Date of Award

2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Graduate Group

Nursing

First Advisor

Linda H. Aiken

Abstract

ABSTRACT

ENSURING THE CONTINUATION OF THE PUBLIC HEALTH NURSES WORKFORCE: COMPARISON OF WORK OUTCOMES WITH NURSES IN OTHER SECTORS OF HEALTHCARE

Melissa L. Charlie

Linda H. Aiken

The Quality Health Outcomes Model (QHOM) is the conceptual model guiding this study (Mitchell, Ferketich, & Jennings, 1998). The specific aims of this study are twofold: (1) compare nurse job outcomes, job dissatisfaction, burnout, and intent to leave, of public health nurses (PHN) with nurses that share historical roots with PHS, specifically school nurses (SN) and home health nurses (HHN); (2) determine the extent to which modifiable features of the work environment, including employment benefits, are associated with favorable nurse outcomes. This dissertation is a secondary analysis of data obtained from the RN4CAST-US, a National Institute of Nursing Research- (NINR-) funded survey of nurses undertaken by the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing in 2015-16. Methods of analysis for this study included descriptive data analysis, tests of difference between groups, measurement of outcomes with logistic regression models, and calculation of predictive probability. The level of analysis was the individual nurse. The sample consisted of 529 PHN, 1208 SN, and 3079 HHN. PHN had the highest percentage (94%) of participation in a retirement plan compared to SN (86%) and HHN (64%); PHN also participated in pension plans at the highest percentage (66%). Regardless of variables added to the logistic regression models, the work environment, measured by the Practice Environment Scale, was significantly associated with reduced odds of high burnout (82%), job dissatisfaction (86%), and intent to leave (72%). The probability of PHN experiencing high burnout was 20%, job dissatisfaction 16%, and intent to leave 16%. SN had the lowest probability of burnout, job dissatisfaction, and intent to leave (15%, 8%, and 7%, respectively). HHN had the highest probability of burnout, job dissatisfaction, and intent to leave (29%, 19%, and 17%, respectively). PHN were dissatisfied with salary, opportunity for advancement, and independence at work. HHN were dissatisfied with their work schedule, retirement, health, and tuition benefits. SN were dissatisfied with their professional status. Additional research is needed focusing on the work environments of PHN, SN, and HHN, and potential development of recruitment and retention strategies to assure continuation of public health nursing.

Embargoed

Available to all on Monday, January 18, 2021

Included in

Nursing Commons

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