title: Work environment issues and intention-to-leave in Portuguese nurses: A cross-sectional study.
abstract: This study extends the Registered Nurses Forecasting (RN4CAST) study evidence base with newly collected data from Portuguese nurses working in acute care hospitals, in which the measurement of the quality of work environment, workload and its association with intention-to-leave emerge as of key importance. Data included surveys of 2235 nurses in 144 nursing units in 31 hospitals via stratified random sampling. Multilevel multivariate regression analysis shows that intention-to-leave is higher among nurses with a specialty degree, nurses aged 35-39, and in nursing units where nurses are less satisfied with opportunities for career advancement, staffing levels and participation in hospital affairs. Analysis with moderation effects showed the observed effect of age and of having a specialty degree on intention-to-leave during the regression analysis is reduced in nursing units where nurses are more satisfied with opportunities for career advancement. The most important finding from the study suggests that promoting retention strategies that increase satisfaction with opportunities for career advancement among Portuguese nurses has the potential to override individual characteristics associated with increased turnover intentions.
authors.affiliation: Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK. Electronic address: Claudia.leone@kcl.ac.uk.
authors.forename: Claudia
authors.initials: C
authors.lastname: Leone
authors.affiliation: Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Luk
authors.initials: L
authors.lastname: Bruyneel
authors.affiliation: Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Anderson
authors.affiliation: Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK.
authors.forename: Trevor
authors.initials: T
authors.lastname: Murrells
authors.affiliation: Public Health and Biostatistics Unit, Institute of Hygiene and Tropical Medicine, Lisbon, Portugal.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dussault
authors.affiliation: Institute for Health Sciences, Catholic University of Portugal, Porto, Portugal.
authors.forename: Élvio
authors.initials: É
authors.lastname: Henriques de Jesus
authors.affiliation: Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Walter
authors.initials: W
authors.lastname: Sermeus
authors.affiliation: University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, PA, United States.
authors.forename: Linda
authors.initials: L
authors.lastname: Aiken
authors.affiliation: Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Rafferty
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002322:Career Mobility; D003430:Cross-Sectional Studies; D006801:Humans; D033182:Intention; D007588:Job Satisfaction; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology; D010558:Personnel Loyalty; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D011174:Portugal; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology*
keywords: Health-workforce; Intention-to-leave; Nurses; Opportunities for career advancement; Portugal; Retention