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Turnover intention among nurses is a well-established predictor of actual turnover. Despite the critical nursing shortages during COVID-19, the relative contributions of individual and organisational factors to increased turnover intention remain insufficiently understood.
This study aimed to identify the determinants of turnover intention among clinical nurses at both individual and organisational levels and to evaluate the independent effects of these factors in infectious situations.
This study conducted a secondary analysis of cross-sectional data collected in Hong Kong between April 2020 and September 2021.
A convenience sample of 188 Chinese registered nurses in Hong Kong was recruited. The survey assessed questions on demographic, organisational and workplace violence-related characteristics, the Post-Traumatic Stress Disorder Checklist-Civilian Version, the Brief Coping Orientation to Problems Experienced Inventory and the Anticipated Turnover Scale. Univariable and structured multi-phase linear regression analyses were performed to identify associated factors and to evaluate the influence of individual- and organisational-level factors. The study followed the STROBE checklist for reporting cross-sectional studies.
The regression model, incorporating individual- and organisational-level factors, explained 22.68% of the variance in turnover intention. Individual-level factors associated with increased turnover intention included younger age, high levels of post-traumatic stress symptoms and low use of accommodation coping strategies. Organisational-level factors included exposure to workplace violence and insufficient support for reporting such incidents.
This study underscores the significance of minimising workplace violence and enhancing workplace safety, in addition to addressing individual-level factors, to reduce nurses' turnover intention—particularly in the context of future pandemics and epidemics.
These findings provide insights into the factors influencing clinical nurses' turnover intention, supporting the development and implementation of targeted clinical protocols and regulations to address modifiable factors and promote a sustainable nursing workforce.
No patient or public contribution.
The aim of the study was to investigate the impact of the use of baby-friendly community initiative (BFCI) model on various stakeholders in the community.
Quasi-experimental research design.
The study was conducted in public premises and online workshops from April 2019 to September 2022. Participants were followed up for a period of 1 month, except for those employed at public premises. The program involved training based on an accredited BFCI framework to cultivate a breastfeeding-friendly attitude and knowledge. A paired sample t-test was used to examine breastfeeding attitude and knowledge scores before and after BFCI training among staff employed from public premises. An analysis of variance was conducted to examine the breastfeeding self-efficacy and attitude scores, measured repeatedly at different timepoints over 1-month timepoint (T0, T1 and T2) among pregnant and postpartum women.
A total of 2340 perinatal women and 1339 staff from public premises were recruited. For staff, there was an increase in the mean score of breastfeeding knowledge and attitude by 5.8 and 6.1, respectively, at T1. Similarly, for perinatal women, there was an increase in the mean score of breastfeeding self-efficacy and attitude by 6.6 and 3.3, respectively, at T1.
In summary, a BFCI model, with active community participation, accreditation and an award system, has been effective in promoting breastfeeding. Adapting the baby-friendly hospital initiative to local contexts and employing a social theory model can enhance breastfeeding promotion and improve infant health outcomes. Prioritizing culturally sensitive breastfeeding education is crucial for successful BFCI implementation.
Healthcare professionals should consider clients' culture and socio-economic backgrounds when providing breastfeeding education to maximize effectiveness. The target audience for breastfeeding education should be expanded to include various community stakeholders beyond families.
What problem did the study address? This study addressed the problem of knowledge gaps among stakeholders in building a breastfeeding-friendly community, particularly in implementing a baby-friendly community initiative (BFCI) as part of a baby-friendly hospital initiative (BFHI). The research filled a service gap by providing effective interventions targeting community stakeholders and assessing the impact of a BFCI program on their knowledge and attitudes towards breastfeeding.
What were the main findings? The findings highlighted the effectiveness of a BFCI program in enhancing breastfeeding knowledge and attitudes among frontline staff and increasing breastfeeding confidence among mothers. These findings contribute to the understanding of the program's impact on different stakeholders in the community.
Where and on whom will the research have an impact? It impacts on global policymakers by providing insights for developing comprehensive guidelines for future BFCI implementations. It also contributes to the creation of a more baby-friendly community, benefiting breastfeeding families and their infants by promoting and supporting breastfeeding families.
This study has adhered to relevant EQUATOR guidelines using the TREND reporting guideline.
No patient or public contribution.
This study provides an overview of the establishment of a localized BFCI program. It also opens up a new direction for the community to investigate BFCI strategies for community stakeholders. It also provides evidence to support other countries in following a similar process, as each country approaches becoming breastfeeding-friendly in its own unique way.
No protocol.
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