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The development and empirical evaluation of an intention to quit structural model for nurses in the public sector in South Africa

Du Plessis, Mienke (2017-12)

Thesis (MCom)--Stellenbosch University, 2017.

Thesis

ENGLISH SUMMARY : Nursing staff turnover is significantly higher than turnover experienced in other occupational groups. Resultantly studying turnover and turnover intent in the health care industry is important. Turnover intent has been cited as the most immediate determinant of actual turnover, and high nurse turnover and consequent diminished staff numbers have a significant detrimental effect on performance and the nature of care received by patients. Countless individual and organisational factors that influence employee turnover and intention to quit have been reported in the literature, which can either heighten or lower turnover intent. The study is based on the theory of the job demands-resources model, distinguishing between factors that operate as either resources or demands, in an individual’s work environment; and how that contributes to turnover or intention to quit. Given the majority of demands inherently present in the work done by nurses, the current study focussed specifically on examining the influence of resources on lowering intention to quit; through their influence on job satisfaction and affective commitment. Organisational resources included in the study were family supportive supervisor behaviour and psychosocial safety climate; whereas resilience and calling orientation were included as personal resources. The study made use of an ex post facto correlational design to test the relationships between the various constructs. A non-probability convenience sample of n = 184 public health sector nurses, employed in hospitals in the Northern and Western Cape, completed a composite questionnaire. Intention to quit was measured with the intention to quit scale by Cohen (1993). Job satisfaction was assessed by means of Ng’s (1993) Nurse Satisfaction Scale (NSS) and the pay satisfaction subscale of the Job Satisfaction Survey (JSS) (Spector, 1985). The Affective commitment scale (ACS) was used to measure Affective commitment. Family supportive supervisor behaviour was assessed with the FSSB scale (Hammer et al., 2008), and psychosocial safety climate with the PSC-12 (Hall et al., 2010). To measure calling orientation, Dik et al. (2012) calling and vocation questionnaire (CVQ) was utilised. Resilience was measured with the resilience subscale of the psychological capital questionnaire (PSQ-24) (Luthans et al., 2007). And finally, perceived organisational effectiveness was assed with a POE questionnaire. The psychometric properties of the measuring instruments, utilized in the study, were examined by means of item analysis and confirmatory factor analysis (CFA). The structural model was tested using Structural Equation Modelling (SEM) to determine the effectiveness with which the model explained unique variance in intention to quit. The two interaction effects within the model was tested by means of moderated multiple regression. The results indicated significant relationships existing between a number of constructs. Both affective commitment and job satisfaction were confirmed as significant predictors of intention to quit. Family supportive supervisor behaviour was shown to significantly influence affective commitment, job satisfaction as well as psychosocial safety climate. Psychosocial safety climate, in turn, emerged as a significant predictor of job satisfaction as well as affective commitment. Support was found for the influence of calling on resilience, as well as job satisfaction on perceived organisational effectiveness. No support was found for the influence of resilience on Psychosocial safety climate, job satisfaction or affective commitment. The influence of perceived organisational effectiveness on calling was also found to be insignificant. While weak evidence in support of calling moderating the relationship between psychosocial safety climate and job satisfaction was obtained, no evidence was found for the moderating effect of resilience. This study contributed to the body of research focussed on the antecedents of intention to quit. Based on the practical implications of the findings several managerial recommendations are put forward. In conclusion, the results indicate that the model provides a partial, yet plausible explanation of the network of variables accounting for variance in intention to quit among public health sector nurses in South Africa.

AFRIKAANSE OPSOMMING : Omset onder verpleeg personeel is beduidend hoër as omset-tendense in ander beroepskategorieë. Dit is daarom belangrik om omset, asook omset-intensies, in die gesondheidsindustrie te bestudeer. Omset intensie word gereken as die mees onmiddellike bepaler van werklike omset. Hoë verpleegster-omset, en dus verminderde personeel-getalle het ʼn beduidende nadelige invloed op prestasie van verpleegsters en die aard van sorg ontvang deur pasiënte. Talle individuele en organisatoriese faktore wat werknemer-omset en omset-intensie beïnvloed deur dit te verhoog of verlaag, word gerapporteer in literatuur. Die huidige studie is gebaseer op die “Job Demands-Resources” model, wat onderskeid tref tussen faktore wat dien as hulpbronne en die wat dien as eise in ʼn individu se werksomgewing; en hoe dit bydra tot omset of omset-intensie. Gegewe die groot hoeveelheid eise inherent teenwoordig in verpleeg personeel se werk het die studie spesifiek gefokus op die invloed van hulpbronne op die verlaging van omset intensie; deur hul invloed op werksbevrediging en affektiewe toegewydheid. Organisatoriese hulpbronne ingesluit in die studie sluit in familie ondersteunende lynbestuur gedrag asook psigososiale veiligheids-klimaat; terwyl veerkragtigheid en roeping oriëntasie ingesluit is as persoonlike hulpbronne. Die studie het gebruik gemaak van n “ex post facto” korrelasie ontwerp om die verwantskappe tussen die verskillende konstrukte te toets. N nie-waarskynlikheid steekproef van n = 184 publieke sektor verpleeg personeel, werkagtig in hospitale in die Noord en Wes-Kaap, het die volledige vraelys voltooi. Omset intensie was gemeet met die “Intention to Quit” skaal deur Cohen (1993). Werksbevrediging was geassesseer deur Ng (1993) se “Nurse Satisfaction Scale” (NSS) asook die “Pay Satisfaction” subskaal van die “Job Satisfaction Survey” (JSS) (Spector, 1985). Die “Affective Commitment Scale” (ACS) was gebruik om affektiewe toegewydheid te meet. Familie ondersteunende supervisor gedrag was gemeet met die “Family Supportive Supervisor Behaviour” (FSSB) skaal (Hammer et al., 2008). Psigososiale veiligheids klimaat is gemeet met die “Psychosocial Safety Climate” PSC-12 vraelys van Hall et al. (2010). Om roeping oriëntasie te assesseer was Dik et al. (2012) se “calling and vocation questionnaire” (CVQ) gebruik. Veerkragtigheid was gemeet deur die verkragtigheid subskaal van die “Psychological Capital Questionnaire” (PSQ-24) (Luthans et al., 2007). Laastens was waargenome organisatoriese effektiwiteit gemeet met n vraelys wat spesifiek vir die doel van hierdie studie ontwikkel was. Die psigometriese eienskappe van die meetinstrumente wat in die studie gebruik is, was ondersoek deur middel van item analise en bevestigende faktor analise. Die strukturele model was getoets met “Structural Equation Modelling” (SEM) om die effektiwiteit waarmee die model unieke variansie in omset intensie verklaar te bepaal. Die twee interaksie effekte in die model is getoets deur middel van “moderated multiple regression”. Die resultate van die studie het aangedui dat beduidende verwantskappe tussen ʼn paar van die konstrukte bestaan. Beide affektiewe toegewydheid asook werkbevrediging is bevestig as beduidende voorspellers van omset intensie. Verder het familie ondersteunende lynbestuur gedrag ʼn beduidende invloed het op affektiewe toegewydheid, werkbevrediging asook psigososiale veiligheidsklimaat gehad. Op sy beurt het psigososiale veiligheids klimaat na vore gekom as n beduidende voorspeller van werkbevrediging, sowel as affektiewe toegewydheid. Ondersteuning was gevind vir die invloed van roeping op veerkragtigheid, asook werksbevrediging op waargenome organisatoriese effektiwiteit. Geen ondersteuning is gevind vir die invloed van veerkragtigheid op psigososiale veiligheids klimaat, werkbevrediging of affektiewe toegewydheid nie. Die invloed van waargenome organisatoriese effektiwiteit op roeping oriëntasie was ook uitgewys as onbeduidend. Terwyl swak bewyse ter ondersteuning van die moderende effek van roeping oriëntasie op die verhouding tussen psigososiale veiligheids klimaat en werksbevrediging gevind is, was daar geen ondersteunede bewyse gevind vir die moderering effek van veerkragtigheid nie. Die studie het bygedra tot die navorsing gefokus op die bepalers van omset-intensie. Gebasseer op die praktiese implikasies van die bevindinge word verskeie bestuursaanbevelings voorgele. Ter afsluiting, die resultate dui aan dat die model ʼn gedeeltelike, maar geloofwaardige verduideliking bied van die veranderlikes wat veranderinge veroorsaak in die omset intensies van verpleeg personeel in die publieke gesondheid sektor in Suid-Afrika.

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