Health problems, turnover intention, and actual turnover among shift work female nurses: Analyzing data from a prospective longitudinal study.

AIMS: This study investigated health problems, turnover intention, and actual turnover among shift work nurses. While turnover intention is often used as a proxy variable for turnover, the relationship between these variables requires clarification. This study tested for relevant associations using prospective longitudinal data with a time lag of 12 months. We also tested for associations between health problems (sleep disturbance, fatigue, and depression) and turnover intentions/turnover, with a focus on the mediating role of turnover intention. METHODS: This study conducted a secondary analysis of data from the Shift Work Nurses' Health and Turnover project, which is a prospective longitudinal cohort study. We analyzed health problems, turnover intention, and actual turnover. The data were analyzed via descriptive statistics, the Pearson's chi-squared test, independent t-test, univariable logistic regression, multiple logistic regression, and causal mediation. RESULTS: Participants included 491 shift work female nurses. Of these, 112 (22.8%) had turnover intention, while 38 (7.7%) left their jobs within the 12-month period of investigation. Of the 112 with turnover intention, 22 left their jobs (OR 5.68. 95% CI 2.84-11.36). The logistic regression analysis showed that sleep disturbance and fatigue were associated with turnover intentions and actual turnover, while depression was only associated with turnover intention. The causal mediation analysis showed that turnover intention mediated the relationship between health problems (sleep disturbance and fatigue) and actual turnover (sleep disturbance OR 1.31, 95%CI = 1.02-1.60; fatigue OR 2.11, 95%CI = 1.50-2.68); sleep disturbance had a natural direct effect on actual turnover (OR 2.66, 95%CI,2.07-3.21). CONCLUSION: Turnover intention strongly predicted actual turnover. Sleep disturbances may result in turnover, even in cases without existing turnover intention. These findings highlight the need for early interventions aimed at preventing and alleviating sleep disturbances for shift work female nurses.

Infection Prevention Performance among In-Flight Cabin Crew in South Korea.

COVID-19 was declared a worldwide pandemic in 2020; thus, preventing in-flight infection transmission is important for stopping global spread via air travel. Infection prevention (IP) performance among aircraft cabin crew is crucial for preventing in-flight transmission. We aimed to identify the level of IP performance and factors affecting IP performance among aircraft cabin crew during the COVID-19 pandemic in South Korea. An online survey was conducted with 177 cabin crew members between August and September 2020. The survey assessed IP performance, and IP awareness, using a five-point Likert scale, and also evaluated simulation-based personal protective equipment (PPE) training experience, and organizational culture. The average IP performance score was 4.56 ± 0.44. Although the performance level for mask-wearing was high (4.73 ± 0.35), hand hygiene (HH) performance (4.47 ± 0.56) was low. Multivariate analysis showed that IP performance was significantly associated with IP awareness (p < 0.05) and simulation-based PPE training experience (p < 0.05). Since HH performance was relatively low, cabin crew and airlines should make efforts to improve HH performance. Furthermore, a high level of IP awareness and PPE training experience can improve IP performance among cabin crew members. Therefore, simulation-based PPE training and strategies to improve IP awareness are essential for preventing in-flight infection transmission.