Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon.
Hum Resour Health. 2013 Sep 30;11:49. doi: 10.1186/1478-4491-11-49.
Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon.
This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment of work environment. Analysis included univariate and bivariate (chi-square, Student's t-test and ANOVA) tests to describe the respondents and examine the significance between nurses' characteristics and their intent to stay. A logistic regression model was constructed to identify factors associated with nurses' intent to stay in underserved areas.
A total of 857 nurses from 63 Primary Healthcare (PHC) centers and hospitals responded to the questionnaire (75.5% response rate). Only 35.1% of nurses indicated their intent to stay in their current job over the coming one to three years. Surveyed nurses were most satisfied with relationship with co-workers and least satisfied with extrinsic rewards. Rural nurses working in PHC centers were more satisfied than their hospital counterparts on all aspects of work and had significantly higher intention to stay (62.5% compared to 31.5% in hospitals, P < 0.001). Regression analysis revealed that nurses less likely to report intent to stay were younger, unmarried, with less years of work experience and were not working towards a higher degree. Analysis reveals a directly proportional relationship between nurses' reported job satisfaction and their intent to stay.
This study reveals poor retention of nurses in rural and underserved areas in Lebanon, especially in the hospital sector. The status quo is disquieting as it reflects an unstable and dissatisfied nursing workforce. Developing targeted retention strategies for younger nurses and those working in hospitals as well as the offering of professional development opportunities and devising an incentive scheme targeting rural nurses is pivotal to enhance nurses' job satisfaction and retention in rural settings.
护理人员短缺和分布不均是全球医疗体系的优先事项。在服务不足的地区，这种不平衡现象往往更为严重，尤其是在发展中国家。尽管这个问题至关重要，但在中东地区，研究服务不足地区护士留用问题的研究很少。本研究调查了在黎巴嫩农村地区工作的护士的特征和与留用相关的因素。
本研究采用非实验性的横断面设计，对在黎巴嫩服务不足地区工作的护士进行调查。黎巴嫩的服务不足地区是根据世卫组织的定义确定的。总共确定了 103 个位于这些地区的卫生设施（医院和初级保健中心），并向这些设施工作的所有护士发放了调查问卷。问卷包括五个部分：人口统计学、工作生活、职业规划、工作满意度和工作环境评估。分析包括单变量和双变量（卡方检验、学生 t 检验和方差分析）检验，以描述受访者并检查护士特征与留任意愿之间的显著性。建立逻辑回归模型以确定与护士留在服务不足地区意愿相关的因素。
共有 857 名来自 63 个初级保健（PHC）中心和医院的护士对问卷做出了回应（75.5%的回应率）。只有 35.1%的护士表示愿意在未来一到三年内留在目前的工作岗位上。调查护士对同事关系最满意，对外在奖励最不满意。在工作的所有方面，在 PHC 中心工作的农村护士比医院同行更满意，并且留任意愿明显更高（62.5%比医院的 31.5%，P < 0.001）。回归分析显示，报告留任意愿较低的护士更年轻、未婚、工作经验较少，且没有向更高学位发展。分析显示，护士报告的工作满意度与留任意愿呈正比关系。
本研究揭示了黎巴嫩农村和服务不足地区护士的留用率较低，尤其是在医院部门。这种现状令人不安，因为它反映了一个不稳定和不满意的护理人员队伍。为年轻护士和在医院工作的护士制定有针对性的留用策略，以及为农村护士提供职业发展机会和制定激励计划，对于提高农村地区护士的工作满意度和留用率至关重要。
