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Predictors of turnover intention in the non-government alcohol and other drug sector
Abstract
Background: Effective delivery of alcohol and other drug (AOD) treatment is reliant on a skilled, experienced, and satisfied workforce. The need to recruit and train workers is universally acknowledged. It is equally important to retain staff, given global shortages of health and human services workers. As few studies have investigated predictors of turnover in the AOD sector, this study examined a range of potential work-related predictors.
Methods: An online survey of 294 non-government AOD workers addressed demographics, health, wellbeing, organizational characteristics, and working conditions. Bivariate analyses were performed, followed by a hierarchical linear regression.
Results: The bivariate analysis found significantly higher turnover intention among workers who were younger, believed they were inadequately paid, on fixed-term contracts, had poor work-life balance, were dissatisfied with the non-government AOD sector, and had high workloads. In the subsequent linear regression significant predictors of turnover intention were dissatisfaction with the sector, high workloads, and tenuous employment status.
Discussion: These findings can inform retention strategies including greater provision of permanent contracts and more manageable workloads. Reported sector dissatisfaction warrants further examination. Prioritizing retention as a core workforce development strategy may help retain trained and experienced workers, maximize return on investment and enhance provision of quality care.
... The purpose of this paper is to examine factors associated with one of the most challenging issues: turnover intention in the casino industry. While research on turnover intention is some of the most robust literature, each industry has unique working conditions and unique stressors (e.g., Lee and Kim, 2020), such as nurses (Labrague et al., 2020), teachers (Addai et al., 2018), and even alcohol treatment workers (McEntee et al., 2021). The same is true for the distinctive sample of front-line casino workers, who face concerns about morality (Lai et al., 2013), job requirements, and the ability to regulate emotional suppression among gambling customers (Taormina and Kuok, 2009). ...
... Organizational contextual factors may be more influential on turnover intention than individual factors (Oluwafemi, 2013). For example, Cohen et al. (2015) found that satisfaction with remote working arrangements negatively affects turnover rates and Yanchus et al. (2017) found that supportive work environments may similarly help, while high workloads and poor work-life balance may lead to higher intentions (McEntee et al., 2021). Many studies investigate both individual-and organizational-level factors when assessing turnover intention (e.g., Van der Heijden et al., 2018). ...
Employee turnover intention is huge challenge for employers, especially in the highly stressful service industry. This study surveyed 1,236 front line casino employees across 29 organizations in Macau, the Casino paradise. Findings reveal that emotional intelligence (EI) plays a crucial role in allowing employ-ees to cope with environmental demands and pressures successfully. Our results demonstrate that job sat-isfaction and occupational commitment can relieve the turnover intention of employees. Additionally, we investigated the moderating effect of an internal service climate (ISC) that is an organizational contextual factor (including psychological environment and re-sources available for employees). Our findings suggest that when the ISC is high, satisfied and committed employees have lower turnover intentions. ISC offers a well being and supportive environment that helps bring down the turnover intention in the very stressful service industry. Our study recommends that companies should provide a positive ISC for employees to reduce turnover intension among employees.
... Individual characteristics are also related to burnout and turnover intention. Many studies show that younger counselors have higher levels of burnout, which is typically operationalized as emotional exhaustion (Baldwin- White, 2016;Ducharme et al., 2007;Knudsen et al., 2006;McEntee et al., 2021;McNulty et al., 2007;Rothrauff et al., 2011;Skinner & Roche, 2021b;Vilardaga et al., 2011). Those with higher education also tend to have higher emotional exhaustion and turnover intention (Ducharme et al., 2007;Knudsen et al., 2003Knudsen et al., , 2006McEntee et al., 2021;McNulty et al., 2007;Yang & Hayes, 2020). ...
... Many studies show that younger counselors have higher levels of burnout, which is typically operationalized as emotional exhaustion (Baldwin- White, 2016;Ducharme et al., 2007;Knudsen et al., 2006;McEntee et al., 2021;McNulty et al., 2007;Rothrauff et al., 2011;Skinner & Roche, 2021b;Vilardaga et al., 2011). Those with higher education also tend to have higher emotional exhaustion and turnover intention (Ducharme et al., 2007;Knudsen et al., 2003Knudsen et al., , 2006McEntee et al., 2021;McNulty et al., 2007;Yang & Hayes, 2020). Other factors, including gender and race, however, have not been consistent predictors of burnout or turnover and require further study. ...
Counselor turnover is a serious problem for substance use disorder (SUD) treatment programs, especially in rural areas. This study examined the relationship between workload, workplace environment, and emotional exhaustion on turnover intentions among SUD treatment counselors in rural Pennsylvania. An online, anonymous survey was administered to rural SUD treatment counselors in Pennsylvania between October and December 2020. Completed surveys from 206 counselors were used for analysis. Variables included multi-dimensional measures of emotional exhaustion, intention to quit, workload, and workplace environment. Results showed age, perceptions of distributive justice, and management communication to be inversely related to emotional exhaustion and intention to quit. A subsequent analysis showed that the direct effects of these variables on intention to quit were reduced with the inclusion of emotional exhaustion in modeling, suggesting a potential mediation effect. Findings indicated that higher levels of emotional exhaustion were directly related to a greater intention to quit. A statistically significant indirect relationship was also found for distributive justice on intention to quit through emotional exhaustion, indicating a significant mediating effect. While counseling is a stressful occupation with high potential for burnout, these results show that organizations can adopt practices that help lower emotional exhaustion and turnover intentions for their counselors which could improve retention in the SUD treatment field. This is especially important for rural areas, where there is a high demand for SUD services and not enough treatment workers to meet that demand.
... Around half (51.4%) reported seven or more years' AOD work experience. While accurate demographic data on the Australian AOD workforce is not available, this profile is consistent with previous surveys [8,38]. ...
... The four wellbeing states explored in this study mirror this complexity and indicate that programs and strategies to prevent burnout and support engagement are priorities to ensure the health and sustainability of the AOD workforce, and the capacity of the workforce to deliver high quality services. Many workforce development challenges facing the AOD field are well documented including the ageing of the workforce [38,43]. Strategies to prevent burnout in younger workers is a particular priority to ensure the future sustainability of the workforce. ...
Introduction:
Alcohol and other drug (AOD) work can be highly meaningful and satisfying, but also intense and highly demanding. This combination often creates significant strain for workers. Mirroring this complexity, this study considered the predictors and outcomes of the concurrent experience of burnout and engagement in AOD workers. The Job Demands-Resources model informed the study.
Methods:
This study utilised data from a recent Australian AOD workforce survey. The sample comprised 886 workers in direct client service roles. K-means cluster analysis on burnout and engagement measures identified four discrete groups: burnt out (15.6%) (high burnout/low engagement), engaged (36.7%) (low burnout/high engagement), overextended (26.5%) (high burnout/high engagement) and indifferent (21.2%) (low burnout/low engagement).
Results:
Multinomial logistic regression analysis indicated that workers were more likely to be burnt out or overextended, rather than engaged, if they reported high work intensity, low organisational openness to change and low support. Multivariate analysis of variance showed burnt-out workers had the least favourable and engaged respondents the most favourable outcomes on job satisfaction, turnover intention, health and life quality. Overextended workers were comparable to indifferent workers on these outcomes.
Discussion and conclusion:
This study offers a unique and nuanced view of AOD worker wellbeing. For the one-quarter of workers reporting simultaneous burnout and engagement, their enthusiasm and commitment did not protect them from poor personal and organisational outcomes typically linked with burnout. The need for systemic and structural interventions is clearly indicated, including open and supportive organisational cultures, leadership development and adequate staffing.
... Qureshi et al. (2013) suggest that workload has a positive effect on turnover intention. Similar research was conducted by McEntee et al. (2021) which show the results that workload, in the same direction, has a very strong influence on turnover intention. Based on these findings, the following hypothesis is formulated: H1: Workload significantly influences turnover intention. ...
The aim of the current study is to investigate the role of job satisfaction as a mediating variable from the influence of workload, work stress and organizational climate on turnover intention. This study utilizes a questionnaire as a data collection instrument, a total of 116 questionnaires were obtained from employees of Bank BTN Syariah Malang (BTN Islamic Banking of Malang). Structural equation model (SEM) based on partial least squares (PLS) was employed as a method to analyze the data. The present study found a significant effect between workload and work stress on job satisfaction and turnover intention. However, organizational climate does not support the proposed hypothesis that organizational climate does not show a vital role in predicting job satisfaction and turnover intention. Furthermore, job satisfaction convincingly affects employees’ intention to leave. Finally, job satisfaction is proven to be a mediator of the influence of workload and work stress on turnover intention. However, unexpectedly, job satisfaction did not mediate the relationship between organizational climate and turnover intention.
... It is also commonly referred to as practice or professional supervision, particularly in communitybased treatment settings [15]. The AOD sector is characterised by several distinct but related challenges, including: the varied mix of skills, experience, qualifications and knowledge of the workforce [16]; diverse and complex client cases [17,18]; difficulties recruiting and retaining workers [19]; limited professional development opportunities [20]; and high rates of stress and burnout among workers [16]. Together, these factors underpin the need for AOD workers to receive effective clinical supervision. ...
Introduction:
Internationally, clinical/practice supervision is considered essential in the development and maintenance of professional proficiency across health disciplines. Among alcohol and other drug (AOD) workers, however, access to effective clinical supervision is limited. This study examined perceived barriers and facilitators to: (i) AOD workers accessing effective clinical supervision; and (ii) effective implementation of a clinical supervision exchange model in the AOD sector.
Methods:
Qualitative interviews with frontline workers (n = 10) and managers (n = 11) employed by eight government and non-government AOD treatment services in Brisbane, Australia were undertaken. Interviews were audio recorded, transcribed and data were thematically analysed.
Results:
Frontline workers and managers shared similar views. Reported barriers and facilitators to accessing effective clinical supervision included limited time, the high cost of providers, availability of skilled clinical supervisors, supervisor-supervisee matching and supervision modality. Participants considered the implementation of a clinical supervision exchange model to be a resource-effective strategy to increase access to external, individual clinical supervision while also exposing workers to a greater diversity of perspectives, increasing sector collaboration and improving the perceived value of clinical supervision among the workforce.
Discussion and conclusions:
The findings of this study suggest that limited time, cost and availability of skilled supervisors are primary barriers to AOD workers accessing high-quality clinical supervision. Implementation of a clinical supervision exchange model is perceived by frontline workers and service delivery managers to be a resource-effective strategy for increasing access to high-quality clinical supervision among workers.
... First, an employee feels dissatisfied with the job, develops a thought process about quitting the job, estimates the cost of leaving the current job, looks for available alternatives, and finally decides to stay or quit after careful evaluation of all alternatives (Mobley, 1977). Turnover intentions are the predecessor of turnover as behavioral intentions predict the actual turnover (Bothma & Roodt, 2012;Mobley, 1977;Kim, 2014;Jeswani & Dave, 2012;McEntee et al., 2021). It was also argued that turnover intentions specify the employee attitude about the current job, and it is developed during a specific period after a complete thought process (Tett & Meyer, 1993;Chiu & Francesco, 2003). ...
Employee turnover is a major concern for organizations. Specifically, among private business schools, it is proved to be one of the major impediments in carrying out academic activities. This phenomenon creates a conundrum for both college administrations and students. Therefore, each academic unit must work to minimize employee turnover. This study aims to identify the elements that influence academicians’ turnover intentions and the ways to negate them. It used a random sample of 236 academicians (professors, assistant professors, associate professors, and lecturers) from various business schools in India. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to analyze the sample. In addition, the structural equation modeling (SEM) approach was used to examine the hypotheses. All variables studied had high loadings of 0.50 or more in CFA. The research model was shown to be fit on three important absolute fit indices: absolute, incremental, and parsimonious. The regression weights of hypotheses were also determined to be significant. The findings indicate that organizational support, compensation, and personnel management had a detrimental effect on turnover intentions at business schools. These results can be used by college administration and management in devising interventions that will assist them in retaining existing talented staff and avoiding the negative repercussions of future turnover.
... Staff turnover has been identified as a workforce development priority for AOD organisations and the broader sector (Gallon et al., 2003;McEntee et al., 2020). Estimates of AOD treatment staff turnover rates range from 25 to 33% annually (Eby et al., 2010;Gallon et al., 2003;Garner et al., 2012) up to 47% for counsellors after 4 years (Eby & Rothrauff-Laschober, 2012). ...
Alcohol and other drugs (AOD) work is rewarding and demanding, creating challenges for workforce sustainability. This study examined two key occupational groups within the AOD workforce: nurses and counsellors. Cross-sectional data from an Australian online survey of the AOD workforce was analysed to identify the socio-demographic and organisational factors that predicted job satisfaction and turnover intentions. Around half of nurses and counsellors were satisfied with their jobs, with the majority satisfied with the AOD sector. For both groups, job and sector satisfaction were positively associated with feeling respected and supported and working in an environment open to change. Satisfaction was the strongest predictor of job and sector turnover intentions for both groups. This study suggests that AOD nurses’ and counsellors’ job satisfaction and retention would be improved with more opportunities to explore innovation, and a great focus on workplace cultures of respect and support.
... For example, previous research showed that low work-related satisfaction among clinicians was associated with negative attitudes towards inpatients [15,16], and diminished service quality [17,18]. Factors such as high workload [8], rapid turnover [19,20], and low social support among the employees [5,21,22] have been associated with lower work-related satisfaction in SUD and mental health services. Additionally, conflicting expectations between inpatient and employers may burden healthcare clinicians and influence their work-related satisfaction adversely [23]. ...
Several psychosocial factors have been suggested as facilitators of change among inpatients treated for substance use disorder (SUD). Research suggests that staff members are also influenced by the practice in which they are involved, and by contextual psychosocial factors at their treatment facilities. This cross-sectional questionnaire survey study was conducted to investigate the role of recovery-orientated interventions in describing work-related satisfaction among clinicians at inpatient SUD treatment facilities. The respondents (n = 407) rated items indicating work-related satisfaction and the degree of recovery orientation at their treatment facilities. The main findings of two block regression analyses indicated that clinicians’ work-related satisfaction was positively influenced by inpatients’ opportunities to pursue their goals and choices, and negatively influenced by inpatient involvement. The change in clinicians’ work-related satisfaction could not be described by the degree of individually tailored and varied interventions at the treatment facility. Clinicians should be supported and involved in the process of implementing measures to increase inpatient involvement in the treatment programmes, and treatment measures that enable inpatients to pursue their goals and choices should be enhanced. The findings of this and previous studies indicate that a recovery-oriented framework promotes clinicians’ work-related satisfaction and has an enabling influence on both inpatients and clinicians.
The purpose of this dissertation has been to contribute knowledge about psychosocial factors that enables mastery for patients during the transition from inpatient SUD treatment to everyday life after discharge.
Published version can be found here (Norwegian): https://skriftserien.oslomet.no/index.php/skriftserien/article/view/759
In Australia, there is no standardised approach to measuring performance of alcohol and other drug (AOD) treatment services. Non-government organisations (NGOs) that provide AOD treatment in Australia manage contracts from multiple funding sources, with performance measures varying between funders. They have reported a high reporting burden and inconsistent expectations from different funders to demonstrate accountability. The primary aim of this thesis was to establish a list of performance measures that are acceptable to service users, treatment providers, and funders; explore approaches to improve implementation of performance measures; and make recommendations to funders of non-government AOD treatment. The research approach involved three phases: 1) an assessment by three independent raters of existing measures used in contracts against best practice; 2) focus groups with service users, treatment providers, and funders (n=10 focus groups) to identify the most important performance measures among diverse stakeholders and explore the challenges associated with implementation; 3) a Delphi process with a purposeful sample of service users, treatment providers, and funders to prioritise a core set of performance measures. Phase One found over 500 unique measures used in contracts for AOD treatment services, with most not adhering to best practice. Further, the majority were output and process measures. In Phase Two, focus groups identified that access, outcome, and experience measures were the most important measurement types across all stakeholder groups, with structural measures also important to service users. In Phase Three, 17 performance measures reached consensus. In contrast to Phase One, the final set were mostly outcome, access, and structural measures (n= 11/17) with only one measure each for output and process. Further, key findings from the focus groups highlighted that identification of measures is only part of a robust performance measurement system. Support systems for collecting, analysing, interpreting, and reporting performance data are also needed. At the policy-level, implementation of the final set of measures can improve accountability of public funds, and support the collection of standardised performance-related data to inform funding decisions and treatment planning. At the practice-level, the measures have the potential to reduce reporting burden, improve organisational efficiency, and inform quality improvement initiatives.
With limited studies on antecedents and consequences of work engagement with special reference to NGOs, two novel antecedents of work engagement, namely workload (job demand) and proactive personality (personal resource) are introduced in the study. By drawing on the revised JD-R model, the study empirically examines the indirect effects of job demands, job resources, personal resources, and ideological resources on organizational outcomes, i.e. intention to quit and organizational citizenship behaviour through work engagement in NGOs. The data collected from paid employees of registered NGOs operating in India were analysed using structural equation modelling. The study reveals that workload does not decrease employees' work engagement in NGOs. Whereas employment insecurity was negatively associated with work engagement. Besides, transformational leadership, intrinsic rewards, community service self-efficacy, proactive personality, and public service motivation played a vital role in fostering work engagement in NGOs. Furthermore, work engagement was negatively associated with the intention to quit and positively associated with organizational citizenship behaviour.
Human services, such as social supports and health care, have low contractibility; services are difficult to specify and measure, and difficult to manage when delivered by a third party. Services can and do fail, resulting in the inefficient use of public resources and potential harm to clients. This article develops a conceptual framing using transaction cost economics (TCE) theory to understand why human services are difficult to contract, and management control theory to understand how services might be managed. This identifies a potential tension between how low contractible services are managed when probity requirements are high. This is explored using a qualitative case study of an intermediary model of outsourcing, focusing on one of 31 Primary Health Networks tasked to commission primary health care under contract to the Australian Government. This study explains how design choices, making use of controls available in different organisational contexts across the intermediary model, overcame the tension between low contractibility and probity. This study adds to our understanding of the TCE characteristic of probity. A greater understanding of why this intermediary model works has the potential to help policy makers and service managers improve the way human services are outsourced. This paper explains why the delivery of complex human services by third parties is difficult to manage. A case study of a Primary Health Network is used to explain how an intermediary model can overcome some of these difficulties.
Introduction
There is growing interest in the role of the non‐government sector in the alcohol and other drug (AOD) service delivery system. This study examined the demographic profile of AOD workers in the non‐government (NGO) compared to government sector, to ascertain their professional development needs, job satisfaction, retention and turnover.
Methods
This study utilised cross‐sectional data from an Australian AOD workforce online survey that assessed participants' demographics, employment profile, professional development needs and barriers. The sample comprised 888 workers in direct client service roles.
Results
Binomial logistic regression analysis indicated that NGO workers were more likely to be younger (<35 years), have AOD lived experience and have an AOD vocational qualification. NGO workers were more likely to earn below the national average salary and report job insecurity; but nonetheless were more likely to feel respected and supported at work, believe their work was meaningful and be satisfied working in the AOD sector. Their top professional development barrier was personal financial cost. NGO workers were more likely to report employer financial costs as a professional development barrier, whereas government workers were more likely to report staff shortages.
Discussion and Conclusions
AOD services in Australia rely increasingly on the NGO sector. Quality services and care pivot on the size, capability and maturity of the workforce. This study highlights the need for systemic interventions addressing structural issues, and the professional development and ongoing support needs of the NGO AOD workforce. Without such support, Australia's AOD services will be potentially jeopardised.
Objective:
Older workers are increasingly prevalent in health and human services, including the alcohol and other drug (AOD) sector. Their turnover intentions have important implications for service system stability and retention.
Methods:
Descriptive and regression analyses of survey data examined age-related differences (<50, ≥50 years old) in non-government workers' demographic, health and professional profiles and predictors of turnover intention.
Results:
Older workers (≥50 years, n = 86) comprised one-third of this workforce. Compared to younger workers (n = 164), they experienced greater discrimination but higher work-life balance and work engagement. Turnover intention was predicted by job satisfaction, discrimination and work engagement.
Conclusion:
Older workers' well-being and workforce retention are essential for effective leadership, succession planning and service continuity. Their needs and retention motivations are identified. Age-specific support mechanisms, proactive retention and anti-discrimination strategies are identified priorities.
The aim of this study is to examine the effect of remuneration on the level of commitment of full-time restaurant staff working in Hotel industry of Malaysia. This study also looks into the moderating effect of Special Peer Support (SPS) on the relationship between remuneration and employee commitment (EC). Data were collected from 380 full time employees working in large scale restaurants of Malaysia. Smart PLS-2 software was used to analyse the data. The findings reveal that there exists a significant and positive impact of remuneration on EC. Moreover, the results also indicate that SPS moderates the remuneration and EC relationship. The findings of the current study suggest that the practitioners and policy makers should increase the level of employee commitment through enhanced remuneration for the purpose to achieve organizational objectives.
Background
Burnout and employee turnover in mental health services are costly and can have a negative impact on service user outcomes. Using the Job Demands-Resources model as a foundation, the aim of this study was to explore the relationships between burnout, turnover intention and job satisfaction in relation to specific job demands and job resources present in the workplace in the context of one Australian mental health service with approximately 1100 clinical staff.
Methods
The study took a cross-sectional survey approach. The survey included demographic questions, measures of burnout, turnover intention, job satisfaction, job demands and job resources.
Results
A total of 277 mental health personnel participated. Job satisfaction, turnover intention and burnout were all strongly inter-correlated. The job resources of rewards and recognition, job control, feedback and participation were associated with burnout, turnover intention and job satisfaction. Additionally, the job demands of emotional demands, shiftwork and work-home interference were associated with the exhaustion component of burnout.
Conclusion
This study is the largest of its kind to be completed with Australian mental health personnel. Results can be used as a foundation for the development of strategies designed to reduce burnout and turnover intention and enhance job satisfaction.
Electronic supplementary material
The online version of this article (10.1186/s12913-018-3841-z) contains supplementary material, which is available to authorized users.
Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change.
High number of turnover rate among employees signals a major weakness towards organizations achievement. This is due to the fact that employees are the key player to determine organizational performance and survival. This study attempts to determine the turnover intention among employees. Employees of Woongjin Coway (M) Sdn Bhd were chosen as subject of interests. Data was collected through questionnaire to 106 employees from four different branches located in the Klang Valley namely Ampang, Cheras, Petaling Jaya and Klang. Stratified random sampling was utilized to reach the minimum number of samples required in this study. SPSS was employed as a tool to aid in analysis of findings. The findings from the study revealed that only two factors namely available job alternatives; and work-life balance have significant impact on employee turnover intention.
Keywords: Turnover Intention, Employee Turnover
This study examined the extent to which changes over time in clinicians' responses to measures of work attitude (eg, job satisfaction) and psychological climate (eg, supervisor support) could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians (N = 96) being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity) explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction.
A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
Aims: A national study was conducted to investigate the extent and nature of job attitudes and well-being of specialist alcohol and other drug (AOD) workers in Australia. As part of that larger study, work stress and job satisfaction and their relationship with turnover intentions were examined. Method: A postal survey measuring working conditions, work stress, job satisfaction, turnover intention and key demographics among specialist frontline workers from AOD treatment services across Australia was undertaken. A total of 1345 responses from workers in 369 participating AOD treatment services were obtained. Findings: Although the majority of workers were satisfied with their jobs, one in five workers reported above average levels of stress. One in five workers also expressed intentions to leave the AOD field. Significant predictors of higher turnover intention were low job satisfaction, high work stress, low workplace social support and negative attitudes towards remuneration. Conclusion: This study was the first attempt to collect empirical data on levels of stress and job satisfaction among the Australian specialist AOD workforce. The findings presented here focus on work stress and job satisfaction and their association with turnover intention. The results indicate cause for concern and have important implications for the development of strategies to minimize turnover and improve the well-being of specialist AOD workers in Australia.
Problems of retention and turnover of allied health professionals are under-researched. A longitudinal (two-year) study of four allied health professions (AHPs) in the British health-care system sampled from three categories – stayers, leavers and returners. Qualitative data identified respondents' (n = 1925) own reasons for staying within the National Health Service (NHS), leaving it or returning to it. Data at the second stage of the study (n = 719) additionally identified reasons for staying in non-NHS employment. Responses show key differences among stayers, leavers and returners for their employment choice decisions. Differences between AHPs in the NHS and those working outside it are also identified. Longitudinal data revealed the influence of the changing employment context on employment choice decisions. Findings are related to the policy context and relevant theoretical literature. Recommendations for future research, particularly focusing on stayers so as to enhance retention strategies, are made.
Purpose - to investigate the relationships between organizational identification, job satisfaction and turnover intention.
Design/methodology/approach - extends social identity theory to employee identification with their organization, discusses the effect of organizational identity on job satisfaction, suggests that strong identification with the organization enhances motivation and positively influences job satisfaction, and depicts a model that links organizational aims and identity, employee organizational identification, job satisfaction, and job and task characteristics, to turnover intention and actual turnover. Validates the model by questionnaire survey of 358 German bank employees, 107 employees of a second German bank, 211 call-centre employees and 459 hospital employees.
Findings - confirms that strong organizational identification does positively influence job satisfaction, finds this relationship in all four samples, and reports that employees who had left their organizations registered higher turnover intentions, lower identification and lower job satisfaction than colleagues remaining with the organization.
Originality/value - demonstrates that managers need to create a sense of belonging.
The increasing demand for alcohol and other drug (AOD) treatment services among the Australian Indigenous population, complex organisational challenges and limitations, and high unemployment rates are likely to negatively impact Indigenous AOD workers' health and well-being. Building the capacity of Indigenous AOD workers is vital, as they play a crucial role in the delivery of treatment services and offer essential support to their communities. A national online survey was conducted to examine organisational, workplace and individual factors that might contribute to levels of stress and well-being among workers who provide services to Indigenous clients. A total of 294 eligible surveys were completed; 184 (63%) from Indigenous and 108 (37%) from non-Indigenous AOD workers. Multiple regression models were conducted to assess the significant predictors of mental health and well-being, job satisfaction, emotional exhaustion, and turnover intention. Indigenous AOD workers typically experienced above average levels of job satisfaction and relatively low levels of emotional exhaustion. However, 1 in 10 reported high levels of emotional exhaustion, a key predictor of turnover intention. Indigenous workers also experienced significantly lower levels of mental health and well-being and greater work/family imbalance, which was a significant contributor to emotional exhaustion. The findings highlight the importance of implementing workforce development strategies that focus on achieving culturally appropriate, equitable and supportive organisational conditions for Indigenous AOD workers. Preventing or managing levels of stress, ensuring adequate and equitable salaries and benefits, and providing more opportunities for career and personal growth may increase job satisfaction and reduce turnover intention among Indigenous workers in the drug and alcohol field.
A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
Background
The alcohol and other drugs (AOD) workforce faces multiple challenges including stigma, limited resources, ideological conflicts and complex demands. An engaged, supported and stable workforce is essential for optimal service provision, quality care, effective harm reduction implementation and cost efficiency. However little research has examined factors that impact worker engagement in the AOD sector. To inform policy and practice on cost efficient service provision and effective workforce development, this study examined a range of potential predictors of work engagement among Australian AOD non-government workers.
Methods
An online, cross-sectional survey of 294 non-government AOD workers measuring demographic, work-related psychosocial, and health and wellbeing variables was conducted in New South Wales, Australia. Multiple hierarchical linear regressions were conducted to identify significant predictors of worker engagement.
Results
Most AOD workers demonstrated high work engagement levels. Significant predictors of engagement included role clarity, leadership quality, growth opportunities, resilience and social support, and older age. These workers were likely to be more energised, enthusiastic and dedicated in their jobs.
Conclusions
This study is an important initial step in understanding work engagement among AOD workers. It offers valuable insights into ways to foster engagement, which in turn may ensure a more sustainable workforce that can deliver high quality care. Workers with high levels of engagement are more likely remain in their AOD roles over longer periods of time, acquire more skills and experience, and be better equipped to address complex demands. Workforce policies and programs specifically designed to enhance leadership skills and role clarity, while enhancing professional growth, resilience, and social supports, particularly for younger workers, are highlighted as essential strategies to promote engagement among AOD workers.
While there is a long-standing and commonly held belief that the characteristics of the alcohol and other drug (AOD) workforce and workplace can impact client treatment outcomes, the available literature has not been systematically reviewed to date. Knowing which characteristics may impact treatment outcomes can help maximise workforce development in AOD services. A systematic review was undertaken, to identify studies of five clinician and organisational workforce characteristics: (1) years of clinical experience; (2) level of education/qualifications; (3) staff turnover; (4) staff-to-client ratio; and (5) professional development, and their relationship to client treatment outcome. Each study was assessed for quality using the Cochrane risk of bias tool. The search identified 1317 records; only 12 studies directly examined the relationship between clinician and organisational workforce characteristics and AOD treatment outcomes. Our analysis revealed a limited number of studies, a lack of high-quality research, and highly variable evidence regarding the relationship between clinician and organisational characteristics, and treatment outcomes. At present, there is an absence of evidence to support a strong association in any direction. Importantly, these findings illustrate the need for higher quality and larger scale research that focuses on clinician and organisational characteristics, taking into account multiple intervening and mediating factors.
Temporary employment, compared with permanent employment, impacts on employees’ attitudes and behaviors. This study provides empirical evidence on the relationships between temporary employment and employee’s turnover intention and organizational citizenship behavior. Using a two-wave panel design, we collect data from a sample of 355 employees from 66 teams in four Chinese organizations. Our results show that, temporary employees have higher turnover intention than permanent employees, but in terms of employee’s OCB, the difference between temporary and permanent employees is not significant. Further, we also explore the mechanism how employee’ss organizational identification as a moderator-for temporary employees high in organizational identification, the negative relationships between temporary employment and OCBs and the positive relationships between temporary employment and turnover intention would be both attenuated.
Background:
The EU Early Warning System currently monitors more than 560 new psychoactive substances, far outweighing the total number of illicit drugs under international control. Due to the recent emergence of NPS and rapidly changing nature of the market, evidence about the way in which the emerging drugs are managed in health and social care settings is limited.
Methods:
The study adopted a mixed methods design, utilising a cross sectional survey and telephone interviews to capture data from staff working in drug and alcohol related services in statutory and voluntary sectors, across the five Health and Social Care (HSC) Trust areas in Northern Ireland. 196 staff participated in the survey and 13 participated in follow up in telephone interviews between August and November 2015.
Results:
Study respondents reported that addressing NPS related issues with service users was a key aspect of their daily role and function. Levels of injecting behaviours were also viewed as relatively high by study participants. Almost all workers used harm reduction as their primary approach when working with service users and the majority of respondents called for additional practical training in relation to addressing drug interactions and intervening with NPS related issues.
Background:
In Scotland community pharmacies are heavily involved in service delivery for people with drug problems (PWDP) as documented through surveys of all community pharmacies in 1995, 2000 and 2006. A further survey in 2014 enabled trends in service demand/provision to be analysed and provides insight into future development.
Methods:
The lead pharmacist in every Scottish pharmacy (n=1246) was invited to complete a postal questionnaire covering attitudes towards PWDP and service provision and level of involvement in services (needle exchange, dispensing for PWDP and methadone supervision). Additional questions covered new services of take-home naloxone (THN) and pharmacist prescribing for opioid dependence. Telephone follow-up of non-responders covered key variables. A comparative analysis of four cross-sectional population surveys of the community pharmacy workforce (1995, 2000, 2006 and 2014) was undertaken.
Results:
Completed questionnaires were returned by 709 (57%) pharmacists in 2014. Key variables (questionnaire or telephone follow-up) were available from 873 (70%). The proportion of pharmacies providing needle exchange significantly increased from 1995 to 2014 (8.6%, 9.5%, 12.2%, 17.8%, p<0.001) as did the proportion of pharmacies dispensing for the treatment of drug misuse (58.9%, 73.4%, 82.6% and 88%, p<0.001). Methadone was dispensed to 16,406 individuals and buprenorphine to 1777 individuals (increased from 12,400 and 192 respectively in 2006). Attitudes improved significantly from 1995 to 2014 (p<0.001). Being male and past training in drug misuse significantly predicted higher attitude scores (p<0.05) in all four years. Attitude score was a consistently significant predictor in all four years for dispensing for the treatment of drug misuse [OR=1.1 (1995 and 2006, CI 1.1-1.3, and 2014 CI 1.1-1.4) and 1.2 (2000), CI 1.3-1.5] and providing needle exchange [OR=1.1 (1995 and 2006), CI 1.1-1.2, 1.1-1.3 and 1.2 (2000 and 2014), CI 1.1-1.3 and 1.1-1.5]. In 2014, 53% of pharmacists felt part of the addiction team and 27.7% did not feel their role was valued by them. Nine pharmacists prescribed for opioid dependence.
Conclusion:
It is possible for pharmacy workforce attitudes and service engagement to improve over time. Training was key to these positive trends. Communication with the wider addiction team could be further developed.
This study investigated work–life interaction across the life course within one industry sector, healthcare. This workforce closely mirrors larger labour force trends such as women's increasing participation in paid work, an ageing workforce and working carers of children and elders. This qualitative study of 105 health professionals provides insight into the work–life challenges and needs of a modern diverse workforce, including the policies and practices that are likely to maximise employee well-being and retention. Indeed, significant differences in work–life perspectives and needs were observed with workers at different life stages. Similarities were also apparent, particularly with regard to work demands and flexibility. It was clear that existing organisational policies (and culture) do not meet the needs of workers across the life course, and led to reduced work hours and turnover intentions. Implications for organisational policies and practices are discussed, with a focus on access to part-time and flexible work.
Among employees of comparable organizations in the United States and New Zealand, role stressors (ambiguity and conflict), along with effort-to-performance uncertainty, performance-to-outcome uncertainty and doubt about acceptance by one's supervisor, generally predicted job satisfaction, psychological strain and turnover intentions. Path analyses of three alternative theoretical models highlighted the importance of job satisfaction as a mediator of the effects of role stressors and uncertainty on strain and turnover intentions. Role stressors contributed separately and via uncertainty to all three outcome measures, but subordinate perceptions of supervisor behaviors added little independent predictive power, once the role stressors and uncertainty were accounted for. These findings support the hypothesis that supervisors can influence the degree of role stress and uncertainty which their subordinates experience, which in turn may affect levels of satisfaction, strain and turnover intentions.
Cross-study differences in the contributions of work attitudes to the turnover process led us to (a) estimate the six relations among job satisfaction, organizational commitment, turnover intention/withdrawal cognitions, and turnover using meta-analysis; (b) assess the effects of several psychometric moderators on those relations; and (c) compare the influences of satisfaction and commitment in the turnover process by applying path analysis to the meta-analytic correlations. Based on aggregations involving a total of 178 independent samples from 155 studies, results showed that (a) satisfaction and commitment each contribute independently to the prediction of intention/cognitions; (b) intention/ cognitions are predicted more strongly by satisfaction than by commitment; (c) intention/cognitions mediate nearly all of the attitudinal linkage with turnover; and (d) attitudinal contributions to the turnover process vary with the use of single- versus multi-item scales, the 9-versus 15-item version of the Organizational Commitment Questionnaire, and turnover intention versus withdrawal cognition scales. [ABSTRACT FROM AUTHOR] Copyright of Personnel Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
The purpose of this study was to examine the impact of staff turnover on perceptions of organizational demands and support among staff who remained employed in substance abuse treatment programs. The sample consisted of 353 clinical staff from 63 outpatient agencies. Two scales from the Survey of Organizational Functioning measured work environment demands (stress and inadequate staffing), and 3 measured supportive work relationships (communication, cohesion, and peer collaboration). Results from a series of multilevel models documented that counselors working in programs that had previously experienced high staff turnover perceived higher demands and lower support within their organization, even after controlling for other potentially burdensome factors such as budget, census, and individual measures of workload. Two individual-level variables, caseload and tenure, were important determinants of work environment demands but were not related to supportive work relationships. Findings suggest that staff turnover increases workplace demands, decreases perceptions of support, and underscores the need to reduce stress and minimize subsequent turnover among clinical staff.
This study examined predictor, moderator, and mediator variables of occupational turnover intention (OcTI) among substance abuse counselors. Data were obtained via questionnaires from 929 counselors working in 225 private substance abuse treatment (SAT) programs across the United States. Hierarchical multiple regression models were conducted to assess predictor, moderator, and mediator variables of OcTI. OcTI scores were relatively low on a 7-point scale, indicating that very few counselors definitely intended to leave the SAT field. Age, certification, positive perceptions of procedural and distributive justice, and hospital-based status negatively predicted OcTI. Counselors' substance use disorder-impacted history moderated the association between organizational commitment and OcTI. Organizational turnover intention partially mediated the link between organizational commitment and OcTI. Workforce stability might be achieved by promoting perceptions of advantages to working in a particular treatment program, having organizational commitment, showing appreciation for counselors' work, and valuing employees from diverse backgrounds.
In the substance abuse treatment field, the annual turnover rate is cited as being anywhere between 19% and 50% (J.A. Johnson & P.M. Roman, 2002; S.L. Gallon, R.M. Gabriel, J.R.W. Knudsen, 2003; H.K. Knudsen, J.A. Johnson, & P.M. Roman, 2003; A.T. McLellan, D. Carise, & H.D. Kleber, 2003). However, no research to date has evaluated these claims by tracking turnover longitudinally using organizational turnover data from substance abuse treatment centers. This research presents the results of a longitudinal study designed to systematically examine actual turnover among counselors and clinical supervisors. Twenty-seven geographically dispersed treatment organizations, serving a wide range of clients in the public and private sector, provided data for the study over a 2-year time span (2008-2009). The annual turnover rate was 33.2% for counselors and 23.4% for clinical supervisors. For both groups, the majority of turnover was voluntary (employee-initiated). Specific reasons for turnover were largely consistent across the two groups, with the most common reason being a new job or new opportunity. The findings are discussed in terms of the unique employment context of substance abuse treatment. Practical recommendations are also discussed to help stem the tide of turnover in the field of substance abuse treatment.
This paper is a report of a study conducted to (1) review and critique the published empirical research on nurses' intention to leave the profession and (2) synthesize the findings across studies.
Lack of nurses and nurse turnover represent problems for the healthcare system in terms of cost, the ability to care for patients and the quality of care. At a time of current nursing shortage, it is important to understand the reasons why nurses intend to leave the profession.
A review was conducted through an initial search of MEDLINE, CINAHL and PsycINFO computerized databases for the period from 1995 to July 2009. The keywords for the search were: Nurs* AND (Personnel turnover OR Career Mobility). Research on nurses' organizational turnover was excluded.
An integrative literature review was carried out using Cooper's five-stage methodology provided a framework for data collection, analysis and synthesis.
A total of 31 studies matching the inclusion criteria were identified. Variety in samples, measurement instruments and measures of intention to leave led to difficulties when attempting to compare or generalize study findings. A number of variables influencing nurses' intention to leave the profession were identified, including demographic, work-related and individual-related variables.
Further research is needed using sound measurement instruments, consistent measures of leaving intention and more rigorous sampling. More in-depth research is needed to give nurses opportunities to explain in their own words the reasons for their intentions to leave.
This paper is a report of a study of (i) which variables are associated with the intention to leave the profession (ii) which variables are associated with the intention to leave the organization; and (iii) how the related variables differ between intentions in a secondary analysis of data of the German part of the European Nurses' Early Exit Study.
Nursing turnover research so far rarely differentiates between leaving the profession or the organization. The identification of specific correlates for different leaving intentions would support better understanding of the turnover process and the development of targeted measures to reduce turnover.
A secondary data analysis of the German sample of the European Nurses' Early Exit-Study was performed, using a generalized linear mixed model approach.
Data from 2119 Registered Nurses in 71 departments of 16 hospitals from 2003 were analysed. Models for intentions to leave the profession explained more of the variance (r(2) = 0.46) than models for intentions to leave the organization (r(2) = 0.28). Both leaving intentions were associated with age, professional commitment and job satisfaction. Intentions to leave the profession were strongly associated with variables related to the personal background and the work/home interface whereas intentions to leave the organization were related to organizational leadership and the local context.
Retention initiatives should address the work-home interface. Surveys assessing nursing turnover should be based on comprehensive turnover definitions, including different leaving directions.
The turbulence created by the emergence of managed care has increased the importance of staff retention for substance abuse treatment centers. This study examines the relationships between management practices, organizational commitment, and turnover intention among substance abuse treatment counselors. Counselors from 345 randomly selected privately funded treatment centers were surveyed about management practices, organizational commitment, and turnover intention. Structural equation model estimates indicate significant associations between these variables. The effects of performance-based rewards and support for creativity, two measures of management practices, on turnover intention are mediated by organizational commitment. Job autonomy has a direct effect on turnover intention. Treatment center administrators may improve staff retention by systematic attention to these factors shown to enhance organizational commitment and reduce counselors' intentions to quit. Such steps may include increasing counselor autonomy, providing rewards for strong job performance, and establishing a work environment that supports creativity and innovation.
Counselor turnover is a significant problem facing substance abuse treatment agencies. Understanding the role of organizational culture in predicting burnout and turnover intention may yield important information on how to address turnover in treatment organizations. Using data collected from 817 counselors employed in a national sample of 253 therapeutic communities (TCs), structural equation modeling was used to estimate the associations between emotional exhaustion, turnover intention, and three measures of organizational culture: centralized decision making, distributive justice, and procedural justice. The model controlled for counselor demographics, credentials, and earnings. Counselors' emotional exhaustion scores were higher in TCs with greater centralized decision making (p < .01) but lower in TCs where greater distributive justice (p < .05) and procedural justice (p < .001) were reported. Likewise, turnover intention was positively associated with centralized decision making (p < .05) and inversely associated with the workplace justice measures (p < .001). These data suggest that management practices in TCs and perhaps in other types of substance abuse treatment facilities likely play a substantial role in counselors' well-being and in their decisions to leave their jobs. Because these practices are not structural features of organizations, they may be targeted for intervention and change.
Many studies have examined predictors of nurses' intention to work in their job, including desire to quit. Intent has been a good predictor of actual turnover. Few longitudinal studies exist that consider regional variables.
To extend the conceptual framework of turnover research to the whole nursing workforce and determine: (1) how do demographics, region (metropolitan statistical area: MSA), movement opportunities, and work setting variables affect registered nurses' (RNs) intent to work and desire to quit; and (2) how do demographics, MSA variables, movement opportunities, and work setting variables affect RNs' work behavior at time 2?
Panel study using Dillman's design method.
Randomly selected national cluster sample from 40 urban geographic regions (MSAs) in 29 states of the United States.
Four thousand surveys were sent. There were 1907 female RNs under 65 (48% response rate) from year 1 of which 1348 responded at year 2 (70% response rate).
The first analyses used desire to quit (explained 65% of the variance) and intent to work from year 1 as dependent variables. Satisfaction and organizational commitment were significant negative predictors of desire to quit. In the logistic regression on intent to work, the work motivation and work-family conflict were positive and significant as well as wages (negative) and three benefit variables. In year 2, the dependent variable was working or not and if working, full-time or not. For this bivariate probit regression no attitudes influenced the work/not work decision, but MSA level variables, wages (positive) and benefits (positive) did. Organizational commitment and higher workload increased the probability of working FT.
Regional differences across markets need to be controlled and their influence investigated. In addition, attitudes as well as wages and benefits were important in certain decisions: these factors are clearly under the influence of employers.
An intriguing hypothesis is that clinical supervision may protect against counselor turnover. This idea has been mentioned in recent discussions of the substance abuse treatment workforce. To test this hypothesis, we extend our previous research on emotional exhaustion and turnover intention among counselors by estimating the associations between clinical supervision and these variables in a large sample (N = 823). An exploratory analysis reveals that clinical supervision was negatively associated with emotional exhaustion and turnover intention. Given our previous findings that emotional exhaustion and turnover intention were associated with job autonomy, procedural justice, and distributive justice, we estimate a structural equation model to examine whether these variables mediated clinical supervision's associations with emotional exhaustion and turnover intention. These data support the fully mediated model. We found that the perceived quality of clinical supervision is strongly associated with counselors' perceptions of job autonomy, procedural justice, and distributive justice, which are, in turn, associated with emotional exhaustion and turnover intention. These data offer support for the protective role of clinical supervision in substance abuse treatment counselors' turnover and occupational well-being.
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