Dual normative commitments mediating the relationship between perceived investment in employees’ development and intention to leave among the healthcare workforce in underserviced areas of Taiwan

Abstract

Introduction: To study the factors affecting the intent to leave of healthcare workers who serve in underserviced areas of Taiwan, the authors tested the mediating role of both professional and organizational commitment in the relationship between perceived investment of employee development and intention to leave among these healthcare workers. Method: This study was designed as a cross-sectional study using a well-organized questionnaire with major study variables consisting of perceived investment in employees' development (PIED), Meyer's occupational and organizational normative commitment, and intent to leave. In total, 692 healthcare workers from 48 health centers were enrolled for study; 616 people, including 415 (68.9%) from mountainous areas and 187 (31.1%) from isolated islands, responded and were valid for analysis. The response rate was 87%. Results: The healthcare worker's PIED was positively correlated with both professional normative commitment and organizational normative commitment and negatively correlated with an individual's intent to leave. The dual normative commitments mediate completely the relationship between PIED and intention to leave in those health workers with government subsidy, while no such effect was noted in those without. Conclusion:The employee's dual commitments of professional and organizational normative commitment mediated the relationship between perceived investment of employee development and intention to leave. The government's investment in on-the-job training and career planning for the healthcare workers in both remote areas and isolated islands is important to enforce their professional and organizational normative commitment, and to retain the workforce in these underserviced areas.

The Role of Continuing Professional Training or Development in Maintaining Current Employment: A Systematic Review

“…New Zealand [6,26], the United Kingdom [7,12], and the United States [27,28] had two studies each. Canada [29], Denmark [30], Ethiopia [31], Finland [32], Ghana [33], Japan [34], Italy [35], Pakistan [36], South Korea [37], Sweden [38], Taiwan [39], and the Netherlands [1] had one study each. One study recruited participants from Singapore and the USA [40], one study recruited participants from eight European countries (Belgium, Finland, France, Germany, Italy, Poland, Slovakia, and the Netherlands) [41], and another study was conducted in seven sub-Saharan African countries (Ethiopia, Kenya, Nigeria, Rwanda, Tanzania, Uganda, and Zambia) [42].…”

“…The relationship between the perceived investment in employee development and employee intention to a leave job was mediated by different factors in two studies [39,40]. Job satisfaction and affective commitment fully explained the relationship between perceived investment in employee development and the intention to leave a job for nurses [40].…”

“…Job satisfaction and affective commitment fully explained the relationship between perceived investment in employee development and the intention to leave a job for nurses [40]. For health care professionals in underserviced areas with a government subsidy program, the relationship between perceived investment in employee development and the intention to leave a job was fully explained by employee professional and organizational commitment, while for those without a government subsidy program, there were both direct and indirect effects of perceived investment in employee development on the intention to a leave job [39].…”

“…Furthermore, a lack of professional development opportunities [31][32][33] and low perceived investment in employee development [39,40] increased the intention to leave a job. Some of the factors that influenced this intention were a lack of access to professional development [23,38], a lack of study opportunities [23], and a lack of access to courses other than study days [12] and/or study days [12].…”

Factors Influencing the Application of Connected Health in Remote Areas, Taiwan: A Qualitative Pilot Study

“…Over the past century, there has been a dramatic increase in life expectancy accompanied by a growth in chronic conditions (such as hypertension, diabetes, coronary diseases, and obesity) [3]. Geographically, Taiwan's remote areas cover mountain areas, isolated islands, and remote townships [4]. In these areas, medical and care services are allowed to be practiced remotely according to the law and regulation of the state.…”