Contribution of job strain to nurses' consideration of leaving the profession -: results from the longitudinal European nurses' early exit study

Objectives The role of work characteristics was assessed, as operationalized by the demand-control model with respect to nurses' intent to leave their profession, using data from the European nurses' early exit (NEXT) study. Methods Data from a self-report questionnaire filled out by 11 606 registered nurses who worked in hospitals in eight European countries and who had participated in both the NEXT baseline assessment (2002-2003) and the NEXT follow-up assessment (2003-2004) were used. Results The countries varied substantially as regards demands, influence, and intent to leave the profession. The variables also varied considerably over time within the countries. Among the nurses not considering leaving the profession in 2002-2003, those initially not exposed to job strain (high demands and low influence) but exposed I year later had a 2.7-fold higher risk of considering to leave the profession [95% confidence interval (95% CI) 2.1-3.4, multivariate logistic regression analysis, adjusted for potential confounders) when compared with the reference group (no job strain both times). The nurses with job strain in both assessments showed a 2.3-fold higher risk (95% CI 1.8-2.9). No increased risk was found for those with job strain in the first assessment but not in the second assessment. The findings were similar for most countries. Conclusions The considerable variability of the job demand-control indicators assessed during the 12-month period may imply a potential for improvement. The results emphasize the importance of changes in job strain in determining fluctuations in nurses' considerations of leaving their profession, even over a short period.