Structural Model of Retention Intention of Nurses in Small- and Medium-Sized Hospitals: Based on Herzberg’s Motivation-Hygiene Theory
Abstract
:1. Introduction
Conceptual Basis and Hypothetical Model
2. Materials and Methods
2.1. Study Design
2.2. Subjects
2.3. Measures
2.3.1. Calling
2.3.2. Resilience
2.3.3. Leader–Member Exchange
2.3.4. Workplace Bullying
2.3.5. Nursing Work Environment
2.3.6. Job Satisfaction
2.3.7. Intention to Stay
2.4. Data Collection
2.5. Data Analysis
3. Results
3.1. General Characteristics of the Subjects
3.2. Descriptive Statistics and Normality Test for the Measured Variable
3.3. Hypothesis Model Test
3.3.1. Goodness-of-Fit Test for the Hypothesis Model
3.3.2. Correlation between Measured Variables and Multicollinearity
3.3.3. Discriminant Validity
3.3.4. Verifying Effectiveness of the Hypothesis Model
3.3.5. Effectiveness Analysis of the Final Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Categories | n | % | Mean ± SD |
---|---|---|---|---|
Gender | Male | 30 | 8.6 | |
Female | 318 | 91.4 | ||
Age (year) | 20~29 | 153 | 44.0 | 33.47 ± 9.17 |
30~39 | 101 | 29.0 | ||
40~49 | 70 | 20.1 | ||
≥50 | 24 | 6.9 | ||
Marital status | Married | 158 | 45.4 | |
Single | 190 | 54.6 | ||
Education level | Diploma | 140 | 40.2 | |
Bachelor | 194 | 55.8 | ||
≥Graduate | 14 | 4.0 | ||
Period working in the current department (years) | <1 | 70 | 20.1 | 6.54 ± 7.44 |
1~<3 | 96 | 27.6 | ||
3~<5 | 41 | 11.8 | ||
5~<10 | 49 | 14.1 | ||
≥10 | 92 | 26.4 | ||
Clinical career (years) | <1 | 32 | 9.2 | 9.24 ± 8.17 |
1~<3 | 67 | 19.2 | ||
3~<5 | 43 | 12.4 | ||
5~<10 | 64 | 18.4 | ||
≥10 | 142 | 40.8 | ||
Position | Staff nurse | 317 | 91.1 | |
≥Charge nurse | 31 | 8.9 | ||
Type of unit | Medical ward | 96 | 27.6 | |
Surgical ward | 95 | 27.3 | ||
Special part | 86 | 24.7 | ||
Comprehensive nursing care service ward | 62 | 17.8 | ||
Outpatient | 9 | 2.6 | ||
Work shift | Three shifts | 227 | 65.2 | |
Two shifts | 28 | 8.1 | ||
Full-time | 78 | 22.4 | ||
Night shift | 15 | 4.3 |
Latent Variable | Measured Variable | Min | Max | Mean ± SD | Skewness | Kurtosis | CR | AVE |
---|---|---|---|---|---|---|---|---|
Calling | 1.17 | 3.75 | 2.17 ± 0.49 | 0.55 | 0.48 | 0.94 | 0.63 | |
Transcendental calling | 1.00 | 4.00 | 1.93 ± 0.63 | 0.44 | 0.05 | |||
Purpose/Meaning | 1.00 | 4.00 | 2.34 ± 0.55 | 0.34 | 0.27 | |||
Prosocial orientation | 1.00 | 4.00 | 2.25 ± 0.52 | 0.09 | 0.19 | |||
Resilience | 0.81 | 3.97 | 2.58 ± 0.55 | −0.03 | 0.04 | 0.95 | 0.66 | |
Hardness | 0.67 | 3.89 | 2.36 ± 0.59 | 0.09 | 0.19 | |||
Patience | 0.88 | 4.00 | 2.54 ± 0.58 | 0.13 | 0.07 | |||
Optimism | 0.25 | 4.00 | 2.47 ± 0.70 | −0.08 | 0.01 | |||
Support | 1.00 | 4.00 | 2.93 ± 0.69 | −0.48 | −0.18 | |||
Spirituality | 0.00 | 4.00 | 2.09 ± 0.77 | 0.07 | −0.14 | |||
Leader–member exchange | 1.17 | 5.00 | 3.55 ± 0.61 | 0.01 | 0.29 | 0.95 | 0.71 | |
Affect | 1.00 | 5.00 | 3.52 ± 0.68 | 0.04 | 0.27 | |||
Loyalty | 1.67 | 5.00 | 3.52 ± 0.71 | 0.04 | −0.12 | |||
Contribution | 1.00 | 5.00 | 3.46 ± 0.66 | −0.12 | 0.31 | |||
Professional Respect | 1.00 | 5.00 | 3.71 ± 0.73 | −0.24 | 0.11 | |||
Workplace Bulling | 1.00 | 3.42 | 2.57 ± 0.53 | 0.82 | 0.25 | 0.95 | 0.68 | |
Verbal attacks | 1.00 | 4.00 | 1.87 ± 0.62 | 0.44 | −0.36 | |||
Improper work instruction | 1.00 | 3.75 | 1.83 ± 0.62 | 0.46 | −0.37 | |||
Physical treat | 1.00 | 3.50 | 1.37 ± 0.59 | 1.54 | 1.68 | |||
Nursing Work Environment | 1.59 | 3.88 | 2.57 ± 0.42 | 0.16 | 0.02 | 0.95 | 0.56 | |
Participation in hospital affairs | 1.00 | 3.89 | 2.49 ± 0.50 | −0.08 | 0.01 | |||
Nursing foundation for quality of care | 1.44 | 4.00 | 2.65 ± 0.44 | −0.14 | 0.15 | |||
Nursing manager ability, leader ship, and support | 1.50 | 4.00 | 2.91 ± 0.50 | −0.14 | −0.08 | |||
Staffing and resource adequacy | 1.00 | 3.75 | 2.24 ± 0.65 | 0.08 | −0.67 | |||
Nurse-physician relations | 1.00 | 4.00 | 2.58 ± 0.57 | −0.57 | 0.52 | |||
Job satisfaction | 1.00 | 10.00 | 5.74 ± 1.90 | −0.12 | −0.52 | 0.82 | 0.80 | |
Retention intention | 1.00 | 8.00 | 5.21 ± 1.43 | −0.21 | −0.07 | 0.84 | 0.91 |
Calling | Resilience | LMX | Workplace Bulling | NWE | JS | IS | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | |
1 | 1 | |||||||||||||||||||||
2 | 0.62 | 1 | ||||||||||||||||||||
3 | 0.64 | 0.65 | 1 | |||||||||||||||||||
4 | 0.28 | 0.45 | 0.33 | 1 | ||||||||||||||||||
5 | 0.32 | 0.54 | 0.39 | 0.79 | 1 | |||||||||||||||||
6 | 0.32 | 0.46 | 0.33 | 0.72 | 0.71 | 1 | ||||||||||||||||
7 | 0.11 | 0.28 | 0.17 | 0.54 | 0.60 | 0.53 | 1 | |||||||||||||||
8 | 0.45 | 0.29 | 0.26 | 0.41 | 0.38 | 0.47 | 0.24 | 1 | ||||||||||||||
9 | 0.17 | 0.23 | 0.17 | 0.19 | 0.22 | 0.19 | 0.21 | 0.15 | 1 | |||||||||||||
10 | 0.18 | 0.21 | 0.21 | 0.22 | 0.25 | 0.21 | 0.23 | 0.20 | 0.74 | 1 | ||||||||||||
11 | 0.18 | 0.26 | 0.19 | 0.31 | 0.32 | 0.26 | 0.23 | 0.17 | 0.71 | 0.74 | 1 | |||||||||||
12 | 0.08 | 0.14 | 0.12 | 0.17 | 0.23 | 0.15 | 0.17 | 0.10 | 0.68 | 0.69 | 0.67 | 1 | ||||||||||
13 | −0.04 | −0.08 | 0.07 | −0.11 | −0.16 | −0.11 | −0.26 | 0.05 | −0.25 | −0.23 | −0.24 | −0.14 | 1 | |||||||||
14 | 0.00 | −0.12 | 0.04 | −0.12 | −0.20 | −0.17 | −0.26 | 0.01 | −0.21 | −0.21 | −0.23 | −0.18 | 0.79 | 1 | ||||||||
15 | 0.08 | −0.09 | 0.01 | −0.13 | −0.17 | −0.13 | −0.29 | 0.06 | −0.13 | −0.14 | −0.14 | −0.14 | 0.63 | 0.56 | 1 | |||||||
16 | 0.14 | 0.16 | 0.16 | 0.17 | 0.18 | 0.15 | 0.13 | 0.46 | 0.50 | 0.46 | 0.47 | 0.47 | −0.15 | −0.19 | −0.10 | 1 | ||||||
17 | 0.18 | 0.15 | 0.21 | 0.13 | 0.13 | 0.15 | 0.07 | 0.19 | 0.03 | 0.13 | 0.11 | 0.06 | −0.05 | −0.17 | 0.09 | 0.41 | 1 | |||||
18 | 0.17 | 0.24 | 0.25 | 0.18 | 0.21 | 0.15 | 0.14 | 0.13 | 0.09 | 0.21 | 0.15 | 0.16 | −0.06 | −0.14 | −0.03 | 0.39 | 0.45 | 1 | ||||
19 | 0.23 | 0.21 | 0.22 | 0.17 | 0.21 | 0.19 | 0.07 | 0.21 | 0.23 | 0.32 | 0.26 | 0.25 | −0.04 | −0.13 | 0.09 | 0.61 | 0.66 | 0.57 | 1 | |||
20 | 0.16 | 0.15 | 0.16 | 0.11 | 0.14 | 0.14 | 0.09 | 0.18 | 0.22 | 0.24 | 0.19 | 0.25 | −0.03 | −0.05 | 0.03 | 0.58 | 0.49 | 0.45 | 0.75 | 1 | ||
21 | 0.23 | 0.37 | 0.19 | 0.31 | 0.34 | 0.36 | 0.27 | 0.23 | 0.20 | 0.16 | 0.26 | 0.13 | −0.17 | −0.23 | −0.12 | 0.25 | 0.32 | 0.21 | 0.27 | 0.20 | 1 | |
22 | 0.23 | 0.42 | 0.17 | 0.31 | 0.35 | 0.37 | 0.27 | 0.20 | 0.31 | 0.18 | 0.34 | 0.17 | −0.27 | −0.25 | −0.23 | 0.23 | 0.11 | 0.09 | 0.16 | 0.16 | 0.45 | 1 |
Latent Variable | Calling | Resilience | LMX | WB | NWE | JS | IS |
---|---|---|---|---|---|---|---|
r | |||||||
r2 | |||||||
(p) | |||||||
Calling | 0.63 † | ||||||
resilience | 0.44 | 0.66 † | |||||
0.19 | |||||||
(<0.001) | |||||||
LMS | 0.23 | 0.29 | 0.71 † | ||||
0.05 | 0.08 | ||||||
(<0.001) | (<0.001) | ||||||
WB | −0.01 | −0.24 | −0.24 | 0.68 † | |||
0 | 0.08 | 0.06 | |||||
–0.89 | (<0.001) | (<0.001) | |||||
NWE | 0.27 | 0.21 | 0.33 | −0.09 | 0.56 † | ||
0.07 | 0.05 | 0.11 | 0.01 | ||||
(<0.001) | (<0.001) | (<0.0014) | −0.085 | ||||
JS | 0.31 | 0.37 | 0.21 | −0.20 | 0.32 | 0.80 † | |
0.09 | 0.14 | 0.04 | 0.04 | 0.1 | |||
(<0.001) | (<0.001) | (<0.001) | (<0.001) | (<0.001) | |||
IS | 0.31 | 0.38 | 0.28 | −0.28 | 0.18 | 0.45 | 0.91 † |
0.1 | 0.14 | 0.08 | 0.24 | 0.03 | 0.2 | ||
(<0.001) | (<0.001) | −0.001 | (<0.001) | (<0.001) | (<0.001) |
Endogenous Variable | Exodoenous Variable | B | SE | β | CR (t) | p | Direct Effect (p) | Indirect Effect (p) | Total Effect (p) | SMC |
---|---|---|---|---|---|---|---|---|---|---|
Job satisfaction | Calling | 0.53 | 0.21 | 0.19 | 2.46 | 0.014 | 0.19 (0.039) | − | 0.19 (0.039) | 0.288 |
Recovery resilience | 0.61 | 0.19 | 0.24 | 3.17 | 0.002 | 0.24 (0.007) | − | 0.24 (0.007) | ||
Leader–member exchange relationship | −0.00 | 0.13 | −0.00 | −0.02 | 0.983 | −0.00 0.997 | − | −0.00 (0.997) | ||
Workplace harassment | −0.46 | 0.17 | −0.16 | −2.64 | 0.008 | −0.16 (0.019) | − | −0.16 (0.019) | ||
Nursing Work environment | 0.68 | 0.20 | 0.21 | 3.42 | <0.001 | 0.21 (0.018) | − | 0.21 (0.018) | ||
Retention Intention | Calling | 0.44 | 0.18 | 0.17 | 2.43 | 0.015 | 0.17 (0.106) | 0.07 (0.039) | 0.24 (0.023) | 0.378 |
Recovery resilience | 0.23 | 0.16 | 0.10 | 1.43 | 0.154 | 0.10 (0.225) | 0.09 (0.016) | 0.19 (0.034) | ||
Leader–member exchange relationship | 0.20 | 0.11 | 0.11 | 1.88 | 0.060 | 0.11 (0.073) | −0.00 (0.996) | 0.11 (0.081) | ||
Workplace harassment | −0.46 | 0.16 | −0.17 | −3.12 | 0.002 | −0.17 (0.011) | −0.06 (0.022) | −0.23 (0.016) | ||
Nursing Work environment | −0.18 | 0.17 | −0.06 | −1.04 | 0.300 | −0.06 (0.381) | 0.08 (0.009) | 0.02 (0.689) | ||
Job satisfaction | 0.35 | 0.06 | 0.37 | 5.66 | <0.001 | 0.37 (0.021) | − | 0.37 (0.021) |
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Lee, J.Y.; Lee, M.H. Structural Model of Retention Intention of Nurses in Small- and Medium-Sized Hospitals: Based on Herzberg’s Motivation-Hygiene Theory. Healthcare 2022, 10, 502. https://doi.org/10.3390/healthcare10030502
Lee JY, Lee MH. Structural Model of Retention Intention of Nurses in Small- and Medium-Sized Hospitals: Based on Herzberg’s Motivation-Hygiene Theory. Healthcare. 2022; 10(3):502. https://doi.org/10.3390/healthcare10030502
Chicago/Turabian StyleLee, Joo Yeon, and Mi Hyang Lee. 2022. "Structural Model of Retention Intention of Nurses in Small- and Medium-Sized Hospitals: Based on Herzberg’s Motivation-Hygiene Theory" Healthcare 10, no. 3: 502. https://doi.org/10.3390/healthcare10030502