[Factors linked to premature leaving of the nursing profession. Confirmation of the impact one year later. Longitudinal analyses of nurses. PRESST/NEXT study].
BACKGROUND
The organization of French medical institutions is changing, and the nursing personnel can encounter difficulties of adaption to these changes. The results of 2 questionnaires of the PRESST/NEXT study relative to working conditions (respectively, the questionnaires "Q0" and "Q12"), sent in a year interval to a sample of nurses were compared.


METHODS
Three samples were made up: a sample of 5376 nurses having answered the initial questionnaire (Q0); a sample of 2627 nurses having answered the questionnaire sent one year after (Q12), and working in the same establishment; a group of 208 nurses having answered the questionnaire "Qex", specific to nurses who left their establishment.


RESULTS
Among nurses who answered the "Qex", approximately 1/5 of nurses chose to leave the profession definitively or temporarily before the retirement age; of these, almost 13% began a new work not in the healthcare sector. Seven factors are significantly related to the intention of leaving the profession: Dissatisfaction regarding professional prospects (Q0: OR = 3.1 and Q12: OR = 2.82); Difficulties assuming the family responsabilities (Q0: OR = 1.36 and Q12: OR = 2.10); Mental health disorders for nurses not followed medically (Q0: OR = 1.76 and Q12: OR = 1.47), and for nurses receiving care for this (Q0 : OR = 1.90 and Q12: OR = 1.77); Dissatisfaction concerning the psychological support available at work (Q0: OR = 1.57 and Q12: OR = 1.87); Tiredness (Q0 : OR = 1.40 and Q12: OR = 1.6); Musculo-skeletal disorders diagnosed by doctor (Q0: OR = 1.32 and Q12: OR = 1.61); Dissatisfaction concerning the use of competences (Q0: OR = 1.27 and Q12: OR = 1.97).


CONCLUSIONS
These results raise questions as to the benefits of new management which promotes flexibility in work and schedules, and which reduces the possibilities of support within the nursing teams. This type of management implies uncertainty for nurses as far as the technical aspects of their work are concerned, and a lack of time for the education and follow-up of patients.
Jasseron
C
C
Unité PRESST-NEXT, Coordination Centrale du Service de Santé au Travail de l'AP-HP, Hôtel Dieu, Paris IV(eme) arrt.
Estryn-Behar
M
M
Le Nezet
O
O
Rahhali
I
I
D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology; D005260:Female; D005602:France; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D024802:Nurse's Role / Q000523:psychology; D015401:Nursing Administration Research; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology*; D009745:Nursing, Supervisory / Q000458:organization & administration; D009784:Occupational Diseases / Q000523:psychology; D009936:Organizational Innovation; D010563:Personnel Turnover / Q000706:statistics & numerical data; D012944:Social Support; D011795:Surveys and Questionnaires; D016526:Workload