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Theoretical model 

Theoretical model 

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Research on burnout and turnover intentions offers some inconsistent findings about the effects of commitment. In addition, a factor which is insufficiently studied in the turnover field is the relationship with the recipient of physicians' work, that is, the patient. This study contributes to the research literature by examining how the moderating...

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... to the development of the theoretical framework hereinafter, Fig. 1 illustrates the theoretical model which was tested. The causal chain on which the model focuses ranges from the exogenous variable job stressors and diffi cult doctor-patient relationships through burnout, moderated by commitment, and eventually to turnover intentions. In this sense, the main aim of this study was to test the interaction effects of commitment (two- way interaction) and handling diffi cult doctor-patient relationships (three-way interaction) on the stress-burnout-turnover intentions ...

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... Longer working times, increased patient loads, shortages of human resources, and shortages of personal protective equipment were explained by the increased turnover intention of healthcare workers during the time of the pandemic (12). Turnover intention which is defined as the probability that employees of the organization will voluntarily leave their jobs at some point in the near future was considered to be the strongest predictor of actual turnover among healthcare personnel (13). COVID-19 and the high rate of the turnover intention of healthcare workers have become major challenges and have placed a heavy burden on the healthcare system (14). ...
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Background Healthcare professional turnover and shortages are perceived as a global issue affecting the performance of healthcare organizations. Studies show that the coronavirus disease has physical and psychological effects on healthcare workers. This study assessed the magnitude of turnover intention and related factors during the COVID-19 pandemic. Methods A hospital-based cross-sectional study of 402 healthcare professionals working in the North Shewa Zone was conducted during the COVID-19 pandemic from 1 February to 28 February 2021. The data were collected using a self-managed structure questionnaire, entered into EpiData version 3.1, and exported to SPSS version 25 for further analysis. We performed a logistic regression analysis to identify factors related to healthcare professionals' turnover intention. Finally, the data were displayed in frequency, percentage, and summary statistics. Result From the total of 402 study participants, 363 of them were involved in the study with a response rate of 90.3%. The magnitude of healthcare professionals' turnover intention was 56.7%. Single marital status (AOR: 3.926; 95% CI: 1.961; 7.861), completion of obligatory service years (AOR: 0.287; 95% CI: 0.152, 0.542), dissatisfaction with the training opportunities (AOR: 2.407) 95% CI: 1.232, 4.701), having no established family (AOR: 2.184; 95% CI: 1.103, 4.326), dissatisfaction with organizational decisions process (AOR: 0.483; 95% CI: 0.250, 0.932), low continuous organizational commitment (AOR: 0.371; 95% CI 0.164; 0.842), dissatisfaction with professional development opportunities (AOR: 2.407; 95% CI: 1.232–4.701), and a non-conducive work environment (AOR: 2.079; 95% CI: 1.199, 3.607) were independent predictors of turnover intention. Conclusions Our study showed that 56.7% of healthcare professionals have turnover intention. Being unmarried, lack of training opportunities, lack of established family, having completed the obligatory service years, non-conducive work environment, low continuous organizational commitment, dissatisfaction with the decision-making of the organization, and dissatisfaction with professional development opportunities of the organization all contributed to a higher rate of healthcare professionals' turnover intention. Recommendations Healthcare organizations and other concerned bodies should create strategies that enhance the working environment, foster continuous organizational commitment, improve organizational decision-making, and provide professional development and training opportunities to lower the rate of turnover intention.
... It occurs as a result of working conditions, organizational and psychological factors that can affect workers' attitudes in and toward the institution. 1 Since health industries are dynamic, needs of the staffing become changing. By considering the changing environment, retaining the present workers and recruiting new staff must meet these changing needs. 2 For employee, turnover is unpredictable; proper human resource strategies are important to reduce the attrition rate that can make the organization advantageous. ...
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Objective: The aim of this study was to assess turnover intention and its associated factors among health professionals in Kafa Zone, Southwest, Ethiopia, 2018. Methods: Cross-sectional study design relied on institution that was employed from 1-30 May 2019. Questionnaires were distributed to 427 participants who were selected by simple random sampling technique from selected health facilities. Epi Data Statistical software version 3.1 for data entry and Statistical Package for Social Sciences software version 21.0 for data analysis were used. Binary logistic regression analysis was used to identify factors associated with turnover intention. Odds ratios with 95% confidence intervals were used to examine associations, and a p-value less than 0.05 was considered significant. Result: Overall, 427 questionnaires were distributed, and 389 were returned making 91.1% response rate. Majority of the respondents were between the age of 21 and 30 years and more than half were male. More than half, 219 (56.3%), of the participants reported that they intended to leave their institution. Being female (adjusted odds ratio 2.65, 95% confidence interval (1.62-4.33)), married (adjusted odds ratio 0.57, 95% confidence interval (0.34-0.96)), degree holders (adjusted odds ratio 0.55, 95% confidence interval (0.34-0.89)), autonomous (adjusted odds ratio 0.51, 95% confidence interval (0.31-0.84) and not satisfied with living place condition (adjusted odds ratio 1.68, 95% confidence interval (1.0-2.83)) were found to have statistically significant association with intention to leave among health professionals in Kafa Zone. Conclusion: Turnover intention of health professionals was high in study area. Sex, educational status, marital status, autonomous, and living place condition were the identified predictors of turnover intention among health professionals. The health managers and stakeholders at different levels should have a discussion session with staff to cut the intention to leave the organization.
... Turnover researchers imply that the decision to leave a job is a combination of workplace interactions, working conditions and psycho-social factors [83]. Some of the findings remind that establishing a positive organizational climate in inpatient care services may help overcome the triggering effect of multiple variables on turnover intention. ...
... It is also evident that negative interactions can increase intragroup conflict, which may result in numerous resignations. Some researchers[80][81][82][83] have already emphasized the possible effects of workplace interactions on turnover rates. However, none of the scholars has focused on the dark side of the relations among nurses. ...
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OBJECTIVES: The high turnover rate of nurses has been a matter of debate among scholars. Nurses’ social interaction patterns and the social structure they are situated within may provide clues about possible causes of their high turnover intentions. This study aims to investigate the possible effects of negative and positive ties on the intention of turnover among nurses. DESIGN & SETTING: A hybrid research methodology was used. Social network analysis was used to reveal the positions of the nurses (n = 126) in the positive and negative networks. A statistical model was formed with varying types of centrality measures, intragroup conflict, and intention to leave variables. The data was collected from all the nurses working in a special branch hospital. RESULTS AND CONCLUSION: The findings of the study clearly indicate that negative interactions directly and indirectly affect the intention to leave, and the nurses demand professional support from their colleagues. The findings also show the existence of a fragmented social structure among nurses, which suggests the increased importance of brokerage roles. Managers should closely monitor the negative interactions among nurses, and they need to use conflict management techniques frequently to reduce hostile relations in the business environment. Managers should especially seek ways to increase altruistic tendencies among colleagues because nurses demand professional support ties more than friendship relations.
... As employees are vital for organizations, employee turnover is a subject matter that is considered to be one of the most serious obstacles to face organizations. It results from combinations of work conditions, organizational and psychological factors interacting with each other to influence employee attitudes in and toward the organization (Raquel & Ana, 2012). In line with Newstorm and Davis (1993), attitudes are practically good predictors of behaviors. ...
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For any organization, the most important challenge is to retain a talented workforce. In order to retain a talented workforce, it is very important to identify factors that affect the intention of employees to leave. Thus, this study examines the effect of work-related attitudes on turnover intention in terms of academic staff context. 334 academic staff were selected as a sample using a stratified random sampling technique. The study was an explanatory design and the required data was collected through adopted questionnaires from prior studies. The obtained data were analyzed using descriptive and inferential statistics. To do so the statistical packaging for social science (SPSS) version 20 was utilized. The descriptive result indicates that the participant’s level of work-related attitudes was low whereas their level of turnover intention was high. Moreover, the results obtained through T-test and ANOVA showed that there were significant differences in the level of turnover intention based on selected demographics and thus have a varying effect on turnover intention. According to the multiple regression results, the best predictor of turnover intention was affective commitment and the insignificant predictor was continuance commitment.
... In agreement with Greenberg (2011), Mostert, Rothmann, Mostert, and Nell (2008) raised a concern that work stress is often viewed as a problem of the individual, however, it should be viewed as a serious problem for the institution as a whole. It has also been revealed that twothirds of sick leave in organisations may be attributed to organisational stress and that high levels of organisational stress may lead to mental and physical ill health, job dissatisfaction, absenteeism, performance deficits, stress-related injuries, turnover and intention to quit (Moreno-Jiménez, Gálvez-Herrer, Rodríguez-Carvajal & Sanz-Vergel, 2012;Bhaga, 2010: 52;Campbell, Lawrence, Spiehler and Williams 2009:4). It is important to note that work stress is restricted to the work environment, is caused by work-related aspects and has consequences for the work context (Viljoen and Rothmann 2009). ...
... Finding is in agreement with Greenberg (2011), Mostert, Rothmann, Mostert and Nell (2008) submitted that work stress is often viewed as a problem of the individual, however, it should be viewed as a serious problem for the institution as a whole. It has also been revealed that two-thirds of sick leave in organisations may be attributed to organisational stress and that high levels of organisational stress may lead to mental and physical ill health, job dissatisfaction, absenteeism, performance deficits, stress-related injuries, turnover and intention to quit (Moreno-Jiménez, Gálvez-Herrer, Rodríguez-Carvajal, &Sanz-Vergel, 2012;Bhaga, 2010: 52;Campbell, Lawrence, Spiehler and Williams 2009:4). Johnson (2010) categorised work stress as physical and psychological work stress. ...
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The paper investigates work stress and information anxiety of library personnel in academic libraries in South-west, Nigeria. The research design adopted for the study was survey method of the correlational type. Simple random sampling technique was used to select a sample population of 308 (60% of the population) out of 703 library personnel in academic libraries in South-west, Nigeria. The findings of this study revealed that the level of work stress of the library personnel is moderate with a mean score X = 52.45; SD=7.366. The level of information anxiety of is also moderate with mean score X=36.87; SD= 6.370. SPSS was used to analyse the data. Delivery of information and service are essential task of library personnel and this must be done efficiently and effectively if the profession is to remain afloat. To this effect, it has been recommended that the academic library managers in South-west, Nigeria should endeavour to sponsor and organise seminars, workshops and conferences for library personnel. This will keep the library personnel abreast of the modern trends and development in academic libraries and thus encourage them to embrace such development to reduce their level of information anxiety. Break time, well-furnished environment, adequate working equipment’ tools, job rescheduling among others will go a long way in helping to alleviate stress in the work environment. The study contributes to literature due to the fact that the project will be useful for other researchers in similar study. Likewise the study provides fresh data for policy makers on ways to reduce work stress.
... More importantly, burnout among healthcare workers has been related with expanded rates in the intent to leave medical profession as well as with higher rates of job turnover [40]. Several studies have associated burnout with one's intention of leaving the profession [41,42]. Results of a survey conducted in Saxony, Germany showed that scores on subscales of emotional exhaustion and depersonalization were associated with an increased chance to wishing to go abroad for clinical work [40]. ...
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Objectives: The aim of this study was to assess the validity and reliability of the Serbian versions of the Copenhagen Burnout Inventory (CBI) and the Study Burnout Inventory (SBI) among fifth-year medical students at 5 universities in Serbia. Material and methods: The study included 573 fifthyear medical students at 5 universities in Serbia. The research instrument consisted of SBI and CBI. The reliability of these instruments was assessed using an internal consistency measure (Cronbach's α), an intra-class coefficient (ICC) and factor analysis. Results: Cronbach's α for SBI was 0.83, including for exhaustion 0.73, for cynicism 0.70, and for inadequacy 0.48. The test-retest reliability (ICC) was 0.75. Cronbach's α for personal burnout on CBI was 0.89, for the faculty-related burnout 0.86, and for the faculty-members-related burnout 0.92. Cronbach's α for CBI was 0.93. The factor analysis for SBI showed 2 factors and for CBI 3 factors. Conclusions: This study revealed that the Serbian versions of both SBI and CBI could be used for the assessment of burnout in this population.
... Broad research has demonstrated that the prevalence of burnout syndrome and its negative consequences among healthcare professionals and, concretely, among residents, are high [13,[37][38][39][40]. In recent years, the main focus of studies on burnout among residents has been determining work-related factors that could contribute to improve the working environment of the residents, which would result in an important reduction in the levels of burnout, in errors in the clinical practice and, therefore, in an improvement in the quality of care [13,15,41,42]. ...
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... In this emerging pragmatism-based model of the DPR, there is evidence of growing mutual distrust between doctors and patients, more incidents of impersonal and ineffective communication and more short-lived and transactional relationships (Ma et al., 2017). Poor DPR not only negatively impacts upon the patient care and patient satisfaction (Wang et al., 2016), but also affects doctors' wellbeing and work attitudes such as their levels of work engagement and turnover intentions (Moreno-Jiménez et al., 2012). ...
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In the increasingly commercialized healthcare environment in China, doctor-patient relationship (DPR) is a job demand for doctors that is linked to various motivational outcomes. Drawing on the Job Demands–Resources (JD-R) model, and the conservation of resources theory, we develop a preliminary conceptual model that links Leader Member Exchange (LMX) as a job resource, and DPR as a challenge job demand, to the levels of work engagement and turnover intentions of doctors working in this healthcare environment. Using two-wave data collected from 381 doctors in a public hospital, we found support for the hypothesized model. Results of a series of SEM analyses revealed that LMX was positively related to DPR and work engagement, while DPR partially mediates the path from LMX to work engagement. In addition, LMX is negatively related to turnover intentions through DPR and subsequently work engagement. Theoretically, this study contributes to the development of the JD-R model by investigating the concept of challenge job demand, and its role in the motivational process, with new evidence from healthcare occupations in China. Practically, this study contributes to the limited number of studies on managing the changing nature of the DPR in China, and in seeking potential solutions based on established organizational constructs.
... According to the conservation of resources (COR) theory (Hobfoll, 2001), as affective commitment to the organization decreases, individuals tend to develop a tendency to seek new jobs to prevent continued loss of resources. Therefore, a decrease in affective commitment results in turnover intention among nurses (Moreno-Jiménez & Gálvez-Herrer, 2012). In conjunction with the previous arguments, we propose the following hypotheses: ...
Article
This study aimed to elaborate on the mechanism by which workplace ostracism influences turnover intention through exploring the sequential mediation effects of emotional labour and nurse-patient relationship. Using a sample of 379 nurses collected from a time-lag survey in a tertiary public hospital in China, we applied structural equation modelling techniques to test our hypothesized model. Our findings revealed that workplace ostracism positively influenced surface acting and deep acting. Workplace ostracism influenced turnover intention through the sequential mediation of surface acting and nurse-patient relationship. The findings of this study imply that nurses should receive education and training in emotional management skills to deal with workplace ostracism. Besides, fostering positive nurse-patient relationships may help reduce nurses’ turnover intention.
... As such, it is having a substantial impact on the working conditions and psychological pressure experienced by medical personnel [68,69], and it is likely to lead to work fatigue [70]. Studies [71,72] have pointed out that the doctor-patient relationship is also an important factor affecting the resignation or career choices of medical personnel. Therefore, we proposed that the character, trust in PMHCIs, and respect for medical personnel could reduce work pressure and increase enthusiasm and job-related well-being. ...
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In some countries, including China, primary health care is rarely utilized because of medical personnel shortages at primary medical and health care institutions (PMHCIs). Several studies suggest that the most effective solution is to guide qualified doctors and medical graduates to work in PMHCIs, but the studies and measures have been formulated only from the perspective of the government and PMHCIs; few have considered the subjective willingness of medical personnel. Therefore, it is necessary to explore the measures to develop human resources of PMHCIs from the guiding object. This research was divided into two parts based on implicit theory and a lexical approach. The first part collected the factors affecting their choosing PMHCIs for employment, and the second part used exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM) to explore the dimensions and paths of the influencing factors. At last, seven factors were obtained from the EFA, and the SEM hypothesis fit the data well. Internal Organization Development, Patient Factor, Remuneration and Development, and Family Support had a significantly positive effect on the Sense of Gain of medical personnel seeking employment at PMHCIs, whereas both Job Responsibilities and Condition of the City Where the PMHCI Is Located had no significant effect. In addition, the indirect effects of Internal Organization Development and Condition of the City Where the PMHCI Is Located on the Sense of Gain were significant. The Patient Factor, Family Support, and Remuneration and Development significantly mediated the relationship between the internal and external environment of the institution and the Sense of Gain, whereas the mediating effect of Job Responsibilities was not significant. The improvement of family support, remuneration and development, and patient factors increase the willingness of medical personnel to seek employment at PMHCIs. In addition, the internal and external environments of a PMHCI play a vital role in guiding medical personnel to PMHCIs for employment. This research provides theoretical support for improving the development of human resources, guiding medical personnel to work in PMHCIs, and promoting the use of primary care services.