Abusive supervision and turnover intention: Mediating effects of psychological empowerment of nurses.
ABSTRACT: Objective:This study aims to determine the mediating effects of psychological empowerment on abusive supervision and turnover intention as perceived by nurses to provide information to change the status of nurse turnover. Methods:A cross-sectional survey (a questionnaire examining perceptions of abusive supervision, measurement of psychological empowerment, and questionnaire for turnover intention) was used to collect data. A total of 1127 clinical nurses, who were recruited through convenience sampling, participated in the survey. Results:Nurses' average perceived abusive supervision, psychological empowerment, and turnover intention scores were 1.62 ± 0.95, 3.24 ± 0.83, and 14.17 ± 3.78, respectively. Psychological empowerment was found to mediate the relationship between abusive supervision and turnover intention (P < 0.01). Turnover intention tends to be stronger and psychological empowerment reduced when nurse managers adopt an abusive leadership style. Conclusions:Nurses' psychological empowerment is an intermediary variable that predicts the relationship between abusive supervision and turnover intention. Nurse managers should manage abusive supervision to increase nurses' psychological empowerment and decrease turnover intention.
Project description:There is a growing interest in understanding how follower reactions toward abusive leadership are shaped by followers' perceptions and attributions. Our studies add to the understanding of the process happening between different levels of leaders' abusive behavior (from constructive leadership as control, laissez-faire, mild to strong abusive) and follower reactions. Specifically, we focus on the role of perception of abusive supervision as a mediator and attribution as a moderator of the relationship between leader abusive behavior and follower reactions. Follower reactions are defined in terms of exit, voice, loyalty, and neglect. Two studies using a two point experimental design and vignettes and a cross-sectional field study were conducted. Perception partly mediates the relationship between leader behavior and reactions (Study 1 and 2). Different attributions (intention, control) moderate the relationship between the perception of abusive supervision and reactions in Study 2 and 3. In Study 2, attribution of intentionality of the leader behavior served as a moderator of the relationship between abusive supervision and loyalty, turnover, and voice. Attribution of intentionality reduced the relationship between perception of abusive supervision and reactions. Attribution of intentionality only strengthened negative reactions when milder abusive leadership was perceived. These results were not supported in Study 3. However, in Study 3, attribution to the supervisor' control served as moderator for loyalty and voice. A stronger relationship between the perception of abusive supervision and reactions emerged for high vs. for low attribution to the supervisor. The differences in results between the studies reflect that in Study 1 and 2 abusive behavior was manipulated and in Study 3 the perception of abusive supervision of actual leaders was assessed. Our findings show that avoidance of abusive supervision should be taken seriously and followers' perception and suffering is not only due to subjective judgment but reflects actual differences in behavior. The relationships are stronger in the field study, because, in practice, abusive behaviors might be more ambiguous. The research presented here can help leaders to better understand their own and the followers' role in the perception of and reaction to abusive supervision.
Project description:According to the concept of abusive supervision, abusive supervisors display hostility towards their employees by humiliating and ridiculing them, giving them the silent treatment, and breaking promises. In this study, we argue that abusive supervision may not be limited to mistreatment at the relationship level and that the abuse is likely to extend to employees' work tasks. Drawing upon the notion that supervisors play a key role in assigning work tasks to employees, we propose that abusive supervisors may display disrespect and devaluation towards their employees through assigning illegitimate (i.e., unnecessary and unreasonable) tasks. Survey data were obtained from 268 healthcare and social services workers. The results showed that abusive supervision was strongly and positively related to illegitimate tasks. Moreover, we found that the relationship between abusive supervision and unreasonable tasks was stronger for nonsupervisory employees at the lowest hierarchical level than for supervisory employees at higher hierarchical levels. The findings indicate that abusive supervision may go beyond relatively overt forms of hostility at the relationship level. Task-level stressors may be an important additional source of stress for employees with abusive supervisors that should be considered to fully understand the devastating effects of abusive supervision on employee functioning and well-being.
Project description:PURPOSE:The purpose of this study was to assess nursing staff's work-related problems as perceived by their managers and thereafter develop strategies that would serve as a guide for nurse managers to manage these problems. METHODS:A descriptive research design was used. The participants included in the study consisted of the following two groups: Group 1-a convenience sample of 150 first-line managers working at three different hospitals; and Group 2-a panel of experts for the Delphi technique, selected using the Snowball sampling technique. Tools for data collection included the following: Tool 1-questionnaire about nursing staff's problems; Tool 2-Delphi technique to develop strategies for managing nursing staff's problems; and Tool 3-opinionnaire format. RESULTS:The recruited first nurse managers were of the opinion that job stress, work overload, conflict, workplace violence, poor performance, staff turnover, demotivation, lack of empowerment, and staff absenteeism were among the common problems faced by staff nurses at work. CONCLUSION:From the expert panelists' perspectives, the newly developed strategy in this study was considered valid; the researchers recommend the strategy developed in this study to be universalized in different health care settings and used as a guide for nurse managers.
Project description:OBJECTIVES:Our aims were to assess the relationship between workplace violence, job satisfaction, burnout, organisational support and turnover intention, and to explore factors associated with turnover intention among nurses in Chinese tertiary hospitals. METHODS:The purposive sampling method was used to collect data from August 2016 through January 2017. A total of 1761 nurses from 9 public tertiary hospitals in 4 provinces (municipalities) located in eastern (Beijing), central (Heilongjiang, Anhui) and western (Shaanxi) regions of China completed the questionnaires (effective response rate=85.20%). A cross-sectional study was conducted using the Workplace Violence Scale, Chinese Maslach Burnout Inventory General Survey, Minnesota Job Satisfaction Questionnaire Revised Short Version, Perceived Organizational Support-Simplified Version Scale and Turnover Intention Scale. RESULTS:A total of 1216 of 1706 (69.1%) participants had high turnover intention. During the previous 12 months, the prevalence of physical violence and psychological violence towards nurses was 9.60% and 59.64%, respectively. As expected, the level of turnover intention was negatively correlated with participants' scores on job satisfaction (r=-0.367, p<0.001) and perceived organisational support (r=-0.379, p<0.001), respectively. Burnout was positively associated with turnover intention (r=0.444, p<0.001). Workplace violence was positively associated with turnover intention (?=0.035, p<0.001) in linear regression analysis. The total effect (?=0.53) of workplace violence on turnover intention comprised its direct effect (?=0.36) and its indirect effect (?=0.17). CONCLUSIONS:Perceived organisational support served as a mediator between workplace violence, job satisfaction, burnout and turnover intention, and it had a significantly negative impact on turnover intention. Therefore, nursing managers should understand the importance of the organisation's support and establish a reasonable incentive system to decrease turnover intention.
Project description:The aim of the study reported in this article was to investigate staff nurses' perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses' involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment.
Project description:Background:Nurses' turnover has been a major concern globally, which is strongly influenced by nurses' intent to leave. However, only a few large sample studies on the predictive factors associated with nurses' turnover intention were conducted in Jiangsu Province. This study mainly aims to examine the level and factors that influence nurses to leave their work in Jiangsu Province of Eastern China. Methods:A cross-sectional survey of 1978 nurses was conducted at 48 hospitals in 14 key cities throughout Jiangsu Province. The turnover intention in nurses was measured by the scale of intent to leave the profession. The work environment of nurses was measured by the Chinese version of the Practice Environment Scale. A multiple linear regression model was applied to analyse the factors associated with turnover intention. Results:The resignation rate of nurses in the hospitals of Jiangsu Province ranged from 0.64% to 12.71% in 2016.The mean scores were 15.50 ± 3.44 for turnover intention, and 3.06 ± 0.51 for work environment. Involvement in hospital affairs, resource adequacy, age, professional title, year(s) working, employment type and education level were the predictors of nurse intent to leave(P < 0.05). Conclusion:The work environment of nurses in hospitals must be improved in staffing and resource and nurses' involvement in hospital affairs. The current study corroborates that nurses have high turnover intention. Thus, effective measures are needed to improve nurse accomplishment, professional status, participation in hospital affairs and career planning to reduce their turnover intention.
Project description:Objectives:This study aims to investigate the environmental and individual factors contributing to male nurses' psychological well-being and to explore the psychological mechanisms that may explain the links between nurses' practice environment and work engagement, thereby presenting the implications for nurse managers. Methods:A total of 161 male nurses from three tertiary first-class hospitals in Changsha City in China participated in the study. We collected the data using the Practice Environment Scale of the Nursing Work Index, the Psychological Capital Questionnaire, and the Utrecht Work Engagement Scale. Results:Scores of male nurses' practice environment (2.88 ± 0.31), psychological capital (4.42 ± 0.62), and work engagement (3.17 ± 1.39) were all above the midpoint; however, the subscales "the nursing staffing and resources adequacy" (2.72 ± 0.48), "hope" (4.33 ± 0.72), and "dedication" (2.96 ± 1.61)scored lowest. Nurses' practice environment and psychological capital positively predicted nurses' work engagement; psychological capital fully mediated the influence of nurses' practice environment on work engagement. Conclusions:Creating a supportive nursing practice environment can increase male nurses' work engagement by developing their psychological capital. Nurse managers can then provide reasonable workload and pathways for male nurses to achieve goals, thereby fostering their hope.
Project description:Background:Despite the inevitable growing rate of nurse turnover worldwide and its consequences, limited empirical data has been published in Indonesia. This study aims to describe the nurse turnover pattern at private hospitals, its causes and consequences as perceived by the hospitals' managers. Methods:A survey method was used to obtain secondary and primary data from five private general hospitals in three administrative regions in East Java, Indonesia. The data of nurse turnover and demographic characteristics were collected. Mann Whitney test and relative risk analysis was performed to explore the role of nurse characteristics on nurses' decision to leave their job. To explore the causes and consequences of nurse turnover, an online survey was conducted to twelve hospital managers. The data was then classified based on similar themes. Results:The data show that nurse turnover is between 12 and 34%. Being up to thirty years old, single, and having worked in the hospital up to three years significantly increase the risk of turnover. Personal reasons, external attractions and unsuitable working conditions are the three common nurse turnover reasons revealed by hospital managers. Hospital managers admitted that nurse turnover disturbs hospital operations, further impacting the hospital's revenue and costs. Conclusions:The nurse turnover is higher than the acceptable level which is significantly predicted by age, marital status and job tenure. Further research is needed to develop nurse retention strategy in their early years of employment, based on the nurse's point of view.
Project description:OBJECTIVES:To explore the role of on-site supervision in community health worker (CHW) programmes and CHW integration into the health system. We compared the functioning of CHW teams reporting to a clinic-based nurse with teams supervised by a community-based nurse. We also consider whether a junior nurse can provide adequate supervision, given the shortage of senior nurses. DESIGN:A case study approach to study six CHW teams with different configurations of supervision and location. We used a range of qualitative methods: observation of CHW and their supervisors (126 days), focus group discussions (12) and interviews (117). SETTING:South Africa where a national CHW programme is being implemented with on-site supervision. PARTICIPANTS:CHWs, their supervisors, clinic managers and staff, district managers, key informants from the community and CHW clients. RESULTS:Effective supervisors supported CHWs through household visits, on-the-job training, debriefing, reviewing CHWs' daily logs and assistance with compiling reports. CHWs led by senior nurses were motivated and performed a greater range of tasks; junior nurses in these teams could better fulfil their role. Clinic-based teams with senior supervisors were better integrated and more able to ensure continuity of care. In contrast, teams with only junior supervisors, or based in the community, had less engagement with clinic staff, and were less able to ensure necessary care for patients, resulting in lower levels of trust from clients. CONCLUSION:Senior supervisors raised CHW skills, and successfully negotiated a place for CHWs in the health system. Collaboration with clinic staff reduced CHWs' marginalisation and increased motivation. Despite being clinic-based, teams without senior supervisors had lower skill levels and were less integrated into the health system.
Project description:BACKGROUND:Structural empowerment is an ever-evolving concept interpreted and applied in many different ways as it focuses on the structures in a healthcare organisation to allow competent nurses to manage empowering opportunities in a professional manner. At a public hospital in the Western Cape, nurses complained about a lack of access to structural empowerment in a hospital, including structures of power, such as clear information, to partake in important decisions. OBJECTIVES:The purpose of this study was to describe how nurse managers could support nurses in accessing structural empowerment through power resources. METHOD:A quantitative design was followed with a survey. The accessible population in this study was different categories of nurses of professional, enrolled and assistant nurses (N = 200), which were on duty at the time of data gathering. The sample was selected by means of probability sampling (n = 110). An existing instrument based on a five-point Likert scale was distributed that took 45 minutes to complete. Descriptive and inferential statistics were calculated, and the chi-square was used to indicate statistical significance differences among the nursing categories on the items (p 0.05). RESULTS:The general results indicated that the majority of nurses had challenges to access structural empowerment through power sources (information, support and resources). Significant differences were found between nurse categories for having the necessary supplies for the job (p = 0.043) and rewards for unusual job performance (p = 0.023). Those aspects on which no significant differences were found are of utmost importance, as they indicate the urgency of addressing limitations in power sources for all categories of nurses. CONCLUSION:Empowerment can be achieved by enabling access to structural empowerment through power sources (i.e. opportunities, information, resources and support) at different levels for all categories of nurses.