural workforce challenges, especially when applied in person-centred approaches [10]. In the Recruit & Retain-Making it Work study, the need for community engagement was identified as an 'essential' strategic element for the recruitment and retention of the 'right' professionals to achieve a 'sustainable', 'fit-for-purpose' workforce [38].…”

Section: A New Frameworkmentioning

confidence: 99%

“…For rural and remote allied health professionals, the most cited extrinsic factors with a negative influence on retention are lack of professional development opportunities, professional isolation and insufficient supervision, while the most cited intrinsic factors with a positive influence on retention are autonomy and community connectedness [9]. However, recent analyses posit that health professionals' decisions to stay or leave a rural health position (retention/turnover) are complex and influenced by 'a myriad of highly interactive dimensions within personal, organisational, social and spatial domains' [10].…”

Section: Introductionmentioning

confidence: 99%

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The Whole-of-Person Retention Improvement Framework: A Guide for Addressing Health Workforce Challenges in the Rural Context

Cosgrave

2020

IJERPH

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People living in rural places face unique challenges due to their geographic isolation and often experience poorer health outcomes compared to people living in major cities. The struggle to attract and retain an adequately-sized and skilled health workforce is a major contributing factor to these health inequities. Health professionals’ decisions to stay or leave a rural position are multifaceted involving personal, organisational, social and spatial aspects. While current rural health workforce frameworks/models recognise the multidimensional and interrelated influences on retention, they are often highly complex and do not easily support the development of strategic actions. An accessible evidence-informed framework that addresses the complexity but presents the evidence in a manner that is straightforward and supports the development of targeted evidence- and place-informed retention strategies is required. The ‘Whole-of-Person Retention Improvement Framework’ (WoP-RIF) has three domains: Workplace/Organisational, Role/Career and Community/Place. The necessary pre-conditions for improving retention through strengthening job and personal satisfaction levels are set out under each domain. The WoP-RIF offers a person-centred, holistic structure that encourages whole-of-community responses that address individual and workforce level needs. It is a significant response to, and resource for, addressing avoidable rural health workforce turnover that rural health services and communities can harness in-place.

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Section: Placementioning

confidence: 99%

Section: A New Frameworkmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Whole-of-Person Retention Improvement Framework: A Guide for Addressing Health Workforce Challenges in the Rural Context

Cosgrave

2020

IJERPH

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“…RNs/NPs who were less satisfied with their primary work community had higher odds of ITL, as did nurses who did not choose to come to work in this community for the flexibility of the work. This latter finding reflects that rural and remote nursing practice demands flexibility in everyday work and in living and working in small communities (Malatzky et al., 2020; Wakerman et al., 2019). The fit of the nurse with the realities of practice and the community is important for retention in rural and remote communities (Malatzky et al., 2020).…”

Section: Discussionmentioning

confidence: 94%

“…The interconnection of nurses, their work, and communities is characteristic of rural and remote practice (Malatzky, Cosgrave, & Gillespie, 2020; Ross, 2017). Different community variables were significantly related to ITL for RNs/NPs and LPNs.…”

Section: Discussionmentioning

confidence: 99%

The importance of organizational commitment in rural nurses' intent to leave

Stewart

MacLeod

Kosteniuk

et al. 2020

Journal of Advanced Nursing

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Aims To examine determinants of intention to leave a nursing position in rural and remote areas within the next year, for Registered Nurses or Nurse Practitioners (RNs/NPs) and Licensed Practical Nurses (LPNs). Design A pan‐Canadian cross‐sectional survey. Methods The Nursing Practice in Rural and Remote Canada II survey (2014–2015) used stratified, systematic sampling and obtained two samples of questionnaire responses on intent to leave from 1,932 RNs/NPs and 1,133 LPNs. Separate logistic regression analyses were conducted for RNs/NPs and LPNs. Results For RNs/NPs, 19.8% of the variance on intent to leave was explained by 11 variables; and for LPNs, 16.9% of the variance was explained by seven variables. Organizational commitment was the only variable associated with intent to leave for both RNs/NPs and LPNs. Conclusions Enhancement of organizational commitment is important in reducing intent to leave and turnover. Since most variables associated with intent to leave differ between RNs/NPs and LPNs, the distinction of nurse type is critical for the development of rural‐specific turnover reduction strategies. Comparison of determinants of intent to leave in the current RNs/NPs analysis with the first pan‐Canadian study of rural and remote nurses (2001–2002) showed similarity of issues for RNs/NPs over time, suggesting that some issues addressing turnover remain unresolved. Impact The geographic maldistribution of nurses requires focused attention on nurses' intent to leave. This research shows that healthcare organizations would do well to develop policies targeting specific variables associated with intent to leave for each type of nurse in the rural and remote context. Practical strategies could include specific continuing education initiatives, tailored mentoring programs, and the creation of career pathways for nurses in rural and remote settings. They would also include place‐based actions designed to enhance nurses' integration with their communities and which would be planned together with communities and nurses themselves.

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Differences in urban and suburban/rural settings regarding care provision and barriers of cancer care for older adults during COVID-19

Pisegna

BrintzenhofeSzoc

Shahrokni

et al. 2022

Support Care Cancer

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Purpose Care for older adults with cancer became more challenging during the COVID-19 pandemic, particularly in urban hotspots. This study examined the potential differences in healthcare providers' provision of as well as barriers to cancer care for older adults with cancer between urban and suburban/rural settings. Methods Members of the Advocacy Committee of the Cancer and Aging Research Group, with the Association of Community Cancer Centers, surveyed multidisciplinary healthcare providers responsible for the direct care of patients with cancer. Respondents were recruited through organizational listservs, email blasts, and social media messages. Descriptive statistics and chi-square tests were used. Results Complete data was available from 271 respondents (urban (n = 144), suburban/rural (n = 127)). Most respondents were social workers (42, 44%) or medical doctors/advanced practice providers (34, 13%) in urban and suburban/rural settings, respectively. Twenty-four percent and 32.4% of urban-based providers reported "strongly considering" treatment delays among adults aged 76-85 and > 85, respectively, compared to 13% and 15.4% of suburban/rural providers (Ps = 0.048, 0.013). More urban-based providers reported they were inclined to prioritize treatment for younger adults over older adults than suburban/rural providers (10.4% vs. 3.1%, p = 0.04) during the pandemic. The top concerns reported were similar between the groups and related to patient safety, treatment delays, personal safety, and healthcare provider mental health. Conclusion These findings demonstrate location-based differences in providers' attitudes regarding care provision for older adults with cancer during the COVID-19 pandemic.

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The utility of conceptualisations of place and belonging in workforce retention: A proposal for future rural health research

Cited by 34 publications

References 54 publications

The Whole-of-Person Retention Improvement Framework: A Guide for Addressing Health Workforce Challenges in the Rural Context

The Whole-of-Person Retention Improvement Framework: A Guide for Addressing Health Workforce Challenges in the Rural Context

The importance of organizational commitment in rural nurses' intent to leave

Differences in urban and suburban/rural settings regarding care provision and barriers of cancer care for older adults during COVID-19

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