IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i23p4801-d292358.html
   My bibliography  Save this article

Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction

Author

Listed:
  • Yi-Chuan Chen

    (School of Nursing, College of Medicine, National Taiwan University (NTU), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan)

  • Yue-Liang Leon Guo

    (Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan
    Department of Environmental and Occupational Medicine, National Taiwan University Hospital (NTUH), No.7, Chung-Shan South Rd., Taipei 10002, Taiwan)

  • Wei-Shan Chin

    (School of Nursing, College of Nursing, Taipei Medical University (TMU), No. 250, Wuxing St., Taipei 11031, Taiwan)

  • Nai-Yun Cheng

    (Institute of Labor, Occupational Safety and Health (ILOSH), Ministry of Labor, No. 99, Lane 407, Hengke Rd., New Taipei City 22143, Taiwan)

  • Jiune-Jye Ho

    (Institute of Labor, Occupational Safety and Health (ILOSH), Ministry of Labor, No. 99, Lane 407, Hengke Rd., New Taipei City 22143, Taiwan)

  • Judith Shu-Chu Shiao

    (School of Nursing, College of Medicine, National Taiwan University (NTU), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan
    Department of Nursing, National Taiwan University Hospital (NTUH), No.7, Chung-Shan South Rd., Taipei 10002, Taiwan
    Occupational Health Nursing and Education Association of Taiwan (OHNEAT), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan)

Abstract

In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient–nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

Suggested Citation

  • Yi-Chuan Chen & Yue-Liang Leon Guo & Wei-Shan Chin & Nai-Yun Cheng & Jiune-Jye Ho & Judith Shu-Chu Shiao, 2019. "Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction," IJERPH, MDPI, vol. 16(23), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:23:p:4801-:d:292358
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/23/4801/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/23/4801/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Dana Hayward & Vicky Bungay & Angela C Wolff & Valerie MacDonald, 2016. "A qualitative study of experienced nurses' voluntary turnover: learning from their perspectives," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(9-10), pages 1336-1345, May.
    2. Anke Wagner & Antje Hammer & Tanja Manser & Peter Martus & Heidrun Sturm & Monika A. Rieger, 2018. "Do Occupational and Patient Safety Culture in Hospitals Share Predictors in the Field of Psychosocial Working Conditions? Findings from a Cross-Sectional Study in German University Hospitals," IJERPH, MDPI, vol. 15(10), pages 1-18, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. María Fuensanta Hellín Gil & José Antonio Ruiz Hernández & Francisco Javier Ibáñez-López & Ana Myriam Seva Llor & Maria Dolores Roldán Valcárcel & Marzena Mikla & María José López Montesinos, 2022. "Relationship between Job Satisfaction and Workload of Nurses in Adult Inpatient Units," IJERPH, MDPI, vol. 19(18), pages 1-16, September.
    2. Mohd Ikhwan Azmi & Aziah Daud & Mohd Nazri Shafei & Anees Abdul Hamid, 2022. "Job Dissatisfaction and Its Predictors among Healthcare Workers of ‘Type 2 Health Clinics’ in North-Eastern Malaysia," IJERPH, MDPI, vol. 19(23), pages 1-13, December.
    3. Teresa Neves & Pedro Parreira & Vitor Rodrigues & João Graveto, 2022. "Organizational Commitment and Intention to Leave of Nurses in Portuguese Hospitals," IJERPH, MDPI, vol. 19(4), pages 1-14, February.
    4. Zhihui Jia & Xiaotong Wen & Xiaohui Lin & Yixiang Lin & Xuyang Li & Guoqing Li & Zhaokang Yuan, 2021. "Working Hours, Job Burnout, and Subjective Well-Being of Hospital Administrators: An Empirical Study Based on China’s Tertiary Public Hospitals," IJERPH, MDPI, vol. 18(9), pages 1-13, April.
    5. Hanna Choi & Sujin Shin, 2022. "The Factors That Affect Turnover Intention According to Clinical Experience: A Focus on Organizational Justice and Nursing Core Competency," IJERPH, MDPI, vol. 19(6), pages 1-12, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jeonghee Hong & Misoon Kim & Eunyoung E. Suh & Sangwoon Cho & Soyoung Jang, 2021. "Comparison of Fatigue, Quality of Life, Turnover Intention, and Safety Incident Frequency between 2-Shift and 3-Shift Korean Nurses," IJERPH, MDPI, vol. 18(15), pages 1-13, July.
    2. Jeong Hye Park & Min Jung Park & Hye Young Hwang, 2019. "Intention to leave among staff nurses in small‐ and medium‐sized hospitals," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(9-10), pages 1856-1867, May.
    3. Anke Wagner & Ladina Schöne & Monika A. Rieger, 2020. "Determinants of Occupational Safety Culture in Hospitals and other Workplaces—Results from an Integrative Literature Review," IJERPH, MDPI, vol. 17(18), pages 1-23, September.
    4. Oumou Salama Daouda & Mounia N Hocine & Laura Temime, 2021. "Determinants of healthcare worker turnover in intensive care units: A micro-macro multilevel analysis," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-13, May.
    5. Anke Wagner & Martina Michaelis & Edwin Luntz & Andrea Wittich & Matthias Schrappe & Constanze Lessing & Monika A. Rieger, 2018. "Assessment of Patient and Occupational Safety Culture in Hospitals: Development of a Questionnaire with Comparable Dimensions and Results of a Feasibility Study in a German University Hospital," IJERPH, MDPI, vol. 15(12), pages 1-24, November.
    6. Sastrawan Sastrawan & Jennifer Margaret Newton & Gulzar Malik, 2019. "Nurses’ integrity and coping strategies: An integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(5-6), pages 733-744, March.
    7. Mary Van Osch & Kathy Scarborough & Sarah Crowe & Angela C. Wolff & Sheryl Reimer‐Kirkham, 2018. "Understanding the factors which promote registered nurses’ intent to stay in emergency and critical care areas," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(5-6), pages 1209-1215, March.
    8. Kapo Wong & Alan Hoi Shou Chan, 2018. "Emerging Issues in Occupational Safety and Health," IJERPH, MDPI, vol. 15(12), pages 1-4, December.
    9. Xiaorong Luan & Ping Wang & Wenxiu Hou & Lili Chen & Fenglan Lou, 2017. "Job stress and burnout: A comparative study of senior and head nurses in China," Nursing & Health Sciences, John Wiley & Sons, vol. 19(2), pages 163-169, June.
    10. Ya‐Ting Ke & Joel F. Stocker, 2019. "On the difficulty of finding one’s place: A qualitative study of new nurses’ processes of growth in the workplace," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(23-24), pages 4321-4331, December.
    11. Jison Ki & Jaegeum Ryu & Jihyun Baek & Iksoo Huh & Smi Choi-Kwon, 2020. "Association between Health Problems and Turnover Intention in Shift Work Nurses: Health Problem Clustering," IJERPH, MDPI, vol. 17(12), pages 1-12, June.
    12. Katarzyna Zebrak & Naomi Yount & Joann Sorra & Theresa Famolaro & Laura Gray & Deborah Carpenter & Andrew Caporaso, 2022. "Development, Pilot Study, and Psychometric Analysis of the AHRQ Surveys on Patient Safety Culture™ (SOPS ® ) Workplace Safety Supplemental Items for Hospitals," IJERPH, MDPI, vol. 19(11), pages 1-16, June.
    13. Jocélia Maria de Azevedo Bringel & Isabel Abreu & Maria-Cláudia Mendes Caminha Muniz & Paulo César de Almeida & Maria-Raquel G. Silva, 2023. "Health Professionals’ Chronotype Association with Salivary Cortisol and Occupational Stress in Neonatal Intensive Care Units," IJERPH, MDPI, vol. 20(9), pages 1-17, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:23:p:4801-:d:292358. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.