Shihong Zhao

OBJECTIVES: Our aims were to assess the relationship between workplace violence, job satisfaction, burnout, organisational support and turnover intention, and to explore factors associated with turnover intention among nurses in Chinese tertiary hospitals. METHODS: The purposive sampling method was used to collect data from August 2016 through January 2017. A total of 1761 nurses from 9 public tertiary hospitals in 4 provinces (municipalities) located in eastern (Beijing), central (Heilongjiang, Anhui) and western (Shaanxi) regions of China completed the questionnaires (effective response rate=85.20%). A cross-sectional study was conducted using the Workplace Violence Scale, Chinese Maslach Burnout Inventory General Survey, Minnesota Job Satisfaction Questionnaire Revised Short Version, Perceived Organizational Support-Simplified Version Scale and Turnover Intention Scale. RESULTS: A total of 1216 of 1706 (69.1%) participants had high turnover intention. During the previous 12 months, the prevalence of physical violence and psychological violence towards nurses was 9.60% and 59.64%, respectively. As expected, the level of turnover intention was negatively correlated with participants' scores on job satisfaction (r=-0.367, p<0.001) and perceived organisational support (r=-0.379, p<0.001), respectively. Burnout was positively associated with turnover intention (r=0.444, p<0.001). Workplace violence was positively associated with turnover intention (β=0.035, p<0.001) in linear regression analysis. The total effect (β=0.53) of workplace violence on turnover intention comprised its direct effect (β=0.36) and its indirect effect (β=0.17). CONCLUSIONS: Perceived organisational support served as a mediator between workplace violence, job satisfaction, burnout and turnover intention, and it had a significantly negative impact on turnover intention. Therefore, nursing managers should understand the importance of the organisation's support and establish a reasonable incentive system to decrease turnover intention.

BACKGROUND AND AIM: The doctor-patient relationship has been a major focus of society. Hospitals' efforts to improve the quality of their medical services have been to reduce the probability of doctor-patient conflicts. In this study, we aimed to determine the gap between expectations and perceptions of service quality according to patients to provide reference data for creating strategies to improve health care quality. METHODS: Twenty-seven hospitals in 15 provinces (municipalities directly beneath the central government) were selected for our survey; we sent out 1,589 questionnaires, of which 1,520 were collected (response rate 95.65%) and 1,303 were valid (85.72% effective recovery rate). Paired t-tests were used to analyze whether there were significant differences between patients' expectations and perceived service quality. A binary logistic regression analysis was used to determine whether there were significant differences in the gap between expectation and perception of service quality according to patients' demographic characteristics. RESULTS: There was a significant difference between the expected and perceived service quality (p < 0.05) according to patients both before and after receiving medical services. Furthermore, the service quality gap of each service dimension was negative. Specifically, the gaps in service quality were as follows: economy, responsiveness, empathy, assurance, reliability, and tangibles. Overall, we can conclude that patients' perceptions of service quality are lower than their expectations. CONCLUSIONS: According to the study results, the quality of health care services as perceived by patients was lower than expected. Hospitals should make adjustments according to the actual situation and should strive to constantly improve the quality of medical services for patients.

AIMS: This study examined how the mediating effect of psychological distress and the moderating role of social support influence the connection between psychological capital and turnover intention among Chinese nurses. BACKGROUND: Nurses play a crucial role in medical and health services, but turnover intentions are common among them. METHODS: A cross-sectional survey was conducted involving 4865 nurses in China. The Chinese Psychological Capital Questionnaire, Depression, Anxiety and Stress Scale, Social Support Rating Scale, and Turnover Intention Scale were used to gather data. Bootstrap and simple slope methods were used to test the mediating effect of psychological distress and the moderating effect of social support. RESULTS: Psychological capital had a significant direct impact on turnover intention among nurses (B = -0.040, t = -10.032, p < .001). Psychological distress had a mediation effect of 46.89% between psychological capital and turnover intention. Moreover, social support had a moderating role in the relationship between psychological distress and psychological capital and between psychological distress and turnover intention. CONCLUSIONS: Psychological capital correlated negatively with psychological distress and turnover intention and indirectly influenced turnover intention through psychological distress. Social support moderated the first and second half of the path in the mediating model of psychological distress. These findings have implications for early intervention for and the prevention of turnover intention in nurses. IMPLICATIONS FOR NURSING MANAGEMENT: This study's findings can inform the design of effective nurse support programmes to reduce the impact of psychological distress on turnover intention among nurses.

Abstract Aim Many people see nursing as a high‐pressure, high‐risk profession. Therefore, job burnout among nursing staff has become an important topic of study and has received widespread attention worldwide. This research intended to evaluate the frequency of and variables related with work burnout among nurses in public hospitals in China. Design Using a multistage random sample procedure, a cross‐sectional survey was carried out in the eastern, central and western areas of China. Method s The Maslach Inventory‐Human Service Survey and demographic information made up the two sections of the questionnaire. Of the 5250 questionnaires sent, 4865 were deemed legitimate, yielding an effective response rate of 92.67%. A linear regression analysis was performed to investigate the variables linked to nursing work burnout. Results Among the 4865 nurses, women accounted for 97.4% of the survey respondents, most of whom were aged 26–35 years. Results showed that the total scores of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA) were 20.02 ± 12.04, 4.78 ± 5.54 and 34.42 ± 10.32 respectively. 50.7% of subjects obtained high or moderated scores on EE, 32.8% of subjects obtained high or moderated scores on DP and 80.4% of subjects obtained low or moderated scores on PA. Age, department, position, post‐establishment, work shift type in recent months, overtime times in recent months and night shift frequency in recent months were negatively correlated with EE, and child status, monthly income, working days per week and sleep quality in recent 1 month were positively correlated with it ( F = 141.827, P &lt; 0.01, R 2 = 0.243). Age, gender, department, post‐establishment, overtime hours in recent months and night shift frequency in recent months were negatively correlated with DP, and child status and sleep quality in the last 1 month were positively correlated with it ( F = 78.794, p &lt; 0.01, R 2 = 0.115). Child status, years of nursing work and sleep quality in the last 1 month were negatively correlated with PA, whereas age, position, work shift type in recent months and night shift frequency in recent months were positively correlated with it ( F = 67.981, p &lt; 0.01, R 2 = 0.089).