Abstract
BackgroundThe shortage of nursing professionals is of growing concern. The causes of this include the demanding physical and mental workload, leading to a dropout of nurses that may start during their education. However, it is unclear to what extent nursing students already perceive a physical and mental workload leading to health problems during their nursing education and placement, and to what extent these health problems cause students to dropout from nursing education. Very few prospective cohort studies have investigated protective and risk factors in relation to dropout and retention among nursing students.MethodsThree cohorts of third-year nursing students will be followed for 2.5 years. Students will be enrolled from the Bachelor of Nursing program of the Rotterdam University of Applied Sciences. At baseline, students will receive a self-administered questionnaire. Primary outcome is dropout from nursing education and dropout from the nursing profession. Data on dropout from nursing education will be retrieved from the student administration on a yearly basis. Dropout from the nursing profession will be measured one year after graduation, using the self-reported questionnaire. Secondary outcomes are presenteeism and sick leave (during internship/work). In addition to student characteristics, the questionnaire asks about physical and mental internship/work characteristics, personal and behavioral factors, and experienced physical and mental burden.Main aims of this study are to determine: 1) the prevalence and incidence rates of dropout, 2) the protective and risk factors, and early indicators of dropout, and 3) the interaction between these factors and the indicators.DiscussionData analysis of a large, prospective cohort study with regard to determinants of dropout and retention of nursing students and newly graduated nurses is in progress. Findings emerging from this study can be used to develop a predictive model to identify the first indicators of dropout from nursing education and nursing profession, for which targeted interventions can be deployed.
Highlights
The shortage of nursing professionals is of growing concern
Research in Australia [7], the USA [8], Canada [9], the UK [10, 11], Finland [12], Ghana [13], Japan [14] and Sweden [15] has shown that, among nurses, physical and mental health problems can lead to dropout and early exit, and that this is a global problem
In 2003 the determinants of stress, burnout and attrition in nursing students, and the relationships between these determinants, were measured in a prospective longitudinal cohort study; the results show that stress, burnout and attrition might be indirectly associated [26]
Summary
Study design This is a prospective cohort study including three consecutive cohorts of third-year nursing students from RUAS, followed until one year after graduation. Population characteristics Questions on respondent characteristics include: gender (male/female), age (years), body height and weight (BMI), educational background (secondary vocational education/ higher professional education/university), nursing educational pathway (fulltime, part-time, in-service), ethnicity (Dutch/western migrant/non-western migrant), Dutch as first language (yes/no), and housing circumstances (living with parents or caregivers/ living on one’s own/ living on one’s own with kids/living on one’s own with partner/living on one’s own with partner and child(ren)) Information on these characteristics will be collected at t0 only. Assessment of prevalence and incidence In the study population, point prevalence will be estimated for mental and physical health problems, absenteeism, presenteeism, and sick leave at baseline (t0), after one year (t1), and one year after graduation (t2), in order to characterize the cohort. For statistical analysis techniques will be used that are robust for missing values (modelling to collected data) and sensitivity analyses will be performed on multiple imputed data sets [49]
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