Intention to leave and associated factors among psychiatric nurses in China: A nationwide cross-sectional study
Section snippets
What is already known about the topic?
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Turnover and shortage of psychiatric nurses may lead to a low quality of healthcare and adverse patient outcomes.
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Psychiatric nurses’ intention to leave is associated with several individual characteristics and job-related factors, some of which are modifiable.
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China faces a shortage of psychiatric nurses, and studies examining Chinese psychiatric nurses’ intention to leave are needed to guide policy change and resource allocation.
What this paper adds
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The proportion of Chinese psychiatric nurses who intend to leave their current job is relatively high.
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Better self-rated health, perceived respect from patients, physician-nurse coordination and job satisfaction are significantly associated with a lower likelihood of intending to leave one’s job.
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One-third of Chinese psychiatric nurses have experienced patient-initiated violence in the past 12 months, and they have a greater likelihood of intending to leave compared with their counterparts who
Design, setting and participants
This study was part of a national cross-sectional survey conducted in December 2017 with the purpose of evaluating the performance of tertiary hospitals to ultimately improve healthcare quality and satisfaction. This survey included basic information about the participating hospitals (e.g. number of beds, nurses and discharges) and investigations among their staff and their patients. In psychiatric settings, the China’s Ministry of Health purposefully sampled 32 tertiary psychiatric hospital in
Descriptive analysis of hospitals and participants
The basic data of 32 tertiary psychiatric hospitals are shown in Table 1. The number of beds within these hospitals ranged from 169 to 2134 with a median of 810. The number of discharges in the past 12 months ranged from 859 to 33,472 with a median of 6094. The average length of stay for each discharge was 49.5 days. The number of nurses, the number of nurses per 100 occupied beds, and the nurse-physician ratio also varied, with medians of 303 (inter-quartile range (IQR) = 161), 0.10
Discussion
Using a large, nationwide sample of nurses from 32 tertiary psychiatric hospitals in China, this study examined nurses’ intention to leave their job and explored factors associated with that choice. In addition, this study provided a profile of the respondents using descriptive analysis. One strength of this study was that we not only focused on nursing staff in specialty psychiatric hospitals but also integrated several individual characteristics and job-related factors in models focused on a
Conclusions
This cross-sectional study demonstrated that gender, personal health, income, workload, items related to nurse-patient and nurse-physician relationships as well as job satisfaction were significantly associated with an intention to leave among psychiatric nurses in China. Given that psychiatric nurses in China are playing a very important role in providing psychiatric care in China and that they are already in short supply, we suggest that the government and hospital administrators pay
Funding
This research was supported by the Beijing Medical and Health Foundation, which did not play a role in the conduct of the research.
Conflict of interests
None declared.
Acknowledgements
The authors thank the Beijing Medical and Health Foundation who funded this research, and we also appreciate the efforts of the hospital administers who facilitated the survey.
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Contributed equally to this paper.