Contribution of job strain to nurses' consideration of leaving the profession-results from the longitudinal European nurses' early exit study

摘要

Objectives The role of work characteristics was assessed, as operationalized by the demand-control modelrnwith respect to nurses' intent to leave their profession, using data from the European nurses' early exit (NEXT)rnstudy.rnMethods Data from a self-report questionnaire filled out by 11 606 registered nurses who worked in hospitalsrnin eight European countries and who had participated in both the NEXT baseline assessment (2002-2003) andrnthe NEXT follow-up assessment (2003-2004) were used.rnResults The countries varied substantially as regards demands, influence, and intent to leave the profession. Thernvariables also varied considerably over time within the countries. Among the nurses not considering leaving thernprofession in 2002-2003, those initially not exposed to job strain (high demands and low influence) but exposedrn1 year later had a 2.7-fold higher risk of considering to leave the profession [95% confidence interval (95% CI)rn2.1-3.4, multivariate logistic regression analysis, adjusted for potential confounders) when compared with thernreference group (no job strain both times). The nurses with job strain in both assessments showed a 2.3-foldrnhigher risk (95% CI 1.8-2.9). No increased risk was found for those with job strain in the first assessment butrnnot in the second assessment. The findings were similar for most countries.rnConclusions The considerable variability of the job demand-control indicators assessed during the 12-monthrnperiod may imply a potential for improvement. The results emphasize the importance of changes in job strain inrndetermining fluctuations in nurses' considerations of leaving their profession, even over a short period.