Effects of work practice environment, work engagement and work pressure on turnover intention among community health nurses: Mediated moderation model.

Abstract

To test the relationship between work practice environment and turnover intention, considering the mediation of work engagement and the moderation of work pressure among community health nurses. A cross-sectional survey design. A total of 410 nurses were recruited from 32 community health centres between September 2016-January 2017 with survey on work practice environment, work engagement, work pressure and turnover intention. Structural equation modelling was used to test a mediated moderation model. Work practice environment was positively associated with higher work engagement and lower turnover intention and work engagement partially mediated the relationship between work practice environment and turnover intention. In addition, work pressure moderated the relationship between work practice environment and work engagement. The improvement of work practice environment including the physical and humanitarian environment could enhance nurse engagement and reduce turnover intention in community, which was more pronounced among high-pressure nurses. In front of the nursing shortage, especially in communities, the strategies on how to retain and motivate nurses have become the focus of concern. Based on the job demands-resources model and the conservation of resources theory, this study examined the effect of work practice environment on turnover intention with the mediation role of work engagement and the moderation role of work pressure among community health nurses. The nurse managers of communities should pay attention to the role of work practice environment in stimulating nurses' engagement and decreasing turnover intention, especially when nurses are under high work pressure.