title: Longitudinal analysis of personal and work-related factors associated with turnover among nurses.
abstract: BACKGROUND
  Although many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically.
  
  
  OBJECTIVE
  This longitudinal study examines specific determinant factors that differentiate between so-called "stayers" and "leavers" within the nursing profession and identifies risk factors for premature leaving by comparing nurses who have left their job or the nursing profession with nurses who stay.
  
  
  METHODS
  This cross-national exploratory European survey included 34,587 nurses (baseline measurement) working in 623 hospitals, nursing homes, and home care institutions and was composed of two measurements with a 1-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. As regards the leavers, the participating nurses were asked to indicate to what extent personal and work-related factors had contributed to the decision to leave their healthcare institution.
  
  
  RESULTS
  Nurses' intent-to-leave scores were higher in the baseline measurement among those who left the organization during the following 12 months than those among nurses who stayed (24.0% vs. 13.5%). A majority of nurses (86.8%) left their profession voluntarily. Involuntary departure occurred more often in Eastern European countries. Nurses indicated that the reasons for leaving were (a) working conditions (e.g., relationship problems, emotional difficulties, time pressure and quality of care, dissatisfaction with use of one's competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) and (b) family reasons (e.g., caring for relatives). For a considerable number of nurses, health reasons and the desire for continuing education added to their decision to leave.
  
  
  CONCLUSIONS
  Healthcare organizations should pay attention to preventive measures to protect labor market potential. Recommendations are made for human resource development in healthcare organizations and for further empirical research to better understand to what extent different policy systems across the European countries explain variance in outcomes.
authors.affiliation: Occupational Health Physician, Department of Occupational Health, Hôtel Dieu, Assistance-Publique-Hôpitaux de Paris, Paris, France. madeleine.estryn-behar@sap.aphp.fr
authors.forename: Madeleine
authors.initials: M
authors.lastname: Estryn-Behar
authors.forename: Beatrice I J M
authors.initials: BI
authors.lastname: van der Heijden
authors.forename: Clementine
authors.initials: C
authors.lastname: Fry
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Hasselhorn
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033182:Intention; D007588:Job Satisfaction; D008297:Male; D016294:Models, Nursing; D008960:Models, Psychological; D015999:Multivariate Analysis; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D010558:Personnel Loyalty; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000458:organization & administration / Q000523:psychology