Portoghese Igor, Galletta Maura, Battistelli Adalgisa, Leiter Michael P
Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Monserrato (Ca), Italy.
Laboratoire EA 4139 Psychologie, Santé et Qualité de Vie, Université Bordeaux Segalen, Bordeaux Cedex, France.
J Nurs Manag. 2015 Sep;23(6):754-64. doi: 10.1111/jonm.12205. Epub 2014 Jan 12.
To analyse nursing turnover intention from the unit by using multilevel approach, examining at the individual level, the relationships between job characteristics, job satisfaction and turnover intention, and at the group level the role of leader-member exchange.
Research on nursing turnover has given little attention to the effects of multilevel factors.
Aggregated data of 935 nurses nested within 74 teams of four Italian hospitals were collected in 2009 via a self-administered questionnaire.
Hierarchical linear modelling showed that job satisfaction mediated the relationship between job characteristics and intention to leave at the individual level. At the unit level, leader-member exchange was directly linked to intention to leave. Furthermore, cross-level interaction revealed that leader-member exchange moderated the relationship between job characteristics and job satisfaction.
This study supported previous research in single-level turnover studies concerning the key role of job satisfaction, providing evidence that job characteristics are important in creating motivating and satisfying jobs. At the unit-level, leader-member exchange offers an approach to understand the role of unit-specific conditions created by leaders on nurses' workplace wellbeing.
This study showed that it is important for nursing managers to recognise the relevance of implementing management practices that foster healthy workplaces centred on high-quality nurse-supervisor relationships.
采用多层次方法分析科室层面的护士离职意愿，在个体层面考察工作特征、工作满意度与离职意愿之间的关系，在团队层面考察领导成员交换的作用。
对护士离职的研究很少关注多层次因素的影响。
2009年通过自填式问卷收集了意大利四家医院74个团队中935名护士的汇总数据。
分层线性模型显示，工作满意度在个体层面中介了工作特征与离职意愿之间的关系。在科室层面，领导成员交换与离职意愿直接相关。此外，跨层次交互作用表明，领导成员交换调节了工作特征与工作满意度之间的关系。
本研究支持了以往单层次离职研究中关于工作满意度关键作用的研究，证明工作特征在创造激励性和满意度高的工作方面很重要。在科室层面，领导成员交换为理解领导创造的科室特定条件对护士工作场所幸福感的作用提供了一种方法。
本研究表明，护理管理者认识到实施以高质量护士-主管关系为中心的促进健康工作场所的管理实践的重要性。
