The influence of changing secular trends in the attitude toward professional autonomy and occupational commitment on intentions of nurses in Japan to quit their current jobs

Objective: To retain the services of nurses providing high-quality care, we examine the relationship between their professional traits, defined as their attitude toward professional autonomy and occupational commitment, and their intentions to quit. We conducted a longitudinal study in Japan on the influence of these professional traits on nurses’ intentions to quit. Methods: On receiving approval from the ethics committee of the university we are affiliated to, anonymous self-report questionnaires were distributed to all nurses from a group of hospitals in west Japan (N = 11,171) on two separate occasions (Time1 and Time2, which were approximately 1 year and 9 months apart). The questionnaire obtained information about the demographics, the nurses’ intentions to quit their current jobs, and their attitude toward professional autonomy and occupational commitment. There were three subscales in their attitude toward professional autonomy: autonomous clinical judgment, control over work conditions, and job-related independence (Asakura et al., 2016). The scale of occupational commitment also included three subscales: affective, continuance, and normative occupational commitment (Meyer et al., 1993). The data were gathered from 1,778 nurses who had been working in the same hospital at T1 and T2 and had responded to both questionnaires. Analysis was conducted using a multiple regression model based on a generalized estimation equation (GEE) in which intention to quit during T2 is a dependent variable and secular change of professional factors, intention to quit during T1, and individual attributes are independent variables. Results: According to GEE, education (β = 0.923, p <.01), intention to quit during T1 (β = 0.557, p <.001) and changing secular trends in control over work conditions (β = 0.075, p <.05) were confirmed as factors that had significant positive influences on nurses’ intentions to quit in the T2 phase. On the contrary, age (β = -0.040, p <.001), changing secular trends in affective occupational commitment (β = -0.225, p <.001), in continuance occupational commitment (β = -0.106, p <.01), and in normative occupational commitment (β = - 0.119, p <.001) were confirmed as factors with a significant negative influence on nurses’ intentions to quit their jobs in phase T2. Gender and changing secular trends in autonomous clinical judgment and in job-related independence were found to have no effect on nurses’ intentions to quit their jobs in T2. Discussion and Conclusions: The findings suggest that conservative health care organizations disallowing nurses from having more control over their jobs see an increase in the number of nurses who wish to quit while establishments with progressive work conditions offering nurses more control over their work see less turnover. Additionally, it is necessary to enhance nurses’ affective, continuance, and normative occupational commitment over time by offering them educational programs and the like to retain their commitment to the job. This research was supported by a Grant-in-Aid for Scientific Research (B) for 2012–2015 from the Japan Society for the Promotion of Science.