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Job burnout and turnover intention among Chinese primary healthcare staff: the mediating effect of satisfaction.

ABSTRACT: OBJECTIVES:Although China has done a lot in strengthening the primary healthcare system, the high turnover intention is still a social problem to be reckoned with. The objective of this study is to explore the mediating effect of satisfaction between job burnout and turnover intention. DESIGN:Cross-sectional study. METHODS:A cross-sectional study was conducted to make sense of the job burnout, satisfaction and turnover intention among primary healthcare workers in central China. Structural equation modelling (SEM) was performed to study the mediating effect of satisfaction between job burnout and turnover intention with maximum likelihood estimation. The mediation effect test was carried out by using the bootstrap method. RESULTS:SEM showed that job burnout was positively related to the turnover intention with the standard path coefficient of 0.845 (C.R.=34.055, p<0.001). The partial mediating effect of satisfaction was 0.047, making up 5.32% of the total effect. The goodness-of-fit was acceptable (Goodness of Fit Index=0.947, Comparative Fit Index=0.975, root mean square error of approximation=0.067, Non-Normed Fit Index=0.971, Incremental Fit Index=0.975). Age, education level, monthly income, hire form and night shift were also found significantly correlated with turnover intention, and no difference was found between physicians and nurses. CONCLUSIONS:The turnover intention is significantly affected by job burnout, satisfaction and demographical characteristics including age, education level, monthly income, hire form and night shift. Satisfaction can be regarded as a mediator between job burnout and turnover intention. Relative measures can be taken to promote enthusiasm and satisfaction thus decreasing the turnover rate.

SUBMITTER: Ran L

PROVIDER: S-EPMC7542935 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Job burnout and turnover intention among Chinese primary healthcare staff: the mediating effect of satisfaction.

Ran Li L Chen Xuyu X Peng Shuzhen S Zheng Feng F Tan Xiaodong X Duan Ruihua R

BMJ open 20201007 10

<h4>Objectives</h4>Although China has done a lot in strengthening the primary healthcare system, the high turnover intention is still a social problem to be reckoned with. The objective of this study is to explore the mediating effect of satisfaction between job burnout and turnover intention.<h4>Design</h4>Cross-sectional study.<h4>Methods</h4>A cross-sectional study was conducted to make sense of the job burnout, satisfaction and turnover intention among primary healthcare workers in central C ...[more]

PMID: 33033013

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Project description:BackgroundBurnout is a growing problem among medical staff worldwide and empathy has been described as an essential competence to attenuate burnout. Previous studies found job satisfaction and job commitment were affected by the empathy and associated with burnout. This study explores the effect and mechanism of empathy on burnout on medical staff and investigates the mediating role of job satisfaction and job commitment in the relationship between empathy and burnout among medical staff.MethodsBased on a self-administered questionnaire which included the Maslach Burnout Inventory (MBI) to measure burnout, 335 responses from medical staff in Tianjin City, China, yielded data on socio-demographic characteristics, empathy, burnout, job satisfaction and job commitment. Bivariate correlation and structured equation modeling (SEM) analyzed the relationships between empathy, job satisfaction, job commitment and burnout multi-group invariant analysis was used to evaluate whether the model was consistent across different type and level of hospitals and different job and employment type subgroups.ResultsA total of 202 (60.3%) medical staff had low level burnout, 115 (34.3%) staff had the moderate level and 18 (5.4%) staff had the high level burnout. The results of the SEM showed that empathy not only had a direct negative effect on burnout ([Formula: see text], but also had an indirect impact through job satisfaction ([Formula: see text] and job commitment ([Formula: see text]. Job commitment was negatively associated burnout ([Formula: see text] but, unexpectedly, job satisfaction was positively associated with burnout ([Formula: see text]. The results also indicated the model was consistent across employment type ([Formula: see text] = 5.904, p > 0.05) and hospital type ([Formula: see text] = 7.748, p > 0.05), but was inconsistent across hospital level ([Formula: see text] = 42.930, p < 0.05) and job type ([Formula: see text] = 52.912, p < 0.05).ConclusionsOur results pointed out the important role that empathy plays in addressing burnout and revealed that managing job satisfaction and increasing the job commitment attenuated burnout. We recommend that the government should accelerate the reform of the resourcing of different hospital levels; facilitate hospital managers to implement additional training; and support hospitals to strengthen psychological testing and counseling to reduce medical staff burnout.

Project description:BACKGROUND:Global countries are suffering from a shortage of health professionals. Turnover intention is closely related to job satisfaction and burnout, making good use of these relationships could alleviate the crisis. Our research aims to examine the mediating role of job satisfaction in the relationship between burnout and turnover intention. METHODS:This research was conducted in Huangpi, China. The convenience sampling method and self-administereded questionnaires were used. 1370 of valid samples were collected with 97.72% effective rate. Descriptive analyses were conducted to describe social demographic factors. The structural equation model (SEM) was performed to adjust model fitting, and the mediation effect test was carried out by using the bootstrap method. Sobel-Z test was used to verify the significance of mediation effect. RESULTS:The mean age was 36.98 (SD?=?9.84). The fitting indices of hypothetical model are not good. After the adjustments, ?2/df?=?5.590, GFI?=?0.932, AGFI?=?0.901, CFI?=?0.977, NFI?=?0.973, IFI?=?0.977, TLI?=?0.970, RESEA?=?0.058. The revised model fitted well, and the SEM was put up by using the bootstrap method. The mediating effect is partial, and Soble-Z test indicates that the mediation effect is significant. Burnout is negatively correlated with job satisfaction (p <?0.01) and the standardized path coefficient is -?0.41. Job satisfaction is also negatively correlated with turnover intention (p?<?0.01) and the standardized path coefficient is -?0.18. Burnout is positively correlated with turnover intention (p?<?0.01) and the standardized path coefficient is 0.83. CONCLUSIONS:Job satisfaction is a mediating variable that affects the relationship between burnout and turnover intention. The mediating effect was a partial mediating effect and has a low impact of 7.4%. Improving treatment and giving more promotion opportunities for workers to improve job satisfaction, conducting career planning course and paying attention to employee psychological health to reduce job burnout. The above measures may be helpful to reduce employee turnover rate and alleviating the current situation of a shortage of health personnel in China.

Project description:BackgroundDespite working in a challenging environment plagued by persistent personnel shortages, public sector midwives in Senegal play a key role in tackling maternal mortality. A better understanding of how they are experiencing their work and how it is affecting them is needed in order to better address their needs and incite them to remain in their posts. This study aims to explore their job satisfaction and its effects on their burnout, intention to quit and professional mobility.MethodsA cohort of 226 midwives from 22 hospitals across Senegal participated in this longitudinal study. Their job satisfaction was measured from December 2007 to February 2008 using a multifaceted instrument developed in West Africa. Three expected effects were measured two years later: burnout, intention to quit and turnover. Descriptive statistics were reported for the midwives who stayed and left their posts during the study period. A series of multiple regressions investigated the correlations between the nine facets of job satisfaction and each effect variable, while controlling for individual and institutional characteristics.ResultsDespite nearly two thirds (58.9%) of midwives reporting the intention to quit within a year (mainly to pursue new professional training), only 9% annual turnover was found in the study (41/226 over 2 years). Departures were largely voluntary (92%) and entirely domestic. Overall the midwives reported themselves moderately satisfied; least contented with their "remuneration" and "work environment" and most satisfied with the "morale" and "job security" facets of their work. On the three dimensions of the Maslach Burnout Inventory, very high levels of emotional exhaustion (80.0%) and depersonalization (57.8%) were reported, while levels of diminished personal accomplishment were low (12.4%). Burnout was identified in more than half of the sample (55%). Experiencing emotional exhaustion was inversely associated with "remuneration" and "task" satisfaction, actively job searching was associated with being dissatisfied with job "security" and voluntary quitting was associated with dissatisfaction with "continuing education".ConclusionsThis study found that although midwives seem to be experiencing burnout and unhappiness with their working conditions, they retain a strong sense of confidence and accomplishment in their work. It also suggests that strategies to retain them in their positions and in the profession should emphasize continuing education.

Project description:OBJECTIVES:Our aims were to assess the relationship between workplace violence, job satisfaction, burnout, organisational support and turnover intention, and to explore factors associated with turnover intention among nurses in Chinese tertiary hospitals. METHODS:The purposive sampling method was used to collect data from August 2016 through January 2017. A total of 1761 nurses from 9 public tertiary hospitals in 4 provinces (municipalities) located in eastern (Beijing), central (Heilongjiang, Anhui) and western (Shaanxi) regions of China completed the questionnaires (effective response rate=85.20%). A cross-sectional study was conducted using the Workplace Violence Scale, Chinese Maslach Burnout Inventory General Survey, Minnesota Job Satisfaction Questionnaire Revised Short Version, Perceived Organizational Support-Simplified Version Scale and Turnover Intention Scale. RESULTS:A total of 1216 of 1706 (69.1%) participants had high turnover intention. During the previous 12 months, the prevalence of physical violence and psychological violence towards nurses was 9.60% and 59.64%, respectively. As expected, the level of turnover intention was negatively correlated with participants' scores on job satisfaction (r=-0.367, p<0.001) and perceived organisational support (r=-0.379, p<0.001), respectively. Burnout was positively associated with turnover intention (r=0.444, p<0.001). Workplace violence was positively associated with turnover intention (?=0.035, p<0.001) in linear regression analysis. The total effect (?=0.53) of workplace violence on turnover intention comprised its direct effect (?=0.36) and its indirect effect (?=0.17). CONCLUSIONS:Perceived organisational support served as a mediator between workplace violence, job satisfaction, burnout and turnover intention, and it had a significantly negative impact on turnover intention. Therefore, nursing managers should understand the importance of the organisation's support and establish a reasonable incentive system to decrease turnover intention.

Project description:BackgroundThe complex interrelationships between professional identity, job satisfaction, burnout, and turnover intention among general practitioners (GPs) are insufficiently understood in China. This study aimed to investigate the interrelationships between professional identity, job satisfaction, burnout, and turnover intention in China, and to examine whether job satisfaction and burnout played mediating roles between professional identity and turnover intention.MethodsA cross-sectional survey was conducted between October, 2017 and February, 2018 in China. The participants were selected using a multistage stratified random sampling method. Data were collected with a self-administered questionnaire from 3236 GPs (response rate, 99.8%) working in community health institutions in China. Professional identity was measured by the 13 items scale, and job satisfaction scale with an 11-item designed by Shi et al. was employed. Burnout was measured using a 22-item Maslach Burnout Inventory-Human Services Survey, and turnover intention was measured with a 6 items scale. Descriptive statistics were calculated and groups' differences were estimated Student's t-test and analyses of variance. Pearson's correlation analysis was used to assess the degree of correlation among different dimensions of professional identity, job satisfaction, burnout, and turnover intention. Structural equation modeling analysis was applied to examine the interrelationships among these study variables based on the hypothesized model.ResultsThe proposed model achieved a good model fit. Job satisfaction had a direct negative effect on turnover intention (β = - 0.38, P < 0.001), burnout had a direct positive effect on turnover intention (β = 0.37, P < 0.001), and professional identity had an indirect negative effect on turnover intention through the mediating effect of job satisfaction and burnout.ConclusionsOur study elucidated the pathways linking professional identity, job satisfaction, and burnout to turnover intention of GPs. This revealed that turnover intention was significantly affected by job satisfaction and burnout, and the effects of professional identity on turnover intention can be mediated by job satisfaction and burnout.

Project description:BackgroundVillage doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout among VDs to evaluate and adjust current health manpower policy.MethodsIn this study, seven databases like PubMed, EMBASE, Web of Science (WOS), WanFang, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) were systematically searched, relevant experts were consulted, and empirical research on job burnout and turnover intention among VDs in international publications was evaluated. Therefore, we evaluated the prevalence of job burnout among VDs in general, across all dimensions and different severity levels, as well as the scores of each category. For turnover intention, we assessed the prevalence of different groups and their overall situation and also identified significant contributors.ResultsIn this study, we integrated 20 research evidences on job burnout and turnover intention among 23,284 VDs from almost all provinces in China, and the prevalence of turnover intention among VDs in China was as high as 44.1% [95% confidence interval (CI): 34.1-54.2], which was two to four times that of primary health workers in high-income countries, but not much different from some developing countries. Simultaneously, VDs with the highest risk of turnover intention were men [odds ratio (OR): 1.22 (1.05-1.43)], those with a monthly income below USD 163.4 [OR: 0.88 (0.78-0.98)], those with a high educational level [OR: 0.88 (0.78-0.98)], and those <40 years old [OR: 1.27 (1.16-1.40)]. Similarly, the detection rate of job burnout toward them was 59.8% (95% CI: 38.7-79.1) with the MBI-GS score being 44.44 (95% CI: 37.02-51.86) in a total of 90, while the detection rate of job burnout in moderate and above almost reached 20%. The most significant contributor that affects job burnout was low personal accomplishment (LPA), and the detection rate for moderate and higher severity was 65.2% (95% CI: 58.7-71.7).ConclusionAttention should be paid to the high turnover intention and severe job burnout of primary health workers in rural areas of developing countries, and targeted measures should be taken to improve the situation. Health policymakers should increase financial subsidies for VDs, set a reasonable workload, improve various health policies such as pension insurance for VDs, and encourage "targeted training" for medical students to enrich and expand their team.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021289139.

Dataset Information

Job burnout and turnover intention among Chinese primary healthcare staff: the mediating effect of satisfaction.

Publications

Job burnout and turnover intention among Chinese primary healthcare staff: the mediating effect of satisfaction.

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