Personnel turnover in health care organizations: Test of a predictive model based on work assessments by employees

It is predicted that institutions in Dutch intramural health care will be increasingly confronted with problems in personnel supply. Instead of making great efforts to keep the inflow of new personnel on the desired level, control of turnover is an alternative solution. In this paper, an explanatory model is constructed, based on previous theories and research findings. It is hypothesized that the more employees have positive attitudes concerning their work and work situation, the greater their satisfaction and commitment and hence the less their intention to leave and the lower actual turnover. This model was tested using a large scale employee questionnaire. The instrument turned out to be reliable (internal consistencies above .70). The questionnaire was administered in eight institutions in four health care sectors (n = 1456). Results indicate that attitudes about work content and personnel management are relevant in predicting intention to leave. All in all, 8 work-related aspects predicted 21% of intention to leave. Aspects with the most predictive value were career guidance, work safety, responsibilities and job discretion. Furthermore, general satisfaction was shown to play an intermediary role in predicting intention to leave. It is concluded that improvements in work content and personnel management can reduce intention to leave and hence the demand for new personnel.     

Supervisory coaching and performance feedback as mediators of the relationships between leadership styles,work engagement,and turnover intention

Human resource development (HRD) is key to organizational success. With some HRD roles devolving to leaders in recent years, a gap in understanding is now evident in how leaders’ leadership styles shape development-oriented behaviours that may effectively assist them in fulfilling their HRD roles, and the corresponding effects that this has on employee work engagement and turnover intention. This study compared the effects of transformational and transactional leadership styles on employee attitudes (i.e. work engagement and turnover intention) through leaders’ behaviours (i.e. supervisory coaching and performance feedback). This study used a multilevel approach (i.e. matching leaders to multiple subordinates) with 500 employees, nested in 65 workgroups from private organizations in Malaysia. As hypothesized, we found a link between transformational (but not transactional) leadership and higher levels of supervisory coaching and performance feedback, and that these job resources mediate the relationship between transformational leadership and work engagement. Furthermore, we found that work engagement mediates the relationships of both supervisory coaching and performance feedback to turnover intention. Overall, the study results reveal one way in which Asian leaders can effectively facilitate some aspects of HRD through development-focused behaviours which serve as job resources to boost work engagement and reduce turnover intention.     

Absenteeism, turnover intention and inequity in the employment relationship

In this field study a preliminary social exchange model was proposed that related perceived inequity in the employment relationship to subsequent absenteeism and turnover intention. From an equity perspective, it was hypothesized that absenteeism and turnover intention are indirectly related to perceived inequity in the exchange relationship with the organization, mediated by feelings of resentment and poor organizational commitment. By employing covariance structure modelling, the model was tested among mental health care professionals (N = 90). The results demonstrated that the relationship between perceived inequity and turnover intention was fully mediated by poor organizational commitment, which was, in turn, partially triggered by feelings of resentment that were associated with perceived inequity. In contrast, there was a strong direct link between inequity in the employment relationship and absenteeism, not mediated by resentment and poor organizational commitment. It was concluded that absenteeism and turnover intention can both be considered to be withdrawal reactions to perceived inequity, but that the two reactions differ in their underlying dynamics. The implications of these findings were discussed.     

Exploring turnover intentions among three professional groups of employees

Abstract

Although considerable research effort has been devoted to understanding work attitudes, behaviours and outcomes regarding turnover intentions, little has been done to explore it across different professions. This study takes a step in this direction and examines the effect of affective commitment, job satisfaction and job performance on turnover intentions across three professions. To this end, we surveyed three professional groups of employees and managers: financial officers and social workers employed in the public sector and lawyers employed in the private sector. The results of these three studies show that turnover intentions vary across these professions. Social workers exhibit lower turnover intentions than financial officers and lawyers, who tend to exhibit high turnover intentions. In addition, we found that job satisfaction and affective commitment are negatively associated with turnover intentions, while no significant relationship was found to exist between job performance and turnover intentions. The implications of this study suggest that both researchers and practitioners should take into consideration not only the organizational context, but also the occupational context while exploring the process of voluntary turnover.     

Absence behaviour,turnover and disability: A study among city bus drivers in the Netherlands

Abstract

Absenteeism, turnover and disability, and relationships between them have been studied among city bus drivers in the Netherlands. The theoretical framework for the study was a cumulative process model of work and health. Absenteeism among these drivers was two to three times as high as the national average, while the risk of disablement was more than twice as high as the risk for male Dutch civil servants in general. Bus drivers who had to leave their job for medical reasons did so at a younger age than other groups of civil servants. The main conditions leading to disablement related to the back, tendons and joints (35%), mental disorders (35%) and cardiovascular diseases (12%). It was shown that long-term absenteeism is a strong precursor of future disability. The research suggests a work-related process of progressive deterioration of health and well-being over a reasonably long period of time. Driving city buses seems to be an occupation with high risks for health and well-being.     

The nature,extent and determinants of violence against psychiatric personnel

Violence against psychiatric staff seems to be on the increase. Such abuse can lead to mental health consequences for the staff and a reluctance to be closely involved with patients. Few Swedish investigations have examined violence against mental nurses and psychiatrists, or undertaken comparative studies between them. In this study we examined the extent, nature and determinants (i.e. risk factors) of violence against psychiatric nurses (n = 731) and psychiatrists (n = 320) working in the eight health care districts of Stockholm. These caregivers were assessed cross-sectionally by means of a questionnaire covering various areas (e.g. violence and work environment). The majority of the participants (85%) reported having been exposed to violence during their careers, with 57% being victimized in the past 12 months. Physical violence was common, and factors such as negative attitudes to work and diminished sense of autonomy were associated with an increased vulnerability to violence. Nurses and psychiatrists did not differ in violence variables. In spite of the weaknesses of the design (cross-sectional self-selecting sample), this study corroborates previous findings and identifies personal factors associated with violence that have received little attention in the literature (e.g. lack of respect for the organization of care).     

Relationships between work-family culture and work attitudes at both the individual and the departmental level

There is a need to better understand the nature of work-family culture and its relationships with job-related outcomes. The main objective of this study was to investigate the associations between a supportive work-family culture and work attitudes (i.e., job satisfaction, work engagement, turnover intentions) at both the individual and work departmental level. Survey-based data were gathered from 52 Finnish work departments (1219 individuals) in the domains of health care, ICT, and the paper industry. Data were analysed via multilevel structural equation modelling. Work-family culture was assessed via managers’ supportiveness, organizational time demands, and the expected career consequences of taking up work-family-related benefits. The results showed, first, that employees in the same work department shared similar perceptions of the department's work-family culture and work attitudes; second, the perceptions of the work-family culture shared within the work department as well as employees’ individual perceptions of it were associated with work attitudes. Thus, the positive effects of a supportive work-family culture on work attitudes were established at both the individual and work departmental levels.     

Employee attitudes to work-based counselling services

Abstract

Work-based counselling services have increasingly been introduced in organizational settings in the 1980s and 1990s. In this paper, a study is reported of the attitudes of 213 employees of a UK Health Authority towards an existing counselling service. Questionnaires sought information about attitudes to counselling, confidentiality, attitudes to those seeking counselling and general health. The results suggested that attitudes to work-based counselling services are predicted by employees' perceptions of those seeking counselling as trustworthy and their beliefs about the confidentiality of the service. The practical implications of these results are examined.     

Linking perceived organizational support with employee work outcomes in a Chinese context: Organizational identification as a mediator

Perceived organizational support (POS) is viewed as an important explanatory framework for understanding the relationship between employees and the workplace, and is regarded by some researchers as central in understanding job-related attitudes and behaviors of employees. However, less research has taken into account the role of organizational identification, which reflects how individuals define the self with respect to their organization, as a potential influence on such relationships. Drawing on a cross-organizational sample of 238 subordinate-supervisor dyads from the People’s Republic of China, we examined whether organizational identification mediates the effect of perceived organizational support (POS) on work outcomes including turnover intentions, work performance, and organizational citizenship behavior (OCB). Results from the current study showed that organizational identification fully mediates the relation of POS to OCB-directed to individuals, and partially mediates relations between POS and other work outcomes (turnover intention, work performance, OCB-directed to organization). Implications for management theory and practice are discussed.     

The moderating role of personality characteristics on the relationship between job insecurity and strain

The experience of job insecurity has been linked to several different outcomes, such as negative attitudes towards work and the organization, turnover intention, as well as health complaints. However, since the strength of these effects have been found to vary across studies, it is vital to identify factors that could influence the relationships. The present study examines the moderating role of three personality characteristics (negative affectivity, positive affectivity, and external locus of control) on the relation between job insecurity and outcomes (mental health complaints, job dissatisfaction, and job-induced tension). Data from 400 nurses at a Swedish acute care hospital (response rate 71%; 91% women, aged 20-68 years) showed that both job insecurity and personality were related to strain. Also, the data indicated some buffering effect of personality. Despite the gender bias of the sample, the study provides additional support for the notion that job insecurity affects strain even after controlling for individual characteristics. The study also expands the literature on job insecurity by pointing out the influence of personality characteristics on the relationship between stressors and strain.     

Self–other agreement in empowering leadership: Relationships with leader effectiveness and subordinates' job satisfaction and turnover intention

We investigated the effect of self–other agreement in empowering leadership on leader effectiveness, job satisfaction, and turnover intention using a sample of 50 Norwegian municipal leaders (46 for leader effectiveness) and 168 (158) of their subordinates. The findings indicated that considering both self and subordinate ratings of empowering leadership was useful in predicting the outcome variables. In particular, subordinates of over-estimators reported lower job satisfaction and higher turnover intention. Moreover, leaders who underestimated their leadership were perceived as more effective by their superiors. For agreement (i.e., leader's self-ratings were in agreement with subordinates' ratings) the relationship between empowering leadership and leader effectiveness was curvilinear with an inverted U shape. Agreement in ratings of empowering leadership was not found to be related to subordinates' job satisfaction and turnover intention. The implications of these findings are discussed.     

内外控人格特质的研究及其在管理中的应用

内外控人格特质是个体对其行为及行为所产生的后果强化后的信念。内外控人格特质的不同不但影响个体对工作的态度,还影响着个体对组织的承诺感及满意度,从而影响到员工工作绩效和离职意图。通过对影响内外控人格特质的因素进行归纳,对目前常用的测量内外控人格特质的量表进行分类,并对内外控人格特质在管理中的应用进行分析的基础上,对国内外内外控人格特质的研究现状进行了较全面的概述,并在此基础上提出了5个方面的研究方向。     

从留职视角预测离职:工作嵌入研究述评

工作嵌入作为源于映像理论和离职展开模型的一个新构念,为员工留职提供了更广阔的解释空间,并展示了预测离职的一个新视角。本文通过文献梳理,从三个方面对国内外工作嵌入研究的最新进展进行了综述:工作嵌入的涵义与测量,工作嵌入的认知基础及其与展开模型的关系,工作嵌入的效应、影响因素及其拓展研究进展。最后,在分析工作嵌入研究现有问题的基础上,提出了未来研究方向和建议。     

Editorial: Cognitive science,occupational stress and organizational health

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Work & stress: Information

The aim of this study was to investigate whether psychosocial factors at work are related to low-back pain among nursing personnel. It was conducted as a short-term follow-up study of 200 Danish female nursing personnel, providing care for the elderly. Self-reported measures of psychosocial factors such as time pressure, emotional demands of clients, control and social support were obtained by questionnaire at baseline, while stress, physical exertion and low-back pain were reported by diary records made in two, three-day periods in the subsequent 6 months. The study examines the possible influence of psychosocial factors preceding low-back pain as well as stress and physical exertion reported simultaneously with low-back pain. Only stress was associated with low-back pain (Odds Ratio (OR)=2.3; Confidence Interval (CI)=1.3-3.9) while neither physical exertion or any of the psychosocial factors were related to low-back pain. A possible pathway connecting emotional demands of clients to low-back pain through the mediation of stress was suggested.     

Getting New Staff to Stay: The Mediating Role of Organizational Identification

Newcomer turnover is a major cost to organizations, and the quality of new employees' experiences in the first few months is critical in determining whether they decide to stay or leave. In a study that focused on the first stage of newcomer socialization, we investigate the impact of perceptions of social validation from the team and the team leader, and perceived fairness of treatment on newcomers' identification with their work team and the organization, specifically measuring the group self‐investment components of identification. The mediating role of these levels of group self‐investment and of the imbalance (i.e. difference) between levels of self‐investment on turnover intentions was also tested. New staff (N=569) joining a large public‐sector organization completed a questionnaire about their socialization experiences in their first 6 months of their employment. Structural equation modelling revealed that social validation by the team and team leaders, and fairness of treatment, predict increased investment with the organization and with the team. Organizational‐level self‐investment and an imbalance in favour of investment with the organization over that of the team mediated decreases in turnover intentions. We conclude that organizations should provide newcomers with validation that promotes identification with their organization during this critical stage of socialization.     

Transformational leadership and optimal functioning at work: On the mediating role of employees' perceived job characteristics and motivation

This study aimed to deepen our understanding of the motivational mechanisms involved in the relationship between transformational leadership (TFL) and employee functioning. Drawing on the TFL literature, the job demands–resources model and self-determination theory, we propose an integrative model that relates TFL to employee psychological health (burnout and psychological distress), attitudes (occupational commitment and turnover intention) and performance (professional efficacy, self-reported individual and objective organizational performance) through two explanatory mechanisms: perceived job characteristics (job demands and resources) and employee motivation (autonomous and controlled). This research was conducted in two occupational settings (nurses and school principals), using a distinct variable operationalization for each. Results of both studies provide support for the hypothesized model, suggesting that TFL relates to optimal job functioning (psychological health, job attitudes and performance) by contributing to favourable perceptions of job characteristics (more resources and less demands) and high-quality work motivation (more autonomous motivation and less controlled motivation) in employees. Theoretical contributions and managerial implications as well as directions for future research are presented.     

Editorial statement: Stress and work compensation

Shift work has been reported to predict health problems, and a possible explanation is that shift work may lead to poorer health habits, thereby increasing a person's vulnerability to illness. This study examined the association between shift work and health habits, as indicated by smoking, alcohol intake, physical activity and by being overweight. A questionnaire was sent to all 2795 female nurses working in the 10 hospitals of two Finnish health care districts. From the 2299 respondents, we selected those 506 shift workers who reported having always done shift work and those 183 day workers who had never done shift work. Shift workers were found to smoke more and to be overweight more often than day workers. These differences gradually increased in each successive age group, being 1.94 pack-years in smoking and 0.9 kg m^-2 in body mass index among nurses over 45 years of age. Shift work was not associated with alcohol intake or sedentary lifestyle. This evidence is compatible with the possibility that shift work in nurses increases smoking and being overweight to a degree that contributes to health problems, including coronary heart disease.     

Beyond leader–member exchange (LMX) differentiation: An indigenous approach to leader–member relationship differentiation

The existing literature has established that leaders differentiate among their followers; however, the focus has long been on the Western leader–member exchange (LMX) theory. This paper examines leader–member relationship differentiation from an indigenous, leader–member guanxi (LMG) perspective. Using a sample of 60 groups and 228 employees, we examined the dual effects of LMG differentiation on employee job satisfaction, organizational commitment, turnover intention, and co-worker helping behavior after controlling for LMX, LMX median, and LMX differentiation. The results of this study supported the proposed dual effects of LMG differentiation, demonstrating that LMG differentiation, in general, is detrimental to employees' work attitudes and their intentions to stay in an organization. On the contrary, interestingly enough, LMG differentiation can accentuate the positive relationship between LMG and job satisfaction, organizational commitment, and co-worker helping behaviors.