Quality of work life and turnover intention in primary healthcare organisations : a cross-sectional study of registered nurses in Saudi Arabia

Purpose: The purpose of this study was to improve the retention of primary healthcare (PHC) nurses through exploring and assessing their quality of work life (QWL) and turnover intention. Design and methods: A cross-sectional survey design was used in this study. Data were collected using a questionnaire comprising four sections (Brooks’ survey of Quality of Nursing Work Life [QNWL], Anticipated Turnover Intention, open-ended questions and demographic characteristics). A convenience sample was recruited from 143 PHC centres in Jazan, Saudi Arabia. A response rate of 87% (n = 508/585) was achieved. The SPSS v17 for Windows and NVivo 8 were used for analysis purposes. Procedures and tests used in this study to analyse the quantitative data were descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression. Qualitative data obtained from responses to the open-ended questions were analysed using the NVivo 8. Findings: Quantitative findings suggested that PHC nurses were dissatisfied with their work life. Respondents’ scores ranged between 45 and 218 (mean = 139.45), which is lower than the average total score on Brooks’ Survey (147). Major influencing factors were classified under four dimensions. First, work life/home life factors: unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs and inadequacy of vacations’ policy. Second, work design factors: high workload, insufficient workforce numbers, lack of autonomy and undertaking many non-nursing tasks. Third, work context factors: management practices, lack of development opportunities, and inappropriate working environment in terms of the level of security, patient care supplies and unavailability of recreation room. Finally, work world factors: negative public image of nursing, and inadequate payment. More positively, nurses were notably satisfied with their co-workers. Conversely, 40.4% (n = 205) of the respondents indicated that they intended to leave their current employment. The relationships between QWL and demographic variables of gender, age, marital status, dependent children, dependent adults, nationality, ethnicity, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to medium effect size of the variation in QWL scores. Using the GLM univariate analysis, education level was also significantly related to the QWL (p < .05). The relationships between turnover intention and demographic variables including gender, age, marital status, dependent children, education level, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to moderate effect size of the variation in the turnover intention scores. Using the GLM univariate analysis, the dependent adults’ variable was also significantly related to turnover intention (p < .05). Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by the QWL F (4,491), 43.71, p < .001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, F (17.433) = 12.04, p < .001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables, R squared change =.19, F change (4, 433) = 30.190, p < .001. The work context variable makes the strongest unique contribution (-.387) to explain the turnover intention, followed by the work design dimension (-.112). The qualitative findings reaffirmed the quantitative findings in terms of QWL and turnover intention. However, the home life/work life and work world dimensions were of great important to both QWL and turnover intention. The qualitative findings revealed a number of new factors that were not included in the survey questionnaire. These included being away from family, lack of family support, social and cultural aspects, accommodation facilities, transportation, building and infrastructure of PHC, nature of work, job instability, privacy at work, patients and community, and distance between home and workplace. Conclusion: Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes. Improving these factors could lead to a higher QWL and increase retention rates and therefore reinforcing the stabilisation of the nursing workforce. Significance of the research: Many countries are examining strategies to attract and retain the health care workforce, particularly nurses. This study identified factors that influence the QWL of PHC nurses as well as their turnover intention. It also determined the significant relationship between QWL and turnover intention. In addition, the present study tested Brooks’ survey of QNWL on PHC nurses for the first time. The qualitative findings of this study revealed a number of new variables regarding QWL and turnover intention of PHC nurses. These variables could be used to improve current survey instruments or to develop new research surveys. The study findings could be also used to develop and appropriately implement plans to improve QWL. This may help to enhance the home and work environments of PHC nurses, improve individual and organisational performance, and increase nurses’ commitment. This study contributes to the existing body of research knowledge by presenting new data and findings from a different country and healthcare system. It is the first of its kind in Saudi Arabia, especially in the field of PHC. It has examined the relationship between QWL and turnover intention of PHC nurses for the first time using nursing instruments. The study also offers a fresh explanation (new framework) of the relationship between QWL and turnover intention among PHC nurses, which could be used or tested by researchers in other settings. Implications for further research: Review of the extant literature reveals little in-depth research on the PHC workforce, especially in terms of QWL and organisational turnover in developing countries. Further research is required to develop a QWL tool for PHC nurses, taking into consideration the findings of the current study along with the local culture. Moreover, the revised theoretical framework of the current study could be tested in further research in other regions, countries or healthcare systems in order to identify its ability to predict the level of PHC nurses’ QWL and their intention to leave. There is a need to conduct longitudinal research on PHC organisations to gain an in-depth understanding of the determents of and changes in QWL and turnover intention of PHC nurses at various points of time. An intervention study is required to improve QWL and retention among PHC nurses using the findings of the current study. This would help to assess the impact of such strategies on reducing turnover of PHC nurses. Focusing on the location of the current study, it would be valuable to conduct another study in five years’ time to examine the percentage of actual turnover among PHC nurses compared with the reported turnover intention in the current study. Further in-depth research would also be useful to assess the impact of the local culture on the perception of expatriate nurses towards their QWL and their turnover intention. A comparative study is required between PHC centres and hospitals as well as the public and private health sector agencies in terms of QWL and turnover intention of nursing personnel. Findings may differ from sector to sector according to variations in health systems, working environments and the case mix of patients.

The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia

Background Quality of work life (QWL) has been found to influence the commitment of health professionals including nurses. However, reliable information on the QWL and turnover intention of primary health care (PHC) nurses is limited. The aim of this study was to examine the relationship between QWL and turnover intention of PHC nurses in Saudi Arabia. Methods A cross-sectional survey was used in this study. Data were collected using Brooks’ survey of Quality of Nursing Work life (QNWL), the Anticipated Turnover Scale and demographic data questions. A total of 508 PHC nurses in the Jazan region, Saudi Arabia completed the questionnaire (RR = 87%). Descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression (SMR), and hierarchical multiple regression (HMR) were applied for analysis using SPSS v17 for Windows. Results Findings suggested that the respondents were dissatisfied with their work life, with almost 40% indicating a turnover intention from their current PHC centres. Turnover intention was significantly related to QWL. Using SMR, 26% of the variance in turnover intention was explained by the QWL, p < 0.001, with R² = .263. Further analysis using HMR found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, p < 0.001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables. Conclusions Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes.

Exploring turnover intention of construction managers in China

Employee turnover has been identified as one of the principal causes of poor performance, low competitiveness and high technology loss in the construction industry. Construction managers normally acquire knowledge and skills in construction methods and management techniques on the basis of long-term practice, and their turnover can significantly impact on a construction organisation's survival and development. Therefore, there has been an increasing need to understand the major critical variables affecting the turnover of construction managers. The aims of this research were to determine these variables and use them to develop a quantitative turnover prediction model. A system framework was first developed to categorise all turnover variables into job satisfaction, organisation commitment and demographic variables and the turnover intention was measured in diverse directions. Based on an empirical study in Hubei province in China, the statistical results indicate that seven job satisfaction and organisational commitment variables dominate the turnover intentions of construction managers.

Gender differences in organizational justice predicting the key employee outcomes of organizational commitment, job satisfaction and turnover intention

All four types of organizational justice – distributive, procedural, interpersonal and informational – were included in this study of gender differences. Both male and female respondents perceived the distributive-procedural justice and interpersonal-informational justice pairings similarly and weakly. Females consistently discriminated more clearly across the pairings, however. The effect of the four justices was also found to be gender-dependent. Males’ perception of distributive justice directly predicted their turnover intentions and commitment to the organization, while females’ perception of distributive justice predicted only job satisfaction. Males’ perceptions of procedural and information justice both predicted job satisfaction. Females’ informational justice perceptions predicted job satisfaction and commitment to the organization. The paper contributes to the literature by presenting results from all four justice types and the simultaneous use of the three outcomes of job satisfaction, organizational commitment and intention to quit. Overall, the males had a diffuse set of relationships between the justice types and the outcomes, whereas the relationships between the justice types and
the outcomes for females tended more to follow a limited number of pathways. The study was validated with data collected on two separate occasions.

The effects of leader-member exchange and employee wellbeing towards employee turnover intention

 Research studies the role of employee wellbeing in relationship of LMX and turnover intention. Academicians from the community colleges, Malaysia were the respondents and structural equation modelling (SEM) was used. Results indicated that LMX is significantly predicts turnover intention and revealed the relationship between LMX and turnover intention decreases when factor on employee wellbeing is amended.

Mentoring functions and turnover intention: the mediating role of perceived organizational support

Despite an increasing number of studies investigating the effects of mentoring on employee work outcomes, limited attention has been placed on the relationship between mentoring functions and turnover intentions. In this study, we examined the relationship between mentoring functions and turnover intentions, and the mediating role of perceived organizational support (POS) on this relationship. Using data collected from 176 employees in three Chinese banks, we found that POS partially mediated the relationship between mentoring functions and employees' turnover intentions.

Perceived Work-related Factors and Turnover Intention : A Case Study of a South Korean Construction Company

Purpose – Employee turnover entails considerable costs and is a major problem for the construction industry. By creating an extensive framework, this study aims to examine whether perceived work-related factors affect turnover intention in South Korean construction companies. Research design – The paper is based on the results of a questionnaire of 136 employees that was conducted and provided by a Korean construction company. Research hypotheses were tested via correlation analyses. The most influencing work-related factors, as well as differences among job levels, were determined by multiple regression analyses. Findings – Communication, immediate leaders, organizational commitment, and organizational pride substantially affect turnover intentions. All of these factors can be considered as relational factors. The most influencing factors differ among job levels. Discussion/practical implications – Immediate leaders should be aware of their role in retaining employees and enhance communication, organizational commitment and pride. This study shows how the importance of certain variables differs for groups of employees. Theoretical implications/limitations– This study is based on a sample of employees from a Korean construction company. Therefore, the generalizability of the findings has to be tested. Future research should test the proposed framework with other factors or resources. Originality/value – This study shed light on the turnover subject in the South Korean construction industry. It shows that different factors can influence turnover intention among job levels. A framework was created, which is based on 16 work-related factors including organizational factors, HRM practices and job attitudes.

Perceived Work-related Factors and Turnover Intention : - A Case Study of a South Korean Construction Company

Purpose – Employee turnover entails considerable costs and is a major problem for the construction industry. By creating an extensive framework, this study aims to examine whether perceived work-related factors affect turnover intention in South Korean construction companies. Research design – The paper is based on the results of a questionnaire of 136 employees that was conducted and provided by a Korean construction company. Research hypotheses were tested via correlation analyses. The most influencing work-related factors, as well as differences among job levels, were determined by multiple regression analyses. Findings – Communication, immediate leaders, organizational commitment, and organizational pride substantially affect turnover intentions. All of these factors can be considered as relational factors. The most influencing factors differ among job levels. Discussion/practical implications – Immediate leaders should be aware of their role in retaining employees and enhance communication, organizational commitment and pride. This study shows how the importance of certain variables differs for groups of employees. Theoretical implications/limitations– This study is based on a sample of employees from a Korean construction company. Therefore, the generalizability of the findings has to be tested. Future research should test the proposed framework with other factors or resources. Originality/value – This study shed light on the turnover subject in the South Korean construction industry. It shows that different factors can influence turnover intention among job levels. A framework was created, which is based on 16 work-related factors including organizational factors, HRM practices and job attitudes.

Human resources management, citizenship behavior, and turnover intention in the portuguese public administration

Framed by a social exchange perspective, this study address the issue of whether positive employees’ perceptions about human resource management practices influence positive attitudes and behaviour. We hypothesize that human resource management practices (HRMP) have a significant negative effect on intention to voluntary leave the organization and a positive effect on organizational citizenship behaviour (OCB), and that OCB could mediate the relationship between HRMP and turnover intention. A sample of 165 employees from the Portuguese public administration participated in the study. Data was analysed through descriptive statistics, confirmatory factor analysis and hypotheses were tested using single and multiple linear regressions. Results indicate that HRMP is positively associated with OCB, but only internal communication practice is highly valued by Portuguese public employees and successfully predicts OCB. HRMP also show a positive association with turnover intention but only celebration and recognition practices are predictors of turnover intention. Contrary to our hypothesis OCB did not acted as mediator between HRMP and turnover intention. Some suggestions on managerial human resource practices were proposed as well as some main questions raised in the Portuguese public administration context.

Nepotism and turnover intentions amongst knowledge workers in Saudi Arabia

This chapter discusses how international assignment was used as tool to expand knowledge within the organisation using the example of the Kingdom of Saudi Arabia, we focus in particularly on the case of repatriation and problems with subsequent staff turnover, among repatriates in Saudi Arabia’s private sector. Before doing so, the chapter provides a background to the Saudi labour market and the impact of Saudization policies that aimed to reduce relying on foreign labour. Following this, the chapter discusses the Saudi government attempt create a national knowledgeable labour force through international assignment. Finally, using the example of an organisation in Saudi Arabia, this chapter illustrates the possible role of Wasta - a prevalent form of nepotism that permeates organizational life in Saudi Arabia - in repatriates managers turnover intention. Our focus is on unravelling the impact of Wasta on HRM practices with a particular focus on the management of the repatriation process of Saudi employees upon their completion of international assignments.

Analysis of employee turnover amongst construction managers in Hubei Province

This study determined the most important factors affecting turnover intention and developed a prediction model of construction manager turnover in Hubei Province, China. This prediction model can help human resource managers take appropriate actions to reduce the rate of construction manager turnover and keep good construction managers.

Explaining employee turnover in an Asian context

Employee turnover is giving sleepless nights to HR managers in many countries in Asia. A widely-held belief in these countries is that employees have developed 'bad' attitudes due to the labour shortage. Employees are believed to job-hop for no reason, or even for fun. Unfortunately, despite employee turnover being such a serious problem in Asia, there is a dearth of studies investigating it; in particular studies using a comprehensive set of variables are rare. This study examines three sets of antecedents of turnover intention in companies in Singapore: demographic, controllable and uncontrollable. Singapore companies provide an appropriate setting as their turnover rates are among the highest in Asia. Findings of the study suggest that organisational commitment, procedural justice and a job-hopping attitude were three main factors associated with turnover intention in Singapore companies.

Turnover Intent Among Middle School Teachers

The purpose of the study was to examine the relations among mentoring, adaptation, satisfaction, commitment, and turnover intention. Two-hundred fifty two middle school teachers from ten Midwestern U.S. schools were surveyed. Hierarchical regression results demonstrated that positive mentoring experiences, successful adaptation, and greater commitment reduced the likelihood of turnover intent.

Perceived Work Status and Turnover Intentions of Casual-Dining Restaurant Employees

The current research examined the effects of perceived work status of hourly employees on the established relationships between turnover intentions and the constructs of autonomy, affective organizational commitment, perceived management concern for employees, and perceived management concern for customers in the casual-dining restaurant industry. Surveys were collected from 296 employees of a multi-unit casual-dining restaurant franchise, part of a large, national, casual-dining restaurant chain. Employeeswith perceived part-time work status revealed a generally negative trend in factors shown to contribute to turnover. Employees who perceived their work status as parttime also showed significantly lower levels of affective organizational commitment than those who perceived their work status as full-time. Additionally, the mean scores of the desirable attributes trended lower for those employees who perceived themselves as part-time. Even more, helping behaviors, so crucial in a casual-dining environment, were lower when employees perceived their work status to be part-time. The current study discusses managerial implications of the research findings and gives suggestions for future research.