The Importance of Individual Variation in Understanding Turnover of Taiwanese Nurses in LTC

Chen, I-Hui

Friday, April 12, 2013

I-Hui Chen, RN, MSN
Roger Brown, PhD
Barbara J. Bowers, RN, PhD, FAAN
School of Nursing, University of Wisconsin-Madison, Madison, WI

Learning Objective 1: The learner will be able to identify subgroups of turnover intention among nursing home nurses in Taiwan.

Learning Objective 2: The learner will be able to know extrinsic and intrinsic job satisfaction predict different subgroups of turnover intention among nursing home nurses in Taiwan.

Background: Research has shown that nursing home (NH) nurse turnover in Taiwan leads to negative consequences for patients and health delivery organizations. However, nurse turnover research has largely been conducted at the aggregate level rather than individual level, making it difficult to understand how to identify individual nurses at risk for turnover. Using turnover intention (TI), as a proxy for turnover, makes it possible to study turnover among currently employed individual nurses. Job satisfaction is well-documented as an important predictor of TI but few studies have explored whether extrinsic or intrinsic satisfaction is more important making it difficult to develop policies directed toward nurse turnover reduction.

Purpose: 1) examine individual nurse differences related to TI; 2) investigate relationships between extrinsic and intrinsic satisfaction and TI.

Methods: A cross-sectional survey using a sample of 186 NH nurses was conducted. Latent class analysis was used to classify nurses, according to their responses to 7 TI indicators, into TI groups. Multinomial logistic regression was used to determine whether extrinsic or intrinsic job satisfaction predicted TI class membership.

Results: A three-class model was found: Group 1: potential leavers with withdrawal plans (n=22, 12%); group 2: potential leavers withdrawing suddenly (n=101, 54%); group 3: low-risk potential leavers (n=63, 34%). Both extrinsic and intrinsic satisfaction predicted class membership, but differentially by group. Specifically, nurses with low extrinsic satisfaction were more likely to belong to group 1 than group 3 and nurses with low intrinsic satisfaction were more likely to belong to group 2 than group 3.

Conclusion: Results from this study indicate that individual differences may influence nurse turnover. Particularly, some nurses are at higher risk of leaving than others. A large proportion of nurses intending to turnover are motivated by intrinsic factors. Policies directed toward nurse turnover reduction should be focused on promoting intrinsic satisfaction.

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