Wynendaele Herlinde, Clays Els, Peeters Ellen, DeJonghe Yannai, Van Hecke Ann, Trybou Jeroen
Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
TIAS School for Business and Society, Utrecht, The Netherlands.
BMC Health Serv Res. 2025 Jun 5;25(1):806. doi: 10.1186/s12913-025-12966-5.
This umbrella review aims to systematically synthesize the current evidence on the factors associated with personnel turnover in the healthcare and welfare sectors, the methodologies used to measure turnover, and the effectiveness of interventions designed to reduce turnover.
Following PRISMA-P guidelines, we analyzed data from January 2013 to July 2023 across multiple databases, including PubMed, Web of Science, CINAHL, Cochrane Database of Systematic Reviews, and Embase. Two reviewers independently screened titles and abstracts for predefined eligibility criteria. They also collaboratively examined 10% of the full texts to ensure compliance with these criteria. Study quality was evaluated using AMSTAR 2, and a Corrected Covered Area analysis was conducted.
The analysis included 37 studies with a total of 511 primary studies. Turnover factors were grouped into three categories: socio-demographics and health status, work environment characteristics, and personal attitude and functioning, highlighting a wide range of factors that influence both turnover intention and actual turnover. Various measurement methodologies were identified, with a notable lack of standardization. Interventions targeting work-related factors showed mixed effectiveness, underscoring the importance of context-specific strategies.
The findings show the complexity and context-specific nature of turnover in healthcare and welfare sectors, requiring targeted, context-specific interventions to address the diverse factors involved. Standardization of measurement methodologies is necessary for comparing turnover rates and the effectiveness of interventions. Future research should focus on filling existing gaps, particularly in non-hospital settings, and on developing and evaluating multifaceted interventions.
本伞状综述旨在系统地综合当前有关医疗保健和福利部门人员流动相关因素、用于衡量人员流动的方法以及旨在减少人员流动的干预措施有效性的证据。
遵循PRISMA-P指南，我们分析了2013年1月至2023年7月期间多个数据库的数据，包括PubMed、科学网、护理学与健康领域数据库、Cochrane系统评价数据库和Embase。两名评审员独立筛选标题和摘要，以确定预定义的纳入标准。他们还共同检查了10%的全文，以确保符合这些标准。使用AMSTAR 2评估研究质量，并进行校正覆盖面积分析。
分析纳入了37项研究，共511项原始研究。人员流动因素分为三类：社会人口统计学和健康状况、工作环境特征以及个人态度和功能，突出了影响人员流动意愿和实际人员流动的广泛因素。确定了各种测量方法，但明显缺乏标准化。针对与工作相关因素的干预措施效果不一，强调了因地制宜策略的重要性。
研究结果表明，医疗保健和福利部门人员流动具有复杂性和因地制宜的特点，需要有针对性的、因地制宜的干预措施来解决其中涉及的各种因素。测量方法的标准化对于比较人员流动率和干预措施的有效性是必要的。未来的研究应侧重于填补现有空白，特别是在非医院环境中，并侧重于开发和评估多方面的干预措施。
