Structural Model of Retention Intention of Nurses in Small- and Medium-Sized Hospitals: Based on Herzberg's Motivation-Hygiene Theory

Abstract

The purpose of this study is to identify factors affecting the retention intention of nurses in small- and medium-sized hospitals and to perform a structural equation model study. Survey data of 348 nurses from 6 small and medium hospitals were analyzed. The collected data were analyzed using the SPSS 25.0 and the AMOS 25.0 programs. As a result of the study, it was confirmed that the endogenous variables influencing job satisfaction were calling, resilience, workplace bullying and nursing work environment, while resilience was the strongest variable as a factor influencing the nursing work environment. It was confirmed that the endogenous variables influencing intention to stay were calling, resilience, workplace bullying and job satisfaction, while job satisfaction was the strongest variable influencing intention to stay. To increase the retention intention of nurses in small and medium hospitals, it is necessary to provide measures to increase the value and meaning of work, and to increase resilience to overcome adversity and adapt to the circumstances. In addition, it is necessary to secure and maintain the resources of nurses in small- and medium-sized hospitals with a strategy to reduce workplace bullying and enhance job satisfaction by improving the organizational culture.

Keywords: Herzberg’s motivation; nurse; retention intention.

Figure 1

Path diagram for the hypothetical model. Calling: Pts = Presence—transcendent summons, Ppw = Presence—purposeful work, Ppo = Presence—prosocial orientation. Resilience: optimism, persistence, hardiness, support. LMX = Leader–member exchange. Pr = Professional respect, loyalty, contribution, affect. WB = Workplace bullying. Va = Verbal attacks, Iwi = Improper work instruction, Pt = Physical threats, NWE = nursing work environment, Npr = Nurse–physician relations, Sra = Staffing and resource adequacy, Nmals = Nurse manager ability, leadership and support, Npha = Nurse participation in hospital affairs, Nfqc = Nursing foundations for quality of care, JS = job satisfaction, IS = intention to stay.