Abstract
BackgroundThroughout China, a growing number of physicians are leaving or intending to depart from their organizations owing to job dissatisfaction. Little information is available about the role of occupational burnout in this association. We set out to analyze the relationship between job satisfaction, burnout, and turnover intention, and further to determine whether occupational burnout can serve as a mediator among Chinese physicians from urban state-owned medical institutions.MethodsA cross-sectional survey was carried out in March 2010 in Hubei Province, central China. The questionnaires assessed sociodemographic characteristics, job satisfaction, burnout, and turnover intention. The job satisfaction and occupational burnout instruments were obtained by modifying the Chinese Physicians' Job Satisfaction Questionnaire (CPJSQ) and the Chinese Maslach Burnout Inventory (CMBI), respectively. Such statistical methods as one-way ANOVA, Pearson correlation, GLM-univariate and structural equation modeling were used.ResultsOf the 1600 physicians surveyed, 1451 provided valid responses. The respondents had medium scores (3.18 +/-0.73) on turnover intention, in which there was significant difference among the groups from three urban areas with different development levels. Turnover intention, which significantly and negatively related to all job-satisfaction subscales, positively related to each subscale of burnout syndrome. Work environment satisfaction (b = -0.074, p < 0.01), job rewards satisfaction (b = -0.073, p < 0.01), organizational management satisfaction (b = -0.146, p < 0.01), and emotional exhaustion (b = 0.135, p < 0.01) were identified as significant direct predictors of the turnover intention of physicians, with 41.2% of the variance explained unitedly, under the control of sociodemographic variables, among which gender, age, and years of service were always significant. However, job-itself satisfaction no longer became significant, with the estimated parameter on job rewards satisfaction smaller after burnout syndrome variables were included. As congregated latent concepts, job satisfaction had both significant direct effects (gamma21 = -0.32, p < 0.01) and indirect effects (gamma11 × beta21 = -0.13, p < 0.01) through occupational burnout (62% explained) as a mediator on turnover intention (47% explained).ConclusionsOur study reveals that several, but not all dimensions of both job satisfaction and burnout syndrome are relevant factors affecting physicians' turnover intention, and there may be partial mediation effects of occupational burnout, mainly through emotional exhaustion, within the impact of job satisfaction on turnover intention. This suggests that enhancements in job satisfaction can be expected to reduce physicians' intentions to quit by the intermediary role of burnout as well as the direct path. It is hoped that these findings will offer some clues for health-sector managers to keep their physician resource motivated and stable.
Highlights
Throughout China, a growing number of physicians are leaving or intending to depart from their organizations owing to job dissatisfaction
This suggests that enhancements in job satisfaction can be expected to reduce physicians’ intentions to quit by the intermediary role of burnout as well as the direct path
The aim of this paper is to describe the degree of turnover intention and compare differences among groups; to estimate actual effect of job satisfaction and burnout syndrome dimensions on turnover intention, based on the correlation examined; and to further verify assumed model on the synthesized relationship among job satisfaction, occupational burnout, and turnover intention as congregated latent concepts to determine whether burnout could serve as a mediator among Chinese physicians from urban stateowned medical institutions
Summary
Throughout China, a growing number of physicians are leaving or intending to depart from their organizations owing to job dissatisfaction. In the case of physicians, who require a very long education and training period, high turnover rates can result in enormous transition costs and the loss of patient confidence, which are extremely serious problems for hospitals. In this context, ensuring the stability of medical teams in stateowned medical institutions, which have been recognized as the most important and most difficult area in a new round of medical system reform throughout China, has become an urgent issue that needs to be addressed
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