Zhang Jingjing, Xia Lin, Wang Yuxin, Yi Ting, Wang Yan, Zhou Enhong, Dong Chaoqun
School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China.
Publicity Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
BMC Nurs. 2024 Jul 30;23(1):522. doi: 10.1186/s12912-024-02205-3.
The turnover of newly graduated nurses is a severe challenge for healthcare systems, and so it is essential to identify its predictive factors. This study investigates whether professional commitment, career adaptability, career self-efficacy, anxiety, and depression levels before and after internship can predict the turnover intention of newly graduated nurses after one year of employment.
In a longitudinal study, 271 undergraduate nursing students recruited by convenience sampling were surveyed before internship (T1), after internship (T2), and after one year of employment (T3), with all surveys conducted on the Wenjuanxing survey platform ( www.wjx.cn ). Generalized linear models and restricted cubic spline models were used to explore possible linear and nonlinear relationships between turnover intention and the variables of interest.
Professional commitment both pre-internship (β = -0.060, p = 0.007, 95% CI [- 0.104, - 0.016]) and post-internship (β = -0.053, p = 0.015, 95% CI [- 0.096, - 0.010]) can negatively predict turnover intention. There is also a negative linear relationship between post-internship career self-efficacy and turnover intention (β = -0.308, p < 0.001, 95% CI [- 0.436, - 0.180]). In addition, professional commitment both pre-internship (adjusted R = 0.046, p = 0.004) and post-internship (adjusted R = 0.068, p < 0.001), career self-efficacy both pre-internship (adjusted R = 0.039, p = 0.008) and post-internship (adjusted R = 0.116, p < 0.001), career adaptability both pre-internship (adjusted R = 0.057, p < 0.001) and post-internship (adjusted R = 0.039, p = 0.008), anxiety both pre-internship (adjusted R = 0.035, p = 0.014) and post-internship (adjusted R = 0.048, p = 0.003), and depression levels both pre-internship (adjusted R = 0.031, P nonlinear = 0.021) and post-internship (adjusted R = 0.053, p = 0.002) are nonlinearly associated with turnover intention.
Nursing educators and clinical care administrators must take action to enhance the professional commitment and career self-efficacy of nursing students during their internship. It is also important to pay attention to their career adaptability, as well as to any anxiety or depression that they may experience during clinical practice. This can help to reduce the turnover intention during the first year of their nursing career.
新毕业护士的离职率对医疗系统构成严峻挑战，因此确定其预测因素至关重要。本研究调查实习前后的职业承诺、职业适应能力、职业自我效能感、焦虑和抑郁水平是否能预测新毕业护士工作一年后的离职意愿。
在一项纵向研究中，通过便利抽样招募的271名本科护理专业学生在实习前（T1）、实习后（T2）和工作一年后（T3）接受了调查，所有调查均在问卷星调查平台（www.wjx.cn）上进行。使用广义线性模型和受限立方样条模型来探索离职意愿与相关变量之间可能的线性和非线性关系。
实习前（β = -0.060，p = 0.007，95% CI [-0.104, -0.016]）和实习后（β = -0.053，p = 0.015，95% CI [-0.096, -0.010]）的职业承诺均能负向预测离职意愿。实习后的职业自我效能感与离职意愿之间也存在负线性关系（β = -0.308，p < 0.001，95% CI [-0.436, -0.180]）。此外，实习前（调整后R = 0.046，p = 0.004）和实习后（调整后R = 0.068，p < 0.001）的职业承诺，实习前（调整后R = 0.039，p = 0.008）和实习后（调整后R = 0.116，p < 0.001）的职业自我效能感，实习前（调整后R = 0.057，p < 0.001）和实习后（调整后R = 0.039，p = 0.008）的职业适应能力，实习前（调整后R = 0.035，p = 0.014）和实习后（调整后R = 0.048，p = 0.003）的焦虑，以及实习前（调整后R = 0.031，P非线性 = 0.021）和实习后（调整后R = 0.053，p = 0.002）的抑郁水平均与离职意愿呈非线性相关。
护理教育工作者和临床护理管理人员必须采取行动，在实习期间提高护理专业学生的职业承诺和职业自我效能感。关注他们的职业适应能力以及临床实习期间可能经历的任何焦虑或抑郁也很重要。这有助于降低他们护理职业生涯第一年的离职意愿。
