title: A multilevel investigation on nursing turnover intention: the cross-level role of leader-member exchange.
abstract: OBJECTIVE
  To analyse nursing turnover intention from the unit by using multilevel approach, examining at the individual level, the relationships between job characteristics, job satisfaction and turnover intention, and at the group level the role of leader-member exchange.
  
  
  BACKGROUND
  Research on nursing turnover has given little attention to the effects of multilevel factors.
  
  
  METHODS
  Aggregated data of 935 nurses nested within 74 teams of four Italian hospitals were collected in 2009 via a self-administered questionnaire.
  
  
  RESULTS
  Hierarchical linear modelling showed that job satisfaction mediated the relationship between job characteristics and intention to leave at the individual level. At the unit level, leader-member exchange was directly linked to intention to leave. Furthermore, cross-level interaction revealed that leader-member exchange moderated the relationship between job characteristics and job satisfaction.
  
  
  CONCLUSIONS
  This study supported previous research in single-level turnover studies concerning the key role of job satisfaction, providing evidence that job characteristics are important in creating motivating and satisfying jobs. At the unit-level, leader-member exchange offers an approach to understand the role of unit-specific conditions created by leaders on nurses' workplace wellbeing.
  
  
  CONCLUSIONS
  This study showed that it is important for nursing managers to recognise the relevance of implementing management practices that foster healthy workplaces centred on high-quality nurse-supervisor relationships.
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Monserrato (Ca), Italy.
authors.forename: Igor
authors.initials: I
authors.lastname: Portoghese
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Monserrato (Ca), Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Galletta
authors.affiliation: Laboratoire EA 4139 Psychologie, Santé et Qualité de Vie, Université Bordeaux Segalen, Bordeaux Cedex, France.
authors.forename: Adalgisa
authors.initials: A
authors.lastname: Battistelli
authors.affiliation: Department of Psychology, Acadia University, Wolfville, NS, Canada.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Leiter
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009745:Nursing, Supervisory; D010563:Personnel Turnover; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: job characteristics; job satisfaction; leader-member exchange; multilevel analysis; nursing turnover