Validation of work pressure and associated factors influencing hospital nurse turnover: a cross-sectional investigation in Shaanxi Province, China

BACKGROUND Nurses' turnover is a major contributor to nursing shortages, strongly influenced by nurses' intentions to leave. Several factors influencing the turnover intention have been well identified in Western countries and large cities in China. However, whether these factors also contribute to nurses' work stress in Midwest China are still unclear. The main purpose of this study was to examine the work pressure and associated factors influencing the nurses' intent to leave. METHODS A cross-sectional questionnaire-based survey with multistage sampling was conducted by recruiting 800 employed registered nurses with >1 year of work experience. Chi-square test and multi-factor logistic regression were applied to attain the relative comparisons. Sub-group analysis was conducted to explore the different turnover intention patterns in different age groups. RESULTS The turnover intention was classified as strong/very-strong (19%), weak (62%), and very-weak (19%). Among the factors influencing the nurses' desire to leave the profession, work pressure was the most prominent. The predominantly associated factors contributing the work stress were age, experience, and workload. However, the scale of income did not affect the intent to leave decision. Pediatrics was identified to be the highest tormented department with a significant (P < 0.05) turnover of nurses. Among different age sub-groups, 30-39 age group nurses in Secondary hospitals demonstrate a stronger intent to leave. CONCLUSION Nurses' turnover intentions were associated with stress, age, job duty, and career commitment in Shaanxi Province. The intent to leave is dynamically multifactorial, and effective managements and supportive strategies are needed to reduce the nurses work stress accordingly.