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문제 정의
- This study was conducted to create a model to explain the effects of job demands and resources on health problems and turnover intention in Korean nurses.
제안 방법
- Among the various university hospitals located in Seoul, three university hospitals with similar nursing grades as designated by the Ministry of Health and Welfare were selected. After explaining the content and purpose of the research to the nursing departments and obtaining their consent, the study selected nurses, who were directly and currently providing care to patients, as the research subjects. The nurses who participated in the study underwent convenience sampling from the nursing department.
- This study is theoretically based on Schaufeli and Bakker’s JD-R model and other previous studies and seeks to confirm the relative impact that numerous variables have on nurses’ job demands, resources, burnout, engagement, health problems, and turnover intention and to investigate the correlations between these variables. For the job demands and job resources components of the JD-R model, this study designated client-related social stress as job demands and job characteristics as job resources. Dealing with patients and other related forms of social stress impact nurses’ work engagement level and can be perceived as factors that affect job demands.
- The results from this study can be used by nursing administrators to identify the relationship between work performance and the job resources that increase task involvement, and thus to utilize the relationships that nurses perceive between these resources and organizational job demands. Furthermore, the findings can be used to create and apply organizational management strategies that take the overarching factors affecting work burnout, work engagement, health problems, and turnover intention in nurses into consideration. By adopting this approach, employee work satisfaction will be maximized and, by extension, so will the organization’s productivity and efficiency.
- 96), and the latent variables in the hypothetical model all demonstrated a satisfactory fit, supporting its convergent validity. In the second stage, the model was adjusted through a discernment validity test comparing the AVE with the SMC. First, the sleep pattern factor in the health problems section had an explained variance of 0.
- The more specific goals were as follows: First, to create a hypothetical model to explain the correlations between job demands and resources, burnout, engagement, health problems and turnover intention in nurses. Second, to test the fit between the hypothetical model and actual data in order to investigate the cause and effect relationship between variables that affect job demands, job resources, work burnout, work engagement, health problems, and turnover intention in nurses.
- 0 factor analysis. Since the model consisted of high-order factors, a high-order factor analysis was used to conduct two separate factor analyses. Convergent validity was verified using factor loading, squared multiple correlation (SMC), standardized residual covariance (SRC), construct reliability (CR), and average variance extraction (AVE); the discernment validity was conducted independently, without regard to the factor correlation [20].
- Once this adjustment was made, the model had a satisfactory fit [Table 1]. The measurement validity was examined, and a confirmatory factor analysis of the model was then conducted using all of the factors for each of the latent variables. The fit of the model was c2 = 334.
- This study was conducted to create a model to explain the effects of job demands and resources on health problems and turnover intention in Korean nurses. The more specific goals were as follows: First, to create a hypothetical model to explain the correlations between job demands and resources, burnout, engagement, health problems and turnover intention in nurses. Second, to test the fit between the hypothetical model and actual data in order to investigate the cause and effect relationship between variables that affect job demands, job resources, work burnout, work engagement, health problems, and turnover intention in nurses.
- The results from this study can be used by nursing administrators to identify the relationship between work performance and the job resources that increase task involvement, and thus to utilize the relationships that nurses perceive between these resources and organizational job demands.
- The study first conducted two rounds of confirmatory factor analyses to test the measurement model, during which the model fit and path correlations were analyzed. Through the first round of confirmatory factor analysis, two questions in the turnover intention section were removed because they did not meet the convergent validity of standardized factor loading 1.
- Therefore, the current study was conducted to create a model and to use the correlations between job demands, job resources, work burnout, and work engagement to examine their relationships with health problems and turnover intention in nurses and to then test the applicability of this model to Korean nurses.
- Third, this study identified a significant correlation between health problems and turnover intention. This relationship results from excessive task-related burdens as well as stress and insufficient defense mechanisms, all of which lead to mental and physical health problems, as demonstrated in this and other studies [26, 27].
- This study applied the JD-R model of Schaufeli and Bakker to examine work burnout, work engagement, health problems, and turnover intention in the nursing field. The results from this study can be used by nursing administrators to identify the relationship between work performance and the job resources that increase task involvement, and thus to utilize the relationships that nurses perceive between these resources and organizational job demands.
- This study applied the job diagnostic survey (JDS) of Hackman and Oldham [14] to the 15 questions (7-point scale) of Yi [11], and an exploratory factor analysis was conducted to examine construct validity and to determine which questions to extract.
- This study is theoretically based on Schaufeli and Bakker’s JD-R model and other previous studies and seeks to confirm the relative impact that numerous variables have on nurses’ job demands, resources, burnout, engagement, health problems, and turnover intention and to investigate the correlations between these variables.
- Job demands can be perceived as a form of job stress because they require continuous physical, emotional, and mental efforts, and negative reactions can occur simultaneously [3]. This study used the Customer-related Social Stressor (CSS) scale of Dormann and Zapf [13] and the 21 questions (7-point scale) of Yi [11] to conduct an exploratory factor analysis to first examine the construct validity and then choose 15 suitable questions. Sub-factors included “unreasonable requests by patients” and other disproportionate expectations (three items), “patient anger over minor details” and other verbal attacks (six items), “dealing with hostile patients” and other difficult patients (three items), and “unclear requests from patients” and other ambiguous expectations (three items).
- This study, based on the JD-R model of Schaufeli and Bakker [3], created and tested a structural model to examine the correlations between job demands, job resources, work burnout, and work engagement and health problems and job turnover intention as well as a possible causal link between job demands and job resources and health problems and turnover intention through work burnout and work engagement. Based on this research, the findings were as follows.
- To examine the validity of the factors used to create a structural equation model for measuring nurses’ health problems and turnover intention, a measurement model was developed and subsequently confirmed using AMOS 7.0 factor analysis.
대상 데이터
- SPSS was used to analyze the participants’ demographic characteristics and the reliability and correlations of the research method. The construct validity was examined during preliminary research through a factor analysis on 110 participants. To examine the validity of the factors used to create a structural equation model for measuring nurses’ health problems and turnover intention, a measurement model was developed and subsequently confirmed using AMOS 7.
데이터처리
- SPSS was used to analyze the participants’ demographic characteristics and the reliability and correlations of the research method.
이론/모형
- Second, a significant inverse correlation between work burnout and work engagement was determined, confirming previous research [6,11,25], in which the Schaufeli and Bakker [3] model was applied to demonstrate the polarity between work burnout and work engagement. Thus, while nurses experiencing work engagement display encouraging behavior to gain personal joy and fulfillment, nurses experiencing work burnout display restrained behavior to avoid exposing them to physical threat or pain.
- This study conducted an exploratory factor analysis of the six questionnaires used in Lee’s study [19] to determine construct validity.
- Work engagement is the sense of fulfillment from and positivity towards given tasks; it indicates a state of passionate and complete engagement in the work [16]. This study conducted an exploratory factor analysis on the Utrecht Work Engagement Scale (UWES) of Schaufeli and Bakker [3] and on the 17 measurement questions (7-point scale) adapted by Yi [11] to examine construct validity. Vigor (three items), dedication (five items), and absorption (three items) were thus extracted for a total of 11 questions.
- The specific characteristics of job resources in the JD-R model are also related to the support that nurses receive in their work environments. Thus, this study used the JD-R model as the basis, work burnout and engagement as mediating variables, and patient-related social stress and work characteristics as exogenous variables to associate with health problems and turnover intention, the endogenous variables, via a hypothetical path model.
- This study conducted an exploratory factor analysis on 12 physical factors and six psychological factors from the Cornell Medical Index (CMI) of Weider et al. [17], specifically adjusted for Koreans, and on six questions on sleep patterns derived from the sleep measurement index of Oh, Song, and Kim [18] to examine their construct validity. Based on the results, physical well-being (six items), psychological well-being (five items), and sleep patterns (six items) were chosen, for a total of 17 questions.
성능/효과
- Lastly, it was found that through work burnout and work engagement, job demands and job resources exert significant indirect effects on health problems and turnover intention. Additionally, this study found that work burnout, a mediating variable, exerted a significant direct influence on health problems and turnover intention, while work engagement, the other mediating variable, had little significant effect on turnover intention. Although the current study was conducted with the prediction that an inverse relationship between work burnout and work engagement would cause work burnout to directly increase and work engagement to directly decrease turnover intention, it found instead that work engagement had no direct influence on turnover intention.
- In the second stage, the model was adjusted through a discernment validity test comparing the AVE with the SMC. First, the sleep pattern factor in the health problems section had an explained variance of 0.45, which was lower than the required 0.5. However, it was not removed because nursing duty is divided into three shifts, and accordingly, this factor reflected the specificity of the sector and was thus appropriate for the study.
- Fourth, an analysis of the direct and indirect effects of job demands, job resources, work burnout, work engagement, and health problems showed that job demands increase work burnout and decrease work engagement, while job resources increase work engagement. This aligns with the findings of previous studies [2,3] using the JD-R model, in which job demands were shown to increase work burnout and decrease work engagement and job resources shown to directly increase work engagement.
- The model fit showed no significant changes (c2 = 302.17, p < 0.001, c2 /df = 2.18, RMSEA = 0.06, GFI = 0.92, AGFI = 0.90, NFI = 0.93, CFI = 0.96), and the latent variables in the hypothetical model all demonstrated a satisfactory fit, supporting its convergent validity.
후속연구
- Thus, the examination of previously conducted studies [2,7,24] suggests that compared to the continuous effort required from nurses when dealing with unreasonable demands, excessive sensitivity, verbal abuse, and the strong sense of patient responsibility, both organizational support and job resources that nurses need to effectively deal with their job demands are lacking. Given that organizational job resources can increase productivity, further research is warranted to determine the relationship that nurses perceive between job demands and job resources.
- On the other hand, this study also found that job resources are a pivotal factor in preventing work burnout; in addition to decreasing work burnout, they also increase work engagement. Therefore, this study proposes that by developing methods to facilitate task variety, work responsibility, task identity, task significance regarding work performance, autonomy regarding given tasks, and feedback regarding task performance, nursing organizations can not only decrease work burnout but also increase work engagement. As there are no precedents for this study in the nursing field, replication studies should be conducted to confirm the results.
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