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The Impact of Social Work Environment, Teamwork Characteristics, Burnout, and Personal Factors Upon Intent to Leave Among European Nurses

Estryn-Béhar, Madeleine MD, PhD*; Van der Heijden, Beatrice I. J. M. PhD; Ogińska, Halszka PhD; Camerino, Donatella PhD§; Le Nézet, Olivier MsC*; Conway, Paul Maurice PhD§; Fry, Clementine MsC*; Hasselhorn, Hans-Martin MD, PhDthe NEXT Study Group

doi: 10.1097/MLR.0b013e31806728d8
Original Article

Objectives: Europe's nursing shortage calls for more effective ways to recruit and retain nurses. This contribution aims to clarify whether and how social work environment, teamwork characteristics, burnout, and personal factors are associated with nurses' intent to leave (ITL).

Methods: Our sample comprises 28,561 hospital-based nurses from 10 European countries. Different occupational levels have been taken into account: qualified registered nurses (n = 18,594), specialized nurses (n = 3957), head nurses (n = 3256), and nursing aides and ancillary staff (n = 2754).

Results: Our outcomes indicate that ITL is quite prevalent across Europe, although we have found some differences across the countries depending on working conditions and economic situation. Quality of teamwork, interpersonal relationships, career development possibilities, uncertainty regarding treatment, and influence at work are associated with nurses' decision to leave the profession across Europe, notwithstanding some country-specific outcomes. A serious lack of quality of teamwork seems to be associated with a 5-fold risk of ITL in 7 countries. As far as personal factors are concerned, our data support the hypothesized importance of work–family conflicts, satisfaction with pay, and burnout. A high burnout score seems to be associated with 3 times the risk of ITL in 5 countries.

Conclusions: To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.

From the *Department of Occupational Health Hôtel Dieu, Assistance-Publique-Hôpitaux de Paris, Paris, France; †Maastricht School of Management, Open University of the Netherlands, University of Twente, The Netherlands; ‡Department of Ergonomics and Effort Physiology, Jagiellonian University Medical College, Krakow, Poland; §Department of Occupational Health, University of Milan, Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano, Italy; and ¶Department of Safety Engineering, University of Wüppertal, Germany.

Supported by the European Commission within the Fifth Framework (Project ID: QLK-6-CT-2001-00475). The NEXT study was initiated by SALTSA (Joint Programme for Working Life Research in Europe) and financed by European Union within the Fifth Framework (Key action no. 6.3. The Population and Disabilities).

Reprints: Madeleine Estryn-Béhar, SCMT Hôtel-Dieu AP-HP, Place du Parvis Notre Dame, 75004 Paris, France. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.