The Magnitude of Turnover Intention and Associated Factors Among Nurses Working at Governmental Hospitals in Southern Ethiopia: A Mixed-Method Study

Abstract

Background

Globally, nurse turnover is a problematic agenda that strongly influences health-care organizations. Nurses account for the largest share of the health-care workforce in most health-care systems, and the need for nursing has increased dramatically, but its turnover is considered a global problem. Especially in Ethiopia, nurse turnover is a serious problem and has a negative impact on the provision of quality health services.

Objective

To assess the magnitude of turnover intention and associated factors among nurses working at Government Hospitals of Wolaita Zone, Southern Ethiopia, May to June 2022.

Methods

An institutional-based cross-sectional study augmented with an explanatory sequential mixed-method approach was conducted among 398 nurses. A simple random sampling technique was used to select participants for quantitative study, and a purposive sampling technique was used for qualitative study. A pretested structured self-administered questionnaire adapted from previous studies and focused group discussions was used for quantitative and qualitative studies, respectively. EpiDataV4.6 was used for data entry, and the Statistical Package for the Social Science version 25 was used for quantitative data analysis. Bivariable and multivariable logistic regression was done. For qualitative data, OpenCode 4.03 software was used for thematic content analysis.

Results

A total of 384 nurses participated in this study with a response rate of 96.48%. Of them, 39.8% had turnover intention. Unsatisfied payments and benefits [AOR: 2.113 (95% CI: 1.19–3.77)], unsatisfied performance appraisal [AOR: 3.185 (95% CI: 1.91–5.32)] and low continuance commitment [AOR: 1.899 (95% CI: 1.13–3.18)] had positive relationship with nurses’ turnover intention.

Conclusion and Recommendations

In this study, nearly 40% of nurses had turnover intention. Unsatisfied payments and benefits, unsatisfied performance appraisal and low continuance commitment were significantly associated with nurses’ turnover intention. Therefore, fair performance appraisal, appropriate and timely payments and benefits and increasing nurses’ commitment towards their hospitals are very important actions that should be taken.

Keywords:

• factors
• government hospitals
• nurses
• turnover
• Wolaita

Abbreviation

ANA, American Nurses Association; AOR, Adjusted Odds Ratio; CI, Confidence Interval; ETB, Ethiopian Birr; FGD, Focused Group Discussion, JSS, Job Satisfaction Survey, US, United States; SPSS, Statistical Package for Social Science; WHO, World Health Organization; WSUCSH, Wolaita Sodo University Comprehensive Specialize Hospital.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

Ethical clearance was obtained from the research and ethics committee of the College of Health Sciences and Medicine, Wolaita Sodo University, through an ethical letter with protocol number MCHS237/13 written on January 05/2022. Then, a letter of cooperation was written to each hospital’s chief executive director, and informed consent was obtained from all study participants before data collection. Respondents were also informed that they had the right to decline the questionnaire, and all the information provided was handled in a confidential manner to protect the respondents’ privacy. Above all, this study was entirely conducted as per the Declaration of Helsinki ethical principles for medical research on human subjects.

Consent for Publication

We ensure that the publisher has the authors’ permission to publish this research finding because all participants were signed on consent form by agreeing to participate on this study.

Acknowledgment

We thank Wollo University for providing us with the opportunity to conduct this study and its ethical approval. We also thank the Hospital managers, head nurses, and staffs of governmental hospitals of Wolaita Zone, who participated in the study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

On behalf of all authors, the corresponding author declares that there is no competing interest.

Additional information

Funding

No funding available.