The influence of professional identity, job satisfaction, burnout on turnover intention among village public health service providers in China in the context of COVID-19: A cross-sectional study

Abstract

BackgroundIn China, COVID-19 has undoubtedly posed a huge challenge to the capacity of rural public health services. Village public health service providers are responsible for reporting and dealing with infectious diseases and public health emergencies. However, the turnover of village public health service providers is gravely threatening the stability of rural primary health system step by step. This study systematically evaluated the effects of professional identity, job satisfaction, burnout on turnover intention of village public health service providers, and further measured the mediating effect of job satisfaction and burnout between professional identity and turnover intention.MethodsFrom May to June 2019, 1,244 village public health service providers in Shandong Province were selected as the research objects. Sociodemographic characteristics, professional identity, job satisfaction, burnout and turnover intention were quantitated by self-completed questionnaire and measured by Likert 5–7 scale. Person correlation analysis, One-way ANOVA, and Structural Equation Modeling (SEM) were used for statistical analysis and mediating effect evaluation.ResultsFive hundred and sixty-four (45.3%) village public health providers had high turnover intension. Professional identity had a direct positive effect on job satisfaction (β = 0.146, p < 0.001), job satisfaction had a direct negative effect on burnout (β = 0.263, p < 0.001), and turnover intension (β = −0.453, p < 0.001), while burnout had a direct positive effect on turnover intension (β = 0.242, p < 0.001). Between professional identity and turnover intention, job satisfaction 95%CI: (−0.289)–(−0.11) had significant mediating effects. Job satisfaction 95%CI: (−0.216)–(−0.077) also had significant mediating effects between professional identity and burnout, and burnout had significant mediating effects between job satisfaction and turnover intension, 95%CI: (−0.116)–(−0.052). These results strongly confirm that professional identity, job satisfaction, and burnout are early and powerful predicators of turnover intention.ConclusionAccording to the results, medical administration and management departments should pay attention to improve the professional attraction of public health services by improving the public's understanding of the profession, reducing work intensity, timely granting of subsidy funds, improving old-age security, ensuring the income level, increasing the new force and so on, so as to reduce turnover intension and ensure the health equity of village residents.

Configurational paths to turnover intention among primary public health workers in Liaoning Province, China: a fuzzy-set qualitative comparative analysis

“…Similar to our study, occupational identity was associated with the TI of physicians [ 39 ]. However, occupational identity is not directly related to Chinese rural public health service workers' intention to leave their jobs but is mediated through job satisfaction [ 26 ]. In rural China, public health services are usually provided by rural doctors on a part-time basis.…”

“…Occupational identity, a strong predictor of TI, refers to a clear understanding of occupational interests, abilities, goals, and values [ 24 , 25 ]. Occupational identity was suggested to indirectly influence TI among rural public health providers through job satisfaction [ 26 ]. Those with high occupational identity are more able to enjoy themselves at work, which may be critical to retention [ 27 ].…”

Effects of work-family conflict on turnover intention among primary medical staff in Huaihai Economic Zone: a mediation model through burnout

“…Burnout is a long-term response to interpersonal stress and chronic negative emotions at work, defined by three dimensions: cynicism, exhaustion, and ineffectiveness ( 34 ). The relationship between turnover intention and factors related to professional identity, emotional labor, and intrinsic motivation could also be moderated by burnout ( 35 – 37 ). Burnout not only affects an individual's quality of life but also has an undeniable effect on organizational performance and costs ( 38 ).…”

“…Although more and more research focuses on this relationship between work-family conflict and turnover intention among primary medical staff, there is limited research on the mediating role between work-family conflict and turnover intention. Especially in China, there is currently little research on the turnover intention of primary medical staff, and most studies focus solely on the turnover intention of doctors or nurses ( 12 , 16 , 17 , 22 , 23 , 35 , 37 ). In rare studies on the turnover intention of primary medical staff, burnout and turnover intention have been involved, but the relationship between work-family conflict and primary medical staff turnover intention has not been explored ( 7 , 9 ).…”

An Empirical Study of Job Burnout and Turnover Intentions of Emergency Physicians: Using Positive Psychological Capital as a Mediating Variable

“…Zhang et al (2022) [29] It is evident that COVID-19 has posed a serious threat to rural healthcare services in China. It is the duty of village public health services workers to identify and address infectious diseases and public health emergencies.…”