title: Age-dependent relationships between work ability, thinking of quitting the job, and actual leaving among Italian nurses: a longitudinal study.
abstract: BACKGROUND
  Qualified nurses commonly report several work-related problems, which may threat their health and work ability, and may have an impact upon retention.
  
  
  OBJECTIVE
  The aim of the present study was to investigate whether perceived work ability is a predictor for different types of thinking of quitting and for actual exit from the workplace.
  
  
  METHODS
  A prospective study has been performed based on 3329 Italian registered nurses which responded to both measurements of the Nurses' Early Exit Study. Institutions were selected by means of a stratified sampling procedure. All the 7447 nurses working in that healthcare organizations were recruited for the study. Baseline questionnaire was collected from 5504 nurses. Response rate at follow-up was 63.4%. Two hundred and fifty-five nurses left the job in the course of the investigation.
  
  
  METHODS
  Several multiple logistic regression analyses were performed controlling for indicators of work-related well-being, socio-demographic, and labour-market characteristics.
  
  
  RESULTS
  As a whole, our results show that among nurses younger than 45 years work ability is a significant predictor of different types of thinking of quitting, but not of actual exit from the workplace: a lower perceived work ability was associated with a higher desire to undertake further education (OR: 3.05; 95% CI: 1.30-7.18) and/or to change workplace (OR: 4.03; 95% CI: 1.84-8.83) or profession (OR: 6.67; 95% CI: 2.78-15.99). In contrast, among the older nurses (>45), only actual exit was predicted by lower work ability scores (OR: 7.14; 95% CI: 1.15-44.13), along with the perception of a larger availability of free nursing posts in the region (OR: 2.70; 95% CI: 1.13-6.43).
  
  
  CONCLUSIONS
  Therefore, we conclude that in the relationship between low perceived work ability and intended or actual exit, a significant part is explained by age itself, but also by the age-related differences in occupational and life opportunities. This contribution concludes with some age-related policies aimed at boosting nurses' retention.
authors.affiliation: Department of Occupational Health, University of Milan, Milan, Italy. donatella.camerino@unimi.it
authors.forename: Donatella
authors.initials: D
authors.lastname: Camerino
authors.forename: Paul Maurice
authors.initials: PM
authors.lastname: Conway
authors.forename: Beatrice Isabella Johanna Maria
authors.initials: BI
authors.lastname: van der Heijden
authors.forename: Madeleine
authors.initials: M
authors.lastname: Estryn-Béhar
authors.forename: Giovanni
authors.initials: G
authors.lastname: Costa
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Hasselhorn
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D033182:Intention; D007558:Italy / Q000453:epidemiology; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology*; D010558:Personnel Loyalty; D010563:Personnel Turnover / Q000706:statistics & numerical data; D011446:Prospective Studies; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013850:Thinking; D014940:Work Schedule Tolerance / Q000523:psychology*