Abstract
BackgroundAs the gatekeepers of rural residents’ health, teams of village doctors play a vital role in improving rural residents’ health. However, the high turnover of village doctors, both individually and collectively, threaten the stability of village medical teams. This research evaluated the influence of job satisfaction, resilience, and work engagement on the village doctors’ turnover intention, and explored the mediating role of work engagement and resilience between job satisfaction and the turnover intention of village doctors in China.MethodsA quantitative study using a self-administered questionnaire containing mostly structured items was conducted among village doctors with a sample size of 2693 from 1345 rural clinics in Shandong province, China, during May and June 2019. All variables including demographic characteristics, job satisfaction, resilience, work engagement and turnover intention were based on available literature, and measured on a 5- or 6-point Likert scale. Such statistical methods as one-way ANOVA, bivariate correlation, exploratory factor analysis (EFA), and Structural Equation Modelling (SEM) were used.ResultsUp to 46.9% of the subjects had a higher turnover intention and more than 26.3% of them had a medium turnover intention. The job satisfaction of village doctors could not only have a direct negative effect on turnover intention (β = − 0.37, p < 0.001), but also have an indirect effect through work engagement (β = − 0.04,=< 0.001). Meanwhile, work engagement also had a direct negative impact on turnover intention (β = − 0.13, p < 0.001), and resilience had an indirect negative impact on turnover intention through work engagement (β = − 0.09, p < 0.001). The above results of this study strongly confirmed that job satisfaction, resilience, and work engagement were early, powerful predicators of village doctors’ turnover intention.ConclusionAccording to the results, the following should be taken seriously to improve job satisfaction: reasonable and fair income, effective promotion mechanism, fair social old-age security, reasonable workload, and strong psychological coping mechanisms for work stress. The turnover intention of village doctors could be reduced through improving job satisfaction, resilience and work engagement.
Highlights
As the gatekeepers of rural residents’ health, teams of village doctors play a vital role in improving rural residents’ health
They are responsible for providing rural residents with life-cycle care involving prevention, treatment, health protection and rehabilitation, as well as two-way referral between village clinics and urban general hospitals, so that village doctors are the indispensable gatekeepers of health for the vast majority of rural residents in China [1]
The purpose of this study is to explore the status of turnover intention of village doctors in China and the effects of job satisfaction, resilience, and work engagement on turnover intention
Summary
As the gatekeepers of rural residents’ health, teams of village doctors play a vital role in improving rural residents’ health. In rural areas there are many serious dilemmas cannot be ignored, such as urgent demand for medical care, poor working conditions and environment, unsmooth promotion mechanism, limited training opportunities, lack of supervision and competition system, aging village medical team, and shortages of new doctors with professional knowledge and comprehensive quality [4], low income and rural residents’ distrust of their medical qualifications and medical technology make the occupational environment of village doctors increasingly severe [5] All these factors have been confirmed to have an impact on village doctors’ burnout and subsequently turnover [3, 6]. As an important part of China’s medical and health service team, when village doctors leave collectively, rural medical institutions may face a “stall” and rural residents may be trapped in incurable difficulties, resulting in more serious social consequences [1, 8]
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