Age-dependent relationships between work ability, thinking of quitting the job, and actual leaving among Italian nurses: A longitudinal study

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Abstract

Background

Qualified nurses commonly report several work-related problems, which may threat their health and work ability, and may have an impact upon retention.

Objective

The aim of the present study was to investigate whether perceived work ability is a predictor for different types of thinking of quitting and for actual exit from the workplace.

Design

A prospective study has been performed based on 3329 Italian registered nurses which responded to both measurements of the Nurses’ Early Exit Study. Institutions were selected by means of a stratified sampling procedure. All the 7447 nurses working in that healthcare organizations were recruited for the study. Baseline questionnaire was collected from 5504 nurses. Response rate at follow-up was 63.4%. Two hundred and fifty-five nurses left the job in the course of the investigation.

Methods

Several multiple logistic regression analyses were performed controlling for indicators of work-related well-being, socio-demographic, and labour-market characteristics.

Results

As a whole, our results show that among nurses younger than 45 years work ability is a significant predictor of different types of thinking of quitting, but not of actual exit from the workplace: a lower perceived work ability was associated with a higher desire to undertake further education (OR: 3.05; 95% CI: 1.30–7.18) and/or to change workplace (OR: 4.03; 95% CI: 1.84–8.83) or profession (OR: 6.67; 95% CI: 2.78–15.99). In contrast, among the older nurses (>45), only actual exit was predicted by lower work ability scores (OR: 7.14; 95% CI: 1.15–44.13), along with the perception of a larger availability of free nursing posts in the region (OR: 2.70; 95% CI: 1.13–6.43).

Conclusion

Therefore, we conclude that in the relationship between low perceived work ability and intended or actual exit, a significant part is explained by age itself, but also by the age-related differences in occupational and life opportunities. This contribution concludes with some age-related policies aimed at boosting nurses’ retention.

Section snippets

Background

In Italy, since the early 1970s fertility rates have declined steeply and are today among the lowest in the world. As decreased fertility rates have been accompanied by an increase in longevity, Italy exhibits today the highest dependency ratio among the OECD countries (OECD, 2000). In addition, in Italy older workers tend to exit the labour market relatively early. In 2002, only 56% of males and 27% of females in the age group 50–64 were still active at the labour market. Large-scale pension

Sample and procedure

Between autumn 2002 and spring 2003, data were collected from 5504 out of the 7447 Italian nurses that were recruited for the study (response rate 73.9%). The respondents were employed at 127 different establishments nested within 16 wider healthcare organizations (4673 nurses from nine hospitals, 179 nurses from five nursing homes and 620 nurses from two home care institutions). The institutions were selected by means of a stratified sampling procedure, with strata defined on the basis of

Results

The socio-demographic characteristics of the samples are shown in Table 2. Sample distribution remained about the same from the baseline and both the follow-up and the exit samples. Owing to early retirement opportunities, most of our nurses in the baseline sample were younger than 45 years (78.4%). They were mostly female, even if male nurses represented a significant part of the Italian sample (25.7%). In fact, Italy reported the highest prevalence of male nurses among the countries

Reflections on the outcomes

As a whole, in our study the proportion of Italian registered nurses with different form of thinking of quitting, or that actually left their job, was higher among those perceiving their work ability to be poor or moderate. However, thinking of quitting and actual leaving were also observed, though to a lower extent, among nurses perceiving their work ability to be good or excellent. This may indicate that actual or intended leaving may be also related to factors other than a nurse's perceived

Conflicts of interest

None.

Funding

The NEXT-Study (Nurses’ Early Exit Study) was initiated by SALTSA (Joint Programme for Working Life Research in Europe) and financed by the European Union within the Fifth Framework Programme (QLK6-CT-2001-00475). Key action no. 6.3. The population and disabilities.

Ethical approval

The NEXT-Study design was approved by the ethical committee of the University of Wuppertal in Germany.

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