Distributive Justice and Turnover Intention Among Medical Staff in Shenzhen, China: The Mediating Effects of Organizational Commitment and Work Engagement

Abstract

Background Turnover of medical staff is a vital issue in the global healthcare system. Previous evidence has confirmed the critical effect of distributive justice on turnover intention, but few studies have focused on the mediating mechanism behind this relationship or the medical staff. This study aimed to examine the mediating roles of organizational commitment and work engagement in the relationship between distributive justice and turnover intention of medical staff, and explore potential occupational differences. Methods Stratified random sampling was adopted to select qualified medical staff from each clinical department of a large general hospital in Shenzhen, China, at a physician-to-nurse ratio of 1:1.5. The medical staff were surveyed using the Distributive Justice Scale, the Organizational Commitment Scale, the Work Engagement Scale, and the Turnover Intention Scale from May to July 2020. Of the 500 medical staff sampled, 480 responded (response rate: 96.00%), and 457 were finally included for analysis (effective response rate: 95.21%). A mediation analysis was performed using Model 6 of the SPSS macro PROCESS program. Results There were significant positive correlations among distributive justice, organizational commitment, and work engagement and significant negative correlations among distributive justice, organizational commitment, work engagement, and turnover intention. Distributive justice directly and negatively affected the turnover intention of physicians and nurses, but there were occupational differences in the underlying mechanism between distributive justice and turnover intention. Distributive justice indirectly affected turnover intention among physicians mainly through the mediating effect of organizational commitment, and indirectly among nurses through three different pathways: the mediating effect of organizational commitment, the mediating effect of work engagement, and the chain mediating effect of organizational commitment and work engagement. Conclusion The relationship between distributive justice and turnover intention was found to be mediated by organizational commitment and work engagement among medical staff in Shenzhen, with variations between physicians and nurses. Thus, appropriately targeted interventions are needed for physicians and nurses to reduce turnover intention.

COVID-19: The effects of perceived organizational justice, job engagement, and perceived job alternatives on turnover intention among frontline nurses

“…The results from the analysis indicated that three aspects of justice (distributive, procedural, and interpersonal) significantly and positively influenced turnover intention. These findings do not agree with our hypotheses and are inconsistent with most past research studies, where distributive justice ( Akgunduz and Cin, 2015 ; Yang et al, 2021 ; Chen et al, 2022 ), procedural justice ( Kumar, 2015 ; Gharbi et al, 2022 ), and interpersonal justice ( Leineweber et al, 2020 ) were mainly observed to affect turnover intention negatively.…”

“…However, it may be complete if we know how (the influencing mechanism through which) these organizational justice components could directly or indirectly influence turnover intentions. Job engagement has been proposed in previous studies (e.g., Park and Johnson, 2019;Cao et al, 2020;Jung et al, 2021;and Chen et al, 2022) to mediate the relationship between turnover intention and its antecedent significantly.…”

“…Highly devoted employees show higher enthusiasm for work engagement than less devoted employees (Suifan et al, 2020). Therefore, we rely on SET and other related studies (e.g., Colquitt et al, 2013;Chen and Jin, 2014;Cao et al, 2020;and Chen et al, 2022) to propose the following hypotheses: H1: Organizational justice will have a significant negative influence on turnover intention.…”

“…In many cases, turnover intention happens when people’s job gives them more dissatisfaction, anxiety, and fear than happiness ( Jung et al, 2021 ). According to Chen et al (2022) , organizational justice is one possible factor that tends to create satisfaction or dissatisfaction, serenity or anxiety, happiness or melancholy, and courage or fear in many organizations, including the healthcare sector. It has also been linked to turnover in previous studies ( Suifan et al, 2017 ; Hussain and Khan, 2019 ; Cao et al, 2020 ; Mengstie, 2020 ).…”

Organizational Justice and Health: A Survey in Hospital Workers

“…Healthcare workers’ perceptions of organizational justice significantly predict turnover intention [ 41 , 42 ] and job satisfaction [ 43 ]. The relationship between distributive justice and turnover intention has been mediated by organizational commitment and work engagement [ 44 ]. The organizational justice perceived by healthcare workers significantly and positively affects their organizational trust and organizational identification [ 45 ].…”