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Review Paper
Effects of Leadership Styles of Nursing Managers on Turnover Intention of Hospital Nurses: A Systematic Review and Meta-Analysis
Cho, Yunjeong , Jeong, Seok Hee , Kim, Hee Sun , Kim, Young Man
J Korean Acad Nurs 2022;52(5):479-498.   Published online October 31, 2022
DOI: https://doi.org/10.4040/jkan.22039
AbstractAbstract PDF
Purpose
This study aimed to examine effect sizes of leadership styles of nursing managers on turnover intention of hospital nurses.
Methods
A systematic review and meta-analysis were conducted in accordance with the PRISMA and MOOSE guidelines. Participants were nurses working in hospitals. The intervention involved nursing managers’ leadership styles; the outcome assessed was nurses’ turnover intention. This was an observational study design. Eleven databases were searched to obtain articles published in Korean or English. Of the 14,428 articles reviewed, 21 were included in systematic review and meta-analysis. Comprehensive Meta-Analysis and R software programs were used.
Results
The total effect size r (ESr) was - 0.25 (95% confidence interval: - 0.29 to - 0.20). Effect sizes of each leadership style on turnover intention were as follows: ethical leadership (ESr = - 0.34), transformational leadership (ESr = - 0.28), authentic leadership (ESr = - 0.23), transactional leadership (ESr = - 0.21), and passive avoidant leadership (ESr = 0.13). Ethical leadership was the most effective style in decreasing turnover intention of hospital nurses.
Conclusion
Positive leadership styles of nurse managers effectively decrease turnover intention of hospital nurses, and negative leadership styles of nurse managers effectively increase turnover intention of hospital nurses. The ethical leadership style is the most effective in decreasing turnover intention of hospital nurses; however, it requires careful interpretation as its effects are reported by only two studies. This study contributes to addressing the high turnover rate of hospital nurses and developing positive leadership styles of nurse managers in hospital settings.

Citations

Citations to this article as recorded by  
  • The effect of organizational communication and grit on turnover intention of rehabilitation hospital nurses: A cross-sectional correlation study
    Inji Ha, Heeok Park, Ji Hun Joung
    Journal of Korean Gerontological Nursing.2025; 27(1): 35.     CrossRef
  • Influence of Leadership Styles on Turnover Intentions in Technology Startups
    Sheeza Fayyaz, Saima Majeed
    Journal of Professional & Applied Psychology .2025; 6(1): 36.     CrossRef
  • Protecting Workers From Rude Customers to Enhance Organizational Identification in Emotional Labor Environments: A Study With Call Center Agents
    Hyojeong Kim, Nagesh N Murthy, Anurag Agarwal, Kwangtae Park
    Production and Operations Management.2025;[Epub]     CrossRef
  • Mediating Effect of Leader-Member Exchange on the Ethical Leadership of Nursing Unit Managers and Turnover Intention of Clinical Nurses: A Nationwide Survey using Proportional Quota Sampling
    Jihun Kim, Sunmi Kim, Nara Han, Seok Hee Jeong
    Journal of Korean Academy of Nursing Administration.2024; 30(1): 42.     CrossRef
  • Effects of Resilience, Nursing Managers’ Empowering Leadership on Turnover Intention among New Nurses: Mediating role of Transition Shock
    Hyun Jin Jung, Hyun Kyung Kim, Seok Hee Jeong
    Journal of Korean Academy of Nursing Administration.2024; 30(3): 212.     CrossRef
  • Investigation of the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions
    Sultan Türkmen Keskin, Meltem Özduyan Kiliç
    Journal of Advanced Nursing.2024; 80(5): 1859.     CrossRef
  • The structural relationship of job stress, job satisfaction, organizational commitment, and turnover intention among youth sports education leaders in Korea
    Myung Kyu Jung, Tae Gyeom Jung, Min Woo Jeon, Ji Hae Lee
    Frontiers in Psychology.2024;[Epub]     CrossRef
  • Effects of Patient Safety Management System, Leadership, and Communication Types on Nurse’ Patient Safety Management Activities
    Eunji Lee, Haejung Lee
    Journal of Korean Academy of Nursing Administration.2024; 30(4): 367.     CrossRef
  • Nursing-sensitive Indicators in East Asian Hospitals: A Scoping Review
    Jae Jun Lee, Won Jin Seo, Dong Ah Park, Hwa Yeong Oh, Seung Eun Lee
    Quality Improvement in Health Care.2024; 30(2): 88.     CrossRef
  • Factors Influencing Nurses Turnover in Saudi Arabia: A Systematic Review
    Abdulmajeed M. Albalawi, Glezzeelyne P. Pascua, Sameer A. Alsaleh, Walaa Sabry, Sitti Nursa Ahajan, Jeseela Abdulla, Amal Abdulalim, Suad S. Salih, Sulaiman Al Sabei
    Nursing Forum.2024;[Epub]     CrossRef
  • Effects of Nursing Unit Managers’ Authentic Leadership, Transformational Leadership, and Transactional Leadership on Turnover Intention in Advanced Beginner Nurses: Mediation Effects of Positive Psychological Capital
    Eun Jeong Kim, Eungyung Kim, Son Ja Lee
    Journal of Korean Academy of Nursing Administration.2023; 29(4): 409.     CrossRef
  • Factors related to the organizational silence of Korean nurses: A systematic review and meta-analysis
    Kyungja Kang, Jeong-Hee Kim
    The Journal of Korean Academic Society of Nursing Education.2023; 29(3): 302.     CrossRef
  • 1,355 View
  • 119 Download
  • 3 Web of Science
  • 12 Crossref
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Research Paper
Relationships among Non-Nursing Tasks, Nursing Care Left Undone, Nurse Outcomes and Medical Errors in Integrated Nursing Care Wards in Small and Medium-Sized General Hospitals
Park, Ju-Young , Hwang, Jee-In
J Korean Acad Nurs 2021;51(1):27-39.   Published online February 28, 2021
DOI: https://doi.org/10.4040/jkan.20201
AbstractAbstract PDF
Purpose
This study aimed to identify the degree of non-nursing tasks and nursing care left undone in integrated nursing care wards, and examine their relationships with nurses’ burnout, job satisfaction, turnover intentions, and medical errors.
Methods
A cross-sectional questionnaire survey was conducted. Data were collected using self-report questionnaires from 346 nurses working in 20 wards of seven small and medium-sized general hospitals, and analyzed using multiple regression and multiple logistic regression analysis with the SPSS WIN 25.0 program.
Results
The mean score for non-nursing tasks was 7.32±1.71, and that for nursing care left undone was 4.42 ± 3.67. An increase in non-nursing tasks (β = .12, p = .021) and nursing care left undone (β = .18, p < .001) led to an increase in nurses’ burnout (F = 6.26, p < .001). As nursing care left undone (β = .13, p = .018) increased, their turnover intentions also (F = 3.96, p < .001) increased, and more medical errors occurred (odds ratio 1.08, 95% confidence interval 1.02~1.15).
Conclusion
Non-nursing tasks and nursing care left undone are positively associated with nurses’ burnout, turnover intentions, and the occurrence of medical errors. Therefore, it is important to reduce non-nursing tasks and nursing care left undone in order to deliver high quality nursing care and in turn increase patient safety.

Citations

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  • First Integration of a Service Robot and a Communication Application into a Nursing Isolation Setting – An Observational Study Evaluating Walking Distances, Stress and Radiation Doses
    Angelika Warmbein, Laura Sehn, Ivanka Rathgeber, Janesca Seif, Christoph Ohneberg, Nicole Stöbich, Astrid Delker, Christian Zach, Inge Eberl, Uli Fischer
    International Journal of Social Robotics.2025;[Epub]     CrossRef
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    Haena Lim, Yeojin Yi
    Nurse Education in Practice.2025; 83: 104283.     CrossRef
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    Leman Şenturan, Gizem Kaya, Tuba Emirtaş
    Research in Nursing & Health.2025;[Epub]     CrossRef
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    Loai M. Zabin, Jamal Qaddumi, Sajed Faisal Ghawadra
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    Young-mi Cho, Sun-hui Kim
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  • Relationships among Nursing Skill Mix, Missed Nursing Care, and Adverse Events in Small and Medium-Sized Hospital Comprehensive Nursing Care Wards
    Yoon Sook Cho, Hyoung Eun Chang, Hyunjung Lee
    Journal of Korean Academy of Nursing Administration.2024; 30(2): 163.     CrossRef
  • Exploring the causes and consequences of non-nursing tasks among nurses in Jordan: An in-depth qualitative investigation
    Ayman Abed Aldarawsheh, Ahmad Rajeh Saifan, Murad Adnan Sawalha, Enas A. Assaf, Intima Alrimawi, Rami A. Elshatarat, Zyad T. Saleh, Wesam T. Almagharbeh, Nermen A. Mohamed, Mudathir M. Eltayeb
    Applied Nursing Research.2024; 77: 151791.     CrossRef
  • Influence of Work Environment, Missed Nursing Care, and Non-Nursing Tasks of Hospital Nurses on Job Stress
    Ji Yeong Park, Kyoung Ja Kim
    Journal of Korean Academy of Nursing Administration.2024; 30(3): 246.     CrossRef
  • A comparative analysis of nurses' reported number of patients and perceived appropriate number of patients in integrated nursing care services
    Hyunjeong Kwon, Jinhyun Kim
    Nursing & Health Sciences.2024;[Epub]     CrossRef
  • Effectiveness of a virtual reality application‐based education programme on patient safety management for nursing students: A pre‐test–post‐test study
    Jae Woo Oh, Ji Eun Kim
    Nursing Open.2023; 10(12): 7622.     CrossRef
  • The Effect of Missed Nursing Care on Adverse Event Experiences, Patient Safety Management Activity, Job Satisfaction and Turnover Intention in Nurses: A Nationwide Survey using Proportional Quota Sampling
    Myung Jin Choi, Seok Hee Jeong
    Journal of Korean Academy of Nursing Administration.2023; 29(4): 490.     CrossRef
  • Pathway Analysis on the Effects of Nursing Informatics Competency, Nursing Care Left Undone, and Nurse Reported Quality of Care on Nursing Productivity among Clinical Nurses
    Mi Yu, Se Young Kim, Ji Min Ryu
    Journal of Korean Academy of Nursing.2023; 53(2): 236.     CrossRef
  • Competency Survey of Caregivers in Medical Tourism Special Zone and Other Regions
    Dong-Yeop Lee, Sang-Bong Lee, Yeong-Im Park, Jin-Geun Lee, Yoon Hee Park, So Young Lee, Dong-Yoon Kang
    Journal of Health Informatics and Statistics.2023; 48(2): 140.     CrossRef
  • Influence of the Team Effectiveness of Nursing Units on Nursing Care Left Undone and Nurse-Reported Quality of Care
    Se Young Kim, Young Ko
    Healthcare.2023; 11(10): 1380.     CrossRef
  • The Impact of Performance of Non-Nursing Tasks on the Attitudes of Nursing Students toward Nursing Profession
    Ibrahim Rawhi Ayasreh, Ferial Hayajneh, Rana Al Awamleh
    Nurse Media Journal of Nursing.2022; 12(2): 151.     CrossRef
  • Clinical Application Value of Group‐Sharing Nursing Management Based on Case Analysis
    Jing Mei, Yifan Wu, Jie Hu, Min Li, Mohammad Farukh Hashmi
    Contrast Media & Molecular Imaging.2022;[Epub]     CrossRef
  • The Effect of Burnout on Quality of Care Using Donabedian’s Framework
    Kathleen M. White, Dorothy Dulko, Bonnie DiPietro
    Nursing Clinics of North America.2022; 57(1): 115.     CrossRef
  • Emotional Labor, Burnout, Medical Error, and Turnover Intention among South Korean Nursing Staff in a University Hospital Setting
    Chan-Young Kwon, Boram Lee, O-Jin Kwon, Myo-Sung Kim, Kyo-Lin Sim, Yung-Hyun Choi
    International Journal of Environmental Research and Public Health.2021; 18(19): 10111.     CrossRef
  • Integrated and Person-Centered Nursing in the Era of the 4th Industrial Revolution
    Hyoung Suk Kim, Sun Joo Jang, Jeung-Im Kim
    Journal of Korean Academy of Nursing.2021; 51(3): 261.     CrossRef
  • Analysis of Nurses' Work Experience in Comprehensive Nursing Care Units of Small and Medium-sized Hospitals
    Mi Ryeong Song, Su Hyang Ryu
    Journal of Korean Academy of Nursing Administration.2020; 26(4): 419.     CrossRef
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Original Articles
Relationship of Workplace Violence to Turnover Intention in Hospital Nurses: Resilience as a Mediator
Kang, Hyun-Jung , Shin, Jaeyong , Lee, Eun-Hyun
J Korean Acad Nurs 2020;50(5):728-736.   Published online October 31, 2020
DOI: https://doi.org/10.4040/jkan.20147
AbstractAbstract PDF
Purpose
This study aimed to identify the relationship between workplace violence and turnover intention, and the mediation effect of resilience on the relationship in hospital nurses.
Methods
This was a cross-sectional study. A total of 237 registered nurses were recruited from three hospitals in South Korea from April to May 2019. Participants were invited to complete self-reported questionnaires that measure workplace violence, turnover intention, resilience, and demographic information. The data obtained were analyzed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval (5,000 bootstrap resampling).
Results
After controlling demographic covariates, workplace violence significantly accounted for the variance of turnover intention. It was also demonstrated that resilience partially mediated the relationship between workplace violence and turnover intention in hospital nurses. A 73.8% of nurses had experienced workplace violence (such as attack on personality, attack on professional status, isolation from work, or direct attack). Conclusion: Workplace violence directly influences turnover intention of nurses and indirectly influences it through resilience. Therefore, hospital administrators need to develop and provide a workplace violence preventive program and resilience enhancement program to decrease nurses’ turnover intention, and leaving.

Citations

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  • Hemşirelerin İş Yerinde Yaşadıkları Psikolojik Şiddet ile Psikolojik Sağlamlılıkları Arasındaki İlişki
    Fatma GÜNDOGDU, Aybüke ULAŞ, Ecem TAŞ, Vildan ÇARDAK, İrem Yaren ŞANDIR, Muhammed DURMAZ, Mehmet Salim ECER
    Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi.2023; 6(3): 608.     CrossRef
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    Özlem Gedik, Refika Ülke Şimdi, Şerife Kıbrıs, Derya Kara (Sivuk)
    Journal of Research in Nursing.2023; 28(6-7): 448.     CrossRef
  • Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey
    Je-Yeon Yun, Sun Jung Myung, Kyung Sik Kim
    Scientific Reports.2023;[Epub]     CrossRef
  • Assessing the effect of nursing stress factors on turnover intention among newly recruited nurses in hospitals in China
    Lulin Zhou, Arielle Doris Kachie Tetgoum, Prince Ewudzie Quansah, Joseph Owusu‐Marfo
    Nursing Open.2022; 9(6): 2697.     CrossRef
  • The influence of experienced violence and the clinical learning environment on vocational identity in nursing students
    Mira Lee, Hee Ok Park, Insook Lee
    The Journal of Korean Academic Society of Nursing Education.2021; 27(3): 321.     CrossRef
  • Factors Affecting on Turnover Intentions of Emergency Department Nurses who have Experienced Verbal Abuse
    Gyoo-Yeong CHO, Mi-Kyung SEO
    JOURNAL OF FISHRIES AND MARINE SCIENCES EDUCATION.2021; 33(2): 314.     CrossRef
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    Bom-Mi Park, Jiyeon Jung
    International Journal of Environmental Research and Public Health.2021; 18(19): 10327.     CrossRef
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    Jeung-Im Kim
    Journal of Korean Academy of Nursing.2020; 50(5): 644.     CrossRef
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The Influence of Grit on Turnover Intention of University Hospital Nurses: The Mediating Effect of Job Involvement
Ji Yeong Jeong, Youn Sook Seo, Jung Hoon Choi, Seong Hee Kim, Min Sook Lee, Sung Hwa Hong, Jung Suk Choi, Da Eun Park
J Korean Acad Nurs 2019;49(2):181-190.   Published online April 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.2.181
AbstractAbstract PDF
Purpose

This study aimed to confirm the mediating effect of job involvement in the relationship between grit and turnover intention among nurses working at university hospitals.

 Methods

Participants included 437 nurses from university hospitals located in C city, Gyeongnam. Data were collected from January 8 to 19, 2018, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffe's test, Pearson's correlation coefficient, and multiple regression, with the SPSS/22.0 program. A mediation analysis was performed according to the Baron and Kenny, and bootstrapping methods.

 Results

There were significant relationships between grit and job involvement (r=.40, p<.001), grit and turnover intention (r=−.29, p<.001), and turnover intention and job involvement (r=−.52, p<.001). Job involvement showed partial mediating effects in the relationship between grit and turnover intention.

 Conclusion

Grit increased job involvement and lowered turnover intention. Therefore, to reduce nurses' turnover intention, it is necessary to develop a program and strategies to increase their grit.

Citations

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    Seulgi Kang, Yoonjung Kim, Hyeji Shin
    Journal of Advanced Nursing.2025; 81(5): 2438.     CrossRef
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    Journal of Korean Association for Qualitative Research.2024; 9(1): 34.     CrossRef
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    Cui Yang, Lu Yang, Dongmei Wu
    Frontiers in Psychology.2023;[Epub]     CrossRef
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    Mi Kyung Park, Won Hwa Kim
    The Journal of Korean Academic Society of Nursing Education.2023; 29(2): 161.     CrossRef
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    Muhammad Ishaq, Afsha Bibi, Fazal Khaliq, Ashfaq Ahmad
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    Ji Sun Yang, Myung Jin Jang
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The Effects of Hospitals’ Family Friendly Management on Married Female Nurses’ Retention Intention: Focused on the Mediating Effects of Work-Family Interface
Jin Hwa Lee, Jee-In Hwang
J Korean Acad Nurs 2019;49(4):386-397.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.386
AbstractAbstract PDF
Abstract Purpose

This study examined the effect of hospitals’ family-friendly management on married female nurses’ retention intention. The focus was the mediating effects of the work-family interface (work-family conflict, work-family enrichment and work-family balance).

 Methods

This study was a cross-sectional study. The participants were 307 nurses working at five public and five private hospitals with more than 200 beds in Seoul. Data were collected using structured questionnaires from September 10 to September 17, 2018 and analyzed with SPSS 24.0. Data were analyzed using an independent t-test, a one-way ANOVA, Pearson's correlation coefficients, and multiple regression following the Baron and Kenny method and Sobel test for mediation.

 Results

There were significant correlations among family-friendly management, the work-family interface, and retention intention. Work-family conflict showed a partial mediating effect on the relationship between family-friendly management and retention intention. Work-family enrichment showed a partial mediating effect on the relationship between family-friendly management and retention intention. Work-family balance showed a partial mediating effect on the relationship between family-friendly management and retention intention.

 Conclusion

These findings indicate that both hospitals’ family-friendly management and nurses’ work-family interface are important factors associated with nurses’ retention intention. Therefore, hospitals should actively implement family-friendly management for nurses and establish strategies to enhance nurses’ work-family interface for effective human resource management.

Citations

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    Sohyun Kim, Wen Liu, Patricia Heyn
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  • Disaster Preparedness and Associated Factors Among Emergency Nurses in Guangdong Province, China: A Descriptive Cross-Sectional Study
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    Eun Sil Jeong, Seok Hee Jeong, Hyun Kyung Kim, Myoung Hee Seo
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    Hyunjung Lee, Hyoung Eun Chang, Jiyeon Ha
    Healthcare.2020; 9(1): 16.     CrossRef
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The Effect of Nurse's Emotional Labor on Turnover Intention: Mediation Effect of Burnout and Moderated Mediation Effect of Authentic Leadership
Soo Yang Na, Hanjong Park
J Korean Acad Nurs 2019;49(3):286-297.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.3.286
AbstractAbstract PDF
Abstract Purpose

To investigate the effect of nurses’ emotional labor on their turnover intention that was mediated by burnout and to examine the moderated mediation effect of authentic leadership.

 Methods

A total of 227 nurses working at two general hospitals in Seoul were recruited from March 21 to May 6 in 2016. Emotional labor including surface acting and deep acting; burnout factors such as emotional exhaustion and personal accomplishment; and turnover intention were assessed. The data were analyzed using SPSS 22.0 and SPSS PROCESS macro.

 Results

Surface acting significantly increased emotional exhaustion and reduced personal accomplishment. Deep acting significantly increased personal accomplishment. Emotional exhaustion significantly increased turnover intention. Conversely, personal accomplishment significantly reduced turnover intention. Surface acting had an indirect effect on turnover intention that was mediated by emotional exhaustion. Deep acting had an indirect effect on turnover intention that was mediated by personal accomplishment. Authentic leadership had a moderated mediation effect on the relationship between surface acting and turnover intention that was mediated by emotional exhaustion.

 Conclusion

The findings of this study indicate that the establishment of strong authentic leadership by head nurses would help nurses reduce their burnout and turnover intention. Conducting intervention studies would be also important to promote better work environments that would enable nurses to fortify the positive aspect of emotional labor and to reduce their burnout levels.

Citations

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    Shin Hee Kim, Mi Sook Oh, Yun Bok Kwak
    Journal of Korean Academy of Nursing Administration.2025; 31(1): 64.     CrossRef
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    Mehmet Akif Köse, Esra Töre
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Patterns and Influential Factors of Inter-Regional Migration of New and Experienced Nurses in 2011~2015
Bohyun Park, Se Young Kim
J Korean Acad Nurs 2017;47(5):676-688.   Published online October 31, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.5.676
AbstractAbstract PDF
Purpose

The purpose of this study was to analyze the migration patterns of new nurses and experienced nurses and to identify the factors influencing inter-regional migration for solving regional imbalances of clinical nurses in South Korea.

 Methods

This study involved a secondary analysis of data from the Health Insurance Review and Assessment Service (HIRA). Data were analyzed using descriptive statistics and multiple logistic regression analysis.

 Results

New nurses tended to migrate from Kyunggi to Seoul. However, experienced nurses tended to migrate from Seoul and Chungchung to Kyunggi. Significant predictors of inter-regional migration among new nurses were location and nurse staffing grade of hospitals. Significant predictors of inter-regional migration among experienced nurses were location, hospital type, nurse staffing grade, ownership of hospitals and age of nurses.

 Conclusion

Inter-regional migration occupied a small portion of total hospital movement among clinical nurses. The regional imbalances of nurses were not caused by the migration from non-metropolitan areas to Seoul. Nurse shortage problems in the small and medium hospitals of the non-metropolitan area can be solved only through improvement of work environment.

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    Yunmi Kim, Hyun-Young Kim
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    Yunmi Kim, Hyun-Young Kim
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    Ji‐Soo Kim
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    Eun‐Kyoung Lee, Ji‐Soo Kim
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The Relationship Among Leadership Styles of Nurse Managers, Job Satisfaction, Organizational Commitment, and Turnover Intention
Na Sun Ha, Jung Choi
Journal of Korean Academy of Nursing 2002;32(6):812-822.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.812
AbstractAbstract PDF

PURPOSE: The Purpose of this study was to identify the relationship among leadership style of nurse managers, job satisfaction, organizational commitment, and turnover intention. METHOD: The subjects were 468 nurses and 19 head nurses who were working at the 3 general hospitals in seoul. The data were collected from July 6 to September 14, 2001 by the structured questionnaires. For data analysis, descriptive statistics, ANOVA, Pearson correlation coefficient, and stepwise multiple regression with SAS package were used. RESULT: 1) The score of the nurse managers' transformational leadership perceived by surbodinates' were higher than that of the nurse managers' transactional leadership. Among 5 subdimensions of the leadership styles perceived by surbodinates', the scores of 'charisma' and 'intellectual stimulation' were highest and 'management by exception' were lowest. 2) 'Charisma', 'intellectual stimulation', 'individual consideration' and 'contingent reward' were positively related to all of variables except 'turnover intention'. 'Management by exception' was negatively related to all of variables and was positively related to 'turnover intention'. 3) 'Job satisfaction' was positively related to 'organizational commitment' and 'Job satisfaction', 'organizational commitment' were negatively related to 'turnover intention'. 4) As a result of stepwise multiple regression analysis, the key determinants of 'turnover intention' were 'organizational commitment' and this explained 44.4% of the total variance of it.

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Predictors of Nurse Turnover: Model Development and Testing
Richard Redman, Sung Hyun Cho, Shake Ketefian, Oi Saeng Hong
Journal of Korean Academy of Nursing 2000;30(7):1667-1678.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.7.1667
AbstractAbstract PDF

BACKGROUND: The phenomenon of nursing turnover has been explained by organizational commitment, job satisfaction, or intent to stay in previous studies; yet the combined contribution of these factors to nurse turnover has not been examined. OBJECTIVES: The purpose of this study was to develop and test a turnover model which included professionalism, job-related variables, job satisfaction, organizational commitment, and intent to stay.
METHOD
A total of 424 registered nurses in a university hospital completed a self-administered questionnaire including Professionalism Scale, Job Diagnostic Survey, Nurse Assessment Survey, and intention to stay. Nurses were classified as to whether they remained in or had left the organization 18 months after the survey. Multiple regression and logistic regression analyses were conducted to test the model.
RESULTS
Overall job satisfaction and intent to stay were the most important determinants of nursing turnover. Organizational commitment positively affected intent to stay and indirectly decreased turnover through intent to stay. Satisfaction with coworkers and supervisor were the most important factors in explaining overall job satisfaction. Satisfaction with pay, autonomy, and feedback from job also positively affected overall job satisfaction.
CONCLUSION
Using the results of the tested model nurse managers and administrators could predict turnover by monitoring its determinants, and ultimately reduce the turnover rate through early intervention.

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Turnover Experience of Male Nurses
Hyunsu Kim, Jeongseop Lee
J Korean Acad Nurs 2017;47(1):25-38.   Published online February 28, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.1.25
AbstractAbstract PDF
Purpose

The aim of this study was to identify turnover experiences of men in nursing and to derive a substantive theory on the turnover experience of men who are nurses.

 Methods

Data were collected through in-depth interviews with 13 men who had worked as a nurse for 1 year or more, and had a turnover experience during that period. Collected data were analyzed on the basis of Strauss and Corbin's grounded theory.

 Results

The core category in the turnover experiences of the respondents was ‘seeking a stable place for me’. In the analysis of the core category, types of ‘contentment’, ‘seeking’, ‘survival’ and ‘confusion’ were identified. The sequential stages of these nurses’ turnover experience were ‘confrontation’, ‘incertitude’, ‘retrying’ and ‘realization’. However, when a problem arose in the process, they returned to the stage of confusion. Thus, these stages could occur in a circular fashion.

 Conclusion

These findings provide a deep understanding of the turnover experience of men in nursing and offers new information about how they adapt to nursing practice. The findings should be useful as foundational data for men who hope to become nurses and also for managers responsible for nurses who are men.

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    Ja-Sook Kim, Suhyun Kim, Hyang-In Cho Chung, Sally Mohammed Farghaly
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    Eunhee Lee
    Human Resources for Health.2019;[Epub]     CrossRef
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Association between Emotional Labor, Emotional Dissonance, Burnout and Turnover Intention in Clinical Nurses: A Multiple-Group Path Analysis across Job Satisfaction
Chi-Yun Back, Dae-Sung Hyun, Sei-Jin Chang
J Korean Acad Nurs 2017;47(6):770-780.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.770
AbstractAbstract PDF
Abstract Purpose

This study was conducted to investigate the influence of emotional labor, emotional dissonance, and burnout on nurse's turnover intention and examine the effect of job satisfaction on the relationships among emotional labor, emotional dissonance, burnout, and turnover intention.

 Methods

The sample consisted of 350 nurses recruited from 6 general hospitals in 2 cities in Korea. A multiple-group analysis was utilized. Data were analyzed using SPSS statistics 23 and AMOS 20.

 Results

In the path analysis, turnover intention was directly related to burnout in clinical nurses who had a high job satisfaction (b=.24, p=.003), while it was indirectly related to emotional dissonance (b=.13, p=.002). In the multiple-group path analysis, turnover intention was directly related to emotional dissonance (b=.18, p=.033) and burnout (b=.26, p=.002) for nurses with low job satisfaction.

 Conclusion

These results indicate that manuals and guidelines to alleviate the negative effects of emotional labor, emotional dissonance, and burnout, and to increase job satisfaction are strongly required to reduce turnover intention in nurses at the organizational level as well as at the individual level.

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    Ji‐Soo Kim
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    Eun‐Kyoung Lee, Ji‐Soo Kim
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Predictors of Turnover among New Nurses using Multilevel Survival Analysis
Suhee Kim, Kyongeun Lee
J Korean Acad Nurs 2016;46(5):733-743.   Published online October 31, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.5.733
AbstractAbstract PDF
Purpose

The purpose of this study was to examine factors influencing new graduate nurse turnover.

 Methods

This study was carried out as a secondary analysis of data from the 2010 Graduates Occupational Mobility Survey (GOMS). A total of 323 nurses were selected for analysis concerning reasons for turnover. Data were analyzed using descriptive statistics and multilevel survival analysis.

 Results

About 24.5% of new nurses left their first job within 1 year of starting their jobs. Significant predictors of turnover among new nurse were job status, monthly income, job satisfaction, the number of hospitals in region, and the number of nurses per 100 beds.

 Conclusion

New graduate nurses are vulnerable to turnover. In order to achieve the best health of the nation, policy approaches and further studies regarding reducing new graduate nurse turnover are needed.

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Influences of Hospital Nurses' perceived reciprocity and Emotional Labor on Quality of Nursing Service and Intent to Leave
Mi-Aie Lee, Eunjeong Kim
J Korean Acad Nurs 2016;46(3):364-374.   Published online June 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.3.364
AbstractAbstract PDF
Purpose

This study was performed to investigate the relationship among reciprocity, emotional labor, nursing service quality and intent to leave, and to identify factors influencing nursing service quality and intent to leave.

 Methods

This study was a cross-sectional survey. Participants were 300 nurses working at five general hospitals in two provincial cities in Gyeongsang Province, Korea. From May 1 to June 30, 2014, data were collected using structured questionnaires and analyzed with SPSS/PC ver 20.0 programs.

 Results

There were relationships between reciprocity and nursing service quality, and intent to leave, and between emotional labor and intent to leave. Participants' general characteristics, reciprocity and emotional labor explained 48.4% of variance in nursing service quality and participants' general characteristics and these two independent variables explained 31.9% of intent to leave.

 Conclusion

These findings indicate that from the perception of hospital nurses, reciprocity and emotional labor are both very important factors to improve the quality of nursing service and decrease the intent to leave. So nursing managers should try to develop various personnel management programs focused on human emotions, and create a mutual respectable organizational culture and work environment.

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    Dluha Mafula, Hidayat Arifin, Ruey Chen, Chien-Mei Sung, Chiu-Kuei Lee, Kai-Jo Chiang, Kondwani Joseph Banda, Kuei-Ru Chou
    Journal of Nursing Regulation.2025; 15(4): 20.     CrossRef
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Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals
Yunmi Kim, Ji Yun Lee, Hyuncheol Kang
J Korean Acad Nurs 2014;44(1):21-30.   Published online February 28, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.1.21
AbstractAbstract PDF
Purpose

This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals.

 Methods

A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators.

 Results

Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable.

 Conclusion

To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

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Effects of Nurses' Mentoring on Turnover Intention: Focused on the Mediating Effects Role Stress and Burnout
Sangsook Han, Ohsook Kim, Yunsu Joo, Eunduck Choi, Jeongwon Han
J Korean Acad Nurs 2013;43(5):605-612.   Published online October 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.5.605
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the casual relationship between nurses' mentoring and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest an adequate model.

 Methods

The survey was conducted with 434 nurses working in general hospitals in Seoul. Data were collected during February 2013, and analyzed with SPSS Windows 18.0 and AMOS 7.0.

 Results

Mentoring was found to have a direct effect on decrease in role stress. Role stress had a direct effect on increase in burnout and mentoring, with role stress as a mediator, there was an indirect effect on burnout. Burnout had a direct effect on increase in turnover intention, and role stress, with burnout as a mediator, and mentoring, through role stress and burnout, an indirect effect was found on increase in turnover intention.

 Conclusion

The results of this study indicate that nursing managers should put effort into reducing role stress and burnout, while seeking to establish a more efficient mentoring system so that for nurses, there will be a lowering of turnover intention.

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    Eunhye Kim, Jinhyun Kim
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Effects of Nurses' Social Capital on Turnover Intention: Focused on the Mediating Effects Organizational Commitment and Organizational Cynicism
Jeongwon Han, Heeyoung Woo, Eunsil Ju, Sohee Lim, Sangsook Han
J Korean Acad Nurs 2013;43(4):517-525.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.517
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the casual relationship between nurses' social capital and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest the best model.

 Methods

This survey was conducted with 315 nurses working in general hospitals in Seoul. Data were collected from December 1 to December 30, 2011, and analyzed using SPSS Windows 18.0 and AMOS 16.0.

 Results

Nurses' social capital was found to have a direct effect on reducting organization cynicism and increasing organizational commitment. Nurses' organizational cynicism and organizational commitment were found to have a direct effect on turnover intention, but social capital did not have a direct effect on turnover intention. However, social capital had a partial and indirect effect on turnover intention through mediating organizational cynicism and organizational commitment.

 Conclusion

Results of this study indicate that nurse managers should put increased effort in reducing nurses' organizational cynicism and improving their organizational commitment, two contrary parameters. At the same time managers need to develop plans to establish social capital more efficiently so that nurses have lower turnover intention.

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Development and Testing of a Nurse Turnover Intention Scale (NTIS)
Eun Ja Yeun, Heejeong Kim
J Korean Acad Nurs 2013;43(2):256-266.   Published online April 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.2.256
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a measurement tool of nurse's turnover intention.

 Methods

Data were collected from questionnaires completed by 678 nurses who worked in 3 university hospitals in South Korea and analyzed using the SPSS 18.0 and AMOS 18 programs. Thirty-seven preliminary items were selected from 161 basic items extracted via a literature review and in depth interviews with 6 hospital nurses. Three steps with factor analysis were undertaken to verify the reliability and validity of the preliminary instruments. Finally, confirmative factor analysis was carried out.

 Results

As a result of the analysis, 3 factors including 10 items were selected. Cronbach's Alpha for the 10 items was .83, for job satisfaction (4 items), .78, for interpersonal relationships (3 items), .80, and for work performance (3 items), .74, which was stable.

 Conclusion

This study is meaningful because through it a scale reflecting Korean culture was developed to measure turnover intention in nurses. Further studies that test the psychometrics of this scale in more diverse samples are warranted.

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Structural Equation Modeling on Nursing Productivity of Nurses in Korea
Se Young Kim, Eun-Kyung Kim, Heon Man Lim, Mi Young Lee, Kwang-Ok Park, Kyoung A Lee
J Korean Acad Nurs 2013;43(1):20-29.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.20
AbstractAbstract PDF
Purpose

The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity.

 Methods

A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program.

 Results

Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity.

 Conclusion

This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.

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Relationships between Compassion Fatigue, Burnout, and Turnover Intention in Korean Hospital Nurses
Kiwol Sung, Youngsook Seo, Jee Hee Kim
J Korean Acad Nurs 2012;42(7):1087-1094.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.7.1087
AbstractAbstract PDF
Purpose

This study aimed to identify relationships between compassion fatigue, burnout, and turnover intention in Korean hospital nurses.

 Methods

In total, 142 hospital nurses were surveyed as part of data collection. Data related to compassion fatigue, burnout, and turnover intention were collected using a questionnaire between May 2011 and September 2011. The data analysis was performed using PASW 19.0 program, which included one-way ANOVA, independent t-tests, Pearson's correlation coefficient, and hierarchical regression analysis.

 Results

This study detected a positive correlation between compassion fatigue and burnout(r=.37, p<.001), and turnover intention(r=.55, p<.001). Compassion fatigue accounted for 29.6% of the variance for turnover intention among Korean hospital nurses.

 Conclusion

The results indicate that it is necessary to reduce compassion fatigue, and turnover intention among Korean hospital nurses.

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A Model on Turnover Intention of Chief Nurse Officers
Kwang-Ok Park, Jong Kyung Kim, Se Young Kim, Sunju Chang
J Korean Acad Nurs 2012;42(1):9-18.   Published online February 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.1.9
AbstractAbstract PDF
Purpose

The purpose of this study was to test the turnover intention model for chief nurse officers in general hospitals. The variables for the study included job stress, social support, job satisfaction, and organization commitment.

 Methods

A predictive, non-experimental design was used with a sample of 144 chief nurse officers from 144 general hospitals. Data were collected using self-administered questionnaires and analyzed using SPSS, AMOS program.

 Results

The overall fitness of the hypothetical model to the data was good (χ2=16.80, p=.052, GFI=.96, AGFI=.90, NFI=.97, CFI=.99). Job stress, social support, job satisfaction, and organization commitment explained 59.0% of the variance in turnover intention by chief nurse officers. Both organization commitment and social support directly influenced turnover intention for chief nurse officers, and job stress and job satisfaction indirectly influenced turnover intention.

 Conclusion

The results imply that chief nurse officers in hospitals need social support and management of job stress to increase job satisfaction and organization commitment, and lower turnover intention.

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A Predictive Model on Turnover Intention of Nurses in Korea
Sook Ja Moon, Sang Sook Han
J Korean Acad Nurs 2011;41(5):633-641.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.633
AbstractAbstract PDF
Purpose

The purpose of this study was to propose and test a predictive model that could explain and predict Korean nurses' turnover intentions.

 Methods

A survey using a structured questionnaire was conducted with 445 nurses in Korea. Six instruments were used in this model. The data were analyzed using SPSS 15.0 and Amos 7.0 program.

 Results

Based on the constructed model, organizational commitment, and burnout were found to have a significant direct effect on turnover intention of nurses. In addition, factors such as empowerment, job satisfaction, and organizational commitment were found to indirectly affect turnover intention of nurse. The final modified model yielded χ2=402.30, p<.001), χ2/df=2.94, RMSEA=0.07, RMR=0.03, GFI=0.90, AGF=0.87, NFI=0.88, CFI=0.92 and good fit indices.

 Conclusion

This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with turnover intention in Korean nurses. Findings from this study can be used to design appropriate strategies to further decrease the nurses' turnover intention in Korea.

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New Nurse Turnover Intention and Influencing Factors
Sang Sook Han, In Soon Sohn, Nam Eun Kim
J Korean Acad Nurs 2009;39(6):878-887.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.878
AbstractAbstract PDF
Purpose

The study was done to identify turnover intention in new nurses according to characteristics of the nurses and other factors affecting turnover and to provide data to set up a strategy to reduce the turnover.

 Methods

Data were collected from 1,077 new nurses who had less than 12 months employment experience and worked in one of 188 hospitals. Eight research instruments were used. Data analysis was done using SPSS WIN 15.0 program.

 Results

Several factors influence new nurse turnover intention. The average score for turnover intention was 2.12. The scores for subscales were self efficacy, 3.76, nursing performance, 3.90, job satisfaction, 2.09, organization commitment, 1.28, stress, 1.32, burnout, 2.82 and nursing organizational culture, 3.29. Turnover intention was related to self efficacy, nursing performance, job satisfaction, organization commitment, stress, burnout, nursing organizational culture, duration of in-class training, duration of on the job training, number of hospital beds, length of employment and duration of employment in current workplace. The predicting factors for turnover intention were burnout, stress, duration of employment in the current workplace, self efficacy and nursing performance. Those factors explained 51.6% of turnover intention.

 Conclusion

New nurse turnover intention can be reduced by mitigating the factors affecting this intention.

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The Mediating Role of Organizational Citizenship Behavior between Organizational Justice and Organizational Effectiveness in Nursing Organizations
Wall-Yun Park, Sook-Hee Yoon
J Korean Acad Nurs 2009;39(2):229-236.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.229
AbstractAbstract PDF
Purpose

This study was a secondary analysis to verify the mediating role of organizational citizenship behavior (OCB) between organizational justice (OJ) and organizational effectiveness (OE) in nursing organizations.

 Methods

The RN-BSNs and their colleagues in Seoul and Busan were subjects. The data was collected for 20 days between September 13 and October 2, 2004. Two hundred eighty three data sets were used for the final analysis. The fitness of models were tested using AMOS 5.

 Results

The fitness of hypothetical model was moderate. Procedural Justice (PJ), Interaction Justice (IJ) and Distributive Justice (DJ) had direct effects on Job Satisfaction (JS), Organizational Commitment (OC) and Turnover Intention (TI) in OE, and indirect effects on JS, OC and TI mediated by OCB. The modified model improved with ideal fitness showed the causal relations among OE. In modified model, PJ, IJ and DJ had direct positive effects on OCB and JS and OC in OE, and indirect effects on JS and OC mediated by OCB. JS and OC in OE had a direct negative effect on TI.

 Conclusion

OCB mediated the relationship between OJ and OE, so the nursing managers should enhance OCB of the nurses in order to improve OE.

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Experiences of Nurse Turnover
Yun-Jung Lee, Kwuy-Bun Kim
Journal of Korean Academy of Nursing 2008;38(2):248-257.   Published online April 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.2.248
AbstractAbstract PDF
Purpose

This study was designed to search for nursing intervention strategies centering around the meaning structure of the nurse's turnover experience by applying phenomenological methods.

 Methods

The participants were 6 nurses in small and medium sized hospitals who had experienced at least 1 turnover. Data were collected used MP3 records. The data analysis was done by Giorgi (1985) method.

 Results

The results were divided into the following categories: 1) Careless decision: wrong decisions, imprudent desire, insufficient patience, unclear future, 2) Inappropriate working environment: irregular working hours, high workload, poor working environment, insufficient understanding of related divisions, lack of opinion collection, low salary, 3) Interpersonal relations problems: discord with colleagues, difficulty in relationships with others, difficulty in daily lives, 4) Lack of specialization: feeling of inertia, lack of role identification, lack of self identification, 5) Inappropriate coping: regret with clinical challenges, difficulty with a new environment, repentance, expectation, relative humility, 6) New self-dignity: expectation, new challenge, relaxing lives, decisions based on future-oriented confidence.

 Conclusion

The finding of this study will offer profound information on the nurse's turnover experience and provide basic raw materials for improving the quality of nursing performance and contribute to the development of hospital organization.

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The Effect of Assertiveness Training on Communication Related Factors and Personnel Turnover Rate among Hospital Nurses
Myung Ja Kang, Haejung Lee
Journal of Korean Academy of Nursing 2006;36(5):681-690.   Published online August 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.5.681
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate.

 Method

A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An ‘Assertiveness Training Program’ for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA.

 Results

The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate.

 Conclusion

There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.

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