title: The importance of social exchange to nurses and nurse assistants: impact on retention factors.
abstract: OBJECTIVE
  The purpose of this study was to test the norm of reciprocity by examining relationships between perceived organisational support (POS), the quality of leader-member exchange (LMX) and psychological contract breach (PCB) and important nurse retention factors identified in the literature.
  
  
  BACKGROUND
  A major cause of turnover among nurses is related to unsatisfying workplaces. Previous research, mainly outside the nursing setting, found that social exchange affects employees' work-related attitudes.
  
  
  METHODS
  A cross-sectional survey was conducted on 217 nurses and nursing assistants to test and refine a model linking POS, LMX, PCB with job satisfaction, trust and turnover intentions.
  
  
  RESULTS
  Hierarchical multiple linear regression revealed that POS, PCB and LMX explained significant variance in all three retention factors: job satisfaction (adjusted R² = 0.502), trust (adjusted R² = 0.462) and turnover intentions (adjusted R² = 0.196). POS and PCB predicted most strongly job satisfaction (P < 0.001) and trust (P < 0.001 and P < 0.01, respectively). LMX predicted most strongly intention to leave (P < 0.01).
  
  
  CONCLUSIONS
  In our study, POS, the quality of LMX and PCB were strongly related to job satisfaction, trust and turnover intentions.
  
  
  CONCLUSIONS
  Nursing managers and leaders should recognize the importance of social exchange within their organisation to build trust, satisfy and retain scarce nurses and nursing assistants.
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Trybou
authors.forename: Kaat
authors.initials: K
authors.lastname: De Pourcq
authors.forename: Michel
authors.initials: M
authors.lastname: Paeshuyse
authors.forename: Paul
authors.initials: P
authors.lastname: Gemmel
mesh_terms: D000328:Adult; D001530:Belgium; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D009728:Nursing Assistants / Q000523:psychology*; D015279:Organizational Culture; D010563:Personnel Turnover / Q000706:statistics & numerical data*
keywords: intent to leave; nurse retention; satisfaction; social exchange; trust