Factors Associated with Home Health Aides' Turnover Intention and Organizational Citizenship Behavior in Long-Term Care Services

Background: The elderly and disabled population has rapidly increased in the world, and the demand for long-term care is also increasing. Home nursing care services are the main service demand. However, the high turnover rate of home health aides has led to a continuous shortage of staff, which affects the quality of care provided. Objective: This research established a model based on the theory of reasoned action to explore the relationships among home health aides' work engagement, job satisfaction, turnover intentions, and organizational citizenship behavior for long-term care providers. Method: In this cross-sectional study, a structured questionnaire was sent to 455 participants, and 402 (response rate 88.4%) took part in the study. The goodness-of-fit test and path analysis of Structural Equation Modeling (SEM) was employed to test the proposed model. Results: Through the goodness-of-fit test of SEM, it was found that the data results have a good model fit. The results of path analysis displayed that home health aides' work engagement and job satisfaction had a significantly negative impact on turnover intention and a significantly positive impact on organizational citizenship behavior; turnover intention had a significantly negative impact on organizational citizenship behavior. Conclusion: This research deduces the theory of reasoned action has sufficient explanatory power for the home health aides' turnover intention and provides evidence that home health aides' work engagement and job satisfaction reduce their turnover intention and promote organizational citizenship behavior.