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Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction

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  • Yi-Chuan Chen

    (School of Nursing, College of Medicine, National Taiwan University (NTU), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan)

  • Yue-Liang Leon Guo

    (Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan
    Department of Environmental and Occupational Medicine, National Taiwan University Hospital (NTUH), No.7, Chung-Shan South Rd., Taipei 10002, Taiwan)

  • Wei-Shan Chin

    (School of Nursing, College of Nursing, Taipei Medical University (TMU), No. 250, Wuxing St., Taipei 11031, Taiwan)

  • Nai-Yun Cheng

    (Institute of Labor, Occupational Safety and Health (ILOSH), Ministry of Labor, No. 99, Lane 407, Hengke Rd., New Taipei City 22143, Taiwan)

  • Jiune-Jye Ho

    (Institute of Labor, Occupational Safety and Health (ILOSH), Ministry of Labor, No. 99, Lane 407, Hengke Rd., New Taipei City 22143, Taiwan)

  • Judith Shu-Chu Shiao

    (School of Nursing, College of Medicine, National Taiwan University (NTU), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan
    Department of Nursing, National Taiwan University Hospital (NTUH), No.7, Chung-Shan South Rd., Taipei 10002, Taiwan
    Occupational Health Nursing and Education Association of Taiwan (OHNEAT), No.1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan)

Abstract

In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient–nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

Suggested Citation

  • Yi-Chuan Chen & Yue-Liang Leon Guo & Wei-Shan Chin & Nai-Yun Cheng & Jiune-Jye Ho & Judith Shu-Chu Shiao, 2019. "Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction," IJERPH, MDPI, vol. 16(23), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:23:p:4801-:d:292358
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    References listed on IDEAS

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    1. Dana Hayward & Vicky Bungay & Angela C Wolff & Valerie MacDonald, 2016. "A qualitative study of experienced nurses' voluntary turnover: learning from their perspectives," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(9-10), pages 1336-1345, May.
    2. Anke Wagner & Antje Hammer & Tanja Manser & Peter Martus & Heidrun Sturm & Monika A. Rieger, 2018. "Do Occupational and Patient Safety Culture in Hospitals Share Predictors in the Field of Psychosocial Working Conditions? Findings from a Cross-Sectional Study in German University Hospitals," IJERPH, MDPI, vol. 15(10), pages 1-18, September.
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    3. Mohd Ikhwan Azmi & Aziah Daud & Mohd Nazri Shafei & Anees Abdul Hamid, 2022. "Job Dissatisfaction and Its Predictors among Healthcare Workers of ‘Type 2 Health Clinics’ in North-Eastern Malaysia," IJERPH, MDPI, vol. 19(23), pages 1-13, December.
    4. Zhihui Jia & Xiaotong Wen & Xiaohui Lin & Yixiang Lin & Xuyang Li & Guoqing Li & Zhaokang Yuan, 2021. "Working Hours, Job Burnout, and Subjective Well-Being of Hospital Administrators: An Empirical Study Based on China’s Tertiary Public Hospitals," IJERPH, MDPI, vol. 18(9), pages 1-13, April.
    5. Hanna Choi & Sujin Shin, 2022. "The Factors That Affect Turnover Intention According to Clinical Experience: A Focus on Organizational Justice and Nursing Core Competency," IJERPH, MDPI, vol. 19(6), pages 1-12, March.

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